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Identifying US County-level characteristics associated with high COVID-19 burden
Daniel Li1,2, Sheila M Gaynor1, Corbin Quick1
1Department of Biostatistics, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Building II, Room 419, Boston, MA, 02115, USA.
BMC Public Health
|May 29, 2021
Summary
Counties with more minorities, segregation, lower education, and comorbidities faced higher COVID-19 burdens. Rural areas saw increased cases in fall, while urban areas did in spring, highlighting geographic and demographic disparities in coronavirus 2019 (COVID-19) impact.
Area of Science:
- Epidemiology
- Public Health
- Health Services Research
Background:
- Identifying county-level factors linked to high coronavirus 2019 (COVID-19) burden is crucial for equitable resource allocation.
- Understanding these associations can alleviate strain on healthcare systems.
Purpose of the Study:
- To investigate county-level characteristics associated with cumulative and weekly COVID-19 case and death rates across the United States.
- To inform data-driven public health interventions and resource allocation strategies.
Main Methods:
- Utilized generalized linear mixed models to analyze data from all 3142 US counties.
- Modeled cumulative and weekly COVID-19 cases and deaths, incorporating state fixed effects and county-specific random effects.
- Adjusted weekly models for seasonal variations and temporal trends using B-splines.
Main Results:
- Higher cumulative COVID-19 rates were linked to rural counties, minority populations, segregation, lower educational attainment, and comorbidities.
- Urban counties and those with minority populations/segregation showed increased weekly rates in spring.
- Rural counties experienced higher weekly case and death rates in fall.
- Socioeconomic disadvantage and comorbidities correlated with greater weekly rates across seasons.
Conclusions:
- County-level data and a unified modeling approach provide a comprehensive view of the US COVID-19 pandemic longitudinally.
- Findings are directly applicable to guiding government resource allocation for public health interventions at the county level.
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