Inequities in spatial accessibility to COVID-19 testing in 30 large US cities

Area of Science:

• Public Health
• Epidemiology
• Health Equity

Background:

• COVID-19 testing is vital for pandemic control.
• Significant spatial and racial/ethnic disparities in COVID-19 outcomes exist in US cities.
• Unequal access to testing sites may contribute to these disparities.

Purpose of the Study:

• To assess spatial inequities in COVID-19 testing accessibility across 30 large US cities.
• To examine the association between social vulnerability and testing site accessibility.
• To identify potential drivers of disparities in COVID-19 testing access.

Main Methods:

• Utilized COVID-19 testing location data from October 2021.
• Developed a spatial accessibility metric based on a 15-minute walkshed per census block group (CBG).
• Employed multilevel negative binomial regression to model the relationship between the Social Vulnerability Index (SVI) and accessibility.

Main Results:

• 53% of analyzed CBGs had a testing site within a 15-minute walk; 36% had sites without restrictions.
• A 1-decile increase in SVI correlated with a 3% decrease in testing accessibility.
• Similar inequities were observed across SVI components and for unrestricted testing sites.

Conclusions:

• Spatial inequities in COVID-19 testing accessibility persist in US cities, disproportionately affecting socially vulnerable populations.
• While most cities show inequity, some demonstrate progress towards equitable testing access.
• Enhancing testing accessibility, particularly for vulnerable groups, is essential for managing COVID-19 transmission and emerging variants.