Unveiling Community Vulnerability to COVID-19 Incidence: A Population-Based Spatial Analysis in Clark County, Nevada

Lung-Chang Chien ¹, L-W Antony Chen ², Chad L Cross ¹

⁰Department of Epidemiology and Biostatistics, University of Nevada, Las Vegas, NV 89154, USA.

International Journal of Environmental Research and Public Health +

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April 16, 2025

View abstract on PubMed

Summary

This study developed a Community Vulnerability Index (CVI) to understand COVID-19 disparities. Higher CVI, driven by minority status and housing issues, correlated with increased COVID-19 incidence in Clark County.

Area Of Science

Public Health
Epidemiology
Socioeconomic Determinants of Health

Background

COVID-19 disparities are linked to community vulnerability beyond socioeconomic status.
Targeted public health interventions require understanding spatial and temporal variations in vulnerability.
Clark County, Nevada, experienced significant COVID-19 impacts necessitating localized assessment.

Purpose Of The Study

To develop and evaluate a novel Community Vulnerability Index (CVI) for Clark County, Nevada.
To assess the relationship between the CVI and temporal variations in COVID-19 incidence.
To identify key community determinants contributing to COVID-19 vulnerability and inform public health strategies.

Main Methods

Utilized American Community Survey and other data to identify 23 community measures at the census tract level.
Constructed the CVI using lagged weighted quantile sum (LWQS) regression linking measures to monthly COVID-19 incidence (March 2020-November 2021).
Employed the Besag-York-Mollié model to evaluate spatial associations between CVI and COVID-19 incidence, controlling for spatial and temporal autocorrelation.

Main Results

Minority status, housing inadequacy, and inactive commuting were primary, consistent contributors to the CVI.
Significant spatial disparities in CVI were observed, concentrated in northern Clark County and the northeastern Las Vegas metropolitan area.
Spatial analyses indicated varying, clustered associations between COVID-19 incidence and CVI in northern and eastern Las Vegas metropolitan areas.

Conclusions

The CVI effectively captures community vulnerability influencing COVID-19 incidence, highlighting spatial inequities.
Findings underscore the complex interplay between community characteristics and COVID-19 outcomes.
The CVI framework offers a versatile tool for assessing and addressing community vulnerability in public health, applicable to COVID-19 testing, vaccination, and hospitalization.

Keywords:

COVID-19 disparity community vulnerability index lagged weighted quantile sum