An LSU Health New Orleans School of Public Health report has found a positive association between social vulnerability and COVID-19 incidence at the census-tract level, and recommends that more resources be allocated to socially vulnerable populations to reduce the incidence of COVID-19. The findings are published in Frontiers in Public Health.
The analysis focused on the state of Louisiana and found that tracts, or geographic areas, with higher levels of social vulnerability were linked to higher rates of coronavirus transmission even after adjusting for population density.
In essence, this means the social determinants of health have a profound impact on whether people contract the virus, a factor that holds true amidst a wide swath of geographies.
WHAT'S THE IMPACT?
According to the Centers for Disease Control and Prevention, "social vulnerability" refers to the resilience of communities when confronted by external stresses on human health – stresses such as natural or human-caused disasters, or disease outbreaks.
The CDC's Agency for Toxic Substances and Disease Registry's Social Vulnerability Index uses U.S. census variables at tract level to help local officials identify communities that may need support in preparing for hazards or recovering from a disaster.
The CDC SVI ranks each tract on 15 social factors, including poverty, unemployment rate, percentage of single-parent households, lack of vehicle access and crowded housing. The factors are grouped into four themes: socioeconomic, household composition and disability, minority and language, and housing and transportation.
The researchers identified census tracts with high levels of both social vulnerability and COVID-19 incidence. They report that as the SVI increases, so too does COVID-19 cumulative incidence.
They also identify some of the factors that increase risk, such as having jobs in which people can't work from home and that bring them into contact with large numbers of people, living in crowded households with less room to physically distance, less ability to buy face masks, and less access to quality scientific information.
They note that African Americans and Hispanics are more likely to live in multigenerational homes, which may make self-isolation more difficult for family members who contract COVID-19. These conditions can lead to increased transmission and community prevalence.
The findings support the notion that the United States faces significant challenges in its handling of the COVID-19 epidemic, particularly due to the nation's structural racism and inattention to the barriers to health at the root of racial health disparities across.
Ultimately, the CDC's Social Vulnerability Index could be useful in identifying locations that are most impacted by COVID-19 and should be targeted for more specific interventions. The factors that contribute to social vulnerability, such as income, education, poverty, race and ethnicity, influence who will suffer the most from the COVID-19 epidemic.
THE LARGER TREND
As far back as August 2020, an analysis of hospitalization rates from the University of Minnesota showed Black, Hispanic, Native American and Alaskan Native populations in the U.S. are significantly more likely to be hospitalized due to COVID-19 than whites.
When compared to the populations of each state, people identified as being African American or Black were hospitalized at higher rates than those who were white in all 12 states reporting data, with Ohio (at 32% of hospitalizations and 13% of population), Minnesota (24.9% hospitalizations and 6.8% population), and Indiana (28.1% hospitalizations and 9.8% population) having the largest disparities.
Hispanics were hospitalized at higher rates than those who were white in 10 of the 11 states reporting this data, with Virginia (36.2% of hospitalizations and 9.6% population), Utah (35.3% hospitalizations and 14.2% population), and Rhode Island (33% hospitalizations and 15.9% population) showing the biggest disparities.
Focus on Health Equity
This month we will be reporting on the challenges, opportunities and success stories as work continues to build a healthcare system that works for everyone.