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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Spatial Inequities in COVID-19 Testing, Positivity, Confirmed Cases, and Mortality in 3 U.S. Cities : An Ecological Study
Annals of internal medicine, v 174(7), pp 936-944
30 Mar 2021
PMID: 33780289
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Preliminary evidence has shown inequities in coronavirus disease 2019 (COVID-19)-related cases and deaths in the United States.
To explore the emergence of spatial inequities in COVID-19 testing, positivity, confirmed cases, and mortality in New York, Philadelphia, and Chicago during the first 6 months of the pandemic.
Ecological, observational study at the ZIP code tabulation area (ZCTA) level from March to September 2020.
Chicago, New York, and Philadelphia.
All populated ZCTAs in the 3 cities.
Outcomes were ZCTA-level COVID-19 testing, positivity, confirmed cases, and mortality cumulatively through the end of September 2020. Predictors were the Centers for Disease Control and Prevention Social Vulnerability Index and its 4 domains, obtained from the 2014-2018 American Community Survey. The spatial autocorrelation of COVID-19 outcomes was examined by using global and local Moran
statistics, and estimated associations were examined by using spatial conditional autoregressive negative binomial models.
Spatial clusters of high and low positivity, confirmed cases, and mortality were found, co-located with clusters of low and high social vulnerability in the 3 cities. Evidence was also found for spatial inequities in testing, positivity, confirmed cases, and mortality. Specifically, neighborhoods with higher social vulnerability had lower testing rates and higher positivity ratios, confirmed case rates, and mortality rates.
The ZCTAs are imperfect and heterogeneous geographic units of analysis. Surveillance data were used, which may be incomplete.
Spatial inequities exist in COVID-19 testing, positivity, confirmed cases, and mortality in 3 large U.S. cities.
National Institutes of Health.
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Details
- Title
- Spatial Inequities in COVID-19 Testing, Positivity, Confirmed Cases, and Mortality in 3 U.S. Cities : An Ecological Study
- Creators
- Usama Bilal - Drexel UniversityLoni P Tabb - Drexel UniversitySharrelle Barber - Drexel UniversityAna V Diez Roux - Drexel University
- Publication Details
- Annals of internal medicine, v 174(7), pp 936-944
- Number of pages
- 9
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Epidemiology and Biostatistics
- Web of Science ID
- WOS:000675809000020
- Scopus ID
- 2-s2.0-85104937110
- Other Identifier
- 991019167460304721
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- Web of Science research areas
- Public, Environmental & Occupational Health