Journal article
Spatial accessibility to healthcare facilities and the cumulative incidence of COVID-19 infection: evidence from the reasons for geographic and racial differences in stroke (REGARDS) study, United States, March 2020 to September 2021
Preventive medicine reports, v 66, 103470
Jun 2026
PMID: 42016505
Featured in Collection : Drexel's Newest Publications
Abstract
Objective
During the pandemic, disparities in COVID-19 infection emerged across geographic and demographic groups, potentially linked to healthcare access disparities. This study examined associations between spatial accessibility to healthcare facilities and COVID-19 incidence in the United States, among older adults in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort from March 2020–September 2021.
Methods
Using 2020–2021 healthcare facility data for 10,089 REGARDS participants, we defined accessibility based on the presence or absence of healthcare facilities within 5 km buffers centered on participant's census tract of residence. We estimated odds ratios using Generalized Estimating Equations, adjusted for age, sex, race/ethnicity, social vulnerability index, and urbanicity.
Results
The absence of certain healthcare facilities was significantly associated with higher COVID-19 infection odds: pharmacies/drugstores (OR = 1.26, 95% CI: 1.03, 1.53), retail clinics (OR = 1.19, 95% CI: 1.03, 1.38), and residential care (OR = 1.34, 95% CI: 1.11, 1.62). Sensitivity analyses using different sized buffers yielded similar results; notably, absence of health practitioner offices was significant at 1 km.
Conclusions
Findings suggest that for older adults, access to healthcare facilities, especially pharmacies/drugstores, retail clinics, and residential care was inversely associated with COVID-19 infection odds. Addressing disparities in healthcare accessibility may help reduce infection risk.
Metrics
1 Record Views
Details
- Title
- Spatial accessibility to healthcare facilities and the cumulative incidence of COVID-19 infection: evidence from the reasons for geographic and racial differences in stroke (REGARDS) study, United States, March 2020 to September 2021
- Creators
- Edwin M. McCulley (Corresponding Author) - Drexel UniversityJana A. Hirsch - Drexel UniversityElizabeth C. Oelsner - Columbia UniversityAlina Schnake-Mahl - Drexel UniversityBrisa N. Sánchez - Drexel UniversityGina S. Lovasi - Drexel UniversityUsama Bilal - Drexel University
- Publication Details
- Preventive medicine reports, v 66, 103470
- Publisher
- Elsevier
- Number of pages
- 6
- Grants
- Grant note
- National Institute of Aging (NIA): R01AG049970, R01AG049970-S1, R01AG072634, R56AG049970 National Heart, Blood, and Lung Institute (NHLBI): R01HL14843 National Institute on Alcohol Abuse and Alcoholism: R01AA028552 Commonwealth Universal Research Enhancement (C.U.R.E) program - Pennsylvania Department of Health-2015 Formula award-SAP: 4100072543 Urban Health Collaborative at Drexel University Built Environment and Health Research Group at Columbia University NHLBI, Collaborating Network of Networks for Evaluating COVID-19 and Therapeutic Strategies (CONNECTS) /Researching COVID to Enhance Recovery (RECOVER): OT2HL156812 National Institute of Neurological Disorders and Stroke (NINDS) NIA: NS041588 NINDS NIH Department of Health and Human Services National Institute of Allergy and Infectious Diseases (NIAID): K01AI168579
This work was supported by the National Institute of Aging (NIA) (grants R01AG049970, R01AG049970-S1, R01AG072634, R56AG049970) , National Heart, Blood, and Lung Institute (NHLBI) (grant R01HL14843) , National Institute on Alcohol Abuse and Alcoholism (R01AA028552) , Commonwealth Universal Research Enhancement (C.U.R.E) program funded by the Pennsylvania Department of Health-2015 Formula award-SAP #4100072543, the Urban Health Collaborative at Drexel University, and the Built Environment and Health Research Group at Columbia University. C4R is supported by NHLBI, Collaborating Network of Networks for Evaluating COVID-19 and Therapeutic Strategies (CONNECTS) /Researching COVID to Enhance Recovery (RECOVER) grant OT2HL156812, with co-funding from the National Institute of Neurological Disorders and Stroke (NINDS) and NIA. REGARDS is supported by NS041588, co-funded by the NINDS, NIA, NIH, and Department of Health and Human Services. Alina Schnake-Mahl was supported by the National Institute of Allergy and Infectious Diseases (NIAID) K01AI168579. The content and the views and conclusions contained in this document are solely the responsibility of the authors and should not be interpreted as representing the official policies, either expressed or implied, of the NIH, NHLBI, NINDS, NIA, or NIAID.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Epidemiology and Biostatistics; Health Management and Policy
- Web of Science ID
- WOS:001751125700001
- Other Identifier
- 991022173461104721