A model of disparities: risk factors associated with COVID-19 infection
Open Access
- 29 July 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in International Journal for Equity in Health
- Vol. 19 (1), 1-10
- https://doi.org/10.1186/s12939-020-01242-z
Abstract
By mid-May 2020, there were over 1.5 million cases of (SARS-CoV-2) or COVID-19 across the U.S. with new confirmed cases continuing to rise following the re-opening of most states. Prior studies have focused mainly on clinical risk factors associated with serious illness and mortality of COVID-19. Less analysis has been conducted on the clinical, sociodemographic, and environmental variables associated with initial infection of COVID-19. A multivariable statistical model was used to characterize risk factors in 34,503cases of laboratory-confirmed positive or negative COVID-19 infection in the Providence Health System (U.S.) between February 28 and April 27, 2020. Publicly available data were utilized as approximations for social determinants of health, and patient-level clinical and sociodemographic factors were extracted from the electronic medical record. Higher risk of COVID-19 infection was associated with older age (OR 1.69; 95% CI 1.41–2.02, p < 0.0001), male gender (OR 1.32; 95% CI 1.21–1.44, p < 0.0001), Asian race (OR 1.43; 95% CI 1.18–1.72, p = 0.0002), Black/African American race (OR 1.51; 95% CI 1.25–1.83, p < 0.0001), Latino ethnicity (OR 2.07; 95% CI 1.77–2.41, p < 0.0001), non-English language (OR 2.09; 95% CI 1.7–2.57, p < 0.0001), residing in a neighborhood with financial insecurity (OR 1.10; 95% CI 1.01–1.25, p = 0.04), low air quality (OR 1.01; 95% CI 1.0–1.04, p = 0.05), housing insecurity (OR 1.32; 95% CI 1.16–1.5, p < 0.0001) or transportation insecurity (OR 1.11; 95% CI 1.02–1.23, p = 0.03), and living in senior living communities (OR 1.69; 95% CI 1.23–2.32, p = 0.001). sisk of COVID-19 infection is higher among groups already affected by health disparities across age, race, ethnicity, language, income, and living conditions. Health promotion and disease prevention strategies should prioritize groups most vulnerable to infection and address structural inequities that contribute to risk through social and economic policy.Keywords
Other Versions
This publication has 29 references indexed in Scilit:
- Temporal trends in air pollution exposure inequality in MassachusettsEnvironmental Research, 2017
- Communities in ActionPublished by The National Academies Press ,2017
- Understanding associations among race, socioeconomic status, and health: Patterns and prospects.Health Psychology, 2016
- Traveling Towards Disease: Transportation Barriers to Health Care AccessJournal of Community Health, 2013
- Low Health Literacy, Limited English Proficiency, and Health Status in Asians, Latinos, and Other Racial/Ethnic Groups in CaliforniaJournal of Health Communication, 2012
- Health disparities: gaps in access, quality and affordability of medical care.2012
- Environmental Health Disparities in HousingAmerican Journal of Public Health, 2011
- Integrating literacy, culture, and language to improve health care quality for diverse populations.American Journal of Health Behavior, 2007
- Promoting Health: Intervention Strategies from Social and Behavioral ResearchAmerican Journal of Health Promotion, 2001
- Applied Logistic RegressionTechnometrics, 1992