Socioeconomic Determinants of COVID-19 Incidence and Mortality in Florida.
Socioeconomic Determinants of COVID-19 Incidence and Mortality in Florida.
复制标题
DOI：
10.7759/cureus.22491
复制
发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Khanna D
中科院分区：
文献类型：
--
作者：
Backer S;Rezene A;Kahar P;Khanna D
健康的各种社会决定因素与生活质量的各种风险和影响有关。具体地说，贫困、缺乏保险覆盖、大家庭规模和社会脆弱性都是导致传染病发病率和死亡率的因素。然而，还没有研究在佛罗里达州全州范围内检查这些因素与新冠肺炎大流行的关系。因此，这项研究的目的是检验佛罗里达州各县的平均家庭规模、贫困、未参保人口、社会脆弱性指数(SVI)以及新冠肺炎发病率和死亡率之间的关系。这一目标是通过分析佛罗里达州州和地方卫生部门的累积病例和死亡报告来实现的。疾控中心新冠肺炎工作组将这些数据汇编成一个单一的数据集。使用美国人口普查局的数据，佛罗里达州的所有县都被分为贫困率、平均家庭规模、未参保率和SVI(社会脆弱性指数)等不同类别。贫困水平分为低(0-12.3%)、中等(12.3%-17.3%)和高(低于联邦贫困线17.3%)。未参保人口比例分为低(0-7.1%)、中(7.1-11.4%)和高(11.4%)。县域平均家庭规模分为低(0-2.4)、中(2.4-2.6)和高(>；2.6)。疾病控制和预防中心(CDC)/有毒物质和疾病登记机构(ATSDR)社会脆弱性指数(SVI)使用了美国关于15个脆弱性社会决定因素的人口普查数据，以评估和帮助弱势社区。在0-1的范围内，SVI指数分为低(0-0.333)、中等(0.334-0.666)和高(0.667-1)，较高的数字意味着社区具有许多社会脆弱性因素。每100,000名居民的平均累积病例和死亡人数按每三分位数计算。对数据的分析显示，佛罗里达州高度贫困县的新冠肺炎病例和死亡率明显高于全国平均水平。相比之下，中等和低贫困率低于平均水平。同样，SVI高的县的病例和死亡率也远远高于各州和全国的平均水平。未参保比例高的县的发病率最高。然而，未参保个人比例较低的县的死亡率最高。新冠肺炎利率与家庭规模之间没有明显的相关性。研究结论是，美国疾病控制与预防中心和美国人口普查数据的汇编表明，贫困、社会脆弱性、缺乏保险覆盖与新冠肺炎的发病率和死亡率上升之间存在显著相关性。未来的研究应该对这种相关性进行统计分析，并检验深静脉血栓形成的个体因素作为潜在的新冠肺炎预测因子。
A wide variety of social determinants of health have been associated with various risks and impacts on quality of life. Specifically, poverty, lack of insurance coverage, large household sizes, and social vulnerability are all factors implicated in incidence and mortality rates of infectious disease. However, no studies have examined the relationship of these factors to the COVID-19 pandemic on a state-wide level in Florida. Thereby, the objective of this study is to examine the relationship between average household size, poverty, uninsured populations, social vulnerability index (SVI), and rates of COVID-19 cases and deaths in Florida counties. The objective was accomplished by analyzing the cumulative case and death reports from state and local health departments in Florida. The data was compiled into a single dataset by the CDC COVID-19 Task Force. Using US Census Bureau data, all Florida counties were classified into tertiles of the separate categories of poverty rate, average household size, uninsured rates, and SVI (Social Vulnerability Index). The poverty level was classified as low (0-12.3%), moderate (12.3-17.3%), and high (>17.3% below the federal poverty line). The uninsured population proportion was classified as low (0-7.1%), moderate (7.1-11.4%), and high (>11.4% uninsured residents). Average county household size was classified as low (0-2.4), moderate (2.4-2.6), and high (>2.6). The Centers for Disease Control and Prevention (CDC)/Agency for Toxic Substances and Disease Registry (ATSDR) Social Vulnerability Index (SVI) used US census data on 15 social determinants of vulnerability to evaluate and assist disadvantaged communities. SVI tertiles were low (0-0.333), moderate (0.334-0.666), and high (0.667-1) on a range of 0-1, with higher numbers signifying communities with many factors of social vulnerability. The mean cumulative cases and deaths per 100,000 inhabitants were calculated in each tertile for each category. Analysis of the data revealed that case and mortality rates due to COVID-19 in the high poverty counties were markedly higher in Florida than the national average. In contrast, moderate and low poverty rates were below average. Similarly, counties with a high SVI had case and mortality rates greatly above state and national averages. Counties with a high proportion of uninsured displayed the highest case rates. However, mortality rates were the highest in counties with a low proportion of uninsured individuals. No clear correlation was observed between COVID-19 rates and household size. It was concluded that compiled CDC and US census data suggests a significant correlation between poverty, social vulnerability, lack of insurance coverage, and increased incidence and mortality from COVID-19. Future research should statistically analyze the correlations and examine the individual factors of SVI as potential COVID-19 predictors.