The Relationship Between Social Determinants of Health and Racial Disparities in COVID-19 Mortality.
The Relationship Between Social Determinants of Health and Racial Disparities in COVID-19 Mortality.
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DOI：
10.1007/s40615-020-00952-y
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发表时间：
2022-03
影响因子：
3.9
通讯作者：
DallaPiazza M
中科院分区：
文献类型：
--
作者：
Dalsania AK;Fastiggi MJ;Kahlam A;Shah R;Patel K;Shiau S;Rokicki S;DallaPiazza M
2019冠状病毒病大流行扩大了美国边缘化人群，特别是黑人群体现有的健康差距。健康的社会决定因素是健康结果的强大驱动因素，可能影响COVID-19种族差异。我们从公开可用的数据库中收集了截至2020年10月28日的COVID-19死亡率、临床协变量和美国县级健康指标的社会决定因素的数据。我们利用负二项回归来评估健康的社会决定因素与COVID-19死亡率之间的关系，重点关注死亡率的种族差异。死亡率较高的县黑人居民比例较高，健康的不利社会决定因素水平也较高。一个县黑人居民百分比、无保险成年人百分比、低出生体重百分比、无高中文凭成年人百分比、监禁率和无互联网家庭百分比每增加1个百分点，COVID-19死亡率分别增加0.9% （95% CI 0.5%-1.3%）、1.9% （95% CI 1.1%-2.7%）、7.6% （95% CI 4.4%-11.0%）、3.5% （95% CI 2.5%-4.5%）、5.4% （95% CI 1.3%-9.7%）和3.4% （95% CI 2.5%-4.2%）。经济特权最低的五分之一县的COVID-19死亡率增加了67.5% （95% CI 35.9%-106.6%）。多变量回归和亚组分析表明，健康的不利社会决定因素可能部分解释了COVID-19死亡率的种族差异。这项研究表明，健康的社会决定因素导致了县一级美国黑人的COVID-19死亡率，突出表明需要制定公共卫生政策，解决健康结果中的种族差异问题。在线版本包含补充材料，可在10.1007/s40615-020-00952-y获得。
The COVID-19 pandemic has magnified existing health disparities for marginalized populations in the United States (U.S.), particularly among Black Americans. Social determinants of health are powerful drivers of health outcomes that could influence COVID-19 racial disparities. We collected data from publicly available databases on COVID-19 death rates through October 28, 2020, clinical covariates, and social determinants of health indicators at the U.S. county level. We utilized negative binomial regression to assess the association between social determinants of health and COVID-19 mortality focusing on racial disparities in mortality. Counties with higher death rates had a higher proportion of Black residents and greater levels of adverse social determinants of health. A one percentage point increase in percent Black residents, percent uninsured adults, percent low birthweight, percent adults without high school diploma, incarceration rate, and percent households without internet in a county increased COVID-19 death rates by 0.9% (95% CI 0.5%–1.3%), 1.9% (95% CI 1.1%–2.7%), 7.6% (95% CI 4.4%–11.0%), 3.5% (95% CI 2.5%–4.5%), 5.4% (95% CI 1.3%–9.7%), and 3.4% (95% CI 2.5%–4.2%), respectively. Counties in the lowest quintile of a measure of economic privilege had an increased COVID-19 death rates of 67.5% (95% CI 35.9%–106.6%). Multivariate regression and subgroup analyses suggested that adverse social determinants of health may partially explain racial disparities in COVID-19 mortality. This study demonstrates that social determinants of health contribute to COVID-19 mortality for Black Americans at the county level, highlighting the need for public health policies that address racial disparities in health outcomes. The online version contains supplementary material available at 10.1007/s40615-020-00952-y.
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DOI：
10.1001/jama.2016.4226
发表时间：
2016-04-26
期刊：
JAMA
影响因子：
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影响因子：
6.3
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Kelly-Irving, Michelle
影响因子：
6.3
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DOI：
10.1017/s1742058x11000130
发表时间：
2011-04
期刊：
Du Bois review : social science research on race
影响因子：
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作者：
Gee GC;Ford CL
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