Coronavirus disease 2019 (COVID-19) in assisted living communities: Neighborhood deprivation and state social distancing policies matter
Coronavirus disease 2019 (COVID-19) in assisted living communities: Neighborhood deprivation and state social distancing policies matter
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DOI：
10.1017/ice.2022.46
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发表时间：
2022-02-22
影响因子：
4.5
通讯作者：
Temkin-Greener, Helena
中科院分区：
文献类型：
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作者：
Guo, Wenhan;Li, Yue;Temkin-Greener, Helena
背景：长期护理设施的居民面临着感染或死于2019冠状病毒病（COVID-19）的风险显著增加。然而，人们对辅助生活社区（ALC）中的COVID-19及其传播的潜在决定因素知之甚少。我们研究了ALC中的COVID-19病例与符合Medicare-Medicaid（双重）资格的少数民族居民比例、社区贫困和州COVID-19政策严格性之间的关联。方法：我们使用5个州ALC中确诊的COVID-19病例数据进行了纵向分析。我们试图确定ALC中COVID-19病例的每周累计数量。协变量是ALC特征、地区贫困指数和州COVID-19政策严格程度。采用多变量两部分模型来确定自变量与爆发可能性和病例总数之间的关联。结果：在我们的研究样本中，截至2020年8月17日，201个ALC（7.04%）报告了1例或多例COVID-19病例。少数民族居民的比例越高，ALC报告至少1例COVID-19病例的可能性越高（比值比[OR]，1.06; P = .032）。在至少有1例病例的条件下，在社会距离政策更严格的州，ALC的病例数较低（发病率比[IRR]，0.98; P < .001）。更大的邻里剥夺与更高的病例数相关（IRR，1.36; P = .049）。结论：具有双重资格的少数民族居民比例较高的ALC更有可能在其社区内爆发COVID-19疫情。位于社会经济贫困社区和州社交距离政策不太严格的州的ALC往往有更多的COVID-19病例。
Background: Residents of long-term care facilities face significantly greater risk of contracting or dying from coronavirus disease 2019 (COVID-19). However, little is known about COVID-19 in assisted living communities (ALCs) and the potential determinants of its spread. We examined the association between COVID-19 cases in ALCs and the proportion of Medicare-Medicaid (dual) eligible minority residents, neighborhood area deprivation, and state COVID-19 policy stringency. Methods: We conducted longitudinal analyses employing data on confirmed COVID-19 cases in ALCs in 5 states. We sought to determine the weekly cumulative number of COVID-19 cases in ALCs. Covariates were ALC characteristics, area deprivation index, and state COVID-19 policy stringency. Multivariate 2-part models were used to determine the associations between independent variables and the likelihood of an outbreak and the overall count of cases. Results: In our study sample, 201 ALCs (7.04%) reported 1 or more COVID-19 cases as of August 17, 2020. A higher percentage of minority residents was associated with an increased likelihood of an ALC reporting at least 1 COVID-19 case (odds ratio [OR], 1.06; P = .032). Conditional on having at least 1 case, ALCs in states with stricter social distancing policies had lower case counts (incidence rate ratio [IRR], 0.98; P < .001). Greater neighborhood deprivation was associated with higher case count (IRR, 1.36; P = .049). Conclusions: ALCs with higher proportions of dual-eligible minority residents were more likely to have COVID-19 outbreaks within their communities. ALCs located in more socioeconomically deprived neighborhoods, and in states with less stringent state social distancing policies, tended to have more COVID-19 cases.