Social determinants of COVID-19 mortality at the county level.
Social determinants of COVID-19 mortality at the county level.
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DOI：
10.1371/journal.pone.0240151
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Brouwer K
中科院分区：
文献类型：
--
作者：
Fielding-Miller RK;Sundaram ME;Brouwer K
截至2020年8月，美国是新冠肺炎疫情的全球震中。新出现的数据表明，“必要”劳动者承担着不成比例的风险，他们更有可能是少数族裔和移民。我们使用公开可用的数据建立了一系列空间自回归模型，评估了县级新冠肺炎死亡率与(1)从事农活的个人百分比，(2)没有一口流利的成年英语者的家庭百分比，(3)65岁以下未参保个人的百分比，以及(4)生活在联邦贫困线以下的个人的百分比之间的关系。我们进一步调整了这些模型的总人口、人口密度和自给定县报告的第一例病例以来的天数。我们发现，在截至2020年7月12日报告了一例新冠肺炎病例的所有县(n=3024)中，农场工人比例越高、贫困人口比例越高、人口密度越高、人口越多、65岁以上居民比例越高，所有这些都独立且显著地与一个县的更高死亡人数相关。在城市县(n=115)，农场工人的比例越高、密度越高、人口越多，死亡人数越多，而县的保险覆盖率越低，死亡人数越少。在非城市县(n=2909)，同样的模式也适用，生活在贫困中的居民和老年居民的比例较高也明显与更多的死亡有关。综上所述，我们的研究结果表明，农场工人可能面临感染新冠肺炎并导致死亡的独特风险，而且这些风险与贫困、保险或新冠肺炎健康活动的语言可及性无关。
As of August 2020, the United States is the global epicenter of the COVID-19 pandemic. Emerging data suggests that “essential” workers, who are disproportionately more likely to be racial/ethnic minorities and immigrants, bear a disproportionate degree of risk. We used publicly available data to build a series of spatial autoregressive models assessing county level associations between COVID-19 mortality and (1) percentage of individuals engaged in farm work, (2) percentage of households without a fluent, adult English-speaker, (3) percentage of uninsured individuals under the age of 65, and (4) percentage of individuals living at or below the federal poverty line. We further adjusted these models for total population, population density, and number of days since the first reported case in a given county. We found that across all counties that had reported a case of COVID-19 as of July 12, 2020 (n = 3024), a higher percentage of farmworkers, a higher percentage of residents living in poverty, higher density, higher population, and a higher percentage of residents over the age of 65 were all independently and significantly associated with a higher number of deaths in a county. In urban counties (n = 115), a higher percentage of farmworkers, higher density, and larger population were all associated with a higher number of deaths, while lower rates of insurance coverage in a county was independently associated with fewer deaths. In non-urban counties (n = 2909), these same patterns held true, with higher percentages of residents living in poverty and senior residents also significantly associated with more deaths. Taken together, our findings suggest that farm workers may face unique risks of contracting and dying from COVID-19, and that these risks are independent of poverty, insurance, or linguistic accessibility of COVID-19 health campaigns.
DOI：
10.1016/j.socscimed.2017.04.007
发表时间：
2018-03
期刊：
Social science & medicine (1982)
影响因子：
--
作者：
Philbin MM;Flake M;Hatzenbuehler ML;Hirsch JS
通讯作者：
Hirsch JS