Social Determinants of COVID-19 in Massachusetts, United States: An Ecological Study.
Social Determinants of COVID-19 in Massachusetts, United States: An Ecological Study.
复制标题
DOI：
10.3961/jpmph.20.256
复制
发表时间：
2020-07-01
期刊：
影响因子：
--
通讯作者：
Hawkins, Devan
中科院分区：
文献类型：
--
作者：
Hawkins, Devan
目的：本研究的目的是评估不同的健康社会决定因素（SDoH）如何与马萨诸塞州（MA）城镇2019冠状病毒病（COVID-19）发病率的变异性相关。方法：获得了MA城镇截至2020年6月10日的病例总数、检测和COVID-19发病率的数据。COVID-19的数据与美国社区调查的城市和城镇层面的各种SDoH变量数据相匹配。这些变量包括有关收入、贫困、就业、租房和保险范围的信息。我们根据这些SDoH变量比较了COVID-19的发病率。结果：根据SDoH变量，COVID-19的发病率存在明显的梯度。贫困程度更高、收入更低、保险覆盖率更低、失业率更高、从事医疗保健等基本服务的劳动力比例更高的社区，COVID-19的发病率更高。这些差异中的大多数并没有被这些城镇的不同检测率所解释。结论：SDoH变量可以解释MA各城镇COVID-19风险的一些变异性。有关SDoH的数据应该成为COVID-19标准监测的一部分。应努力解决可能使社区面临更高风险的社会因素。
OBJECTIVES: The aim of this study was to assess how different social determinants of health (SDoH) may be related to variability in coronavirus disease 2019 (COVID-19) rates in cities and towns in Massachusetts (MA).METHODS: Data about the total number of cases, tests, and rates of COVID-19 as of June 10, 2020 were obtained for cities and towns in MA. The data on COVID-19 were matched with data on various SDoH variables at the city and town level from the American Community Survey. These variables included information about income, poverty, employment, renting, and insurance coverage. We compared COVID-19 rates according to these SDoH variables.RESULTS: There were clear gradients in the rates of COVID-19 according to SDoH variables. Communities with more poverty, lower income, lower insurance coverage, more unemployment, and a higher percentage of the workforce employed in essential services, including healthcare, had higher rates of COVID-19. Most of these differences were not accounted for by different rates of testing in these cities and towns.CONCLUSIONS: SDoH variables may explain some of the variability in the risk of COVID-19 across cities and towns in MA. Data about SDoH should be part of the standard surveillance for COVID-19. Efforts should be made to address social factors that may be putting communities at an elevated risk.