Regional variation in COVID-19 disparities: connections with immigrant and Latinx communities in US counties
Regional variation in COVID-19 disparities: connections with immigrant and Latinx communities in US counties
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DOI：
10.1016/j.annepidem.2020.08.016
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发表时间：
2021-01-01
影响因子：
5.6
通讯作者：
Liu, Han
中科院分区：
文献类型：
--
作者：
Strully, Kate;Yang, Tse-Chuan;Liu, Han
目的：考虑美国拉丁美洲裔亚组和地区的异质性，评估各县COVID-19病例与种族和出生构成之间的关系。方法：利用县级数据和多层负二项模型，我们评估了COVID-19病例与外国出生、拉丁裔、黑人或亚洲人的居民百分比之间的关系，给出了所有县的综合估计值，并对各地区进行了分层。考虑到拉丁美洲人不同的风险因素，我们还评估了来自特定拉丁美洲裔群体的居民百分比的关联。结果：外国出生居民百分比与COVID-19发病率呈正相关（IRR = 1.106; 95% CI: 1.074 ~ 1.139）。调整后的拉丁裔百分比的关联在所有国家合并后都不显著，但这掩盖了异质性。中美洲人较多的县发病率较高（IRR =1.130; 95% CI: 1.067-1.197）。而且，在东北部和中西部，波多黎各人较多的县的病例率更高。在调整了外国出生的比例后，与亚洲人比例的关联不显著。在先前证据的证实下，黑人居民的百分比与COVID-19病例率呈正相关（IRR = 1.031; 95% CI: 1.025-1.036）。结论：移民较多的县以及中美洲或黑人居民较多的县有更多的COVID-19病例。在东北部和中西部，波多黎各居民较多的县也有更多的COVID-19病例。(C) 2020爱思唯尔公司版权所有。
Purpose: To evaluate associations between counties' COVID-19 cases and racial-ethnic and nativity composition, considering heterogeneity across Latin American-origin subgroups and regions of the United States.Methods: Using county-level data and multilevel negative binomial models, we evaluate associations between COVID-19 cases and percentages of residents that are foreign-born, Latinx, Black, or Asian, presenting estimates for all counties combined and stratifying across regions. Given varying risk factors among Latinx, we also evaluate associations for percentages of residents from specific Latin Americanorigin groups.Results: Percentage of foreign-born residents is positively associated with COVID-19 case rate (IRR = 1.106; 95% CI: 1.074-1.139). Adjusted associations for percentage Latinx are nonsignificant for all counties combined, but this obscures heterogeneity. Counties with more Central Americans have higher case rates (IRR =1.130; 95% CI: 1.067-1.197). And, in the Northeast and Midwest, counties with more Puerto Ricans have higher case rates. Associations with percentage Asians are nonsignificant after adjusting for percentage foreign-born. With the confirmation of prior evidence, the percentage of Black residents is positively and robustly associated with COVID-19 case rate (IRR = 1.031; 95% CI: 1.025-1.036).Conclusions: Counties with more immigrants, as well as more Central American or Black residents, have more COVID-19 cases. In the Northeast and Midwest, counties with more Puerto Rican residents also have more COVID-19 cases. (C) 2020 Elsevier Inc. All rights reserved.