Census Tract Patterns and Contextual Social Determinants of Health Associated With COVID-19 in a Hispanic Population From South Texas: A Spatiotemporal Perspective
BackgroundPrevious studies have shown that various social determinants of health (SDOH) may have contributed to the disparities in COVID-19 incidence and mortality among minorities and underserved populations at the county or zip code level. ObjectiveThis analysis...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2021-08-01
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| Series: | JMIR Public Health and Surveillance |
| Online Access: | https://publichealth.jmir.org/2021/8/e29205 |
| _version_ | 1797735807020171264 |
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| author | Cici Bauer Kehe Zhang Miryoung Lee Susan Fisher-Hoch Esmeralda Guajardo Joseph McCormick Isela de la Cerda Maria E Fernandez Belinda Reininger |
| author_facet | Cici Bauer Kehe Zhang Miryoung Lee Susan Fisher-Hoch Esmeralda Guajardo Joseph McCormick Isela de la Cerda Maria E Fernandez Belinda Reininger |
| author_sort | Cici Bauer |
| collection | DOAJ |
| description |
BackgroundPrevious studies have shown that various social determinants of health (SDOH) may have contributed to the disparities in COVID-19 incidence and mortality among minorities and underserved populations at the county or zip code level.
ObjectiveThis analysis was carried out at a granular spatial resolution of census tracts to explore the spatial patterns and contextual SDOH associated with COVID-19 incidence from a Hispanic population mostly consisting of a Mexican American population living in Cameron County, Texas on the border of the United States and Mexico. We performed age-stratified analysis to identify different contributing SDOH and quantify their effects by age groups.
MethodsWe included all reported COVID-19–positive cases confirmed by reverse transcription–polymerase chain reaction testing between March 18 (first case reported) and December 16, 2020, in Cameron County, Texas. Confirmed COVID-19 cases were aggregated to weekly counts by census tracts. We adopted a Bayesian spatiotemporal negative binomial model to investigate the COVID-19 incidence rate in relation to census tract demographics and SDOH obtained from the American Community Survey. Moreover, we investigated the impact of local mitigation policy on COVID-19 by creating the binary variable “shelter-in-place.” The analysis was performed on all COVID-19–confirmed cases and age-stratified subgroups.
ResultsOur analysis revealed that the relative incidence risk (RR) of COVID-19 was higher among census tracts with a higher percentage of single-parent households (RR=1.016, 95% posterior credible intervals [CIs] 1.005, 1.027) and a higher percentage of the population with limited English proficiency (RR=1.015, 95% CI 1.003, 1.028). Lower RR was associated with lower income (RR=0.972, 95% CI 0.953, 0.993) and the percentage of the population younger than 18 years (RR=0.976, 95% CI 0.959, 0.993). The most significant association was related to the “shelter-in-place” variable, where the incidence risk of COVID-19 was reduced by over 50%, comparing the time periods when the policy was present versus absent (RR=0.506, 95% CI 0.454, 0.563). Moreover, age-stratified analyses identified different significant contributing factors and a varying magnitude of the “shelter-in-place” effect.
ConclusionsIn our study, SDOH including social environment and local emergency measures were identified in relation to COVID-19 incidence risk at the census tract level in a highly disadvantaged population with limited health care access and a high prevalence of chronic conditions. Results from our analysis provide key knowledge to design efficient testing strategies and assist local public health departments in COVID-19 control, mitigation, and implementation of vaccine strategies. |
| first_indexed | 2024-03-12T13:04:25Z |
| format | Article |
| id | doaj.art-744d2bd66f274773a95a3ef350e737e9 |
| institution | Directory Open Access Journal |
| issn | 2369-2960 |
| language | English |
| last_indexed | 2024-03-12T13:04:25Z |
| publishDate | 2021-08-01 |
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| record_format | Article |
| series | JMIR Public Health and Surveillance |
| spelling | doaj.art-744d2bd66f274773a95a3ef350e737e92023-08-28T18:28:31ZengJMIR PublicationsJMIR Public Health and Surveillance2369-29602021-08-0178e2920510.2196/29205Census Tract Patterns and Contextual Social Determinants of Health Associated With COVID-19 in a Hispanic Population From South Texas: A Spatiotemporal PerspectiveCici Bauerhttps://orcid.org/0000-0002-2337-7965Kehe Zhanghttps://orcid.org/0000-0001-8013-265XMiryoung Leehttps://orcid.org/0000-0003-4088-304XSusan Fisher-Hochhttps://orcid.org/0000-0002-7894-5114Esmeralda Guajardohttps://orcid.org/0000-0003-4790-1132Joseph McCormickhttps://orcid.org/0000-0002-5844-8102Isela de la Cerdahttps://orcid.org/0000-0003-3625-8954Maria E Fernandezhttps://orcid.org/0000-0002-7979-7379Belinda Reiningerhttps://orcid.org/0000-0003-4446-9735 BackgroundPrevious studies have shown that various social determinants of health (SDOH) may have contributed to the disparities in COVID-19 incidence and mortality among minorities and underserved populations at the county or zip code level. ObjectiveThis analysis was carried out at a granular spatial resolution of census tracts to explore the spatial patterns and contextual SDOH associated with COVID-19 incidence from a Hispanic population mostly consisting of a Mexican American population living in Cameron County, Texas on the border of the United States and Mexico. We performed age-stratified analysis to identify different contributing SDOH and quantify their effects by age groups. MethodsWe included all reported COVID-19–positive cases confirmed by reverse transcription–polymerase chain reaction testing between March 18 (first case reported) and December 16, 2020, in Cameron County, Texas. Confirmed COVID-19 cases were aggregated to weekly counts by census tracts. We adopted a Bayesian spatiotemporal negative binomial model to investigate the COVID-19 incidence rate in relation to census tract demographics and SDOH obtained from the American Community Survey. Moreover, we investigated the impact of local mitigation policy on COVID-19 by creating the binary variable “shelter-in-place.” The analysis was performed on all COVID-19–confirmed cases and age-stratified subgroups. ResultsOur analysis revealed that the relative incidence risk (RR) of COVID-19 was higher among census tracts with a higher percentage of single-parent households (RR=1.016, 95% posterior credible intervals [CIs] 1.005, 1.027) and a higher percentage of the population with limited English proficiency (RR=1.015, 95% CI 1.003, 1.028). Lower RR was associated with lower income (RR=0.972, 95% CI 0.953, 0.993) and the percentage of the population younger than 18 years (RR=0.976, 95% CI 0.959, 0.993). The most significant association was related to the “shelter-in-place” variable, where the incidence risk of COVID-19 was reduced by over 50%, comparing the time periods when the policy was present versus absent (RR=0.506, 95% CI 0.454, 0.563). Moreover, age-stratified analyses identified different significant contributing factors and a varying magnitude of the “shelter-in-place” effect. ConclusionsIn our study, SDOH including social environment and local emergency measures were identified in relation to COVID-19 incidence risk at the census tract level in a highly disadvantaged population with limited health care access and a high prevalence of chronic conditions. Results from our analysis provide key knowledge to design efficient testing strategies and assist local public health departments in COVID-19 control, mitigation, and implementation of vaccine strategies.https://publichealth.jmir.org/2021/8/e29205 |
| spellingShingle | Cici Bauer Kehe Zhang Miryoung Lee Susan Fisher-Hoch Esmeralda Guajardo Joseph McCormick Isela de la Cerda Maria E Fernandez Belinda Reininger Census Tract Patterns and Contextual Social Determinants of Health Associated With COVID-19 in a Hispanic Population From South Texas: A Spatiotemporal Perspective JMIR Public Health and Surveillance |
| title | Census Tract Patterns and Contextual Social Determinants of Health Associated With COVID-19 in a Hispanic Population From South Texas: A Spatiotemporal Perspective |
| title_full | Census Tract Patterns and Contextual Social Determinants of Health Associated With COVID-19 in a Hispanic Population From South Texas: A Spatiotemporal Perspective |
| title_fullStr | Census Tract Patterns and Contextual Social Determinants of Health Associated With COVID-19 in a Hispanic Population From South Texas: A Spatiotemporal Perspective |
| title_full_unstemmed | Census Tract Patterns and Contextual Social Determinants of Health Associated With COVID-19 in a Hispanic Population From South Texas: A Spatiotemporal Perspective |
| title_short | Census Tract Patterns and Contextual Social Determinants of Health Associated With COVID-19 in a Hispanic Population From South Texas: A Spatiotemporal Perspective |
| title_sort | census tract patterns and contextual social determinants of health associated with covid 19 in a hispanic population from south texas a spatiotemporal perspective |
| url | https://publichealth.jmir.org/2021/8/e29205 |
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