Porter Grace, Desai Koosh, George Varghese, Coughlin Steven S, Moore Justin Xavier
Institute of Preventive and Public Health, Medical College of Georgia, Augusta University, Augusta, Georgia, USA.
Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA.
Health Equity. 2021 Mar 2;5(1):91-99. doi: 10.1089/heq.2020.0089. eCollection 2021.
To examine county-level factors associated with coronavirus disease 2019 (COVID-19) incidence and mortality in Georgia, focusing on changes after relaxation of "shelter-in-place" orders on April 24, 2020. County-level data on confirmed COVID-19 cases and deaths were obtained from the Johns Hopkins 2019 Novel Coronavirus Data Repository and linked with county-level data from the 2020 County Health Rankings. We examined associations of county-level factors with mortality and incidence rates (quantiles) using a logistic regression model. This research was conducted in June-July 2020 in Augusta, GA. Counties in the highest quartile for mortality had higher proportions of non-Hispanic (NH)-Black residents (median: 37.4%; interquartile range [IQR]: 29.5-45.0; <0.01) and residents with incomes less than $20,000 (median: 32.9%; IQR: 26.6-35.0; <0.01). Counties in the highest quartile for NH-Black residents (38.7-78.0% NH-Black population) showed a 13-fold increase in odds (odds ratio=13.15, 95% confidence interval=1.40-123.80, =0.05) for increased COVID-19 mortality controlling for income. Although highlighted by the pandemic, racial disparities predated COVID-19, exposing the urgency for diversion of resources to address the systematic residential segregation, educational gaps, and poverty levels experienced disproportionately by Black communities.
为研究佐治亚州与2019冠状病毒病（COVID-19）发病率和死亡率相关的县级因素，重点关注2020年4月24日“就地避难”令放宽后的变化。从约翰·霍普金斯2019新型冠状病毒数据存储库获取了县级COVID-19确诊病例和死亡数据，并将其与2020年县健康排名中的县级数据相关联。我们使用逻辑回归模型研究了县级因素与死亡率和发病率（分位数）之间的关联。这项研究于2020年6月至7月在佐治亚州奥古斯塔进行。死亡率处于最高四分位数的县，非西班牙裔（NH）黑人居民比例更高（中位数：37.4%；四分位间距[IQR]：29.5 - 45.0；<0.01），收入低于20,000美元的居民比例也更高（中位数：32.9%；IQR：26.6 - 35.0；<0.01）。NH黑人居民比例处于最高四分位数的县（NH黑人人口占38.7 - 78.0%），在控制收入后，COVID-19死亡率增加的几率增加了13倍（优势比 = 13.15，95%置信区间 = 1.40 - 123.80，P = 0.05）。尽管大流行凸显了这一问题，但种族差异在COVID-19之前就已存在，这凸显了将资源用于解决黑人社区不成比例面临的系统性居住隔离、教育差距和贫困水平问题的紧迫性。
