Cuadros Diego F, Branscum Adam J, Mukandavire Zindoga, Miller F DeWolfe, MacKinnon Neil
Department of Geography and Geographic Information Science, University of Cincinnati, Cincinnati, OH; Health Geography and Disease Modeling Laboratory, University of Cincinnati, Cincinnati, OH; Geospatial Health Advising Group, University of Cincinnati, Cincinnati, OH.
Department of Biostatistics, College of Public Health and Human Sciences, Oregon State University, Corvallis, OH.
Ann Epidemiol. 2021 Jul;59:16-20. doi: 10.1016/j.annepidem.2021.04.007. Epub 2021 Apr 22.
There is a growing concern about the COVID-19 epidemic intensifying in rural areas in the United States (U.S.). In this study, we described the dynamics of COVID-19 cases and deaths in rural and urban counties in the U.S.
Using data from April 1 to November 12, 2020, from Johns Hopkins University, we estimated COVID-19 incidence and mortality rates and conducted comparisons between urban and rural areas in three time periods at the national level, and in states with higher and lower COVID-19 incidence rates.
Results at the national level showed greater COVID-19 incidence rates in urban compared to rural counties in the Northeast and Mid-Atlantic regions of the U.S. at the beginning of the epidemic. However, the intensity of the epidemic has shifted to a rapid surge in rural areas. In particular, high incidence states located in the Mid-west of the country had more than 3,400 COVID-19 cases per 100,000 people compared to 1,284 cases per 100,000 people in urban counties nationwide during the third period (August 30 to November 12).
Overall, the current epicenter of the epidemic is located in states with higher infection rates and mortality in rural areas. Infection prevention and control efforts including healthcare capacity should be scaled up in these vulnerable rural areas.
美国农村地区的新冠疫情加剧，引发了越来越多的关注。在本研究中，我们描述了美国农村和城市县新冠病例及死亡情况的动态变化。
利用约翰·霍普金斯大学2020年4月1日至11月12日的数据，我们估算了新冠发病率和死亡率，并在国家层面以及新冠发病率较高和较低的州，对三个时间段内的城乡地区进行了比较。
国家层面的结果显示，疫情初期，美国东北部和大西洋中部地区城市县的新冠发病率高于农村县。然而，疫情强度已转向农村地区迅速激增。特别是，该国中西部的高发病率州每10万人中有超过3400例新冠病例，而在第三阶段（8月30日至11月12日），全国城市县每10万人中有1284例病例。
总体而言，当前疫情的中心位于农村地区感染率和死亡率较高的州。应在这些脆弱的农村地区加强包括医疗能力在内的感染预防和控制措施。
