Department of Health, Society, & Behavior, Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine.
Department of Criminology, Law and Society in the School of Social Ecology, and Department of Sociology, University of California, Irvine.
Am J Infect Control. 2024 Jan;52(1):3-14. doi: 10.1016/j.ajic.2023.07.008. Epub 2023 Aug 9.
This study investigated whether socio-spatial factors surrounding United States skilled nursing facilities related to Covid-19 case counts among residents, staff, and facility personnel and deaths among residents.
With data on 12,403 United States skilled nursing facilities and Census data we estimated multilevel models to assess relationships between facility and surrounding area characteristics from June 2020 to September 2022 for cumulative resident and facility personnel case counts and resident deaths.
Facilities with more Black or Latino residents experienced more cases incident rate ratios (IRR = 1.005; 1.004) and deaths (IRR = 1.008) among residents during the first 6 months of the pandemic but were no different thereafter. Facilities with more racial and ethnic heterogeneity and percent Black or Latino in the surrounding buffer experienced more Covid-19 cases and deaths in the first 6 months, but no such differences were observed in the subsequent 24 months. Facilities surrounded by higher percent Latino consistently experienced more cases among staff and facility personnel over the study period (IRR = 1.006; 1.001).
Findings indicated socio-spatial health disparities in cases among residents, staff, and facility personnel in the first 6 months of the pandemic, with some disparities fading thereafter. This pattern likely suggests the importance of the adoption and adherence to pandemic-related safety measures in skilled nursing facilities nationwide.
本研究调查了美国熟练护理设施周围的社会空间因素与居民、工作人员和设施人员的新冠病例数以及居民死亡之间是否存在关联。
利用 2020 年 6 月至 2022 年 9 月期间有关 12403 家美国熟练护理设施和人口普查数据，我们使用多水平模型评估了设施和周围地区特征之间的关系，以评估居民和设施人员累计病例数和居民死亡数。
在疫情的前 6 个月，拥有更多黑人和拉丁裔居民的设施中居民的病例发生率比（IRR=1.005；1.004）和死亡（IRR=1.008）更高，但此后无差异。种族和民族异质性更大、周围缓冲区的黑人和拉丁裔比例更高的设施在头 6 个月经历了更多的新冠病例和死亡，但在随后的 24 个月内没有观察到这种差异。设施周围的拉丁裔比例较高，工作人员和设施人员的病例数在研究期间一直较高（IRR=1.006；1.001）。
研究结果表明，在疫情的前 6 个月，居民、工作人员和设施人员的病例存在社会空间健康差异，此后一些差异逐渐消失。这种模式可能表明，在全国范围内，熟练护理设施中采用和遵守与大流行相关的安全措施非常重要。
