From the Morehouse School of Medicine, Atlanta, Georgia.
Case Western Reserve Medical School, Cleveland, Ohio.
South Med J. 2024 Nov;117(11):640-645. doi: 10.14423/SMJ.0000000000001757.
The coronavirus disease 2019 (COVID-19) pandemic has disproportionately affected Black and Latinx communities. Ecologic analyses have shown that counties with a higher percentage of Latinx and Black people have worse COVID-19 outcome rates. Few ecologic analyses have been published at the neighborhood (census tract) level. We sought to determine whether certain sociodemographic neighborhood ecologies were associated with COVID-19 case and death rates in metropolitan Atlanta, Georgia.
We used census data and principal-component analysis to identify unique neighborhood ecologies. We then estimated correlation coefficients to determine whether the neighborhood profiles produced by a principal-component analysis were correlated with COVID-19 case and death rates. We conducted geographically weighted regression models to assess how correlation coefficients varied spatially for neighborhood ecologies and COVID-19 outcomes.
We identified two unique neighborhood profiles: (1) high percentage of residents, Hispanic ethnicity, without a high school diploma, without health insurance, living in crowded households, and lower percentage older than 65 years; and (2) high percentage of residents, Black race, living in poverty, unemployed, and households receiving Supplemental Nutrition Assistance Program benefits. Profile 1 was associated with COVID-19 case rate (Pearson = 0.462, < 0.001) and profile 2 was associated with COVID-19 death rate (Spearman = 0.279, < 0.001). Correlations between neighborhood profiles and COVID-19 outcomes varied spatially.
Neighborhoods were differentially at risk of COVID-19 cases or deaths depending on their sociodemographic ecology at the beginning of the COVID-19 pandemic. Prevention methods and interventions may need to consider different social determinants of health when addressing potential cases and deaths during future emergent epidemics.
2019 年冠状病毒病（COVID-19）大流行对黑人和拉丁裔社区的影响不成比例。生态分析表明，拉丁裔和黑人比例较高的县 COVID-19 预后率较差。发表的关于邻里（普查区）层面的生态分析很少。我们试图确定在佐治亚州亚特兰大都会区，某些社会人口统计学邻里生态是否与 COVID-19 病例和死亡率相关。
我们使用人口普查数据和主成分分析来确定独特的邻里生态。然后，我们估计相关系数，以确定主成分分析产生的邻里概况是否与 COVID-19 病例和死亡率相关。我们进行了地理加权回归模型，以评估邻里生态和 COVID-19 结果的相关系数在空间上的变化。
我们确定了两个独特的邻里概况：（1）居民比例高，西班牙裔，没有高中文凭，没有医疗保险，居住在拥挤的家庭中，65 岁以上的比例较低；（2）居民比例高，黑人，生活贫困，失业，家庭接受补充营养援助计划（SNAP）福利。概况 1 与 COVID-19 病例率相关（Pearson = 0.462，<0.001），概况 2 与 COVID-19 死亡率相关（Spearman = 0.279，<0.001）。邻里概况与 COVID-19 结果之间的相关性在空间上有所不同。
在 COVID-19 大流行开始时，邻里的社会人口统计学生态不同，其 COVID-19 病例或死亡的风险也不同。在应对未来突发传染病的潜在病例和死亡时，预防方法和干预措施可能需要考虑不同的健康决定因素。
