Kang Jung A, Quigley Denise D, Chastain Ashley M, Ma Hsin S, Shang Jingjing, Stone Patricia W
Columbia University School of Nursing, New York, NY, USA.
RAND Corporation, Santa Monica, CA, USA.
Med Care Res Rev. 2025 Apr;82(2):119-136. doi: 10.1177/10775587241298566. Epub 2024 Dec 10.
This systematic review investigates disparities in COVID-19 outcomes (infections, hospitalizations, and deaths) between urban and rural populations in the United States. Of the 3,091 articles screened, 55 were selected. Most studies ( = 43) conducted national analyses, using 2020 data, with some extending into 2021. Findings show urban areas had higher COVID-19 cases and hospitalizations in 2020, while rural areas saw increased cases in 2021 and mixed hospitalization results. Urban areas also had higher mortality rates in 2020, with rural rates rising in 2021 and 2022. Most studies did not explore reasons for urban/rural differences. The few that did found that vulnerable groups, including racially and ethnically minoritized populations, older adults, and those with comorbidities and lower socioeconomic status and vaccination rates, experienced exacerbated disparities in rural regions. COVID-19 outcomes varied over time and by area due to population density, healthcare infrastructure, and socioeconomic factors. Tailored interventions are essential for health equity and effective policies.
本系统评价调查了美国城乡人口在新冠病毒病（COVID-19）相关结果（感染、住院和死亡）方面的差异。在筛选的3091篇文章中，选取了55篇。大多数研究（n = 43）使用2020年数据进行全国性分析，部分研究延伸至2021年。研究结果显示，2020年城市地区的COVID-19病例和住院人数较多，而农村地区在2021年病例数增加，住院情况则有不同结果。2020年城市地区的死亡率也较高，农村地区的死亡率在2021年和2022年有所上升。大多数研究未探讨城乡差异的原因。少数研究发现，包括少数族裔、老年人、患有合并症以及社会经济地位和疫苗接种率较低的弱势群体，在农村地区的差异更为明显。由于人口密度、医疗基础设施和社会经济因素，COVID-19相关结果随时间和地区而有所不同。针对性干预对于实现健康公平和制定有效政策至关重要。
