COVID deaths vary by race, community, social factors

Social determinants of health (SDOH) tied to COVID-19 death rates varied by race and community type in the first year of the pandemic, suggests an observational spatial analysis involving 3,142 counties in all 50 US states and Washington, DC.The study was published late last week in JAMA Network Open.SDOH are nonmedical factors, such as where people live and work, that influence health outcomes such as COVID-19 infection and death."Racial disparities in health largely emanate from the inequitable access to social, economic, and physical or built environmental conditions resulting from racism in the US," the researchers wrote. "Specifically, racism interacts with and exists within societal structures and systems to shape the major SDOH."Limited Internet access tied to more deathsUniversity of Chicago researchers analyzed Centers for Disease Control and Prevention (CDC) COVID-19 data from Jan 22, 2020, to Feb 28, 2021, identifying counties with high proportions of residents of a single race (Black, Hispanic, or White) and high coronavirus-related death rates as "concentrated longitudinal-impact counties."Among 3,142 total counties, 531 were classified as concentrated longitudinal-impact counties, with 11.0% having a large Black population relative to other counties, 6.3% having a large Hispanic population, and 1.1% having a large share of White residents.Overall, 489,254 people in the included counties died.

All concentrated longitudinal-impact counties had significantly higher COVID-19 death rates than other counties. Median deaths per 100,000 residents were 231.4 in such counties with a large Black population, 218.8 in such counties with a large proportion of Hispanic residents, and 251.8 in such counties with a large