Racial, Ethnic, and Geographic Disparities in Novel Coronavirus (Severe Acute Respiratory Syndrome Coronavirus 2) Test Positivity in North Carolina.
Journal Article (Journal Article)
BACKGROUND: Emerging evidence suggests that black and Hispanic communities in the United States are disproportionately affected by coronavirus disease 2019 (COVID-19). A complex interplay of socioeconomic and healthcare disparities likely contribute to disproportionate COVID-19 risk. METHODS: We conducted a geospatial analysis to determine whether individual- and neighborhood-level attributes predict local odds of testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We analyzed 29 138 SARS-CoV-2 tests within the 6-county catchment area for Duke University Health System from March to June 2020. We used generalized additive models to analyze the spatial distribution of SARS-CoV-2 positivity. Adjusted models included individual-level age, gender, and race, as well as neighborhood-level Area Deprivation Index, population density, demographic composition, and household size. RESULTS: Our dataset included 27 099 negative and 2039 positive unique SARS-CoV-2 tests. The odds of a positive SARS-CoV-2 test were higher for males (odds ratio [OR], 1.43; 95% credible interval [CI], 1.30-1.58), blacks (OR, 1.47; 95% CI, 1.27-1.70), and Hispanics (OR, 4.25; 955 CI, 3.55-5.12). Among neighborhood-level predictors, percentage of black population (OR, 1.14; 95% CI, 1.05-1.25), and percentage Hispanic population (OR, 1.23; 95% CI, 1.07-1.41) also influenced the odds of a positive SARS-CoV-2 test. Population density, average household size, and Area Deprivation Index were not associated with SARS-CoV-2 test results after adjusting for race. CONCLUSIONS: The odds of testing positive for SARS-CoV-2 were higher for both black and Hispanic individuals, as well as within neighborhoods with a higher proportion of black or Hispanic residents-confirming that black and Hispanic communities are disproportionately affected by SARS-CoV-2.
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Duke Authors
- Lantos, Paul Michael
- Martinez-Bianchi, Viviana Sandra
- Pan, William Kuang-Yao
- Turner, Nicholas
- Woods, Christopher Wildrick
Cited Authors
- Turner, NA; Pan, W; Martinez-Bianchi, VS; Panayotti, GMM; Planey, AM; Woods, CW; Lantos, PM
Published Date
- January 2021
Published In
Volume / Issue
- 8 / 1
Start / End Page
- ofaa413 -
PubMed ID
- 33575416
Pubmed Central ID
- PMC7499753
International Standard Serial Number (ISSN)
- 2328-8957
Digital Object Identifier (DOI)
- 10.1093/ofid/ofaa413
Language
- eng
Conference Location
- United States