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US communities with limited access to the Internet had higher death rates from the coronavirus during the first full year of the pandemic, researchers said.
In a study published earlier this month in the journal JAMA Network Open, the University of Chicago authors wrote that for places with limited access between 2.4 and 6 deaths per 100,000 people, they could be prevented, depending on whether they were rural, suburban or urban.
“Adopting an asset-based approach, we believe this finding indicates that there is a need for greater awareness of the fundamental assets of technological access to reliable information, remote work, education opportunities, resource procurement and/or social community. Populations with access still remain The limited internet is understudied and they are often left out of pandemic research.”
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By analyzing Centers for Disease Control and Prevention (CDC) mortality data for all US counties in 50 states and the District of Columbia reported from January 22, 2020 to February 28, 2021, the group identified the counties with a high concentration of a single ingredient. and ethnic populations and a high level of COVID-19 deaths as “concentrated provinces with longitudinal impact”.
Other racial and ethnic demographic data were obtained from publicly available data sets.
Social determinants of health (SDOH) that can correlate with mortality across counties have been examined, with researchers focusing on black, Latino, and non-white Americans in rural, suburban, or urban settings.
Four indicators were used to measure multiple dimensions of SDOH: the index of socioeconomic advantage, the index of limited mobility, the index of urban basic opportunity, and the index of cohesion and mixed access for immigrants.
Using modeling to examine associations between SDOH and COVID-19 mortality at the county level, they found that 531 of the 3,142 counties were identified as having longitudinal centered effect counties.
Of those counties 347 had large black Americans, 198 had large Hispanic populations and 33 had large non-Hispanic white residents.
In addition, nearly 490,000 deaths related to COVID-19 have been reported.
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“Most of the longitudinal impact counties concentrated with a large black or African American population than other counties were spread across urban, suburban, and rural areas and experienced many disadvantages, including higher income inequality and a more preventable hospital stay. Most Counties with a concentrated longitudinal effect with more Hispanic or Latino populations than other counties in urban areas, 130 of these counties had a higher proportion of people who lacked health insurance. and has limited access to quality health care.”
In urban areas, the index of cohesion and mixed access for immigrants was inversely associated with COVID-19 mortality and higher COVID-19 mortality rates were associated with preventable hospital stays in rural areas and higher socioeconomic vulnerability in suburban areas.
For most longitudinal impact counties concentrated with a large black or Hispanic population than for other counties, rates of severe housing problems were higher than the national average and most longitudinal impact counties with large concentrations of non-Hispanic black and white had higher proportions of Families that do not have access to the Internet.
They said the study findings underscore how places and people intersect within the multifaceted power structures that produce and reproduce inequalities in health outcomes.
“Dimensions of SDOH are clearly important to health outcomes, but the results of this study add nuance to this assumption by demonstrating that SDOH potentially shapes health in unique ways, depending on a community’s rural and urban contexts as well as its racial and ethnic makeup,” the authors wrote. “We found that non-Hispanic white populations in rural areas and Hispanic or Hispanic residents in urban areas were particularly vulnerable to COVID-19 mortality, while black or African American populations across rural and urban contexts performed poorly (in terms of mortality). ) during the first year of the epidemic. For urban, rural, and suburban communities, some dimensions of SDOH appeared more significant to COVID-19 mortality rates, suggesting that social levers may play the largest role in moving the needle on population health in different types of communities.”
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Limitations of their study include that analyzes of other racial and ethnic groups were excluded, that the cross-sectional study used an exploratory spatio-data analysis approach, that the scale at the county level may not capture the full picture of the affected population, and that there is the potential confounding factor for vaccines that will be available at the end of 2020. and that it primarily analyzed the SDOH barriers associated with exposure to COVID-19 mortality.
To address health disparities and guide policies and programs, they called for further study.