Role of Geographic Risk Factors and Social Determinants of Health in COVID-19 Epidemiology: Longitudinal Geospatial Analysis in a Midwest Rural Region

IntroductionThe SARS-CoV-2 (COVID-19) pandemic has exposed health disparities throughout the USA, particularly among racial and ethnic minorities. As a result, there is a need for data-driven approaches to pinpoint the unique constellation of clinical and social determinants of health (SDOH) risk factors that give rise to poor patient outcomes following infection in US communities.MethodsWe combined county-level COVID-19 testing data, COVID-19 vaccination rates and SDOH information in Tennessee. Between February and May 2021, we trained machine learning models on a semimonthly basis using these datasets to predict COVID-19 incidence in Tennessee counties. We then analyzed SDOH data features at each time point to rank the impact of each feature on model performance.ResultsOur results indicate that COVID-19 vaccination rates play a crucial role in determining future COVID-19 disease risk. Beginning in mid-March 2021, higher vaccination rates significantly correlated with lower COVID-19 case growth predictions. Further, as the relative importance of COVID-19 vaccination data features grew, demographic SDOH features such as age, race and ethnicity decreased while the impact of socioeconomic and environmental factors, including access to healthcare and transportation, increased.ConclusionIncorporating a data framework to track the evolving patterns of community-level SDOH risk factors could provide policy-makers with additional data resources to improve health equity and resilience to future public health emergencies.

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Aiming for Health Equity: The role of Public Health Policy and Primary Healthcare Comment on "Universal Health Coverage for Non-Communicable Diseases and Health Equity: Lessons From Australian Primary Healthcare"

International Journal of Health Policy and Management ◽

10.34172/ijhpm.2021.112 ◽

2021 ◽

Author(s):

Bo Burström

Keyword(s):

Public Health ◽

Social Determinants Of Health ◽

Healthcare System ◽

Health Equity ◽

Social Determinants ◽

Primary Healthcare ◽

Communicable Diseases ◽

Determinants Of Health ◽

Non Communicable Diseases

This commentary refers to the article by Fisher et al on lessons from Australian primary healthcare (PHC), which highlights the role of PHC to reduce non-communicable diseases (NCDs) and promote health equity. This commentary discusses important elements and features when aiming for health equity, including going beyond the healthcare system and focusing on the social determinants of health in public health policies, in PHC and in the healthcare system as a whole, to reduce NCDs. A wider biopsychosocial view on health is needed, recognizing the importance of social determinants of health, and inequalities in health. Public funding and universal access to care are important prerequisites, but regulation is needed to ensure equitable access in practice. An example of a PHC reform in Sweden indicates that introducing market solutions in a publicly funded PHC system may not benefit those with greater needs and may reduce the impact of PHC on population health.

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Commissioning and social determinants: evidence and opportunities

Local Authorities and the Social Determinants of Health ◽

10.1332/policypress/9781447356233.003.0015 ◽

2020 ◽

pp. 269-282

Author(s):

Chris O’Leary ◽

Chris Fox

Keyword(s):

Social Determinants Of Health ◽

Social Determinants ◽

Local Area ◽

Determinants Of Health ◽

Purchasing Power ◽

Local Authorities ◽

The Social ◽

The Uk ◽

Conceptual Confusion

This chapter argues that local authorities can and should use their purchasing power strategically to address the social determinants of health that affect their local area. It examines commissioning and procurement as local authority functions, defining these concepts and exploring the conceptual confusion between the two. The chapter then looks at the evidence of current practice of local authorities (with a particular focus on local authorities in the UK) in strategic use of their purchasing power. Core to the argument is the role of local voluntary organisations and small and medium-sized enterprises (SMEs), so there is a particular focus on the commissioning experience of these types of organisations. Finally, the chapter makes the case for the role that voluntary sector organisations can play in addressing social determinants of health, before drawing some broad conclusions about the way forward.

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