Abstract
Background
Personal health behaviours, which rely on community characteristics, could affect individual vulnerability on disease infection. Due to insufficient study to examine health behaviours as risk factors of COVID-19 infection, we conducted municipal level spatial analysis to investigate association between health behaviours and COVID-19 incidence.
Methods
We extracted cumulative COVID-19 incidence data from January 20th 2020 to February 25th 2021, health behaviours, health condition, socio-economic factors, and covariates in municipal level from publicly available dataset. We chose variables, which were standardized, considering multicollinearity (VIF<10). Further, we employed bayesian hierarchical negative binomial model with intrinsic conditional autoregressive (iCAR) and Besag, York and Mollié (BYM) model, and used deviance information criterion (DIC) for final model selection.
Results
The mean cumulative COVID-19 incidence per 10,000 population among 229 municipality was 13.73 (Standard deviation=11.43). iCAR model (DIC=2,825.3) outperformed BYM model (DIC=14,009.4). The results of iCAR model highlighted that incidence was associated with dental hygiene practice (incidence risk ratios [IRR]=0.92, 95% Credible Interval [CI]=0.85–1.00), whether tried to be thin (IRR=1.10, 95% CI = 1.00–1.20), proportion of medical personnel (IRR=1.09, 95% CI = 1.01–1.17), and volume of public transportation (IRR=1.19, 95% CI = 1.05–1.35), even after adjusting for various confounding factors.
Conclusions
Municipality with lower cumulative incidence was likely to have more people who practiced to keep dental hygiene and less people who tried to be thin.
Key messages
Municipal level spatial analysis resulted that health behaviours were associated with COVID-19 incidence in South Korea.
Spatial analysis of the regional variation of hypertensive disease mortality and its socio-economic correlates in South Korea
