scholarly journals Association between county-level risk groups and COVID-19 outcomes in the United States: a socioecological study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Sadiya S. Khan ◽  
Amy E. Krefman ◽  
Megan E. McCabe ◽  
Lucia C. Petito ◽  
Xiaoyun Yang ◽  
...  
Keyword(s):  
United States ◽  
Rural Areas ◽  
Urban Areas ◽  
Latent Class ◽  
Communicable Disease ◽  
Local Level ◽  
Healthcare Access ◽  
The United States ◽  
County Level ◽  
Health Factors

Abstract Background Geographic heterogeneity in COVID-19 outcomes in the United States is well-documented and has been linked with factors at the county level, including sociodemographic and health factors. Whether an integrated measure of place-based risk can classify counties at high risk for COVID-19 outcomes is not known. Methods We conducted an ecological nationwide analysis of 2,701 US counties from 1/21/20 to 2/17/21. County-level characteristics across multiple domains, including demographic, socioeconomic, healthcare access, physical environment, and health factor prevalence were harmonized and linked from a variety of sources. We performed latent class analysis to identify distinct groups of counties based on multiple sociodemographic, health, and environmental domains and examined the association with COVID-19 cases and deaths per 100,000 population. Results Analysis of 25.9 million COVID-19 cases and 481,238 COVID-19 deaths revealed large between-county differences with widespread geographic dispersion, with the gap in cumulative cases and death rates between counties in the 90th and 10th percentile of 6,581 and 291 per 100,000, respectively. Counties from rural areas tended to cluster together compared with urban areas and were further stratified by social determinants of health factors that reflected high and low social vulnerability. Highest rates of cumulative COVID-19 cases (9,557 [2,520]) and deaths (210 [97]) per 100,000 occurred in the cluster comprised of rural disadvantaged counties. Conclusions County-level COVID-19 cases and deaths had substantial disparities with heterogeneous geographic spread across the US. The approach to county-level risk characterization used in this study has the potential to provide novel insights into communicable disease patterns and disparities at the local level.

scholarly journals Stroke Incidence and Case Fatality According to Rural or Urban Residence

Stroke ◽  
2019 ◽  
Vol 50 (10) ◽  
pp. 2661-2667 ◽  
Author(s):  
Olivier Grimaud ◽  
Yacine Lachkhem ◽  
Fei Gao ◽  
Cindy Padilla ◽  
Mélanie Bertin ◽  
...  
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Healthcare Access ◽  
Case Fatality ◽  
The United States ◽  
Stroke Severity ◽  
Day Case ◽  
Stroke Incidence ◽  
Stroke Registry ◽  
Stroke Type

Background and Purpose— Recent findings suggest that in the United States, stroke incidence is higher in rural than in urban areas. Similar analyses in other high-income countries are scarce with conflicting results. In 2008, the Brest Stroke Registry was started in western France, an area that includes about 366 000 individuals living in various urban and rural settings. Methods— All new patients with stroke included in the Brest Stroke Registry from 2008 to 2013 were classified as residing in town centers, suburbs, isolated towns, or rural areas. Poisson regression was used to analyze stroke incidence and 30-day case fatality variations in the 4 different residence categories. Models with case fatality as outcome were adjusted for age, stroke type, and stroke severity. Results— In total, 3854 incident stroke cases (n=2039 women, 53%) were identified during the study period. Demographic and socio-economic characteristics and primary healthcare access indicators were significantly different among the 4 residence categories. Patterns of risk factors, stroke type, and severity were comparable among residence categories in both sexes. Age-standardized stroke rates varied from 2.90 per thousand (95% CI, 2.59–3.21) in suburbs to 3.35 (95% CI, 2.98–3.73) in rural areas for men, and from 2.14 (95% CI, 2.00–2.28) in town centers to 2.34 (95% CI, 2.12–2.57) in suburbs for women. Regression models suggested that among men, stroke incidence was significantly lower in suburbs than in town centers (incidence rate ratio =0.87; 95% CI, 0.77–0.99). Case fatality risk was comparable across urban categories but lower in rural patients (relative risk versus town centers: 0.76; 95% CI, 0.60–0.96). Conclusions— Stroke incidence was comparable, and the 30-day case fatality only slightly varied in the 4 residence categories despite widely different socio-demographic features covered by the Brest Stroke Registry.

scholarly journals Identification of county-level health factors associated with COVID-19 mortality in the United States

2020 ◽  
Vol 34 (6) ◽  
pp. 437 ◽  
Author(s):  
Wei Pan ◽  
Yasuo Miyazaki ◽  
Hideyo Tsumura ◽  
Emi Miyazaki ◽  
Wei Yang
Keyword(s):  
United States ◽  
The United States ◽  
County Level ◽  
Factors Associated ◽  
Health Factors

scholarly journals Spatial Clustering of County-Level COVID-19 Rates in the U.S

2021 ◽  
Vol 18 (22) ◽  
pp. 12170
Author(s):  
Marcus R. Andrews ◽  
Kosuke Tamura ◽  
Janae N. Best ◽  
Joniqua N. Ceasar ◽  
Kaylin G. Battey ◽  
...  
Keyword(s):  
United States ◽  
Health Disparities ◽  
Rural Areas ◽  
Metropolitan Areas ◽  
Spatial Clustering ◽  
The United States ◽  
County Level ◽  
Communities Of Color ◽  
States Data ◽  
The U.S

Despite the widespread prevalence of cases associated with the coronavirus disease 2019 (COVID-19) pandemic, little is known about the spatial clustering of COVID-19 in the United States. Data on COVID-19 cases were used to identify U.S. counties that have both high and low COVID-19 incident proportions and clusters. Our results suggest that there are a variety of sociodemographic variables that are associated with the severity of COVID-19 county-level incident proportions. As the pandemic evolved, communities of color were disproportionately impacted. Subsequently, it shifted from communities of color and metropolitan areas to rural areas in the U.S. Our final period showed limited differences in county characteristics, suggesting that COVID-19 infections were more widespread. The findings might address the systemic barriers and health disparities that may result in high incident proportions of COVID-19 clusters.

Bicyclist Crash Types on National, State, and Local Levels: A New Look

2019 ◽  
Vol 2673 (6) ◽  
pp. 664-676 ◽  
Author(s):  
Libby Thomas ◽  
Krista Nordback ◽  
Rebecca Sanders
Keyword(s):  
United States ◽  
Rural Areas ◽  
Urban Areas ◽  
The United States ◽  
Fatal Crash ◽  
Serious Injury ◽  
State And Local ◽  
Crash Types ◽  
Serious Injuries ◽  
The City

This paper presents an overview of prevalent bicyclist crash types in the United States, providing insights for practitioners that may be useful in planning safer networks and taking other proactive and risk-based approaches to treatment. The study compares fatal bicyclist crash types from national data with serious injury and all-severity bicyclist collisions from the state of North Carolina (NC) and the city of Boulder, Colorado. Overall, bicyclist fatalities in the United States are more prevalent in urban areas (69%) than rural areas (29%). Though the majority of all-severity crashes are at intersections, most fatal and disabling injury bicyclist crashes occur at non-intersection locations, including nearly one-third of bicyclists who die from collisions involving overtaking motorists. Top intersection crash types across national fatal and all-severity crashes in NC and Boulder include bicyclists failing to yield and motorists turning across a bicyclist’s path. However, many of the top all-severity types in the two jurisdictions differ from the top fatal crash types nationwide. These comparisons provide a fresh look at bicyclist crash type trends and have potential importance with respect to planning safer networks for Vision Zero communities, since a key finding is that locations and crash types most prevalent among fatal and serious injuries may differ from the most prevalent types for all-severity crashes. The findings could be useful to agencies lacking their own resources for risk-based assessment, but also suggest it is important to analyze higher severity crash types and jurisdiction-specific data when possible.

scholarly journals A County-Level Susceptibility Index and Coronavirus Disease 2019 Mortality in the United States: A Socioecological Study

2020 ◽  
Author(s):  
Sadiya S. Khan ◽  
Megan E. McCabe ◽  
Amy E. Krefman ◽  
Lucia C. Petito ◽  
Xiaoyun Yang ◽  
...  
Keyword(s):  
United States ◽  
Latent Class ◽  
The United States ◽  
County Level ◽  
Linear Regression Models ◽  
Susceptibility Index ◽  
First Case ◽  
Per Capita ◽  
Multiple Domains ◽  
Increased Susceptibility

ABSTRACTAs of June 2020, the United States (US) has experienced the highest number of deaths related to coronavirus disease 2019 (Covid-19) in the world, but significant geographic heterogeneity exists at the county-level. Therefore, we sought to classify counties in the United States across multiple domains utilizing a socioecological framework and examine the association between these county-level groups and Covid-19 mortality. We harmonized and linked county-level sociodemographic, health, and environmental metrics associated with increased susceptibility for Covid-19 mortality. Latent class analysis defined a county-level susceptibility index (CSI) based on these metrics (n=2701 counties). Next, we used linear regression models to estimate the associations of the CSI and Covid-19 deaths per capita and initial mortality doubling time (as of 6/2/20), adjusted for days since first Covid-19 case. We identified 4 groups classified by the CSI with distinct sociodemographic, health, and environmental profiles and widespread geographic dispersion. Covid-19 deaths per capita were significantly higher in the group consisting of rural, vulnerable counties (55.8 [95% CI 50.3-61.2] deaths per 100,000) compared with the group with diverse, urban counties (32.2 [27.3-37.0]) at similar points in the outbreak (76 days since first case). Our findings can inform equitable resource allocation for Covid-19 to allow targeted public health preparedness and response in vulnerable counties.

scholarly journals Demographic and Disease Characteristics of People With Multiple Sclerosis Living in Urban and Rural Areas

2006 ◽  
Vol 8 (3) ◽  
pp. 89-97 ◽  
Author(s):  
Robert J. Buchanan ◽  
Randolph Schiffer ◽  
Alexa Stuifbergen ◽  
Li Zhu ◽  
Suojin Wang ◽  
...  
Keyword(s):  
United States ◽  
Multiple Sclerosis ◽  
Rural Areas ◽  
Urban Areas ◽  
The United States ◽  
Primary Progressive ◽  
Disease Characteristics ◽  
Urban Rural ◽  
Disease Modifying ◽  
Urban And Rural Areas

This study compares demographic and disease-related characteristics of people with multiple sclerosis (MS) living in urban and rural areas. The data analyzed for this study were collected from a survey of 1518 people with MS living throughout the United States from October 2004 through January 2005. We found significant urban-rural differences in various MS characteristics, including type of MS. A significantly larger proportion of people with MS in remote rural areas than their urban counterparts responded that they had primary progressive MS. People with MS in rural areas were significantly more likely than those in urban areas to report that MS symptoms interfered with their independence. A significantly larger proportion of people with MS in remote rural areas than in urban areas were not receiving disease-modifying medications. Our results suggest that MS disease expression varies across urban-rural gradients. Although the findings are not definitive, we hope that other investigative groups will build on these results and work toward confirming and understanding them.

scholarly journals Sexuality and the city: The geography of LGBT participation in the United States

2021 ◽  
Author(s):  
Jack Thompson ◽  
Stuart James Turnbull-Dugarte
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Local Level ◽  
The United States ◽  
Lower Percentage ◽  
Critical Gap ◽  
Level Data ◽  
Urban Rural ◽  
Using Data ◽  
Lgbt Individuals

The literature on LGBT participation is growing, but there is still little empirical analysis on the importance of urbanicity in shaping Queer activism. In this paper, we address this critical gap by examining how patterns of participation among LGBT Americans vary by geographic context. Using data from the 2020 Cooperative Election Study (CES) to explore how patterns of LGBT participation differ across the urban-rural interface, we find that individuals identifying as LGBT living in urban areas exhibit higher rates of participation than those living in rural areas, and that these results hold across multiple urban-rural classification schemes. Estimating a multilevel model that leverages local-level data on the density of the LGBT population, we also provide strong empirical validation of the theoretical effects of intragroup contact and mobilization on LGBT participation in large metro areas. When we limit our sample to respondents living in the 55 largest metro areas in the US but vary the metro-level percentage of LGBT individuals, we find that LGBT individuals living in metro areas with a higher percentage of LGBT individuals exhibit higher rates of participation relative to metro areas with a lower percentage of LGBT individuals. The results indicate that urban contexts foster Queer participation by engendering intragroup contact and mobilization among LGBT populations.

HOSPITAL SERVICES FOR CHILDREN

PEDIATRICS ◽  
1953 ◽  
Vol 12 (3S) ◽  
pp. 7-12
Keyword(s):  
United States ◽  
Rural Areas ◽  
Urban Areas ◽  
Hospital Care ◽  
The United States ◽  
Child Health Services ◽  
Age Group ◽  
Hospital Services ◽  
Pediatric Study ◽  
General Field

THE practice of pediatrics, in its broadest aspects, parallels and is influenced by developments in the general field of medicine. At the same time, it possesses special characteristics largely dictated by the nature of the age group which it serves. Hospital care for children is influenced in the same way both by developments in the general field of hospital care and by the special needs of the pediatric age group. Immediately preceding the collection of data for the pediatric study, the entire hospital field was surveyed by the Commission on Hospital Care. The results were published by the Commonwealth Fund in Hospital Services in the United Stales. These data, plus those derived from the American Academy of Pediatric's study of child health services, provide a rich background of information as to the amount and distribution of hospital facilities for children. In the latter study, attention was also given to quality of care. Areas of Need Amount and Distribution of Hospital Facilities for Children Hospital services for children show the same trends which the Study brought out in other fields—that facilities are more readily available in urban areas and poorest in the rural areas; that there are more in northeastern United States and less in the Southeast; that there are more and better facilities in the wealthy areas and fewer and poorer in the areas with a lower per capita income. A number of communities have improved their hospital facilities independently, using the information in Hospital Services in the United States as a guide in solving their problems.

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