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Racial, Ethnic, and Geographic Disparities in Novel Coronavirus (Severe Acute Respiratory Syndrome Coronavirus 2) Test Positivity in North Carolina.
Abstract
<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.
Type
Journal articlePermalink
https://hdl.handle.net/10161/22415Published Version (Please cite this version)
10.1093/ofid/ofaa413Publication Info
Turner, Nicholas A; Pan, William; Martinez-Bianchi, Viviana S; Panayotti, Gabriela
M Maradiaga; Planey, Arrianna M; Woods, Christopher W; & Lantos, Paul M (2021). Racial, Ethnic, and Geographic Disparities in Novel Coronavirus (Severe Acute Respiratory
Syndrome Coronavirus 2) Test Positivity in North Carolina. Open forum infectious diseases, 8(1). pp. ofaa413. 10.1093/ofid/ofaa413. Retrieved from https://hdl.handle.net/10161/22415.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Paul Michael Lantos
Professor of Medicine
I am interested in the spatial epidemiology of infectious diseases. My research utilizes
geographic information systems (GIS) and geostatistical analyses to understand the
spatial and spatiotemporal distribution of diseases, and their relationship with environmental
and demographic factors. I currently have active studies evaluating the spatial distribution
of numerous domestic and international infectious diseases, including SARS-CoV-2 (COVID-19),
cytomegalovirus, influenza, and Lyme disease. A
Viviana Sandra Martinez-Bianchi
Associate Professor in Family Medicine and Community Health
Health Disparities, Access to Health Care, Women's Health, Latino Health Care, Chronic
Disease Management, Socioeconomic Determinants of Health. Population Health.
William Kuang-Yao Pan
Elizabeth Brooks Reid and Whitelaw Reid Associate Professor
William Pan, PhD, Assistant Professor of Global Environmental Health, joined the faculty
at Duke in 2011. He holds a joint appointment at DGHI and the Nicholas School of Environment,
and is Adjunct Assistant Professor in the Department of International Health at Johns
Hopkins Bloomberg School of Public Health. Pan’s research interests focuses on Population,
Health, and Environmental interactions in developing countries, with particular interest
in translational research directed toward sus
Nicholas Turner
Assistant Professor of Medicine
Christopher Wildrick Woods
Wolfgang Joklik Distinguished Professor of Global Health
1. Emerging Infections 2. Global Health 3. Epidemiology of infectious diseases
4. Clinical microbiology and diagnostics 5. Bioterrorism Preparedness 6. Surveillance
for communicable diseases 7. Antimicrobial resistance
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