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Racial, Ethnic, and Geographic Disparities in Novel Coronavirus (Severe Acute Respiratory Syndrome Coronavirus 2) Test Positivity in North Carolina.

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Date
2021-01
Authors
Turner, Nicholas A
Pan, William
Martinez-Bianchi, Viviana S
Panayotti, Gabriela M Maradiaga
Planey, Arrianna M
Woods, Christopher W
Lantos, Paul M
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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 article
Subject
Bayesian statistics
COVID-19
SARS-CoV-2
disparities
geographic information systems
Permalink
https://hdl.handle.net/10161/22415
Published Version (Please cite this version)
10.1093/ofid/ofaa413
Publication 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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Scholars@Duke

Lantos

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
Martinez-Bianchi

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.
Pan

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
Turner

Nicholas Turner

Assistant Professor of Medicine
Woods

Christopher Wildrick Woods

Professor of Medicine
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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