COVID-19 INFECTION IS ASSOCIATED WITH ECONOMIC DISADVANTAGE IN A PARTICULAR GEOGRAPHIC AREA, STUDY FINDS Written by Amanda Torres Published on December 9, 2020 Category: Faculty, Research
According to a new ecological study led by the University of Miami Miller School of Medicine, understanding how social determinants of health play a role in COVID-19 infections could help with the development of strategies to prevent the spread of the virus. Social determinants of health are conditions in the place where people live, learn, work, and interact, which in turn affect a wide range of health and quality-of-life risks and outcomes. The cross-sectional study — published in the November 2020 issue of the Journal of General Internal Medicine — found that COVID-19 infection is associated specifically with economic disadvantage and stress reported in a particular geographical area and not with its racial/ethnic distribution. “These findings are consistent with reports from many other conditions. Racial health disparities are driven by socio-economic disadvantage and not by biological or genetic differences,” said study lead author Ana Palacio, M.D., M.P.H., professor of clinical medicine in the Miller School’s Department of Public Health Sciences.
“Therefore, as we consider the steps to contain the pandemic, addressing or mitigating social determinants of health should be among the top priorities.” “Our findings highlight the importance of integrating clinical, social and geographic data in a privacy compliant manner. Where we live affects our health trajectory,” added study senior author Leonardo Tamariz, M.D., M.P.H., professor of medicine in the Miller School’s Department of Medicine. “Having this information is pivotal to develop the necessary policies or programs to improve health outcomes in our community.” Dr. Palacio and Dr. Tamariz analyzed 95,594 COVID-19 positive cases across 79 ZIP codes within Miami-Dade County. They found that the highest COVID-19 incidence was for ZIP code 33125, where residents had a median household income of $21,106, 6 percent were Black, and 93 percent were Hispanic. Within this ZIP code, there were 69.8 COVID-19 cases per 1,000 inhabitants. The lowest incident rate ratio, they found, was for ZIP code 33146, which
had a median household income of $96,609, had 3 percent Black residents and 53 percent Hispanic residents. There were 26.1 COVID-19 cases per 1,000 inhabitants within this ZIP code. Dr. Palacio and Dr. Tamariz conducted the study using COVID-19 cases reported by the Florida Department of Health’s COVID-19 data and surveillance dashboard, which reports the cumulative number of positive COVID-19 tests by county and by ZIP code. Using 2010 Census data, experts imputed race/ethnicity from each ZIP code, as well as described median household income by ZIP code. The study included two sources of social determinants of health data. The first was ZIP code-level data from 2010 Census population data using Mami-Dade projections. Data included total population, race and ethnicity, median household income, and average household size by ZIP code to match how the COVID-19 cases are reported in Florida. The second source was individual-level self-reported social determinants of
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