County-level demographic, social, economic, and lifestyle correlates of COVID-19 infection and death trajectories during the first wave of the pandemic in the United States

Abstract

Background The US COVID-19 epidemic impacted counties differently across space and time, though large-scale transmission dynamics are unclear. The study's objective was to group counties with similar trajectories of COVID-19 cases and deaths and identify county-level correlates of the distinct trajectory groups. Methods Daily COVID-19 cases and deaths were obtained from 3141 US counties from January through June 2020. Clusters of epidemic curve trajectories of COVID-19 cases and deaths per 100,000 people were identified with Proc Traj. We utilized polytomous logistic regression to estimate Odds Ratios for trajectory group membership in relation to county-level demographics, socioeconomic factors, school enrollment, employment and lifestyle data. Results Six COVID-19 case trajectory groups and five death trajectory groups were identified. Younger counties, counties with a greater proportion of females, Black and Hispanic populations, and greater employment in private sectors had higher odds of being in worse case and death trajectories. Percentage of counties enrolled in grades 1–8 was associated with earlier-start case trajectories. Counties with more educated adult populations had lower odds of being in worse case trajectories but were generally not associated with worse death trajectories. Counties with higher poverty rates, higher uninsured, and more living in non-family households had lower odds of being in worse case and death trajectories. Counties with higher smoking rates had higher odds of being in worse death trajectory counties. Discussion In the absence of clear guidelines and personal protection, smoking, racial and ethnic groups, younger populations, social, and economic factors were correlated with worse COVID-19 epidemics that may reflect population transmission dynamics during January–June 2020. After vaccination of high-risk individuals, communities with higher proportions of youth, communities of color, smokers, and workers in healthcare, service and goods industries can reduce viral spread by targeting vaccination programs to these populations and increasing access and education on non-pharmaceutical interventions.

COVID-19 Vaccination Uptake and Hesitancy Among Current Tobacco Users

“…Our study provided a firsthand look at vaccine uptake and willingness among tobacco users in the U.S, a group at greater risk for COVID-19 disease severity if infected. 18,19,32 Within our study, nearly 60% reported receiving at least one dose of the COVID-19 vaccine which is on par with the national average in the U.S (57%; as of May 22, 2021). 2…”

“…Our study provided a firsthand look at vaccine uptake and willingness among tobacco users in the U.S, a group at greater risk for COVID-19 disease severity if infected. 18,19,32 Within our study, nearly 60% reported receiving at least one dose of the COVID-19 vaccine which is on par with the national average in the U.S (57%; as of May 22, 2021). 2 While current adult tobacco users were eligible for vaccination for more than 3 months at the time of survey, 40% had not received their first dose of the COVID-19 vaccine.…”

Perception of COVID-19 Testing in the Entire Population

“…The combination of social distance and testing is still an effective strategy in reducing the burden of disease (36). Increasing access and education on nonpharmaceutical interventions could reduce viral spread (37), but emphasis should also be placed on the social aspect, positively motivating people, improving their attitudes, but also their trust. There are many social and cultural factors that shape perceptions and responses to risk messaging, while outrage factors, danger, immediacy, uncertainty, familiarity, personal control, scientific uncertainty, and trust in institutions and media appear to be key (38,39).…”

Toward the Renewal of the Sustainable Urban Indicators’ System after a Global Health Crisis. Practical Application in Granada, Spain

“…On the other hand, the social characteristics of the population are another factor to take into account since the most vulnerable groups have been particularly affected due to circumstances such as the area of the city where they live, where they work, or gender and age factors [50]. Urban areas with a high rate of crime or violence could make it difficult to control COVID-19 [51] as well as a deficiency of infrastructure and housing [52] because of insufficient resources.…”