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Differences in COVID-19 Risk by Race and County-Level Social Determinants of Health among Veterans

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  • Hoda S. Abdel Magid

    (VA Palo Alto Healthcare System, US Department of Veterans Affairs, Palo Alto, CA 94304, USA
    Department of Epidemiology and Population Health, Stanford University, Stanford, CA 94305, USA
    Stanford Center for Population Health Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
    Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, MDP-152, 705 Willow Road, Menlo Park, CA 94025, USA)

  • Jacqueline M. Ferguson

    (VA Palo Alto Healthcare System, US Department of Veterans Affairs, Palo Alto, CA 94304, USA
    Stanford Center for Population Health Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA
    Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, MDP-152, 705 Willow Road, Menlo Park, CA 94025, USA
    Authors contributed equally.)

  • Raymond Van Cleve

    (VA Palo Alto Healthcare System, US Department of Veterans Affairs, Palo Alto, CA 94304, USA)

  • Amanda L. Purnell

    (Veterans Affairs Central Office, Washington, DC 20420, USA)

  • Thomas F. Osborne

    (VA Palo Alto Healthcare System, US Department of Veterans Affairs, Palo Alto, CA 94304, USA
    Department of Radiology, Stanford University School of Medicine, Stanford, CA 94305, USA)

Abstract

COVID-19 disparities by area-level social determinants of health (SDH) have been a significant public health concern and may also be impacting U.S. Veterans. This retrospective analysis was designed to inform optimal care and prevention strategies at the U.S. Department of Veterans Affairs (VA) and utilized COVID-19 data from the VAs EHR and geographically linked county-level data from 18 area-based socioeconomic measures. The risk of testing positive with Veterans’ county-level SDHs, adjusting for demographics, comorbidities, and facility characteristics, was calculated using generalized linear models. We found an exposure–response relationship whereby individual COVID-19 infection risk increased with each increasing quartile of adverse county-level SDH, such as the percentage of residents in a county without a college degree, eligible for Medicaid, and living in crowded housing.

Suggested Citation

  • Hoda S. Abdel Magid & Jacqueline M. Ferguson & Raymond Van Cleve & Amanda L. Purnell & Thomas F. Osborne, 2021. "Differences in COVID-19 Risk by Race and County-Level Social Determinants of Health among Veterans," IJERPH, MDPI, vol. 18(24), pages 1-9, December.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:24:p:13140-:d:701176
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    References listed on IDEAS

    as
    1. Elizabeth Wrigley-Field, 2020. "US racial inequality may be as deadly as COVID-19," Proceedings of the National Academy of Sciences, Proceedings of the National Academy of Sciences, vol. 117(36), pages 21854-21856, September.
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