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

Hoda S. Abdel Magid, Jacqueline M. Ferguson, Raymond Van Cleve, Amanda L. Purnell and Thomas F. Osborne
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Hoda S. Abdel Magid: VA Palo Alto Healthcare System, US Department of Veterans Affairs, Palo Alto, CA 94304, USA
Jacqueline M. Ferguson: VA Palo Alto Healthcare System, US Department of Veterans Affairs, Palo Alto, CA 94304, USA
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

IJERPH, 2021, vol. 18, issue 24, 1-9

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.

Keywords: Veterans; COVID-19; social determinants of health; county-level; race; health disparities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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