Social vulnerability and spatial patterns of COVID-19 mortality: Global implications for respiratory health equity

Gregory D Kearney, Ogugua Ndili Obi, Veeranna Maddipati, Gregory Levitin and Guangxiao Hu

PLOS ONE, 2026, vol. 21, issue 7, 1-16

Abstract: Background: The pandemic highlighted geographic inequities in COVID-19 mortality worldwide, reflecting structural and social vulnerabilities that exacerbated respiratory disease outcomes. The primary aim of this study was to examine the spatial relationship between COVID-19 mortality and communities characterized by greater social disadvantage in North Carolina. This application highlights the value of spatial analytic approaches when considering inequities in respiratory mortality. Methods: This study analyzed 25,051 COVID-19 deaths occurring in North Carolina from March 2020 through April 2022 using state vital statistics data and the Centers for Disease Control and Prevention, Social Vulnerability Index data. SaTScan™ was used to identify mortality hot spots, and Moran’s I in ArcGIS Pro was used to assess spatial autocorrelation at the ZIP-Code Tabulation Area level. The Mann–Whitney U test was used to assess differences in social vulnerability index scores in mortality hot spots areas and non-hot spots areas. Results: Local bivariate analysis identified moderate spatial clustering characterized by high–high (mortality–vulnerability) hot spots and spatial outliers. In non-parametric testing, COVID-19 mortality hot spot areas had significantly higher, but modestly elevated, median overall social vulnerability index scores compared with non–hot spot areas (0.58 vs. 0.45; p

Date: 2026
References: Add references at CitEc
Citations:

Downloads: (external link)
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0352270 (text/html)
https://journals.plos.org/plosone/article/file?id= ... 52270&type=printable (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0352270

DOI: 10.1371/journal.pone.0352270

Access Statistics for this article

More articles in PLOS ONE from Public Library of Science
Bibliographic data for series maintained by plosone ().