COVID-19 prevention is shaped by polysocial risk: A cross-sectional study of vaccination and testing disparities in underserved populations

David R Brown, Derek D Cyr, Lisa Wruck, Troy A Stefano, Nader Mehri, Zoran Bursac, Richard Munoz, Marianna K Baum, Eileen Fluney, Prasad Bhoite, Nana Aisha Garba, Frederick W Anderson, Haley R Fonseca, Sara Assaf and Krista M Perreira

PLOS ONE, 2025, vol. 20, issue 7, 1-17

Abstract: Understanding disparities in COVID-19 preventive efforts among underserved populations requires a holistic approach that considers multiple social determinants of health (SDOH). While disparities in individual COVID-19 risk factors are well-documented, the cumulative impact of these factors on vaccine uptake and testing remains insufficiently quantified. This study applies a polysocial risk framework to assess the combined influence of geo-demographic, economic, and health-related factors on COVID-19 vaccination and testing. Using cross-sectional data from 9,758 participants enrolled in the NIH Rapid Acceleration of Diagnostics – Underserved Populations (RADx-UP) program (February 2020–April 2023), we analyzed associations between polysocial risk and preventive behaviors using multivariable generalized estimating equations (GEE). Overall, 72.5% of participants reported COVID-19 vaccination, and 82.1% reported testing. However, disparities were evident across polysocial risk profiles. Individuals experiencing intersecting geo-demographic (Non-Hispanic Black, age 45, Southern residence), economic (low education, unemployment, financial hardship), and health-related risk factors (substance use, low CVD risk, no flu vaccination) were 43−48 percentage points less likely to be vaccinated compared to groups with higher adoption (p

Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0328779

DOI: 10.1371/journal.pone.0328779

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