Expanding Vulnerability Indices for Pandemic Effects
Abstract
In this study, our goal is to identify potentially vulnerable communities that could be subject to ongoing or compounding impacts from the pandemic and/or that may experience a slower recovery due to sociodemographic factors. For this purpose, we compiled information from multiple databases related to sociodemographic and health variables. We used a ranking-based method to integrate them and develop new combined indices. We also investigated a time-dependent correlation between vulnerability components and COVID-19 statistics to understand their time-dependent relationship. We ultimately developed pandemic vulnerability indices by combining CDC’s social vulnerability index, our newly developed composite health vulnerability index, and COVID-19 impact indices. We also considered additional assessments include expected annual loss due to natural hazards and community resilience. Potential hot spots (at the county level) were identified throughout the United States, and some general trends were noted. Counties with high COVID-19 impact indices and higher values of the pandemic vulnerability indices were primarily located in the southern United States or coastal areas in the Eastern and Southwestern United States at the beginning of the COVID-19 pandemic. Over time, the computed pandemic vulnerability indices shifted to higher values for counties in the southern and north-central United States, while values calculated for the northwestern and northeastern communities tended to decrease.
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Data Availability Statement
All of the data, models, or code that support the findings of this study are available from the corresponding author upon reasonable request.
Acknowledgments
This research was supported by Healthcare Ready under a grant from the Walmart Foundation (Grant No. 62439989). Any opinions, findings, and conclusions expressed in this paper/presentation are those of the authors and do not necessarily reflect the views of the funding organization or any other organization.
References
Amadeo, K., and J. Mansa. 2021. “How health care inequality increases costs for everyone.” Accessed June 2, 2021. https://www.thebalance.com/health-care-inequality-facts-types-effect-solution-4174842.
Amram, O., S. Amiri, R. B. Lutz, B. Rajan, and P. Monsivais. 2020. “Development of a vulnerability index for diagnosis with the novel coronavirus, COVID-19, in Washington State, USA.” Health Place 64 (Jul): 102377. https://doi.org/10.1016/j.healthplace.2020.102377.
Berenguer, J., P. Ryan, J. Rodríguez-Baño, I. Jarrín, J. Carratalà, J. Pachón, M. Yllescas, J. R. Arribas, E. A. Muñoz, and P. P. G. Divasson. 2020. “Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain.” Clin. Microbiol. Infect. 26 (11): 1525–1536. https://doi.org/10.1016/j.cmi.2020.07.024.
CDC (Centers for Disease Control and Prevention). 2022a. “COVID data tracker.” Accessed May 1, 2022. https://covid.cdc.gov/covid-data-tracker.
CDC (Centers for Disease Control and Prevention). 2022b. “COVID-19 Vaccinations in the United States,County | Data | Centers for Disease Control and Prevention.” Accessed May 12, 2022. https://data.cdc.gov/Vaccinations/COVID-19-Vaccinations-in-the-United-States-County/8xkx-amqh.
CDC (Centers for Disease Control and Prevention). 2022c. “CDC museum COVID-19 timeline.” Accessed May 23, 2022. https://www.cdc.gov/museum/timeline/covid19.html.
Centers for Medicare and Medicaid Services 2017. “Chronic conditions.” Accessed March 24, 2021. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Chronic-Conditions/CC_Main.
Cheng, L., M. Yang, J. De Vos, and F. Witlox. 2020. “Examining geographical accessibility to multi-tier hospital care services for the elderly: A focus on spatial equity.” J. Transp. Health 19 (Dec): 100926. https://doi.org/10.1016/j.jth.2020.100926.
Cole, B. 2020. “The impact of the COVID-19 pandemic on access to health care. National Academy of Social Insurance.” Health Policy Brief 17 (Jul): 1–31.
Cutter, S. L., B. J. Boruff, and W. L. Shirley. 2003. “Social vulnerability to environmental hazards.” Social Sci. Q. 84 (2): 242–261. https://doi.org/10.1111/1540-6237.8402002.
Daras, K., A. Alexiou, T. C. Rose, I. Buchan, D. Taylor-Robinson, and B. Barr. 2021. “How does vulnerability to COVID-19 vary between communities in England? Developing a Small Area Vulnerability Index (SAVI).” J. Epidemiol. Community Health 75 (8): 729–734. https://doi.org/10.1136/jech-2020-215227.
Dasgupta, S., V. B. Bowen, A. Leidner, K. Fletcher, T. Musial, C. Rose, A. Cha, G. Kang, E. Dirlikov, and E. Pevzner. 2020. “Association between social vulnerability and a county’s risk for becoming a COVID-19 Hotspot—United States, June 1–July 25, 2020.” MMWR Morb. Mortal Wkly. Rep. 69 (42): 1535. https://doi.org/10.15585/mmwr.mm6942a3.
Dickman, S. L., D. U. Himmelstein, and S. Woolhandler. 2017. “Inequality and the health-care system in the USA.” Lancet 389 (10077): 1431–1441. https://doi.org/10.1016/S0140-6736(17)30398-7.
ESRI. 2021. “JHU centers for civic impact Covid-19 county cases (Daily Update).” Accessed October 28, 2020. https://coronavirus-resources.esri.com/datasets/4cb598ae041348fb92270f102a6783cb?showData=true.
Fekete, A. 2009. “Validation of a social vulnerability index in context to river-floods in Germany.” Nat. Hazards Earth Syst. Sci. 9 (2): 393–403. https://doi.org/10.5194/nhess-9-393-2009.
FEMA. 2021. “National risk index for natural hazards (NRI) | FEMA.gov.” Accessed June 24, 2021. https://www.fema.gov/flood-maps/products-tools/national-risk-index.
Flanagan, B. E., E. W. Gregory, E. J. Hallisey, J. L. Heitgerd, and B. Lewis. 2011. “A social vulnerability index for disaster management.” J. Homeland Secur. Emergency Manage. 8 (1). https://doi.org/10.2202/1547-7355.1792.
Gall, M. 2007. “Indices of social vulnerability to natural hazards: A comparative evaluation.” Ph.D. dissertation, Dept. of Geography, Univ. of South Carolina.
Hazards and Vulnerability Research Institute 2015. “Baseline Resilience Indicators for Communities.” Accessed June 28, 2021. https://artsandsciences.sc.edu/geog/hvri/bric.
HIFLD (Homeland Infrastructure Foundation-Level Data). 2020. “Hospitals.” Accessed June 1, 2021. https://hifld-geoplatform.opendata.arcgis.com/datasets/geoplatform::hospitals/about.
Khazanchi, R., E. R. Beiter, S. Gondi, A. L. Beckman, A. Bilinski, and I. Ganguli. 2020. “County-level association of social vulnerability with COVID-19 cases and deaths in the USA.” J Gen. Intern. Med. 35 (9): 2784–2787. https://doi.org/10.1007/s11606-020-05882-3.
Kiaghadi, A., H. S. Rifai, and W. Liaw. 2020. “Assessing COVID-19 risk, vulnerability and infection prevalence in communities.” PLoS One 15 (10): e0241166. https://doi.org/10.1371/journal.pone.0241166.
Luo, W., and Y. Qi. 2009. “An enhanced two-step floating catchment area (E2SFCA) method for measuring spatial accessibility to primary care physicians.” Health Place 15 (4): 1100–1107. https://doi.org/10.1016/j.healthplace.2009.06.002.
Luo, W., and T. Whippo. 2012. “Variable catchment sizes for the two-step floating catchment area (2SFCA) method.” Health Place 18 (4): 789–795. https://doi.org/10.1016/j.healthplace.2012.04.002.
Melvin, S. C., C. Wiggins, N. Burse, E. Thompson, and M. Monger. 2020. “The role of public health in COVID-19 emergency response efforts from a rural health perspective.” Prev. Chron. Dis. 17 (Jul): E70–E70. https://doi.org/10.5888/pcd17.200256.
Nardo, M., M. Saisana, A. Saltelli, and S. Tarantola. 2005. “Tools for composite indicators building.” In European commission, 140. Ispra, Italy: Institute for the Protection and Security of the Citizen.
Neutens, T. 2015. “Accessibility, equity and health care: Review and research directions for transport geographers.” J. Transp. Geogr. 43 (Feb): 14–27. https://doi.org/10.1016/j.jtrangeo.2014.12.006.
ODPHP (Office of Disease Prevention and Health Promotion). 2020. “Public health infrastructure | Healthy people.” Accessed June 2, 2021. https://www.healthypeople.gov/2020/topics-objectives/topic/public-health-infrastructure.
Oppel, R. Jr., R. Gebeloff, K. K. R. Lai, W. Wright, and M. Smith. 2020. “The fullest look yet at the racial inequity of coronavirus.” The New York Times, July 5, 2020.
Quigley, M. C., J. Attanayake, A. King, and F. Prideaux. 2020. “A multi-hazards earth science perspective on the COVID-19 pandemic: The potential for concurrent and cascading crises.” Environ. Syst. Dec. 40 (2): 199–215. https://doi.org/10.1007/s10669-020-09772-1.
Radke, J., and L. Mu. 2000. “Spatial decompositions, modeling and mapping service regions to predict access to social programs.” Geogr. Inf. Sci. 6 (2): 105–112. https://doi.org/10.1080/10824000009480538.
Rufat, S., E. Tate, C. T. Emrich, and F. Antolini. 2019. “How valid are social vulnerability models?” Ann. Am. Assoc. Geogr. 109 (4): 1131–1153. https://doi.org/10.1080/24694452.2018.1535887.
Rx Open. 2020. “Healthcare Ready. Rx Open.”Accessed June 1, 2021. https://www.rxopen.org/.
Shultz, J. M., J. P. Kossin, A. Hertelendy, F. Burkle, C. Fugate, R. Sherman, J. Bakalar, K. Berg, A. Maggioni, and Z. Espinel. 2020. “Mitigating the twin threats of climate-driven Atlantic hurricanes and COVID-19 transmission.” Disaster Med. Public Health Preparedness 14 (4): 494–503. https://doi.org/10.1017/dmp.2020.243.
SVI (Social Vulnerability Index) 2018. “Centers for Disease Control and Prevention/ Agency for Toxic Substances and Disease Registry/ Geospatial Research, Analysis, and Services Program.” Accessed March 19, 2020. https://www.data-and-tools-download.html.
The New York Times. 2020. “Covid-19-data/mask-use.” July 23, 2021.
The New York Times. 2022. “Coronavirus (Covid-19) data in the United States.” November 10, 2022.
UC Davis Health. 2022. “Learn how the COVID-19 vaccine works, potential side effects and more | UC Davis Health.” Accessed May 5, 2022. https://health.ucdavis.edu/coronavirus/covid-19-vaccine/how-covid-19-vaccines-work.
Wang, F. 2012. “Measurement, optimization, and impact of health care accessibility: A methodological review.” Ann. Assoc. Am. Geogr. 102 (5): 1104–1112. https://doi.org/10.1080/00045608.2012.657146.
Wen, L., and N. Sadeghi. 2020. “Addressing racial health disparities in the COVID-19 pandemic: Immediate and long-term policy solutions.” Health Affairs Blog (Jul). https://doi.org/10.1377/hblog20200716.620294.
Woolf, S. H. 2015. How are income and wealth linked to health and longevity? Washington, DC: Urban Institute.
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Received: Dec 7, 2021
Accepted: Sep 16, 2022
Published online: Dec 30, 2022
Published in print: May 1, 2023
Discussion open until: May 30, 2023
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