New Providence Research Identifies Sociodemographic and Environmental Factors that Increase Likelihood of COVID-19 Infection
The study, published in the International Journal for Equity in Health, finds more than a dozen factors associated with greater odds of infection
RENTON, Wash., August 12, 2020 – Providence, one of the largest health care systems in the nation, recently released a study which finds that increased odds of COVID-19 infection are associated with more than a dozen sociodemographic—particularly race and ethnicity—and environmental factors, including residing in a neighborhood with financial insecurity, low air quality, housing insecurity and transportation insecurity. Many of these factors reflect the impact of longstanding structural racism in our country. The new data, published in the International Journal for Equity in Health, can be used to proactively focus efforts in vulnerable communities and help prevent the spread of COVID-19.
“The results of our research continue to highlight the hard work ahead of us, not only in fighting COVID-19, but in reducing health inequities across our nation,” said Rhonda Medows, M.D., president, population health management at Providence. “Health care goes beyond the walls of a hospital. It is closely aligned with housing, transportation, primary language, policies, racial bias and access to care, which underscores the importance of working within the communities around us to help stop the spread of the virus.”
Using data sourced from across the Providence health system, as well as publicly available data sets, researchers identified clinical, sociodemographic and environmental factors associated with a higher likelihood of contracting COVID-19:
- Environmental factors, including housing, financial, and transportation insecurity, as well as low air quality and living in senior living facilities.
- Sociodemographic factors, including race/ethnicity, religious affiliation, age, employment status, marital status and primary language.
- Clinical factors, including serious illness such as older age, male gender, diabetes, chronic kidney disease, high BMI, access to care and immunosuppression.
The research team used de-identified data from more than 34,000 COVID tests across more than five million patients to develop a multivariable logistic regression model to identify predictors associated with acquiring COVID-19. These factors include patient specific clinical information such as chronic condition diagnosis, health history and current medications from the electronic medical record, as well as proxy sociodemographic and environmental factors such as air quality or income level, by geocoding the patient’s address and matching it to publicly available data, at the block group or tract level. This analysis enabled the team to calculate a relative risk of contraction for individuals when compared to the risk of the average population.
Interestingly, some clinical factors previously found to increase mortality risk, including hypertension and cardiovascular disease, liver disease, lung disease, and asthma were not significantly associated with initial COVID-19 infection. The findings demonstrate how knowledge of the complex mixture of clinical, ethnic, linguistic and environmental factors can enable a targeted approach to management of the virus in at-risk communities in an effort to decrease COVID-19 infections.
“Our goal in developing the risk model was to enable our caregivers, ministries and healthcare providers across the country to proactively mitigate risks in communities disproportionately impacted by the virus, especially in communities of color,” said Karen Boudreau, M.D., F.A.A.F.P., senior vice president of enterprise care management at Providence. “These data and subsequent research efforts will help guide our work with vulnerable communities to improve health equity and start to bend the curve on infection.”
Providence is a national, not-for-profit Catholic health system comprising a diverse family of organizations and driven by a belief that health is a human right. With 51 hospitals, 1,085 physician clinics, senior services, supportive housing and many other health and educational services, the health system and its partners employ more than 120,000 caregivers serving communities across Alaska, California, Montana, New Mexico, Oregon, Texas, and Washington, with system offices in Renton, Wash., and Irvine, Calif. Learn about our vision of health for a better world at Providence.org.
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