Associations of County-Level Social Determinants of Health with COVID-19 Related Hospitalization Among People with HIV: A Retrospective Analysis of the U.S. National COVID Cohort Collaborative (N3C).
Access to care
Area-level
COVID-19 hospitalization
County-level
HIV
Pandemic
Race and ethnicity
SARS-CoV-2 infection
Social determinants of health
Journal
AIDS and behavior
ISSN: 1573-3254
Titre abrégé: AIDS Behav
Pays: United States
ID NLM: 9712133
Informations de publication
Date de publication:
18 Sep 2024
18 Sep 2024
Historique:
accepted:
12
08
2024
medline:
18
9
2024
pubmed:
18
9
2024
entrez:
18
9
2024
Statut:
aheadofprint
Résumé
Individually, the COVID-19 and HIV pandemics have differentially impacted minoritized groups due to the role of social determinants of health (SDoH) in the U.S. Little is known how the collision of these two pandemics may have exacerbated adverse health outcomes. We evaluated county-level SDoH and associations with hospitalization after a COVID-19 diagnosis among people with (PWH) and without HIV (PWOH) by racial/ethnic groups. We used the U.S. National COVID Cohort Collaborative (January 2020-November 2023), a nationally-sampled electronic health record repository, to identify adults who were diagnosed with COVID-19 with HIV (n = 22,491) and without HIV (n = 2,220,660). We aggregated SDoH measures at the county-level and categorized racial/ethnic groups as Non-Hispanic (NH) White, NH-Black, Hispanic/Latinx, NH-Asian and Pacific Islander (AAPI), and NH-American Indian or Alaskan Native (AIAN). To estimate associations of county-level SDoH with hospitalization after a COVID-19 diagnosis, we used multilevel, multivariable logistic regressions, calculating adjusted relative risks (aRR) with 95% confidence intervals (95% CI). COVID-19 related hospitalization occurred among 11% of PWH and 7% of PWOH, with the highest proportion among NH-Black PWH (15%). In evaluating county-level SDoH among PWH, we found higher average household size was associated with lower risk of COVID-19 related hospitalization across racial/ethnic groups. Higher mean commute time (aRR: 1.76; 95% CI 1.10-2.62) and higher proportion of adults without health insurance (aRR: 1.40; 95% CI 1.04-1.84) was associated with a higher risk of COVID-19 hospitalization among NH-Black PWH, however, NH-Black PWOH did not demonstrate these associations. Differences by race and ethnicity exist in associations of adverse county-level SDoH with COVID-19 outcomes among people with and without HIV in the U.S.
Identifiants
pubmed: 39292319
doi: 10.1007/s10461-024-04466-0
pii: 10.1007/s10461-024-04466-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NIMH NIH HHS
ID : R01MH131542
Pays : United States
Investigateurs
Melissa A Haendel
(MA)
Christopher G Chute
(CG)
Kenneth R Gersing
(KR)
Anita Walden
(A)
Tellen D Bennett
(TD)
David A Eichmann
(DA)
Justin Guinney
(J)
Warren A Kibbe
(WA)
Hongfang Liu
(H)
Philip R O Payne
(PRO)
Emily R Pfaff
(ER)
Peter N Robinson
(PN)
Joel H Saltz
(JH)
Heidi Spratt
(H)
Justin Starren
(J)
Christine Suver
(C)
Adam B Wilcox
(AB)
Andrew E Williams
(AE)
Chunlei Wu
(C)
Davera Gabriel
(D)
Stephanie S Hong
(SS)
Kristin Kostka
(K)
Harold P Lehmann
(HP)
Richard A Moffitt
(RA)
Michele Morris
(M)
Matvey B Palchuk
(MB)
Xiaohan Tanner Zhang
(XT)
Richard L Zhu
(RL)
Emily R Pfaff
(ER)
Benjamin Amor
(B)
Mark M Bissell
(MM)
Marshall Clark
(M)
Andrew T Girvin
(AT)
Stephanie S Hong
(SS)
Kristin Kostka
(K)
Adam M Lee
(AM)
Robert T Miller
(RT)
Michele Morris
(M)
Matvey B Palchuk
(MB)
Kellie M Walters
(KM)
Anita Walden
(A)
Yooree Chae
(Y)
Connor Cook
(C)
Alexandra Dest
(A)
Racquel R Dietz
(RR)
Thomas Dillon
(T)
Patricia A Francis
(PA)
Rafael Fuentes
(R)
Alexis Graves
(A)
Julie A McMurry
(JA)
Andrew J Neumann
(AJ)
Shawn T O'Neil
(ST)
Usman Sheikh
(U)
Andréa M Volz
(AM)
Elizabeth Zampino
(E)
Christopher P Austin
(CP)
Samuel Bozzette
(S)
Mariam Deacy
(M)
Nicole Garbarini
(N)
Michael G Kurilla
(MG)
Sam G Michael
(SG)
Joni L Rutter
(JL)
Meredith Temple-O'Connor
(M)
Mark M Bissell
(MM)
Katie Rebecca Bradwell
(KR)
Andrew T Girvin
(AT)
Amin Manna
(A)
Nabeel Qureshi
(N)
Mary Morrison Saltz
(MM)
Christine Suver
(C)
Christopher G Chute
(CG)
Julie A McMurry
(JA)
Andréa M Volz
(AM)
Anita Walden
(A)
Carolyn Bramante
(C)
Jeremy Richard Harper
(JR)
Wenndy Hernandez
(W)
Farrukh M Koraishy
(FM)
Federico Mariona
(F)
Saidulu Mattapally
(S)
Amit Saha
(A)
Satyanarayana Vedula
(S)
Informations de copyright
© 2024. The Author(s).
Références
Martin EG, Ansari B, Hart-Malloy R, Smith DK, Delaney KP, Gift TL, et al. Racial and ethnic disparities in HIV diagnoses among heterosexually active persons in the United States nationally and by state, 2018. PLoS ONE. 2021;16: e0257583.
pubmed: 34543322
pmcid: 8451999
doi: 10.1371/journal.pone.0257583
HIV Statistics Impact on Racial and Ethnic Minorities | HIV.gov [Internet]. [cited 2023 May 10]. Available from: https://www.hiv.gov/hiv-basics/overview/data-and-trends/impact-on-racial-and-ethnic-minorities/
Sullivan PS, Satcher Johnson A, Pembleton ES, Stephenson R, Justice AC, Althoff KN, et al. Epidemiology of HIV in the USA: epidemic burden, inequities, contexts, and responses. Lancet. 2021;397:1095–106.
pubmed: 33617774
doi: 10.1016/S0140-6736(21)00395-0
CDC. Estimated HIV Incidence and Prevalence in the United States. 2015–2019 [Internet]. Centers for Disease Control and Prevention; 2021 May. Available from: http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html
Yang X, Sun J, Patel RC, Zhang J, Guo S, Zheng Q, et al. Associations between HIV infection and clinical spectrum of COVID-19: a population level analysis based on US National COVID Cohort Collaborative (N3C) data. Lancet HIV. 2021;8:e690-700.
pubmed: 34655550
pmcid: 8514200
doi: 10.1016/S2352-3018(21)00239-3
Islam JY, Madhira V, Sun J, Olex A, Franceschini N, Kirk G, et al. Racial disparities in COVID-19 test positivity among people living with HIV in the United States. Int J STD AIDS. 2022;33:462–6.
pubmed: 35306931
pmcid: 8935143
Lopez L, Hart LH, Katz MH. Racial and ethnic health disparities related to COVID-19. JAMA. 2021;325:719–20.
pubmed: 33480972
doi: 10.1001/jama.2020.26443
Miller KW, Gandhi RT. The severity of COVID-19 across the spectrum of HIV. Curr Opin HIV AIDS. 2023;18:119–25.
pubmed: 37144613
pmcid: 10321774
doi: 10.1097/COH.0000000000000791
Sun J, Patel RC, Zheng Q, Madhira V, Olex AL, Islam JY, et al. COVID-19 disease severity among people with HIV infection or solid organ transplant in the United States: a nationally-representative, multicenter, observational cohort study. medRxiv. 2021. https://doi.org/10.1101/2021.07.26.21261028 .
doi: 10.1101/2021.07.26.21261028
pubmed: 34909794
pmcid: 8669861
Waterfield KC, Shah GH, Etheredge GD, Ikhile O. Consequences of COVID-19 crisis for persons with HIV: the impact of social determinants of health. BMC Public Health. 2021;21:299.
pubmed: 33546659
pmcid: 7863613
doi: 10.1186/s12889-021-10296-9
Spears CE, Taylor BS, Liu AY, Levy SM, Eaton EF. Intersecting epidemics: the impact of coronavirus disease 2019 on the HIV prevention and care continua in the United States. AIDS. 2022;36:1749–59.
pubmed: 35730392
doi: 10.1097/QAD.0000000000003305
Social determinants of health [Internet]. [cited 2024 Jan 21]. Available from: https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1
Johnson Lyons S, Gant Z, Jin C, Dailey A, Nwangwu-Ike N, Satcher JA. A census tract-level examination of differences in social determinants of health among people with HIV, by race/ethnicity and geography, United States and Puerto Rico, 2017. Public Health Rep. 2022;137:278–90.
pubmed: 33629905
doi: 10.1177/0033354921990373
Benbow ND, Aaby DA, Rosenberg ES, Brown CH. County-level factors affecting Latino HIV disparities in the United States. PLoS ONE. 2020;15: e0237269.
pubmed: 32785252
pmcid: 7423131
doi: 10.1371/journal.pone.0237269
Gu T, Mack JA, Salvatore M, Prabhu Sankar S, Valley TS, Singh K, et al. Characteristics associated with racial/ethnic disparities in COVID-19 outcomes in an academic health care system. JAMA Netw Open. 2020;3: e2025197.
pubmed: 33084902
pmcid: 7578774
doi: 10.1001/jamanetworkopen.2020.25197
Rossen LM, Branum AM, Ahmad FB, Sutton P, Anderson RN. Excess deaths associated with COVID-19, by age and race and ethnicity—United States, January 26–October 3, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:1522–7.
pubmed: 33090978
pmcid: 7583499
doi: 10.15585/mmwr.mm6942e2
Romano SD, Blackstock AJ, Taylor EV, El Burai FS, Adjei S, Singleton C-M, et al. Trends in racial and ethnic disparities in COVID-19 hospitalizations, by region—United States, March–December 2020. MMWR Morb Mortal Wkly Rep. 2021;70:560–5.
pubmed: 33857068
pmcid: 8344991
doi: 10.15585/mmwr.mm7015e2
Beltran RM, Holloway IW, Hong C, Miyashita A, Cordero L, Wu E, et al. Social determinants of disease: HIV and COVID-19 experiences. Curr HIV/AIDS Rep. 2022;19:101–12.
pubmed: 35107810
pmcid: 8808274
doi: 10.1007/s11904-021-00595-6
Sprague C, Simon SE. Ending HIV in the USA: integrating social determinants of health. Lancet. 2021;398:742–3.
pubmed: 34454663
doi: 10.1016/S0140-6736(21)01236-8
Madlock-Brown C, Wilkens K, Weiskopf N, Cesare N, Bhattacharyya S, Riches NO, et al. Clinical, social, and policy factors in COVID-19 cases and deaths: methodological considerations for feature selection and modeling in county-level analyses. BMC Public Health. 2022;22:747.
pubmed: 35421958
pmcid: 9008430
doi: 10.1186/s12889-022-13168-y
Haendel MA, Chute CG, Bennett TD, Eichmann DA, Guinney J, Kibbe WA, et al. The national COVID cohort collaborative (N3C): rationale, design, infrastructure, and deployment. J Am Med Inform Assoc. 2021;28:427–43.
pubmed: 32805036
doi: 10.1093/jamia/ocaa196
Bennett TD, Moffitt RA, Hajagos JG, Amor B, Anand A, Bissell MM, et al. Clinical characterization and prediction of clinical severity of SARS-CoV-2 infection among US adults using data from the US National COVID Cohort Collaborative. JAMA Netw Open. 2021;4: e2116901.
pubmed: 34255046
pmcid: 8278272
doi: 10.1001/jamanetworkopen.2021.16901
Sun J, Zheng Q, Madhira V, Olex AL, Anzalone AJ, Vinson A, et al. Association between immune dysfunction and COVID-19 breakthrough infection after SARS-CoV-2 vaccination in the US. JAMA Intern Med. 2022;182:153–62.
pubmed: 34962505
doi: 10.1001/jamainternmed.2021.7024
Latest Phenotype National-COVID-Cohort-Collaborative/Phenotype_Data_Acquisition Wiki GitHub [Internet]. [cited 2023 Nov 1]. Available from: https://github.com/National-COVID-Cohort-Collaborative/Phenotype_Data_Acquisition/wiki/Latest-Phenotype
Hurwitz E, Anzalone A, Sun J, Wilkins K, Vaidya D, Fadul N, et al. Computational phenotyping within the National COVID Cohort Collaborative: a use-case for identifying people living with HIV. Seattle: AMIA; 2023.
Butler DC, Petterson S, Phillips RL, Bazemore AW. Measures of social deprivation that predict health care access and need within a rational area of primary care service delivery. Health Serv Res. 2013;48:539–59.
pubmed: 22816561
doi: 10.1111/j.1475-6773.2012.01449.x
Kind AJH, Buckingham WR. Making neighborhood-disadvantage metrics accessible: the neighborhood atlas. N Engl J Med. 2018;378:2456–8.
pubmed: 29949490
pmcid: 6051533
doi: 10.1056/NEJMp1802313
Residential Segregation - Black/White* | County Health Rankings & Roadmaps [Internet]. [cited 2024 Jan 21]. Available from: https://www.countyhealthrankings.org/explore-health-rankings/county-health-rankings-model/health-factors/social-economic-factors/family-and-social-support/residential-segregation-blackwhite
SNAP Participation Map [Internet]. [cited 2024 Jan 21]. Available from: https://frac.org/snap-county-map/snap-counties.html
USDA ERS - Rural-Urban Continuum Codes [Internet]. [cited 2024 Jan 21]. Available from: https://www.ers.usda.gov/data-products/rural-urban-continuum-codes/
USDA ERS - Food Environment Atlas [Internet]. [cited 2022 Dec 2]. Available from: https://www.ers.usda.gov/data-products/food-environment-atlas/
The Geography of Social Capital in America [Internet]. United States Congress Joint Economic Committee; 2019 April. Available from: https://www.jec.senate.gov/public/index.cfm/republicans/2018/4/the-geography-of-social-capital-in-america
Maroko AR, Doan TM, Arno PS, Hubel M, Yi S, Viola D. Integrating social determinants of health with treatment and prevention: a new tool to assess local area deprivation. Prev Chronic Dis. 2016;13:E128.
pubmed: 27634778
pmcid: 5027849
doi: 10.5888/pcd13.160221
County Business Patterns (CBP) [Internet]. [cited 2022 Dec 2]. Available from: https://www.census.gov/programs-surveys/cbp.html
Bennett TD, Moffitt RA, Hajagos JG, Amor B, Anand A, Bissell MM, et al. The national COVID cohort collaborative: clinical characterization and early severity prediction. medRxiv. 2021. https://doi.org/10.1101/2021.01.12.21249511 .
doi: 10.1101/2021.01.12.21249511
pubmed: 34341796
pmcid: 8328064
COVID-NET Interactive Dashboard | CDC [Internet]. [cited 2024 Jan 21]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/covidnetdashboard/de/powerbi/dashboard.html
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.
pubmed: 3558716
doi: 10.1016/0021-9681(87)90171-8
Russell CD, Lone NI, Baillie JK. Comorbidities, multimorbidity and COVID-19. Nat Med. 2023;29:334–43.
pubmed: 36797482
doi: 10.1038/s41591-022-02156-9
Vatcheva KP, Lee M, McCormick JB, Rahbar MH. Multicollinearity in regression analyses conducted in epidemiologic studies. Epidemiology (Sunnyvale). 2016;6(2):227.
pubmed: 27274911
doi: 10.4172/2161-1165.1000227
Zhang J, Yu KF. What’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. JAMA. 1998;280:1690–1.
pubmed: 9832001
doi: 10.1001/jama.280.19.1690
MacKinnon JG, Nielsen MØ, Webb MD. Cluster-robust inference: a guide to empirical practice. J Econom. 2023;232:272–99.
doi: 10.1016/j.jeconom.2022.04.001
Puebla Neira D, Watts A, Seashore J, Polychronopoulou E, Kuo Y-F, Sharma G. Smoking and risk of COVID-19 hospitalization. Respir Med. 2021;182: 106414.
pubmed: 33915414
pmcid: 8052507
doi: 10.1016/j.rmed.2021.106414
Maroko AR, Nash D, Pavilonis BT. COVID-19 and inequity: a comparative spatial analysis of New York City and Chicago hot spots. J Urban Health. 2020;97:461–70.
pubmed: 32691212
pmcid: 7371785
doi: 10.1007/s11524-020-00468-0
Vahidy FS, Nicolas JC, Meeks JR, Khan O, Pan A, Jones SL, et al. Racial and ethnic disparities in SARS-CoV-2 pandemic: analysis of a COVID-19 observational registry for a diverse US metropolitan population. BMJ Open. 2020;10: e039849.
pubmed: 32784264
pmcid: 7418666
doi: 10.1136/bmjopen-2020-039849
Rodriguez-Diaz CE, Guilamo-Ramos V, Mena L, Hall E, Honermann B, Crowley JS, et al. Risk for COVID-19 infection and death among Latinos in the United States: examining heterogeneity in transmission dynamics. Ann Epidemiol. 2020;52:46-53.e2.
pubmed: 32711053
pmcid: 7375962
doi: 10.1016/j.annepidem.2020.07.007
Dwyer-Lindgren L, Mokdad AH, Srebotnjak T, Flaxman AD, Hansen GM, Murray CJ. Cigarette smoking prevalence in US counties: 1996–2012. Popul Health Metr. 2014;12:5.
pubmed: 24661401
pmcid: 3987818
doi: 10.1186/1478-7954-12-5
Travel Time to Work in the United States: 2019 [Internet]. [cited 2023 Dec 12]. Available from: https://www.census.gov/library/publications/2021/acs/acs-47.html
Liao TF, De Maio F. Association of social and economic inequality with coronavirus disease 2019 incidence and mortality across US counties. JAMA Netw Open. 2021;4: e2034578.
pubmed: 33471120
pmcid: 7818127
doi: 10.1001/jamanetworkopen.2020.34578
Islam SJ, Nayak A, Hu Y, Mehta A, Dieppa K, Almuwaqqat Z, et al. Temporal trends in the association of social vulnerability and race/ethnicity with county-level COVID-19 incidence and outcomes in the USA: an ecological analysis. BMJ Open. 2021;11: e048086.
pubmed: 34301657
doi: 10.1136/bmjopen-2020-048086
Freese KE, Vega A, Lawrence JJ, Documet PI. Social vulnerability is associated with risk of COVID-19 related mortality in U.S. counties with confirmed cases. J Health Care Poor Underserved. 2021;32:245–57.
pubmed: 33678695
doi: 10.1353/hpu.2021.0022
Wang L, Calzavara A, Baral S, Smylie J, Chan AK, Sander B, et al. Differential patterns by area-level social determinants of health in coronavirus disease 2019 (COVID-19)-related mortality and non-COVID-19 mortality: a population-based study of 11.8 million people in Ontario. Canada Clin Infect Dis. 2023;76:1110–20.
pubmed: 36303410
doi: 10.1093/cid/ciac850
Moss JL, Johnson NJ, Yu M, Altekruse SF, Cronin KA. Comparisons of individual- and area-level socioeconomic status as proxies for individual-level measures: evidence from the Mortality Disparities in American Communities study. Popul Health Metr. 2021;19:1–10.
pubmed: 33413469
pmcid: 7792135
doi: 10.1186/s12963-020-00244-x
Shih Y-CT, Bradley C, Yabroff KR. Ecological and individualistic fallacies in health disparities research. J Natl Cancer Inst. 2023;115:488–91.
pubmed: 36912704
pmcid: 10165478
doi: 10.1093/jnci/djad047
Tai DBG, Shah A, Doubeni CA, Sia IG, Wieland ML. The disproportionate impact of COVID-19 on racial and ethnic minorities in the United States. Clin Infect Dis. 2021;72:703–6.
pubmed: 32562416
doi: 10.1093/cid/ciaa815
Tsai J, Wilson M. COVID-19: a potential public health problem for homeless populations. Lancet Public Health. 2020;5:e186–7.
pubmed: 32171054
pmcid: 7104053
doi: 10.1016/S2468-2667(20)30053-0
Yearby R, Clark B, Figueroa JF. Structural racism in historical and modern US health care policy. Health Aff (Millwood). 2022;41:187–94.
pubmed: 35130059
doi: 10.1377/hlthaff.2021.01466
Kerr J, Smith A, Nzama N, Bullock NAA, Chandler C, Osezua V, et al. Systematic review of neighborhood factors impacting HIV care continuum participation in the United States. J Urban Health. 2023;101(1):31–63.
pubmed: 38093034
doi: 10.1007/s11524-023-00801-3
Gillot M, Gant Z, Hu X, Satcher JA. Linkage to HIV medical care and social determinants of health among adults with diagnosed HIV infection in 41 states and the district of columbia, 2017. Public Health Rep. 2022;137:888–900.
pubmed: 34318733
doi: 10.1177/00333549211029971
Aidala AA, Wilson MG, Shubert V, Gogolishvili D, Globerman J, Rueda S, et al. Housing status, medical care, and health outcomes among people living with HIV/AIDS: a systematic review. Am J Public Health. 2016;106:e1-23.
pubmed: 26562123
pmcid: 4695926
doi: 10.2105/AJPH.2015.302905
Menza TW, Hixson LK, Lipira L, Drach L. Social determinants of health and care outcomes among people with HIV in the united states. Open Forum Infect Dis. 2021;8:ofab330.
pubmed: 34307729
pmcid: 8297699
doi: 10.1093/ofid/ofab330
Hogan JW, Galai N, Davis WW. Modeling the impact of social determinants of health on HIV. AIDS Behav. 2021;25:215–24.
pubmed: 34478016
pmcid: 8414021
doi: 10.1007/s10461-021-03399-2
Viner RM, Ozer EM, Denny S, Marmot M, Resnick M, Fatusi A, et al. Adolescence and the social determinants of health. Lancet. 2012;379:1641–52.
pubmed: 22538179
doi: 10.1016/S0140-6736(12)60149-4