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Social Determinants and Indicators of COVID-19 Among Marginalized Communities: A Scientific Review and Call to Action for Pandemic Response and Recovery

Published online by Cambridge University Press:  02 May 2022

Whitney S. Brakefield ,
Olufunto A. Olusanya Open the ORCID record for Olufunto A. Olusanya [Opens in a new window] ,
Brianna White  and
Arash Shaban-Nejad
Whitney S. Brakefield
Affiliation:
The University of Tennessee Health Science Center (UTHSC) - Oak Ridge National Laboratory (ORNL) Center for Biomedical Informatics, Department of Pediatrics, College of Medicine, Memphis, TN, USA The Bredesen Center for Data Science and Engineering, University of Tennessee, Knoxville, TN, USA
Olufunto A. Olusanya*
Affiliation:
The University of Tennessee Health Science Center (UTHSC) - Oak Ridge National Laboratory (ORNL) Center for Biomedical Informatics, Department of Pediatrics, College of Medicine, Memphis, TN, USA
Brianna White
Affiliation:
The University of Tennessee Health Science Center (UTHSC) - Oak Ridge National Laboratory (ORNL) Center for Biomedical Informatics, Department of Pediatrics, College of Medicine, Memphis, TN, USA
Arash Shaban-Nejad
Affiliation:
The University of Tennessee Health Science Center (UTHSC) - Oak Ridge National Laboratory (ORNL) Center for Biomedical Informatics, Department of Pediatrics, College of Medicine, Memphis, TN, USA
*
Corresponding author: Olufunto A. Olusanya, Email: oolusan1@uthsc.edu.
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Abstract

Coronavirus disease 2019 (COVID-19) has placed massive socio-psychological, health, and economic burdens including deaths on countless lives; however, it has disproportionally impacted certain populations. Co-occurring Social Determinants of Health (SDoH) disparities and other underlying determinants have exacerbated the COVID-19 pandemic. This literature review sought to (1) examine literature focused on SDoH and COVID-19 outcomes ie, infectivity, hospitalization, and death rates among marginalized communities; and (2) identify SDoH disparities associated with COVID-19 outcomes. We searched electronic databases for studies published from October 2019 to October 2021. Studies that were selected were those intersecting SDoH indicators and COVID-19 outcomes and were conducted in the United States. Our review underscored the disproportionate vulnerabilities and adverse outcomes from COVID-19 that have impacted racial/ethnic minority communities and other disadvantaged groups (ie, senior citizens, and displaced/homeless individuals). COVID-19 outcomes were associated with SDoH indicators, ie, race/ethnicity, poverty, median income level, housing density, housing insecurity, health-care access, occupation, transportation/commuting patterns, education, air quality, food insecurity, old age, etc. Our review concluded with recommendations and a call to action to integrate SDoH indicators along with relevant health data when implementing intelligent solutions and intervention strategies to pandemic response/recovery among vulnerable populations.

Keywords

COVID-19SARS-CoV-2social determinants of healthhealth disparitiesethnic minoritiespandemic preparednesshealth intelligence
Type
Concepts in Disaster Medicine
Information
Disaster Medicine and Public Health Preparedness , Volume 17 , 2023 , e193
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

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References

World Health Organization. WHO covid-19 case definition. Accessed February 27, 2022. https://www.who.int/publications/i/item/WHO-2019-nCoV-Surveillance_Case_Definition-2020.2.Google Scholar
World Health Organization. WHO coronavirus (COVID-19) dashboard. Accessed February 27, 2022. https://covid19.who.int/ Google Scholar
IHME. Covid-19 projections. Institute for Health Metrics and Evaluation. Accessed February 27, 2022. https://covid19.healthdata.org/united-states-of-america.Google Scholar
Wang, B, Li, R, Lu, Z, et al. Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis. Aging. 2020;12(7):6049-6057. doi: 10.18632/aging.103000 Google ScholarPubMed
Smith, MW. What are the complications of coronavirus (COVID-19)? WebMD. Published August 9, 2021. Accessed February 25, 2021. https://www.webmd.com/lung/coronavirus-complications#1.Google Scholar
World Health Organization. Social determinants of health. Accessed February 3, 2021. https://www.who.int/social_determinants/sdh_definition/en Google Scholar
Centers for Disease Control and Prevention. Social determinants of health. Published September 30, 2021. Accessed November 28, 2021. https://www.cdc.gov/socialdeterminants/index.htm Google Scholar
ODPHP. Social determinants of health. Healthy people. 2020. Accessed November 28, 2021. https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources Google Scholar
Paul, R, Arif, A, Pokhrel, K, et al. The Association of Social Determinants of Health with Covid-19 mortality in rural and urban counties. J Rural Health. 2021;37(2):278-286. doi: 10.1111/jrh.12557 Google ScholarPubMed
Palacio, A, Tamariz, L. Social determinants of health mediate COVID-19 disparities in South Florida. J Gen Intern Med. 2020;36(2):472-477. doi: 10.1007/s11606-020-06341-9 Google ScholarPubMed
Cyrus, E, Clarke, R, Hadley, D, et al. The impact of covid-19 on African American communities in the United States. Health Equity. 2020;4(1):476-483. doi: 10.1089/heq.2020.0030 Google ScholarPubMed
Shah, M, Sachdeva, M, Dodiuk-Gad, RP. Covid-19 and racial disparities. J Am Acad Dermatol. 2020;83(1). doi: 10.1016/j.jaad.2020.04.046 Google ScholarPubMed
Vasquez Reyes, M. The disproportional impact of COVID-19 on African Americans. Health Hum Rights. 2020;22(2):299-307.Google ScholarPubMed
Rozenfeld, Y, Beam, J, Maier, H, et al. A model of disparities: risk factors associated with COVID-19 infection. Int J Equity Health. 2020;19(1):126. doi: 10.1186/s12939-020-01242-z Google Scholar
US Census. Income and poverty in the United States: 2018. Census.gov. Published October 8, 2021. Accessed November 28, 2021. https://www.census.gov/library/publications/2019/demo/p60-266.html Google Scholar
Neelon, B, Mutiso, F, Mueller, NT et al. Spatial and temporal trends in social vulnerability and covid-19 incidence and death rates in the United States. PLoS One. 2021;16(3):e0248702. doi: 10.1371/journal.pone.0248702 Google ScholarPubMed
Hathaway, ED. American Indian and Alaska native people: social vulnerability and Covid-19. J Rural Health. 2020;37(1):256-259. doi: 10.1111/jrh.12505 Google ScholarPubMed
Kakol, M, Upson, D, Sood, A. Susceptibility of southwestern American Indian tribes to coronavirus disease 2019 (Covid-19). J Rural Health. 2020;37(1):197-199. doi: 10.1111/jrh.12451 Google ScholarPubMed
Fielding-Miller, RK, Sundaram, ME, Brouwer, K. Social determinants of covid-19 mortality at the county level. PLoS One. 2020;15(10):0240151. doi: 10.1371/journal.pone.0240151 Google ScholarPubMed
Calderón-Larrañaga, A, Dekhtyar, S, Vetrano, DL, et al. Covid-19: risk accumulation among biologically and socially vulnerable older populations. Ageing Res Rev. 2020;63:101149. doi: 10.1016/j.arr.2020.101149 Google ScholarPubMed
Bauer, C, Zhang, K, Lee, M, et al. Census tract patterns and contextual social determinants of health associated with covid-19 in a Hispanic population from South Texas: a spatiotemporal perspective. JMIR Public Health Surveill. 2021;7(8):e29205. doi: 10.2196/29205 CrossRefGoogle Scholar
Coughlin, CG, Sandel, M, Homelessness, Stewart AM., children, and covid-19: a looming crisis. Pediatrics. 2020;146(2). doi: 10.1542/peds.2020-1408 CrossRefGoogle ScholarPubMed
Ogunyemi, D, Mantilla, R, Markus, A, et al. Associations between structural and social determinants of health with Covid infection rates at a safety net hospital. Cureus. 2021;13(8):e17397. doi: 10.7759/cureus.17397 Google Scholar
Bai, S, Jiao, J, Chen, Y. Mapping the intercounty transmission risk of COVID-19 in New York State. SSRN. 2020. doi:10.2139/ssrn.3582774Google Scholar
Islam, SJ, Nayak, A, Hu, Y, 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(7):e048086. doi: 10.1136/bmjopen-2020-048086 CrossRefGoogle Scholar
Chen, Y, Jiao, J, Bai, S, et al. Modeling the spatial factors of COVID-19 in New York City. SSRN. 2020. doi:10.2139/ssrn.3606719Google Scholar
Tessum, CW, Apte, JS, Goodkind, AL, et al. Inequity in consumption of goods and services adds to racial–ethnic disparities in air pollution exposure. Proc Natl Acad Sci U S A. 2019;116(13):6001-6006. doi: 10.1073/pnas.1818859116 CrossRefGoogle ScholarPubMed
Wu, X, Nethery, RC, Sabath, MB, et al. Air pollution and covid-19 mortality in the United States: strengths and limitations of an ecological regression analysis. Sci Adv. 2020;6(45):eabd4049. doi: 10.1126/sciadv.abd4049 CrossRefGoogle ScholarPubMed
Millett, GA, Jones, AT, Benkeser, D, et al. Assessing differential impacts of COVID-19 on Black Communities. Ann Epidemiol. 2020;47:37-44. doi: 10.1016/j.annepidem.2020.05.003 Google ScholarPubMed
Nittle, N. People of color are at greater risk of COVID-19. systemic racism in the food system plays a role. Civil Eats. Published March 31, 2021. Accessed November 28, 2021. https://civileats.com/2020/05/05/people-of-color-are-at-greater-risk-of-covid-19-systemic-racism-in-the-food-system-plays-a-role/ Google Scholar
Alleyne, KR. Opinion | how covid-19 is a perfect storm for Black Americans. The Washington Post. Published April 27, 2020. Accessed November 28, 2021. https://www.washingtonpost.com/opinions/2020/04/26/we-must-address-social-determinants-affecting-black-community-defeat-covid-19/ Google Scholar
Sharma, SV, Chuang, R-J, Rushing, M, et al. Social determinants of health–related needs during COVID-19 among low-income households with children. Prev Chronic Dis. 2020;17:E119. doi: 10.5888/pcd17.200322 Google ScholarPubMed
Shin, EK, Kwon, Y, Shaban-Nejad, A. Geo-clustered chronic affinity: pathways from socio-economic disadvantages to Health Disparities. JAMIA Open. 2019;2(3):317-322. doi: 10.1093/jamiaopen/ooz029 CrossRefGoogle ScholarPubMed
Kim, SJ, Bostwick, W. Social vulnerability and racial inequality in covid-19 deaths in Chicago. Health Educ Behav. 2020;47(4):509-513. doi: 10.1177/1090198120929677 CrossRefGoogle ScholarPubMed
Gold, JAW, Wong, KK, Szablewski, CM, et al. Characteristics and clinical outcomes of adult patients hospitalized with COVID-19 — Georgia, March 2020. MMWR Morb Mortal Wkly Rep. 2020;69(18):545-550. doi: 10.15585/mmwr.mm6918e1 CrossRefGoogle ScholarPubMed
The Covid Racial Data tracker. The COVID Tracking Project. Accessed November 28, 2021. https://covidtracking.com/race Google Scholar
Yancy, CW. Covid-19 and African Americans. JAMA. 2020;323(19):1891. doi: 10.1001/jama.2020.6548 CrossRefGoogle ScholarPubMed
Gutman, M, Yang, A, Shakya, T, et al. Navajo community left to fight COVID-19 with limited resources. ABC News. Accessed November 28, 2021. https://abcnews.go.com/Health/navajo-community-left-fight-covid-19-limited-resources/story?id=70490722 Google Scholar
Nagle, R. Native Americans being left out of US coronavirus data and labelled as ‘other’. The Guardian. Published April 24, 2020. Accessed November 28, 2021. https://www.theguardian.com/us-news/2020/apr/24/us-native-americans-left-out-coronavirus-data.Google Scholar
Webb Hooper, M, Nápoles, AM, Pérez-Stable, EJ. Covid-19 and racial/ethnic disparities. JAMA. 2020;323(24):2466. doi: 10.1001/jama.2020.8598 Google ScholarPubMed
Laurencin, CT, McClinton, A. The COVID-19 pandemic: a call to action to identify and address racial and ethnic disparities. J Racial Ethn Health Disparities. 2020;7(3):398-402. doi: 10.1007/s40615-020-00756-0 CrossRefGoogle Scholar
Heath, S. How the coronavirus affects social determinants of health. Patient Engagement HIT. Published March 24, 2020. Accessed November 28, 2021. https://patientengagementhit.com/news/how-the-coronavirus-affects-social-determinants-of-health Google Scholar
Green, H, Fernandez, R, MacPhail, C. The social determinants of health and health outcomes among adults during the COVID-19 pandemic: a systematic review. Public Health Nurs. 2021;38(6):942-952. doi: 10.1111/phn.12959 CrossRefGoogle ScholarPubMed
Abrams, EM, Szefler, SJ. Covid-19 and the impact of social determinants of health. Lancet Respir Med. 2020;8(7):659-661. doi: 10.1016/s2213-2600(20)30234-4 CrossRefGoogle ScholarPubMed
Ryan, BJ, Coppola, D, Canyon, DV, et al. Covid-19 Community Stabilization and sustainability framework: an integration of the Maslow Hierarchy of needs and social determinants of health. Disaster Med Public Health Prep. 2020;14(5):623-629. doi: 10.1017/dmp.2020.109 CrossRefGoogle ScholarPubMed
Jani, A. Preparing for covid-19’s aftermath: simple steps to address social determinants of health. J R Soc Med. 2020;113(6):205-207. doi: 10.1177/0141076820921655 Google ScholarPubMed
Meneses-Navarro, S, Freyermuth-Enciso, MG, Pelcastre-Villafuerte, BE, et al. The challenges facing indigenous communities in Latin America as they confront the COVID-19 pandemic. Int J Equity Health. 2020;19(1):63. doi: 10.1186/s12939-020-01178-4 CrossRefGoogle ScholarPubMed
Brakefield, WS, Ammar, N, Olusanya, OA, et al. An urban population health observatory system to support COVID-19 pandemic preparedness, response, and management: design and development study. JMIR Public Health Surveill. 2021;7(6):e28269. doi: 10.2196/28269 CrossRefGoogle ScholarPubMed
Shin, EK, Shaban-Nejad, A. Urban decay and pediatric asthma prevalence in Memphis, Tennessee: urban data integration for efficient population health surveillance. IEEE Access. 2018;6:46281-46289. doi: 10.1109/access.2018.2866069 Google Scholar
Shin, EK, LeWinn, K, Bush, N, et al. Association of maternal social relationships with cognitive development in early childhood. JAMA Netw Open. 2019;2(1):186963. doi: 10.1001/jamanetworkopen.2018.6963 CrossRefGoogle ScholarPubMed
Ye, J. The role of health technology and informatics in a global public health emergency: practices and implications from the COVID-19 pandemic. JMIR Med Inform. 2020;8(7):e19866. doi: 10.2196/19866 CrossRefGoogle Scholar
Toussie, D, Voutsinas, N, Finkelstein, M, et al. Clinical and chest radiography features determine patient outcomes in young and middle-aged adults with covid-19. Radiology. 2020;297(1):E197-e206. doi: 10.1148/radiol.2020201754 Google Scholar
Pappan, N, Austin, S, Venkat, D, et al. Identifying social determinants of health and allocating resources during the COVID-19 pandemic. Infect Dis Clin Pract (Baltim Md). 2021;29(4):e221-e223. doi: 10.1097/ipc.0000000000001003 CrossRefGoogle ScholarPubMed