One year into the pandemic: the impacts of social vulnerability on COVID-19 outcomes and urban–rural differences in the conterminous United States

ABSTRACT

This paper first explores spatial distributions and patterns of COVID-19 case rates (cases/100,000 people) and mortality rates (deaths/100,000 people) and their disparities between urban and rural counties in the contiguous US. A county-level social vulnerability index was created using principal component analysis. Social vulnerability components were regressed against both county case and mortality rates. Results suggest that hotspots of case and mortality rates are clustered in Midwest and Upper-Midwest US. We found substantial disparities in case and mortality rates between urban and rural counties. County social vulnerability was positively correlated with both case and mortality rates suggesting counties with higher social vulnerability had higher case and mortality rates. Relationships between social vulnerability components and case and mortality rates vary across the conterminous US. Additionally, counties with increased racial and ethnic minorities, higher percentages of minors, and lower median household income are associated with higher COVID-19 case and mortality rates.

KEYWORDS:

• COVID-19
• social vulnerability
• urban–rural differences
• spatially varying relationships

Supplementary material

Supplemental data for this article can be accessed here.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

COVID-19 confirmed cases and mortalities data are publicly available at https://usafacts.org/visualizations/coronavirus-covid-19-spread-map/; American Community Survey (ACS) data are publicly available at https://www.census.gov/programs-surveys/acs; Centers for Disease Control and Prevention (CDC) data are publicly available at https://www.atsdr.cdc.gov/placeandhealth/svi/index.html; and National Historical Geographic Information System (NHGIS) for social vulnerability data are publicly available at https://www.nhgis.org/.