Social Determinants of Health Amplify the Association Between Ethnicity and COVID19: A Retrospective-Cohort study
DOI:
https://doi.org/10.5195/ijms.2021.1125Keywords:
social determinants of health, health care disparities, ethnicityAbstract
Background: People in racial and ethnic minority groups have been shown to be at increased risk for a variety of diseases, including COVID-19. However, the role that social needs play in this increased risk has not yet been quantified. Investigating these roles can elicit a greater understanding of how social needs influence how this disease is contracted and spread. Methods: A retrospective analysis was conducted of 1,969 Lynn Community Health Center patients. Patients that visited the center between February 1st and July 1st, 2020, tested for COVID-19, and screened for social determinants of health (SDOH) risk factors were included. Demographics were compared between COVID-19 positive and negative patients. Confounding by age on the association between ethnicity and COVID-19 status was evaluated. A stratified analysis was performed to evaluate the effect modification of SDOH on the relationship between race, ethnicity, and COVID-19 status. Results: Hispanic patients had 2.93 times the odds of a positive COVID-19 test compared to Non-Hispanics (95% CI: 2.37, 3.64). With at least one SDOH risk factor, Hispanics had 4.71 times the odds of a positive COVID-19 test relative to Non-Hispanics (95% CI: 3.10, 7.14). With no SDOH risk factors, Hispanics had 2.45 times the odds of a positive COVID-19 test relative to Non-Hispanics (95% CI: 1.91, 3.16). No significant associations were found for race. Conclusion: Ethnicity had a significant impact on COVID-19 status in our population, where the effect of ethnicity on COVID-19 status was amplified for those with SDOH risk factors
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