Many studies have investigated causes of COVID-19 and explored safety measures for preventing COVID-19 infections. Unfortunately, these studies fell short to address disparities in health status and resources among decentralized communities in the United States. In this study, we utilized an advanced modeling technique to examine complex associations of county-level health factors with COVID-19 mortality for all 3141 counties in the United States. Our results indicated that counties with more uninsured people, more housing problems, more urbanized areas, and longer commute are more likely to have higher COVID-19 mortality. Based on the nationwide population-based data, this study also echoed prior research that used local data, and confirmed that county-level sociodemographic factors, such as more Black, Hispanic, and older subpopulations, are attributed to high risk of COVID-19 mortality. We hope that these findings will help set up priorities on high risk communities and subpopulations in future for fighting the novel virus.

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This retrospective cohort study used electronic health records to explore the effect of race/ethnicity, insurance status, and area deprivation on post-discharge outcomes in older patients undergoing hip fracture surgery between 2015 and 2018 ( N = 1,150). Inverse probability of treatment weight-adjusted regression analysis was used to identify the effects of the predictors on outcomes. White patients had higher 90- and 365-day readmission risks than Black patients and higher all-period readmissions than the Other racial/ethnic (Hispanic, Asian, American Indian, and Multicultural) group ( p < .000). Black patients had a higher risk of 30- and 90-day readmission than the Other racial/ethnic group ( p < .000). Readmission risk across 1-year follow-up was generally higher among patients from less deprived areas than more deprived areas ( p < .05). The 90- and 365-day mortality risk was lower for patients from less deprived areas (vs. more deprived areas) and patients with Medicare Advantage (vs. Medicare), respectively ( p < .05). Our findings can guide efforts to identify patients for additional post-discharge support. Nevertheless, the findings regarding readmission risks contrast with previous knowledge and thus require more validation studies.

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