Exploring the Relation between Contextual Social Determinants of Health and COVID-19 Occurrence and Hospitalization

Abstract

It is prudent to take a unified approach to exploring how contextual social determinants of health (SDoH) relate to COVID-19 occurrence and outcomes. Poor geographically represented data and a small number of contextual SDoH examined in most previous research studies have left a knowledge gap in the relationships between contextual SDoH and COVID-19 outcomes. In this study, we linked 199 contextual SDoH factors covering 11 domains of social and built environments with electronic health records (EHRs) from a large clinical research network (CRN) in the National Patient-Centered Clinical Research Network (PCORnet) to explore the relation between contextual SDoH and COVID-19 occurrence and hospitalization. We identified 15,890 COVID-19 patients and 63,560 matched non-COVID-19 patients in Florida between January 2020 and May 2021. We adopted a two-phase multiple linear regression approach modified from that in the exposome-wide association (ExWAS) study. After removing the highly correlated SDoH variables, 86 contextual SDoH variables were included in the data analysis. Adjusting for race, ethnicity, and comorbidities, we found six contextual SDoH variables (i.e., hospital available beds and utilization, percent of vacant property, number of golf courses, and percent of minority) related to the occurrence of COVID-19, and three variables (i.e., farmers market, low access, and religion) related to the hospitalization of COVID-19. To our best knowledge, this is the first study to explore the relationship between contextual SDoH and COVID-19 occurrence and hospitalization using EHRs in a major PCORnet CRN. As an exploratory study, the causal effect of SDoH on COVID-19 outcomes will be evaluated in future studies.

Analysis of the Epidemic Curve of the Waves of COVID-19 Using Integration of Functions and Neural Networks in Peru

“…There are a few investigations that aim to find correlations between COVID-19 (deaths, cases, etc.) and other variables, such as COVID-19 occurrences and hospitalizations and Contextual Social Determinants of Health (SDoHs) [9]. However, to the best of the authors' knowledge, there are no studies on the correlation between social isolation measures and death rates from COVID-19.…”

“…According to the World Health Organization (WHO), up until 25 February 2024, the number of COVID-19 deaths (the cumulative total) was more than seven million, with 7141 in the 28 days leading up until that date (among which 84 were Peruvians) [5]. As a result, coronaviruses, the COVID-19 pandemic, and new variants are a notable subject of study in the scientific community [6][7][8][9]. In addition, the cumulative number of deaths is the most critical indicator of the impact of the pandemic in most countries, showing typical behavior in the form of waves [10].…”