Relationship of Social Vulnerability, COVID-19 Mortality, Life Expectancy, and Chronic Disease Prevalence: Policy Implications for Public Health and Social Sciences Funding
15-Dec-3403.pdf
Peter John Fos
Minority Health and Health Equity Research Center, Dillard University
Peggy Ann Honore'
Louisiana State University Health Sciences Center, School of Public Health, School of Medicine
Katrina Patchus Kellum
Dillard University, College of Nursing
Background: The Centers for Disease Control and Prevention and its affiliate the Agency for Toxic Substances & Disease Registry established an index to identify the social vulnerability for natural disasters and infectious disease outbreaks for communities in the United States. This index, potentially, may be useful in evaluating the impact of social vulnerability on health.
Aim: The objective of the study is to identify the relationship of the Social Vulnerability index with COVID-19, chronic diseases, and life expectancy.
Methods: Social Vulnerability Index values were obtained for counties in Georgia, Louisiana (parishes), Michigan, and Mississippi. Current data on COVID-19, diabetes and obesity prevalence, premature age-adjusted death rates, and life expectancy were obtained from the County Health Ranking and Roadmaps. Pearson's correlation coefficients were calculated for the relationship of social vulnerability and health outcomes. The relationship of funding for public health and social services interventions that target the social determinants of health as a mechanism for reducing community vulnerabilities was also examined.
Results: Correlations were determined between social vulnerability and several health outcomes, both infectious and chronic diseases. Life expectancy was correlated with social vulnerability, overall and by race. Study findings found a positive correlation between social vulnerability and COVID-19 infections and mortality, premature age-adjusted mortality, and the prevalence of diabetes and obesity. There is a negative correlation between social vulnerability and life expectancy. Additionally, life expectancy was greater in non-Hispanic Whites compared to non-Hispanic Blacks.
Conclusion: The study results can be used to guide policies directed to improvements in the social determinants of health that target reductions in community vulnerabilities. Social vulnerability of communities can be reduced with adequate resource allocations in public health and social services to mitigate untoward health outcomes associated with natural disasters and disease outbreaks.
Keywords: social vulnerability, COVID-19, life expectancy, social sciences funding
FOS, Peter John; HONORE', Peggy Ann; KELLUM, Katrina Patchus. Relationship of Social Vulnerability, COVID-19 Mortality, Life Expectancy, and Chronic Disease Prevalence: Policy Implications for Public Health and Social Sciences Funding. Medical Research Archives, [S.l.], v. 10, n. 12, jan. 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/3403>. Date accessed: 29 jan. 2023. doi: https://doi.org/10.18103/mra.v10i12.3403.
1. United Nations. (2022, October 21). Retrieved from
https://www.un.org/en/pdfs/UNCOVID19ResearchRoadmap.pdf
2. Centers for Disease Control and Prevention. CDC's Social Vulnerability Index (SVI). 2018. https://svi.scd.gov/factsheet.html. Accessed on September 25, 2022.
3. Taylor LA, Tan AX, Coyle, et al. Leveraging the social determinants of health: What works? PLoS One. 2016;11(8):e0160217. https://doi.org/journal.pone.0160217
4. Woolf SH. Social policy as health policy, JAMA. 2009;30(11):1166-1169. https://doi.org/jama.20090320
5. Office of Disease Prevention and Health Promotion. Healthy People 2030. Department of Health and Human Services.
6. World Health Organization. Social determinants of health. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1
7. Biggs EN, Maloney PM, Rung AL, Peters ES, Robinson WT. The relationship between social vulnerability and COVID-19 incidence among Louisiana census tracts. Front Public Health. 2020;8:617976. https://doi.org/10.3389/fpubh.2020.617976
8. Goulding AN, Ramphul RC, Seferovic M, Aagaard KM. Is social vulnerability associated with COVID-19 among pregnant women? Am J Obstet Gynecol. 2021;24(2)supplement:S678-S679. https://doi.org/10.1016/j.ajog.2020.12.1125
9. Hughes MM, Wang A, Grossman MK, et al. County-level COVID-19 vaccination coverage and social vulnerability – United States, December 14, 2020 – March 1, 2021. MMWR Morb Mort Wkly Rep. 2021;70(12):431-436. https://www.cdc.gov/vaccines/covid-19/vaccination-provider-support.html
10. Khazanchi R, Beiter ER, Gondi S, Beckman AL, Bilinski A, Ganguli I. County-level association of social vulnerability with COVID-19 cases and deaths in the USA. J Gen Intern Med. 2020;35(9):2784-2787. https://doi.org/10.1007/s11606-020-05882-3
11. Saelee R, Zell E, Murthy BP, et al. Disparities in COVID-19 vaccination coverage between urban and rural counties: United States, December 14, 2020-January31, 2022. MMWR Morb Mort Wkly Rep. 2022;71(9): 335-340.
12. Hathaway ED. American Indian and Alaska Native People: Social vulnerability and COVID-19. J Rural Health. 2021;37:256-259. https://doi.org/10.111/jrh.12505
13. Andersson C, Vasan RS. Epidemiology of cardiovascular disease in young individuals. Nat Rev Cardiol. 2018;15:230-240. https://doi.org/10.1038/nrcardio.2017.154
14. Khan SU, Javed Z, Lone A, et al. Social vulnerability and premature cardiovascular mortality among US counties, 2014-2018. Circulation. 2021;144(16):1272-1279. https://doi.org/10.1161/CIRCULATIONAHA.121.054516
15. Muennig PA, Reynold M, Fink DS, Zafari Z, Geronimus AT. America's declining well-being, health, and life expectancy: Not just a white problem. Am J Public Health. 2018; 108(12):1626-1631. https://doi.org/10.2105/AJPH.2018.304585
16. Singh GK, Lee H. Marked disparities in life expectancy by education, poverty level, occupation, and housing tenure in the United States, 1997-2014. Int J MCH AIDS. 2021;10(1): 7-18. https://doi.org/10.21106/ijma.402
17. Nguyen TN, Ngangue P, Bouhai T, Ryan BL, Stewart M, Fortin M. Social vulnerability in patients with multimorbidity: a cross-sectional analysis. Int J Environ Res Public Health. 2019;16(7):1244. https://doi.org/10.3390/ojerph16071244
18. Willysha J, Jack, C, Tyrdlik K. Examining the intersection of life expectancy and social vulnerability by locality. NC Med J. 2022;86(5):322-324.
19. Ohsfeldt RL, et al. Inpatient hospital costs for COVID-19 patients in the United States. Adv Ther. 2021;35:5557-5595. https://doi.org/10.1007/s12325-021-01887-4
20. Bartsch SM, Ferguson MC, McKinnell JA, O'Shea KJ, Wedlock PT, Siegmund SS, Lee BY. The potential health care costs and resource use associated with COVID-19 in the United States. Health Aff. 2020;39(6). https://doi.org/10.1377/hlthaff.2020.00426
21. Center on Budget and Policy Priorities (2022). Policy basics: Where do our federal tax dollars go? https://cbpp.org/research/federal-budget/where-do-our-federal-dollars-go
22. Himmelstein DU, Wollhandler S. Public health's falling share of US health spending. Am J Public Health. 2016;106(1):56-57.
23. Bradley EH, Canavan M, Rogan E, et al. Variation in health outcomes: The role of spending on social services, public health, and health care. Health Aff. 2010;35(3). https://doi.org/10.1377/hlthaff.2015.0814
24. Papanicolas I. The relationship between health spending and social spending in high-income countries: How does the US compare? Health Aff. 2019;38(9):1567-1575. https://doi.org/10.1377/hlthaff.2018.05187
25. Fos PJ, Honoré PA, Kellum KP. The relationship of diabetes and COVID-19: A health disparity. Diabetes & its Complications. 2020;4(1):1-8. doi:10.33425/2639-9326.1065.
26. Fos P, Honoré PA, Honoré RL. Air Pollution and COVID-19. European Journal of Environment and Public Health. 2021;5(2). doi:10721601/ejeph/9706
27. Fos PJ, Honoré PA, Kellum KP. Narrowing of the racial gap in opioid-involved deaths: Implications for policy and practice. Journal of Public Health Issues and Practices. 2021;5(1). doi:10.33790/jphip1100125.
28. Fos PJ, Honoré PA Honoré RL, Patterson K. (2021). Health status in fence-line communities: The impact of air pollution. International Journal of Family Medicine and Primary Care. 2021;2(3):1040.
29. Fos PJ, Honoré PA, Kellum KP. COVID-19 mortality, diabetes, and obesity: The impact of health inequity. Journal of Public Health Issues and Practices. 2021;5(2):187. doi:10.33790/jphip1100187
30. Fos PJ, Honoré PA, Kellum KP (2022). The impact of the COVID-19 pandemic on the opioid epidemic: A statewide analysis. Journal of Public Health Issues and Practices. 2022;6(1):205. doi:10.33790/jphip1100205
31. University of Wisconsin Population Health Institute. County Health Rankings and Roadmaps. Accessed on October 3, 2022. https://countyhealthrankings.org
32. Arias E, Tejada-Vera B, Ahmad F, Kochanek KD. Provisional life expectancy estimates for 2020. Vital Statistics Rapid Release, no. 15. Hyattsville, MD. National Center for Health Statistics. July 2021. Accessed on November 27, 2022. http://dx.doi.org/10.15620/cdc:107201
33. Perry AM, Romer C, Barr A. Why is life expectancy so low in Black neighborhood? Brookings, December 20, 2021. Accessed on November 27, 2022. https://www.brookings.edu/blog/the-avenue/2021/12/20/why-is-life-expectancy-so-low-in-black-neighborhoods/
34. Goux DM, Maurin E. The effect of overcrowding housing in children's performance at school. J Public Health Econ. 2005;89(5):797-819.
35. Neelon B, Mutiso F, Mueller NT, Pearce JL, Benjamin-Neelon SE. Spatial and temporal trends in social vulnerability and COVID-19 incidence and death rates in the United States. PLoS One. 2021;16(3):e0248702. https://doi.org/10.1371/journal.pone.0248702
36. Dwyer-Lindgren L, Parkes K, Kelly YO, et al. Life expectancy by county, race, and ethnicity in the USA, 2000-2019: A systematic analysis of health disparities. Lancet. 2022;400(10345): 25-28. https://doi.org/10.1016/S0140-6736(22)00876-5