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. 2021 Sep 24;16(9):e0257622.
doi: 10.1371/journal.pone.0257622. eCollection 2021.

Census tract socioeconomic indicators and COVID-19-associated hospitalization rates-COVID-NET surveillance areas in 14 states, March 1-April 30, 2020

Jonathan M Wortham  1   2 , Seth A Meador  1 , James L Hadler  3 , Kimberly Yousey-Hindes  3 , Isaac See  1   2 , Michael Whitaker  1 , Alissa O'Halloran  1 , Jennifer Milucky  1 , Shua J Chai  4   5 , Arthur Reingold  4 , Nisha B Alden  6 , Breanna Kawasaki  6 , Evan J Anderson  7   8   9 , Kyle P Openo  7   8   9 , Andrew Weigel  10 , Maya L Monroe  11 , Patricia A Ryan  11 , Sue Kim  12 , Libby Reeg  12 , Ruth Lynfield  13 , Melissa McMahon  13 , Daniel M Sosin  14 , Nancy Eisenberg  15 , Adam Rowe  16 , Grant Barney  16 , Nancy M Bennett  17 , Sophrena Bushey  17 , Laurie M Billing  18 , Jess Shiltz  18 , Melissa Sutton  19 , Nicole West  19 , H Keipp Talbot  20 , William Schaffner  20 , Keegan McCaffrey  21 , Melanie Spencer  22 , Anita K Kambhampati  1 , Onika Anglin  1 , Alexandra M Piasecki  1 , Rachel Holstein  1 , Aron J Hall  1 , Alicia M Fry  1   2 , Shikha Garg  1   2 , Lindsay Kim  1   2
Affiliations

Census tract socioeconomic indicators and COVID-19-associated hospitalization rates-COVID-NET surveillance areas in 14 states, March 1-April 30, 2020

Jonathan M Wortham et al. PLoS One. .

Abstract

Objectives: Some studies suggested more COVID-19-associated hospitalizations among racial and ethnic minorities. To inform public health practice, the COVID-19-associated Hospitalization Surveillance Network (COVID-NET) quantified associations between race/ethnicity, census tract socioeconomic indicators, and COVID-19-associated hospitalization rates.

Methods: Using data from COVID-NET population-based surveillance reported during March 1-April 30, 2020 along with socioeconomic and denominator data from the US Census Bureau, we calculated COVID-19-associated hospitalization rates by racial/ethnic and census tract-level socioeconomic strata.

Results: Among 16,000 COVID-19-associated hospitalizations, 34.8% occurred among non-Hispanic White (White) persons, 36.3% among non-Hispanic Black (Black) persons, and 18.2% among Hispanic or Latino (Hispanic) persons. Age-adjusted COVID-19-associated hospitalization rate were 151.6 (95% Confidence Interval (CI): 147.1-156.1) in census tracts with >15.2%-83.2% of persons living below the federal poverty level (high-poverty census tracts) and 75.5 (95% CI: 72.9-78.1) in census tracts with 0%-4.9% of persons living below the federal poverty level (low-poverty census tracts). Among White, Black, and Hispanic persons living in high-poverty census tracts, age-adjusted hospitalization rates were 120.3 (95% CI: 112.3-128.2), 252.2 (95% CI: 241.4-263.0), and 341.1 (95% CI: 317.3-365.0), respectively, compared with 58.2 (95% CI: 55.4-61.1), 304.0 (95%: 282.4-325.6), and 540.3 (95% CI: 477.0-603.6), respectively, in low-poverty census tracts.

Conclusions: Overall, COVID-19-associated hospitalization rates were highest in high-poverty census tracts, but rates among Black and Hispanic persons were high regardless of poverty level. Public health practitioners must ensure mitigation measures and vaccination campaigns address needs of racial/ethnic minority groups and people living in high-poverty census tracts.

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Conflict of interest statement

Dr. Anderson reports consulting for AbbVie, Pfizer, and Sanofi-Pasteur and clinical trials research funding from MedImmune, Regeneron, PaxVax, Pfizer, GSK, Merck, Novavax, Sanofi Pasteur, Micron, and Janssen. He also works on a safety monitoring board for Kentucky Bioprocessing, Inc. All are outside of the submitted work. No other disclosures were reported. Nonetheless, this does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Age-adjusted COVID-19-associated hospitalization rates by census tract-level poverty strata (quartile)—COVID-NET catchment areas in 14 states, March–April 2020.
Fig 2
Fig 2. Age adjusted COVID-19-associated hospitalization rates by census tract-level poverty strata (quartiles) and race/ethnicity—COVID-NET catchment areas in 14 states, March–April 2020.
Fig 3
Fig 3. Age-adjusted COVID-19-associated hospitalization rates by census tract-level poverty strata (quartiles) and race/ethnicity—COVID-NET catchment areas in 14 states, March–April 2020.
See this image and copyright information in PMC

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