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dc.contributor.authorBerman, Adam E.
dc.contributor.authorMiller, D. Douglas
dc.contributor.authorRahn, Daniel W.
dc.contributor.authorHess, David C.
dc.contributor.authorThompson, Mark A.
dc.contributor.authorMossialos, Elias A.
dc.contributor.authorWaller, Jennifer L.
dc.date.accessioned2023-11-28T16:38:19Z
dc.date.available2023-11-28T16:38:19Z
dc.date.issued2021-09
dc.identifier.citationBerman, A. E., Miller, D. D., Rahn, D. W., Hess, D. C., Thompson, M. A., Mossialos, E. A., & Waller, J. L. (2021). A County-Level Analysis of Socioeconomic and Clinical Predictors of COVID-19 Incidence and Case-Fatality Rates in Georgia, March–September 2020. Public Health Reports, 136(5), 626-635. https://doi.org/10.1177/00333549211023267en_US
dc.identifier.urihttp://hdl.handle.net/10675.2/624910
dc.description.abstractObjectives: The global COVID-19 pandemic has affected various populations differently. We investigated the relationship between socioeconomic determinants of health obtained from the Robert Wood Johnson Foundation County Health Rankings and COVID-19 incidence and mortality at the county level in Georgia. Methods: We analyzed data on COVID-19 incidence and case-fatality rates (CFRs) from the Georgia Department of Public Health from March 1 through August 31, 2020. We used repeated measures generalized linear mixed models to determine differences over time in Georgia counties among quartile health rankings of health outcomes, health behaviors, clinical care, social and economic factors, and physical environment. Results: COVID-19 incidence per 100 000 population increased across all quartile county groups for all health rankings (range, 23.1-51.6 in May to 688.4-1062.0 in August). COVID-19 CFRs per 100 000 population peaked in April and May (range, 3312-6835) for all health rankings, declined in June and July (range, 827-5202), and increased again in August (range, 1877-3310). Peak CFRs occurred later in counties with low health rankings for health behavior and clinical care and in counties with high health rankings for social and economic factors and physical environment. All interactions between the health ranking quartile variables and month were significant (P <.001). County-level Gini indices were associated with significantly higher rates of COVID-19 incidence (P <.001) but not CFRs. Conclusions: From March through August 2020, COVID-19 incidence rose in Georgia’s counties independent of health rankings categorization. Differences in time to peak CFRs differed at the county level based upon key health rankings. Public health interventions should incorporate unique strategies to improve COVID-19–related patient outcomes in these environments.en_US
dc.language.isoenen_US
dc.publisherSage Journalsen_US
dc.subjectCOVID-19en_US
dc.subjectGeorgiaen_US
dc.subjectmortalityen_US
dc.subjectsocioeconomic determinants of healthen_US
dc.titleA County-Level Analysis of Socioeconomic and Clinical Predictors of COVID-19 Incidence and Case-Fatality Rates in Georgia, March–September 2020en_US
dc.contributor.departmentAugusta Universityen_US
dc.identifier.journalPublic Health Reportsen_US
refterms.dateFOA2023-11-28T16:38:20Z


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