ArticleJournal of racial and ethnic health disparities2022
Racial/Ethnic Heterogeneity and Rural-Urban Disparity of COVID-19 Case Fatality Ratio in the USA: a Negative Binomial and GIS-Based Analysis.
Article in Journal of racial and ethnic health disparities, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 3 of them syntheses that pooled it.
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Who cites it
46 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Urban and Rural Disparities in COVID-19 Outcomes in the United States: A Systematic Review.Medical care research and review : MCRR · 2025Pooled it
- Effects of the built environment and human factors on the spread of COVID-19: A systematic literature review.The Science of the total environment · 2022Pooled it
- Methods Used in the Spatial and Spatiotemporal Analysis of COVID-19 Epidemiology: A Systematic Review.International journal of environmental research and public health · 2022Pooled it
- Community-level determinants of buprenorphine provider availability: A ZCTA-level (zip code tabulation area) analysis.Drug and alcohol dependence reports · 2026Article
- Robust COVID-19 Mortality Risk Assessment: Validation of a Two-Step Algorithm From the National COVID Cohort Collaborative.The Journal of infectious diseases · 2026Article
- Environmental Exposures and COVID-19 Experiences in the United States, 2020-2022.International journal of environmental research and public health · 2025Article
- No brain MRI abnormalities after mild-to-moderate COVID-19: an observational study.Neuroradiology · 2025Observational
- Ingroup Favoritism Surrounding COVID-19 Vaccinations in the Hispanic Communities: Experimental Study.Journal of medical Internet research · 2025Article
- An ecological study of COVID-19 outcomes among Florida counties.BMC public health · 2025Article
- Analysis of equity in the distribution of human resources and hospital beds and its association with the COVID-19 mortality rate: a case of Iran.BMC health services research · 2025Article
- Recognising the heterogeneity of Indigenous Peoples during the COVID-19 pandemic: a scoping review across Canada, Australia, New Zealand and the USA.BMJ public health · 2024Article
- The rural mortality penalty in U.S. hospital patients with COVID-19.Population health metrics · 2024Article
- Article
- The Psychosocial Impact of the COVID-19 Pandemic on Families of Youth of Color: A Prospective Cohort Study.Journal of pediatric psychology · 2024Article
- Campus Racial Climate, Psychological Well-being, and Race-Based Traumatic Stress Symptoms Among Monoracial Black and Biracial Black Students Following Heightened Exposure to Police Brutality.Journal of racial and ethnic health disparities · 2024Article
- Incarceration's lingering health effects on Black men: impacts persist into retirement.AIMS public health · 2024Article
- Inequity in Washington state covid-19-related crowdfunding.Social sciences & humanities open · 2024Article
- Toward decolonized fiscal relationships between universities and community organizations: Lessons learned from the California Community Engagement Alliance Against COVID-19.Critical public health · 2024Article
- The rural mortality penalty in U.S. hospital patients with COVID-19.Research square · 2023Article
- Refining 2SVCA Method for Measuring Telehealth Accessibility of Primary Care Physicians in Baton Rouge, Louisiana.Cities (London, England) · 2023Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The 2019 coronavirus disease (COVID-19) has exacerbated inequality in the United States of America (USA). Black, indigenous, and people of color (BIPOC) are disproportionately affected by the pandemic. This study examines determinants of COVID-19 case fatality ratio (CFR) based on publicly sourced data from January 1 to December 18, 2020, and sociodemographic and rural-urban continuum data from the US Census Bureau. Nonspatial negative binomial Poisson regression and geographically weighted Poisson regression were applied to estimate the global and local relationships between the CFR and predictors-rural-urban continuum, political inclination, and race/ethnicity in 2407 rural counties. The mean COVID-19 CFR among rural counties was 1.79 (standard deviation (SD) = 1.07; 95% CI 1.73-1.84) higher than the total US counties (M = 1.69, SD = 1.18; 95% CI: 1.65-1.73). Based on the global NB model, CFR was positively associated with counties classified as "completely rural" (incidence rate ratio (IRR) = 1.24; 95% CI: 1.12-1.39) and "mostly rural" (IRR = 1.26; 95% CI: 1.15-1.38) relative to "mostly urban" counties. Nonspatial regression indicates that COVID-19 CFR increases by a factor of 8.62, 5.87, 2.61, and 1.36 for one unit increase in county-level percent Blacks, Hispanics, American Indians, and Asian/Pacific Islanders, respectively. Local spatial regression shows CFR was significantly higher in rural counties with a higher share of BIPOC in the Northeast and Midwest regions, and political inclination predicted COVID-19 CFR in rural counties in the Midwest region. In conclusion, spatial and racial/ethnic disparities exist for COVID-19 CFR across the US rural counties, and findings from this study have implications for public health.
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