ArticlePloS one2021
Spatial and temporal trends in social vulnerability and COVID-19 incidence and death rates in the United States.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
65 citing papers in PubMed, 4 syntheses or guidelines pooled it, 105 citations in OpenAlex.
- Main social vulnerability indicators in the COVID-19 pandemic in Iran.Frontiers in public health · 2023Pooled it
- Global variations in the burden of SARS-CoV-2 infection and its outcomes in pregnant women by geographical region and country's income status: a meta-analysis.BMJ global health · 2022Pooled it
- Social vulnerability indicators in pandemics focusing on COVID-19: A systematic literature review.Public health nursing (Boston, Mass.) · 2022Pooled it
- What Makes Urban Communities More Resilient to COVID-19? A Systematic Review of Current Evidence.International journal of environmental research and public health · 2022Pooled it
- Increasing COVID-19 Testing and Vaccination Uptake in the Take Care Texas Community-Based Randomized Trial: Adaptive Geospatial Analysis.JMIR formative research · 2025Trial
- Integrating mathematical modelling and artificial intelligence to combat emerging viral syndemics: A systematic review.New microbes and new infections · 2026Review
- [Social determinants and COVID-19 mortality: Systematic review of the role of primary care].Atencion primaria · 2026Article
- Contextual impact of socio-economic inequalities on health: a case study of COVID-19 mortality among populations with and without diabetes in France.BMJ public health · 2026Article
- COVID-19 Deaths and Minority Health Social Vulnerability, in the U.S., January 1, 2020 through June 24, 2023.Journal of racial and ethnic health disparities · 2025Article
- Association Between Social Vulnerability and Infection-Induced SARS-CoV-2 Antibody Seroprevalence Among Children: United States, 2021-2022.Public health reports (Washington, D.C. : 1974) · 2025Article
- The Dynamic Impact of Community Social Vulnerability on COVID-19 Outcomes: A Census Tract-level Analysis of Fulton County, Georgia.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Utilization of Telemedicine for Patients Receiving In-Center Hemodialysis in the United States.Journal of the American Society of Nephrology : JASN · 2025Article
- Using EMS data to explore community-level factors associated with firearm violence in North Carolina.Injury epidemiology · 2024Article
- An Application of Social Vulnerability Index to Infant Mortality Rates in Ohio Using Geospatial Analysis- A Cross-Sectional Study.Maternal and child health journal · 2024Article
- The Use of Telemedicine by US Nephrologists for In-Center Hemodialysis Care During the Pandemic: An Analysis of National Medicare Claims.Kidney medicine · 2024Article
- Community Socioeconomic Status, Acute Cardiovascular Hospitalizations, and Mortality in Medicare, 2003 to 2019.Circulation. Cardiovascular quality and outcomes · 2024Article
- Inequality in COVID-19 mortality in Quebec associated with neighbourhood-level vulnerability domains.Canadian journal of public health = Revue canadienne de sante publique · 2024Article
- Who Gets Sick From COVID-19? Sociodemographic Correlates of Severe Adult Health Outcomes During Alpha- and Delta-Variant Predominant Periods: September 2020-November 2021.The Journal of infectious diseases · 2024Article
- Evolving patterns of COVID-19 mortality in US counties: A longitudinal study of healthcare, socioeconomic, and vaccination associations.PLOS global public health · 2024Article
- Association of US county-level social vulnerability index with breast, colorectal, and lung cancer screening, incidence, and mortality rates across US counties.Frontiers in oncology · 2024Article
5 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundSocially vulnerable communities may be at higher risk for COVID-19 outbreaks in the US. However, no prior studies examined temporal trends and differential effects of social vulnerability on COVID-19 incidence and death rates. Therefore, we examined temporal trends among counties with high and low social vulnerability to quantify disparities in trends over time.
methodsWe conducted a longitudinal analysis examining COVID-19 incidence and death rates from March 15 to December 31, 2020, for each US county using data from USAFacts. We classified counties using the Social Vulnerability Index (SVI), a percentile-based measure from the Centers for Disease Control and Prevention, with higher values indicating more vulnerability. Using a Bayesian hierarchical negative binomial model, we estimated daily risk ratios (RRs) comparing counties in the first (lower) and fourth (upper) SVI quartiles, adjusting for rurality, percentage in poor or fair health, percentage female, percentage of smokers, county average daily fine particulate matter (PM2.5), percentage of primary care physicians per 100,000 residents, daily temperature and precipitation, and proportion tested for COVID-19.
resultsAt the outset of the pandemic, the most vulnerable counties had, on average, fewer cases per 100,000 than least vulnerable SVI quartile. However, on March 28, we observed a crossover effect in which the most vulnerable counties experienced higher COVID-19 incidence rates compared to the least vulnerable counties (RR = 1.05, 95% PI: 0.98, 1.12). Vulnerable counties had higher death rates starting on May 21 (RR = 1.08, 95% PI: 1.00,1.16). However, by October, this trend reversed and the most vulnerable counties had lower death rates compared to least vulnerable counties.
conclusionsThe impact of COVID-19 is not static but can migrate from less vulnerable counties to more vulnerable counties and back again over time.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.