ArticleInternational journal of general medicine2021
Social Determinants of Health Correlating with Mechanical Ventilation of COVID-19 Patients: A Multi-Center Observational Study.
Article in International journal of general medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Racial and Ethnic Disparities in the Use of Invasive Ventilation for Bacterial Pneumonia in the United States.Respiratory care · 2025Article
- Realizing the potential of social determinants data in EHR systems: A scoping review of approaches for screening, linkage, extraction, analysis, and interventions.Journal of clinical and translational science · 2024Article
- Racial inequality in health care of adults hospitalized with COVID-19.Cadernos de saude publica · 2023Article
- Social Needs Identified by Diagnostic Codes in Privately Insured U.S. Adults.American journal of preventive medicine · 2022Article
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Authors and funding
5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
importanceSeveral studies have relayed the disproportionate impact of COVID-19 on marginalized communities; however, few have specifically examined the association between social determinants of health and mechanical ventilation (MV).
objectiveTo determine which demographics impact MV rates among COVID-19 patients.
designThis observational study included COVID-19 patient data from eight hospitals' electronic medical records (EMR) between February 25, 2020, to December 31, 2020. Associations between demographic data and MV rates were evaluated using uni- and multivariate analyses.
settingMulticenter (eight hospitals), largest health system in Southeast Michigan.
participantsInpatients with a positive RT-PCR for SARS-CoV-2 on nasopharyngeal swab. Exclusion criteria were missing demographic data or non-permanent Michigan residents. EXPOSURE: Patients were divided into two groups: MV and non-MV. MAIN OUTCOME AND MEASURES: The primary outcome was MV rate per demographic. A multivariate model then predicted the odds of MV per demographic descriptor. Hypotheses were formulated prior to data collection.
resultsAmong 11,304 COVID-19 inpatients investigated, 1621 (14.34%) were MV, and 49.96% were male with a mean age of 63.37 years (17.79). Significant social determinants for MV included Black race (40.19% MV vs 31.31% non-MV, p<0.01), poverty (14.60% vs. 13.21%, p<0.01), and disability (12.65% vs 9.14%; p<0.01). Black race (AOR 1.61 (CI 1.41-1.83; p<0.01)), median income (AOR 0.99 (CI 0.99-0.99; p<0.01)), disability (AOR 1.55 (CI 1.26, 1.90; p<0.01)), and non-English-speaking status (AOR 1.26 (CI 1.05, 1.53)) had significantly higher odds of MV. CONCLUSIONS AND RELEVANCE: Black race, low socioeconomic status, disability, and non-English-speaking status were significant risk factors for MV from COVID-19. An urgent need remains for a pandemic response program that strategizes care for marginalized communities.
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