Community Roots of COVID-19 Infection Rates Between Population Composition and Regional Systems in Romania.

This is an analysis of conditions favouring the cumulative COVID-19 infection rates between February 2020 and April 2021 in Romania, as an Eastern European society, at the local community level. What are the socio-demographic and location profiles of the local communities by considering their infection rates with SARS-COV-2 at the beginning of the pandemia as a dependent variable? This is the research question that structured the approach. The general hypothesis that is tested is that reported infections with the new coronavirus are higher in communities of higher social interactions. The theoretical model is tested by multiple regression analysis working on more than 2500 local communities, out of the 3200 local administrative units of the country. Data basis for testing the model are coming from the National Institute of Public Health and the National Institute of Statistics. Higher COVID infection rates are favoured by socio-human capital, the regional capital, migration abroad experience, and modernity at a local level. Other factors are captured by the cultural areas as subregions of historical regions of the country, formed by neighboured similar counties. Nuclei of higher infections with COVID-19 are located in developed communities around large cities, high modernity areas, and communities of high emigration abroad. Principles for health public policies are formulated at the end by considering the role of decentralisation, and better ways to do a rapid and good diagnosis at local levels. To our knowledge, this is one of the very few studies that address determinants of COVID-19 infections at the local community level for a whole country in Europe. New research questions are formulated as an outcome of conclusions. They could be answered only by supplementary multilevel research. Limitations of analysis are derived from the fact that we are using only ecological, spatially aggregated data, and not multilevel ones. Relations that were recorded to the community could not be transferred to the individual level.