ArticleJMIR public health and surveillance2023
Residential Segregation and County-Level COVID-19 Booster Coverage in the Deep South: Surveillance Report and Ecological Study.
Article in JMIR public health and surveillance, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Built Environment, Community Safety, and Diabetes in the Deep South: A County Level Geospatial Analysis.Journal of racial and ethnic health disparities · 2026Article
- Impacts of Residential Segregation and Comorbidity on Racial Disparities in Acute Care Utilization.Journal of racial and ethnic health disparities · 2026Article
- Medical Trustworthiness and COVID-19: Examining Health Beliefs and Vaccine Uptake in Disinvested Black Communities.Journal of racial and ethnic health disparities · 2025Article
- Telehealth-Readiness, Healthcare Access, and Cardiovascular Health in the Deep South: A Spatial Perspective.International journal of environmental research and public health · 2025Article
- Article
- Feasibility and assessment of a comprehensive emergency department-based intervention for patients at risk of HIV.PloS one · 2024Article
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Authors and funding
9 authors.
Funding
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Abstract
backgroundCOVID-19 had a greater impact in the Deep South compared with other regions in the United States. While vaccination remains a top priority for all eligible individuals, data regarding the progress of booster coverage in the Deep South and how the coverage varies by county and age are sparse. Despite existing evidence of racial and ethnic disparities in COVID-19 vaccinations at the individual level, there is an urgent need for evidence at the population level. Such information could highlight vulnerable communities and guide future health care policy-making and resource allocation.
objectiveWe aimed to evaluate county-level COVID-19 booster coverage by age group in the Deep South and explore its association with residential segregation.
methodsAn ecological study was conducted at the population level by integrating COVID-19 vaccine surveillance data, residential segregation index, and county-level factors across the 418 counties of 5 Deep South states from December 15, 2021, to October 19, 2022. We analyzed the cumulative percentages of county-level COVID-19 booster uptake by age group (eg, 12 to 17 years, 18 to 64 years, and at least 65 years) by the end of the study period. The longitudinal relationships were examined between residential segregation, the interaction of time and residential segregation, and COVID-19 booster coverage using the Poisson model.
resultsAs of October 19, 2022, among the 418 counties, the median of booster uptake was 40% (IQR 37.8%-43%). Compared with older adults (ie, at least 65 years; median 63.1%, IQR 59.5%-66.5%), youth (ie, 12 to 17 years; median 14.1%, IQR 11.3%-17.4%) and adults (ie, 18 to 64 years; median 33.4%, IQR 30.5%-36.5%) had lower percentages of booster uptake. There was geospatial heterogeneity in the county-level COVID-19 booster coverage. We found that higher segregated counties had lower percentages of booster coverage. Such relationships attenuated as time increased. The findings were consistent across the age groups.
conclusionsThe progress of county-level COVID-19 booster coverage in the Deep South was slow and varied by age group. Residential segregation precluded the county-level COVID-19 booster coverage across age groups. Future efforts regarding vaccination strategies should focus on youth and adults. Health care facilities and resources are needed in racial and ethnic minority communities.
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