Associations between area-level health-related social factor indices and risk of acute COVID-19: An EHR-based cohort study from the RECOVER program
Associations between area-level health-related social factor indices and risk of acute COVID-19: An EHR-based cohort study from the RECOVER program
ABSTRACT BackgroundResearch demonstrates that SARS-CoV-2 infection (COVID-19) among adults disproportionately impacts racial and ethnic minorities and those living in lower-income communities. Similar research in children is limited due, in part, to the relatively low COVID-19 incidence in children compared to adults. This analysis, conducted as part of the RECOVER Initiative, explores this question. MethodsElectronic health record (EHR) data from PEDSnet, a multi-institutional research network of pediatric healthcare organizations, were geocoded and linked to two indices of contextual social deprivation: the Area Deprivation Index and the Child Opportunity Index. Univariate statistics were employed to test the association between each index and COVID19 positivity among children ages 0-20 tested at one of six Children’s hospitals. Multivariate logistic regression was used to explore the relationship between these social context indices and racial disparities in positivity, controlling co-variates. ResultsBoth ADI and COI were significantly associated with COVID-19 positivity in univariate and adjusted models, particularly in the pre-delta and delta variant waves. ADI showed a stronger association. Higher rates of positivity were found for non-Hispanic Black, Hispanic, and multi-racial children compared to non-Hispanic White children. These racial disparities remained significant after control for either index and for other variables. ConclusionADI and COI are significantly associated with COVID-19 test positivity in a population of children and adolescents tested in children’s hospital settings. These social contextual variables do not fully explain racial disparities, arguing that racial disparities are not solely a reflection of socioeconomic status. Future disparities research should consider both race and social context.
Webb Ryan、Patel Payal B、Forrest Christopher B.、Lee Grace M.、Mejias Asuncion、Pajor Nathan M、Sills Marion R.、Jhaveri Ravi、Chisolm Deena J.、Rao Suchitra、Mendonca Eneida A、Musante Jordan、Schuchard Julia、Salamon Katherine S.
Applied Clinical Research Center, Children?ˉs Hospital of PhiladelphiaDepartment of Neurology, University of WashingtonApplied Clinical Research Center, Children?ˉs Hospital of PhiladelphiaDepartment of Pediatrics (Infectious Diseases), Stanford University School of MedicineDivision of Infectious Diseases, Department of Pediatrics, Nationwide Children?ˉs Hospital and The Ohio State UniversityDivision of Biomedical Informatics and Department of Pediatrics, Cincinnati Children?ˉs Hospital Medical CenterDepartment of Pediatrics, University of Colorado School of Medicine, Aurora, CO and OCHIN, IncDivision of Infectious Diseases, Ann & Robert H. Lurie Children?ˉs Hospital of ChicagoCenter for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute, Nationwide Children?ˉs HospitalDepartment of Pediatrics, University of Colorado School of Medicine and Children?ˉs Hospital ColoradoDivision of Biomedical Informatics and Department of Pediatrics, Cincinnati Children?ˉs Hospital Medical CenterApplied Clinical Research Center, Children?ˉs Hospital of PhiladelphiaApplied Clinical Research Center, Children?ˉs Hospital of PhiladelphiaDepartment of Psychology, Nemours Children?ˉs Health
医学研究方法预防医学儿科学
Webb Ryan,Patel Payal B,Forrest Christopher B.,Lee Grace M.,Mejias Asuncion,Pajor Nathan M,Sills Marion R.,Jhaveri Ravi,Chisolm Deena J.,Rao Suchitra,Mendonca Eneida A,Musante Jordan,Schuchard Julia,Salamon Katherine S..Associations between area-level health-related social factor indices and risk of acute COVID-19: An EHR-based cohort study from the RECOVER program[EB/OL].(2025-03-28)[2025-05-01].https://www.medrxiv.org/content/10.1101/2022.12.02.22282944.点此复制
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