Association between Environment, Health and COVID-19 Prevalence: Injustice or Disadvantage?

Abstract:

The spread of coronavirus all around the globe has severely affected human lives and the economy and put pressure on public health infrastructures. While many studies have investigated the effect of various social, demographic, economic, environmental, and other determinants on the vulnerability of communities to COVID-19 individually, there is a lack of convergent approaches that take all of the factors mentioned above into account in a more holistic manner. In this study, we developed a decision support framework to examine vulnerability and the potential for environmental injustice and sociodemographic disadvantage in shaping healthy communities. The framework takes into account 46 different variables distributed into 5 broad categories:1) access to medical services, 2) underlying health conditions, 3) environmental exposures, 4) vulnerability to natural disasters, and 5) sociodemographic, behavioral, and lifestyle factors. The vulnerabilities of communities, at the census tract level, across the five categories, and overall were estimated using rank-based exceedance and K-means cluster analyses. The output of the model was validated by finding strong and significant correlations (P-values <<0.05, 0.215<ρ<0.53) among the estimated vulnerabilities and normalized confirmed cases of COVID-19 at the census tract level. Using Harris County in Texas as a testbed, our study showed that 17% of the County population are at higher risk levels for COVID-19; among those, 10.6% were seniors, and 23.7% were between the ages of 45-65. The developed framework is transferable and scalable to any other part of the US such that policy- and decision-makers can examine ways to alleviate environmental injustice and sociodemographic barriers to health within their communities. The framework also enables a detailed examination of allocations of resources, such as medical services, under constraints.