VCOM Research Day Program Book 2023

Medical Student Research Publ ic Health

11 The Impact of Social Determinants of Health on COVID-19 Outcomes in Virginia

Bruce Liberi, OMS III 1 ; David Redden, PhD 2 ; Theresa McCann, PhD, MPH, CHSE 1 Corresponding author: bliberi@vcom.edu

1 Edward Via College of Osteopathic Medicine- Virginia Campus 2 Edward Via College of Osteopathic Medicine- Auburn Campus

The novel SARS-CoV-2 virus (COVID-19) pandemic has reportedly exacerbated preexisting health disparities throughout the United States. According to the United States Centers for Disease Control and Prevention, health disparities are “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.” These disparities are often outside the direct influence of the medical system and are thus termed Social Determinants of Health. Recently, there has been much interest regarding the impact Social Determinants of Health have had on COVID-19 outcomes. Previously, we showed that the Southwest Region of Virginia, which has a lower average socioeconomic status than the rest of the state, had

higher age adjusted mean rates of COVID-19 cases and deaths when compared to the rest of Virginia. To add to that body of work and others, we set out to determine whether Social Determinants of Health impacted rates of COVID-19 outcomes in Virginia. The Virginia Department of Health’s Open Data Portal has a Health Opportunity Index (HOI) dataset, a proxy for Social Determinants of Health, and additional datasets with information about COVID-19 outcomes and Virginia population demographics. We used these datasets to compare age adjusted mean rates of COVID-19 cases, hospitalizations, and deaths for each of the five regions in Virginia, the HOI score for each Virginia region, and correlated the HOI score with COVID-19 outcomes across the state. Using Analysis of Variance, we found significant differences

in the age adjusted mean rates of COVID-19 cases (p<0.001) and deaths (p=0.001) between the regions, and that the regions themselves had significantly different HOI scores (p<0.0001). Additionally, we found that the HOI score for each Virginia Health District had a strong negative correlation with the age adjusted mean rates of COVID-19 cases (p<0.0001) and deaths (p=0.0005). This means in Virginia as the HOI score increases for a Health District the age adjusted mean rates of COVID-19 cases and deaths decreases. We believe this work furthers our understanding of the impact Social Determinants of health have had on COVID-19 outcomes and helps to explain the variability in outcomes across Virginia.

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