COVID-19 Deaths in the United States: Shifts in Hot Spots over the Three Phases of the Pandemic and the Spatiotemporally Varying Impact of Pandemic Vulnerability
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data
2.2. Emerging Hot Spot Analysis (Space-Time Pattern Mining)
2.3. Geographically and Temporally Weighted Regression
3. Results
3.1. Spatiotemporal Trend in COVID-19 Mortality Rates
3.2. Results of the Global Regression Model
3.3. Results of the GTWR Model
4. Discussion and Conclusions
Author Contributions
Funding
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Data Components in Four Major Domains | Characteristic | Description |
---|---|---|
1. Infection Rate | ||
Infection prevalence (Transmissible cases) | Dynamic | Cases from the last 14 days divided by population size (counts are obtained from the USA Facts website). The greater this metric, the more likely the virus is to continue to spread. |
Rate of disease spread | Dynamic | New cases (for the last 14 days) divided by total active cases (counts are obtained from the USA Facts website). The value is close to 1 during exponential growth phase and declines linearly to 0 over the two-week incubation period if there are no new cases. |
2. Intervention Measures | ||
Social distancing score | Dynamic | Changes in overall distance traveled and nonessential visits relative to previous year. A higher score indicates more travel and contact, i.e., less social distancing (derived from Unacast mobile phone data). |
COVID-19 testing metric (state-level) | Dynamic | Population divided by the number of COVID-19 tests (the inverse of the total tests per population). A higher number indicates that fewer people are getting tested, i.e., lower testing rate (derived from the COVID Tracking Project [Atlantic Monthly Group 2020]). |
3. Population Concentration | ||
Daytime population density | Static | The greater daytime population density, the more likely the disease will spread (derived from 2018 CDC SVI). |
Baseline traffic | Static | Average traffic volume per meter of major roadways (derived from 2018 Environmental Justice Screening and Mapping Tool of the U.S. Environmental Protection Agency). |
Residential density (SVI housing type and transportation score) | Static | One of the four themes in the SVI (derived from 2018 CDC SVI). Calculated based on families in multi-unit structures, mobile homes, overcrowding (persons > rooms), no vehicle, and persons in group quarters. |
4. Health and Environment | ||
% Black | Static | Percentage of Black or African American. |
% Native Americans | Static | Percentage of American Indian or Alaska Native. |
Air pollution | Static | Average daily levels of particulate matter 2.5 (µg/m3) (derived from 2014 Environmental Public Health Tracking Network). |
% aged 65 and over | Static | Percentage of population aged 65 and older (derived from 2014 to 2018 ACS). |
Premature death | Static | Years of potential life lost before age 75 per 100,000 (derived from 2016 to 2018 National Center for Health Statistics: Mortality Files). |
Smoking | Static | Percentage of adult smokers (derived from 2017 Behavioral Risk Factor Surveillance System). |
Diabetes | Static | Percentage of adults with diabetes (aged 20 and order) (derived from 2016 U.S. Diabetes Surveillance System). |
Obesity | Static | Percentage of population aged 20 and older with a body mass index ≥ 30 kg/m2. |
% uninsured | Static | Percentage of population uninsured (derived from 2018 CDC SVI). |
SVI socioeconomic status score | Static | One of the four themes in the SVI (derived from 2018 CDC SVI). Calculated based on percent below poverty, percent unemployed, income, and percent with no high school diploma. |
Hospital beds | Static | Hospital beds in general medical and surgical hospitals (derived from the Homeland Infrastructure Foundation-Level Data). |
Pattern | Definition |
---|---|
Intensifying hot (cold) spot | A location in which at least 90% of time steps present clustering of high (low) values and the intensity of clustering is increasing over time. |
Diminishing hot (cold) spot | A location in which at least 90% of time steps present clustering of high (low) values and the intensity of clustering is decreasing over time. |
Persistent hot (cold) spot | A location in which at least 90% of time steps present clustering of high (low) values without an increasing or decreasing trend in the intensity of clustering. |
Consecutive hot (cold) spot | A location with a single continuous run of clustering of high (low) values for less than 90% of all time steps. |
Sporadic hot (cold) spot | A location in which clustering of high (low) values is on again and off again over time without a history of clustering of low (high) values for all time steps. |
Oscillating hot (cold) spot | A location with clustering of high (low) values for the latest time step with a history of clustering of low (high) values during previous time steps. |
New hot (cold) spot | A location in which clustering of high (low) values has never been identified except for in the latest time step. |
Historical hot (cold) spot | A location in which clustering of high (low) values has always been identified except for in the latest time step. |
No pattern detected | A location with no statistically significant hot or cold spot pattern detected. |
Parameter | Coefficient Estimate | Standard Error | t-Statistic | p-Value |
---|---|---|---|---|
Intercept | 0.395 ** | 0.146 | 2.703 | 0.007 |
Infection prevalence | 0.305 *** | 0.006 | 52.929 | <0.001 |
Disease spread | −1.594 *** | 0.102 | −15.697 | <0.001 |
Social distancing score | 0.205 *** | 0.023 | 8.850 | <0.001 |
COVID-19 testing metric | 0.301 *** | 0.042 | 7.151 | < 0.000 |
Baseline traffic | 1.739 × 10−4 *** | 4.274 × 10−5 | 4.069 | <0.001 |
Residential density | 0.106 * | 0.049 | 2.167 | 0.030 |
% Black | 1.299 *** | 0.102 | 12.779 | <0.001 |
% Native Americans | 0.434 . | 0.228 | 1.905 | 0.057 |
Air pollution | 0.084 *** | 0.008 | 9.987 | <0.001 |
% aged 65 and over | 0.019 *** | 0.003 | 5.876 | <0.001 |
Premature death | 3.010 × 10−5 *** | 7.577 × 10−6 | 3.973 | <0.001 |
Smoking | −2.199 *** | 0.526 | −4.183 | <0.001 |
Diabetes | 1.499 *** | 0.387 | 3.874 | <0.001 |
% uninsured | 0.028 *** | 0.003 | 9.749 | <0.001 |
Hospital beds | −11.720 *** | 2.779 | −4.219 | <0.001 |
Parameter | Mean | Minimum | Lower Quartile | Median | Upper Quartile | Maximum |
---|---|---|---|---|---|---|
Intercept | 0.208 | −2.793 | −0.861 | 0.126 | 1.534 | 3.962 |
Infection prevalence | 0.419 | 0.064 | 0.210 | 0.298 | 0.596 | 1.466 |
Disease spread | −3.504 | −27.958 | −5.115 | −1.474 | −0.682 | 1.997 |
Social distancing score | 0.285 | −0.103 | 0.131 | 0.217 | 0.448 | 0.779 |
COVID-19 testing metric | 1.132 | −12.838 | −0.291 | 0.342 | 2.384 | 13.457 |
Baseline traffic | 1.454 × 10−4 | −7.520 × 10−4 | −9.066 × 10−5 | 5.327 × 10−5 | 3.842 × 10−4 | 2.282 × 10−3 |
Residential density | 0.155 | −0.294 | 0.066 | 0.131 | 0.219 | 0.782 |
% Black | 0.094 | −21.078 | −0.129 | 0.653 | 1.951 | 13.017 |
% Native Americans | −0.174 | −5.712 | −1.316 | −0.592 | 1.112 | 3.289 |
Air pollution | 0.090 | −0.062 | 0.055 | 0.088 | 0.134 | 0.205 |
% aged 65 and over | 0.023 | −0.043 | 0.012 | 0.025 | 0.035 | 0.067 |
Premature death | 2.838 × 10−5 | −6.394 × 10−5 | −2.276 × 10−6 | 2.749 × 10−5 | 5.431 × 10−5 | 1.360 × 10−4 |
Smoking | −2.079 | −12.232 | −4.436 | −1.957 | −0.867 | 12.762 |
Diabetes | 1.515 | −8.721 | 0.693 | 1.487 | 2.210 | 10.722 |
% uninsured | 0.010 | −0.098 | −0.001 | 0.013 | 0.027 | 0.055 |
Hospital beds | −1.011 | −45.437 | −11.090 | 0.231 | 6.630 | 57.624 |
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Park, Y.M.; Kearney, G.D.; Wall, B.; Jones, K.; Howard, R.J.; Hylock, R.H. COVID-19 Deaths in the United States: Shifts in Hot Spots over the Three Phases of the Pandemic and the Spatiotemporally Varying Impact of Pandemic Vulnerability. Int. J. Environ. Res. Public Health 2021, 18, 8987. https://doi.org/10.3390/ijerph18178987
Park YM, Kearney GD, Wall B, Jones K, Howard RJ, Hylock RH. COVID-19 Deaths in the United States: Shifts in Hot Spots over the Three Phases of the Pandemic and the Spatiotemporally Varying Impact of Pandemic Vulnerability. International Journal of Environmental Research and Public Health. 2021; 18(17):8987. https://doi.org/10.3390/ijerph18178987
Chicago/Turabian StylePark, Yoo Min, Gregory D. Kearney, Bennett Wall, Katherine Jones, Robert J. Howard, and Ray H. Hylock. 2021. "COVID-19 Deaths in the United States: Shifts in Hot Spots over the Three Phases of the Pandemic and the Spatiotemporally Varying Impact of Pandemic Vulnerability" International Journal of Environmental Research and Public Health 18, no. 17: 8987. https://doi.org/10.3390/ijerph18178987