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Spatial Risk Factors for Pillar 1 COVID-19 Excess Cases and Mortality in Rural Eastern England, UK.
Brainard, Julii; Rushton, Steve; Winters, Tim; Hunter, Paul R.
  • Brainard J; Norwich Medical School, University of East Anglia, Norwich, UK.
  • Rushton S; School of Natural and Environmental Sciences, Newcastle University, Newcastle upon Tyne, UK.
  • Winters T; Insight and Analytics, Norfolk County Council, Norwich, UK.
  • Hunter PR; Norwich Medical School, University of East Anglia, Norwich, UK.
Risk Anal ; 42(7): 1571-1584, 2022 07.
Article in English | MEDLINE | ID: covidwho-2097864
ABSTRACT
Understanding is still developing about spatial risk factors for COVID-19 infection or mortality. This is a secondary analysis of patient records in a confined area of eastern England, covering persons who tested positive for SARS-CoV-2 through end May 2020, including dates of death and residence area. We obtained residence area data on air quality, deprivation levels, care home bed capacity, age distribution, rurality, access to employment centers, and population density. We considered these covariates as risk factors for excess cases and excess deaths in the 28 days after confirmation of positive Covid status relative to the overall case load and death recorded for the study area as a whole. We used the conditional autoregressive Besag-York-Mollie model to investigate the spatial dependency of cases and deaths allowing for a Poisson error structure. Structural equation models were applied to clarify relationships between predictors and outcomes. Excess case counts or excess deaths were both predicted by the percentage of population age 65 years, care home bed capacity and less rurality older population and more urban areas saw excess cases. Greater deprivation did not correlate with excess case counts but was significantly linked to higher mortality rates after infection. Neither excess cases nor excess deaths were predicted by population density, travel time to local employment centers, or air quality indicators. Only 66% of mortality was explained by locally high case counts. Higher deprivation clearly linked to higher COVID-19 mortality separate from wider community prevalence and other spatial risk factors.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Air Pollution / COVID-19 Type of study: Observational study / Prognostic study Limits: Aged / Humans Country/Region as subject: Europa Language: English Journal: Risk Anal Year: 2022 Document Type: Article Affiliation country: Risa.13835

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Air Pollution / COVID-19 Type of study: Observational study / Prognostic study Limits: Aged / Humans Country/Region as subject: Europa Language: English Journal: Risk Anal Year: 2022 Document Type: Article Affiliation country: Risa.13835