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Background: Understanding how population density affected the transmission of COVID-19 is vitally important, since crowded cities were the epicenters for the disease. Since human contact was the main cause of the spread, population-weighted densities have been shown to be a better measure than conventional densities, since the variation in density across subareas matters more than the density in the total area. Objectives: This study investigates the impact of population-weighted density and other demographics on the rate of COVID-19 spread in the United States. Methods: The study considers population-weighted density and many other demographics. The population-weighted density index is the weighted average of density across the tracts, where tracts are weighted by population. Multivariate analysis has been used to determine the elasticity of the spread. Results: Using U.S. county-level data, we calculated the elasticity of COVID-19 spread with respect to population-weighted density to be 0.085 after controlling for other factors. In addition to the density, the proportion of people over 65 years of age, the number of total healthcare workers, and average temperature in each county positively contributed to the case numbers, while education level and income per capita had a negative effect. Discussion: For the spread, understanding the population characteristics and dynamics is as important as understanding the infectious disease itself. This will help policy makers to utilize and reallocate the resources more effectively. If the spread is successfully contained early, there will be less stress placed upon the healthcare system, resulting in better healthcare access for those who are sick. Conclusions: Our analysis suggests that population-weighted density can be a useful tool to control and manage outbreaks, especially within the early stage of the spread. We presented the early dynamics of the spread and recommended a policy measure on how to transfer healthcare workers from low-spread-risk areas to high-spread-risk areas to utilize resources better.
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Abstract Background Misperceptions on the higher rates of peer alcohol use are predictive of increased personal use among university students. Objectives This study aims to assess the prevalence, perceived peers' social norms and other predictors of alcohol use in a sample of Turkish university students. Methods This study is established upon the baseline Turkish data on alcohol use of the project Social Norms Intervention for the prevention of Polydrug usE (SNIPE). The data was obtained by a self-reported, online questionnaire from 858 students of Marmara University who were registered to the study web page. Results Alcohol use and drunkenness rates were 62.6%, and 40.9%, respectively. Twenty point two percent of students reported drinking alcohol at least once a week in the last two months. Majority of students (70.4%) reported that religion has an important or very important role in their lives. Perceived higher frequency of peer alcohol use (p<0.000) and drunkenness (p<0.000) were significantly associated with personal alcohol use frequency. Tobacco use rate was 60.2% and positively associated with alcohol use frequency (p<0.000). In all participants, male gender (OR: 1.56; 95% CI: 1.07-2.28), giving less importance to religion (OR: 20.91; 95% CI: 10.95-39.95), tobacco use everyday/almost everyday (OR: 17.88; 95% CI: 9.33-34.29), perceived positive peer attitude towards alcohol use (OR: 2.192; 95% CI: 1.25-3.82) and perceived higher frequency of peer alcohol use (OR: 3.487; 95% CI: 1.66-7.31) were found to be associated risk factors for alcohol use. Age (OR: 1.186, CI 95%: 1.03-1.36) and perceived positive peer attitude towards alcohol use (OR: 3.86, CI 95%: 1.84-8.09) were the additional risk factors among female student whereas perceived positive peer alcohol use frequency (OR: 8.08, CI 95%: 2.40-27.10) among male students. Discussion As the first study conducted in Turkey applying social norms theory, our results indicate the noticeable misperceptions of students regarding their peers' alcohol use. Based on our results, targeting both tobacco and alcohol use, and a gender-sensitive approach employing social norms interventions may enhance the preventive strategies for risky alcohol use among university students.