Impact of Social Vulnerability on COVID-19 Incidence and Outcomes in the United States

Aditi Nayak; Shabatun J Islam; Anurag Mehta; Yi-An Ko; Shivani A Patel; Abhinav Goyal; Samaah Sullivan; Tene T Lewis; Viola Vaccarino; Alanna A Morris; Arshed A Quyyumi

Community-level social disadvantage and vulnerability to disasters can influence the incidence of COVID-19 and its adverse outcomes in several ways. For example, lower socioeconomic status (SES) is associated with poor healthcare access, which may increase risk for adverse outcomes. 1 Labor inequalities, lack of workplace protections, and household overcrowding may decrease the ability to adhere to social-distancing guidelines. 2 Additionally, race-ethnic minorities and immigrants are less likely to have access to appropriate and timely healthcare. 3 Evidence suggests that these inequalities contributed to disease spread and severity during the H1N1 influenza pandemic. 4 Real-time evaluation of the impact of community-level social vulnerability on disease incidence and adverse outcomes during the ongoing COVID-19 pandemic is important to guide public health policy and healthcare resource allocation in the U.S. The Social Vulnerability Index (SVI), created and maintained by the Geospatial Research, Analysis, and Services Program (GRASP) at the Centers for Disease Control and Prevention (CDC) and Agency for Toxic Substances and Disease Registry, is a percentile-based index of county-level vulnerability to disasters. 5,6 Herein, we report the association of SVI with COVID-19 case-fatality rates (CFR) and incidence in the U.S.