How education and racial segregation intersect in neighborhoods with persistently low COVID-19 vaccination rates in Philadelphia

BMC Public Health

Theodore J. Corbin¹  Usama Bilal²  John A. Rich³  Edward J. Miech⁴ 

[1] Department of Emergency Medicine, Rush University Medical Center;Department of Epidemiology and Biostatistics, Urban Health Collaborative, Dornsife School of Public Health, Drexel University;Department of Health Management and Policy, Center for Nonviolence and Social Justice, Dornsife School of Public Health, Drexel University;Regenstrief Institute, Center for Health Services Research;

关键词: COVID-19 vaccination;    Residential racial segregation;    Education;    Health inequity;    Configurational comparative methods;    Coincidence analysis;   

DOI  :  10.1186/s12889-022-13414-3

来源: DOAJ

【 摘 要 】

Abstract Background COVID-19 infection has disproportionately affected socially disadvantaged neighborhoods. Despite this disproportionate burden of infection, these neighborhoods have also lagged in COVID-19 vaccinations. To date, we have little understanding of the ways that various types of social conditions intersect to explain the complex causes of lower COVID-19 vaccination rates in neighborhoods. Methods We used configurational comparative methods (CCMs) to study COVID-19 vaccination rates in Philadelphia by neighborhood (proxied by zip code tabulation areas). Specifically, we identified neighborhoods where COVID-19 vaccination rates (per 10,000) were persistently low from March 2021 – May 2021. We then assessed how different combinations of social conditions (pathways) uniquely distinguished neighborhoods with persistently low vaccination rates from the other neighborhoods in the city. Social conditions included measures of economic inequities, racial segregation, education, overcrowding, service employment, public transit use, health insurance and limited English proficiency. Results Two factors consistently distinguished neighborhoods with persistently low COVID-19 vaccination rates from the others: college education and concentrated racial privilege. Two factor values together – low college education AND low/medium concentrated racial privilege – identified persistently low COVID-19 vaccination rates in neighborhoods, with high consistency (0.92) and high coverage (0.86). Different values for education and concentrated racial privilege – medium/high college education OR high concentrated racial privilege – were each sufficient by themselves to explain neighborhoods where COVID-19 vaccination rates were not persistently low, likewise with high consistency (0.93) and high coverage (0.97). Conclusions Pairing CCMs with geospatial mapping can help identify complex relationships between social conditions linked to low COVID-19 vaccination rates. Understanding how neighborhood conditions combine to create inequities in communities could inform the design of interventions tailored to address COVID-19 vaccination disparities.

【 授权许可】

Unknown