Exploring the Relation between Contextual Social Determinants of Health and COVID-19 Occurrence and Hospitalization

IF 3.4 Q2 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS Informatics Pub Date : 2024-01-15 DOI:10.3390/informatics11010004
Aokun Chen, Yunpeng Zhao, Yi Zheng, Hui Hu, Xia Hu, Jennifer N. Fishe, W. Hogan, Elizabeth A Shenkman, Yi Guo, Jiang Bian
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Abstract

It is prudent to take a unified approach to exploring how contextual social determinants of health (SDoH) relate to COVID-19 occurrence and outcomes. Poor geographically represented data and a small number of contextual SDoH examined in most previous research studies have left a knowledge gap in the relationships between contextual SDoH and COVID-19 outcomes. In this study, we linked 199 contextual SDoH factors covering 11 domains of social and built environments with electronic health records (EHRs) from a large clinical research network (CRN) in the National Patient-Centered Clinical Research Network (PCORnet) to explore the relation between contextual SDoH and COVID-19 occurrence and hospitalization. We identified 15,890 COVID-19 patients and 63,560 matched non-COVID-19 patients in Florida between January 2020 and May 2021. We adopted a two-phase multiple linear regression approach modified from that in the exposome-wide association (ExWAS) study. After removing the highly correlated SDoH variables, 86 contextual SDoH variables were included in the data analysis. Adjusting for race, ethnicity, and comorbidities, we found six contextual SDoH variables (i.e., hospital available beds and utilization, percent of vacant property, number of golf courses, and percent of minority) related to the occurrence of COVID-19, and three variables (i.e., farmers market, low access, and religion) related to the hospitalization of COVID-19. To our best knowledge, this is the first study to explore the relationship between contextual SDoH and COVID-19 occurrence and hospitalization using EHRs in a major PCORnet CRN. As an exploratory study, the causal effect of SDoH on COVID-19 outcomes will be evaluated in future studies.
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探索健康的社会决定因素与 COVID-19 发生率和住院率之间的关系
为了谨慎起见,我们应该采取统一的方法来探讨健康的社会决定因素(SDoH)与 COVID-19 的发生和结果之间的关系。以往的大多数研究中,由于数据的地域代表性较差,且所研究的背景性 SDoH 数量较少,因此在背景性 SDoH 与 COVID-19 结果之间的关系方面存在知识空白。在本研究中,我们将国家以患者为中心的临床研究网络(PCORnet)中一个大型临床研究网络(CRN)的电子健康记录(EHR)与 199 个情境 SDoH 因素(涵盖社会和建筑环境的 11 个领域)联系起来,探讨情境 SDoH 与 COVID-19 发生和住院之间的关系。我们确定了 2020 年 1 月至 2021 年 5 月期间佛罗里达州的 15,890 名 COVID-19 患者和 63,560 名匹配的非 COVID-19 患者。我们采用了一种两阶段多元线性回归方法,该方法借鉴了全暴露组关联(ExWAS)研究的方法。在剔除高度相关的 SDoH 变量后,86 个背景 SDoH 变量被纳入数据分析。在对种族、民族和合并症进行调整后,我们发现 6 个 SDoH 环境变量(即医院可用床位和使用率、空置房百分比、高尔夫球场数量和少数民族百分比)与 COVID-19 的发生有关,3 个变量(即农贸市场、交通不便和宗教)与 COVID-19 的住院治疗有关。据我们所知,这是第一项在主要的 PCORnet CRN 中使用电子病历探讨环境 SDoH 与 COVID-19 发生和住院之间关系的研究。作为一项探索性研究,SDoH 对 COVID-19 结果的因果效应将在今后的研究中进行评估。
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来源期刊
Informatics
Informatics Social Sciences-Communication
CiteScore
6.60
自引率
6.50%
发文量
88
审稿时长
6 weeks
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