Few studies have assessed how the intersection of social determinants of health and environmental hazards contributes to racial disparities in COVID-19. The aim of our study was to compare COVID-19 disparities in testing and positivity to cumulative environmental health impacts, and to assess how unique social and environmental determinants of health relate to COVID-19 positivity in Seattle, King County, WA, at the census tract level. Publicly available data (n = 397 census tracts) were obtained from Public Health–Seattle & King County, 2018 ACS 5-year estimates, and the Washington Tracking Network. COVID-19 testing and positive case rates as of July 12, 2020, were mapped and compared to Washington State Environmental Health Disparities (EHD) Map cumulative impact rankings. We calculated odds ratios from a series of univariable and multivariable logistic regression analyses using cumulative impact rankings, and community-level socioeconomic, health, and environmental factors as predictors and having ≥ 10% or < 10% census tract positivity as the binary outcome variable. We found a remarkable overlap between Washington EHD cumulative impact rankings and COVID-19 positivity in King County. Census tracts with ≥ 10 % COVID-19 positivity had significantly lower COVID-19 testing rates and higher proportions of people of color and faced a combination of low socioeconomic status–related outcomes, poor community health outcomes, and significantly higher concentrations of fine particulate matter (PM 2.5 ). King County communities experiencing high rates of COVID-19 face a disproportionate cumulative burden of environmental and social inequities. Cumulative environmental health impacts should therefore systematically be considered when assessing for risk of exposure to and health complications resulting from COVID-19. Supplementary Information The online version contains supplementary material available at 10.1007/s40615-021-01063-y.
【저자키워드】 COVID-19, Racial disparities, social determinants of health, Cumulative impacts, Environmental health disparities, Environmental exposures, 【초록키워드】 risk, outcome, outcomes, Health, COVID-19 testing, Impact, Community, Complication, network, predictor, environmental health, estimates, Combination, Concentration, Analysis, disparity, Odds ratio, Washington, census tract, determinant, Racial, supplementary material, available data, overlap, multivariable logistic regression, hazard, Intersection, cumulative, positive, Seattle, significantly lower, Public, environmental factor, state, impacts, resulting, proportion, calculated, contribute, unique, significantly higher, mapped, Map, King, social determinant, univariable, 【제목키워드】 Impact, King,