The Town-Level Prevalence of Chronic Lung Conditions and Death From COVID-19 Among Older Adults in Connecticut and Rhode Island.

INTRODUCTION: As of November 2021, older adults (aged ≥65 y) accounted for 81% of all deaths from COVID-19 in the US. Chronic lung diseases increase the risk for severe COVID-19 illness and death. The aim of this research was to examine the association between town-level rates of asthma and chronic obstructive pulmonary disease (COPD) and deaths from COVID-19 in 208 towns in Connecticut and Rhode Island. METHODS: We conducted a multistep analysis to examine the association between town-level chronic lung conditions and death from COVID-19. Pairwise correlations were estimated and bivariate maps were created to assess the relationship between COVID-19 deaths per 100,000 people and 1) asthma prevalence and 2) COPD prevalence among adults aged 65 years or older. We used multiple linear regression models to examine whether chronic lung conditions and other town-level factors were associated with COVID-19 death rates in Connecticut and Rhode Island. RESULTS: Initial bivariate correlation and mapping analyses suggested positive correlations between asthma and COPD prevalence and COVID-19 death rates. However, after controlling for town-level factors associated with chronic lung conditions and COVID-19 death rates, multiple linear regression models did not support an association, but town-level factors (African American race and Hispanic ethnicity, age ≥65 y, and low educational attainment) were significant predictors of COVID-19 death rates. CONCLUSION: We found significant associations between town-level factors and COVID-19, adding to the current understanding of the impact of social determinants of health on outcomes.

Spatial Distribution of COVID-19 and Comorbidities in New England

At the onset of the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) identified chronic conditions which elevated the risk of COVID-19 complications: chronic obstructive pulmonary disease (COPD), diabetes, heart disease, kidney disease, and obesity. The aim of this study is to visualize the spatial distribution of confirmed cases of COVID-19 and local rates of comorbidities in CT, MA, NH, and RI and to identify the spatial clustering of hot spot between COVID-19 cases and rates of a summary measure of comorbidities across communities. This study collected data from state’s departments of public health in 4 New England states of confirmed COVID-19 cases as of February 25th, 2021 and extracted community-level rates of comorbidities among adults age 65+ from recent Healthy Aging Data Report (www.healthyagingdatareports.org). Results showed that the cities Bridgeport, CT (n=14,637), Boston, MA (n=57,912), Manchester, NH (n=9,658), and Providence, RI (n=26,792) had the highest rates of COVID-19 and the highest population density. The GIS based map illustrated that the largest cities with the highest population densities had both relatively high incidences of COVID-19 and heavy burdens of comorbidities. This study found that the hot spot areas of COVID-19 were observed in communities with the highest chronic disease burdens. These hot spots of COVID-19 and comorbidities are areas where resources (testing, masks, vaccines) should be surged to protect the community. The identification of hot spots may motivate residents to take every mitigation step to prevent and control COVID-19.