Community versus individual risk of SARS-CoV-2 infection in two municipalities of Louisiana, USA: An assessment of Area Deprivation Index (ADI) paired with seroprevalence data over time

PLoS One. 2021 Nov 30;16(11):e0260164. doi: 10.1371/journal.pone.0260164. eCollection 2021.

Abstract

Objective: Determine whether an individual is at greater risk of severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) infection because of their community or their individual risk factors.

Study design and setting: 4,752 records from two large prevalence studies in New Orleans and Baton Rouge, Louisiana were used to assess whether zip code tabulation areas (ZCTA)-level area deprivation index (ADI) or individual factors accounted for risk of infection. Logistic regression models assessed associations of individual-level demographic and socioeconomic factors and the zip code-level ADI with SARS-CoV-2 infection.

Results: In the unadjusted model, there were increased odds of infection among participants residing in high versus low ADI (both cities) and high versus mid-level ADI (Baton Rouge only) zip codes. When individual-level covariates were included, the odds of infection remained higher only among Baton Rouge participants who resided in high versus mid-level ADI ZCTAs. Several individual factors contributed to infection risk. After adjustment for ADI, race and age (Baton Rouge) and race, marital status, household size, and comorbidities (New Orleans) were significant.

Conclusions: While higher ADI was associated with higher risk of SARS-CoV-2 infection, individual-level participant characteristics accounted for a significant proportion of this association. Additionally, stage of the pandemic may affect individual risk factors for infection.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / epidemiology*
  • COVID-19 / virology*
  • Cities
  • Female
  • Humans
  • Male
  • Middle Aged
  • New Orleans
  • Probability
  • Residence Characteristics*
  • Risk Factors
  • SARS-CoV-2 / physiology*
  • Seroepidemiologic Studies
  • Social Deprivation*
  • Time Factors
  • Young Adult

Grants and funding

Data collection from the prevalence studies was awarded to AKF and LS by ReNOLA and Ochsner Health, who funded the New Orleans portion of the study. ReNOLA was not involved in the study design, execution, or analysis. AKF and LS are employed by Ochsner Health. Therefore, Ochsner Health was involved in the design, execution, analysis and writing of this paper. Funds for the Baton Rouge study were awarded to LS by the Baton Rouge Area Foundation (www.braf.org), Louisiana COVID-19 Health Equity Task Force, and The Humana Foundation (www.humanafoundation.org), with additional support from The Blue Cross and Blue Shield of Louisiana Foundation (bcbslafoundation.org), Healthy Blue (choosehealthybluela.com), the Huey and Angelina Wilson Foundation (hawilsonfoundation.org), and the Irene W. and C.B. Pennington Foundation (penningtonfamilyfoundation.org). These funders were not involved in study design, execution, or analysis. The authors have not been paid to write this article beyond regular employment contracts.