Contextual factors and the COVID-19 outbreak rate across U.S. counties in its initial phase.

ABSTRACT:

Background

This study examines the association of contextual factors with the COVID-19 outbreak rate across U.S. counties in its initial phase.

Methods

Contextual factors are simultaneously tested at the county- and state-level with a multilevel linear model using full maximum likelihood.

Results

The variation between states is substantial and significant (ICC = 0.532, u ₀ = 8.20E-04, P < .001). At the state level, the cultural value of collectivism and the contextual factor of government spending are positively associated with the outbreak rate. At the county level, the racial and ethnic composition contributes to outbreak differences, disproportionally affecting black/African, native, Asian, and Hispanic Americans as well as native Hawaiians

SUBMITTER: Messner W 

PROVIDER: S-EPMC7853692 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature