Coronavirus disease 2019 (COVID-19) in assisted living communities: Neighborhood deprivation and state social distancing policies matter.

Abstract

BACKGROUND:

Residents of long-term care facilities face significantly greater risk of contracting or dying from coronavirus disease 2019 (COVID-19). However, little is known about COVID-19 in assisted living communities (ALCs) and the potential determinants of its spread. We examined the association between COVID-19 cases in ALCs and the proportion of Medicare-Medicaid (dual) eligible minority residents, neighborhood area deprivation, and state COVID-19 policy stringency.

METHODS:

We conducted longitudinal analyses employing data on confirmed COVID-19 cases in ALCs in 5 states. We sought to determine the weekly cumulative number of COVID-19 cases in ALCs. Covariates were ALC characteristics, area deprivation index, and state COVID-19 policy stringency. Multivariate 2-part models were used to determine the associations between independent variables and the likelihood of an outbreak and the overall count of cases.

RESULTS:

In our study sample, 201 ALCs (7.04%) reported 1 or more COVID-19 cases as of August 17, 2020. A higher percentage of minority residents was associated with an increased likelihood of an ALC reporting at least 1 COVID-19 case (odds ratio [OR], 1.06; P = .032). Conditional on having at least 1 case, ALCs in states with stricter social distancing policies had lower case counts (incidence rate ratio [IRR], 0.98; P < .001). Greater neighborhood deprivation was associated with higher case count (IRR, 1.36; P = .049).

CONCLUSIONS:

ALCs with higher proportions of dual-eligible minority residents were more likely to have COVID-19 outbreaks within their communities. ALCs located in more socioeconomically deprived neighborhoods, and in states with less stringent state social distancing policies, tended to have more COVID-19 cases.

• Authors: Wenhan Guo, Yue Li, Helena Temkin-Greener
• Journal: Infection control and hospital epidemiology (Infect Control Hosp Epidemiol) Vol. 43 Issue 8 Pg. 1004-1009 (08 2022) ISSN: 1559-6834 [Electronic] United States
• PMID: 35189992 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S., Research Support, Non-U.S. Gov't)

Topics

• Aged
• COVID-19 (epidemiology, prevention & control)
• Disease Outbreaks
• Humans
• Medicare
• Physical Distancing
• Policy
• United States (epidemiology)