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Inequities in spatial accessibility to Covid-19 testing in 30 large US cities

Bibliographic Data

ID4770685
AuthorsPricila H Mullachery (0000-0003-4758-3875, Temple University, corresponding author), Ran Li (0000-0002-4699-4755), Steven Melly, Steven J Melly (0000-0002-4332-3104), Jennifer Kolker (0000-0003-4364-9566), Sharrelle Barber (0000-0002-4699-187X, Center for Health and Gender Equity), Ana V Diez Roux (0000-0001-9658-7050, Drexel University), Usama Bilal (0000-0002-9868-7773, Drexel University)
Year2022
Volume310
Pages115307
Publication date2022-10-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSocial Science & Medicine (JOURNAL)
Journal identifiersISSN: 0277-9536 • E-ISSN: 1873-5347
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2022.115307
PMID36049353
OpenAlexW4293564068
LanguageEN
Citations received16
References cited44

Testing for SARS-CoV-2 infection has been a key strategy to mitigate and control the COVID-19 pandemic. Wide spatial and racial/ethnic disparities in COVID-19 outcomes have emerged in US cities. Previous research has highlighted the role of unequal access to testing as a potential driver of these disparities. We described inequities in spatial accessibility to COVID-19 testing locations in 30 large US cities. We used location data from Castlight Health Inc corresponding to October 2021. We created an accessibility metric at the level of the census block group (CBG) based on the number of sites per population in a 15-minute walkshed around the centroid of each CBG. We also calculated spatial accessibility using only testing sites without restrictions, i.e., no requirement for an appointment or a physician order prior to testing. We measured the association between the social vulnerability index (SVI) and spatial accessibility using a multilevel negative binomial model with random city intercepts and random SVI slopes. Among the 27,195 CBG analyzed, 53% had at least one testing site within a 15-minute walkshed, and 36% had at least one site without restrictions. On average, a 1-decile increase in the SVI was associated with a 3% (95% Confidence Interval: 2% - 4%) lower accessibility. Spatial inequities were similar across various components of the SVI and for sites with no restrictions. Despite this general pattern, several cities had inverted inequity, i.e., better accessibility in more vulnerable areas, which indicates that some cities may be on the right track when it comes to promoting equity in COVID-19 testing. Testing is a key component of the strategy to mitigate transmission of SARS-CoV-2 and efforts should be made to improve accessibility to testing, particularly as new and more contagious variants become dominant

Census · Confidence interval · Coronavirus disease 2019 (COVID-19 · Decile · Disease · Geography · Health equity · Pandemic · Population · Psychological intervention · Public health · Social vulnerability · Sociology · Statistics · COVID-19 and healthcare impacts · COVID-19 epidemiological studies · Demography · Health disparities and outcomes · Mathematics · Medicine

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Unique citing works16
Citations per year5,33
Citation span2023 - 2026 (4)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 16
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