Instructor of Public Health, Public Health Program, School of Arts and Sciences, MCPHS University, Boston, MA, USA
Copyright © 2020 The Korean Society for Preventive Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST
The authors have no conflicts of interest associated with the material presented in this paper.
FUNDING
None.
AUTHOR CONTRIBUTIONS
All work was done by DH.
Variables | Quartile |
|||
---|---|---|---|---|
First | Second | Third | Fourth | |
Residents below the poverty line (%) | 0.0 - 4.7 | 4.8 - 7.4 | 7.5 - 12.4 | ≥12.5 |
Median income (US$) | 0 - 58 465 | 58 466 - 75 734 | 75 735 - 95 693 | ≥95 694 |
Employment in healthcare and social assistance industry (%) | 0.00 - 13.09 | 13.10 - 15.99 | 16.00 - 18.56 | ≥18.57 |
Employment in transportation industry (%) | 0.00 - 1.53 | 1.54 - 2.86 | 2.87 - 4.26 | ≥4.27 |
Employment in service occupations (%) | 0.0 - 13.6 | 13.7 - 17.2 | 17.3 - 21.4 | ≥21.5 |
Employment in healthcare support occupations (%) | 0.00 - 1.47 | 1.48 - 2.80 | 2.81 - 4.78 | ≥4.79 |
Residents who rented (%) | 0.0 - 23.1 | 23.2 - 32.8 | 32.9 - 45.9 | ≥46.0 |
Residents who were uninsured (%) | 0.0 - 1.2 | 1.3 - 2.3 | 2.4 - 3.6 | ≥3.7 |
Unemployment (%) | 0.0 - 3.6 | 3.7 - 5.1 | 5.2 - 6.4 | ≥6.5 |
Social variable | n (%) | Cases per 100 000 residents (95% CI) | Tests per 100 000 residents (95% CI) | Rate ratio (95% CI) |
|||
---|---|---|---|---|---|---|---|
Model 11 | Model 22 | Model 33 | |||||
Percentage of residents in poverty | |||||||
First quartile | 6985 (8.0) | 898.5 (877.5, 919.6) | 7518.4 (7457.4, 7579.3) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | |
Second quartile | 8819 (10.1) | 1104.6 (1081.6, 1127.6) | 8138.0 (8075.5, 8200.6) | 1.23 (1.19, 1.27) | 1.14 (1.10, 1.17) | 1.26 (1.22, 1.30) | |
Third quartile | 16 338 (18.7) | 1311.9 (1291.8, 1332.0) | 8720.6 (8668.8, 8772.5) | 1.46 (1.42, 1.50) | 1.24 (1.21, 1.28) | 1.39 (1.35, 1.43) | |
Fourth quartile | 55 114 (63.2) | 2052.9 (2035.8, 2070.1) | 10 990.1 (10 950.5, 11 029.8) | 2.28 (2.23, 2.34) | 1.49 (1.45, 1.53) | 1.96 (1.91, 2.02) | |
Median income | |||||||
Fourth quartile | 8024 (9.2) | 882.9 (863.6, 902.2) | 7164.5 (7109, 7219.6) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | |
Third quartile | 15 709 (18.0) | 1312.6 (1292.1, 1333.1) | 9246.3 (9191.8, 9300.7) | 1.49 (1.45, 1.53) | 1.17 (1.14, 1.21) | 1.41 (1.37, 1.45) | |
Second quartile | 28 530 (32.7) | 1563.0 (1544.8, 1581.1) | 9310.7 (9266.5, 9355.0) | 1.77 (1.73, 1.82) | 1.33 (1.29, 1.36) | 1.57 (1.53, 1.61) | |
First quartile | 34 993 (40.1) | 2222.0 (2198.7, 2245.3) | 11 515.2 (11 462.2, 11 568.1) | 2.52 (2.46, 2.58) | 1.47 (1.44, 1.51) | 2.19 (2.14, 2.25) | |
Employment in healthcare and social assistance industry | |||||||
First quartile | 5496 (10.5) | 733.2 (713.8, 752.6) | 8389.1 (8323.9, 8454.3) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | |
Second quartile | 11 169 (21.4) | 876.9 (860.6, 893.2) | 9319.5 (9267.8, 9371.3) | 1.20 (1.16, 1.24) | 1.38 (1.34, 1.41) | 1.52 (1.48, 1.56) | |
Third quartile | 12 126 (23.3) | 931.5 (915.0, 948.1) | 9679.7 (9636.4, 9723.0) | 1.27 (1.23, 1.31) | 1.43 (1.40, 1.47) | 1.51 (1.48, 1.55) | |
Fourth quartile | 23 311 (44.7) | 1089.9 (1075.9, 1103.9) | 10 289.3 (10 236.7, 10 341.9) | 1.49 (1.44, 1.53) | 1.47 (1.43, 1.50) | 1.71 (1.67, 1.75) | |
Employment in transportation industry | |||||||
First quartile | 7939 (9.1) | 817.7 (799.7, 835.6) | 8093.1 (8036.5, 8149.7) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | |
Second quartile | 12 269 (14.1) | 1123.4 (1103.5, 1143.3) | 8127.4 (8073.9, 8180.8) | 1.37 (1.34, 1.41) | 1.54 (1.50, 1.59) | 1.43 (1.39, 1.47) | |
Third quartile | 42 371 (48.6) | 1743.0 (1726.4, 1759.6) | 10 107.4 (10 067.5, 10 147.4) | 2.13 (2.08, 2.18) | 1.90 (1.86, 1.95) | 1.91 (1.86, 1.96) | |
Fourth quartile | 24 677 (28.3) | 2438.8 (2408.4, 2469.3) | 11 269.6 (11 204.2, 11 335.0) | 2.98 (2.91, 3.06) | 2.14 (2.09, 2.20) | 2.99 (2.91, 3.06) | |
Employment in service occupations | |||||||
First quartile | 9688 (11.1) | 877.0 (859.5, 894.5) | 8051.2 (7998.3, 8104.1) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | |
Second quartile | 11 322 (13.0) | 1307.7 (1283.6, 1331.8) | 8605.5 (8543.7, 8667.3) | 1.49 (1.45, 1.53) | 1.44 (1.40, 1.48) | 1.59 (1.55, 1.64) | |
Third quartile | 27 609 (31.6) | 1531.8 (1513.7, 1549.8) | 9151.8 (9107.6, 9195.9) | 1.75 (1.71, 1.79) | 1.60 (1.56, 1.63) | 1.63 (1.60, 1.67) | |
Fourth quartile | 38 637 (44.3) | 2229.6 (2207.4, 2251.9) | 11 464.6 (11 414.2, 11 515.0) | 2.54 (2.49, 2.60) | 1.66 (1.62, 1.70) | 2.36 (2.31, 2.42) | |
Employment in healthcare support occupations | |||||||
First quartile | 6563 (7.5) | 785.3 (766.3, 804.3) | 7591.1 (7532.0, 7650.2) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | |
Second quartile | 14 751 (16.9) | 1213.1 (1193.6, 1232.7) | 8494.4 (8442.6, 8546.2) | 1.54 (1.50, 1.59) | 1.41 (1.37, 1.45) | 1.64 (1.59, 1.69) | |
Third quartile | 32 926 (37.7) | 1720.4 (1701.8, 1738.9) | 9635.6 (9591.6, 9679.5) | 2.19 (2.13, 2.25) | 1.70 (1.66, 1.75) | 2.03 (1.98, 2.09) | |
Fourth quartile | 33 016 (37.8) | 2143.7 (2120.5, 2166.8) | 11 433.3 (11 368.9, 11 475.7) | 2.73 (2.66, 2.80) | 1.70 (1.65, 1.75) | 2.55 (2.48, 2.62) | |
Percentage of residents who rented | |||||||
First quartile | 6533 (7.5) | 928.5 (906.0, 951.0) | 7496.9 (7432.9, 7560.9) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | |
Second quartile | 9603 (11.0) | 1152.2 (1129.2, 1175.3) | 8440.3 (8378.0, 8502.7) | 1.24 (1.20, 1.28) | 1.11 (1.07, 1.14) | 1.20 (1.16, 1.24) | |
Third quartile | 18 569 (21.3) | 1489.9 (1468.4, 1511.3) | 9227.6 (9174.3, 9280.9) | 1.60 (1.56, 1.65) | 1.27 (1.24, 1.31) | 1.44 (1.40, 1.48) | |
Fourth quartile | 52 551 (60.2) | 1930.3 (1913.8, 1946.8) | 10 614.4 (10 575.7, 10 653.1) | 2.08 (2.03, 1.13) | 1.38 (1.34, 1.41) | 1.56 (1.52, 1.61) | |
Percentage of residents who were uninsured | |||||||
First quartile | 5402 (6.2) | 902.3 (878.3, 926.4) | 7135.3 (7067.6, 7202.9) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | |
Second quartile | 13 129 (15.0) | 1056.1 (1038.0, 1074.1) | 8652.1 (8600.4, 8703.9) | 1.17 (1.13, 1.21) | 0.96 (0.93, 0.99) | 1.09 (1.05, 1.12) | |
Third quartile | 22 907 (26.3) | 1597.3 (1576.6, 1618.0) | 9763.5 (9712.4, 9814.6) | 1.77 (1.72, 1.82) | 1.28 (1.24, 1.32) | 1.55 (1.50, 1.60) | |
Fourth quartile | 45 818 (52.5) | 2054.8 (2036.0, 2073.6) | 10 618.4 (19 575.6, 10 661.2) | 2.28 (2.21, 2.34) | 1.47 (1.42, 1.51) | 1.87 (1.82, 1.93) | |
Unemployment rate | |||||||
First quartile | 7848 (9.0) | 952.8 (931.7, 973.9) | 7887.2 (7826.5, 7947.8) | 1.00 (reference) | 1.00 (reference) | 1.00 (reference) | |
Second quartile | 14 471 (16.6) | 1200.0 (1180.4, 1219.5) | 8779.6 (8746.6, 8852.5) | 1.26 (1.23, 1.29) | 1.06 (1.03, 1.09) | 1.15 (1.12, 1.18) | |
Third quartile | 22 661 (26.0) | 1844.1 (1820.1, 1868.1) | 10 012.4 (9956.5, 10,068.3) | 1.94 (1.89, 1.99) | 1.40 (1.36, 1.43) | 1.74 (1.70, 1.79) | |
Fourth quartile | 42 276 (48.5) | 1881.1 (1863.2, 1899.1) | 10 365.7 (10 323.6, 10 407.8) | 1.97 (1.93, 2.02) | 1.44 (1.41, 1.48) | 1.54 (1.50, 1.58) | |
Total | 87 256 (100) | 1584.8 (1574.3, 1595.3) | 9573.0 (9547.2, 9589.9) | - | - | - |
Social variables | Positive rate, % (95% CI) | Rate ratio (95% CI) |
|
---|---|---|---|
Model 1 | Model 2 | ||
Percentage of residents in poverty | |||
First quartile | 12.0 (11.7, 12.2) | 1.00 (reference) | 1.00 (reference) |
Second quartile | 13.6 (13.3, 13.9) | 1.14 (1.10, 1.17) | 1.16 (1.12, 1.20) |
Third quartile | 15.0 (14.8, 15.3) | 1.26 (1.22, 1.29) | 1.19 (1.16, 1.22) |
Fourth quartile | 18.7 (18.5, 18.8) | 1.56 (1.52, 1.60) | 1.33 (1.29, 1.36) |
Median income | |||
Fourth quartile | 12.3 (12.1, 12.6) | 1.00 (reference) | 1.00 (reference) |
Third quartile | 14.2 (14.0, 14.4) | 1.15 (1.12, 1.18) | 1.09 (1.06, 1.12) |
Second quartile | 16.8 (16.6, 17.0) | 1.36 (1.33, 1.40) | 1.23 (1.20, 1.26) |
First quartile | 19.3 (19.1, 19.5) | 1.57 (1.53, 1.60) | 1.40 (1.36, 1.43) |
Employment in healthcare and social assistance industry | |||
First quartile | 13.1 (12.8, 13.2) | 1.00 (reference) | 1.00 (reference) |
Second quartile | 15.8 (15.6, 16.1) | 1.21 (1.18, 2.14) | 1.29 (1.26, 1.33) |
Third quartile | 17.3 (17.1, 17.5) | 1.32 (1.29, 1.35) | 1.31 (1.27, 1.34) |
Fourth quartile | 17.7 (17.5, 18.0) | 1.36 (1.32, 1.39) | 1.36 (1.33, 1.39) |
Employment in transportation industry | |||
First quartile | 10.1 (9.9, 10.3) | 1.00 (reference) | 1.00 (reference) |
Second quartile | 13.8 (13.6, 14.1) | 1.37 (1.33, 1.41) | 1.41 (1.37, 1.45) |
Third quartile | 17.2 (17.1, 17.4) | 1.71 (1.67, 1.75) | 1.59 (1.55, 1.63) |
Fourth quartile | 21.6 (21.4, 21.9) | 2.14 (2.09, 2.20) | 2.09 (2.04, 2.14) |
Employment in service occupations | |||
First quartile | 10.9 (10.7, 11.1) | 1.00 (reference) | 1.00 (reference) |
Second quartile | 15.2 (14.9, 15.5) | 1.40 (1.36, 1.43) | 1.48 (1.44, 1.52) |
Third quartile | 16.7 (16.5, 16.9) | 1.54 (1.50, 1.57) | 1.47 (1.43, 1.50) |
Fourth quartile | 19.4 (19.3, 19.6) | 1.79 (1.75, 1.83) | 1.79 (1.66, 1.74) |
Employment in healthcare support occupations | |||
First quartile | 10.3 (10.1, 10.6) | 1.00 (reference) | 1.00 (reference) |
Second quartile | 14.3 (14.1, 14.5) | 1.38 (1.34, 1.42) | 1.44 (1.40, 1.49) |
Third quartile | 17.9 (17.7, 18.0) | 1.73 (1.68, 1.77) | 1.65 (1.61, 1.69) |
Fourth quartile | 18.8 (18.6, 19.0) | 1.81 (1.77, 1.86) | 1.73 (1.68, 1.77) |
Percentage of residents who rented | |||
First quartile | 12.4 (12.1, 12.7) | 1.00 (reference) | 1.00 (reference) |
Second quartile | 13.7 (13.4, 13.9) | 1.10 (1.07, 1.14) | 1.06 (1.02, 1.09) |
Third quartile | 16.1 (15.9, 16.4) | 1.30 (1.27, 1.34) | 1.16 (1.13, 1.20) |
Fourth quartile | 18.2 (18.0, 18.3) | 1.47 (1.43, 1.51) | 1.14 (1.10, 1.17) |
Percentage of residents who were uninsured | |||
First quartile | 12.6 (12.3, 13.0) | 1.00 (reference) | 1.00 (reference) |
Second quartile | 12.2 (12.0, 12.4) | 0.97 (0.94, 1.00) | 0.91 (0.88, 0.94) |
Third quartile | 16.4 (16.2, 16.6) | 1.29 (1.26, 1.33) | 1.17 (1.13, 1.20) |
Fourth quartile | 19.4 (19.2, 19.5) | 1.53 (1.49, 1.57) | 1.32 (1.28, 1.36) |
Unemployment rate | |||
First quartile | 12.1 (11.8, 12.3) | 1.00 (reference) | 1.00 (reference) |
Second quartile | 13.6 (13.4, 13.9) | 1.13 (1.10, 1.16) | 1.04 (1.01, 1.07) |
Third quartile | 18.4 (18.2, 18.7) | 1.52 (1.49, 1.56) | 1.38 (1.35, 1.42) |
Fourth quartile | 18.1 (18.0, 18.3) | 1.50 (1.47, 1.54) | 1.25 (1.22, 1.28) |
Total | 16.6 (16.4, 16.7) | - | - |
Model 1: social variables only; Model 2: social variables and proportion tested; Model 3: social variables and median age of city or town. CI, confidence interval.
Model 1: social variables only; Model 2: social variables and median age of city or town. CI, confidence interval.