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The association of voter turnout with county-level coronavirus disease 2019 occurrence early in the pandemic.

ABSTRACT: PURPOSE:The ongoing coronavirus disease 2019 (COVID-19) severely impacted both health and the economy. Absent an effective vaccine, preventive measures used, some of which are being relaxed, have included school closures, restriction of movement, and banning of large gatherings. Our goal was to estimate the association of voter turnout with county-level COVID-19 risks. METHODS:We used publicly available data on voter turnout in the March 10 primary in three states, COVID-19 confirmed cases by day and county, and county-level census data. We used zero-inflated negative binomial regression to estimate the association of voter turnout with COVID-19 incidence, adjusted for county-level population density and proportions: over age 65 years, female, Black, with college education, with high school education, poor, obese, and smokers. RESULTS:COVID-19 risk was associated with voter turnout, most strongly in Michigan during the week starting 3 days postelection (risk ratio, 1.24; 95% confidence interval, 1.16-1.33). For longer periods, the association was progressively weaker (risk ratio 0.98-1.03). CONCLUSIONS:Despite increased absentee-ballot voting in the primary, our results suggest an association of voter turnout in at least one state with a detectable increase in risks associated with and perhaps due to greater exposures related to the primary.

SUBMITTER: Flanders WD

PROVIDER: S-EPMC7328545 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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The association of voter turnout with county-level coronavirus disease 2019 occurrence early in the pandemic.

Flanders W Dana WD Flanders William D WD Goodman Michael M

Annals of epidemiology 20200701

<h4>Purpose</h4>The ongoing coronavirus disease 2019 (COVID-19) severely impacted both health and the economy. Absent an effective vaccine, preventive measures used, some of which are being relaxed, have included school closures, restriction of movement, and banning of large gatherings. Our goal was to estimate the association of voter turnout with county-level COVID-19 risks.<h4>Methods</h4>We used publicly available data on voter turnout in the March 10 primary in three states, COVID-19 confir ...[more]

PMID: 32951804

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Project description:ObjectiveTo evaluate whether delivering during the early the coronavirus disease 2019 (COVID-19) pandemic was associated with increased risk of maternal death or serious morbidity from common obstetric complications compared with a historical control period.MethodsThis was a multicenter retrospective cohort study with manual medical-record abstraction performed by centrally trained and certified research personnel at 17 U.S. hospitals. Individuals who gave birth on randomly selected dates in 2019 (before the pandemic) and 2020 (during the pandemic) were compared. Hospital, health care system, and community risk-mitigation strategies for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in response to the early COVID-19 pandemic are described. The primary outcome was a composite of maternal death or serious morbidity from common obstetric complications, including hypertensive disorders of pregnancy (eclampsia, end organ dysfunction, or need for acute antihypertensive therapy), postpartum hemorrhage (operative intervention or receipt of 4 or more units blood products), and infections other than SARS-CoV-2 (sepsis, pelvic abscess, prolonged intravenous antibiotics, bacteremia, deep surgical site infection). The major secondary outcome was cesarean birth.ResultsOverall, 12,133 patients giving birth during and 9,709 before the pandemic were included. Hospital, health care system, and community SARS-CoV-2 mitigation strategies were employed at all sites for a portion of 2020, with a peak in modifications from March to June 2020. Of patients delivering during the pandemic, 3% had a positive SARS-CoV-2 test result during pregnancy through 42 days postpartum. Giving birth during the pandemic was not associated with a change in the frequency of the primary composite outcome (9.3% vs 8.9%, adjusted relative risk [aRR] 1.02, 95% CI 0.93-1.11) or cesarean birth (32.4% vs 31.3%, aRR 1.02, 95% CI 0.97-1.07). No maternal deaths were observed.ConclusionDespite substantial hospital, health care, and community modifications, giving birth during the early COVID-19 pandemic was not associated with higher rates of serious maternal morbidity from common obstetric complications.Clinical trial registrationClinicalTrials.gov, NCT04519502.

Project description:ImportancePreterm birth is a leading cause of preventable neonatal morbidity and mortality. Preterm birth rates at the national level may mask important geographic variation in rates and trends at the county level.ObjectiveTo estimate age-standardized preterm birth rates by US county from 2007 to 2019.Design, setting, and participantsThis serial cross-sectional study used data from the National Center for Health Statistics composed of all live births in the US between 2007 and 2019. Data analyses were performed between March 22, 2022, and September 29, 2022.Main outcomes and measuresAge-standardized preterm birth (<37 weeks' gestation) and secondarily early preterm birth (<34 weeks' gestation) rates by county and year calculated with a validated small area estimation model (hierarchical bayesian spatiotemporal model) and percent change in preterm birth rates using log-linear regression models.ResultsBetween 2007 and 2019, there were 51 044 482 live births in 2383 counties. In 2007, the national age-standardized preterm birth rate was 12.6 (95% CI, 12.6-12.7) per 100 live births. Preterm birth rates varied significantly among counties, with an absolute difference between the 90th and 10th percentile counties of 6.4 (95% CI, 6.2-6.7). The gap between the highest and lowest counties for preterm births was 20.7 per 100 live births in 2007. Several counties in the Southeast consistently had the highest preterm birth rates compared with counties in California and New England, which had the lowest preterm birth rates. Although there was no statistically significant change in preterm birth rates between 2007 and 2019 at the national level (percent change, -5.0%; 95% CI, -10.7% to 0.9%), increases occurred in 15.4% (95% CI, 14.1%-16.9%) of counties. The absolute and relative geographic inequalities were similar across all maternal age groups. Higher quartile of the Social Vulnerability Index was associated with higher preterm birth rates (quartile 4 vs quartile 1 risk ratio, 1.34; 95% CI, 1.31-1.36), which persisted across the study period. Similar patterns were observed for early preterm birth rates.Conclusions and relevanceIn this serial cross-sectional study of county-level preterm and early preterm birth rates, substantial geographic disparities were observed, which were associated with place-based social disadvantage. Stability in aggregated rates of preterm birth at the national level masked increases in nearly 1 in 6 counties between 2007 and 2019.

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The association of voter turnout with county-level coronavirus disease 2019 occurrence early in the pandemic.

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The association of voter turnout with county-level coronavirus disease 2019 occurrence early in the pandemic.

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