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Will the economic growth benefit public health? Health vulnerability, urbanization and COVID-19 in the USA.

ABSTRACT: Economic growth has a significant impact on health vulnerability primarily through the process of urbanization. This paper conducts a pioneer study by analyzing the impact of regional economic growth and urbanization on the public health vulnerability in the 51 states and territories of the USA from 2011 to 2018 with a fixed-effect panel data regression model. We construct an epidemiological vulnerability index (EVI) using regional smoking, diabetes, obesity, and hypertension, collect CDC social vulnerability index (SVI) as state-level public health vulnerability status, and use COVID-19 to test the actual effect of health vulnerability. The preliminary results show that higher regional economic growth is related to lower EVI and SVI, while urbanization is positively associated with regional health vulnerability and the severity of COVID-19 from case rate and death rate. Robustness check with unemployment shows the same result. We conclude that economic growth is related to lower public health vulnerability, and urbanization has negative public health benefits. Our finding indicates an urgent need to balance the externalities generated by economic development and urbanization trends on public health vulnerability by promoting reasonable medical resource distribution, health practices and safety, improving social and environmental justice, and other health management measures.

Supplementary information

The online version contains supplementary material available at 10.1007/s00168-021-01103-9.

SUBMITTER: Fan Y

PROVIDER: S-EPMC8782711 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Since its outbreak, COVID-19 disease has claimed over one hundred thousand lives in the United States, resulting to multiple and complex nation-wide challenges. In this study, we employ global and local regression models to assess the influence of socio-economic and health conditions on COVID-19 mortality in contiguous USA. For a start, stepwise and exploratory regression models were employed to isolate the main explanatory variables for COVID-19 mortality from the ensemble 33 socio-economic and health parameters between January 1st and 16th of September 2020. Preliminary results showed that only five out of the examined variables (case fatality rate, vulnerable population, poverty, percentage of adults that report no leisure-time physical activity, and percentage of the population with access to places for physical activity) can explain the variability of COVID-19 mortality across the Counties of contiguous USA within the study period. Consequently, we employ three global and two local regression algorithms to model the relationship between COVID-19 and the isolated socio-economic and health variables. The outcomes of the regression analyses show that the adopted models can explain 61%-81% of COVID-19 mortality across the contiguous USA within the study period. However, MGWR yielded the highest R2 (0.81) and lowest AICc values (4031), emphasizing that it is the most efficient among the adopted regression models. The computed average adjusted R2 values show that local regression models (mean adj. R2 = 0.80) outperformed the global regression models (mean adj. R2 = 0.64), indicating that the former is ideal for modeling spatial causal relationships. The GIS-based optimized cluster analyses results show that hotspots for COVID-19 mortality as well as socioeconomic variables are mostly delineated in the South, Mid-West and Northeast of contiguous USA. COVID-19 mortality exhibited positive and significant association with black race (0.51), minority (0.48) and poverty (0.34). Whereas, the percentage of persons that attended college was negatively associated with poverty (-0.51), obesity (-0.50) and diabetes (-0.45). Results show that education is crucial to improve socio-economic and health conditions of the Americans. We conclude that investing in people's standard of living would reduce the vulnerability of an entire population.

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Will the economic growth benefit public health? Health vulnerability, urbanization and COVID-19 in the USA.

Supplementary information

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