Social Vulnerability Is Associated with Risk of COVID-19 Related Mortality in U.S. Counties with Confirmed Cases

Objectives. To determine the association between the Center for Disease Control and Prevention's (CDC) Social Vulnerability Index (SVI) with the risk of COVID-19-related mortality. Methods. We merged by county CDC's SVI and the New York Times data on coronavirus cases. We estimated the association between the SVI and risk of death from COVID-19 per 100,000 people in counties with confirmed cases (n=2,755 U.S. counties) using multivariable Poisson regression. Results. The adjusted risk of COVID-19-related death followed a non-linear pattern, with the lowest risk among SVIs from 0.05 to 0.55 (roughly 3.1 to 3.5/100,000 people) and highest risk corresponding to SVI=0.95 (6.5/100,000). Compared with a SVI=0.35, SVIs of 0.85 and 0.95 were associated with 2.3 (2.1, 2.5) and 3.4 (3.1, 3.7) excess deaths per 100,000, respectively. Conclusions. High social vulnerability is associated with increased risk of COVID-19-related mortality among U.S. counties with confirmed cases.