Exploring the Association of Social Vulnerabilities with COVID-19 Outcomes and Reviewing Strategies for Promoting COVID-19 Vaccination
Abstract
Coronavirus disease 2019 (COVID-19), caused by a Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), remains a public health threat across the globe. Since its index case in December 2019, COVID-19 has spread worldwide, claiming over one million lives in the United States (U.S.), of which more than 93,000 were from Texas. As with other zoonotic coronaviruses, SARS-CoV-2 spreads through contact with infected respiratory secretions or contaminated surfaces. Social Determinants of Health (SDoH) may be associated with COVID-19 outcomes, such as mortality and low vaccination uptake. This dissertation sought to examine the association of the Minority Health Social Vulnerability Index (MH SVI), a composite measure of 34 SDoH indicators, with COVID-19 mortality and vaccination coverage in Texas and explore strategies of interventions employed to promote COVID-19 vaccination uptake in the U.S. Paper 1 uses an ecological analysis of counties to examine the cross-sectional association of MH SVI and COVID-19 mortality among all populations in Texas. Using Geographic Information System (GIS), the paper displays a bivariate relationship between county-level MH SVI and COVID-19 deaths per 100,000 population. In addition, the paper uses the negative binomial regression to assess the association between the MH SVI and COVID-19 mortality rates in Texas. Similarly, paper 2 employs an ecological analysis approach to determine the association between the MH SVI and COVID-19 vaccination coverage among adolescents in Texas. The paper also demonstrates the distribution of COVID-19 vaccination coverage and county-level MH SVI by counties in Texas using the GIS. In addition, paper 2 uses the negative binomial regression to determine the association between MH SVI and COVID-19 vaccination coverage in Texas counties among adolescents. Finally, paper 3 describes and explores the effectiveness of COVID-19 vaccination promotion strategies in the U.S. This paper utilizes the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) and a scoping review method by Arksey & O’Malley (2005) to present various theoretical underpinnings, change methods, and effectiveness of strategies aimed at promoting COVID-19 vaccination uptake in the U.S. Overall, this dissertation contributes to the literature on COVID-19 pandemic disparities. It also identifies specific vulnerabilities and SDoH indicators that health planners need to focus on while implementing COVID-19 control programs in Texas and the U.S. Finally, these findings offer opportunities for planners and researchers to expand implementation science research and practice on vaccination interventions in the U.S.
Subject Area
Public health|Behavioral Sciences|Psychology
Recommended Citation
Nyachoti, Dennis Ogeto, "Exploring the Association of Social Vulnerabilities with COVID-19 Outcomes and Reviewing Strategies for Promoting COVID-19 Vaccination" (2023). Texas Medical Center Dissertations (via ProQuest). AAI30422988.
https://digitalcommons.library.tmc.edu/dissertations/AAI30422988