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?:abstract
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Objective: To develop indicators of vulnerability for coronavirus disease 2019 (covid-19) infection in Los Angeles County (LAC) by race and neighborhood characteristics. Design: Development of indicators that combines pre-existing medical vulnerabilities with social and built-environment data by zip code tabulation areas (ZTCAs). Setting: Neighborhoods in LAC categorized by race/ethnicity ranked into quintiles by relative vulnerability: Non-Hispanic white; Black; Latinx: Cambodians, Hmong and Laotians combined (CHL); and Other Asians. Data Sources: AskCHIS Neighborhood Edition, American Community Survey 2014-2018, and California Department of Parks and Recreation. Main Outcome Measures: 1) Pre-Existing Health Condition, 2) Barriers to Accessing Healthcare, 3) Built Environment Risk, and 4) CDC\'s Social Vulnerability. Results: Neighborhoods most vulnerable to covid-19 are characterized by significant clustering of racial minorities, low income households and unmet medical needs. An overwhelming 73% of Blacks reside in the neighborhoods with the two highest quintiles of pre-existing health conditions, followed by Latinx (70%) and CHL (60%), while 60% of whites reside in low or the lowest vulnerable neighborhoods. For the Barriers to Accessing Healthcare indicator, 40% of Latinx reside in the highest vulnerability places followed by Blacks, CHL and other Asians (29%, 22%, and 16% respectively), compared with only 7% of Whites reside in such neighborhoods. The Built Environment Indicator finds CHL (63%) followed by Latinx (55%) and Blacks (53%) reside in the neighborhoods designated as high or the highest vulnerability compared to 32% of Whites residing in these neighborhoods. The Social Vulnerability Indicator finds 42% of Blacks and Latinx and 38% of CHL residing in neighborhoods of high vulnerability compared with only 8% of Whites residing these neighborhoods. Conclusions: Vulnerability to covid-19 infections differs by neighborhood and racial/ethnic groups. Our vulnerability indicators when utilized in decision-making of re-openings or resource distribution such as testing, vaccine distribution, hotel rooms for quarantine and other covid-19-related resources can provide an equity driven data approach for the most vulnerable.
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