Towards optimization of community vulnerability indices for COVID-19 prevalence

Abstract Background The Centers for Disease Control and Prevention (CDC)’s social vulnerability index (SVI) for exploring social and health disparities in the United States may not be suitable for assessing COVID-19 risk in specific communities and subpopulations. This study aims to develop the comm...

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Main Authors: Lung-Chang Chien, L.-W. Antony Chen, Chad L. Cross, Edom Gelaw, Cheryl Collins, Lei Zhang, Cassius Lockett
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-22751-y
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author Lung-Chang Chien
L.-W. Antony Chen
Chad L. Cross
Edom Gelaw
Cheryl Collins
Lei Zhang
Cassius Lockett
author_facet Lung-Chang Chien
L.-W. Antony Chen
Chad L. Cross
Edom Gelaw
Cheryl Collins
Lei Zhang
Cassius Lockett
author_sort Lung-Chang Chien
collection DOAJ
description Abstract Background The Centers for Disease Control and Prevention (CDC)’s social vulnerability index (SVI) for exploring social and health disparities in the United States may not be suitable for assessing COVID-19 risk in specific communities and subpopulations. This study aims to develop the community vulnerability index (CVI) optimized for demographic-specific COVID-19 prevalence at the census tract level and apply it to Clark County, Nevada, which includes the vibrant Las Vegas metropolitan area. Methods We constructed the CVI using fifteen social condition variables from the CDC’s SVI along with eight additional community variables measuring inactive commuting, park deprivation, retail density, low-income homeowner or renter severe housing cost burden, housing inadequacy, segregation, and population density. Deploying weighted quantile sum (WQS) regression through a bootstrapping technique, the CVI was optimized by linking the 23 community variables to cumulative confirmed cases of COVID-19 from January 2020 to November 2021, excluding reinfections. This study resulted in whole-population and 13 demographic-specific CVIs representative of various age (0–4, 5–17, 18–24, 25–49, 50–64, and 65 +), race (White, Black, Hispanic, Asian/Pacific Islander, and others), and sex (male and female) groups. Results All WQS regressions revealed significant associations between the CVIs and corresponding COVID-19 prevalence. The most influential variables to the whole-population CVI included minority status, park deprivation, aged 17 and younger, inactive commuting, and housing inadequacy, which also contributed significantly to several CVIs corresponding to COVID-19 prevalence in subpopulations. Other influential community variables to the CVIs in general varied by subpopulation. The distributions of the subpopulation CVIs showed different levels of spatial disparities, with the largest disparities observed in female, White, and age 50–64 groups. Conclusions This study established a practical approach to optimize CVI for assessing COVID-19 risk. The incorporation of additional variables, specificity for subpopulations, and adaptability through the WQS regression collectively contribute to its value in informing evidence-based policy decisions and guiding targeted interventions to mitigate the impact of COVID-19 on vulnerable communities.
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spelling doaj-art-1dabde8d80af47cc8ac223cde1a3cf552025-08-20T02:11:11ZengBMCBMC Public Health1471-24582025-04-0125111210.1186/s12889-025-22751-yTowards optimization of community vulnerability indices for COVID-19 prevalenceLung-Chang Chien0L.-W. Antony Chen1Chad L. Cross2Edom Gelaw3Cheryl Collins4Lei Zhang5Cassius Lockett6Department of Epidemiology and Biostatistics, University of Nevada Las VegasDepartment of Environmental and Global Health, University of Nevada Las VegasDepartment of Epidemiology and Biostatistics, University of Nevada Las VegasDepartment of Epidemiology and Biostatistics, University of Nevada Las VegasDesert Research InstituteSouthern Nevada Health DistrictSouthern Nevada Health DistrictAbstract Background The Centers for Disease Control and Prevention (CDC)’s social vulnerability index (SVI) for exploring social and health disparities in the United States may not be suitable for assessing COVID-19 risk in specific communities and subpopulations. This study aims to develop the community vulnerability index (CVI) optimized for demographic-specific COVID-19 prevalence at the census tract level and apply it to Clark County, Nevada, which includes the vibrant Las Vegas metropolitan area. Methods We constructed the CVI using fifteen social condition variables from the CDC’s SVI along with eight additional community variables measuring inactive commuting, park deprivation, retail density, low-income homeowner or renter severe housing cost burden, housing inadequacy, segregation, and population density. Deploying weighted quantile sum (WQS) regression through a bootstrapping technique, the CVI was optimized by linking the 23 community variables to cumulative confirmed cases of COVID-19 from January 2020 to November 2021, excluding reinfections. This study resulted in whole-population and 13 demographic-specific CVIs representative of various age (0–4, 5–17, 18–24, 25–49, 50–64, and 65 +), race (White, Black, Hispanic, Asian/Pacific Islander, and others), and sex (male and female) groups. Results All WQS regressions revealed significant associations between the CVIs and corresponding COVID-19 prevalence. The most influential variables to the whole-population CVI included minority status, park deprivation, aged 17 and younger, inactive commuting, and housing inadequacy, which also contributed significantly to several CVIs corresponding to COVID-19 prevalence in subpopulations. Other influential community variables to the CVIs in general varied by subpopulation. The distributions of the subpopulation CVIs showed different levels of spatial disparities, with the largest disparities observed in female, White, and age 50–64 groups. Conclusions This study established a practical approach to optimize CVI for assessing COVID-19 risk. The incorporation of additional variables, specificity for subpopulations, and adaptability through the WQS regression collectively contribute to its value in informing evidence-based policy decisions and guiding targeted interventions to mitigate the impact of COVID-19 on vulnerable communities.https://doi.org/10.1186/s12889-025-22751-yCOVID-19Vulnerability indexWeighted quantile sum regression
spellingShingle Lung-Chang Chien
L.-W. Antony Chen
Chad L. Cross
Edom Gelaw
Cheryl Collins
Lei Zhang
Cassius Lockett
Towards optimization of community vulnerability indices for COVID-19 prevalence
BMC Public Health
COVID-19
Vulnerability index
Weighted quantile sum regression
title Towards optimization of community vulnerability indices for COVID-19 prevalence
title_full Towards optimization of community vulnerability indices for COVID-19 prevalence
title_fullStr Towards optimization of community vulnerability indices for COVID-19 prevalence
title_full_unstemmed Towards optimization of community vulnerability indices for COVID-19 prevalence
title_short Towards optimization of community vulnerability indices for COVID-19 prevalence
title_sort towards optimization of community vulnerability indices for covid 19 prevalence
topic COVID-19
Vulnerability index
Weighted quantile sum regression
url https://doi.org/10.1186/s12889-025-22751-y
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