Neighborhood characteristics associated with COVID-19 burden—the modifying effect of age

Abstract

Background: Neighborhood characteristics have been linked to community incidence of COVID-19, but the modifying effect of age has not been examined. Objective: We adapted a neighborhood-wide analysis study (NWAS) design to systematically examine associations between neighborhood characteristics and COVID-19 incidence among different age groups. Methods: The number of daily cumulative cases of COVID-19 by zip code area in Illinois has been made publicly available by the Illinois Department of Public Health. The number of COVID-19 cases was reported for eight age groups (under 20, 20–29, 30–39, 40–49, 50–59, 60–69, 70–79, and 80+). We reviewed this data published from May 23 through June 17, 2020 with complete data for all eight age groups and linked the data to neighborhood characteristics measured by the American Community Survey (ACS). Geographic age-specific cumulative incidence (cases per 1000 people) of COVID-19 was calculated by dividing the number of daily cumulative cases by the population of the same age group at each zip code area. The association between individual characteristics and COVID-19 incidence was examined using Poisson regression models. Results: At the zip code level, neighborhood socioeconomic status was a more important risk factor of COVID-19 incidence in children and working-age adults than in seniors. Social demographics and housing conditions were important risk factors of COVID-19 incidence in older age groups. We additionally observed significant associations between transportation-related variables and COVID-19 incidences in multiple age groups. Significance: We concluded that age modified the association between neighborhood characteristics and COVID-19 incidence.