Date of Award

January 2022

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

James Hadler

Second Advisor

Laura Bothwell

Abstract

Abstract:Background. This thesis explores the epidemiology of COVID-19 hospitalization among residents of New Haven County and Middlesex County, Connecticut from July - September 2021 with an emphasis on quantifying racial/ethnic and SES disparities. Two previous studies, the first conducted from March - May 2020 and the second conducted from July - December 2020, used COVID-NET Surveillance data from New Haven and Middlesex counties to explore the same questions. This thesis will compare findings with these previous studies to better understand how the epidemiology of COVID-19 hospitalization and racial/ethnic and SES disparities have changed in New Haven and Middlesex counties. Methods. Addresses of patients hospitalized with laboratory confirmed SARS-CoV-2, gathered by COVID-NET Surveillance, were geocoded and individuals were identified as either community- dwelling or institutionalized. Census tract measures of poverty and crowding were found for all community dwelling cases. Age adjusted incidence rates and age adjusted relative risks were calculated to determine the level of risk associated with race/ethnicity and census tract levels of poverty and crowding. Results. An individual’s Black or Hispanic race/ethnicity was more strongly associated with hospitalization for COVID-19 than the levels of poverty or crowding in their census tract. Racial and ethnic disparities had declined since the March 2020 - May 2020 time period but increased for non-Hispanic Blacks compared to the July 2020 - December 2020 time period. Conclusion. Racial/ethnic disparities in hospitalization have fluctuated in magnitude but have persisted throughout the COVID-19 pandemic. Decreased racial/ethnic disparities compared to the March 2020 - May 2020 time period may reflect the increased diversity of individuals working out of the home post- lockdown. An increase in hospitalization of non-Hispanic Black individuals when compared to White individuals may be explained by decreased access to and acceptability of vaccination.

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This is an Open Access Thesis.

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