Linking Local-Level Chronic Disease and Social Vulnerability Measures to Inform Planning Efforts: A COPD Example
ORIGINAL RESEARCH — Volume 20 — August 17, 2023
PEER REVIEWED
Figure 1.
Prevalence of chronic obstructive pulmonary disease (COPD) by categories for the 4 vulnerability themes and the overall social vulnerability index (SVI) at the (a) county and (b) census tract level. Categories were based on quartiles of rankings and categorized into low (quartile 1), moderate (quartiles 2 and 3), and high (quartile 4). All pairwise differences in median county- and tract-level COPD prevalence were significantly different (P< .001) for the overall SVI and for all themes, except for the comparison of county-level moderate and high vulnerability for the Housing type and Transportation theme. Median and population weighted COPD prevalence estimates are shown in the figures and the estimated number of adults with COPD (in millions) are provided in the figure labels.
| Level and theme or overall index | Median COPD prevalence,% | Population weighted COPD prevalence, % | Estimated number of adults with COPD (millions) | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Low | Moderate | High | Low | Moderate | High | Low | Moderate | High | |
| A. County | |||||||||
| Socioeconomic theme | 7.0 | 9.1 | 11.2 | 5.9 | 7.4 | 9.3 | 4.3 | 11.5 | 2.5 |
| Household composition and disability theme | 6.9 | 9.1 | 10.6 | 6.1 | 8.0 | 10.1 | 7.6 | 8.4 | 2.3 |
| Minority status and language theme | 9.8 | 9.1 | 7.9 | 9.9 | 8.1 | 6.5 | 1.5 | 6.5 | 10.3 |
| Housing type and transportation theme | 8.3 | 9.3 | 9.3 | 6.9 | 7.5 | 6.9 | 2.1 | 9.6 | 6.6 |
| Overall SVI | 7.4 | 9.2 | 10.4 | 6.4 | 7.2 | 7.8 | 2.9 | 10.9 | 4.5 |
| B. Census tract | |||||||||
| Socioeconomic theme | 5.1 | 7.2 | 9.3 | 5.2 | 7.2 | 9.0 | 3.2 | 8.6 | 4.7 |
| Household composition and disability theme | 4.9 | 6.9 | 9.5 | 5.0 | 7.1 | 9.5 | 3.1 | 8.5 | 5.0 |
| Minority status and language theme | 7.9 | 6.7 | 6.4 | 8.0 | 6.9 | 6.6 | 4.5 | 8.2 | 3.9 |
| Housing type and transportation theme | 5.9 | 7.1 | 7.7 | 6.1 | 7.2 | 7.7 | 3.5 | 8.4 | 4.7 |
| Overall SVI | 5.3 | 7.1 | 8.7 | 5.4 | 7.1 | 8.7 | 3.2 | 8.6 | 4.7 |
Two US maps of model-based prevalence estimates of chronic obstructive pulmonary disease categorized by quartiles, one at the county level and one at the census tract level. Prevalence ranged from 3.5% to 19.7% across counties and 1.1% to 26.7% across census tracts. Counties and census tracts in the highest model-based COPD quartile were clustered along the Ohio and lower Mississippi rivers.
Figure 2.
County- and census tract–level model-based prevalence estimates of chronic obstructive pulmonary disease, US, 2018. Maps were classified into 4 classes using quartiles (county: quartile 1 [3.5%–7.3%], quartile 2 [7.4%–8.9%], quartile 3 [9.0%–10.6%], quartile 4 [10.7%–19.7%]; census tract: quartile 1 [1.1%–5.3%], quartile 2 [5.4%–6.9%], quartile 3 [7.0%–8.9%], quartile 4 [9.0%–26.7%]). Source: PLACES: Local Data for Better Health, County Data 2022 release (www.cdc.gov/places).
Maps show 5 US county maps and 5 US census tract maps. At the county and tract level, high COPD prevalence with high vulnerability for the socioeconomic and household composition and disability themes and the overall SVI clustered along the Ohio and lower Mississippi Rivers. Low COPD prevalence clustered with low vulnerability for the socioeconomic theme and the overall SVI in counties in the West North Central region.
Figure 3.
Areas of concordance (low vulnerability and low prevalence; high vulnerability and high prevalence) and discordance (low vulnerability and high prevalence; high vulnerability and low prevalence) between categories of chronic obstructive pulmonary disease prevalence and social vulnerability, US, 2018. Prevalence estimates and rankings were each categorized as low when in quartile 1 and high when in quartile 4. Concordance and discordance are mapped by county and census tract by 4 vulnerability themes: socioeconomic, household composition and disability, minority status and language, and housing type and transportation, and by the overall social vulnerability index. Source: PLACES: Local Data for Better Health (2020 data release), www.cdc.gov/places. 2018 CDC/ATSDR SVI (2020 data release) (https://www.atsdr.cdc.gov/placeandhealth/svi).
Text version of supplemental figure: Five US county maps and 5 US census tract maps display 3 × 3 bivariate maps of 3 levels of COPD prevalence (low, moderate, and high) by 3 levels (low, moderate, and high) of each of the 4 vulnerability themes (socioeconomic, household composition and disability, minority status and language, housing type and transportation) and the overall social vulnerability index. The map shows clusters of counties and tracts along the Ohio and lower Mississippi rivers in the high COPD prevalence and high vulnerability category for the socioeconomic, household composition and disability, and overall index.
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