COVID-19 Emergence and Social and Health Determinants in Colorado: A Rapid Spatial Analysis

Abstract

The aim of this rapid analysis was to investigate the spatial patterns of COVID-19 emergence across counties in Colorado. In the U.S. West, Colorado has the second highest number of cases and deaths, second only to California. Colorado is also reporting, like other states, that communities of color and low-income persons are disproportionately affected by COVID-19. Using GIS and correlation analysis, this study explored COVID-19 incidence and deaths from March 14 to April 8, 2020, with social determinants and chronic conditions. Preliminary results demonstrate that COVID-19 incidence intensified in mountain communities west of Denver and along the Urban Front Range, and evolved into new centers of risk in eastern Colorado. Overall, the greatest increase in COVID-19 incidence was in northern Colorado, i.e., Weld County, which reported the highest rates in the Urban Front Range. Social and health determinants associated with higher COVID-19-related deaths were population density and asthma, indicative of urban areas, and poverty and unemployment, suggestive of rural areas. Furthermore, a spatial overlap of high rates of chronic diseases with high rates of COVID-19 may suggest a broader syndemic health burden, where comorbidities intersect with inequality of social determinants of health.

Keywords: COVID-19; Colorado; GIS; coronavirus; multiple chronic conditions; pandemic; social determinants of health; spatial analysis.

Figure 1

Map of Colorado counties, highlighting the Denver Metropolitan area. Source: CDPHE [21].

Figure 2

Maps of COVID-19 case counts (dot density) and incidence rates (per 100,000 persons) across counties in Colorado on March 14, 2020 (top panel) and April 8, 2020 (bottom panel). Source: CDPHE [6,20]

Figure 3

Maps of COVID-19 Incidence rates (per 100,000 persons) across five time points: March 14; March 18; March 25; April 1; and April 8, 2020, using the inverse distance weighted interpolation method. Incidence rates are displayed as high (red) to low (blue) intensity. Source: CDPHE [6,20].

Figure 4

Number of COVID-19 outbreaks by county in Colorado. Outbreaks are associated with facilities such as seniors and assisted living, meat packing plants, and jails, from March 11 to April 8. Source: CDPHE [34].