Understanding the Differences in COVID-19 Case Fatality Rates Observed Across Alabama Counties. Issue 3 (May 2021)

• Record Type: Journal Article
• Authors: Velayati, Arash; Dahale, Devesh; Dahlin, Arielle; Hamilton, Caleb; Provost, Lloyd P.; Erwin, Paul
• Is Part Of: Journal of public health management and practice. Volume 27:Issue 3(2021)
• Publication Date: 2021-05
• Subjects: case fatality rate -- COVID-19 -- funnel chart -- social determinants of health; Public health administration -- United States -- Periodicals; 253.6
• DOI: 10.1097/PHH.0000000000001366
• Languages: English
• ISSNs: 1078-4659

Abstract

Abstract : To understand county-level variation in case fatality rates of COVID-19, a statewide analysis of COVID-19 incidence and fatality data was performed, using publicly available incidence and case fatality rate data of COVID-19 for all 67 Alabama counties and mapped with health disparities at the county level. A specific adaptation of the Shewhart p-chart, called a funnel chart, was used to compare case fatality rates. Important differences in case fatality rates across the counties did not appear to be reflective of differences in testing or incidence rates. Instead, a higher prevalence of comorbidities and vulnerabilities was observed in high fatality rate counties, while showing no differences in access to acute care. Funnel charts reliably identify counties with unexpected high and low COVID-19 case fatality rates. Social determinants of health are strongly associated with such differences. These data may assist in public health decisions including vaccination strategies, especially in southern states with similar demographics. Abstract : Supplemental Digital Content is Available in the Text.