Validation of a Neighborhood-Level COVID Local Risk Index in 47 Large U.S. Cities
Table of Contents
Table of Contents
Report Publish Date: July 2022
This research article describes a study that tested the accuracy of the COVID Local Risk Index, or CLRI, a city and neighborhood level metric that allowed health departments to see where local risk for COVID-19 transmission and illness was highest.
Primary Takeaways
“We validated the CLRI as an accurate tool to capture small area-level SARS COV-2-related risk in 47 U.S. cities, demonstrated most strongly by our pooled model results,” the authors write. “In the majority of included cities, we found the CLRI to be strongly associated with positivity and SARS COV-2-related hospitalizations and mortality.”
The researchers say the tool had a weaker association with cities’ and neighborhoods’ COVID-19 incidence levels.
Overview and Objectives
While county-level data were widely available during the COVID-19 pandemic, data about COVID incidence, illness, hospitalizations, and deaths in cities and neighborhoods were less easy to get. It was important for local health officials to have data about where COVID was hitting hardest in their cities so they could target responses to the places at highest risk.
The authors of this study wanted to test the accuracy of the COVID Local Risk Index, a tool that had been rolled out on the City Health Dashboard, a free portal containing data on health metrics and the factors that determine health in 750 U.S. cities.
Hypothesis or Approach
The authors compared the measurements provided by CLRI to data on COVID incidence and outcomes (illness, hospitalizations, and death) in 47 large cities.
How This Influences Change
The CLRI is an example of researchers quickly building a tool to measure local incidence and outcomes of a deadly pandemic; it could provide a model for future infectious disease outbreaks.
Research: Go Deeper
Objectives: To present the COVID Local Risk Index (CLRI), a measure of city- and neighborhood-level risk for SARS COV-2 infection and poor outcomes, and validate it using sub-city SARS COV-2 outcome data from 47 large U.S. cities.
Methods: Cross-sectional validation analysis of CLRI against SARS COV-2 incidence, percent positivity, hospitalization, and mortality. CLRI scores were validated against ZCTA-level SARS COV-2 outcome data gathered in 2020–2021 from public databases or through data use agreements using a negative binomial model.
Results: CLRI was associated with each SARS COV-2 outcome in pooled analysis. In city-level models, CLRI was positively associated with positivity in 11/14 cities for which data were available, hospitalization in 6/6 cities, mortality in 13/14 cities, and incidence in 33/47 cities.
Conclusions: CLRI is a valid tool for assessing sub-city risk of SARS COV-2 infection and illness severity. Stronger associations with positivity, hospitalization and mortality may reflect differential testing access, greater weight on components associated with poor outcomes than transmission, omitted variable bias, or other reasons. City stakeholders can use the CLRI, publicly available on the City Health Dashboard (www.cityhealthdashboard.com), to guide SARS COV-2 resource allocation.
Health & Place, July 2022. https://doi.org/10.1016/j.healthplace.2022.102814
Research Team
This study and report was conducted and created by the following people.
- Ben R. Spoer
- Edwin McCulley
- Taylor M. Lampe
- Pei Yang Hsie
- Alexander Chen
- Rebecca Ofrane
- Heather Rollins
- Lorna E. Thorpe
- Usama Bilal
- Marc N. Gourevitch
Similar Research to Explore
Pandemic-Driven Health Policies To Address Social Needs And Health Equity
Household Experiences in America During the Delta Variant Outbreak
