Friday, May 27, 2022

County Health Rankings predict COVID Mortality in the 10 County Area

 

Last year I looked at COVID mortality and County Health Rankings (CHR) numbers for the whole state of PA. This year, the state does not make cumulative mortality numbers readily available. This makes updating the numbers subject to copying error. For this year, I thought I would focus on ten county region surrounding Cambria County.

The 10 county area is listed in the table at the top. The univariate correlation coefficients are presented in the table below for the COVID measures above and the CHR rankings for health outcomes and health factors. Health outcomes is a composite of length of life and quality of life measures. Health factors is a composite of health behaviors, clinical care, social and economic, and physical environment factors. The correlation matrix is presented below. Because of the small sample size, correlation coefficients of 0.632 or higher or -0.632 or lower were flagged as significant and presented in bold below.

 

% COVID Fully Vaccinated 

Case Mortality %

COVID Case Rate /100,000

COVID Mortality /100,000

Hosp  /100,000

County Health Outcomes Rank

Health Factors Rank

% COVID Fully Vaccinated 

1

Case Mortality

-0.738

1.000

COVID Case Rate

0.158

0.311

1.000

COVID Mortality /100,000

-0.579

0.953

0.583

1.000

Hosp /100,000

0.360

-0.440

0.134

-0.339

1.000

County Health Outcomes Rank

-0.289

0.632

0.344

0.642

-0.254

1.000

Health Factors Rank

-0.462

0.730

0.398

0.747

-0.409

0.850

1.000

Length of life rank

-0.297

0.696

0.232

0.659

-0.242

0.896

0.683

Quality of Life Rank

-0.160

0.428

0.368

0.477

-0.254

0.925

0.826

Health Behaviors rank

-0.363

0.678

0.477

0.726

-0.227

0.676

0.913

Clinical Care rank

-0.548

0.803

0.232

0.764

-0.420

0.828

0.785

Soc & Econ Factors rank

-0.357

0.598

0.318

0.608

-0.414

0.843

0.950

Phys env rank

0.031

0.135

-0.381

0.003

-0.242

0.385

0.116

The COVID case and population adjusted mortality rates were most strongly associated with the CHR rankings of length of life, health behaviors, and clinical care. A positive correlation with the rankings suggest that the lower the ranking is, the higher the COVID mortality. Case mortality is simply the number of COVID deaths divided by the number of COVID cases.




























The above graph shows the scatter plot for the length of life rank showing a linear association with COVID case mortality. The R squared statistic of 0.485 means that 48.5% of the variability in case mortality is accounted for by the length of life ranking. The regression equation says that for every unit a county is ranked lower, there is a predicted increase of 0.02% in the case mortality. There were no strong outliers in in this plot. 




























The strongest correlation for the health factors rankings was clinical care at 0.808. The scatter plot above shows a stronger correlation between that and case mortality accounting for 64.5% of its variability. If it were 100% of the variability, all of the counties would fall on the regression line. Like length of life, the regression equation predicts that for every unit lower that a county is ranked, a 0.02% increase in case mortality should happen.

These sub rankings are themselves composites of dozens of statistics. The individual statistics should shed more light on what variables may be driving COVID vaccination, case, mortality, and hospitalization rates. The devil is always in the details. This will be the next step.

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