Abstract
Objectives Health inequalities were often exacerbated during the emerging epidemic. This study examined urban-rural inequalities among COVID-19 patients aged 65 or above in US Florida from March 2 to May 27, 2020.
Methods A retrospective cohort study was conducted using individual patient records. Multivariable Poisson and logistic models were used to calculate adjusted incidence of COVID- 19 and the associated rates of emergency department (ED) visits, hospitalizations and deaths.
Results As of May 27, 2020, there were 13,659 elderly COVID-19 patients (people aged 65 or above) in Florida and 14.9% of them died. Elderly people living in small metropolitan areas were less likely to be diagnosed with COVID-19 than those living in large metropolitan areas. There were significant decreasing trends of ED visit and hospitalization rates across metropolitan statuses for both men and women. Those patients living in small metropolitan or rural areas were less likely to be hospitalized than those living in large metropolitan areas (35% and 34% versus 41%). Elderly women aged 75 or above living in rural areas had 113% higher adjusted incidence of COVID-19 than those living in large metropolitan areas, and the rates of hospitalizations were lower compared with those living in large metropolitan areas ((29% versus 46%; OR: 0.37 [0.25- 0.54]; p <0.001).
Conclusions In US Florida, elderly people living in small metropolitan or rural areas suffered heavier burden of COVID-19 than those living in large metropolitan areas.
Competing Interest Statement
The authors have declared no competing interest.
Clinical Trial
N/A
Funding Statement
None
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Yes
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No IRB approval needed as the analysis was conducted on publicly available data.
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Yes
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Yes
Data Availability
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