Characterizing Post-Pandemic Social Determinants of Health of the Population Testing for COVID-19 in a Nationwide Network in the United States
Author(s)
Xiaowu Sun, PhD, Laura L. Lupton, MHA, MD, Shiyu Lin, MS, Sravanthi Mikkilineni, B.Tech, Leena Samuel, MS, Joaquim G. Fernandes, MS, David G. Fairchild, MD;
CVS Health, Woonsocket, RI, USA
CVS Health, Woonsocket, RI, USA
Presentation Documents
OBJECTIVES: COVID-19 can cause severe illness. Testing for SARS-CoV-2 within the first few days of infection allows for early detection and treatment. Socially vulnerable populations may experience barriers which limit their access to healthcare. This study describes the social vulnerability characteristics of patients testing for SARS-CoV-2 at a nationwide network.
METHODS: SARS-CoV-2 testing records were identified from the MinuteClinic (MC) research database. There are about 900+ MC locations in local neighborhoods across the United States. Centers for Disease Control (CDC) Social Vulnerability Index (SVI) was linked to the MC database by zip code of patient’s residence. Tests were summarized by quartiles of overall SVI and its 4 constituent themes and 16 factors. The first and fourth quartiles indicate least and most vulnerable communities, respectively.
RESULTS: There were 129,745 tests for 126,000 patients between September 1 and November 30, 2024. Patients were 18.3% <18 years, 73.0% 18-64 years and 8.7% 65 years or older; 62.4% Female; 57.3% White, 9.5% Black, 8.6% Hispanic, 4.9% Asian, and 19.7% other or unknown; 7.3% had Medicare and 7.4% Medicaid. The 3rd and 4th quartiles together accounted for 67.5% of the MC COVID testing population, demonstrating greater social vulnerability than would be expected in the general population. The strongest drivers of social vulnerability within the combined 3rd/4th quartiles were: 60.9% of those with vulnerability Socioeconomic Status - No Health Insurance; 65.9% of those with vulnerability Socioeconomic Status - Housing Cost Burden; 75.0% of those with vulnerability Housing Type/Transportation; 87.1% of those with vulnerability Racial & Ethnic Minority Status; and 92.3% of those with vulnerability Household Characteristics - English Language Proficiency.
CONCLUSIONS: A high percentage of the population testing for COVID-19 at a nationwide network came from vulnerable communities. Community-based testing may help to address barriers to healthcare access in vulnerable communities.
METHODS: SARS-CoV-2 testing records were identified from the MinuteClinic (MC) research database. There are about 900+ MC locations in local neighborhoods across the United States. Centers for Disease Control (CDC) Social Vulnerability Index (SVI) was linked to the MC database by zip code of patient’s residence. Tests were summarized by quartiles of overall SVI and its 4 constituent themes and 16 factors. The first and fourth quartiles indicate least and most vulnerable communities, respectively.
RESULTS: There were 129,745 tests for 126,000 patients between September 1 and November 30, 2024. Patients were 18.3% <18 years, 73.0% 18-64 years and 8.7% 65 years or older; 62.4% Female; 57.3% White, 9.5% Black, 8.6% Hispanic, 4.9% Asian, and 19.7% other or unknown; 7.3% had Medicare and 7.4% Medicaid. The 3rd and 4th quartiles together accounted for 67.5% of the MC COVID testing population, demonstrating greater social vulnerability than would be expected in the general population. The strongest drivers of social vulnerability within the combined 3rd/4th quartiles were: 60.9% of those with vulnerability Socioeconomic Status - No Health Insurance; 65.9% of those with vulnerability Socioeconomic Status - Housing Cost Burden; 75.0% of those with vulnerability Housing Type/Transportation; 87.1% of those with vulnerability Racial & Ethnic Minority Status; and 92.3% of those with vulnerability Household Characteristics - English Language Proficiency.
CONCLUSIONS: A high percentage of the population testing for COVID-19 at a nationwide network came from vulnerable communities. Community-based testing may help to address barriers to healthcare access in vulnerable communities.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HPR132
Topic
Health Policy & Regulatory
Topic Subcategory
Health Disparities & Equity
Disease
SDC: Infectious Disease (non-vaccine)