High COVID-19 Mortality Risk in Pennsylvania’s Rural Counties

Raeven Faye Chandler, Shannon M. Monnat, and Yue Sun

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COVID-19 cases in Pennsylvania have been concentrated in eastern urban counties this far (counties with relatively low prevalence of the chronic health conditions that increase risk of death from COVID-19). However, the 14-day incident rate has recently begun increasing in several rural counties that have high prevalence of several chronic health conditions that increase risk of severe complications and death from COVID-19. Should COVID-19 continue to spread, several of PA’s rural counties are at risk of high rates of hospitalization and death. The map below displays variation in chronic health comorbidities across PA counties (click here for interactive map). The health risk index is comprised of county-level prevalence rates of obesity, diabetes, chronic obstructive pulmonary disease, high blood pressure, and heart disease along with percentage of adults who are age 65 and older. Because the index is standardized, values below 0 represent below average risk, and values greater than 0 represent above average risk. PA county index scores range from a high of 2.53 in Sullivan County (highest risk) to a low of -3.49 in Centre County (lowest risk). The average standardized score for metropolitan counties is -0.467, compared to 0.576 for nonmetro counties. Of the 30 nonmetro counties in PA, 16 are categorized as “high risk” or “very high risk” and only four are categorized as “low risk”. Of note, the four metro counties that are categorized as “high risk” are considered rural by the Center for Rural Pennsylvania. As all counties in The Commonwealth reach the final stage of reopening, and case counts continue to grow in places that were relatively unaffected during the early stage of the pandemic, local representatives and stakeholders should keep a watchful eye on these high-risk rural counties with severe COVID-19 health vulnerabilities.

About the Authors 
Raeven Faye Chandler (rfc134@psu.edu) is Director of the Pennsylvania Population Network (PPN) and Assistant Research Professor at The Pennsylvania State University. Shannon M. Monnat (smmonnat@maxwell.syr.edu) is the Lerner Center Director and Lerner Chair for Public Health Promotion, Associate Professor of Sociology, and Co-Director of the Policy, Place, and Population Health (P3H) Lab in the Maxwell School of Citizenship and Public Affairs at Syracuse University (SU). Yue Sun (ysun46@syr.edu) is a PhD student in the Sociology Department, a Lerner Center Graduate Research Assistant, and a Graduate Affiliate of the P3H Lab at SU.

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