Vulnerable Population Dashboard

This dashboard provides an initial look into how to quantify the level of vulnerability within an area (as defined by ZIP code, ZCTA). Interacting with the data at this level allows local decision makers to understand the vulnerability of their populations, as well as the vulnerability of neighboring regions.

We know several of the Coalition partners are also working on this topic, and we’d like to combine our information to improve everyone’s situational awareness.

Our methodology for creating the dashboard is described below.

Dimensions of Vulnerability

As of 20 March 2020, there was no CDC recommendation for how to assess – and compare – each individual community’s vulnerability to adverse COVID-19 outcomes. To understand this vulnerability, each community’s leadership must pull together data and conduct assessments of the COVID-19 risk specific to that geographic area.

We propose an approach that layers three types of data to build a community vulnerability index and assess COVID-19 risk in each ZIP Code tabulation area (ZCTA) 1. We started with medical risk factors and added social risk factors (also called social determinants of health) and health care resource risk factors.

We feel that that these measures are likely to drive the burden of acute outcomes related to COVID-19 and can best inform a community vulnerability assessment to assist local decision makers. We aggregated variables under each of these categories to form three distinct assessments of community vulnerability to adverse outcome related to COVID-19. We are focusing on the vulnerability of a community to impacts of COVID-19, assuming that all communities are vulnerable to community transmission of this novel virus.

Medical Risk

This measure includes a total of 10 risk factors.2 We included these medical risk factors for two reasons: literature searches for risk factors for hospitalization and death related to COVID-19; and known risk factors for adverse outcomes related to influenza infection, given the similarities between influenza and COVID-19.

Social Risk

This measure includes a total of 4 risk factors.3 We included these social risk factors based on literature review of the social determinants of health field4, as well as the CDC’s Social Vulnerability Index.5

Health Care Resource Risk

This measure includes a total of 3 risk factors.6 We included these resource risk factors because they are likely to drive the extent to which hospitals in each community can respond to individuals with severe COVID-19.

Processing Data

We pulled risk measure datasets from a breadth of public sources including the CDC7,8, American Academy of Family Physicians9, the Department of Housing and Urban Development10, and the U.S. Census Bureau11.

These disparate data sources vary in many ways, most importantly at the geographic resolution: some datasets are available at the ZCTA level, while others are available at more or less granular levels (e.g., address level or state level, respectively).

To create a single dataset, we aggregated variables originally available at a more granular level than ZCTA (e.g., address) up to the ZCTA level. For risk measures at less granular level (e.g., county or state), we used an algorithm to proportionally distribute the values across the ZCTAs in that area based on population. This data was normalized to allow comparison across factors and then combined.

Questions? Please email C19HCC@mitre.org.

Dashboards

COVID-19 Vulnerability Measures

COVID-19 Vulnerability Summary


References

[1] ZIP Code Tabulation Areas. Available from: https://www.census.gov/programs-surveys/geography/guidance/geo-areas/zctas.html. Accessed March 20, 2020.

[2] The list of factors includes: Age 65 and Older, Heart Disease, COPD, Diabetes, Cancer, Smoking, Asthma, Kidney Disease, American Indian or Alaskan Native (Non-Hispanic), Residents in Nursing Homes

[3] The list of factors includes: Percent Uninsured, Percent Below 200% Federal Poverty Level, Percent Homeless, Percent Migrants, etc.

[4] UNS Resource Guide; Available from: https://bphc.hrsa.gov/sites/default/files/bphc/programopportunities/fundingopportunities/NAP/uns_resource_guide.pdf; Accessed March 20, 2020.

[5] U.S. Centers for Disease Control and Prevention (CDC). Social Vulnerability Index. Available from: https://svi.cdc.gov; Accessed March 20, 2020.

[6] The list of factors includes: Hospital Bed Count per Capita, ICU Beds per Capita, and Distance to Hospital

[7] Behavioral Risk Factor Surveillance System. Available from: https://www.cdc.gov/brfss/annual_data/annual_2018.html. Accessed March 20, 2020.

[8] Social Vulnerability Index. Available from: https://svi.cdc.gov/data-and-tools-download.html. Accessed March 20, 2020.

[9] Uniform Data System: https://www.udsmapper.org/. Accessed March 20, 2020.

[10] Homelessness Estimates: https://www.hudexchange.info/resource/5948/2019-ahar-part-1-pit-estimates-of-homelessness-in-the-us/. Accessed March 20, 2020.

[11] American Community Survey. Available from: https://www.census.gov/programs-surveys/acs/data.html. Accessed March 20, 2020.