Spatial Variation of Health Care Access and Responses to the COVID-19 Pandemic in Appalachia

Authors: Jamison Conley*, West Virginia University, Jeralynn Cossman, University of Texas at San Antonio, Daniel Totzkay, West Virginia University, Megan Dillow, West Virginia University, Alan Goodboy, alan.goodboy@mail.wvu.edu, Shari Steinman, West Virginia University, Matthew Jacobsmeier, West Virginia University
Topics: Health and Medical, Spatial Analysis & Modeling
Keywords: health care access, COVID-19, Appalachia
Session Type: Virtual Paper
Day: 4/9/2021
Start / End Time: 11:10 AM / 12:25 PM
Room: Virtual 7
Presentation File: No File Uploaded


There has been substantial geographic variation in both the infectious disease dynamics of the COVID-19 pandemic and the responses to it. Appalachia faces considerable challenges with an older population that has a disproportionately high rate of risk factors for COVID-19 to become severe coupled with limited health care access and facilities. This presentation focuses on how limitations in health care access and the variation in access across Appalachia impacted reactions to the pandemic. This research is part of a larger project assessing risk information management and reactions to precaution recommendations at the outset of the COVID-19 pandemic in Appalachia.
The data comes from a longitudinal study conducted over eight weeks of Appalachian adult residents starting mid-April 2020. Each individual was sent bi-weekly surveys to measure and examine trajectories of novel coronavirus/COVID-19 perceptions and reactions to official precautions. Individuals reported perceived barriers to access to health care, and spatial lag regression and geographically weighted regression are used to analyze the extent to which these reported barriers, as well as distances to health care facilities, impact reactions to precaution recommendations and the extent to which individuals are likely to seek health care for COVID-19. These are also regressed against the infection rate in Appalachian counties after the eight-week period to determine the impact these access barriers had on the longer-term COVID-19 infection rate.

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