Spatial variability

2019-20 coronavirus outbreak

Demography

Ordinary least squares

Ecology

Biology

Statistics

Spatial epidemiology

Cartography

Virology

Geographically Weighted Regression

Spatial ecology

Acoustics

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Outbreak

Coronavirus disease 2019 (COVID-19)

Regression analysis

Spatial analysis

Physics

Mathematics

Geography

Infectious disease (medical specialty)

Internal medicine

Sociology

Remote sensing

Epidemiology

Medicine

Pandemic

Disease

Spatial dependence

Period (music)

Spatial heterogeneity

Pathology

Annals of Epidemiology

This study aims to understand how spatial structures, the interconnections between counties, matter in understanding the coronavirus disease 2019 (COVID-19) period prevalence across the United States. We assemble a county-level data set that contains COVID-19–confirmed cases through June 28, 2020, and various sociodemographic measures from multiple sources. In addition to an aspatial regression model, we conduct spatial lag, spatial error, and spatial autoregressive combined models to systematically examine the role of spatial structure in shaping geographical disparities in the COVID-19 period prevalence. The aspatial ordinary least squares regression model tends to overestimate the COVID-19 period prevalence among counties with low observed rates, but this issue can be effectively addressed by spatial modeling. Spatial models can better estimate the period prevalence for counties, especially along the Atlantic coasts and through the Black Belt. Overall, the model fit among counties along both coasts is generally good with little variability evident, but in the Plain states, the model fit is conspicuous in its heterogeneity across counties. Spatial models can help partially explain the geographic disparities in the COVID-19 period prevalence. These models reveal spatial variability in the model fit including identifying regions of the country where the fit is heterogeneous and worth closer attention in the immediate short term.

A spatial analysis of the COVID-19 period prevalence in U.S. counties through June 28, 2020: where geography matters?