ATLANTA - In the last 21 months, over 87,000 Georgians have ended up in the hospital with COVID-19, and 13,600 have required intensive care, according to the Georgia Department of Public Health.
It has been clear since early on in the pandemic that the coronavirus is hitting Americans in racial and ethnic minority groups, like Blacks and Hispanics, harder.
And, Emory University Hospital cardiology fellow Dr. Saba Islam is the lead researcher on new study that finds where you live may also play a big part in what happens if you end up in a hospital bed with this virus.
"I think this needs to be a big public health concern, that the neighborhood environment you live in really impacts your health," Dr. Islam says
The researchers used the American Heart Association's COVID-19 Cardiovascular Disease Registry, to study data collected on over 17,000 people hospitalized with the virus at 107 medical centers across the US.
Dr. Islam says they found COVID-19 patients who came from poorer, or more "socially vulnerable" neighborhoods had a nearly 25% higher chance of dying in the hospital or suffering a major cardiovascular event, such as heart attack or stroke or new-onset heart failure, than patients who came from more affluent communities.
"So, we adjusted for age, sex, comorbidities and saw that it's beyond that, it's beyond race, age, sex, pre-existing comorbidities," Dr. Islam says. "So, we were thinking maybe it's because the patients were sicker when they presented to the hospital. So, we adjusted for that as well. And what we saw was that really didn't impact anything. These patients were still having higher in-hospital mortality as well as cardiovascular events, which was quite surprising."
Islam says researchers are not sure why patients from poorer communities had worse outcomes.
"So, one thing could be environmental factors," Islam says. "So, we weren't able to adjust, for example, for pollution in a neighborhood. Other things might be the quality of the hospitals that these individuals have access to. So, that could be causing it, or whether they're having access to cutting edge treatments."
Another possibility, she says, could be the patients' underlying medical conditions may not be under control.
"So these patients may not be taking blood pressure medication, or their diabetes may not be as well controlled as patients who live in less vulnerable neighborhoods," Islam says.
Dr. Islam says providers often so focus on treating the immediate needs of the patient without asking about their lives and challenges outside of the hospital.
This study, she says, shows those things matter, too.
"Health goes beyond what we often think about in the hospital, beyond the blood pressure, beyond the lab values that you see in front of you," Islam says. "You need take into account the social context of the patient."
The study was presented Monday at the American Heart Association's Scientific Sessions 2021, which is being held entirely virtually because of the pandemic.