UC Irvine

Background

This study investigated whether socio-spatial factors surrounding U.S. skilled nursing facilities related to Covid-19 case counts among residents, staff, and facility personnel and deaths among residents.

Methods

With data on 12,403 U.S. skilled nursing facilities and Census data we estimated multilevel models to assess relationships between facility and surrounding area characteristics from June 2020 to September 2022 for cumulative resident and facility personnel case counts and resident deaths.

Results

Facilities with more Black or Latino residents experienced more cases (IRR = 1.005; 1.004) and deaths (IRR = 1.008) among residents during the first six months of the pandemic, but were no different thereafter. Facilities with more racial/ethnic heterogeneity and percent Black or Latino in the surrounding buffer experienced more Covid-19 cases and deaths in the first six months, but no such differences were observed in the subsequent 24 months. Facilities surrounded by higher percent Latino consistently experienced more cases among staff and facility personnel over the study period (IRR = 1.006; 1.001).

Conclusions

Findings indicated socio-spatial health disparities in cases among residents, staff, and facility personnel in the first six months of the pandemic, with some disparities fading thereafter. This pattern likely suggests the importance of the adoption and adherence to pandemic related safety measures in skilled nursing facilities nationwide.