Sub-national Analysis of Vulnerabilities related to COVID-19 Risk in India

Background: The COVID-19 pandemic has emerged as an unprecedented epidemiological and economic crisis before humanity, although not everyone shall be facing it equally. In particular, the low-and-middle income countries including India continue to suffer from widespread socioeconomic, demographic and health system vulnerabilities related to COVID-19 risk. However, there is paucity of scientific analysis that examined the spatial heterogeneities in the socioeconomic vulnerabilities related to COVID-19 risk and potential mitigation strategies at the sub-national level in India. Objective: The present study examined the demographic, socioeconomic and health status related vulnerabilities shaping COVID-19 risk across 36 States/Union Territories in India. In addition, an attempt has been made to develop a composite measure of socioeconomic vulnerability indicators framework (SVIF) by incorporating diverse set indicators which may allow a comprehensive understanding of risk factors that increases the vulnerability to COVID-19 at the sub-national level in India. Data and Methods: Using secondary data from the Ministry of Health and Family Welfare (MoHFW), Government of India; Census of India (2011); 2015-16 National Family Health Survey; and various rounds of the National Sample Survey, we examined vulnerability to COVID-19 risk at sub-national level in India during 16th March to 3rd May, 2020. Descriptive statistics, Principal Component Analysis (PCA), and negative binomial regression model have been used to examine the predictors of COVID-19 risk in India. Finding and Conclusion: There persist substantial heterogeneities in the COVID-19 risk across states and union territories in India. The underlying demographic, socioeconomic and health infrastructure characteristics drives the socioeconomic vulnerabilities related to COVID-19 in India. Concerted socially inclusive policy action to ameliorate the migrant crisis, and sustained livelihood/economic support for the most vulnerable population groups is critical to mitigate the COVID-19 pandemic in India