COVID-19 Mortality Across ZIP codes in Four Major Texas Cities

The COVID-19 pandemic has continued to perpetuate adverse health outcomes across the U.S. Ongoing work has emphasized the role of the social determinants of health (SdoH) in producing unequal outcomes for cases and fatalities from the virus. In furthering their efforts, this study investigates contributions to differences in mortality rates across ZIP codes. A ZIP code level analysis provides a mechanism to explore contextual processes that operate within counties, especially as variation in large metropolitan areas are under-valued in county-level analyses of the pandemic. Fixed-effects Ordinary Least Squares (OLS) regressions are conducted to examine the relationship between socio-environmental factors and COVID-19 mortality across ZIP codes within the four largest counties in Texas: Bexar County, Dallas County, Harris County, and Tarrant County. Results indicate there is significant association between poverty rate and COVID-19 mortality rates across ZIP Codes. The full model maintains a predictive power of 70%, emphasizing the influence of SEF in perpetuating disparities. These findings underscore the importance of examining health inequalities at the local level