Experts in Their Field Shed Light on the Disparities of Infectious Disease Transmission in Rural and Urban Areas with Application to Virginia
The College of Health and Human Services held its third COVID-19 Webinar Series, welcoming new panel members who shared their research and recent findings with the community. Moderated by Dean Germaine Louis, the panel heard from Dr. Cara L. Frankenfeld, associate professor of epidemiology, biostatistics and global and community health at George Mason; Dr. Caterina M. Scoglio, professor of electrical and computer engineering at Kansas State University, and Dr. Srini Venkatramanan, research scientist, network systems science and advanced computing from University of Virginia’s Biocomplexity Institute and Initiative.
Frankenfeld began by pointing out key distinctions between rural and urban populations, and how these communities are impacted differently by COVID-19. Geographic disparities are common in infectious diseases due to contrasting industries that drive the economy in rural and urban communities.
“In rural areas we see manufacturing, mining and farming. These industries are more susceptible to in-person contact, with higher risk of transmission,” explains Frankenfeld.
Other key disparities seen in rural areas are higher percentages of poverty, and low education rates.
Rural communities also have high numbers of elder populations and have less access to health care, including limited access to virus testing and health care facilities. In addition, more than half of rural counties have no hospital ICU beds. While we have yet to see a significant negative effect of this problem, it is a growing concern of health care professionals. Over 15% of Americans live in rural areas and are experiencing differential access to health care. It is vital to consider these communities going forward with COVID-19 relief and response systems.
Scoglio, who has studied counties in Kansas, presented insight with relevant application to Virginia. She found that a mostly urban county—Wyandotte county—where part of Kansas City is located, had approximately 1,400 cases. Some rural counties with special populations (e.g., penitentiaries and meat packing plants) had over 1,000 cases. One college county, where you might expect infection rates to be high, only had approximately 60 cases, and the majority of rural counties saw very low numbers, at 0 to 5 cases. This demonstrates the importance of considering the composition of different counties in expected infection rates. Virginia also has a dichotomy of communities, from heavily populated counties of Northern Virginia, to rural areas across the rest of the state, including several counties with universities.
“There are distinct strengths and vulnerabilities rural communities face when combatting infectious disease transmission,” states Scoglio.
Some advantages of rural communities that keep their infection rates low are how spread out households are, with fewer contact locations. However, many have close ties to other households. Scoglio conducted a study focusing on behavior and social awareness during COVID-19. According to a survey of 500 rural households, they found low compliance with stay at home orders. The study found that 49% of respondents would still visit a few households outside of their own home, even during a serious pandemic with recommended stay at home orders.
“It is difficult to get people to change their behaviors and routines,” concludes Scoglio.
From a more technical perspective, the panel heard from Venkatramanan, who works with the Biocomplexity Institute & Initiative which uses big data and simulations to interpret massively interactive systems. His current work aims to analyze COVID-19 transmission throughout rural and urban communities across the United States, and he has previously provided pandemic response for influenza, Ebola, Zika and now COVID-19 support for Virginia and the Department of Defense.
Venkatramanan provided visualizations on nationwide statistics of high demand resources, in order to better understand and visualize the disparities between rural and urban geographic areas that also apply to Virginia’s geography. “COVID is now reaching rural America, and we are starting to see more cases emerging, particularly in these special locations that include close contact industries,” states Venkatramanan.
In closing, rural and urban counties have distinguishing characteristics that set them up to experience COVID-19 in potentially different ways. The key characteristics discussed by the panelists were age, healthcare accessibility, and economic industries.