Coronavirus testing disparities associated with community level deprivation, racial inequalities, and food insecurity in West Virginia

PURPOSE: Social determinants of health and racial inequalities impact healthcare access and subsequent coronavirus testing. Limited studies have described the impact of these inequities on rural minorities living in Appalachia. This study investigates factors affecting testing in rural communities. METHODS: PCR testing data were obtained for March through September 2020. Spatial regression analyses were fit at the census tract level. Model outcomes included testing and positivity rate. Covariates included rurality, percent Black population, food insecurity, and area deprivation index (a comprehensive indicator of socioeconomic status). RESULTS: ]) and percent Black population (IRR = 0.94, 0.90, 0.97) displayed substantial effects on the test positivity rate. CONCLUSIONS: Findings highlight disparities in coronavirus testing among communities with rural minorities. Limited testing in these communities may misrepresent coronavirus incidence.