Department of Nutrition Sciences Professor, Tim Garvey, M.D., and team set out to investigate the effects of both cardiometabolic disease (CMD)–such as obesity and type 2 diabetes–and social determinants of health (SDoH)–like educational attainment, social vulnerability index, rurality, and healthcare access– on COVID-19 outcomes.

In the past, research has been done on the effects of cardiometabolic disease on COVID-19 outcomes, but never in combination with social determinants of health. By adding social determinants of health to the mix, researchers were able to improve their model predictions and also found that SDoH independently contributes to poor outcomes.

Using data from UAB Health System, researchers conducted a retrospective, longitudinal study on cardiometabolic markers and SDoH. They built a predictive model on these two factors and then evaluated how the model performed against actual outcomes.

Researchers found that those with identified cardiometabolic markers within the last three years were more likely to have negative outcomes related to a positive COVID-19 diagnosis. Researchers considered a poor outcome to be hospitalizations, intensive care unit admission, and mortality.

In addition to fine tuning the predictive model, adding SDoH factors to the model allowed researchers to discover that those living in the Deep South, those with high social vulnerability, or those with no or public insurance had a higher risk for severe COVID-19 outcomes.

In fact, individuals with no or public insurance face a three-to-four-fold increased risk of hospitalization and ICU stays as well as a nearly a six-to-eight fold increase in risk of mortality.

Garvey, who is also associate director of the UAB Comprehensive Diabetes Center and Director of the Diabetes Research Center, sees this data as an opportunity to equip physicians in the Deep South and beyond.

“Ultimately, we want to use this data and these findings to promote health equity across at-risk populations,” said Garvey. “This data not only helps us identify these populations who are at high risk of severe COVID-19 outcomes, but as we stated in our study, it has the potential to help guide treatment, intervention, and prevention efforts to improve health and health equity.”

Garvey and team thanked COVID-19 CORE—a collaboration involving the University of Alabama’s COVID-19 Enterprise Research Initiative, the UAB Scientific Community of Outcomes Researchers, and the UAB Center for Clinical and Translational Science—for facilitating the use of institutional data to examine population health outcomes.

All study authors include Division of Preventive Medicine Professor Carrie Howell, Ph.D., Department of Cell, Developmental and Integrative Biology Postdoctoral Trainee Li Zhang, Department of Biostatistics Professor Nengjun Yi, Ph.D., Department of Family and Community Medicine Vice Chair for Research and Professor Tapan Mehta, Ph.D., and Division of Preventive Medicine Professor Andrea Cherrington, M.D.