Unveiling Community Vulnerability to COVID-19 Incidence: A Population-Based Spatial Analysis in Clark County, Nevada.

Community vulnerability is influenced by various determinants beyond socioeconomic status and plays a crucial role in COVID-19 disparities. This study aimed to develop and evaluate a novel community vulnerability index (CVI) related to temporal variations in COVID-19 incidence to provide insights into spatial disparities and inform targeted public health interventions in Clark County, Nevada. Utilizing data from the American Community Survey and other sources, 23 community measures were identified at the census tract level. The CVI was constructed using a lagged weighted quantile sum (LWQS) regression linking these measures to the monthly COVID-19 incidence from March 2020 to November 2021. The Besag-York-Mollié model subsequently evaluated the spatial association between the CVI and COVID-19 incidence, controlling for temporal and spatial autocorrelations. This study identified minority status, housing inadequacy, and inactive commuting as primary contributors to the CVI that consistently influenced COVID-19 vulnerability over time. The CVI demonstrated significant spatial disparities, with higher values found in northern Clark County and the northeastern Las Vegas metropolitan area. Spatial analyses revealed varying associations between COVID-19 incidence and the CVI across census tracts, with significant associations clustered in the northern and eastern regions of the Las Vegas metropolitan area. These findings advance our understanding of the complex interplay between community conditions and COVID-19. The CVI framework may be applied to other COVID-19 outcomes such as testing, vaccination, and hospitalization, offering a valuable tool for assessing and addressing community vulnerability.