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Abstract
COVID-19 has uncovered racial/ethnic, gender, and socioeconomic vulnerabilities among low-income females, or those earning an annual income at or below the federal poverty level (<$40K per year), who are most often employed in industries that required continuous work throughout the pandemic. While many working females (18-64 years) have an increased risk of susceptibility, exposure, and infection, an even greater risk is observed among low-income minority adult females because, in order to secure the economic stability of their households, they often need to work in settings that require working in close proximity with other workers and thus potentially be exposed to COVID-19 infection. Largely due to their social and socioeconomic determinants of health (SDOH), including transportation, housing, economic stability, underlying health conditions “comorbidities”, and healthcare access, low-income minority females have a significantly higher risk of hospitalizations and deaths. Therefore, this study focused on understanding the impact of SDOH factors on COVID-associated health outcomes, given the influence of specific covariates (i.e., age, race/ethnicity, and comorbidities). Secondary analysis involved combining several sub-datasets from National COVID Cohort Collaborative (N3C) data, in order to evaluate the risk of hospitalization and deaths among COVID-positive low-income adult females, who continued to work during the pandemic and earned an annual income of less than $40K. The association and significance of the SDOH factors, age, race/ethnicity, and outcome variables were assessed using the Chi-square test of independence and multivariable logistic regression. The risk of hospitalizations and deaths increased parallel to age and prevalence of comorbidities. Non-Hispanic Black (NHB) females faced significantly higher odds of hospitalization compared to non-Hispanic White (NHW) and Hispanic/Latino females. The level of association and significance between the SDOH factors and COVID-associated hospitalization varied by race/ethnicity, while all comorbidity associations with the outcome variables were significant. These findings confirm a relationship and association between SDOH factors, covariates, and COVID-associated health outcomes among low-income adult females.