Geospatial Perspectives on the Intersection of Chronic Disease and COVID-19

Abstract

This collection of articles in Preventing Chronic Disease (PCD) brings together scientists and practitioners from the breadth of public health and the social sciences to demonstrate how geospatial perspectives can contribute to understanding and addressing the intersection of chronic disease and COVID-19, a respiratory disease caused by the SARS-CoV-2 virus. The COVID-19 pandemic has affected chronic disease in many complex ways. Early in the pandemic, it became clear that people with chronic conditions and those in older age groups were at the highest risk for COVID-19 hospitalization and death. Racial and ethnic minority populations experienced disproportionately worse health outcomes. Pandemic-related disruptions to the health care system and individuals’ concerns about health care–related exposures affected chronic disease management: in-person visits for people with chronic conditions declined, supply chain disruptions led to shortages of medications, and the number of cancer screenings, treatments, and surgeries declined in the United States. More recent evidence suggests that COVID-19 may exacerbate existing chronic diseases and increase the risk of developing new chronic conditions, such as diabetes in adults, type 1 diabetes in children, neurological disorders, dementia, mental illness, and cardiovascular disease. In addition, an estimated one-half of COVID-19 survivors worldwide continue to have COVID-related health problems 6 months or more after recovery from the acute infection, making “long COVID” our newest and still largely unresearched chronic disease. Finally, social and economic inequities underlie disparities in incidence of both chronic diseases and COVID-19, an intersection that has been labeled a syndemic, defined as the “presence of 2 or more disease states that adversely interact with each other, negatively affecting the mutual course of each disease trajectory, enhancing vulnerability, and which are made more deleterious by experienced inequities”.