The Spatial Association of Demographic and Population Health Characteristics with COVID-19 Prevalence Across Districts in India

In less-developed countries, the lack of granular data limits the researcher's ability to study the spatial interaction of different factors on the COVID-19 pandemic. This study designs a novel database to examine the spatial effects of demographic and population health factors on COVID-19 prevalence across 640 districts in India. The goal is to provide a robust understanding of how spatial associations and the interconnections between places influence disease spread. In addition to the linear Ordinary Least Square regression model, three spatial regression models-Spatial Lag Model, Spatial Error Model, and Geographically Weighted Regression are employed to study and compare the variables explanatory power in shaping geographic variations in the COVID-19 prevalence. We found that the local GWR model is more robust and effective at predicting spatial relationships. The findings indicate that among the demographic factors, a high share of the population living in slums is positively associated with a higher incidence of COVID-19 across districts. The spatial variations in COVID-19 deaths were explained by obesity and high blood sugar, indicating a strong association between pre-existing health conditions and COVID-19 fatalities. The study brings forth the critical factors that expose the poor and vulnerable populations to severe public health risks and highlight the application of geographical analysis vis-a-vis spatial regression models to help explain those associations.