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.