The 2019 coronavirus disease (COVID-19) has exacerbated inequality in the United States of America (USA). Black, indigenous, and people of color (BIPOC) are disproportionately affected by the pandemic. This study examines determinants of COVID-19 case fatality ratio (CFR) based on publicly sourced data from January 1 to December 18, 2020, and sociodemographic and rural-urban continuum data from the US Census Bureau. Nonspatial negative binomial Poisson regression and geographically weighted Poisson regression were applied to estimate the global and local relationships between the CFR and predictors—rural-urban continuum, political inclination, and race/ethnicity in 2407 rural counties. The mean COVID-19 CFR among rural counties was 1.79 (standard deviation (SD) = 1.07; 95% CI 1.73-1.84) higher than the total US counties (M = 1.69, SD = 1.18; 95% CI: 1.65-1.73). Based on the global NB model, CFR was positively associated with counties classified as “completely rural” (incidence rate ratio (IRR) = 1.24; 95% CI: 1.12-1.39) and “mostly rural” (IRR = 1.26; 95% CI: 1.15-1.38) relative to “mostly urban” counties. Nonspatial regression indicates that COVID-19 CFR increases by a factor of 8.62, 5.87, 2.61, and 1.36 for one unit increase in county-level percent Blacks, Hispanics, American Indians, and Asian/Pacific Islanders, respectively. Local spatial regression shows CFR was significantly higher in rural counties with a higher share of BIPOC in the Northeast and Midwest regions, and political inclination predicted COVID-19 CFR in rural counties in the Midwest region. In conclusion, spatial and racial/ethnic disparities exist for COVID-19 CFR across the US rural counties, and findings from this study have implications for public health.

Pregnant women and children are the most vulnerable populations for malaria infection. Yet, knowledge of risk, and preventive measures are poor among this population. Using the 2015 Nigeria Malaria Indicator Survey, we applied logit link function to estimate the associations of wealth status, educational attainment, and region of residence with malaria risk knowledge and prevention strategies (using a treated mosquito net and malaria drugs) among 739 Nigerian pregnant women aged 15–49 years. Urban women who had obtained a secondary school education (Adjusted odds ratio [aOR] = 2.12; 95% confidence interval [CI] 1.09–4) or higher (aOR = 8.31; 95% CI 3.2–22) had more knowledge of malaria risk. Urban women in the South-West (aOR = 5.02; [CI] 2.02–12.50) and South-East (aOR = 2.68; 95% CI 1.19–6.06) were more likely to use treated mosquito nets during pregnancy. Women in the urban South-West (aOR = 4.04; 95% CI 1.5–11) were more likely to use malaria drugs during pregnancy than those in the North-Central. A wide regional disparity in the knowledge of malaria risks and use of preventive measures exists. Thus, promoting equal access to malaria preventive measures as well as improving knowledge about malaria transmission by mosquitoes should be considered as essential components of ongoing malaria control and elimination efforts in Nigeria.

There is a lack of studies in sub-Saharan African countries, specifically Ghana, demonstrating the relationship between greenness and hypertension. We use Greenness (Enhanced Vegetation Index, EVI) data to examine its association on hypertension among Ghanaian adults in urban areas. Participants with higher exposure to greenness was significantly associated with lower odds of hypertension OR: 0.63 (95% CI:0.41–0.95) than participants with low levels of greenness exposure. Our findings recommend a positive attitudinal change toward the preservation of green spaces as well as the allocation and prioritization of green spaces by policymakers in areas rapidly undergoing urbanization.

Health disparity is an unacceptable, unjust, or inequitable difference in health outcomes among different groups of people that affects access to optimal health care, as well as deterring it. Health disparity adversely affects disadvantaged subpopulations due to a higher incidence and prevalence of a particular disease or ill health. Existing health disparity determines whether a disease outbreak such as coronavirus disease 2019, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), will significantly impact a group or a region. Hence, health disparity assessment has become one of the focuses of many agencies, public health practitioners, and other social scientists. Successful elimination of health disparity at all levels requires pragmatic approaches through an intersectionality framework and robust data science.