Publication date: Jun 16, 2025

The novel coronavirus (COVID-19) continues to shed light on the disproportionately negative impact of public health pandemics among racial/ethnic minorities and other systematically marginalized communities persistency experiencing poorer health and health outcomes. Far less statistical investigation has been conducted to confirm the disease agnostic social determinants correlated with the intersection of emergent crisis, chronic health conditions and local contexts to inform proactive response strategies. This study investigated the influence of Social Vulnerability (SV), barriers to access to vaccination and Racial Disparities (RD) on COVID-19 infection and death rates among Georgian residents using Georgia Department of Public Health data and County Health Rankings & Roadmaps. We adjusted analyses for other predictors of outcomes by using the Poisson Generalized Linear Mixed Models (with county as the unit of analysis). We iteratively modeled county-specific infection/death rates as a function of the Social Vulnerability Index (SVI, % Racial Population Gap (RPG) [(60+years % White – %African Americans/Blacks (AA)/Black)], education, %unemployed, %uninsured, % obese, % fully vaccinated, racial differences in respiratory infection discharge rates and %AA /Black residents (w/o RPG in the model). Per adjusted models’ results of COVID-19 related death,, I) AA/Blacks, relative to Whites, were 51% more likely to die (p-value

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