COVID-19 Pandemic and Its Effects Within the Southern Community Cohort Study

This supplemental application (PA-18-591) is submitted in response to NOT -OD-20-097 to enhance theSouthern Community Cohort Study (SCCS) data to permit evaluation of the effects of the CoronavirusDisease 2019 (COVID-19) pandemic within the SCCS, a prospective cohort study that includes primarilyAfrican American and low-income populations in the southeast US. COVI D-19 has resulted in a globalpandemic. The burden of these outbreaks appears to be unequally shared in the US, with reports that rates ofinfection or severe outcomes, including death, are more common among older adults, those with comorbidities,and African Americans. Transmission reduction is only achievable through adherence to individual infectionprevention behaviors and community-level interventions, such as social distancing. As the COVID-19pandemic is expected to last multiple months and perhaps years, there is an urgent and unmet need tounderstand 1) the extent of adherence to infection prevention recommendations, particularly among individualsat high risk for adverse outcomes, and 2) the factors that are associated with adherence in order to informcontinued interventions for infection prevention. In addition, the same public health measures intended toreduce transmission have also resulted in record levels of unemployment, social isolation, food insecurity, andmany other challenges. While these effects have been observed across multiple US populations, they alsohave the potential to exacerbate existing health disparities in vulnerable populations or to create new ones.The effect of the pandemic on lifestyle factors related to cancer or other chronic diseases and the general wellbeingof already vulnerable populations is not yet well described nor understood. Many pandemic interventionshave been aimed at 'flattening the curve' in order to reduce the potential to overburden the health care system,including the cancellation or delay of health care procedures and appointments. There are many additionalpotential factors which could affect access to and utilization of health care services during the COVID-19pandemic, all of which may result from or exacerbate cancer and other health disparities within the US. Thus,the aims of this supplemental application are 1) To determine adherence to SARS-CoV-2 infection preventionand transmission reduction recommendations and individual and contextual factors that are associated withadherence; 2) To evaluate racial/ethnic, socioeconomic, geographic and urban/rural disparities in well-beingand lifestyle behaviors resulting from the COVID-19 pandemic containment and mitigation efforts; and 3) Toevaluate racial/ethnic, socioeconomic, geographic and urban/rural disparities in healthcare access during theCOVID-19 pandemic, including access to SARS-CoV-2 testing, as well as routine and urgent clinical care. Thedata from this study will enable better quantification of COVI D-19 pandemic effects in a diverse US populationclassified by race, geography, socioeconomic status, and other attributes. These findings will help to informindividual-level and community-level public health interventions during the COVID-19 pandemic.