Spatial Clustering of COVID-19 Mortality Rates Across Counties and by Noncore, Micropolitan, and Metropolitan County Characteristics, December 2020–January 2021


This policy brief examines spatial clusters of COVID-19 mortality rates across counties in the United States between December 2020 and January 2021. Between December 2020 and January 2021, COVID-19 deaths were at their peak, hospital capacity was stretched, and COVID-19 vaccines were not widely available, making this a critical time period to examine.

Key Findings:

  • Spatial clusters of high COVID-19 mortality rates occurred in Iowa, South Dakota, Kansas, Pennsylvania, Texas, and Arizona.
  • A higher percentage of clusters of high COVID-19 mortality rates were in noncore and micropolitan counties compared to metropolitan counties.
  • High COVID-19 mortality cluster counties tended to have higher average percentages of Hispanic populations, particularly in micropolitan counties.
  • Noncore counties that were high COVID-19 mortality clusters had the highest average nursing home bed density and the highest average proportion of Medicare beneficiaries with multiple chronic conditions.
RUPRI Center for Rural Health Policy Analysis
Whitney Zahnd, Khyathi Gadag V, Fred Ullrich, Keith Mueller