Impact of Spatial and Social Determinants on Invasive Fungal Infection Risk

: Invasive fungal infections (IFIs) are a growing public health challenge, leading to over 1.5 million deaths each year worldwide. Contextual factors are believed to be critical components of IFI risk as evidenced by historical fungal outbreaks associated with specific geographic distributions and ecological disruptions. Certain communities are thought to be particularly vulnerable with greater exposure to high-risk contextual factors, leading to higher rates of and worse outcomes from IFIs. In addition, socioeconomic status may impact IFI outcomes, due to delays in diagnosis, access to care, and quality of care. However, prior studies of IFI epidemiology have focused primarily on host factors without adequately considering the uneven distribution of hazards and their spatiotemporal trends related to socioeconomic factors. The objective of this proposal is to assess the impact of social determinants on IFI risk by leveraging a national data source, the National COVID Cohort Collaborative, and a more granular hospital system electronic-health medical records data source. In Aim 1, we will determine neighborhood-level contextual and socioeconomic predictors of IFIs. In Aim 2, we will examine the association between individual socioeconomic status factors and clinical outcomes of IFIs. This work will advance our understanding of the spatial and social determinants of IFI risk and outcomes as well as provide a robust training platform for the award recipient, Dr. Lucy Li. Through both research and career development training, Dr. Li will acquire essential skills in large data analysis, including advanced methods in spatial science and social factors research, time series analyses, and risk prediction modeling. Dr. Li will then be well positioned to be an independent clinical investigator focused on IFIs in at-risk populations with an expertise in integrating spatial and social factors data into population health analyses.