ADVANCEMENT OF THE SCIENCE
race. Respondents indicated whether they were Hispanic or Latino. The distribution of age, gender or sex, race, and ethnicity was compared between survey respondents and the entire population of the 11 ZIP Codes of interest using estimates from the American Community Survey 5-Year Data 2019 (U.S. Census Bureau, 2021). Residential addresses of survey respon- dents were geocoded at the census tract level. Their residential distance from the facility was calculated using Esri’s ArcGIS Pro desk- top application, and respondents were cat- egorized as living <1, 1 to <3, 3 to <5, 5 to <10, 10 to <15, or ≥15 mi from the facility. Geospatial analyses used data from the Social Vulnerability Index (SVI), in which a higher quartile indicates higher social vulnerability (i.e., a community’s susceptibility to negative eects from disasters) than a lower quartile (ATSDR, 2022). The survey asked about contact with mate- rial and respondents chose all that applied: smoke, dust, debris, other, none, or unsure. Respondents also indicated if they smelled an odor. The survey then asked about the high- est level of healthcare received because of the incident: formal healthcare services (i.e., hos- pitalization; visit to an ED, urgent care center, or outpatient clinic; or telehealth consult), self-treatment, or no healthcare needed. The survey asked, “Over the past 2 weeks since the event have you experienced wors- ening of a preexisting or a new onset of any of the following symptoms?” and allowed respondents to select all that applied from a list of symptoms organized by category: ears, nose, and throat (ENT); neurological; ophthalmic; cardiopulmonary; psychiat- ric; and skin. Respondents reporting a new or worsening symptom within the 2 weeks prior to survey completion were categorized as symptomatic and all others as asymptom- atic. Among symptomatic respondents, it was determined which symptoms were reported, how many symptoms were reported, and how many symptom categories were involved. The survey was administered by lever- aging the Qualtrics XM Platform client engagement system, which is an existing system that was used for COVID-19 vac- cination registration. The survey was pub- licly available July 1–15, 2021, and residents could access it through a link shared via news outlets, social media, and the local
Characteristics of General Health Survey Respondents by Symptom Status and Overall and Characteristics of the General Population From 11 ZIP Codes, Winnebago County, Illinois, July 2021 TABLE 1 continued from page 9
Characteristic
Asymptomatic Respondents ( n = 1,109) # (%)
Symptomatic Respondents ( n = 911) # (%)
Respondents Overall ( N = 2,020) # (%)
General Population From 11 ZIP Codes ( N = 240,043) # (%)
Residential distance from the facility <1 mi
26 (2.3)
92 (10.1)
118 (5.8)
– – – – – – – – –
1–<3 mi 3–<5 mi 5–<10 mi 10–<15 mi
140 (12.6)
175 (19.2)
315 (15.6)
86 (7.8)
90 (9.9)
176 (8.7)
233 (21.0) 438 (39.5) 186 (16.8)
177 (19.4) 280 (30.7)
410 (20.3) 718 (35.5) 283 (14.0)
≥15 mi
97 (10.6)
Healthcare use
No healthcare needed
1,096 (98.8)
451 (49.5) 347 (38.1)
1,547 (76.6)
Self-treated
8 (0.7) 3 (0.3)
355 (17.6)
Consulted a healthcare professional via phone or video conferencing Visited an emergency department, urgent care, or outpatient clinic
45 (4.9)
48 (2.4)
0 (0)
57 (6.3)
57 (2.8)
–
Hospitalized
0 (0)
4 (0.4) 7 (0.8)
4 (0.2) 9 (0.4)
– –
Missing
2 (0.2)
Note. Data include survey respondents of the general health survey and exclude first responders. General population data were obtained from the American Community Survey 5-Year Data 2019. a Survey respondents self-identified their gender. The American Community Survey 5-Year Data 2019 presents proportions for sex. b The non-Hispanic or Latino proportion of the general population was calculated by subtracting the number of Hispanic or Latino proportion from the total population.
health department website. Additionally, on July 5, the Qualtrics system was used to send the survey link to 40,217 email addresses of registered residents from 11 ZIP Codes of interest (5 identified through surveillance data and 6 nearby ones) and it was noted whether a respondent accessed the survey through the email link. On July 12, the sur- vey link was emailed to registered residents of a neighboring Wisconsin county. Survey data were analyzed in R soft- ware (version 4.1.0) and a response was excluded if it was a duplicate entry, the residential addresses did not geocode, it was missing symptom data, or it was from
a first responder. Duplicate entries were determined by identifying duplicate unique identifiers created by the Qualtrics system; the earliest entry was included and subse- quent entries with the same unique identi- fier were excluded. Additionally, geospatial analysis was conducted to visualize the distribution of respondents reporting any symptom. Frequencies were calculated for reported demographic characteristics, resi- dential distance from the facility, health- care use, contact with material, smelling an odor, and symptoms for residents from the general public responding to the general health survey. Multivariable logistic regres-
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Volume 85 • Number 7
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