Spatial Exploration of Social Vulnerability and COVID-19-Related Health Outcomes in Mississippi.

• Mississippi (MS) is one of the hardest-hit states with a high cumulative COVID-19 incidence and mortality compared to the US national average.• Educational and economic disadvantages likely resulted in the poor health outcomes of Mississippi Delta residents.• Significant spatial autocorrelation was found in COVID-19 incidence, mortality, and overall CDC SVI rankings.• Subtheme 1, representing socio-economic status, was significantly associated with mortality.• Subtheme 2, household composition and disability, was significantly associated with both incidence and mortality. The COVID-19 pandemic has caused more than 48 million cases and 800,000 deaths in the United States. Mississippi (MS) is one of the hardest-hit states with a high incidence and mortality compared to the US national average. This paper explores the relationship of MS county-level COVID-19- related incidence and mortality (through December 2, 2021) with the Center for Disease Control's Social Vulnerability Index (CDC SVI). The CDC SVI consists of four major subthemes: [1] socio-economic status, [2] household composition and disability, [3] minority status and language, and finally, [4] housing type and transportation. We found that the overall SVI ranking has a statistically significant association with reported COVID-19 cumulative mortality at the county level. Among the SVI sub-themes, subtheme 1 (socio-economic status) and subtheme 2 (household composition and disability) showed a significant relationship with incidence and mortality (p < 0.05). The results of our analysis will assist in understanding the spatial relationship between CDC SVI themes and the health effects of COVID-19 in MS and the surrounding areas.