Examining community trends related to demographic and socioeconomic risk factors associated with COVID-19 has been vital in informing public health strategies since the onset of the pandemic. This study is an exploratory epidemiological analysis of COVID-19 incidence and associated risk factors in individuals residing in Saginaw County, Michigan. This descriptive study used data on 2619 COVID-19 cases among Saginaw County, Michigan, residents confirmed between January and September of 2020 in the Michigan Disease Surveillance System. Two analyses were performed, one to examine COVID-19 outcomes (e.g., incidence, hospitalization, and mortality) between city and non-city residents by race/ethnicity, and the other to explore the association between household size and risk of COVID-19 infection at the census-tract level. Compared to those residing outside the city, city-dwelling Non-Hispanic White and Hispanic residents were more likely to have tested positive for COVID-19 (CIRR=1.28, 95% Wald CI: 1.08-1.51, p=0.004 and CIRR=1.87, 95% Wald CI: 1.49-2.35, p<0.0001, respectively) and were more likely to be hospitalized from COVID-19-related illness (CHRR=1.8, 95% Wald CI: 1.09-2.98, p=0.021 and CHRR=4.22, 95% Wald CI: 1.98-9.00, p=0.0002, respectively). Also, the COVID-19 incidence rate decreased, albeit non-significantly, with increasing household size per census tract (beta=-0.26, p=0.29). The urban-rural race/ethnicity COVID-19 disparities between Non-Hispanic White and Hispanic residents point to geographic and/or race/ethnic inequities in access to testing, treatment, and/or preventative measures for residents of Saginaw County, Michigan.
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