Demographic Risk Factors, Challenges Meeting Basic Needs, and COVID-19 Risk and Protective Behaviors in a Majority Rural, Latinx, and Spanish-Speaking Sample

Using a social determinants of health framework, we investigated whether COVID-19 risk and protective behaviors varied as a function of demographic risk factors (age, race/ethnicity, language, rural/urban residence) and pandemic wave in a sample of 1,644 Pacific Northwest adults (78% Latinx) surveyed between March 2021 and August 2022. We also investigated whether challenges in meeting basic needs (e.g., housing) moderated effects on risk and protective behaviors. Mixed model regressions indicated older adults engaged in fewer risky behaviors than younger adults, and both Latinx (compared to non-Latinx) and those predominantly speaking Spanish at home (compared to English) endorsed fewer risk and more protective behaviors. Black, Indigenous and People of Color (BIPOC) participants engaged in more protective behaviors than non-BIPOC. Relative to the first pandemic wave, participants engaged in both fewer risk and fewer protective behaviors in later waves. There were no significant interactions in predicting risk; however, BIPOC participants endorsing more basic needs challenges reported engaging in more protective behaviors. Study limitations, future directions, and implications for research and practice are discussed.