TABLE 3.

HLM contextual model

Fixed effect	Coeffi‐cients a	Standard error	Confidence interval	P	Effect size b	Relia‐bility	Impact threshold	Confound threshold
Outbreak rate	64.085	0.004	[56.574; 71.596]	<.001		0.958
State institutions
Party control c	−7.695	0.007	[−21.687; 6.297]	.287	−15.390
Gender of governor d	−3.197	0.006	[−14.884; 8.490]	.595	−8.197
Government spending	5.948	0.002	[1.963; 9.933]	.005	2.279		0.935	90.134%
People cultural values
Collectivism	1.330	< 0.001	[0.760; 1.900]	<.001	0.117		0.401	55.875%
Racial composition
Black and African American	0.485	< 0.001	[0.265; 0.705]	<.001	0.101		0.045	54.720%
Native American	0.909	< 0.001	[0.515; 1.303]	<.001	0.119		0.049	56.643%
Asian American	2.629	0.001	[1.420; 3.838]	<.001	0.888		0.044	53.983%
Native Hawaiian	5.924	< 0.001	[5.530; 6.318]	.010	5.485		0.049	56.643%
Hispanic American	0.269	< 0.001	[0.048; 0.490]	.017	0.019		0.027	77.765%
Income and education
Household income e	2.418	0.001	[0.044; 4.792]	.046	1.715		0.001	1.799%
Nonproficiency in English	1.884	0.001	[0.320; 3.448]	.018	0.505		0.008	16.948%
Math grade f	−0.002	< 0.001	[−0.004; 0.000]	.010	0.000		0.001	1.952%
Other demographics
Persons under 18 years	0.029	< 0.001	[−0.418; 0.476]	.898	0.008
Median age	0.619	< 0.001	[0.207; 1.031]	.003	0.101		0.019	33.479%
Female persons	0.286	< 0.001	[−0.316; 0.888]	.353	0.093
Personal health
Social associations	−0.552	< 0.001	[−0.966; −0.138]	.009	−0.093		0.013	25.050%
Sleep deprivation	1.638	< 0.001	[0.829; 2.447]	<.001	0.382		0.038	50.562%
Preventable hospitalization	0.001	< 0.001	[0.001; 0.001]	.002	0.000		1.000	100.000%
Obesity	−0.896	< 0.001	[−1.361; −0.431]	<.001	−0.199		0.035	48.136%
Smoking	−1.789	0.001	[−3.077; −0.501]	.007	−0.504		0.015	27.992%
External health
Air pollution	6.159	0.001	[4.507; 7.811]	<.001	3.158		0.101	73.162%
Rural area	−0.322	< 0.001	[−0.406; −0.238]	<.001	−0.010		0.104	73.816%
Food environment	−0.901	0.001	[−3.478; 1.676]	.493	−0.593
Other confounders
Outbreak date	−0.060	< 0.001	[−0.162; 0.042]	.247	−0.006
Density	0.173	< 0.001	[0.065; 0.281]	.002	0.000		0.022	37.663%
Temperature	−0.263	< 0.001	[−0.780; 0.254]	.319	−0.023

Random effects	Variance	df	χ 2	P
Variance between state intercepts (τ 00)	5.70E−04	43	350.334	<.001
Variance within states (σ 2)	7.20E−03

Note: This table provides the detailed results for the multilevel linear model. Run‐time deletion reduced the number of level‐1 records from 3118 to 2958 and level‐2 from 50 to 48.

^a The coefficients are multiplied with 1000 for more intuitive figures. Ditto for the confidence interval.

^b The effect size is calculated as coefficient/standard deviation, again multiplied with 1000.

^c Party control: 0 = Democratic, 1 = Republican.

^d Gender of governor: 0 = male, 1 = female.

^e The variable for household income is divided by 10 000.

^f All effects for Math grade are from a separately calculated model because the variable is unavailable for 675 counties across the United States. Consequently, run‐time deletion reduced the number of level‐1 records to 2403 and level‐2 to 43. This updates some P‐values but does not affect the sign of the coefficients.