Community socioeconomic deprivation and SARS-CoV-2 infection risk: findings from Portugal

Abstract

Background Socioeconomic differences have been observed in the risk of acquiring infectious diseases, but evidence regarding SARS-CoV-2 remains sparse. Hence, this study aimed to investigate the association between SARS-CoV-2 infection risk and socioeconomic deprivation, exploring whether this association varied according to different phases of the national pandemic response. Methods A cross-sectional study was conducted. Data routinely collected for patients with a laboratorial result recorded in SINAVE®, between 2 March and 14 June 2020, were analysed. Socioeconomic deprivation was assessed using quintiles of the European Deprivation Index (Q1-least deprived to Q5-most deprived). Response phases were defined as before, during and after the national State of Emergency. Associations were estimated using multilevel analyses. Results The study included 223 333 individuals (14.7% were SARS-CoV-2 positive cases). SARS-CoV-2 infection prevalence ratio increased with deprivation [PR(Q1)=Ref; PR(Q2)=1.37 (95% CI 1.19–1.58), PR(Q3)=1.48 (95% CI 1.26–1.73), PR(Q4)=1.73 (95% CI 1.47–2.04), PR(Q5)=2.24 (95% CI 1.83–2.75)]. This was observed during the State of Emergency [PR(Q5)=2.09 (95% CI 1.67–2.62)] and more pronounced after the State of Emergency [PR(Q5)= 3.43 (95% CI 2.66–4.44)]. Conclusion The effect of socioeconomic deprivation in the SARS-CoV-2 infection risk emerged after the implementation of the first State of Emergency in Portugal, and became more pronounced as social distancing policies eased. Decision-makers should consider these results when deliberating future mitigation measures.

Public health interventions successfully mitigated multiple incursions of SARS-CoV-2 Delta variant in the Australian Capital Territory

“…The two major incursions, ACT.19 and ACT.20, varied considerably in the affected demographic groups, and subsequently in duration and total number of cases. Several studies have already demonstrated a disproportionate risk of SARS-CoV-2 infection in socioeconomically disadvantaged groups and in ethnic minorities [32][33][34][35][36], and it is wellestablished that socioeconomic factors are generally important determinants of health and disease. At a local level, the use of genomic epidemiology to differentiate between the two overlapping incursions led to a greater understanding of transmission in at-risk populations and the need for enhanced mitigation measures in these settings, such as culturally appropriate engagement and the deployment of in-reach interventions in association with non-government organizations.…”

Area-level inequalities in Covid-19 outcomes in Brazil in 2020 and 2021: An analysis of 1,894,165 severe Covid-19 cases

“…In 2020, when analyzing the spread of the disease in populations, Horton ( Horton, 2020 ) characterized Covid-19 as a syndemic, that is, being the product of the interaction between pre-existing clinical conditions and social, economic, and political factors. Studies conducted in Latin America ( Cifuentes et al, 2021 ), North America ( Karmakar et al, 2021 ), Europe ( Magalhães et al, 2021 ), Asia ( Yoshikawa and Kawachi, 2021 ), and Africa ( Shaw et al, 2021 ) have confirmed the existence of strong inequality, with worse outcomes from Covid-19 being described among populations with worse socioeconomic indicators, whether individual or contextual.…”

Can an Ecological Index of Deprivation Be Used at the Country Level? The Case of the French Version of the European Deprivation Index (F-EDI)

“…A large variety of ecological indices of deprivation have been developed around the world to study socio-economic and territorial inequalities [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. They have been widely used in recent years to assess and analyse social inequalities in health [ 9 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. To construct them, it is necessary to define “deprivation”, and to identify indicators that measure it.…”

“…The European Deprivation Index (EDI) is one of the available national ecological indices of deprivation, and has already been widely used in studies of social inequalities in health [ 24 , 25 , 26 , 27 , 28 ], but also outside the health field [ 42 ]. Due to its concept and methods of construction, the EDI is likely to be replicated across Europe, and updated over time.…”