COVID-19 and the need to prioritize health equity and social determinants of health

Takian, Amirhossein; Kiani, Mohammad Mehdi; Khanjankhani, Khatere

doi:10.1007/s00038-020-01398-z

Cited by 60 publications

(54 citation statements)

References 5 publications

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“…It is known that there is a socioeconomic gradient, resulting in social and health inequalities related to the COVID-19 outbreak (20,21). In particular, socioeconomic characteristics like lower income and lower education are associated with an increased risk of COVID-19 related mortality (22,23), which stresses the necessity to reduce health inequalities (24). Similarly, lower educated people almost have a doubled risk of getting infected with COVID-19 as compared to higher educated people (25).…”

Section: Summary Of Main Findingsmentioning

confidence: 99%

Protective Behavior in Course of the COVID-19 Outbreak—Survey Results From Germany

Lüdecke

Knesebeck

2020

Front. Public Health

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Objective: The COVID-19 outbreak means far-reaching changes in the organization of daily lives. Disease-related literacy and factors such as age, gender, or education play a major role in shaping individual practices of protective behavior. This paper investigates different types and frequency of practicing protective behaviors, as well as socio-demographic factors that are associated with such behavioral change. Methods: Data stem from a cross-sectional survey in Germany. Three thousand seven hundred and sixty-five people were contacted, 3,186 participated in the survey. Information on behavior to lower the risk of becoming infected with COVID-19 was assessed by nine items (answer options yes/no). For each item, logistic regression models were used to estimate odds ratios (OR), using education, sex, and age as main predictors and adjusting for partnership status and household composition. Results: People with lower educational level were less likely to avoid gatherings (OR = 0.63; 95%CI = 0.48-0.83), adapt their work situation (OR = 0.66; 95%CI = 0.52-0.82), reduce personal contacts and meetings (OR = 0.71; 95%CI = 0.55-0.93), or increase hand hygiene (OR = 0.53; 95%CI = 0.38-0.73). Being female was associated with higher odds of protective behavior for most outcomes. Exceptions were wearing face masks and adapting the own work situation. Associations between respondents' age and individual behavior change were inconsistent and mostly weak. Conclusion: Disease specific knowledge is essential in order to enable people to judge information on COVID-19. Health education programs aiming at improving COVID-19 knowledge are helpful to build up appropriate practices and reduce the spread of the disease. Strategies are needed to guarantee easy access and better dissemination of high-quality news and fact-checks. Socioeconomic characteristics should be taken into account in the development of infection control measures.

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Section: Summary Of Main Findingsmentioning

confidence: 99%

Protective Behavior in Course of the COVID-19 Outbreak—Survey Results From Germany

Lüdecke

Knesebeck

2020

Front. Public Health

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“…Risk factors leading to COVID-19 disease, hospitalization, and mortality are not only at the individual or biological level; neighborhood-level factors and their interactions with individual-level factors are also responsible for the observed disparities. Lack of access to health care, unemployment, less education, and poor housing conditions significantly increase the risk of COVID-19 infection [28][29][30][31]. These determinants of health can be studied collectively as neighborhood or area deprivation.…”

Section: Preliminary Reports Show a Relationship Between The Neighbormentioning

confidence: 99%

The Effect of Area Deprivation on COVID-19 Risk in Louisiana

Oral

Straif-Bourgeois

et al. 2020

Preprint

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Purpose: Louisiana currently has the highest per capita case count for COVID-19 in the United States and disproportionately affects the Black or African American population. Neighborhood deprivation has been observed to be associated with poorer health outcomes. The purpose of this study was to examine the relationship between neighborhood deprivation and COVID-19 in Louisiana. Methods: The Area Deprivation Index (ADI) was calculated and used to classify neighborhood deprivation at the census tract level. A total of 17 US census variables were used to calculate the ADI for each of the 1148 census tracts in Louisiana. The data were extracted from the American Community Survey (ACS) 2018. The neighborhoods were categorized into quintiles as well as low and high deprivation. The publicly available COVID-19 cumulative case counts by census tract was obtained from the Louisiana Department of Health website on July 31, 2020. Descriptive and Poisson regression analyses were performed. Results: Neighborhoods in Louisiana were substantially different with respect to deprivation. The ADI ranged from 136.00 for the most deprived neighborhood and -33.87 in the least deprived neighborhood. We observed that individuals residing in the most deprived neighborhoods had a 45% higher risk of COVID-19 disease compared to those residing in the least deprived neighborhoods. Conclusion: While the majority of previous studies were focused on very limited socio-environmental factors such as crowding and income, this study used a composite area-based deprivation index to examine the role of neighborhood environment on COVID-19. We observed a positive relationship between neighborhood deprivation and COVID-19 risk in Louisiana. The study findings can be utilized to promote public health preventions measures besides social distancing, wearing a mask while in public and frequent handwashing in vulnerable neighborhoods with greater deprivation.

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“…Country differences have emerged in rates of new cases and deaths despite having a similar policy response that involves, among other things, physical distancing. Some of this variation may relate to social contextual factors that influence compliance with health advisories (e.g., physical distancing, washing hands frequently, wearing a facemask) and tolerance of prolonged disruptions to travel, work and social and cultural activities ( Gilles et al, 2011 ; van der Weerd et al, 2011 ) in addition to underlying social inequities in vulnerability and health care access ( Takian et al, 2020 ). We investigated why some countries have experienced lower COVID-19 mortality than others by examining income inequality and social bonds and linkages that facilitate collective action.…”

Section: Introductionmentioning

confidence: 99%

The trouble with trust: Time-series analysis of social capital, income inequality, and COVID-19 deaths in 84 countries

Elgar

Stefaniak

Wohl

2020

Social Science & Medicine

257

210

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Can social contextual factors explain international differences in the spread of COVID-19? It is widely assumed that social cohesion, public confidence in government sources of health information and general concern for the welfare of others support health advisories during a pandemic and save lives. We tested this assumption through a time-series analysis of cross-national differences in COVID-19 mortality during an early phase of the pandemic. Country data on income inequality and four dimensions of social capital (trust, group affiliations, civic responsibility and confidence in public institutions) were linked to data on COVID-19 deaths in 84 countries. Associations with deaths were examined using Poisson regression with population-averaged estimators. During a 30-day period after recording their tenth death, mortality was positively related to income inequality, trust and group affiliations and negatively related to social capital from civic engagement and confidence in state institutions. These associations held in bivariate and mutually controlled regression models with controls for population size, age and wealth. The results indicate that societies that are more economically unequal and lack capacity in some dimensions of social capital experienced more COVID-19 deaths. Social trust and belonging to groups were associated with more deaths, possibly due to behavioural contagion and incongruence with physical distancing policy. Some countries require a more robust public health response to contain the spread and impact of COVID-19 due to economic and social divisions within them.

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COVID-19 and the need to prioritize health equity and social determinants of health

Cited by 60 publications

References 5 publications

Protective Behavior in Course of the COVID-19 Outbreak—Survey Results From Germany

Protective Behavior in Course of the COVID-19 Outbreak—Survey Results From Germany

The Effect of Area Deprivation on COVID-19 Risk in Louisiana

The trouble with trust: Time-series analysis of social capital, income inequality, and COVID-19 deaths in 84 countries

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