Importance of collecting data on socioeconomic determinants from the early stage of the COVID-19 outbreak onwards

Khalatbari-Soltani, Saman; Cumming, Robert; Delpierre, Cyrille; Kelly-Irving, Michelle

doi:10.1136/jech-2020-214297

Cited by 304 publications

(364 citation statements)

References 25 publications

(27 reference statements)

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“…13 Communities of color are also more likely to experience lower socioeconomic status, 22 and be employed as essential workers. 10 Additionally, for these and other vulnerable groups, lack of personal transportation is both a barrier to healthcare access 23 and social distancing, further exacerbating infection risk. For these reasons, communities of color experience more structural barriers to social distancing measures and are more vulnerable to severe illness.…”

Section: Sociodemographic Risk Factorsmentioning

confidence: 99%

A Model of Disparities: Risk Factors Associated with COVID-19 Infection

Rozenfeld

Beam

Maier

et al. 2020

Preprint

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Background By mid-May 2020, there were over 1.5 million cases of (SARS-CoV-2) or COVID-19 across the U.S. with new confirmed cases continuing to rise following the re-opening of most states. Prior studies have focused mainly on clinical risk factors associated with serious illness and mortality of COVID-19. Emerging risk factors in the U.S., including clinical, sociodemographic, and environmental variables associated with contraction of COVID-19 have not been widely studied to assess disparities across populations. Methods A multivariable statistical model was used to identify predictors associated with COVID-19 contraction in the study population of 34,503 patients, comparing laboratory confirmed positive and negative COVID-19 cases in the Providence Health System (U.S.) between February 28 and April 27, 2020. Publicly available data were utilized as approximations for social determinants of health, and patient-level clinical and sociodemographic factors were extracted from the electronic medical record. Results Higher risk of contraction was associated with older age (OR 1.69; 95% CI 1.41-2.02, p<0.0001), male gender (OR 1.32; 95% CI 1.21-1.44, p<0.0001), Asian race (OR 1.43; 95% CI 1.18-1.72, p= 0.0002), Black/African American race (OR 1.51; 95% CI 1.25-1.83, p<0.0001), Latino ethnicity (OR 2.07; 95% CI 1.77-2.41, p<0.0001), non-English language (OR 2.09; 95% CI 1.7-2.57, p<0.0001), high school education or less (OR 1.02; 95% CI 1.01-1.14, p=0.04), residing in a neighborhood with financial insecurity (OR 1.10; 95% CI 1.01-1.25, p=0.04), low air quality (OR 1.01; 95% CI 1.0-1.04, p=0.05), housing insecurity (OR 1.32; 95% CI 1.16-1.5, p< 0.0001) or transportation insecurity (OR 1.11; 95% CI 1.02-1.23, p=0.03), and living in senior living communities (OR 1.69; 95% CI 1.23-2.32, p= 0.001). Conclusions Risks associated with COVID-19 contraction reflect disparities across age, race, ethnicity, language, socioeconomic status, and living conditions. Health promotion and disease prevention strategies should prioritize groups most vulnerable to contraction and address structural inequities that contribute to risk through social and economic policy.

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Section: Sociodemographic Risk Factorsmentioning

confidence: 99%

A Model of Disparities: Risk Factors Associated with COVID-19 Infection

Rozenfeld

Beam

Maier

et al. 2020

Preprint

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“…Although a shred of evidence suggests stark race, ethnic, and SES disparities in COVID-19, the evidence are not consistent. For example, while some reports suggest the higher rates of mortality in minority groups [6,25,28], a study by Azar didn't nd such differences by race and ethnicity [29] which necessitates conducting a review study to systematically collect data, compare and document ndings from the different studies.…”

Section: Rationalmentioning

confidence: 99%

“…People with low-SES are more likely to experience work stress, which increases the risk of cardiovascular disease [32] and disrupts the function of the immune system [33], and consequently results in lower resistance to COVID-19. Lowincome could in uence the housing conditions of the individuals in a way that increases the risk of the spread of the infectious disease, for example, small and overcrowded houses [6]. Lower education levels could increase the COVID-19 severity indirectly by behavioral pathways, poor diet, smoking, and other risk factors [34].…”

Section: Rationalmentioning

confidence: 99%

“…Racial, ethnic, and socioeconomic status (SES) disparities in health are ubiquitous [6,7] and have been linked directly or indirectly to individual life expectancy and mortality [8]. Evidence shows a connection between low-SES and high risk of infectious disease in terms of both incidence and severity [9,10].…”

Section: Introductionmentioning

confidence: 99%

“…This calls for research studies to identify and understand the status of disparities across different population groups [7,12]. Because their speci c SES could in uence the incidence and severity of the disease in a variety of ways [6], low-SES and racial/ethnic minority groups need to be considered as high-risk populations during epidemics of infectious diseases [13].…”

Section: Introductionmentioning

confidence: 99%

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Protocol for a Systematic Review and Meta-analysis of Racial, Ethnic, and Socioeconomic Disparities in COVID-19

Khanijahani

Gholipour

Azami-Aghdash

et al. 2020

Preprint

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Background: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV-2. It has become a pandemic and an international public emergency. Preliminary evidence shows that as the pandemic spreads throughout the countries, disparities are observed in health outcomes of patients with COVID-19, especially in terms of morbidity and mortality. Methods: A systematic review and meta-analyses will be conducted to measure the racial, ethnic, and socioeconomic disparities in COVID-19. The target population includes the population of the countries during the pandemic of COVID-19. The exposure is minority ethnicity and low-socioeconomic status. Minority or low-socioeconomic status groups will be compared to the majority or high-socioeconomic status groups. The main outcomes of interests include 1) mortality rate, 2) morbidity rate, 3) deaths among the infected individuals, 4) availability of healthcare resources, 5) accessibility of healthcare resources, 6) time to recovery, 7) complications; and 8) access to testing.Discussion: By quantifying and documenting the existence and extent of the racial, ethnic, and socioeconomic disparities in COVID-19, we will identify the areas that deserve immediate action to prevent devastating consequences. The results of this systematic review will help policymakers to adopt effective strategies in managing the COVID-19 crisis in a just way not only in the absence of certain treatment and vaccination but also after reaching them as well. Systematic review registration: PROSPERO registry number: CRD42020190105

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A rapid scoping review of COVID‐19 and vulnerable workers: Intersecting occupational and public health issues

Côté

Durant

MacEachen

et al. 2021

American J Industrial Med

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Background This article reports the results of a rapid scoping review of the literature on COVID‐19 transmission risk to workers in essential sectors such as retail, health care, manufacturing, and agriculture, and more particularly the experiences of workers in precarious employment and social situations. Methods Following scoping review methods, we included 30 studies that varied in terms of methodology and theoretical approaches. The search included peer‐reviewed articles and grey literature published between March and September 2020. Results Based on the studies reviewed, we found that COVID‐19 infection and death rates increased not only with age and comorbidities, but also with discrimination and structural inequities based on racism and sexism. Racial and ethnic minority workers, including migrant workers, are concentrated in high‐risk occupations and this concentration is correlated to lower socioeconomic conditions. The COVID‐19 pandemic appears in the occupational health and safety spotlight as an exacerbator of already existing socioeconomic inequalities and social inequalities in health, especially in light of the intersection of issues related to racism, ethnic minority status, and sexism. Conclusions This review provides early evidence about the limitations of institutions' responses to the pandemic, and their capacity to provide a safe and decent working environment for all workers, regardless of their employment status or the social protections they may enjoy under normal circumstances. It is also important to think about these issues in the postpandemic context, when conditions of precariousness and vulnerability persist and possibly worsen.

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Importance of collecting data on socioeconomic determinants from the early stage of the COVID-19 outbreak onwards

Cited by 304 publications

References 25 publications

A Model of Disparities: Risk Factors Associated with COVID-19 Infection

A Model of Disparities: Risk Factors Associated with COVID-19 Infection

Protocol for a Systematic Review and Meta-analysis of Racial, Ethnic, and Socioeconomic Disparities in COVID-19

A rapid scoping review of COVID‐19 and vulnerable workers: Intersecting occupational and public health issues

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