Poverty and survival from COVID-19 in Mexico

Abstract

Background Recent evidence points to the relevance of poverty and inequality as factors affecting the spread and mortality of the COVID-19 pandemic in Latin America. This study aimed to determine whether COVID-19 patients living in Mexican municipalities with high levels of poverty have a lower survival compared with those living in municipalities with low levels. Methods Retrospective cohort study. Secondary data was used to define the exposure (multidimensional poverty level) and outcome (survival time) among patients diagnosed with COVID-19 between 27 February and 1 July 2020. Crude and adjusted hazard ratios (HR) from Cox regression were computed. Results Nearly 250 000 COVID-19 patients were included. Mortality was 12.3% reaching 59.3% in patients with ≥1 comorbidities. Multivariate survival analyses revealed that individuals living in municipalities with extreme poverty had 9% higher risk of dying at any given time proportionally to those living in municipalities classified as not poor (HR 1.09; 95% CI 1.06–1.12). The survival gap widened with the follow-up time up to the third to fourth weeks after diagnosis. Conclusion Evidence suggests that the poorest population groups have a lower survival from COVID-19. Thus, combating extreme poverty should be a central preventive strategy.

Higher COVID-19 mortality in low-income communities in the City of Cape Town – a descriptive ecological study

“…Data from the United States (USA) has shown that low socioeconomic status, and race as its proxy, were significantly associated with COVID-19 incidence and mortality 7 . Similar findings have been reported in the United Kingdom (UK) [8][9][10] . Data from Brazil and Mexico further support the idea that the poorest population groups have lower survival from COVID-19 9,10 .…”

“…Similar findings have been reported in the United Kingdom (UK) [8][9][10] . Data from Brazil and Mexico further support the idea that the poorest population groups have lower survival from COVID-19 9,10 .…”

The income gradient in COVID-19 mortality and hospitalisation: An observational study with social security administrative records in Mexico

“…Unlike previous studies that analysed the effect of income at the patient level, 18 , 19 our dataset includes information on pre-existing health conditions, and thus allows us to test whether comorbidities are a likely mechanism behind the association between income and COVID-19 mortality. In contrast to the existing literature on the association of socioeconomic vulnerability and COVID-19 severity in Mexico, 22 , 23 , 24 , 26 we are able to link COVID-19 outcomes to individual-level earnings data. Finally, lack of healthcare access is not a relevant variable here since all the individuals in our study had such access through the numerous facilities of IMSS (clinics and hospitals around the country).…”

“…Gutiérrez and Bertozzi 22 and Millán-Guerrero et al. 23 found that higher poverty is positively associated with hospitalisation and death. Ortiz-Hernández and Pérez-Sastré 24 and Bello-Chavolla et al.…”

Punt Politics as Failure of Health System Stewardship: Evidence from the COVID-19 Pandemic Response in Brazil and Mexico

“…Absent travel restrictions between cities and states, or international travel, the patchwork of policy responses allowed the virus – and in Brazil deadly variants such as the Gamma variant – to spread and seed itself around the world. The outcomes have been especially severe in dense, low-income, urban communities, where poverty and informality drive people to work [ 2 , 78 ].…”