Temporal trends in within-city inequities in COVID-19 incidence rate by area-level deprivation in Madrid, Spain

Gullón, Pedro; Cuesta-Lozano, Daniel; Cuevas-Castillo, Carmen; Fontán-Vela, Mario; Franco, Manuel

doi:10.1016/j.healthplace.2022.102830

Cited by 17 publications

(11 citation statements)

References 47 publications

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“…In most countries, COVID-19 has disproportionately affected poor and excluded populations, who have a higher prevalence of chronic diseases, which, in turn, are risk factors for acquiring COVID-19. Social determinants of health (SDH), including SES, neighborhood and race or ethnicity, may have a significant role in COVID-19 outcomes because they can influence the probability of developing these chronic diseases [7] and also of receiving adequate management and treatment for them and for COVID-19 [8][9][10][11]. In Spain, due to the universal free access to the health system, the quality of healthcare may not be decreased in these disadvantaged populations, but their accessibility may be more limited for several causes, including work-related reasons, health system overload or ignorance of access mechanisms [12].…”

Section: Introductionmentioning

confidence: 99%

Economic Migrants and Clinical Course of SARS-CoV-2 Infection: A Follow-Up Study

Martínez-Alfonso¹,

Mesas

Jimenez-Olivas³

et al. 2022

Int J Public Health

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Objective: To analyze whether social deprivation and economic migrant (EM) status influence the risk of being hospitalized with COVID-19.Methods: This was a retrospective follow-up study including all patients older than 18 years attending the Daroca Health Center in Madrid, Spain, diagnosed with COVID-19 during September 2020. Data on EM status and other sociodemographic, lifestyle and comorbidities that could affect the clinical course of the infection were obtained from electronic medical records.Results: Of the 796 patients positive for COVID-19, 44 (5.53%) were hospitalized. No significant differences were observed between those who were hospitalized and those who were not in the mean of social deprivation index or socioeconomic status, but EM status was associated with the risk of being hospitalized (p = 0.028). Logistic regression models showed that years of age (OR = 1.07; 95% CI: 1.04–1.10), EM status (OR = 5.72; 95% CI: 2.56–12.63) and hypertension (OR = 2.22; 95% CI: 1.01–4.85) were the only predictors of hospitalization.Conclusion: Our data support that EM status, rather than economic deprivation, is the socioeconomic factor associated with the probability of hospital admission for COVID-19 in Madrid, Spain.

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Section: Introductionmentioning

confidence: 99%

Economic Migrants and Clinical Course of SARS-CoV-2 Infection: A Follow-Up Study

Martínez-Alfonso¹,

Mesas

Jimenez-Olivas³

et al. 2022

Int J Public Health

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“…Similar to our findings, a national scale study conducted in Belgium [ 17 ] found increasing socioeconomic inequalities in SARS-CoV-2 infection as vaccination coverage increased. Moreover, in a second study conducted in Madrid, Spain, inequalities in infection affecting deprived areas were shown to peak when vaccination coverage reached 70% of the adult population [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic Inequalities in SARS-CoV-2 Infection and COVID-19 Health Outcomes in Urban Italy During the COVID-19 Vaccine Rollout, January–November 2021

Fotakis,

Mateo-Urdiales,

Fabiani

et al. 2024

J Urban Health

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This study analysed the evolution of the association of socioeconomic deprivation (SED) with SARS-CoV-2 infection and COVID-19 outcomes in urban Italy during the vaccine rollout in 2021. We conducted a retrospective cohort analysis between January and November 2021, comprising of 16,044,530 individuals aged ≥ 20 years, by linking national COVID-19 surveillance system data to the Italian SED index calculated at census block level. We estimated incidence rate ratios (IRRs) of infection and severe COVID-19 outcomes by SED tercile relative to the least deprived tercile, over three periods defined as low (0–10%); intermediate (> 10–60%) and high (> 60–74%) vaccination coverage. We found patterns of increasing relative socioeconomic inequalities in infection, hospitalisation and death as COVID-19 vaccination coverage increased. Between the low and high coverage periods, IRRs for the most deprived areas increased from 1.09 (95%CI 1.03–1.15) to 1.28 (95%CI 1.21–1.37) for infection; 1.48 (95%CI 1.36–1.61) to 2.02 (95%CI 1.82–2.25) for hospitalisation and 1.57 (95%CI 1.36–1.80) to 1.89 (95%CI 1.53–2.34) for death. Deprived populations in urban Italy should be considered as vulnerable groups in future pandemic preparedness plans to respond to COVID-19 in particular during mass vaccination roll out phases with gradual lifting of social distancing measures.

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“…People from the most economically deprived areas of the ACM are more likely to have frontline essential jobs, use public transport, travel further, share their home with more people, and have therefore been disproportionally affected by COVID-19, both in infections and mortality [ 43 , 44 ]. This could have created a stronger awareness in favor of vaccination.…”

Section: Discussionmentioning

confidence: 99%

Effect of Primary Care Center Characteristics, Healthcare Worker Vaccination Status and Patient Economic Setting on Patient Influenza Vaccination Coverage Rates

et al. 2023

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Background: Reaching the public health organizations targets of influenza vaccination in at-risk patient groups remains a challenge worldwide. Recognizing the relationship between the healthcare system characteristics and the economic environment of the population with vaccination uptake can be of great importance to improve. Methods: Several characteristics were correlated in this retrospective ecological study with data from 6.8 million citizens, 15,812 healthcare workers across 258 primary care health centers, and average income by area of the care center in Spain. Results: No correlation between HCW vaccination status and patient vaccination was found. A weak negative significant correlation between the size of the population the care center covers and their vaccination status did exist (6 mo.–59 yr., r = 0.19, p = 0.002; 60–64 yr., r = 0.23, p < 0.001; ≥65 yr., r = 0.23, p ≥ 0.001). The primary care centers with fewer HCWs had better uptake in the at-risk groups in the age groups of 60–64 yr. (r = 0.20, p = 0.002) and ≥65 (r = 0.023, p ≥ 0.001). A negative correlation was found regarding workload in the 6 mo.–59 yr. age group (r = 0.18, p = 0.004), which showed the at-risk groups that lived in the most economically deprived areas were more likely to be vaccinated. Conclusions: This study reveals that the confounding variables that determine influenza vaccination in a population and in HCWs are complex. Future influenza campaigns should address these especially considering the possibility of combining influenza and SARS-CoV-2 vaccines each year.

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Temporal trends in within-city inequities in COVID-19 incidence rate by area-level deprivation in Madrid, Spain

Cited by 17 publications

References 47 publications

Economic Migrants and Clinical Course of SARS-CoV-2 Infection: A Follow-Up Study

Economic Migrants and Clinical Course of SARS-CoV-2 Infection: A Follow-Up Study

Socioeconomic Inequalities in SARS-CoV-2 Infection and COVID-19 Health Outcomes in Urban Italy During the COVID-19 Vaccine Rollout, January–November 2021

Effect of Primary Care Center Characteristics, Healthcare Worker Vaccination Status and Patient Economic Setting on Patient Influenza Vaccination Coverage Rates

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