Testing, infection and complication rates of COVID-19 among people with a recent history of homelessness in Ontario, Canada: a retrospective cohort study

Richard, Lucie; Booth, Richard; Rayner, Jennifer; Clemens, Kristin K.; Forchuk, Cheryl; Shariff, Salimah Z.

doi:10.9778/cmajo.20200287

Cited by 94 publications

(107 citation statements)

References 24 publications

(21 reference statements)

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“…Studies published since June 2020 tend to support our findings of disparities in COVID-19 infection, hospitalization, and mortality by race or ethnicity [88][89][90][91][92][93][94][95][96], socioeconomic status and deprivation [88-90, 92, 93, 97], and housing insecurity [95,96,98,99]. At least two recent studies did not find associations between race and mortality outcomes among those able to access hospital care [100,101], contrary to findings of most other research, including this review.…”

Section: Plos Onecontrasting

confidence: 50%

Social determinants of COVID-19 incidence and outcomes: A rapid review

et al. 2021

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Early reports indicate that the social determinants of health are implicated in COVID-19 incidence and outcomes. To inform the ongoing response to the pandemic, we conducted a rapid review of peer-reviewed studies to examine the social determinants of COVID-19. We searched Ovid MEDLINE, Embase, PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials from December 1, 2019 to April 27, 2020. We also searched the bibliographies of included studies, COVID-19 evidence repositories and living evidence maps, and consulted with expert colleagues internationally. We included studies identified through these supplementary sources up to June 25, 2020. We included English-language peer-reviewed quantitative studies that used primary data to describe the social determinants of COVID-19 incidence, clinical presentation, health service use and outcomes in adults with a confirmed or presumptive diagnosis of COVID-19. Two reviewers extracted data and conducted quality assessment, confirmed by a third reviewer. Forty-two studies met inclusion criteria. The strongest evidence was from three large observational studies that found associations between race or ethnicity and socioeconomic deprivation and increased likelihood of COVID-19 incidence and subsequent hospitalization. Limited evidence was available on other key determinants, including occupation, educational attainment, housing status and food security. Assessing associations between sociodemographic factors and COVID-19 was limited by small samples, descriptive study designs, and the timeframe of our search. Systematic reviews of literature published subsequently are required to fully understand the magnitude of any effects and predictive utility of sociodemographic factors related to COVID-19 incidence and outcomes. PROSPERO: CRD4202017813.

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Section: Plos Onecontrasting

confidence: 50%

Social determinants of COVID-19 incidence and outcomes: A rapid review

et al. 2021

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“…The compounding overlap between COVID-19 impacts and climate risk has generated difficult immediate challenges, for example when homeless shelters (Richard et al, 2021), evacuation centres (Shultz et al, 2020) and refugee camps (Kamrujjaman et al, 2021) designed to protect individuals from natural hazards can increase COVID-19 transmissibility. In urban contexts the design limits of critical infrastructure can be doubly important during a compound event, for example, COVID-19 transmission risks can be increased by poor quality sanitation or unreliable water supply (Dawson, 2020), or when pit latrines or combined sewer systems overflow during floods (Han & He, 2021).…”

Section: Compound and Dynamic Vulnerabilitymentioning

confidence: 99%

A climate resilience research renewal agenda: learning lessons from the COVID-19 pandemic for urban climate resilience

Pelling

2021

Climate and Development

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Learning lessons from the COVID-19 pandemic opens an opportunity for enhanced research and action on inclusive urban resilience to climate change. Lessons and their implications are used to describe a climate resilience research renewal agenda. Three key lessons are identified. The first lesson is generic, that climate change risk coexists and interacts with other risks through overlapping social processes, conditions and decision-making contexts. Two further lessons are urban specific: that networks of connectivity bring risk as well as resilience and that overcrowding is a key indicator of the multiple determinants of vulnerability to both COVID-19 and climate change impacts. From these lessons three research priorities arise: dynamic and compounding vulnerability, systemic risk and risk root cause analysis. These connected agendas identify affordable and healthy housing, social cohesion, minority and local leadership and multiscale governance as entry points for targeted research that can break cycles of multiple risk creation and so build back better for climate change as well as COVID-19 in recovery and renewal.

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“…Across these levels of aggregation, we also assessed data reporting across eight equity-related indicator strata. Building on the COVKID Report Card's assessment of reporting across age and race/ethnicity, we assessed reporting across individual-level exposure to four congregate living and institutional settings that are vulnerable to COVID-19 outbreaks (long-term care and detention facilities, homeless shelters, and schools) (Blair et al 2020;Hsu et al 2020;Public Health Ontario 2020a;Richard et al 2021) and eight individuallevel social markers (age, sex, immigration status, race/ethnicity, healthcare worker status, occupational sector, and income and education groups). The latter social markers have been identified as key social determinants of health and infectious disease burden (Semenza et al 2016;Solar and Irwin 2010).…”

Section: Scorecard Indicatorsmentioning

confidence: 99%

Identifying gaps in COVID-19 health equity data reporting in Canada using a scorecard approach

Blair

Warsame

Naik

et al. 2021

Can J Public Health

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Objective To assess health equity-oriented COVID-19 reporting across Canadian provinces and territories, using a scorecard approach. Methods A scan was performed of provincial and territorial reporting of five data elements (cumulative totals of tests, cases, hospitalizations, deaths, and population size) across three units of aggregation (province or territory level, health regions, and local areas) (15 "overall" indicators), and for four vulnerable settings (long-term care and detention facilities, schools, and homeless shelters) and eight social markers (age, sex, immigration status, race/ethnicity, healthcare worker status, occupational sector, income, and education) (180 "equity-related" indicators) as of December 31, 2020. Per indicator, one point was awarded if case-delimited data were released, 0.7 points if only summary statistics were reported, and 0 if neither was provided. Results were presented using a scorecard approach. Results Overall, information was more complete for cases and deaths than for tests, hospitalizations, and population size denominators needed for rate estimation. Information provided on jurisdictions and their regions, overall, tended to be more available (average score of 58%, "D") than that for equity-related indicators (average score of 17%, "F"). Only British Columbia, Alberta, and Ontario provided case-delimited data, with Ontario and Alberta providing case information for local areas. No jurisdiction reported on outcomes according to patients' immigration status, race/ethnicity, income, or education. Though several provinces reported on cases in long-term care facilities, only Ontario and Quebec provided detailed information for detention facilities and schools, and only Ontario reported on cases within homeless shelters and across occupational sectors. Conclusion One year into the pandemic, socially stratified reporting for COVID-19 outcomes remains sparse in Canada. However, several "best practices" in health equity-oriented reporting were observed and set a relevant precedent for all jurisdictions to follow for this pandemic and future ones.

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Testing, infection and complication rates of COVID-19 among people with a recent history of homelessness in Ontario, Canada: a retrospective cohort study

Cited by 94 publications

References 24 publications

Social determinants of COVID-19 incidence and outcomes: A rapid review

Social determinants of COVID-19 incidence and outcomes: A rapid review

A climate resilience research renewal agenda: learning lessons from the COVID-19 pandemic for urban climate resilience

Identifying gaps in COVID-19 health equity data reporting in Canada using a scorecard approach

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