Objectives: International evidence of socioeconomic inequalities in COVID-19 outcomes is extensive and growing, but less is known about the temporal dynamics of these inequalities over the course of the pandemic.Methods: We systematically searched the Embase and Scopus databases. Additionally, several relevant journals and the reference lists of all included articles were hand-searched. This study follows the PRISMA guidelines for scoping reviews.Results: Forty-six studies were included. Of all analyses, 91.4% showed stable or increasing socioeconomic inequalities in COVID-19 outcomes over the course of the pandemic, with socioeconomically disadvantaged populations being most affected. Furthermore, the study results showed temporal dynamics in socioeconomic inequalities in COVID-19, frequently initiated through higher COVID-19 incidence and mortality rates in better-off populations and subsequent crossover dynamics to higher rates in socioeconomically disadvantaged populations (41.9% of all analyses).Conclusion: The identified temporal dynamics of socioeconomic inequalities in COVID-19 outcomes have relevant public health implications. Socioeconomic inequalities should be monitored over time to enable the adaption of prevention and interventions according to the social particularities of specific pandemic phases.
Background The COVID-19 pandemic has led to physical distancing measures to control the spread of SARS-CoV-2. Evidence on contact dynamics in different socioeconomic groups is still sparse. This study aimed to investigate the association of socioeconomic status with private and professional contact reductions in the first COVID-19 wave in Germany. Methods Data from two especially affected municipalities were derived from the population-based cross-sectional seroepidemiological CORONA-MONITORING lokal study (data collection May–July 2020). The study sample (n = 3,637) was restricted to working age (18–67 years). We calculated the association of educational and occupational status (low, medium, high) with self-reported private and professional contact reductions with respect to former contact levels in the first wave of the pandemic. Multivariate Poisson regressions were performed to estimate prevalence ratios (PR) adjusted for municipality, age, gender, country of birth, household size, contact levels before physical distancing measures, own infection status, contact to SARS-CoV-2 infected people and working remotely. Results The analyses showed significant differences in the initial level of private and professional contacts by educational and occupational status. Less private contact reductions with lower educational status (PR low vs. high = 0,79 [CI = 0.68–0.91], p = 0.002; PR medium vs. high = 0,93 [CI = 0.89–0.97], p = 0.001) and less professional contact reductions with lower educational status (PR low vs. high = 0,87 [CI = 0.70–1.07], p = 0.179; PR medium vs. high = 0,89 [CI = 0.83–0.95], p = 0.001) and lower occupational status (PR low vs. high = 0,62 [CI = 0.55–0.71], p < 0.001; PR medium vs. high = 0,82 [CI = 0.77–0.88], p < 0.001) were observed. Conclusions Our results indicate disadvantages for groups with lower socioeconomic status in private and professional contact reductions in the first wave of the pandemic. This may be associated with the higher risk of infection among individuals in lower socioeconomic groups. Preventive measures that a) adequately explain the importance of contact restrictions with respect to varying living and working conditions and b) facilitate the implementation of these reductions especially in the occupational setting seem necessary to better protect structurally disadvantaged groups during epidemics.
ZusammenfassungAuf Intensivstationen ist die Weitergabe von Informationen besonders wichtig. Ob Dienstwechsel oder Verlegung von Patienten – alle betreuenden Pflegenden sind auf eine angemessene Übergabe und die Kenntnis sicherheitsrelevanter Aspekte im Umgang mit den Patienten angewiesen. Dennoch sind übermittelte Informationen oft falsch oder unzureichend. Wie es dazu kommt und was man dagegen tun kann, beleuchtet der folgende Beitrag und fokussiert dabei auf das spezielle Setting der Respiratory Care Unit.
Background The COVID-19 pandemic has led to physical distancing measures across a range of countries to control the spread of the virus. Evidence referring to contact dynamics in different socioeconomic populations is still sparse and may contribute to the explaining of socioeconomic inequality of infections. Methods Data came from two early COVID-19 hotspots in Germany using the CORONA-MONITORING-lokal study (CoMoLo). The sample (n = 3,637) was restricted to working age (18-67 years). We calculated the association of individual education and occupation status (low, middle, high) and self-reported private and professional contact reductions. Using weighting factors (adaptation to local age, gender and education distribution), we performed multivariate Poisson regressions (prevalence ratios; PR) with different sets of covariates: hotspot, age, sex, country of birth, household size, contact level before physical distancing measures and home office. Results The descriptive analyses show a clear socioeconomic gradient in private (low education: 70,0%; middle: 79,1%; high: 86,2%) and professional contact reductions (low education: 54,6%; middle: 61,3; high: 77,2%). The multivariate analyses confirm these associations, with a stronger gradient for professional contacts (private contact reduction: PR low vs. high education = 0,83 [KI:0.74-0.93]; professional contact reduction: PR low vs. high education = 0,75 [KI:0.64-0.89]) as well as for professional contact reduction when occupational status is considered instead of education. Conclusions Our results show disadvantages in groups with lower educational or occupational status in private and professional contact reductions in the first pandemic wave. This might result in a higher risk of infection. Preventive measures that a) adequately explain the importance of contact restrictions and b) facilitate the implementation of these reductions seem necessary to better protect structurally disadvantaged people during epidemics. Key messages • Groups with lower educational or occupational status were less likely of being able to reduce their private and professional contacts in the first wave of the pandemic. • Socioeconomic differences were more pronounced in professional contact reduction compared to private contact reduction.
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