Assessing the Impact of Individual Characteristics and Neighborhood Socioeconomic Status During the COVID-19 Pandemic in the Provinces of Milan and Lodi

Abstract

Social inequalities in health are known to be influenced by the socioeconomic status of the territory in which people live. In the context of the ongoing coronavirus disease 2019 (COVID-19) pandemic, this study is aimed at assessing the role of 5 area-level indicators in shaping the risk of contagion in the provinces of Milan and Lodi (Lombardy, Italy), namely: educational disadvantage, unemployment, housing crowding, mobility, and population density. The study area includes the municipalities at the origin of the first Italian epidemic outbreak. Data on COVID-19 patients from the Integrated Datawarehouse for COVID Analysis in Milan were used and matched with aggregate-level data from the National Institute of Statistics Italy (Istat). Multilevel logistic regression models were used to estimate the association between the census block-level predictors and COVID-19 infection, independently of age, sex, country of birth, and preexisting health conditions. All the variables were significantly associated with the outcome, with different effects before and after the lockdown and according to the province of residence. This suggests a pattern of socioeconomic inequalities in the outbreak, which should be taken into account in the eventuality of future epidemics to contain their spread and its related disparities.

Seroprevalence of SARS-CoV-2 antibodies in social housing areas in Denmark

“…According to the Danish authorities, 15 residential areas are currently defined as social housing (SH) areas, characterized by low employment rates, low income, low education level, high crime rate and/or increased proportion of immigrants (3). Some reports suggest that ethnic minorities in a number of countries are over-represented among those infected with COVID-19, just as socioeconomic inequality is described among SARS-CoV-2 infected persons (4)(5)(6). A Danish report from October 2020 showed similar patterns, where people of non-Western background accounted for 25.7% of cases with SARS-CoV-2 infection, despite representing only 8.9% of the population (7,8).…”

Temperature-mortality association during and before the COVID-19 pandemic in Italy: A nationwide time-stratified case-crossover study

“…A current systematic review concluded that apart from the individual-level factors like age and sex, community-level factors such as socioeconomic status could affect the temperature-mortality association ( Son et al, 2019 ). Italy has seen significant socioeconomic inequalities such as educational disparity and unemployment in the context of the COVID-19 pandemic ( Consolazio et al, 2021 ), which played a crucial role in vulnerability to high and low temperatures ( Marí-Dell'Olmo et al, 2019 ). Our results show that a higher cold-related mortality risk during the 2020 COVID-19 pandemic than the same months during 2015–2019 but with no difference for the changes in the heat effects.…”

COVID-19 Pandemic and Equal Access to Vaccines

“…Inequality as regards the risk of contracting COVID-19 is due to the fact that certain individuals, communities, and populations are at a higher risk of contracting the infection or of contracting a particularly severe infection [ 4 ] than others. The first risk is linked to individual circumstances [ 5 ] (immunodepression), social circumstances [ 6 ] (community living, close living quarters, homelessness), and work-related circumstances [ 7 , 8 ] (frequent contact with the public, poor protection in the work environment) [ 9 ].…”