Temporal Dynamics of Socioeconomic Inequalities in COVID-19 Outcomes Over the Course of the Pandemic—A Scoping Review

Beese, Florian; Waldhauer, Julia; Wollgast, Lina; Pförtner, Timo-Kolja; Wahrendorf, Morten; Haller, Sebastian; Hoebel, Jens; Wachtler, Benjamin

doi:10.3389/ijph.2022.1605128

Cited by 21 publications

(26 citation statements)

References 78 publications

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“…Each additional percentage point of farmworkers in a county was associated with 5.79 more deaths (5.51 directly, 0.28 via indirect ‘spillover’ to the next county, p <0.001), while each additional percentage point of individuals living in poverty was associated with 4.41 additional deaths (4.20 directly, 0.22 indirect, p <0.001) [ 22 ]. These results are consistent with findings from different parts of the world at different periods of the pandemic [ 2 – 4 , 8 , 23 – 26 ].…”

Section: Introductionsupporting

confidence: 92%

Socioeconomic disparities and concentration of the spread of the COVID-19 pandemic in the province of Quebec, Canada

et al. 2023

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Background Recent studies suggest that the risk of SARS-CoV-2 infection may be greater in more densely populated areas and in cities with a higher proportion of persons who are poor, immigrant, or essential workers. This study examines spatial inequalities in SARS-CoV-2 exposure in a health region of the province of Quebec in Canada. Methods The study was conducted on the 1206 Canadian census dissemination areas in the Capitale-Nationale region of the province of Quebec. The observation period was 21 months (March 2020 to November 2021). The number of cases reported daily in each dissemination area was identified from available administrative databases. The magnitude of inequalities was estimated using Gini and Foster-Greer-Thorbecke (FGT) indices. The association between transmission and socioeconomic deprivation was identified based on the concentration of transmission in socially disadvantaged areas and on nonparametric regressions relating the cumulative incidence rate by area to ecological indicators of spatial disadvantage. Quantification of the association between median family income and degree of exposure of dissemination areas was supplemented by an ordered probit multiple regression model. Results Spatial disparities were elevated (Gini = 0.265; 95% CI [0.251, 0.279]). The spread was more limited in the less densely populated areas of the Quebec City agglomeration and outlying municipalities. The mean cumulative incidence in the subsample made up of the areas most exposed to the pandemic was 0.093. The spread of the epidemic was concentrated in the most disadvantaged areas, especially in the densely populated areas. Socioeconomic inequality appeared early and increased with each successive pandemic wave. The models showed that areas with economically disadvantaged populations were three times more likely to be among the areas at highest risk for COVID-19 (RR = 3.55; 95% CI [2.02, 5.08]). In contrast, areas with a higher income population (fifth quintile) were two times less likely to be among the most exposed areas (RR = 0.52; 95% CI [0.32, 0.72]). Conclusion As with the H1N1 pandemics of 1918 and 2009, the SARS-CoV-2 pandemic revealed social vulnerabilities. Further research is needed to explore the various manifestations of social inequality in relation to the pandemic.

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Section: Introductionsupporting

confidence: 92%

Socioeconomic disparities and concentration of the spread of the COVID-19 pandemic in the province of Quebec, Canada

et al. 2023

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“…The COVID-19 pandemic which started in early 2020 can be regarded as a world health crisis, which has not been seen for over 100 years. Today, there is a vast majority of reports about the early effects of the pandemic on the societal and the individual level [ 23 , 24 , 25 , 26 ]. A decline in health-related QOL has been reported for the general population [ 45 , 46 ] as well as for vulnerable subgroups such as cancer patients [ 31 , 47 , 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

“…The onset of the COVID-19 pandemic represented an exceptional situation and affected essential areas of daily life, the economy, and supportive and healthcare [ 23 , 24 , 25 ] as well as mental health [ 26 ]. In the German healthcare system, resources were prioritized for potential, very sick COVID-19 patients [ 27 ], which led to changes in the oncological care in Germany—mainly in follow-up care, psycho-oncologic care, and surgery [ 28 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

Young Adult German Breast Cancer Patients Participating in a Three-Week Inpatient Mother–Child Rehab Program Have High Needs for Supportive Care

Hammersen

Fischer

Pursche³

et al. 2023

Cancers

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A known cut-off problem hampers the interpretation of quality of life (QOL) scores. The purpose of this study was to apply a novel approach for the EORTC QLQ-C30 instrument to identify the proportion of breast cancer (BC) patients in need of supportive care. Changes in QOL during the COVID-19 pandemic were evaluated, as well as changes over time (after treatment termination and up to 4 years later). Data were obtained from a cohort study on young adult BC patients with minor children participating in a mother–child rehab program. Cross-sectional QOL data were collected from 2015 to 2021 (baseline). Follow-up data were available for up to 4 years after diagnosis for a subgroup. The baseline cohort included 853 women (mean age 35 years). More than 50% had a need for supportive care. In the subgroup with follow-up, this proportion remained at a high level up to several years after diagnosis. During the COVID-19 pandemic, changes regarding the proportion with this need were not as high as expected—with the exception of changes on the QLQ-C30 scale ‘role functioning’ (+15%). Even several years after diagnosis, every second BC patient with minor children had a need for supportive care, which is much higher than previously found. Healthcare staff should be aware of this potential need and should address this issue.

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“…There is international evidence that the risk of infection in the early phases of the pandemic was higher in socioeconomically better-off groups, e.g. due to former higher mobility rates (business travel, vacation travel) [34], which is compatible with our findings of higher private and professional contacts in higher educational and occupational groups before implementation of the mitigation strategies [35]. However, as the pandemic progressed, the dynamics reversed and the risk of infection was higher in socioeconomically disadvantaged groups [36][37][38], which also can be seen as a result of less contact reductions in lower educational and occupational groups, as found in our analysis.…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic differences in the reduction of face-to-face contacts in the first wave of the COVID-19 pandemic in Germany

et al. 2022

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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.

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Temporal Dynamics of Socioeconomic Inequalities in COVID-19 Outcomes Over the Course of the Pandemic—A Scoping Review

Cited by 21 publications

References 78 publications

Socioeconomic disparities and concentration of the spread of the COVID-19 pandemic in the province of Quebec, Canada

Socioeconomic disparities and concentration of the spread of the COVID-19 pandemic in the province of Quebec, Canada

Young Adult German Breast Cancer Patients Participating in a Three-Week Inpatient Mother–Child Rehab Program Have High Needs for Supportive Care

Socioeconomic differences in the reduction of face-to-face contacts in the first wave of the COVID-19 pandemic in Germany

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