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英格兰养老院中地区贫困状况是否与新冠病毒病(COVID-19)的更大影响相关?对COVID-19疫情和死亡情况的初步分析。

Is area deprivation associated with greater impacts of COVID-19 in care homes across England? A preliminary analysis of COVID-19 outbreaks and deaths.

作者信息

Bach-Mortensen Anders Malthe, Degli Esposti Michelle

机构信息

Social Policy and Intervention, University of Oxford, Oxford, UK

Social Policy and Intervention, University of Oxford, Oxford, UK.

出版信息

J Epidemiol Community Health. 2021 Jul;75(7):624-627. doi: 10.1136/jech-2020-215039. Epub 2021 Feb 8.

Abstract

INTRODUCTION

The COVID-19 pandemic has disproportionately impacted care homes and vulnerable populations, exacerbating existing health inequalities. However, the role of area deprivation in shaping the impacts of COVID-19 in care homes is poorly understood. We examine whether area deprivation is linked to higher rates of COVID-19 outbreaks and deaths among care home residents across upper tier local authorities in England (n=149).

METHODS

We constructed a novel dataset from publicly available data. Using negative binomial regression models, we analysed the associations between area deprivation (Income Deprivation Affecting Older People Index (IDAOPI) and Index of Multiple Deprivation (IMD) extent) as the exposure and COVID-19 outbreaks, COVID-19-related deaths and all-cause deaths among care home residents as three separate outcomes-adjusting for population characteristics (size, age composition, ethnicity).

RESULTS

COVID-19 outbreaks in care homes did not vary by area deprivation. However, COVID-19-related deaths were more common in the most deprived quartiles of IDAOPI (incidence rate ratio (IRR): 1.23, 95% CI 1.04 to 1.47) and IMD extent (IRR: 1.16, 95% CI 1.00 to 1.34), compared with the least deprived quartiles.

DISCUSSION

These findings suggest that area deprivation is a key risk factor in COVID-19 deaths among care home residents. Future research should look to replicate these results when more complete data become available.

摘要

引言

新冠疫情对养老院和弱势群体的影响尤为严重,加剧了现有的健康不平等现象。然而,人们对地区贫困在塑造新冠疫情对养老院影响方面的作用了解甚少。我们研究了地区贫困是否与英格兰上级地方当局(共149个)养老院居民中新冠疫情爆发率和死亡率较高有关。

方法

我们从公开数据构建了一个新数据集。使用负二项回归模型,我们分析了作为暴露因素的地区贫困(影响老年人的收入剥夺指数(IDAOPI)和多重剥夺指数(IMD)程度)与养老院居民中的新冠疫情爆发、新冠相关死亡和全因死亡这三个不同结局之间的关联,并对人口特征(规模、年龄构成、种族)进行了调整。

结果

养老院中的新冠疫情爆发情况并未因地区贫困而有所不同。然而,与最不贫困的四分位数相比,在IDAOPI最贫困的四分位数(发病率比(IRR):1.23,95%置信区间1.04至1.47)和IMD程度最贫困的四分位数(IRR:1.16,95%置信区间1.00至1.34)中,新冠相关死亡更为常见。

讨论

这些发现表明,地区贫困是养老院居民新冠死亡的一个关键风险因素。未来的研究应在有更完整数据时尝试重复这些结果。

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