Cancer Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Biostatistics Group, Health Science Department, University of Leicester, Leicester, UK.
Health Soc Care Community. 2022 Sep;30(5):e1959-e1965. doi: 10.1111/hsc.13627. Epub 2021 Nov 5.
This study aimed to investigate the relationship between socioeconomic status and COVID-19 mortality in Iran. We performed a retrospective cohort study on data from the hospitalised COVID-19 patients in Qazvin. We collected data on education, self-reported socioeconomic status, and location of residence as a proxy for socioeconomic status (SES). We applied the Blinder-Oaxaca decomposition approach to assess the role of socioeconomic inequality in COVID-19 mortality and determine the main contributors to the observed inequality. Overall, 941 patients (48.96%) had low SES, while only 24.87% (n = 478) were classified in the high SES category. The mortality rate was significantly higher in the low SES group, and we spotted a 17.13% gap in COVID-19 mortality between the high and low SES patients (p < 0.001). Age was the main contributor to the observed inequality, responsible for 6.91% of the gap (p < 0.001). Having co-morbidities (1.53%) and longer length of stay (LOS) in hospitals (0.95%) in the low SES group were other main determinants of the inequality in COVID-19 mortality (p < 0.05). In the unexplained part of our model, the effect of increased age (10.61%) and a positive RT-PCR test result (3.43%) were more substantial in the low SES group compared to the high SES patients (p < 0.05). The low SES people had an increased risk of getting COVID-19, and the disease has been more severe and fatal among them. Increased age, co-morbidities, and LOS were identified as the main drivers of this inequality.
本研究旨在探讨伊朗社会经济地位与 COVID-19 死亡率之间的关系。我们对卡兹温住院 COVID-19 患者的数据进行了回顾性队列研究。我们收集了教育、自我报告的社会经济地位以及居住地等社会经济地位（SES）的代理数据。我们应用 Blinder-Oaxaca 分解方法来评估社会经济不平等在 COVID-19 死亡率中的作用，并确定观察到的不平等的主要原因。总体而言，941 名患者（48.96%）社会经济地位较低，而仅有 24.87%（n=478）被归类为社会经济地位较高。低社会经济地位组的死亡率明显较高，我们发现高社会经济地位和低社会经济地位患者之间 COVID-19 死亡率存在 17.13%的差距（p<0.001）。年龄是导致观察到的不平等的主要原因，占差距的 6.91%（p<0.001）。在低社会经济地位组中，患有合并症（1.53%）和住院时间延长（0.95%）是 COVID-19 死亡率不平等的其他主要决定因素（p<0.05）。在我们模型的未解释部分中，与高社会经济地位患者相比，年龄增加（10.61%）和 RT-PCR 检测结果阳性（3.43%）对低社会经济地位患者的影响更大（p<0.05）。社会经济地位较低的人感染 COVID-19 的风险增加，而且他们的病情更严重，死亡率更高。年龄增加、合并症和 LOS 被确定为这种不平等的主要驱动因素。
