Arceo-Gomez Eva O, Campos-Vazquez Raymundo M, Esquivel Gerardo, Alcaraz Eduardo, Martinez Luis A, Lopez Norma G
Universidad Iberoamericana, Mexico City, Mexico.
Centro de Estudios Económicos, El Colegio de México, Carretera Picacho Ajusco 20, Col. Ampliación Fuentes del Pedregal, Mexico City 14110, Mexico.
Lancet Reg Health Am. 2022 Feb;6:100115. doi: 10.1016/j.lana.2021.100115. Epub 2021 Nov 10.
The COVID-19 pandemic revealed large structural inequalities that led to disparities in health outcomes related to socioeconomic status. So far, most of the evidence is based on aggregated data or simulations with individual data, which point to various possible mechanisms behind the association. To date, there have been no studies regarding an income gradient in COVID-19 mortality based on individual-level data and adjusting for comorbidities or access to healthcare.
In this paper, we use linked employee-patient data for patients tested for COVID-19 at the Mexican Institute of Social Security. We estimate the association of the probability of dying with income centiles, using a probit estimation and adjusting for COVID-19 diagnosis, sociodemographic variables, and comorbidities.
After controlling for all these variables, we find that persons in the lowest income decile still had a probability of dying from COVID-19 five times greater than those at the top decile.
Our results imply that the association between income and COVID outcomes is not explained by the prevalence of comorbidities or by a lack of access to healthcare among the low-income population.
This study was not supported by any external funding source.
新冠疫情暴露出巨大的结构性不平等，导致与社会经济地位相关的健康结果存在差异。到目前为止，大多数证据基于汇总数据或个体数据模拟，这些数据指出了这种关联背后的各种可能机制。迄今为止，尚无基于个体层面数据并对合并症或医疗保健可及性进行调整的关于新冠死亡率收入梯度的研究。
在本文中，我们使用墨西哥社会保障研究所对新冠病毒检测呈阳性患者的员工-患者关联数据。我们使用概率单位估计法，并对新冠诊断、社会人口统计学变量和合并症进行调整，估计死亡概率与收入百分位数之间的关联。
在控制所有这些变量后，我们发现收入最低十分位数人群死于新冠的概率仍比最高十分位数人群高五倍。
我们的结果表明，收入与新冠结果之间的关联不能用合并症的流行情况或低收入人群缺乏医疗保健可及性来解释。
本研究未得到任何外部资金支持。
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