Mongin Denis, Cullati Stéphane, Kelly-Irving Michelle, Rosselet Maevane, Regard Simon, Courvoisier Delphine S
Faculty of medicine, University of Geneva, 26 avenue de Beau Séjour, Geneva 1206, Switzerland.
Division Quality of care, Department of Readaptation and Geriatrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
EClinicalMedicine. 2022 Mar 28;46:101352. doi: 10.1016/j.eclinm.2022.101352. eCollection 2022 Apr.
Neighbourhood socio-economic inequities have been shown to affect COVID-19 incidence and mortality, as well as access to tests. This article aimed to study how associations of inequities and COVID-19 outcomes varied between the first two pandemic waves from a gender perspective.
We performed an ecological study based on the COVID-19 database of Geneva between Feb 26, 2020, and June 1, 2021. Outcomes were the number of tests per person, the incidence of COVID-19 cases, the incidence of COVID-19 deaths, the positivity rate, and the delay between symptoms and test. Outcomes were described by neighbourhood socio-economic levels and stratified by gender and epidemic waves (first wave, second wave), adjusting for the proportion of inhabitants older than 65 years.
Low neighbourhood socio-economic levels were associated with a lower number of tests per person (incidence rate ratio [IRR] of 0.88, 0.85 and 0.83 for low, moderate, and highly vulnerable neighbourhood respectively), a higher incidence of COVID-19 cases and of COVID-19 deaths (IRR 2.3 for slightly vulnerable, 1.9 for highly vulnerable). The association between socio-economic inequities and incidence of COVID-19 deaths was mainly present during the first wave of the pandemic, and was stronger amongst women. The increase in COVID-19 cases amongst vulnerable populations appeared mainly during the second wave, and originated from a lower access to tests for men, and a higher number of COVID-19 cases for women.
The COVID-19 pandemic affected people differently depending on their socio-economic level. Because of their employment and higher prevalence of COVID-19 risk factors, people living in neighbourhoods of lower socio-economic levels, especially women, were more exposed to COVID-19 consequences.
This research was supported by the research project SELFISH, financed by the Swiss National Science Foundation, grant number 51NF40-160590 (LIVES centre international research project call).
社区社会经济不平等已被证明会影响新冠疫情的发病率、死亡率以及检测机会。本文旨在从性别角度研究不平等与新冠疫情结果之间的关联在疫情前两波中是如何变化的。
我们基于2020年2月26日至2021年6月1日日内瓦的新冠疫情数据库进行了一项生态学研究。结果指标包括人均检测次数、新冠病例发病率、新冠死亡发病率、阳性率以及症状出现与检测之间的延迟时间。结果指标按社区社会经济水平进行描述，并按性别和疫情波次（第一波、第二波）分层，同时对65岁以上居民的比例进行了调整。
社区社会经济水平较低与人均检测次数较少相关（低、中、高脆弱性社区的发病率比[IRR]分别为0.88、0.85和0.83），新冠病例和新冠死亡的发病率较高（轻度脆弱社区的IRR为2.3，高度脆弱社区的IRR为1.9）。社会经济不平等与新冠死亡发病率之间的关联主要出现在疫情第一波期间，且在女性中更为明显。弱势群体中新冠病例的增加主要出现在第二波疫情期间，其原因是男性检测机会较少，而女性新冠病例较多。
新冠疫情对不同社会经济水平的人群影响各异。由于就业情况以及新冠风险因素的较高流行率，生活在社会经济水平较低社区的人群，尤其是女性，更容易受到新冠疫情后果的影响。
本研究得到了由瑞士国家科学基金会资助的SELFISH研究项目的支持，资助编号为51NF40 - 160590（LIVES中心国际研究项目征集）。
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