Division of Public Health Emergency Response Research, Korea Disease Control and Prevention Agency, Cheongju, Korea.
Department of Preventive Medicine, Pusan National University School of Medicine, Busan, Korea.
Epidemiol Health. 2022;44:e2022107. doi: 10.4178/epih.e2022107. Epub 2022 Nov 15.
Socioeconomic disparities have been reported as major risk factors contributing to the spread of coronavirus disease 2019 (COVID-19) at the community level. We conducted an epidemiological study on COVID-19 incidence risk using area-based deprivation indices (DIs) reflecting the characteristics of the susceptible population.
A database of the confirmed COVID-19 cases in 8 metropolitan cities in Korea from January 20, 2020 to December 31, 2021 was combined with area-based DI scores and standardized prevalence rates of diabetes and hypertension from the Korean Community Health Survey. Relative risk (RR) levels were estimated using a generalized linear model with a Poisson distribution by age group.
The risk of COVID-19 incidence generally increased with increasing age, especially in patients aged ≥75 years. The RR of COVID-19 incidence per interquartile range increment of the composite deprivation index (composite DI) was 1.54 (95% confidence interval [CI], 1.34 to 1.70). Notably, in the first wave, the risk of COVID-19 incidence was approximately 3 times higher in the region with the lowest socioeconomic status than in the region with the highest status (RR, 3.08; 95% CI, 2.42 to 3.78 based on the the composite DI and RR, 3.13; 95% CI, 2.53 to 3.83 based on the social deprivation index).
This study provides scientific evidence that socioeconomic deprivation is an important risk factor for the spread of COVID-19. This finding suggests that a mid-term to long-term strategy is needed to protect susceptible populations and reduce the burden of COVID-19 in the community.
社会经济地位的差异已被报道为导致社区层面 2019 年冠状病毒病（COVID-19）传播的主要危险因素。我们使用反映易感人群特征的基于区域的剥夺指数（DI）对 COVID-19 发病率风险进行了一项流行病学研究。
将韩国 8 个大都市地区从 2020 年 1 月 20 日至 2021 年 12 月 31 日确诊的 COVID-19 病例数据库与基于区域的 DI 评分以及韩国社区健康调查中的糖尿病和高血压标准化患病率相结合。使用泊松分布的广义线性模型按年龄组估计相对风险（RR）水平。
COVID-19 发病率的风险通常随着年龄的增长而增加，尤其是≥75 岁的患者。复合剥夺指数（复合 DI）每增加一个四分位间距，COVID-19 发病率的 RR 为 1.54（95%置信区间[CI]，1.34 至 1.70）。值得注意的是，在第一波疫情中，社会经济地位最低地区的 COVID-19 发病率风险约是社会经济地位最高地区的 3 倍（RR，3.08；95%CI，2.42 至 3.78，基于复合 DI；RR，3.13；95%CI，2.53 至 3.83，基于社会剥夺指数）。
本研究提供了科学证据，表明社会经济剥夺是 COVID-19 传播的重要危险因素。这一发现表明，需要采取中期到长期的战略来保护易感人群，并减轻社区中 COVID-19 的负担。
