Hoskins Susan, Beale Sarah, Nguyen Vincent, Boukari Yamina, Yavlinsky Alexei, Kovar Jana, Byrne Thomas, Fong Wing Lam Erica, Geismar Cyril, Patel Parth, Johnson Anne M, Aldridge Robert W, Hayward Andrew
Centre for Public Health Data Science, University College London, London, England, NW1 2DA, UK.
Institute of Epidemiology and Health Care, University College London, London, England, WC1E 7HB, UK.
NIHR Open Res. 2023 Sep 28;3:46. doi: 10.3310/nihropenres.13445.1. eCollection 2023.
Individuals living in deprived areas in England and Wales undertook essential activities more frequently and experienced higher rates of SARS-CoV-2 infection than less deprived communities during periods of restrictions aimed at controlling the Alpha (B.1.1.7) variant. We aimed to understand whether these deprivation-related differences changed once restrictions were lifted.
Among 11,231 adult Virus Watch Community Cohort Study participants multivariable logistic regressions were used to estimate the relationships between deprivation and self-reported activities and deprivation and infection (self-reported lateral flow or PCR tests and linkage to National Testing data and Second Generation Surveillance System (SGSS)) between August - December 2021, following the lifting of national public health restrictions.
Those living in areas of greatest deprivation were more likely to undertake essential activities (leaving home for work (aOR 1.56 (1.33 - 1.83)), using public transport (aOR 1.33 (1.13 - 1.57)) but less likely to undertake non-essential activities (indoor hospitality (aOR 0.82 (0.70 - 0.96)), outdoor hospitality (aOR 0.56 (0.48 - 0.66)), indoor leisure (aOR 0.63 (0.54 - 0.74)), outdoor leisure (aOR 0.64 (0.46 - 0.88)), or visit a hairdresser (aOR 0.72 (0.61 - 0.85))). No statistical association was observed between deprivation and infection (P=0.5745), with those living in areas of greatest deprivation no more likely to become infected with SARS-CoV-2 (aOR 1.25 (0.87 - 1.79).
The lack of association between deprivation and infection is likely due to the increased engagement in non-essential activities among the least deprived balancing the increased work-related exposure among the most deprived. The differences in activities highlight stark disparities in an individuals' ability to choose how to limit infection exposure.
在旨在控制阿尔法（B.1.1.7）变体的限制措施实施期间，生活在英格兰和威尔士贫困地区的个人比贫困程度较低的社区更频繁地进行必要活动，且感染新冠病毒的比例更高。我们旨在了解一旦限制措施解除，这些与贫困相关的差异是否会发生变化。
在11231名成年病毒观察社区队列研究参与者中，采用多变量逻辑回归来估计2021年8月至12月全国公共卫生限制措施解除后，贫困与自我报告的活动之间以及贫困与感染（自我报告的侧向流动或聚合酶链反应检测以及与国家检测数据和第二代监测系统（SGSS）的关联）之间的关系。
生活在贫困程度最高地区的人更有可能进行必要活动（离家上班（调整后比值比1.56（1.33 - 1.83）），使用公共交通工具（调整后比值比1.33（1.13 - 1.57）），但进行非必要活动的可能性较小（室内餐饮（调整后比值比0.82（0.70 - 0.96）），户外餐饮（调整后比值比0.56（0.48 - 0.66）），室内休闲（调整后比值比0.63（0.54 - 0.74）），户外休闲（调整后比值比0.64（0.46 - 0.88）），或去理发店（调整后比值比0.72（0.61 - 0.85）））。未观察到贫困与感染之间的统计学关联（P = 0.5745），生活在贫困程度最高地区的人感染新冠病毒的可能性并不更高（调整后比值比1.25（0.87 - 1.79））。
贫困与感染之间缺乏关联可能是由于贫困程度最低的人群中非必要活动参与度增加，抵消了贫困程度最高人群中与工作相关的接触增加。活动差异凸显了个人在选择如何限制感染暴露能力方面的巨大差距。
