Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland.
School of Population and Global Health, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada.
Int J Public Health. 2024 Jul 3;69:1606861. doi: 10.3389/ijph.2024.1606861. eCollection 2024.
To assess the association between socioeconomic status (SES) and self-reported adherence to preventive measures in Switzerland during the COVID-19 pandemic.
4,299 participants from a digital cohort were followed between September 2020 and November 2021. Baseline equivalised disposable income and education were used as SES proxies. Adherence was assessed over time. We investigated the association between SES and adherence using multivariable mixed logistic regression, stratifying by age (below/above 65 years) and two periods (before/after June 2021, to account for changes in vaccine coverage and epidemiological situation).
Adherence was high across all SES strata before June 2021. After, participants with higher equivalised disposable income were less likely to adhere to preventive measures compared to participants in the first (low) quartile [second (Adj.OR, 95% CI) (0.56, 0.37-0.85), third (0.38, 0.23-0.64), fourth (0.60, 0.36-0.98)]. We observed similar results for education.
No differences by SES were found during the period with high SARS-CoV-2 incidence rates and stringent measures. Following the broad availability of vaccines, lower incidence, and eased measures, differences by SES started to emerge. Our study highlights the need for contextual interpretation when assessing SES impact on adherence to preventive measures.
评估在 COVID-19 大流行期间，瑞士社会经济地位（SES）与自我报告的预防措施依从性之间的关系。
对 2020 年 9 月至 2021 年 11 月期间一个数字队列中的 4299 名参与者进行了随访。基线等效可支配收入和教育程度被用作 SES 的代表。依从性随时间进行评估。我们使用多变量混合逻辑回归，按年龄（<65 岁/>65 岁）和两个时期（2021 年 6 月之前/之后，以考虑疫苗覆盖率和流行病学情况的变化）进行分层，研究 SES 与依从性之间的关系。
在 2021 年 6 月之前，所有 SES 阶层的依从性都很高。之后，与第一（低）四分位数的参与者相比，收入较高的参与者不太可能遵守预防措施[第二（调整后的 OR，95%CI）（0.56，0.37-0.85），第三（0.38，0.23-0.64），第四（0.60，0.36-0.98）]。我们在教育程度方面也观察到了类似的结果。
在 SARS-CoV-2 发病率高且措施严格的时期，没有发现 SES 差异。在广泛使用疫苗、发病率降低和放宽措施之后，SES 差异开始显现。我们的研究强调了在评估 SES 对预防措施依从性的影响时需要进行背景解释。
