Bingöl K B, Meulman I, Wassing K R M, Meer I M van der
Department of Epidemiology and Policy advice, Public Health Service of Haaglanden, The Hague, The Netherlands.
Center for Health, Care and Society, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
BMC Public Health. 2025 Jul 2;25(1):2232. doi: 10.1186/s12889-025-23364-1.
The COVID-19 pandemic has been a global health crisis since late 2019. By the end of 2021, the Netherlands reported over 3 million cases, leading to significant hospital and Intensive Care Unit (ICU) admissions. This study investigated the impact of demographic, socio-economic, health, including vaccination coverage, and neighborhood characteristics on COVID-19-related hospital and ICU admissions, with a focus on neighborhood differences in the region Haaglanden, the Netherlands.
This cross-sectional study included residents aged 25-79 years from the region Haaglanden. Data were stratified across three COVID-19 waves. Individual-level registry data from 2020 to 2021 were used, covering demographics, socio-economic factors, health information and neighborhood characteristics, linked to COVID-19-related hospital and ICU admissions. Multivariable logistic models were conducted per wave to estimate the odds of both COVID-19-related hospital and ICU admissions.
More than 700.000 inhabitants from the region Haaglanden were included per wave. COVID-19-related hospital admissions were 0.08% (n = 571) in the first wave, 0.40% (n = 2.865) in the second, and 0.17% (n = 858) in the third wave. ICU admissions were 0.02% (n = 159) in the first wave, 0.07% (n = 530) in the second, and 0.03% (n = 192) in the third wave. Hospital and ICU admission odds were higher among older individuals, males, lower-educated individuals, those of Moroccan origin, residents with lower income and wealth, poor physical health and those living in low socio-economic neighborhoods. In the third wave, neighborhoods with vaccination coverage below 60% had the highest rates of hospital and ICU admissions.
This study highlighted that individual and neighborhood factors were associated with a higher risk of COVID-19-related hospital and ICU admissions, with the individual risk factors often concentrated in neighborhoods with low socio-economic status scores. Public health strategies should focus on high-risk individuals and incorporate tailored interventions, while early identification of disadvantaged areas is key for effective resource allocation and reducing disparities during future outbreaks.
自2019年末以来，新冠疫情一直是一场全球健康危机。截至2021年底，荷兰报告了超过300万例病例，导致大量患者入院治疗并入住重症监护病房（ICU）。本研究调查了人口统计学、社会经济、健康因素（包括疫苗接种覆盖率）以及社区特征对新冠相关住院和ICU收治情况的影响，重点关注荷兰海牙地区的社区差异。
这项横断面研究纳入了海牙地区25至79岁的居民。数据按三次新冠疫情浪潮进行分层。使用了2020年至2021年的个人层面登记数据，涵盖人口统计学、社会经济因素、健康信息和社区特征，并与新冠相关住院和ICU收治情况相关联。每一波疫情都进行了多变量逻辑回归模型分析，以估计新冠相关住院和ICU收治的几率。
每一波疫情都纳入了海牙地区超过70万居民。第一波疫情中，新冠相关住院率为0.08%（n = 571），第二波为0.40%（n = 2865），第三波为0.17%（n = 858）。第一波疫情中ICU收治率为0.02%（n = 159），第二波为0.07%（n = 530），第三波为0.03%（n = 192）。年龄较大者、男性、受教育程度较低者、摩洛哥裔、收入和财富较低者、身体健康状况较差者以及生活在社会经济地位较低社区的居民，其住院和入住ICU的几率更高。在第三波疫情中，疫苗接种覆盖率低于60%的社区，其住院和ICU收治率最高。
本研究强调个人和社区因素与新冠相关住院和ICU收治的较高风险相关，个人风险因素往往集中在社会经济地位得分较低的社区。公共卫生策略应关注高危个体并纳入针对性干预措施，而早期识别弱势地区是有效资源分配和减少未来疫情期间差异的关键。
