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COVID-19: Original Article
Unemployment and COVID-19-related mortality: a historical cohort study of 50,000 COVID-19 patients in Fars, Iran
Alireza Mirahmadizadeh, Mohammad Taghi Badeleh Shamooshaki, Amineh Dadvar, Mohammad Javad Moradian, Mohammad Aryaie
Epidemiol Health. 2022;44:e2022032.   Published online March 12, 2022
DOI: https://doi.org/10.4178/epih.e2022032
  • 10,333 View
  • 410 Download
  • 3 Web of Science
  • 6 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Previous studies have estimated the risk of death associated with unemployment in the coronavirus disease 2019 (COVID-19) pandemic, but no studies have examined unemployment before COVID-19 infection as a risk factor for COVID-19-related mortality. Thus, this study aimed to investigate COVID-19 mortality among this population.
METHODS
Data on 50,038 people aged 25-59 years were collected from 38 agencies in Fars Province, Iran, from February 2020 to July 2021. Follow-up lasted from participants’ diagnosis with COVID-19 based on the results of a reverse transcription-polymerase chain reaction test to participants’ death or the end of the study period. The association between unemployment and COVID-19-related mortality was estimated using the Poisson regression method, and a sensitivity analysis was conducted to calculate the E-value.
RESULTS
Unemployment was associated with a 2.41-fold (95% confidence interval [CI], 2.01 to 2.90) higher age-adjusted and sex-adjusted risk of COVID-19-related mortality. The adjusted Poisson regression analysis showed 8.82 (95% CI, 6.42 to 12.11), 2.84 (95% CI, 1.90 to 4.24), and 1.58 (95% CI, 1.24 to 2.01) times higher risks of COVID-19-related mortality among unemployed people aged 25-39 years, 40-49 years, and 50-59 years, respectively, than among their employed counterparts. Unemployment increased the risk of COVID-19 mortality by 3.31 (95% CI, 2.31 to 4.74) and 2.30 (95% CI, 1.86 to 2.84) times in female and male, respectively. The E-value was 3.43, reflecting the minimum strength of confounding required to shift the association between unemployment and COVID-19-related mortality toward the null.
CONCLUSIONS
Unemployment prior to COVID-19 infection increased the risk of COVID-19-related mortality. COVID-19-related mortality disproportionately impacted unemployed women and younger unemployed people.
Summary
Key Message
This study adds new insights to the existing body of work on the topic of unemployment and COVID-19-related mortality. Unemployment prior to COVID-19 infection was found to increase the risk of COVID-19-related mortality, which disproportionately burdened unemployed female and younger unemployed people. It seems older unemployed people and unemployed males may tend to have more financial resources and savings when they lose a job, making younger unemployed people and unemployed female more vulnerable to financial stress, which can lead to deferred care and increase their risk of COVID-19-related mortality.

Citations

Citations to this article as recorded by  
  • How do socioeconomic determinants of health affect the likelihood of living with HTLV-1 globally? A systematic review with meta-analysis
    Nydile Ramesh, Beatrice Cockbain, Graham P. Taylor, Carolina Rosadas
    Frontiers in Public Health.2024;[Epub]     CrossRef
  • Modelling the spatial varying relationships between socioeconomic inequalities and COVID-19 mortality in the African subregion
    Yaw K. Awuah-Mensah, Eric N. Aidoo
    Earth Science Informatics.2024; 17(4): 2959.     CrossRef
  • The Anatomy of Unemployment: Determinants During and After the COVID-19 Crisis
    Matus Senci, Lucia Svabova, Tomas Kliestik
    Management Dynamics in the Knowledge Economy.2024; 12(1): 86.     CrossRef
  • Is there a relationship between internet access and COVID-19 mortality? Evidence from Nigeria based on a spatial analysis
    Richard Adeleke
    Dialogues in Health.2023; 2: 100102.     CrossRef
  • Determinant Factors of Mortality in Pre-elderly and Elderly Patients With COVID-19 in Jakarta, Indonesia
    Thresya Febrianti, Ngabila Salama, Inggariwati, Dwi Oktavia
    Journal of Preventive Medicine and Public Health.2023; 56(3): 231.     CrossRef
  • The gamma-Maxwell regression for COVID-19 mortality rates of the 50 U.S. largest cities
    N.S.S. da Costa, G.M. Cordeiro
    Model Assisted Statistics and Applications.2023; 18(3): 193.     CrossRef
Original Article
Predictors of Colorectal Cancer Survival in Golestan, Iran: A Population-based Study
Mohammad Aryaie, Gholamreza Roshandel, Shahryar Semnani, Mohsen Asadi-Lari, Mohsen Aarabi, Mohammad Ali Vakili, Vahideh Kazemnejhad, Seyed Mehdi Sedaghat, Masoud Solaymani-Dodaran
Epidemiol Health. 2013;35:e2013004.   Published online June 20, 2013
DOI: https://doi.org/10.4178/epih/e2013004
  • 18,261 View
  • 131 Download
  • 15 Crossref
AbstractAbstract PDF
Abstract
<sec><title>OBJECTIVES</title><p>We aimed to investigate factors associated with colorectal cancer survival in Golestan, Iran.</p></sec><sec><title>METHODS</title><p>We used a population based cancer registry to recruit study subjects. All patients registered since 2004 were contacted and data were collected using structured questionnaires and trained interviewers. All the existing evidences to determine the stage of the cancer were also collected. The time from first diagnosis to death was compared in patients according to their stage of cancer using the Kaplan-Meir method. A Cox proportional hazard model was built to examine their survival experience by taking into account other covariates.</p></sec><sec><title>RESULTS</title><p>Out of a total of 345 subjects, 227 were traced. Median age of the subjects was 54 and more than 42% were under 50 years old. We found 132 deaths among these patients, 5 of which were non-colorectal related deaths. The median survival time for the entire cohort was 3.56 years. A borderline significant difference in survival experience was detected for ethnicity (log rank test, p=0.053). Using Cox proportional hazard modeling, only cancer stage remained significantly associated with time of death in the final model.</p></sec><sec><title>CONCLUSIONS</title><p>Colorectal cancer occurs at a younger age among people living in Golestan province. A very young age at presentation and what appears to be a high proportion of patients presenting with late stage in this area suggest this population might benefit substantially from early diagnoses by introducing age adapted screening programs.</p></sec>
Summary

Citations

Citations to this article as recorded by  
  • Prognostic Factors of Rectal Cancer in Southern Iran
    Seyed Vahid Hosseini, Abbas Rezaianzadeh, Salar Rahimikazerooni, Alimohammad Bananzadeh, Afrouz Farghadin, Mohammad Zare Band Amiry, Ahmad Izadpanah, Mohammad Mohammadianpanah, Sohrab Iranpour
    Journal of Gastrointestinal Cancer.2022; 53(1): 113.     CrossRef
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    Lactatia Motsuku, Wenlong Carl Chen, Mazvita Molleen Muchengeti, Megan Naidoo, Tamlyn Mac Quene, Patricia Kellett, Matshediso Ivy Mohlala, Kathryn M. Chu, Elvira Singh
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    Gholamreza Roshandel, Shahryar Semnani, Abdolreza Fazel, Mohammadreza Honarvar, MohammadHossein Taziki, SeyedMehdi Sedaghat, Nafiseh Abdolahi, Mohammad Ashaari, Mohammad Poorabbasi, Susan Hasanpour, SeyedAhmad Hosseini, SeyedMohsen Mansuri, Ataollah Jahan
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  • Preferences for Colorectal Cancer Screening Tests: Differences Between Insured and Uninsured Beneficiaries of Iranian Health Transformation Plan
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    Health Scope.2018;[Epub]     CrossRef
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