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Original Article Effect of socioeconomic disparities on the risk of COVID-19 in 8 metropolitan cities in the Korea: a community-based study
Myung-Jae Hwang1orcid , Shin Young Park1orcid , Tae-Ho Yoon2orcid , Jinhwa Jang1orcid , Seon-Young Lee1orcid , Myeongsu Yoo1orcid , Yoo-Yeon Kim1orcid , Hae-Kwan Cheong3orcid , Donghyok Kwon1orcid , Jong-Hun Kim3orcid
Epidemiol Health 2022;44e2022107-0
DOI: https://doi.org/10.4178/epih.e2022107
Published online: November 15, 2022
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1Division of Public Health Emergency Response Research, Korea Disease Control and Prevention Agency, Cheongju, Korea
2Department of Preventive Medicine, Pusan National University School of Medicine, Busan, Korea
3Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
Corresponding author:  Donghyok Kwon,
Email: vethyok@korea.kr
Jong-Hun Kim,
Email: kimjh32@skku.edu
Received: 13 May 2022   • Accepted: 15 November 2022

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.

Epidemiol Health : Epidemiology and Health