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Epidemiology and Health 2022;e2022107.
DOI: https://doi.org/10.4178/epih.e2022107    [Accepted] Published online Nov 15, 2022.
Effect of socioeconomic disparities on the risk of COVID-19 in eight metropolitan cities, the Republic of Korea: a community-based study
Myung-Jae Hwang1  , Shin Young Park1  , Tae-Ho Yoon2  , Jinhwa Jang1  , Seon-Young Lee1  , Myeongsu Yoo1  , Yoo-Yeon Kim1  , Hae-Kwan Cheong3  , Donghyok Kwon1  , Jong-Hun Kim3 
1Division of Public Health Emergency Response Research, Korea Disease Control and Prevention Agency, Cheongju, Korea
2Department of Preventive and Occupational and Environmental Medicine, Medical College, Pusan National University, Busan, Korea
3Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
Correspondence  Donghyok Kwon ,Email: kimjh32@skku.edu
Jong-Hun Kim ,Email: kimjh32@skku.edu
Received: May 13, 2022  Accepted after revision: Nov 15, 2022
Socioeconomic disparities have been reported as the main risk factors contributing to the spread of coronavirus disease 2019 (COVID-19) at the community level. We conducted an epidemiological study on the risk of COVID-19 incidence using area deprivation indices (DIs) depending on the characteristics of the susceptible population.
The database of the confirmed COVID-19 cases in eight metropolitan cities, the Republic of Korea, from January 20, 2020 to December 31, 2021, was combined with the area DIs and standardized prevalence of diabetes and hypertension from the community health survey. The relative risk (RR) was estimated using a generalized linear model with Poisson distribution by age group.
The risk of COVID-19 incidence increased with the increasing age group, especially in patients aged ≥75 years. The RR per interquartile range increment of total social deprivation index (total SDI) was 1.54 (95% confidence interval [CI]: 1.34–1.70) in the COVID-19 incidence. Especially, the risk of COVID-19 incidence in the first wave was about three times higher in the region belonging to the lowest socioeconomic status than in the region with the highest socioeconomic status. The risk was 3.08 (95% CI: 2.42 to 3.78) based on the total SDI and 3.13 (95% CI: 2.53 to 3.83) based on the social deprivation index.
This study provides scientific evidence that socioeconomic inequity is an important risk factor for the spread of COVID-19. This finding suggests that a mid-to-long-term strategy is needed for the susceptible population to reduce the burden of COVID-19 in the community.
Keywords: COVID-19; Socioeconomic disparity; Area deprivation index; Community; Republic of Korea
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