Deprivation and Exposure to Public Activities during the COVID-19 Pandemic in England and Wales
Deprivation and Exposure to Public Activities during the COVID-19 Pandemic in England and Wales
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英格兰和威尔士 COVID-19 大流行期间公共活动的剥夺和暴露
DOI：
10.1101/2021.04.26.21255732
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Beale S
中科院分区：
文献类型：
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作者：
Beale S
背景不同的公共活动暴露可能会导致SARS-CoV-2感染和结果中明显的剥夺相关的不平等，但尚未直接调查。我们着手调查病毒观察-一项位于英格兰和威尔士的大型社区队列研究-的参与者是否报告了根据邮政编码水平的社会经济剥夺在2019冠状病毒病大流行的秋冬阶段对公共活动和非家庭接触的不同暴露。（调查中，人数为20 120-25 228人）在2020年11月下旬、2020年12月下旬及2021年2月中旬的3个每周时段内汇报日常活动。根据参与者的居住地邮政编码，使用英语或威尔士多重残疾五分位数指数对残疾进行量化。我们使用泊松混合效应模型与强大的标准误估计之间的关系剥夺和风险暴露于公共活动在每个调查periods.ResultsRelative参与者在最贫困的地区，参与者在最贫困的地区表现出较高的风险暴露于车辆共享（各时间点的调整风险比（aRR）范围：1.73-8.52），公共交通（aRR：3.13-5.73）、外出工作或接受教育（aRR：1.09-1.21），基本商店（aRR：1.09-1.13）和非家庭接触者（a）经常资源：结论不同的暴露于必要的公共活动，如参加工作场所和参观必要的商店，可能会导致感染风险和结果的不平等。采取公共卫生干预措施，减少基本活动期间的接触，并提供财政和实际支助，使低收入工人能够在传播高峰期呆在家里，这可能会减少与新冠肺炎有关的不平等。
BackgroundDifferential exposure to public activities may contribute to stark deprivation-related inequalities in SARS-CoV-2 infection and outcomes but has not been directly investigated. We set out to investigate whether participants in Virus Watch—a large community cohort study based in England and Wales—reported differential exposure to public activities and non-household contacts during the autumn–winter phase of the COVID-19 pandemic according to postcode-level socioeconomic deprivation.MethodsParticipants (n=20 120–25 228 across surveys) reported their daily activities during 3 weekly periods in late November 2020, late December 2020 and mid-February 2021. Deprivation was quantified based on participants’ residential postcode using English or Welsh Index of Multiple Deprivation quintiles. We used Poisson mixed-effect models with robust standard errors to estimate the relationship between deprivation and risk of exposure to public activities during each survey period.ResultsRelative to participants in the least deprived areas, participants in the most deprived areas exhibited elevated risk of exposure to vehicle sharing (adjusted risk ratio (aRR) range across time points: 1.73–8.52), public transport (aRR: 3.13–5.73), work or education outside of the household (aRR: 1.09–1.21), essential shops (aRR: 1.09–1.13) and non-household contacts (aRR: 1.15–1.19) across multiple survey periods.ConclusionDifferential exposure to essential public activities—such as attending workplaces and visiting essential shops—is likely to contribute to inequalities in infection risk and outcomes. Public health interventions to reduce exposure during essential activities and financial and practical support to enable low-paid workers to stay at home during periods of intense transmission may reduce COVID-related inequalities.