Race, ethnicity, community-level socioeconomic factors, and risk of COVID-19 in the United States and the United Kingdom.
Race, ethnicity, community-level socioeconomic factors, and risk of COVID-19 in the United States and the United Kingdom.
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DOI：
10.1016/j.eclinm.2021.101029
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发表时间：
2021-08
影响因子：
15.1
通讯作者：
COPE Consortium
中科院分区：
文献类型：
--
作者：
Lo CH;Nguyen LH;Drew DA;Warner ET;Joshi AD;Graham MS;Anyane-Yeboa A;Shebl FM;Astley CM;Figueiredo JC;Guo CG;Ma W;Mehta RS;Kwon S;Song M;Davies R;Capdevila J;Sudre CH;Wolf J;Cozier YC;Rosenberg L;Wilkens LR;Haiman CA;Marchand LL;Palmer JR;Spector TD;Ourselin S;Steves CJ;Chan AT;COPE Consortium
关于个人和社区层面的社会经济因素对2019冠状病毒病（COVID-19）个人风险的种族/民族差异的综合影响，之前的调查有限。我们通过COVID Symptom Study智能手机应用程序，对2，102，364名参与者的前瞻性队列进行了横断面分析，这些参与者分别于2020年3月29日在美国（US）和2020年3月24日在英国（UK）至2020年12月2日。我们使用社区贫困指数（NDI）和多重贫困指数（IMD）来研究社区贫困的贡献，以观察COVID-19发病率的种族/民族差异。ClinicalTrials.gov注册号：NCT 04331509。与非西班牙裔白色参与者相比，美国非西班牙裔黑人的COVID-19检测阳性风险增加（多变量校正比值比[OR]，1.32; 95%置信区间[CI]，1.18-1.47）和西班牙裔受试者（OR，1.42; 95% CI，1.33-1.52）和英国黑人（OR，1.17; 95%CI，1.02-1.34），南亚（OR，1.39; 95%CI，1.30-1.49）和中东参与者（OR，1.38; 95%CI，1.18-1.61）。根据NDI/IMD，这种高风险与生活在更贫困的社区有关。在考虑COVID-19风险的下游介质后，与美国和英国的白色参与者相比，社区水平的剥夺仍然分别介导了黑人16.6%和7.7%的超额风险。我们的研究结果说明了健康的社会决定因素在种族和少数民族经历的不成比例的COVID-19风险中的关键作用。
There is limited prior investigation of the combined influence of personal and community-level socioeconomic factors on racial/ethnic disparities in individual risk of coronavirus disease 2019 (COVID-19). We performed a cross-sectional analysis nested within a prospective cohort of 2,102,364 participants from March 29, 2020 in the United States (US) and March 24, 2020 in the United Kingdom (UK) through December 02, 2020 via the COVID Symptom Study smartphone application. We examined the contribution of community-level deprivation using the Neighborhood Deprivation Index (NDI) and the Index of Multiple Deprivation (IMD) to observe racial/ethnic disparities in COVID-19 incidence. ClinicalTrials.gov registration: NCT04331509. Compared with non-Hispanic White participants, the risk for a positive COVID-19 test was increased in the US for non-Hispanic Black (multivariable-adjusted odds ratio [OR], 1.32; 95% confidence interval [CI], 1.18–1.47) and Hispanic participants (OR, 1.42; 95% CI, 1.33–1.52) and in the UK for Black (OR, 1.17; 95% CI, 1.02–1.34), South Asian (OR, 1.39; 95% CI, 1.30–1.49), and Middle Eastern participants (OR, 1.38; 95% CI, 1.18–1.61). This elevated risk was associated with living in more deprived communities according to the NDI/IMD. After accounting for downstream mediators of COVID-19 risk, community-level deprivation still mediated 16.6% and 7.7% of the excess risk in Black compared to White participants in the US and the UK, respectively. Our results illustrate the critical role of social determinants of health in the disproportionate COVID-19 risk experienced by racial and ethnic minorities.
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影响因子：
15.8
作者：
Seligman B;Ferranna M;Bloom DE
通讯作者：
Bloom DE
影响因子：
2.1
作者：
Iceland, John;Mateos, Pablo;Sharp, Gregory
通讯作者：
Sharp, Gregory
影响因子：
5.2
作者：
Hatef E;Chang HY;Kitchen C;Weiner JP;Kharrazi H
通讯作者：
Kharrazi H
影响因子：
7.4
作者：
Jones, Jeb;Sullivan, Patrick S.;Siegler, Aaron J.
通讯作者：
Siegler, Aaron J.
影响因子：
5.2
作者：
Lee SF;Nikšić M;Rachet B;Sanchez MJ;Luque-Fernandez MA
通讯作者：
Luque-Fernandez MA