Socioeconomic inequalities in the spread of coronavirus-19 in the United States: A examination of the emergence of social inequalities.
Socioeconomic inequalities in the spread of coronavirus-19 in the United States: A examination of the emergence of social inequalities.
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DOI：
10.1016/j.socscimed.2020.113554
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
Link BG
中科院分区：
文献类型：
--
作者：
Clouston SAP;Natale G;Link BG
量化社会经济地位在预测新冠肺炎病例和死亡分布中的贡献差异。分析使用了所有县最初感染浪潮中每天COVID+病例计数的发病率数据，与美国人口普查数据合并，以衡量县级SES和混杂因素。多变量分析依赖于生存分析和泊松回归来检查县级指标病例以及新冠肺炎在感染县的发病率和死亡率的时间，以检查新冠肺炎的传播和严重程度，同时调整黑人种族、西班牙裔民族、年龄、性别和城市化程度。考察了社会距离参数对影响的调节作用。结果表明，较高的社会经济地位与较早的指标性病例发病率有关，但随着社会距离的发生，社会经济地位的不平等反转，因此在社会经济地位较高的县，发病率增长较慢，病死率较低。这项研究是迄今为止首次表明，当一种可能影响任何人的机会主义疾病遇到美国的不平等制度，并受到其强有力的塑造时，会发生什么。
To quantify the contribution variation in socioeconomic status in predicting the distribution of COVID-19 cases and deaths. Analyses used incidence data on daily COVID + case counts from all counties from the initial wave of infections, merged with data from the U.S. census data to measure county-level SES and confounders. Multivariable analyses relied on survival analyses and Poisson regression to examine timing of county-level index cases and of COVID-19 incidence and mortality in infected counties to examine the spread and severity of COVID-19 while adjusting for adjusted for Black race, Hispanic ethnicity, age, gender, and urbanicity. Effect moderation by social distancing parameters was examined. Results indicate that higher SES was associated with earlier incidence of index cases, but that as social distancing took place inequalities in SES inverted so that growth in incidence was slower in higher SES counties, where case-fatality rates were lower. This study is the first to date to show what happens when an opportunistic disease that could affect anyone meets the American system of inequality and is powerfully shaped by it.
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