Religious affiliation and COVID-19-related mortality: a retrospective cohort study of prelockdown and postlockdown risks in England and Wales
Religious affiliation and COVID-19-related mortality: a retrospective cohort study of prelockdown and postlockdown risks in England and Wales
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DOI：
10.1136/jech-2020-215694
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发表时间：
2021-06-01
影响因子：
6.3
通讯作者：
Bannister, Neil
中科院分区：
文献类型：
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作者：
Gaughan, Charlotte Hannah;Ayoubkhani, Daniel;Bannister, Neil
背景COVID-19死亡风险与人口和行为因素有关;此外，宗教集会与COVID-19的传播有关。我们试图了解英格兰和威尔士宗教团体在首次全国封锁前后COVID-19相关死亡风险的变化。方法我们对2011年人口普查中枚举的英格兰和威尔士常住居民（n=47 873 294，估计应答率94%）进行了一项回顾性队列研究，使用关联死亡证明评估涉及COVID-19的死亡风险。估计考克斯回归模型比较宗教群体之间的风险。将时间依赖系数添加到模型中，允许单独估计锁定期之前和之后的HR。结果与基督徒相比，所有宗教群体的COVID-19死亡风险均升高;穆斯林和犹太男性的年龄调整HR最大，分别为2.5（95%CI 2.3至2.7）和2.1（95%CI 1.9至2.5）。穆斯林和犹太女性的相应HR分别为1.9（95% CI 1.7至2.1）和1.5（95% CI 1.7至2.1）。两组之间的风险差异在封锁后缩小。那些没有宗教信仰的人在封锁前后与COVID-19相关的死亡风险最低。结论COVID-19死亡风险的大部分变化可以通过控制社会人口统计学和地理决定因素来解释;然而，与所有其他群体相比，犹太人的死亡风险仍然较高。封锁措施与宗教团体之间COVID-19死亡率差异的减少有关;需要进一步研究以了解因果机制。
Background COVID-19 mortality risk is associated with demographic and behavioural factors; furthermore, religious gatherings have been linked with the spread of COVID-19. We sought to understand the variation in risk of COVID-19-related death across religious groups in England and Wales both before and after the first national lockdown. Methods We conducted a retrospective cohort study of usual residents in England and Wales enumerated at the 2011 Census (n=47 873 294, estimated response rate 94%) for risk of death involving COVID-19 using linked death certificates. Cox regression models were estimated to compare risks between religious groups. Time-dependent coefficients were added to the model allowing HRs before and after lockdown period to be estimated separately. Results Compared with Christians, all religious groups had an elevated risk of death involving COVID-19; the largest age-adjusted HRs were for Muslim and Jewish males at 2.5 (95% CI 2.3 to 2.7) and 2.1 (95% CI 1.9 to 2.5), respectively. The corresponding HRs for Muslim and Jewish females were 1.9 (95% CI 1.7 to 2.1) and 1.5 (95% CI 1.7 to 2.1), respectively. The difference in risk between groups contracted after lockdown. Those who affiliated with no religion had the lowest risk of COVID-19-related death before and after lockdown. Conclusion The majority of the variation in COVID-19 mortality risk was explained by controlling for sociodemographic and geographic determinants; however, those of Jewish affiliation remained at a higher risk of death compared with all other groups. Lockdown measures were associated with reduced differences in COVID-19 mortality rates between religious groups; further research is required to understand the causal mechanisms.