How does vulnerability to COVID-19 vary between communities in England? Developing a Small Area Vulnerability Index (SAVI).
How does vulnerability to COVID-19 vary between communities in England? Developing a Small Area Vulnerability Index (SAVI).
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DOI：
10.1136/jech-2020-215227
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发表时间：
2021-08
影响因子：
6.3
通讯作者：
Barr B
中科院分区：
文献类型：
--
作者：
Daras K;Alexiou A;Rose TC;Buchan I;Taylor-Robinson D;Barr B
在英格兰COVID-19流行的最初一波期间，一些人口特征与死亡风险增加有关，包括年龄、种族、收入剥夺、养老院居住和住房条件。为了有针对性地采取控制措施并为未来的流行病浪潮做出计划，公共卫生机构需要了解这些脆弱性是如何在社区内分布和聚集的。我们对英国6789个小区域进行了横断面生态分析。我们评估了每个地区COVID-19死亡率与五项脆弱性指标之间的关系，这些指标涉及种族、贫困、长期健康状况的普遍程度、居住在养老院和居住在过度拥挤的住房中。利用多变量泊松回归模型的估计得到小区域脆弱性指数。四项脆弱性指标与年龄调整后的COVID-19死亡率独立相关。(1)住在养老院、(2)过去5年因长期健康状况住院的人口比例、(3)少数民族背景和(4)居住在过度拥挤的住房中的人口比例每增加一个SD，年龄调整后的COVID-19死亡率分别增加28%、19%、8%和11%。西北、西米德兰兹和东北地区对COVID-19的脆弱性明显更高，一些社区聚集了高度脆弱性。我们的分析表明，受第二波大流行影响最大的社区。
During the initial wave of the COVID-19 epidemic in England, several population characteristics were associated with increased risk of mortality—including, age, ethnicity, income deprivation, care home residence and housing conditions. In order to target control measures and plan for future waves of the epidemic, public health agencies need to understand how these vulnerabilities are distributed across and clustered within communities. We performed a cross-sectional ecological analysis across 6789 small areas in England. We assessed the association between COVID-19 mortality in each area and five vulnerability measures relating to ethnicity, poverty, prevalence of long-term health conditions, living in care homes and living in overcrowded housing. Estimates from multivariable Poisson regression models were used to derive a Small Area Vulnerability Index. Four vulnerability measures were independently associated with age-adjusted COVID-19 mortality. Each SD increase in the proportion of the population (1) living in care homes, (2) admitted to hospital in the past 5 years for a long-term health condition, (3) from an ethnic minority background and (4) living in overcrowded housing was associated with a 28%, 19% 8% and 11% increase in age-adjusted COVID-19 mortality rate, respectively. Vulnerability to COVID-19 was noticeably higher in the North West, West Midlands and North East regions, with high levels of vulnerability clustered in some communities. Our analysis indicates the communities who will be most at risk from a second wave of the pandemic.
影响因子：
6.3
作者：
Allik, Mirjam;Leyland, Alastair;Dundas, Ruth
通讯作者：
Dundas, Ruth
影响因子：
4.2
作者：
Noble, M;Wright, G;Dibben, C
通讯作者：
Dibben, C