Abstract
Aim
Social inequalities influence population health outcomes and well-being. The aim of the study was to analyze the association between the main demographic, social, and economic determinants and the outcomes related to COVID-19 infection and severity and COVID-19 vaccination.
Subject and methods
A population-based cohort study was carried out including the Navarre (Spain) population aged 15–64 years. The study period was from September 2020–September 2021. We analyzed the association between the main determinants (sex, age range, migrant status, and income level) and COVID-19 infection and related outcomes using logistic regression models.
Results
The study cohort included 431,091 people (49.4% female, median age of 43.0 years, 21.2% migrants, 57.1% with an income <18,000 €). Female individuals showed a significantly higher risk of COVID-19 infection than their male counterparts [adjusted odds ratio (aOR) 1.05, 95% confidence interval (95%CI) 1.04–1.07], but lower Intensive Care Unit (ICU) admission (aOR 0.61, 95%CI 0.49–0.77) and mortality (aOR 0.41, 95%CI 0.28–0.61). People between 61–64 years had a lower risk of COVID-19 infection than people with 15–25 years (aOR 0.32, 95%CI 0.31–0.34), but a higher ICU admission (aOR 39.40, 95%CI 18.19–103.16) and mortality (aOR 301.95, 95%CI 41.03–2222.19). Migrant people showed a higher risk of COVID-19 infection (aOR 1.42, 95%CI 1.39–1.45) and ICU admission (aOR 2.13, 95%CI 1.67–2.72). People with lower income levels had a lower risk of COVID-19 infection (OR 0.90, 95%CI 0.88–0.92) and a higher mortality risk (aOR 3.29, 95%CI 2.16–5.03) compared to non-immigrants.
Conclusion
The study revealed the strong correlation between social determinants and health outcomes.
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Data availability
Only aggregate and anonymized data will be made available upon formal request.
Code availability
Not applicable.
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All authors contributed to the study conception and design. Data extraction was carried out by Javier Gorricho. Data depuration and analysis were performed by Julián Librero. Results were discussed and interpreted by all the authors. The first draft of the manuscript was written by Leire Leache and Marta Gutiérrez-Valencia. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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The study protocol was approved by the Ethics Committee of Navarre (Spain) in June 2022 (PI_2022/50). The information was extracted in an anonymized manner by the BARDENA database managers and processed in accordance with ethical standards and data protection regulations.
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The Ethics Committee of Navarre (Spain) waived the requirement of obtaining informed consent.
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Leache, L., Librero, J., Gutiérrez-Valencia, M. et al. Impact of demographic, social and economic determinants in COVID-19 related outcomes in the middle-aged population of Navarre (Spain). J Public Health (Berl.) (2023). https://doi.org/10.1007/s10389-023-02124-8
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DOI: https://doi.org/10.1007/s10389-023-02124-8