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Socioeconomic Inequalities in COVID-19 Incidence During Different Epidemic Phases in South Korea

OBJECTIVE: Area-level socioeconomic status (SES) is associated with coronavirus disease 2019 (COVID-19) incidence. However, the underlying mechanism of the association is context-specific, and the choice of measure is still important. We aimed to evaluate the socioeconomic gradient regarding COVID-1...

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Autores principales: Yoo, Dae-sung, Hwang, Minji, Chun, Byung Chul, Kim, Su Jin, Son, Mia, Seo, Nam-Kyu, Ki, Myung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8957264/
https://www.ncbi.nlm.nih.gov/pubmed/35345769
http://dx.doi.org/10.3389/fmed.2022.840685
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author Yoo, Dae-sung
Hwang, Minji
Chun, Byung Chul
Kim, Su Jin
Son, Mia
Seo, Nam-Kyu
Ki, Myung
author_facet Yoo, Dae-sung
Hwang, Minji
Chun, Byung Chul
Kim, Su Jin
Son, Mia
Seo, Nam-Kyu
Ki, Myung
author_sort Yoo, Dae-sung
collection PubMed
description OBJECTIVE: Area-level socioeconomic status (SES) is associated with coronavirus disease 2019 (COVID-19) incidence. However, the underlying mechanism of the association is context-specific, and the choice of measure is still important. We aimed to evaluate the socioeconomic gradient regarding COVID-19 incidence in Korea based on several area-level SES measures. METHODS: COVID-19 incidence and area-level SES measures across 229 Korean municipalities were derived from various administrative regional data collected between 2015 and 2020. The Bayesian negative binomial model with a spatial autocorrelation term was used to estimate the incidence rate ratio (IRR) and relative index of inequality (RII) of each SES factor, with adjustment for covariates. The magnitude of association was compared between two epidemic phases: a low phase (<100 daily cases, from May 6 to August 14, 2020) and a rebound phase (>100 daily cases, from August 15 to December 31, 2020). RESULTS: Area-level socioeconomic inequalities in COVID-19 incidence between the most disadvantaged region and the least disadvantaged region were observed for nonemployment rates [RII = 1.40, 95% credible interval (Crl) = 1.01–1.95] and basic livelihood security recipients (RII = 2.66, 95% Crl = 1.12–5.97), but were not observed for other measures in the low phase. However, the magnitude of the inequalities of these SES variables diminished in the rebound phase. A higher area-level mobility showed a higher risk of COVID-19 incidence in both the low (IRR = 1.67, 95% Crl = 1.26–2.17) and rebound phases (IRR = 1.28, 95% Crl = 1.14–1.44). When SES and mobility measures were simultaneously adjusted, the association of SES with COVID-19 incidence remained significant but only in the low phase, indicating they were mutually independent in the low phase. CONCLUSION: The level of basic livelihood benefit recipients and nonemployment rate showed social stratification of COVID-19 incidence in Korea. Explanation of area-level inequalities in COVID-19 incidence may not be derived only from mobility differences in Korea but, instead, from the country's own context.
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spelling pubmed-89572642022-03-27 Socioeconomic Inequalities in COVID-19 Incidence During Different Epidemic Phases in South Korea Yoo, Dae-sung Hwang, Minji Chun, Byung Chul Kim, Su Jin Son, Mia Seo, Nam-Kyu Ki, Myung Front Med (Lausanne) Medicine OBJECTIVE: Area-level socioeconomic status (SES) is associated with coronavirus disease 2019 (COVID-19) incidence. However, the underlying mechanism of the association is context-specific, and the choice of measure is still important. We aimed to evaluate the socioeconomic gradient regarding COVID-19 incidence in Korea based on several area-level SES measures. METHODS: COVID-19 incidence and area-level SES measures across 229 Korean municipalities were derived from various administrative regional data collected between 2015 and 2020. The Bayesian negative binomial model with a spatial autocorrelation term was used to estimate the incidence rate ratio (IRR) and relative index of inequality (RII) of each SES factor, with adjustment for covariates. The magnitude of association was compared between two epidemic phases: a low phase (<100 daily cases, from May 6 to August 14, 2020) and a rebound phase (>100 daily cases, from August 15 to December 31, 2020). RESULTS: Area-level socioeconomic inequalities in COVID-19 incidence between the most disadvantaged region and the least disadvantaged region were observed for nonemployment rates [RII = 1.40, 95% credible interval (Crl) = 1.01–1.95] and basic livelihood security recipients (RII = 2.66, 95% Crl = 1.12–5.97), but were not observed for other measures in the low phase. However, the magnitude of the inequalities of these SES variables diminished in the rebound phase. A higher area-level mobility showed a higher risk of COVID-19 incidence in both the low (IRR = 1.67, 95% Crl = 1.26–2.17) and rebound phases (IRR = 1.28, 95% Crl = 1.14–1.44). When SES and mobility measures were simultaneously adjusted, the association of SES with COVID-19 incidence remained significant but only in the low phase, indicating they were mutually independent in the low phase. CONCLUSION: The level of basic livelihood benefit recipients and nonemployment rate showed social stratification of COVID-19 incidence in Korea. Explanation of area-level inequalities in COVID-19 incidence may not be derived only from mobility differences in Korea but, instead, from the country's own context. Frontiers Media S.A. 2022-03-08 /pmc/articles/PMC8957264/ /pubmed/35345769 http://dx.doi.org/10.3389/fmed.2022.840685 Text en Copyright © 2022 Yoo, Hwang, Chun, Kim, Son, Seo and Ki. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Yoo, Dae-sung
Hwang, Minji
Chun, Byung Chul
Kim, Su Jin
Son, Mia
Seo, Nam-Kyu
Ki, Myung
Socioeconomic Inequalities in COVID-19 Incidence During Different Epidemic Phases in South Korea
title Socioeconomic Inequalities in COVID-19 Incidence During Different Epidemic Phases in South Korea
title_full Socioeconomic Inequalities in COVID-19 Incidence During Different Epidemic Phases in South Korea
title_fullStr Socioeconomic Inequalities in COVID-19 Incidence During Different Epidemic Phases in South Korea
title_full_unstemmed Socioeconomic Inequalities in COVID-19 Incidence During Different Epidemic Phases in South Korea
title_short Socioeconomic Inequalities in COVID-19 Incidence During Different Epidemic Phases in South Korea
title_sort socioeconomic inequalities in covid-19 incidence during different epidemic phases in south korea
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8957264/
https://www.ncbi.nlm.nih.gov/pubmed/35345769
http://dx.doi.org/10.3389/fmed.2022.840685
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