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Social and Policy Determinants of COVID-19 Infection Across 23 Countries: An Ecological Study

OBJECTIVES: This study aimed to identify the social and policy determinants of coronavirus disease 2019 (COVID-19) infection across 23 countries. METHODS: COVID-19 indicators (incidence, mortality, and fatality) for each country were calculated by direct and indirect standardization. Multivariable r...

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Autores principales: Kim, Kyungsik, Jeung, Young-Do, Choi, Jeoungbin, Park, Sue K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society for Preventive Medicine 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8995935/
https://www.ncbi.nlm.nih.gov/pubmed/35391526
http://dx.doi.org/10.3961/jpmph.21.396
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author Kim, Kyungsik
Jeung, Young-Do
Choi, Jeoungbin
Park, Sue K.
author_facet Kim, Kyungsik
Jeung, Young-Do
Choi, Jeoungbin
Park, Sue K.
author_sort Kim, Kyungsik
collection PubMed
description OBJECTIVES: This study aimed to identify the social and policy determinants of coronavirus disease 2019 (COVID-19) infection across 23 countries. METHODS: COVID-19 indicators (incidence, mortality, and fatality) for each country were calculated by direct and indirect standardization. Multivariable regression analyses were used to identify the social and policy determinants of COVID-19 infection. RESULTS: A higher number of doctors per population was related to lower incidence, mortality, and fatality rates of COVID-19 in 23 countries (β=−0.672, −0.445, and −0.564, respectively). The number of nurses/midwives per population was associated with lower mortality and fatality rates of COVID-19 in 23 countries (β=−0.215 and −0.372, respectively). Strengthening of policy restriction indicators, such as restrictions of public gatherings, was related to lower COVID-19 incidence (β=−0.423). A national Bacillus Calmette–Guérin vaccination policy conducted among special groups or in the past was associated with a higher incidence of COVID-19 in 23 countries (β=0.341). The proportion of the elderly population (aged over 70 years) was related to higher mortality and fatality rates (β=0.209 and 0.350, respectively), and income support was associated with mortality and fatality rates (β=−0.362 and −0.449, respectively). CONCLUSIONS: These findings do not imply causality because this was a country-based correlation study. However, COVID-19 transmission can be influenced by social and policy determinants such as integrated health systems and policy responses to COVID-19. Various social and policy determinants should be considered when planning responses to COVID-19.
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spelling pubmed-89959352022-04-20 Social and Policy Determinants of COVID-19 Infection Across 23 Countries: An Ecological Study Kim, Kyungsik Jeung, Young-Do Choi, Jeoungbin Park, Sue K. J Prev Med Public Health Original Article OBJECTIVES: This study aimed to identify the social and policy determinants of coronavirus disease 2019 (COVID-19) infection across 23 countries. METHODS: COVID-19 indicators (incidence, mortality, and fatality) for each country were calculated by direct and indirect standardization. Multivariable regression analyses were used to identify the social and policy determinants of COVID-19 infection. RESULTS: A higher number of doctors per population was related to lower incidence, mortality, and fatality rates of COVID-19 in 23 countries (β=−0.672, −0.445, and −0.564, respectively). The number of nurses/midwives per population was associated with lower mortality and fatality rates of COVID-19 in 23 countries (β=−0.215 and −0.372, respectively). Strengthening of policy restriction indicators, such as restrictions of public gatherings, was related to lower COVID-19 incidence (β=−0.423). A national Bacillus Calmette–Guérin vaccination policy conducted among special groups or in the past was associated with a higher incidence of COVID-19 in 23 countries (β=0.341). The proportion of the elderly population (aged over 70 years) was related to higher mortality and fatality rates (β=0.209 and 0.350, respectively), and income support was associated with mortality and fatality rates (β=−0.362 and −0.449, respectively). CONCLUSIONS: These findings do not imply causality because this was a country-based correlation study. However, COVID-19 transmission can be influenced by social and policy determinants such as integrated health systems and policy responses to COVID-19. Various social and policy determinants should be considered when planning responses to COVID-19. Korean Society for Preventive Medicine 2022-03 2022-02-10 /pmc/articles/PMC8995935/ /pubmed/35391526 http://dx.doi.org/10.3961/jpmph.21.396 Text en Copyright © 2022 The Korean Society for Preventive Medicine https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Kyungsik
Jeung, Young-Do
Choi, Jeoungbin
Park, Sue K.
Social and Policy Determinants of COVID-19 Infection Across 23 Countries: An Ecological Study
title Social and Policy Determinants of COVID-19 Infection Across 23 Countries: An Ecological Study
title_full Social and Policy Determinants of COVID-19 Infection Across 23 Countries: An Ecological Study
title_fullStr Social and Policy Determinants of COVID-19 Infection Across 23 Countries: An Ecological Study
title_full_unstemmed Social and Policy Determinants of COVID-19 Infection Across 23 Countries: An Ecological Study
title_short Social and Policy Determinants of COVID-19 Infection Across 23 Countries: An Ecological Study
title_sort social and policy determinants of covid-19 infection across 23 countries: an ecological study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8995935/
https://www.ncbi.nlm.nih.gov/pubmed/35391526
http://dx.doi.org/10.3961/jpmph.21.396
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