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

Frontiers in Medicine

article

Dae-sung Yoo¹  Minji Hwang¹  Byung Chul Chun¹  Su Jin Kim⁵  Mia Son⁶  Nam-Kyu Seo⁷  Myung Ki¹ 

[1] Department of Public Health, Korea University Graduate School;Veterinary Epidemiology Division;BK21FOUR R&E Center for Learning Health Systems, Korea University;Department of Preventive Medicine, College of Medicine, Korea University;Department of Emergency Medicine, College of Medicine, Korea University;Department of Preventive Medicine, School of Medicine, Kangwon National University;Department of Non-Benefits Management, National Health Insurance Service/Health Insurance Policy Research Institute

关键词: COVID-19;    inequality;    mobility;    SARS-CoV2;    social distancing;    socioeconomic;    spatial analyses;   

DOI  :  10.3389/fmed.2022.840685

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

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 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.

【 授权许可】

CC BY