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Explaining the deprivation gap in COVID-19 mortality rates: A decomposition analysis of geographical inequalities in England

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  • Albani, Viviana
  • Welsh, Claire E.
  • Brown, Heather
  • Matthews, Fiona E.
  • Bambra, Clare

Abstract

One of the most consistent and worrying features of the COVID-19 pandemic globally has been the disproportionate burden of the epidemic in the most deprived areas. Most of the literature so far though has focused on estimating the extent of these inequalities. There has been much less attention paid to exploring the main pathways underpinning them. In this study, we employ the syndemic pandemic theoretical framework and apply novel decomposition methods to investigate the proportion of the COVID-19 mortality gap by area-level deprivation in England during the first wave of the pandemic (January to July 2020) was accounted for by pre-existing inequalities in the compositional and contextual characteristics of place. We use a decomposition approach to explicitly quantify the independent contribution of four inequalities pathways (vulnerability, susceptibility, exposure and transmission) in explaining the more severe COVID-19 outcomes in the most deprived local authorities compared to the rest. We find that inequalities in transmission (73%) and in vulnerability (49%) factors explained the highest proportion of mortality by deprivation. Our results suggest that public health agencies need to develop short- and long-term strategies to alleviate these underlying inequalities in order to alleviate the more severe impacts on the most vulnerable communities.

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  • Albani, Viviana & Welsh, Claire E. & Brown, Heather & Matthews, Fiona E. & Bambra, Clare, 2022. "Explaining the deprivation gap in COVID-19 mortality rates: A decomposition analysis of geographical inequalities in England," Social Science & Medicine, Elsevier, vol. 311(C).
    • Handle: RePEc:eee:socmed:v:311:y:2022:i:c:s0277953622006256
    DOI: 10.1016/j.socscimed.2022.115319
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    1. André Decoster & Thomas Minten & Johannes Spinnewijn, 2021. "The Income Gradient in Mortality during the Covid-19 Crisis: Evidence from Belgium," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 19(3), pages 551-570, September.
    2. Clouston, Sean A.P. & Natale, Ginny & Link, Bruce G., 2021. "Socioeconomic inequalities in the spread of coronavirus-19 in the United States: A examination of the emergence of social inequalities," Social Science & Medicine, Elsevier, vol. 268(C).
    3. Klaus Desmet & Romain Wacziarg, 2020. "Understanding Spatial Variation in COVID-19 across the United States," NBER Working Papers 27329, National Bureau of Economic Research, Inc.
    4. Michael Fletcher & Kate C. Prickett & Simon Chapple, 2022. "Immediate employment and income impacts of Covid-19 in New Zealand: evidence from a survey conducted during the Alert Level 4 lockdown," New Zealand Economic Papers, Taylor & Francis Journals, vol. 56(1), pages 73-80, January.
    5. Ulrich Kohler & Kristian Bernt Karlson & Anders Holm, 2011. "Comparing coefficients of nested nonlinear probability models," Stata Journal, StataCorp LP, vol. 11(3), pages 420-438, September.
    6. Serina Chang & Emma Pierson & Pang Wei Koh & Jaline Gerardin & Beth Redbird & David Grusky & Jure Leskovec, 2021. "Mobility network models of COVID-19 explain inequities and inform reopening," Nature, Nature, vol. 589(7840), pages 82-87, January.
    7. Persico, Claudia L. & Johnson, Kathryn R., 2021. "The effects of increased pollution on COVID-19 cases and deaths," Journal of Environmental Economics and Management, Elsevier, vol. 107(C).
    8. Brandily, Paul & Brébion, Clément & Briole, Simon & Khoury, Laura, 2021. "A poorly understood disease? The impact of COVID-19 on the income gradient in mortality over the course of the pandemic," European Economic Review, Elsevier, vol. 140(C).
    9. Lowcock, E.C. & Rosella, L.C. & Foisy, J. & McGeer, A. & Crowcroft, N., 2012. "The social determinants of health and pandemic h1n1 2009 influenza severity," American Journal of Public Health, American Public Health Association, vol. 102(8), pages 51-58.
    10. Macintyre, Sally & Ellaway, Anne & Cummins, Steven, 2002. "Place effects on health: how can we conceptualise, operationalise and measure them?," Social Science & Medicine, Elsevier, vol. 55(1), pages 125-139, July.
    11. Mikolai, Julia & Keenan, Katherine & Kulu, Hill, 2020. "Household level health and socio-economic vulnerabilities and the COVID-19 crisis: An analysis from the UK," SocArXiv 4wtz8, Center for Open Science.
    12. Paul Rutter & Oliver Mytton & Matthew Mak & Liam Donaldson, 2012. "Socio-economic disparities in mortality due to pandemic influenza in England," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 57(4), pages 745-750, August.
    13. Morrissey, Karyn & Spooner, Fiona & Salter, James & Shaddick, Gavin, 2021. "Area level deprivation and monthly COVID-19 cases: The impact of government policy in England," Social Science & Medicine, Elsevier, vol. 289(C).
    14. Bambra, Clare & Smith, Katherine E. & Pearce, Jamie, 2019. "Scaling up: The politics of health and place," Social Science & Medicine, Elsevier, vol. 232(C), pages 36-42.
    15. Ruck, Damian J. & Bentley, R. Alexander & Borycz, Joshua, 2021. "Early warning of vulnerable counties in a pandemic using socio-economic variables," Economics & Human Biology, Elsevier, vol. 41(C).
    16. Menon, Nidhiya, 2021. "Does BMI predict the early spatial variation and intensity of Covid-19 in developing countries? Evidence from India," Economics & Human Biology, Elsevier, vol. 41(C).
    17. Jung, Juergen & Manley, James & Shrestha, Vinish, 2021. "Coronavirus infections and deaths by poverty status: The effects of social distancing," Journal of Economic Behavior & Organization, Elsevier, vol. 182(C), pages 311-330.
    18. Ulrich Kohler, 2011. "Comparing coefficients between nested nonlinear probability models," German Stata Users' Group Meetings 2011 08, Stata Users Group.
    19. Asher, Twisha & Deb, Partha & Gangaram, Anjelica, 2021. "Nursing facilities, food manufacturing plants and COVID-19 cases and deaths," Economics Letters, Elsevier, vol. 201(C).
    20. Elliott, Susan J., 2018. "50 years of medical health geography(ies) of health and wellbeing," Social Science & Medicine, Elsevier, vol. 196(C), pages 206-208.
    21. Cummins, Steven & Curtis, Sarah & Diez-Roux, Ana V. & Macintyre, Sally, 2007. "Understanding and representing 'place' in health research: A relational approach," Social Science & Medicine, Elsevier, vol. 65(9), pages 1825-1838, November.
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    Cited by:

    1. Devlin, Anne & Whelan, Adele & McGuinness, Seamus, 2024. "COVID-19 infection rates and social disadvantage in Ireland: An area-level analysis," Research Series, Economic and Social Research Institute (ESRI), number RS187.
    2. Mikolai, Júlia & Dorey, Peter & Keenan, Katherine & Kulu, Hill, 2023. "Spatial patterns of COVID-19 and non-COVID-19 mortality across waves of infection in England, Wales, and Scotland," Social Science & Medicine, Elsevier, vol. 338(C).

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