Multi-level policy responses to tackle socioeconomic inequalities in the incidence of COVID-19 in a European urban area
Malmusi, Davide (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Pasarín, M. Isabel (Institut d'Investigació Biomèdica Sant Pau)
Marí-Dell'Olmo, Marc 1978- (Institut d'Investigació Biomèdica Sant Pau)
Artazcoz, Lucía 1963- (Institut d'Investigació Biomèdica Sant Pau)
Diez, Elia (Institut d'Investigació Biomèdica Sant Pau)
Tolosa, Sara (Agència de Salut Pública de Barcelona)
Rodríguez-Sanz, Maica (Institut d'Investigació Biomèdica Sant Pau)
Pérez Albarracín, Glòria (Institut d'Investigació Biomèdica Sant Pau)
Peña-Gallardo, C. (Consorci Sanitari de Barcelona)
Borrell i Thió, Carme (Institut d'Investigació Biomèdica Sant Pau)

Data:	2022
Resum:	Background: Spain has been hit hard by COVID-19 since March 2020, especially in its metropolitan areas. We share experiences from Barcelona in measuring socioeconomic inequalities in the incidence of COVID-19 in the different waves, and in implementing coordinated and equity-oriented public health policy responses. Methods: We collected daily data on confirmed COVID-19 cases, geocoded the address of residence to assign each case to one of the 73 neighborhoods and 1068 census tracts, and calculated the cumulative incidence of COVID-19 by neighborhood and five income groups (quintiles of census tracts) by sex across four waves of the pandemic. We adjusted hierarchical Bayesian spatial models to obtain the relative risk (RR) of cumulative incidences in each quintile compared with the richest areas. A variety of public health policies implemented to tackle the pandemic and especially these inequalities in COVID-19 incidence and vaccination are selected and described. Results: Area-level income inequalities in the incidence of COVID-19 were present at different degree in all four waves. In the second wave (10/1/2020 to 12/6/2020), RR for the poorest income quintile census tracts compared with the richest was 1. 43 (95% credible interval-CI-: 1. 22-1. 67) for men and 1. 58 (95% CI: 1. 35-1. 83) for women. Later, inequalities in vaccination coverage also arose. Equity-oriented policy responses included: "health hotels" or home delivery of basic products for individuals with COVID-19 and without adequate conditions for isolation; new emergency facilities for homeless people, including those with active drug use; mass screening in high incidence areas; contingency plans for nursing homes and schools; adapting community health programs for their early reactivation; digital self-appointment support points and community vaccination days. Conclusion: COVID-19 hit Barcelona neighborhoods unequally, with variations between waves. The rapid availability of geolocalized data and by socioeconomic level helped public authorities to implement targeted policies and collaborative interventions for the most vulnerable populations. Further studies would be needed to evaluate their impact.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	COVID-19 ; Inequalities ; Public policies ; Urban areas
Publicat a:	International Journal for Equity in Health, Vol. 21 Núm. 1 (december 2022) , p. 28, ISSN 1475-9276

DOI: 10.1186/s12939-022-01628-1
PMID: 35183189

11 p, 2.9 MB

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