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Social inequality and the syndemic of chronic disease and COVID-19: county-level analysis in the USA.
Islam, Nazrul; Lacey, Ben; Shabnam, Sharmin; Erzurumluoglu, A Mesut; Dambha-Miller, Hajira; Chowell, Gerardo; Kawachi, Ichiro; Marmot, Michael.
  • Islam N; Nuffield Department of Population Health, University of Oxford, Oxford, Oxfordshire, UK nazrul.islam@ndph.ox.ac.uk.
  • Lacey B; MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
  • Shabnam S; Nuffield Department of Population Health, University of Oxford, Oxford, Oxfordshire, UK.
  • Erzurumluoglu AM; Leicester Diabetes Centre, University of Leicester, Leicester, UK.
  • Dambha-Miller H; MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
  • Chowell G; MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
  • Kawachi I; Department of Primary Care and Population Health, University of Southampton, Southampton, UK.
  • Marmot M; Department of Population Health Sciences, Georgia State University, Atlanta, Georgia, USA.
J Epidemiol Community Health ; 2021 Jan 05.
Article in English | MEDLINE | ID: covidwho-1066919
Semantic information from SemMedBD (by NLM)
1. IMPACT gene AFFECTS Chronic disease
Subject
IMPACT gene
Predicate
AFFECTS
Object
Chronic disease
2. IMPACT gene AFFECTS Chronic disease
Subject
IMPACT gene
Predicate
AFFECTS
Object
Chronic disease
ABSTRACT

BACKGROUND:

Given the effect of chronic diseases on risk of severe COVID-19 infection, the present pandemic may have a particularly profound impact on socially disadvantaged counties.

METHODS:

Counties in the USA were categorised into five groups by level of social vulnerability, using the Social Vulnerability Index (a widely used measure of social disadvantage) developed by the US Centers for Disease Control and Prevention. The incidence and mortality from COVID-19, and the prevalence of major chronic conditions were calculated relative to the least vulnerable quintile using Poisson regression models.

RESULTS:

Among 3141 counties, there were 5 010 496 cases and 161 058 deaths from COVID-19 by 10 August 2020. Relative to the least vulnerable quintile, counties in the most vulnerable quintile had twice the rates of COVID-19 cases and deaths (rate ratios 2.11 (95% CI 1.97 to 2.26) and 2.42 (95% CI 2.22 to 2.64), respectively). Similarly, the prevalence of major chronic conditions was 24%-41% higher in the most vulnerable counties. Geographical clustering of counties with high COVID-19 mortality, high chronic disease prevalence and high social vulnerability was found, especially in southern USA.

CONCLUSION:

Some counties are experiencing a confluence of epidemics from COVID-19 and chronic diseases in the context of social disadvantage. Such counties are likely to require enhanced public health and social support.
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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Type of study: Risk factors Language: English Clinical aspect: Etiology Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Type of study: Risk factors Language: English Clinical aspect: Etiology Year: 2021
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