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Social Determinants of Health and Risk of SARS-CoV-2 Infection in Community-Dwelling Older Adults Living in a Rural Latin American Setting.
Del Brutto, Oscar H; Mera, Robertino M; Recalde, Bettsy Y; Costa, Aldo F.
  • Del Brutto OH; School of Medicine, Universidad Espíritu Santo - Ecuador, Samborondón, Ecuador. oscardelbrutto@hotmail.com.
  • Mera RM; , Air Center 3542, PO Box 522970, Miami, FL, 33152-2970, USA. oscardelbrutto@hotmail.com.
  • Recalde BY; Department of Epidemiology, Gilead Sciences, Inc., Foster City, CA, USA.
  • Costa AF; Community Center, The Atahualpa Project, Atahualpa, Ecuador.
J Community Health ; 46(2): 292-297, 2021 04.
Article in English | MEDLINE | ID: covidwho-645740
ABSTRACT
High social risk, as measured by the social determinants of health (SDH), may increase the risk of SARS-CoV-2 infection. However, this association has not been studied in rural communities. Using the Atahualpa Project cohort, we aimed to assess the association between SDH and SARS-CoV-2 seropositivity in community-dwelling older adults living in rural Ecuador. SARS-CoV-2 antibodies were determined in 319 individuals aged ≥ 60 years that completed a validated field instrument to assess their social risk before the introduction of this novel pandemic. Multivariate models were fitted to assess the independent association between SDH-and each of their components-and SARS-CoV-2 seropositivity, after adjusting for relevant covariates. According to the Gijon scale, 102 (32%) individuals had a high social risk (≥ 10 points). A total of 141 (44%) individuals were seropositive to SARS-CoV-2. A fully-adjusted logistic regression model showed an independent) association between social risk and SARS-CoV-2 positivity (OR 1.15; 95% CI 1.04-1.27; p = 0.008). For every unit of the total SDH score, the odds of SARS-CoV-2 seropositivity increased 15% (95% CI 3.7-27%). In addition, multivariate models showed that the individual component of SDH more strongly associated with SARS-CoV-2 seropositivity was housing, which suggested that lack of basic home facilities may increase the risk of SARS-CoV-2 infection. Knowledge on the association between high social risk and SARS-CoV-2 infection is indispensable for the development of cost-effective preventive strategies for controlling modifiable factors that are in the path of SARS-CoV-2 infection among older adults living in underserved communities.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rural Population / Independent Living / Social Determinants of Health / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Aged / Female / Humans / Male Country/Region as subject: South America / Ecuador Language: English Journal: J Community Health Year: 2021 Document Type: Article Affiliation country: S10900-020-00887-9

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rural Population / Independent Living / Social Determinants of Health / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Aged / Female / Humans / Male Country/Region as subject: South America / Ecuador Language: English Journal: J Community Health Year: 2021 Document Type: Article Affiliation country: S10900-020-00887-9