Socioeconomic inequalities associated with mortality for COVID-19 in Colombia: A cohort nation-wide study (preprint)

ABSTRACT

Background: After eight months of the COVID-19 pandemic, Latin American countries have some of the highest rates in COVID-19 mortality. Despite being one of the most unequal regions of the world, there is a scarce report of the effect of socioeconomic conditions on COVID-19 mortality in their countries. We aimed to identify the effect of some socioeconomic inequality-related factors on COVID-19 mortality in Colombia. Methods: We conducted a survival analysis in a nation-wide retrospective cohort study of confirmed cases of COVID-19 in Colombia from March 2nd to October 26th, 2020. We calculated the time to death or recovery for each confirmed case in the cohort. We used an extended multivariable time-dependent Cox regression model to estimate the hazard risk ratio (HR) by age groups, sex, ethnicity, type of health insurance, area of residence, and socioeconomic strata. Results: There were 1 033 218 confirmed cases and 30 565 deaths for COVID-19 in Colombia between March 2nd and October 26th. The risk of dying for COVID-19 among confirmed cases was higher in males (HR=1.68 95% CI 1.64-1.72), in people older than 60 years (HR=296.58 95% CI 199.22-441.51), in indigenous people (HR=1.20 95% CI 1.08-1.33), in people with subsidized health insurance regime (HR=1.89 95% CI 1.83-1.96), and in people living in the very low socioeconomic strata (HR=1.44 95% CI 1.24-1.68). Conclusion: Our study provides evidence of socioeconomic inequalities in COVID-19 mortality in terms of age groups, sex, ethnicity, type of health insurance regime, and socioeconomic status.