Geographic concentration of SARS-CoV-2 cases by social determinants of health in metropolitan areas in Canada: a cross-sectional study
Understanding inequalities in SARS-CoV-2 transmission associated with the social determinants of health could help the development of effective mitigation strategies that are responsive to local transmission dynamics. This study aims to quantify social determinants of geographic concentration of SAR...
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| Veröffentlicht in: | Canadian Medical Association journal (CMAJ) 2022-02, Vol.194 (6), p.E195-E204 |
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| creator | Xia, Yiqing Ma, Huiting Moloney, Gary Velásquez García, Héctor A Sirski, Monica Janjua, Naveed Z Vickers, David Williamson, Tyler Katz, Alan Yiu, Kristy Kustra, Rafal Buckeridge, David L Brisson, Marc Baral, Stefan D Mishra, Sharmistha Maheu-Giroux, Mathieu |
| description | Understanding inequalities in SARS-CoV-2 transmission associated with the social determinants of health could help the development of effective mitigation strategies that are responsive to local transmission dynamics. This study aims to quantify social determinants of geographic concentration of SARS-CoV-2 cases across 16 census metropolitan areas (hereafter, cities) in 4 Canadian provinces, British Columbia, Manitoba, Ontario and Quebec.
We used surveillance data on confirmed SARS-CoV-2 cases and census data for social determinants at the level of the dissemination area (DA). We calculated Gini coefficients to determine the overall geographic heterogeneity of confirmed cases of SARS-CoV-2 in each city, and calculated Gini covariance coefficients to determine each city's heterogeneity by each social determinant (income, education, housing density and proportions of visible minorities, recent immigrants and essential workers). We visualized heterogeneity using Lorenz (concentration) curves.
We observed geographic concentration of SARS-CoV-2 cases in cities, as half of the cumulative cases were concentrated in DAs containing 21%-35% of their population, with the greatest geographic heterogeneity in Ontario cities (Gini coefficients 0.32-0.47), followed by British Columbia (0.23-0.36), Manitoba (0.32) and Quebec (0.28-0.37). Cases were disproportionately concentrated in areas with lower income and educational attainment, and in areas with a higher proportion of visible minorities, recent immigrants, high-density housing and essential workers. Although a consistent feature across cities was concentration by the proportion of visible minorities, the magnitude of concentration by social determinant varied across cities.
Geographic concentration of SARS-CoV-2 cases was observed in all of the included cities, but the pattern by social determinants varied. Geographically prioritized allocation of resources and services should be tailored to the local drivers of inequalities in transmission in response to the resurgence of SARS-CoV-2. |
| doi_str_mv | 10.1503/cmaj.211249 |
| format | Article |
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We used surveillance data on confirmed SARS-CoV-2 cases and census data for social determinants at the level of the dissemination area (DA). We calculated Gini coefficients to determine the overall geographic heterogeneity of confirmed cases of SARS-CoV-2 in each city, and calculated Gini covariance coefficients to determine each city's heterogeneity by each social determinant (income, education, housing density and proportions of visible minorities, recent immigrants and essential workers). We visualized heterogeneity using Lorenz (concentration) curves.
We observed geographic concentration of SARS-CoV-2 cases in cities, as half of the cumulative cases were concentrated in DAs containing 21%-35% of their population, with the greatest geographic heterogeneity in Ontario cities (Gini coefficients 0.32-0.47), followed by British Columbia (0.23-0.36), Manitoba (0.32) and Quebec (0.28-0.37). Cases were disproportionately concentrated in areas with lower income and educational attainment, and in areas with a higher proportion of visible minorities, recent immigrants, high-density housing and essential workers. Although a consistent feature across cities was concentration by the proportion of visible minorities, the magnitude of concentration by social determinant varied across cities.
Geographic concentration of SARS-CoV-2 cases was observed in all of the included cities, but the pattern by social determinants varied. Geographically prioritized allocation of resources and services should be tailored to the local drivers of inequalities in transmission in response to the resurgence of SARS-CoV-2.</description><identifier>ISSN: 0820-3946</identifier><identifier>EISSN: 1488-2329</identifier><identifier>DOI: 10.1503/cmaj.211249</identifier><identifier>PMID: 35165131</identifier><language>eng</language><publisher>Canada: CMA Joule Inc</publisher><subject>Canada ; Canada - epidemiology ; Cities ; Cities - epidemiology ; Coronaviruses ; COVID-19 ; COVID-19 - economics ; COVID-19 - epidemiology ; Cross-Sectional Studies ; Demographic aspects ; Demography - economics ; Demography - statistics & numerical data ; Disease transmission ; Distribution ; Epidemics ; Epidemiology ; Essential workers ; Ethics ; Health aspects ; Health surveillance ; Humans ; Immigrants ; Laboratories ; Metropolitan areas ; Population ; Provinces ; Public health ; SARS-CoV-2 ; Severe acute respiratory syndrome coronavirus 2 ; Social Determinants of Health - economics ; Social Determinants of Health - statistics & numerical data ; Sociodemographics ; Socioeconomic Factors ; Urban areas</subject><ispartof>Canadian Medical Association journal (CMAJ), 2022-02, Vol.194 (6), p.E195-E204</ispartof><rights>2022 CMA Impact Inc. or its licensors.</rights><rights>COPYRIGHT 2022 CMA Joule Inc.</rights><rights>Copyright Joule Inc Feb 14, 2022</rights><rights>2022 CMA Impact Inc. or its licensors 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c640t-fd17ff990cd93bc13f3f4a01b78da42f6366be824f16ea26b7c643427369951d3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8900797/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8900797/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35165131$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xia, Yiqing</creatorcontrib><creatorcontrib>Ma, Huiting</creatorcontrib><creatorcontrib>Moloney, Gary</creatorcontrib><creatorcontrib>Velásquez García, Héctor A</creatorcontrib><creatorcontrib>Sirski, Monica</creatorcontrib><creatorcontrib>Janjua, Naveed Z</creatorcontrib><creatorcontrib>Vickers, David</creatorcontrib><creatorcontrib>Williamson, Tyler</creatorcontrib><creatorcontrib>Katz, Alan</creatorcontrib><creatorcontrib>Yiu, Kristy</creatorcontrib><creatorcontrib>Kustra, Rafal</creatorcontrib><creatorcontrib>Buckeridge, David L</creatorcontrib><creatorcontrib>Brisson, Marc</creatorcontrib><creatorcontrib>Baral, Stefan D</creatorcontrib><creatorcontrib>Mishra, Sharmistha</creatorcontrib><creatorcontrib>Maheu-Giroux, Mathieu</creatorcontrib><title>Geographic concentration of SARS-CoV-2 cases by social determinants of health in metropolitan areas in Canada: a cross-sectional study</title><title>Canadian Medical Association journal (CMAJ)</title><addtitle>CMAJ</addtitle><description>Understanding inequalities in SARS-CoV-2 transmission associated with the social determinants of health could help the development of effective mitigation strategies that are responsive to local transmission dynamics. This study aims to quantify social determinants of geographic concentration of SARS-CoV-2 cases across 16 census metropolitan areas (hereafter, cities) in 4 Canadian provinces, British Columbia, Manitoba, Ontario and Quebec.
We used surveillance data on confirmed SARS-CoV-2 cases and census data for social determinants at the level of the dissemination area (DA). We calculated Gini coefficients to determine the overall geographic heterogeneity of confirmed cases of SARS-CoV-2 in each city, and calculated Gini covariance coefficients to determine each city's heterogeneity by each social determinant (income, education, housing density and proportions of visible minorities, recent immigrants and essential workers). We visualized heterogeneity using Lorenz (concentration) curves.
We observed geographic concentration of SARS-CoV-2 cases in cities, as half of the cumulative cases were concentrated in DAs containing 21%-35% of their population, with the greatest geographic heterogeneity in Ontario cities (Gini coefficients 0.32-0.47), followed by British Columbia (0.23-0.36), Manitoba (0.32) and Quebec (0.28-0.37). Cases were disproportionately concentrated in areas with lower income and educational attainment, and in areas with a higher proportion of visible minorities, recent immigrants, high-density housing and essential workers. Although a consistent feature across cities was concentration by the proportion of visible minorities, the magnitude of concentration by social determinant varied across cities.
Geographic concentration of SARS-CoV-2 cases was observed in all of the included cities, but the pattern by social determinants varied. Geographically prioritized allocation of resources and services should be tailored to the local drivers of inequalities in transmission in response to the resurgence of SARS-CoV-2.</description><subject>Canada</subject><subject>Canada - epidemiology</subject><subject>Cities</subject><subject>Cities - epidemiology</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - economics</subject><subject>COVID-19 - epidemiology</subject><subject>Cross-Sectional Studies</subject><subject>Demographic aspects</subject><subject>Demography - economics</subject><subject>Demography - statistics & numerical data</subject><subject>Disease transmission</subject><subject>Distribution</subject><subject>Epidemics</subject><subject>Epidemiology</subject><subject>Essential workers</subject><subject>Ethics</subject><subject>Health aspects</subject><subject>Health 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concentration of SARS-CoV-2 cases by social determinants of health in metropolitan areas in Canada: a cross-sectional study</title><author>Xia, Yiqing ; Ma, Huiting ; Moloney, Gary ; Velásquez García, Héctor A ; Sirski, Monica ; Janjua, Naveed Z ; Vickers, David ; Williamson, Tyler ; Katz, Alan ; Yiu, Kristy ; Kustra, Rafal ; Buckeridge, David L ; Brisson, Marc ; Baral, Stefan D ; Mishra, Sharmistha ; Maheu-Giroux, Mathieu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c640t-fd17ff990cd93bc13f3f4a01b78da42f6366be824f16ea26b7c643427369951d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Canada</topic><topic>Canada - epidemiology</topic><topic>Cities</topic><topic>Cities - epidemiology</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - economics</topic><topic>COVID-19 - epidemiology</topic><topic>Cross-Sectional Studies</topic><topic>Demographic 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(CMAJ)</jtitle><addtitle>CMAJ</addtitle><date>2022-02-14</date><risdate>2022</risdate><volume>194</volume><issue>6</issue><spage>E195</spage><epage>E204</epage><pages>E195-E204</pages><issn>0820-3946</issn><eissn>1488-2329</eissn><abstract>Understanding inequalities in SARS-CoV-2 transmission associated with the social determinants of health could help the development of effective mitigation strategies that are responsive to local transmission dynamics. This study aims to quantify social determinants of geographic concentration of SARS-CoV-2 cases across 16 census metropolitan areas (hereafter, cities) in 4 Canadian provinces, British Columbia, Manitoba, Ontario and Quebec.
We used surveillance data on confirmed SARS-CoV-2 cases and census data for social determinants at the level of the dissemination area (DA). We calculated Gini coefficients to determine the overall geographic heterogeneity of confirmed cases of SARS-CoV-2 in each city, and calculated Gini covariance coefficients to determine each city's heterogeneity by each social determinant (income, education, housing density and proportions of visible minorities, recent immigrants and essential workers). We visualized heterogeneity using Lorenz (concentration) curves.
We observed geographic concentration of SARS-CoV-2 cases in cities, as half of the cumulative cases were concentrated in DAs containing 21%-35% of their population, with the greatest geographic heterogeneity in Ontario cities (Gini coefficients 0.32-0.47), followed by British Columbia (0.23-0.36), Manitoba (0.32) and Quebec (0.28-0.37). Cases were disproportionately concentrated in areas with lower income and educational attainment, and in areas with a higher proportion of visible minorities, recent immigrants, high-density housing and essential workers. Although a consistent feature across cities was concentration by the proportion of visible minorities, the magnitude of concentration by social determinant varied across cities.
Geographic concentration of SARS-CoV-2 cases was observed in all of the included cities, but the pattern by social determinants varied. Geographically prioritized allocation of resources and services should be tailored to the local drivers of inequalities in transmission in response to the resurgence of SARS-CoV-2.</abstract><cop>Canada</cop><pub>CMA Joule Inc</pub><pmid>35165131</pmid><doi>10.1503/cmaj.211249</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0820-3946 |
| ispartof | Canadian Medical Association journal (CMAJ), 2022-02, Vol.194 (6), p.E195-E204 |
| issn | 0820-3946 1488-2329 |
| language | eng |
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| source | MEDLINE; PubMed Central; Directory of Open Access Journals; Alma/SFX Local Collection |
| subjects | Canada Canada - epidemiology Cities Cities - epidemiology Coronaviruses COVID-19 COVID-19 - economics COVID-19 - epidemiology Cross-Sectional Studies Demographic aspects Demography - economics Demography - statistics & numerical data Disease transmission Distribution Epidemics Epidemiology Essential workers Ethics Health aspects Health surveillance Humans Immigrants Laboratories Metropolitan areas Population Provinces Public health SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 Social Determinants of Health - economics Social Determinants of Health - statistics & numerical data Sociodemographics Socioeconomic Factors Urban areas |
| title | Geographic concentration of SARS-CoV-2 cases by social determinants of health in metropolitan areas in Canada: a cross-sectional study |
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