The association of combinations of social factors and SARs-CoV-2 infection: A retrospective population-based cohort study in Ontario, 2020–2021
Objective: The COVID-19 pandemic highlighted and exacerbated health inequities worldwide. While several studies have examined the impact of individual social factors on COVID infection, our objective was to examine how interactions of social factors were associated with the risk of testing positive...
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Elsevier
2024-12-01
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| Series: | Dialogues in Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772653324000339 |
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| author | Sydney Persaud Michael Fitzgerald Steven Hawken Peter Tanuseputro Lisa Boucher William Petrcich Martin Wellman Colleen Webber Esther Shoemaker Robin Ducharme Simone Dahrouge Daniel Myran Ahmed M. Bayoumi Susitha Wanigaratne Gary Bloch David Ponka Brendan T. Smith Aisha Lofters Austin Zygmunt Krystal Kehoe MacLeod Luke A. Turcotte Beate Sander Michelle Howard Sarah Funnell Jennifer Rayner Kurtis Kitagawa Sureya Ibrahim Claire E. Kendall |
| author_facet | Sydney Persaud Michael Fitzgerald Steven Hawken Peter Tanuseputro Lisa Boucher William Petrcich Martin Wellman Colleen Webber Esther Shoemaker Robin Ducharme Simone Dahrouge Daniel Myran Ahmed M. Bayoumi Susitha Wanigaratne Gary Bloch David Ponka Brendan T. Smith Aisha Lofters Austin Zygmunt Krystal Kehoe MacLeod Luke A. Turcotte Beate Sander Michelle Howard Sarah Funnell Jennifer Rayner Kurtis Kitagawa Sureya Ibrahim Claire E. Kendall |
| author_sort | Sydney Persaud |
| collection | DOAJ |
| description | Objective: The COVID-19 pandemic highlighted and exacerbated health inequities worldwide. While several studies have examined the impact of individual social factors on COVID infection, our objective was to examine how interactions of social factors were associated with the risk of testing positive for SARS-CoV-2 during the first two years of the pandemic. Study design and setting: We conducted an observational cohort study using linked health administrative data for Ontarians tested for SARS-CoV-2 between January 1st, 2020, and December 31st, 2021. We constructed multivariable models to examine the association between SARS-CoV-2 positivity and key variables including immigration status (immigrants vs. other Ontarians), and neighbourhood variables for household size, income, essential worker status, and visible minority status. We report main and interaction effects using odds ratios and predicted probabilities, with age and sex controlled in all models. Results: Of 6,575,523 Ontarians in the cohort, 88.5 % tested negative, and 11.5 % tested positive for SARS-CoV-2. In all models, immigrants and those living in neighbourhoods with large average household sizes had greater odds of testing positive for SARS-CoV-2. The strength of these associations increased with increasing levels of neighbourhood marginalization for income, essential worker proportion and visible minority proportion. We observed little change in the probability of testing positive across neighbourhood income quintiles among other Ontarians who live in neighbourhoods with smaller households, but a large change in probability among other Ontarians who live in neighbourhoods with larger households. Conclusion: Our study found that SARS-CoV-2 positivity was greater among people with certain combinations of social factors, but in all cases the probability of testing positive was consistently greater for immigrants than for other Ontarians. Examining interactions of social factors can provide a more nuanced and more comprehensive understanding of health inequity than examining factors separately. |
| format | Article |
| id | doaj-art-34fb25b8bf1c48c0bf4b6d241c9b226e |
| institution | OA Journals |
| issn | 2772-6533 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Dialogues in Health |
| spelling | doaj-art-34fb25b8bf1c48c0bf4b6d241c9b226e2025-08-20T01:57:04ZengElsevierDialogues in Health2772-65332024-12-01510019710.1016/j.dialog.2024.100197The association of combinations of social factors and SARs-CoV-2 infection: A retrospective population-based cohort study in Ontario, 2020–2021Sydney Persaud0Michael Fitzgerald1Steven Hawken2Peter Tanuseputro3Lisa Boucher4William Petrcich5Martin Wellman6Colleen Webber7Esther Shoemaker8Robin Ducharme9Simone Dahrouge10Daniel Myran11Ahmed M. Bayoumi12Susitha Wanigaratne13Gary Bloch14David Ponka15Brendan T. Smith16Aisha Lofters17Austin Zygmunt18Krystal Kehoe MacLeod19Luke A. Turcotte20Beate Sander21Michelle Howard22Sarah Funnell23Jennifer Rayner24Kurtis Kitagawa25Sureya Ibrahim26Claire E. Kendall27Bruyère Research Institute, Ottawa, Ontario K1R 6M1, CanadaBruyère Research Institute, Ottawa, Ontario K1R 6M1, CanadaICES, Ottawa, Ontario K1Y 4E9, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario K1H 8L6, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario K1H 8M5, CanadaDepartment of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong KongBruyère Research Institute, Ottawa, Ontario K1R 6M1, CanadaICES, Ottawa, Ontario K1Y 4E9, CanadaICES, Ottawa, Ontario K1Y 4E9, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario K1H 8L6, CanadaBruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada; ICES, Ottawa, Ontario K1Y 4E9, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario K1H 8L6, CanadaBruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada; Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba R3E 0T6, CanadaOttawa Hospital Research Institute, Ottawa, Ontario K1H 8L6, CanadaBruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada; ICES, Ottawa, Ontario K1Y 4E9, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario K1G 5Z3, CanadaBruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada; ICES, Ottawa, Ontario K1Y 4E9, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario K1H 8L6, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario K1G 5Z3, CanadaInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario M5T 3M6, Canada; Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario M5B 1T8, Canada; Division of General Internal Medicine, St. Michael’s Hospital, Toronto, Ontario M5B 1W8, Canada; Department of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada; Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, CanadaICES, Ottawa, Ontario K1Y 4E9, Canada; Edwin S.H. Leong Center for Healthy Children, University of Toronto, Toronto, Ontario M5G 0A4, CanadaInner City Health Associates, Toronto, Ontario M5A 1E3, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario M5G 1V7, CanadaBruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario K1G 5Z3, CanadaDalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5T 3M7, Canada; Public Health Ontario, Toronto, Ontario M5B 1W2, CanadaICES, Ottawa, Ontario K1Y 4E9, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5T 3M7, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario M5G 1V7, Canada; Women’s College Hospital, Toronto, Ontario M5S 1B2, CanadaFaculty of Medicine, University of Ottawa, Ottawa, Ontario K1G 5Z3, Canada; Public Health Ontario, Toronto, Ontario M5B 1W2, CanadaBruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario K1H 8L6, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario K1G 5Z3, CanadaDepartment of Health Sciences, Brock University, St. Catharines, Ontario L2S 3A1, CanadaICES, Ottawa, Ontario K1Y 4E9, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario M5T 3M6, Canada; Public Health Ontario, Toronto, Ontario M5B 1W2, Canada; Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario M5G 2C4, CanadaDepartment of Family Medicine, McMaster University, Hamilton, Ontario L8N 3Z5, CanadaFaculty of Health Sciences, Queen’s University, Kingston, Ontario K7L 3N6, Canada; Department of Family Medicine, Queen’s University, Kingston, Ontario K7L 3G2, CanadaInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario M5T 3M6, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario M5G 1V7, Canada; Alliance for Healthier Communities, Toronto, Ontario M6A 3B6, CanadaBruyère Research Institute, Ottawa, Ontario K1R 6M1, CanadaBruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada; Centre for Community Learning & Development, Toronto, Ontario M5A 2B3, CanadaBruyère Research Institute, Ottawa, Ontario K1R 6M1, Canada; ICES, Ottawa, Ontario K1Y 4E9, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario K1H 8M5, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario K1G 5Z3, Canada; Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario M5B 1T8, Canada; Corresponding author at: 85 Primrose Ave, Ottawa, ON K1R 7G5, Canada.Objective: The COVID-19 pandemic highlighted and exacerbated health inequities worldwide. While several studies have examined the impact of individual social factors on COVID infection, our objective was to examine how interactions of social factors were associated with the risk of testing positive for SARS-CoV-2 during the first two years of the pandemic. Study design and setting: We conducted an observational cohort study using linked health administrative data for Ontarians tested for SARS-CoV-2 between January 1st, 2020, and December 31st, 2021. We constructed multivariable models to examine the association between SARS-CoV-2 positivity and key variables including immigration status (immigrants vs. other Ontarians), and neighbourhood variables for household size, income, essential worker status, and visible minority status. We report main and interaction effects using odds ratios and predicted probabilities, with age and sex controlled in all models. Results: Of 6,575,523 Ontarians in the cohort, 88.5 % tested negative, and 11.5 % tested positive for SARS-CoV-2. In all models, immigrants and those living in neighbourhoods with large average household sizes had greater odds of testing positive for SARS-CoV-2. The strength of these associations increased with increasing levels of neighbourhood marginalization for income, essential worker proportion and visible minority proportion. We observed little change in the probability of testing positive across neighbourhood income quintiles among other Ontarians who live in neighbourhoods with smaller households, but a large change in probability among other Ontarians who live in neighbourhoods with larger households. Conclusion: Our study found that SARS-CoV-2 positivity was greater among people with certain combinations of social factors, but in all cases the probability of testing positive was consistently greater for immigrants than for other Ontarians. Examining interactions of social factors can provide a more nuanced and more comprehensive understanding of health inequity than examining factors separately.http://www.sciencedirect.com/science/article/pii/S2772653324000339SARS-CoV-2COVID-19 positivitySocial determinants of healthHealth equity |
| spellingShingle | Sydney Persaud Michael Fitzgerald Steven Hawken Peter Tanuseputro Lisa Boucher William Petrcich Martin Wellman Colleen Webber Esther Shoemaker Robin Ducharme Simone Dahrouge Daniel Myran Ahmed M. Bayoumi Susitha Wanigaratne Gary Bloch David Ponka Brendan T. Smith Aisha Lofters Austin Zygmunt Krystal Kehoe MacLeod Luke A. Turcotte Beate Sander Michelle Howard Sarah Funnell Jennifer Rayner Kurtis Kitagawa Sureya Ibrahim Claire E. Kendall The association of combinations of social factors and SARs-CoV-2 infection: A retrospective population-based cohort study in Ontario, 2020–2021 Dialogues in Health SARS-CoV-2 COVID-19 positivity Social determinants of health Health equity |
| title | The association of combinations of social factors and SARs-CoV-2 infection: A retrospective population-based cohort study in Ontario, 2020–2021 |
| title_full | The association of combinations of social factors and SARs-CoV-2 infection: A retrospective population-based cohort study in Ontario, 2020–2021 |
| title_fullStr | The association of combinations of social factors and SARs-CoV-2 infection: A retrospective population-based cohort study in Ontario, 2020–2021 |
| title_full_unstemmed | The association of combinations of social factors and SARs-CoV-2 infection: A retrospective population-based cohort study in Ontario, 2020–2021 |
| title_short | The association of combinations of social factors and SARs-CoV-2 infection: A retrospective population-based cohort study in Ontario, 2020–2021 |
| title_sort | association of combinations of social factors and sars cov 2 infection a retrospective population based cohort study in ontario 2020 2021 |
| topic | SARS-CoV-2 COVID-19 positivity Social determinants of health Health equity |
| url | http://www.sciencedirect.com/science/article/pii/S2772653324000339 |
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