Chung, GKK;
Chan, SM;
Chan, YH;
Yip, TCF;
Ma, HM;
Wong, GLH;
Chung, RYN;
... Woo, J; + view all
(2021)
Differential impacts of multimorbidity on covid-19 severity across the socioeconomic ladder in Hong Kong: A syndemic perspective.
International Journal of Environmental Research and Public Health
, 18
(15)
, Article 8168. 10.3390/ijerph18158168.
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Abstract
The severity of COVID-19 infections could be exacerbated by the epidemic of chronic diseases and underlying inequalities in social determinants of health. Nonetheless, there is scanty evidence in regions with a relatively well-controlled outbreak. This study examined the socioeconomic patterning of COVID-19 severity and its effect modification with multimorbidity in Hong Kong. 3074 local COVID-19 cases diagnosed from 5 July to 31 October 2020 were analyzed and followed up until 30 November 2020. Data on residential addresses, socio-demographic background, COVID-19 clinical conditions, and pre-existing chronic diseases of confirmed cases were retrieved from the Centre for Health Protection and the Hospital Authority. Results showed that, despite an independent adverse impact of multimorbidity on COVID-19 severity (aOR = 2.35 [95% CI = 1.72–3.19]), it varied across the socioeconomic ladder, with no significant risk among those living in the wealthiest areas (aOR = 0.80 [0.32–2.02]). Also, no significant association of the area-level income-poverty rate with severe COVID-19 was observed. In conclusion, the socioeconomic patterning of severe COVID-19 was mild in Hong Kong. Nonetheless, socioeconomic position interacted with multimorbidity to determine COVID-19 severity with a mitigated risk among the socioeconomically advantaged. Plausible explanations include the underlying socioeconomic inequalities in chronic disease management and the equity impact of the public-private dual-track healthcare system.
| Type: | Article |
|---|---|
| Title: | Differential impacts of multimorbidity on covid-19 severity across the socioeconomic ladder in Hong Kong: A syndemic perspective |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3390/ijerph18158168 |
| Publisher version: | https://doi.org/10.3390/ijerph18158168 |
| Language: | English |
| Additional information: | © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). |
| Keywords: | COVID-19; multimorbidity; socioeconomic inequalities; Hong Kong |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10133199 |
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