Explaining the deprivation gap in COVID-19 mortality rates: A decomposition analysis of geographical inequalities in England

Albani, Viviana; Welsh, Claire E.; Brown, Heather; Matthews, Fiona E.; Bambra, Clare

Abstract

One of the most consistent and worrying features of the COVID-19 pandemic globally has been the disproportionate burden of the epidemic in the most deprived areas. Most of the literature so far though has focused on estimating the extent of these inequalities. There has been much less attention paid to exploring the main pathways underpinning them. In this study, we employ the syndemic pandemic theoretical framework and apply novel decomposition methods to investigate the proportion of the COVID-19 mortality gap by area-level deprivation in England during the first wave of the pandemic (January to July 2020) was accounted for by pre-existing inequalities in the compositional and contextual characteristics of place. We use a decomposition approach to explicitly quantify the independent contribution of four inequalities pathways (vulnerability, susceptibility, exposure and transmission) in explaining the more severe COVID-19 outcomes in the most deprived local authorities compared to the rest. We find that inequalities in transmission (73%) and in vulnerability (49%) factors explained the highest proportion of mortality by deprivation. Our results suggest that public health agencies need to develop short- and long-term strategies to alleviate these underlying inequalities in order to alleviate the more severe impacts on the most vulnerable communities.

Citation

Albani, V., Welsh, C. E., Brown, H., Matthews, F. E., & Bambra, C. (2022). Explaining the deprivation gap in COVID-19 mortality rates: A decomposition analysis of geographical inequalities in England. Social science & medicine, 311, Article 115319. https://doi.org/10.1016/j.socscimed.2022.115319

• Journal Article Type: Article
• Acceptance Date: Aug 25, 2022
• Online Publication Date: Sep 5, 2022
• Publication Date: Oct 1, 2022
• Deposit Date: Dec 10, 2023
• Publicly Available Date: Dec 12, 2023
• Journal: Social Science and Medicine
• Print ISSN: 0277-9536
• Electronic ISSN: 1873-5347
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 311
• Article Number: 115319
• DOI: https://doi.org/10.1016/j.socscimed.2022.115319
• Keywords: Pandemic; Inequality; COVID-19; Socio-economic; Deprivation
• Public URL: https://hull-repository.worktribe.com/output/4450856