Syndemic Pandemic in Portugal: Social Inequality in Risk Factors Associated With COVID-19 Mortality

Detalhes bibliográficos
Autor(a) principal: Perelman, Julian
Data de Publicação: 2022
Tipo de documento: Artigo
Idioma: por
eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/16031
Resumo: Introduction: International evidence has unveiled the existence of social inequalities in the risk of death associated with SARS-CoV-2 (COVID-19). In Portugal, the impossibility to identify the socioeconomic condition of deceased people hinders this evaluation. This study analyzes the social inequalities in the risk factors of COVID-19 mortality in Portugal.Material and Methods: We used data from the sixth National Health Survey, carried out between September 2019 and December 2019, for the subgroup of people aged between 25 and 79 years old (n = 12 052). We considered the comorbidities with demonstrated link to COVID-19 mortality: asthma, chronic bronchitis, cardiovascular (CVD) and cerebrovascular disease, diabetes, hypertension, chronic renal disease (CRD), and obesity. The inequality, stratified by sex, was measured in terms of education and income, using logistic regression (odds ratios and relative index of inequality).Results: Compared to men with the lowest level of formal education, we measured a risk reduction, among men with tertiary education, of CVD (-90%), chronic bronchitis (-75%), stroke (-70%), diabetes (-62%), hypertension (-41%), and obesity (-43%). Among tertiaryeducated women, we observed a reduced risk of CRD (-77%), hypertension, diabetes, stroke (-70%), obesity (-64%), and CVD (-55%). Except for obesity among men, the risk of disease was always significantly lower in the highest income quintile, compared with the lowest.Conclusion: In 2019, we observed socioeconomic inequalities of high magnitude for the eight diseases with demonstrated link to COVID-19 mortality.
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spelling Syndemic Pandemic in Portugal: Social Inequality in Risk Factors Associated With COVID-19 MortalityPandemia Sindémica em Portugal: Desigualdade Social nos Fatores de Risco Associados à Mortalidade por COVID-19COVID-19Healthcare DisparitiesMortalityPortugalSARS-CoV-2Socioeconomic FactorsCOVID-19Disparidades em Assistência à SaúdeFactores SocioeconómicosMortalidadePortugalSARS-CoV-19Introduction: International evidence has unveiled the existence of social inequalities in the risk of death associated with SARS-CoV-2 (COVID-19). In Portugal, the impossibility to identify the socioeconomic condition of deceased people hinders this evaluation. This study analyzes the social inequalities in the risk factors of COVID-19 mortality in Portugal.Material and Methods: We used data from the sixth National Health Survey, carried out between September 2019 and December 2019, for the subgroup of people aged between 25 and 79 years old (n = 12 052). We considered the comorbidities with demonstrated link to COVID-19 mortality: asthma, chronic bronchitis, cardiovascular (CVD) and cerebrovascular disease, diabetes, hypertension, chronic renal disease (CRD), and obesity. The inequality, stratified by sex, was measured in terms of education and income, using logistic regression (odds ratios and relative index of inequality).Results: Compared to men with the lowest level of formal education, we measured a risk reduction, among men with tertiary education, of CVD (-90%), chronic bronchitis (-75%), stroke (-70%), diabetes (-62%), hypertension (-41%), and obesity (-43%). Among tertiaryeducated women, we observed a reduced risk of CRD (-77%), hypertension, diabetes, stroke (-70%), obesity (-64%), and CVD (-55%). Except for obesity among men, the risk of disease was always significantly lower in the highest income quintile, compared with the lowest.Conclusion: In 2019, we observed socioeconomic inequalities of high magnitude for the eight diseases with demonstrated link to COVID-19 mortality.Introdução: A evidência internacional tem demonstrado desigualdades sociais no risco de morte por SARS-CoV-2 (COVID-19). Em Portugal, a impossibilidade de identificar a condição socioeconómica dos indivíduos falecidos impede esta medição. Este estudo analisa as desigualdades sociais nos fatores de risco de morte por COVID-19 em Portugal.Material e Métodos: Foram utilizados dados do sexto Inquérito Nacional de Saúde, conduzido entre setembro e dezembro de 2019, para pessoas entre 25 e 79 anos (n = 12 052). Foram consideradas as morbilidades com ligação demonstrada à morte por COVID-19: asma, bronquite crónica, doenças cardiovasculares (DCV) e cerebrovasculares (AVC), diabetes, hipertensão, doença renal crónica (DRC) e obesidade. A desigualdade, estratificada por sexo, foi medida em termos de educação e rendimento, através de regressões logísticas (odds ratios e índice relativo de desigualdade).Resultados: Em comparação com os homens com o nível de educação mais baixo, foi medido um risco inferior, para os homens com educação terciária, de DCV (-90%), bronquite crónica (-75%), AVC (-70%), diabetes (-62%), hipertensão (-41%) e obesidade (-43%). Nas mulheres com educação terciária, foi observada uma redução de risco de DRC (-77%), hipertensão, diabetes e AVC (-70%), obesidade (-64%) e DCV (-55%). Exceto no caso da obesidade nos homens, o risco de doença foi sempre estatisticamente inferior no quinto quintil de rendimento, comparado com o primeiro.Conclusão: Existiam, em 2019, desigualdades socioeconómicas de grande magnitude para oito doenças cuja ligação à mortalidade por COVID-19 foi amplamente identificada.Ordem dos Médicos2022-06-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/16031Acta Médica Portuguesa; Vol. 35 No. 6 (2022): June; 443-449Acta Médica Portuguesa; Vol. 35 N.º 6 (2022): Junho; 443-4491646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/16031https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/16031/6635https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/16031/15219Direitos de Autor (c) 2022 Acta Médica Portuguesa - Ordem dos Médicosinfo:eu-repo/semantics/openAccessPerelman, Julian2023-07-30T03:01:41Zoai:ojs.www.actamedicaportuguesa.com:article/16031Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:44.726811Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Syndemic Pandemic in Portugal: Social Inequality in Risk Factors Associated With COVID-19 Mortality
Pandemia Sindémica em Portugal: Desigualdade Social nos Fatores de Risco Associados à Mortalidade por COVID-19
title Syndemic Pandemic in Portugal: Social Inequality in Risk Factors Associated With COVID-19 Mortality
spellingShingle Syndemic Pandemic in Portugal: Social Inequality in Risk Factors Associated With COVID-19 Mortality
Perelman, Julian
COVID-19
Healthcare Disparities
Mortality
Portugal
SARS-CoV-2
Socioeconomic Factors
COVID-19
Disparidades em Assistência à Saúde
Factores Socioeconómicos
Mortalidade
Portugal
SARS-CoV-19
title_short Syndemic Pandemic in Portugal: Social Inequality in Risk Factors Associated With COVID-19 Mortality
title_full Syndemic Pandemic in Portugal: Social Inequality in Risk Factors Associated With COVID-19 Mortality
title_fullStr Syndemic Pandemic in Portugal: Social Inequality in Risk Factors Associated With COVID-19 Mortality
title_full_unstemmed Syndemic Pandemic in Portugal: Social Inequality in Risk Factors Associated With COVID-19 Mortality
title_sort Syndemic Pandemic in Portugal: Social Inequality in Risk Factors Associated With COVID-19 Mortality
author Perelman, Julian
author_facet Perelman, Julian
author_role author
dc.contributor.author.fl_str_mv Perelman, Julian
dc.subject.por.fl_str_mv COVID-19
Healthcare Disparities
Mortality
Portugal
SARS-CoV-2
Socioeconomic Factors
COVID-19
Disparidades em Assistência à Saúde
Factores Socioeconómicos
Mortalidade
Portugal
SARS-CoV-19
topic COVID-19
Healthcare Disparities
Mortality
Portugal
SARS-CoV-2
Socioeconomic Factors
COVID-19
Disparidades em Assistência à Saúde
Factores Socioeconómicos
Mortalidade
Portugal
SARS-CoV-19
description Introduction: International evidence has unveiled the existence of social inequalities in the risk of death associated with SARS-CoV-2 (COVID-19). In Portugal, the impossibility to identify the socioeconomic condition of deceased people hinders this evaluation. This study analyzes the social inequalities in the risk factors of COVID-19 mortality in Portugal.Material and Methods: We used data from the sixth National Health Survey, carried out between September 2019 and December 2019, for the subgroup of people aged between 25 and 79 years old (n = 12 052). We considered the comorbidities with demonstrated link to COVID-19 mortality: asthma, chronic bronchitis, cardiovascular (CVD) and cerebrovascular disease, diabetes, hypertension, chronic renal disease (CRD), and obesity. The inequality, stratified by sex, was measured in terms of education and income, using logistic regression (odds ratios and relative index of inequality).Results: Compared to men with the lowest level of formal education, we measured a risk reduction, among men with tertiary education, of CVD (-90%), chronic bronchitis (-75%), stroke (-70%), diabetes (-62%), hypertension (-41%), and obesity (-43%). Among tertiaryeducated women, we observed a reduced risk of CRD (-77%), hypertension, diabetes, stroke (-70%), obesity (-64%), and CVD (-55%). Except for obesity among men, the risk of disease was always significantly lower in the highest income quintile, compared with the lowest.Conclusion: In 2019, we observed socioeconomic inequalities of high magnitude for the eight diseases with demonstrated link to COVID-19 mortality.
publishDate 2022
dc.date.none.fl_str_mv 2022-06-01
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dc.language.iso.fl_str_mv por
eng
language por
eng
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/16031/6635
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/16031/15219
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2022 Acta Médica Portuguesa - Ordem dos Médicos
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Direitos de Autor (c) 2022 Acta Médica Portuguesa - Ordem dos Médicos
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application/pdf
dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 35 No. 6 (2022): June; 443-449
Acta Médica Portuguesa; Vol. 35 N.º 6 (2022): Junho; 443-449
1646-0758
0870-399X
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