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Abstract
Background We examined whether COVID-19 could exert inequalities in socioeconomic conditions and health in Hong Kong, where there has been a relatively low COVID-19 incidence.
Methods 752 adult respondents from a previous random sample participated in a telephone survey from 20 April to 11 May 2020. We examined demographic and socioeconomic factors, worry of COVID-19, general health, economic activity, and personal protective equipment (PPE) and related hygiene practice by deprivation status. The associations between deprivation and negative COVID-19 related issues were analysed using binary logistic regressions, while the associations of these issues with health were analysed using linear regressions. Path analysis was conducted to determine the direct effect of deprivation, and the indirect effects via COVID-19 related issues, on health. Interactions between deprivation and the mediators were also tested.
Results Deprived individuals were more likely to have job loss/instability, less reserves, less utilisation and more concerns of PPE. After adjustments for potential confounders, being deprived was associated with having greater risk of low reserve of face masks, being worried about the disease and job loss/instability. Being deprived had worse physical (β=−0.154, p<0.001) and mental health (β=−0.211, p<0.001) and had an indirect effect on mental health via worry and job loss/instability (total indirect effect: β=−0.027, p=0.017; proportion being mediated=11.46%). In addition, significant interaction between deprivation and change of economic activity status was observed on mental health-related quality of life.
Conclusion Even if the COVID-19 incidence was relatively low, part of the observed health inequality can be explained by people’s concerns over livelihood and economic activity, which were affected by the containment measures. We should look beyond the incidence to address COVID-19 related health inequalities.
- health inequalities
- social inequalities
- poverty
- deprivation
- communicable diseases
Data availability statement
Data are available upon reasonable request. The data that support the findings of this study are available on request from the corresponding author, RY-NC. The data are not publicly available due to containing information that could compromise the privacy of research participants.
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Data availability statement
Data are available upon reasonable request. The data that support the findings of this study are available on request from the corresponding author, RY-NC. The data are not publicly available due to containing information that could compromise the privacy of research participants.
Footnotes
Correction notice This article has been corrected since it first published. The provenance and peer review statement has been included.
Contributors All authors contributed to the write-up of this manuscript. RY-NC oversaw the study and is responsible for the conceptualisation of the study, study design, data collection, data analysis, data interpretation and led the write-up of the manuscript. SYSW and DC are responsible for the data collection, data analysis and data interpretation. GK-KC, MM, JA, PG, HW, EL, JW and E-KY are responsible for the data interpretation.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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