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  • P23 The contribution of socio-economic disadvantages and household composition to ethnic inequalities in severe COVID-19: mediation analyses of national linked Scottish data

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SSM Annual Scientific Meeting
Posters
Wednesday 4th September
Session A: Marginalised groups, 14:00–15:00
P23 The contribution of socio-economic disadvantages and household composition to ethnic inequalities in severe COVID-19: mediation analyses of national linked Scottish data
  1. S Amele1,
  2. E Kibuchi1,
  3. R McCabe1,
  4. E Demou1,
  5. AH Leyland1,
  6. P Henery2,
  7. K Hainey1,
  8. AF Fagbamigbe3,4,
  9. A Kurdi5,6,
  10. C McCowan7
  1. 1MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, UK
  2. 2Public Health Scotland, Glasgow, UK
  3. 3Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
  4. 4Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
  5. 5Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, UK
  6. 6Department of Pharmacology, College of Pharmacy, Hawler Medical University, Erbil, Iraq
  7. 7School of Medicine, University of St Andrews, St Andrews, UK
  8. 8Usher Institute, the University of Edinburgh, UK
  9. 9School of Health, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
  10. 10Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK

Abstract

Background We explored the extent to which socioeconomic disadvantage contributed to ethnic inequalities in severe COVID-19 outcomes (hospitalisation or death) in Scotland.

Methods We used linked 2011 Scottish Census and health records data. We applied marginal structural models to estimate ethnic inequalities in severe COVID-19, using the counterfactual disparity measure (CDM), before and after accounting for area level deprivation (Scottish Index of Multiple Deprivation (SIMD) quintiles) and household size, and proportion eliminated (PE). Ethnicity was considered in its disaggregated form and as a binary measure (White vs. Non-White).

Results Non-White individuals had a higher likelihood of having severe COVID-19 compared to White individuals (hazards ratio (HR): 1.4, 95% confidence interval (CI): 1.3, 1.5). The CDM, accounting for SIMD, was 1.2 (1.0, 1.4) representing an attenuation of 52.7% 95%CI (52.6%, 52.9%). When holding household size constant across ethnic groups, the elevated risk of severe COVID-19 was attenuated by 88.6% (88.4%,88.8%) to 1.0(0.9, 1.2).

For disaggregated ethnicity, South Asian had elevated risks of severe COVID-19 compared to White Scottish 1.7(1.5, 1.9). If disparities in SIMD and household size were eliminated, the risk in severe COVID-19 among South Asian would reduce by 16.50% and 9.81% compared to White Scottish respectively. Estimates for the African, Caribbean, or Black and Other ethnic groups were imprecise due to smaller numbers of events.

Conclusion SIMD and household size contributed to ethnic inequalities in COVID-19 outcomes, but differences were not fully explained by these mediators. Reducing socioeconomic disparities will help reduce ethnic inequalities in COVID-19 outcomes, but broader policies are likely needed.

  • COVID-19
  • ethnicity
  • socioeconomic disadvantage
  • mediation
  • ethnic inequalities.

https://doi.org/10.1136/jech-2024-SSMabstracts.118

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