We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Waves of inequality: income differences in intensive care due to Covid-19 in Sweden.
- Authors
Gauffin, Karl; Östergren, Olof; Cederström, Agneta
- Abstract
Background Socioeconomically vulnerable groups were overall more likely to develop severe Covid-19, but specific conditions in terms of preparedness, knowledge and the properties of the virus itself changed during the course of the pandemic. Inequalities in Covid-19 may therefore shift over time. This study examines the relationship between income and intensive care (ICU) episodes due to Covid-19 in Sweden during three distinct waves. Methods This study uses Swedish register data on the total adult population and estimates the relative risk (RR) of ICU episodes due to Covid-19 by income quartile for each month between March 2020 and May 2022, and for each wave, using Poisson regression analyses. Results The first wave had modest income-related inequalities, while the second wave had a clear income gradient, with the lowest income quartile having an increased risk compared to the high-income group [RR: 1.55 (1.36–1.77)]. In the third wave, the overall need for ICU decreased, but RRs increased, particularly in the lowest income quartile [RR: 3.72 (3.50–3.96)]. Inequalities in the third wave were partly explained by differential vaccination coverage by income quartile, although substantial inequalities remained after adjustment for vaccination status [RR: 2.39 (2.20–2.59)]. Conclusions The study highlights the importance of considering the changing mechanisms that connect income and health during a novel pandemic. The finding that health inequalities increased as the aetiology of Covid-19 became better understood could be interpreted through the lens of adapted fundamental cause theory.
- Subjects
SWEDEN; INTENSIVE care units; RELATIVE medical risk; HEALTH policy; COVID-19; HEALTH services accessibility; PUBLIC health; VACCINATION coverage; INCOME; SOCIOECONOMIC factors; DESCRIPTIVE statistics; RESEARCH funding; HEALTH equity; DATA analysis software; POISSON distribution
- Publication
European Journal of Public Health, 2023, Vol 33, Issue 4, p574
- ISSN
1101-1262
- Publication type
Article
- DOI
10.1093/eurpub/ckad094