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Comprehensive evaluation of the impact of sociodemographic inequalities on adverse outcomes and excess mortality during the coronavirus disease 2019 (COVID-19) pandemic in Mexico City

Antonio-Villa, Neftali Eduardo, Fernandez-Chirino, Luisa, Pisanty-Alatorre, Julio, Mancilla-Galindo, Javier, Kammar-García, Ashuin, Vargas-Vázquez, Arsenio, González-Díaz, Armando, Fermín-Martínez, Carlos A., Márquez-Salinas, Alejandro, Guerra, Enrique C., Bahena-López, Jessica Paola, Villanueva-Reza, Marco, Márquez-Sánchez, Jessica, Jaramillo-Molina, Máximo Ernesto, Gutiérrez-Robledo, Luis Miguel and Bello-Chavolla, Omar Yaxmehen (2022) Comprehensive evaluation of the impact of sociodemographic inequalities on adverse outcomes and excess mortality during the coronavirus disease 2019 (COVID-19) pandemic in Mexico City. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 74 (5). 785 - 792. ISSN 1058-4838

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Identification Number: 10.1093/cid/ciab577

Abstract

BACKGROUND: The impact of the coronavirus disease 2019 (COVID-19) pandemic in Mexico City has been sharp, as several social inequalities at all levels coexist. Here we conducted an in-depth evaluation of the impact of individual and municipal-level social inequalities on the COVID-19 pandemic in Mexico City. METHODS: We analyzed suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases, from the Mexico City Epidemiological Surveillance System from 24 February 2020 to 31 March 2021. COVID-19 outcomes included rates of hospitalization, severe COVID-19, invasive mechanical ventilation, and mortality. We evaluated socioeconomic occupation as an individual risk, and social lag, which captures municipal-level social vulnerability, and urban population density as proxies of structural risk factors. Impact of reductions in vehicular mobility on COVID-19 rates and the influence of risk factors were also assessed. Finally, we assessed discrepancies in COVID-19 and non-COVID-19 excess mortality using death certificates from the general civil registry. RESULTS: We detected vulnerable groups who belonged to economically unfavored sectors and experienced increased risk of COVID-19 outcomes. Cases living in marginalized municipalities with high population density experienced greater risk for COVID-19 outcomes. Additionally, policies to reduce vehicular mobility had differential impacts modified by social lag and urban population density. Finally, we report an under-registry of COVID-19 deaths along with an excess mortality closely related to marginalized and densely populated communities in an ambulatory setting. This could be attributable to a negative impact of modified hospital admission criteria during the pandemic. CONCLUSIONS: Socioeconomic occupation and municipality-wide factors played a significant role in shaping the course of the COVID-19 pandemic in Mexico City.

Item Type: Article
Official URL: https://academic.oup.com/cid
Additional Information: © 2021 The Authors
Divisions: LSE
Subjects: H Social Sciences > HV Social pathology. Social and public welfare. Criminology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited: 24 Mar 2022 11:42
Last Modified: 09 Jun 2022 13:57
URI: http://eprints.lse.ac.uk/id/eprint/114453

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