Socioeconomic inequalities associated with mortality for COVID-19 in Colombia: a cohort nationwide study

BackgroundAfter 8 months of the COVID-19 pandemic, Latin American countries have some of the highest rates in COVID-19 mortality. Despite being one of the most unequal regions of the world, there is a scarce report of the effect of socioeconomic conditions on COVID-19 mortality in their countries. W...

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Bibliographic Details
Published in:Journal of epidemiology and community health (1979) 2021-07, Vol.75 (7), p.610-615
Main Authors: Cifuentes, Myriam Patricia, Rodriguez-Villamizar, Laura Andrea, Rojas-Botero, Maylen Liseth, Alvarez-Moreno, Carlos Arturo, Fernández-Niño, Julián Alfredo
Format: Article
Language:English
Subjects:
Cohort analysis
cohort studies
Coronaviruses
COVID-19
Health insurance
Indigenous peoples
Minority & ethnic groups
Mortality
Original Research
Pandemics
social inequalities
Socioeconomic factors
Socioeconomics
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Summary:BackgroundAfter 8 months of the COVID-19 pandemic, Latin American countries have some of the highest rates in COVID-19 mortality. Despite being one of the most unequal regions of the world, there is a scarce report of the effect of socioeconomic conditions on COVID-19 mortality in their countries. We aimed to identify the effect of some socioeconomic inequality-related factors on COVID-19 mortality in Colombia.MethodsWe conducted a survival analysis in a nation-wide retrospective cohort study of confirmed cases of COVID-19 in Colombia from 2 March 2020 to 26 October 2020. We calculated the time to death or recovery for each confirmed case in the cohort. We used an extended multivariable time-dependent Cox regression model to estimate the HR by age groups, sex, ethnicity, type of health insurance, area of residence and socioeconomic strata.ResultsThere were 1 033 218 confirmed cases and 30 565 deaths for COVID-19 in Colombia between 2 March and 26 October. The risk of dying for COVID-19 among confirmed cases was higher in males (HR 1.68 95% CI 1.64 to 1.72), in people older than 60 years (HR 296.58 95% CI 199.22 to 441.51), in indigenous people (HR 1.20 95% CI 1.08 to 1.33), in people with subsidised health insurance regime (HR 1.89 95% CI 1.83 to 1.96) and in people living in the very low socioeconomic strata (HR 1.44 95% CI 1.24 to 1.68).ConclusionOur study provides evidence of socioeconomic inequalities in COVID-19 mortality in terms of age groups, sex, ethnicity, type of health insurance regimen and socioeconomic status.
ISSN:0143-005X
1470-2738
DOI:10.1136/jech-2020-216275