This is a summary, written by members of the CITF Secretariat, of
Ma H., Chan A. K. Baral S. D, Fahim C., Straus S., Sander B., Mishra S. Which curve are we flattening? The disproportionate impact of COVID-19 among economically marginalized communities in Ontario, Canada, was unchanged from wild-type to omicron. medRxiv. 2022. DOI: 10.24.22281104
The results and/or conclusions contained in the research do not necessarily reflect the views of all CITF members.
A preprint, not yet peer-reviewed, from CITF-funded researchers Dr. Sharmistha Mishra, Ms. Huiting Ma, Dr. Sharon Straus (University of Toronto) and their Wellness Hub team, indicated that public health interventions implemented since the first wave of the COVID-19 pandemic did not sufficiently address income-related health disparities. Among the risk factors that contributed to exposure to SARS-CoV-2 are household size and crowding, workplace exposure, and systemic barriers to prevention and care.
Economically marginalized communities faced disproportionately higher risks of infection and death from COVID-19 across Canada, particularly during the first wave of the pandemic. Yet, these disparities were expected to dissipate in subsequent waves, given the efforts undertaken in Canada to ensure equity, including access to vaccination.
The research team evaluated inequalities with regards to hospitalizations and deaths, access to vaccines, and incidents of SARS-CoV-2 infection.
- In Ontario, over the course of the pandemic, hospitalizations and deaths remained concentrated among the 20% of the population living in the lowest income neighbourhoods. These health inequalities remained substantial and persisted across COVID-19 waves.
- When it came to vaccine access and infection rates, the disparity between lower and higher income groups was less. However, economically disadvantaged people did have lower levels of vaccination and higher incidents of SARS-CoV-2 infection than did higher income individuals throughout the pandemic.
- Researchers estimated that the income-related inequalities regarding the rate of hospitalizations and deaths were 10-fold greater than those related to vaccine access and infection rates, suggesting that the real problem is the high rate of hospitalization and death among those from lower income groups.
Researchers highlighted that ongoing evaluation of the effectiveness and equity of programs implemented since the beginning of the pandemic is essential to inform public health responses to future waves of COVID-19, and other potential future threats.
This study used individual-level surveillance and neighbourhood-level income data to explore the inequalities in COVID-19 related-hospitalizations and deaths that occurred during the first five waves of COVID-19 (from February 2020 to February 2022) in Ontario. Travel-related cases and residents of long-term care homes were excluded from the study.