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The social determinants of health and pandemic h1n1 2009 influenza severity

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  • Lowcock, E.C.
  • Rosella, L.C.
  • Foisy, J.
  • McGeer, A.
  • Crowcroft, N.

Abstract

Objectives. We explored the effects of social determinants of health on pandemic H1N1 2009 influenza severity and the role of clinical risk factors in mediating such associations. Methods. We used multivariate logistic regression with generalized estimating equations to examine the associations between individual- and ecologicallevel social determinants of health and hospitalization for pandemic H1N1 2009 illness in a case-control study in Ontario, Canada. Results. During the first pandemic phase (April 23-July 20, 2009), hospitalization was associated with having a high school education or less and living in a neighborhood with high material or total deprivation. We also observed the association with education in the second phase (August 1-November 6, 2009). Clinical risk factors for severe pandemic H1N1 2009 illness mediated approximately 39% of the observed association. Conclusions. The main clinical risk factors for severe pandemic H1N1 2009 illness explain only a portion of the associations observed between social determinants of health and hospitalization, suggesting that the means by which the social determinants of health affect pandemic H1N1 2009 outcomes extend beyond clinically recognized risk factors.

Suggested Citation

  • Lowcock, E.C. & Rosella, L.C. & Foisy, J. & McGeer, A. & Crowcroft, N., 2012. "The social determinants of health and pandemic h1n1 2009 influenza severity," American Journal of Public Health, American Public Health Association, vol. 102(8), pages 51-58.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2012.300814_0
    DOI: 10.2105/AJPH.2012.300814
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    1. Baser, Onur, 2021. "Population density index and its use for distribution of Covid-19: A case study using Turkish data," Health Policy, Elsevier, vol. 125(2), pages 148-154.
    2. Heyuan You & Xin Wu & Xuxu Guo, 2020. "Distribution of COVID-19 Morbidity Rate in Association with Social and Economic Factors in Wuhan, China: Implications for Urban Development," IJERPH, MDPI, vol. 17(10), pages 1-14, May.
    3. Albani, Viviana & Welsh, Claire E. & Brown, Heather & Matthews, Fiona E. & Bambra, Clare, 2022. "Explaining the deprivation gap in COVID-19 mortality rates: A decomposition analysis of geographical inequalities in England," Social Science & Medicine, Elsevier, vol. 311(C).
    4. Masahiro Shoji & Susumu Cato & Takashi Iida & Kenji Ishida & Asei Ito & Kenneth Mori McElwain, 2022. "Variations in Early-Stage Responses to Pandemics: Survey Evidence from the COVID-19 Pandemic in Japan," Economics of Disasters and Climate Change, Springer, vol. 6(2), pages 235-258, July.
    5. Máté Kapitány-Fövény & Mihály Sulyok, 2020. "Social markers of a pandemic: modeling the association between cultural norms and COVID-19 spread data," Palgrave Communications, Palgrave Macmillan, vol. 7(1), pages 1-9, December.
    6. Maria Esther Irigoyen-Camacho & Maria Consuelo Velazquez-Alva & Marco Antonio Zepeda-Zepeda & Maria Fernanda Cabrer-Rosales & Irina Lazarevich & Antonio Castaño-Seiquer, 2020. "Effect of Income Level and Perception of Susceptibility and Severity of COVID-19 on Stay-at-Home Preventive Behavior in a Group of Older Adults in Mexico City," IJERPH, MDPI, vol. 17(20), pages 1-16, October.
    7. Ignacio Amate-Fortes & Almudena Guarnido-Rueda, 2023. "Inequality, public health, and COVID-19: an analysis of the Spanish case by municipalities," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(1), pages 99-110, February.
    8. Edmund Seto & Esther Min & Carolyn Ingram & BJ Cummings & Stephanie A. Farquhar, 2020. "Community-Level Factors Associated with COVID-19 Cases and Testing Equity in King County, Washington," IJERPH, MDPI, vol. 17(24), pages 1-13, December.
    9. Tara L Upshaw & Chloe Brown & Robert Smith & Melissa Perri & Carolyn Ziegler & Andrew D Pinto, 2021. "Social determinants of COVID-19 incidence and outcomes: A rapid review," PLOS ONE, Public Library of Science, vol. 16(3), pages 1-22, March.
    10. Isaac Koomson & Moses Okumu & David Ansong, 2022. "Introducing the Disease Outbreak Resilience Index (DORI) Using the Demographic and Health Surveys Data from sub-Saharan Africa," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 162(3), pages 1149-1175, August.
    11. Emily E. Wiemers & Scott Abrahams & Marwa AlFakhri & V. Joseph Hotz & Robert F. Schoeni & Judith A. Seltzer, 2020. "Disparities in Vulnerability to Severe Complications from COVID-19 in the United States," NBER Working Papers 27294, National Bureau of Economic Research, Inc.
    12. Ehlert, Andree, 2021. "The socio-economic determinants of COVID-19: A spatial analysis of German county level data," Socio-Economic Planning Sciences, Elsevier, vol. 78(C).
    13. James L. Doti, 2021. "Examining the impact of socioeconomic variables on COVID-19 death rates at the state level," Journal of Bioeconomics, Springer, vol. 23(1), pages 15-53, April.

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