IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v311y2022ics0277953622006256.html
   My bibliography  Save this article

Explaining the deprivation gap in COVID-19 mortality rates: A decomposition analysis of geographical inequalities in England

Author

Listed:
  • Albani, Viviana
  • Welsh, Claire E.
  • Brown, Heather
  • Matthews, Fiona E.
  • Bambra, Clare

Abstract

One of the most consistent and worrying features of the COVID-19 pandemic globally has been the disproportionate burden of the epidemic in the most deprived areas. Most of the literature so far though has focused on estimating the extent of these inequalities. There has been much less attention paid to exploring the main pathways underpinning them. In this study, we employ the syndemic pandemic theoretical framework and apply novel decomposition methods to investigate the proportion of the COVID-19 mortality gap by area-level deprivation in England during the first wave of the pandemic (January to July 2020) was accounted for by pre-existing inequalities in the compositional and contextual characteristics of place. We use a decomposition approach to explicitly quantify the independent contribution of four inequalities pathways (vulnerability, susceptibility, exposure and transmission) in explaining the more severe COVID-19 outcomes in the most deprived local authorities compared to the rest. We find that inequalities in transmission (73%) and in vulnerability (49%) factors explained the highest proportion of mortality by deprivation. Our results suggest that public health agencies need to develop short- and long-term strategies to alleviate these underlying inequalities in order to alleviate the more severe impacts on the most vulnerable communities.

Suggested Citation

  • 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).
    • Handle: RePEc:eee:socmed:v:311:y:2022:i:c:s0277953622006256
    DOI: 10.1016/j.socscimed.2022.115319
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953622006256
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2022.115319?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. André Decoster & Thomas Minten & Johannes Spinnewijn, 2021. "The Income Gradient in Mortality during the Covid-19 Crisis: Evidence from Belgium," The Journal of Economic Inequality, Springer;Society for the Study of Economic Inequality, vol. 19(3), pages 551-570, September.
    2. Clouston, Sean A.P. & Natale, Ginny & Link, Bruce G., 2021. "Socioeconomic inequalities in the spread of coronavirus-19 in the United States: A examination of the emergence of social inequalities," Social Science & Medicine, Elsevier, vol. 268(C).
    3. Klaus Desmet & Romain Wacziarg, 2020. "Understanding Spatial Variation in COVID-19 across the United States," NBER Working Papers 27329, National Bureau of Economic Research, Inc.
    4. Michael Fletcher & Kate C. Prickett & Simon Chapple, 2022. "Immediate employment and income impacts of Covid-19 in New Zealand: evidence from a survey conducted during the Alert Level 4 lockdown," New Zealand Economic Papers, Taylor & Francis Journals, vol. 56(1), pages 73-80, January.
    5. Ulrich Kohler & Kristian Bernt Karlson & Anders Holm, 2011. "Comparing coefficients of nested nonlinear probability models," Stata Journal, StataCorp LP, vol. 11(3), pages 420-438, September.
    6. Serina Chang & Emma Pierson & Pang Wei Koh & Jaline Gerardin & Beth Redbird & David Grusky & Jure Leskovec, 2021. "Mobility network models of COVID-19 explain inequities and inform reopening," Nature, Nature, vol. 589(7840), pages 82-87, January.
    7. Persico, Claudia L. & Johnson, Kathryn R., 2021. "The effects of increased pollution on COVID-19 cases and deaths," Journal of Environmental Economics and Management, Elsevier, vol. 107(C).
    8. Brandily, Paul & Brébion, Clément & Briole, Simon & Khoury, Laura, 2021. "A poorly understood disease? The impact of COVID-19 on the income gradient in mortality over the course of the pandemic," European Economic Review, Elsevier, vol. 140(C).
    9. 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.
    10. Macintyre, Sally & Ellaway, Anne & Cummins, Steven, 2002. "Place effects on health: how can we conceptualise, operationalise and measure them?," Social Science & Medicine, Elsevier, vol. 55(1), pages 125-139, July.
    11. Mikolai, Julia & Keenan, Katherine & Kulu, Hill, 2020. "Household level health and socio-economic vulnerabilities and the COVID-19 crisis: An analysis from the UK," SocArXiv 4wtz8, Center for Open Science.
    12. Paul Rutter & Oliver Mytton & Matthew Mak & Liam Donaldson, 2012. "Socio-economic disparities in mortality due to pandemic influenza in England," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 57(4), pages 745-750, August.
    13. Morrissey, Karyn & Spooner, Fiona & Salter, James & Shaddick, Gavin, 2021. "Area level deprivation and monthly COVID-19 cases: The impact of government policy in England," Social Science & Medicine, Elsevier, vol. 289(C).
    14. Bambra, Clare & Smith, Katherine E. & Pearce, Jamie, 2019. "Scaling up: The politics of health and place," Social Science & Medicine, Elsevier, vol. 232(C), pages 36-42.
    15. Ruck, Damian J. & Bentley, R. Alexander & Borycz, Joshua, 2021. "Early warning of vulnerable counties in a pandemic using socio-economic variables," Economics & Human Biology, Elsevier, vol. 41(C).
    16. Menon, Nidhiya, 2021. "Does BMI predict the early spatial variation and intensity of Covid-19 in developing countries? Evidence from India," Economics & Human Biology, Elsevier, vol. 41(C).
    17. Jung, Juergen & Manley, James & Shrestha, Vinish, 2021. "Coronavirus infections and deaths by poverty status: The effects of social distancing," Journal of Economic Behavior & Organization, Elsevier, vol. 182(C), pages 311-330.
    18. Ulrich Kohler, 2011. "Comparing coefficients between nested nonlinear probability models," German Stata Users' Group Meetings 2011 08, Stata Users Group.
    19. Asher, Twisha & Deb, Partha & Gangaram, Anjelica, 2021. "Nursing facilities, food manufacturing plants and COVID-19 cases and deaths," Economics Letters, Elsevier, vol. 201(C).
    20. Elliott, Susan J., 2018. "50 years of medical health geography(ies) of health and wellbeing," Social Science & Medicine, Elsevier, vol. 196(C), pages 206-208.
    21. Cummins, Steven & Curtis, Sarah & Diez-Roux, Ana V. & Macintyre, Sally, 2007. "Understanding and representing 'place' in health research: A relational approach," Social Science & Medicine, Elsevier, vol. 65(9), pages 1825-1838, November.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Brandily, Paul & Brébion, Clément & Briole, Simon & Khoury, Laura, 2021. "A poorly understood disease? The impact of COVID-19 on the income gradient in mortality over the course of the pandemic," European Economic Review, Elsevier, vol. 140(C).
    2. Curtis, Sarah & Cunningham, Niall & Pearce, Jamie & Congdon, Peter & Cherrie, Mark & Atkinson, Sarah, 2021. "Trajectories in mental health and socio-spatial conditions in a time of economic recovery and austerity: A longitudinal study in England 2011–17," Social Science & Medicine, Elsevier, vol. 270(C).
    3. Bambra, Clare & Smith, Katherine E. & Pearce, Jamie, 2019. "Scaling up: The politics of health and place," Social Science & Medicine, Elsevier, vol. 232(C), pages 36-42.
    4. Stefanie Sperlich & Frauke-Marie Adler & Johannes Beller & Batoul Safieddine & Juliane Tetzlaff & Fabian Tetzlaff & Siegfried Geyer, 2022. "Getting Better or Getting Worse? A Population-Based Study on Trends in Self-Rated Health among Single Mothers in Germany between 1994 and 2018," IJERPH, MDPI, vol. 19(5), pages 1-13, February.
    5. Mitchell, Richard & Dujardin, Claire & Popham, Frank & Farfan Portet, Maria-Isabel & Thomas, Isabelle & Lorant, Vincent, 2011. "Using matched areas to explore international differences in population health," Social Science & Medicine, Elsevier, vol. 73(8), pages 1113-1122.
    6. Spielman, Seth E. & Yoo, Eun-hye, 2009. "The spatial dimensions of neighborhood effects," Social Science & Medicine, Elsevier, vol. 68(6), pages 1098-1105, March.
    7. Garthwaite, Kayleigh & Bambra, Clare, 2017. "“How the other half live”: Lay perspectives on health inequalities in an age of austerity," Social Science & Medicine, Elsevier, vol. 187(C), pages 268-275.
    8. Anna-Karin Ivert & Marie Torstensson Levander & Juan Merlo, 2013. "Adolescents' Utilisation of Psychiatric Care, Neighbourhoods and Neighbourhood Socioeconomic Deprivation: A Multilevel Analysis," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-1, November.
    9. Xuezhen Xu & Fang Wang & Tao Xu & Sufyan Ullah Khan, 2023. "How Does Capital Endowment Impact Farmers’ Green Production Behavior? Perspectives on Ecological Cognition and Environmental Regulation," Land, MDPI, vol. 12(8), pages 1-27, August.
    10. Samuel H. Fishman & S. Philip Morgan & Robert A. Hummer, 2018. "Smoking and Variation in the Hispanic Paradox: A Comparison of Low Birthweight Across 33 US States," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 37(5), pages 795-824, October.
    11. Zajacova, Anna & Montez, Jennifer Karas, 2018. "Explaining the increasing disability prevalence among mid-life US adults, 2002 to 2016," Social Science & Medicine, Elsevier, vol. 211(C), pages 1-8.
    12. Belon, Ana Paula & Nieuwendyk, Laura M. & Vallianatos, Helen & Nykiforuk, Candace I.J., 2014. "How community environment shapes physical activity: Perceptions revealed through the PhotoVoice method," Social Science & Medicine, Elsevier, vol. 116(C), pages 10-21.
    13. Myrskylä, Mikko & Elo, Irma T. & Kohler, Iliana V. & Martikainen, Pekka, 2014. "The association between advanced maternal and paternal ages and increased adult mortality is explained by early parental loss," Social Science & Medicine, Elsevier, vol. 119(C), pages 215-223.
    14. Watson, Barry & Kong, Nancy & Phipps, Shelley, 2022. "Dreaming of a Brighter Future? The Impact of Economic Vulnerability on University Aspirations," IZA Discussion Papers 15539, Institute of Labor Economics (IZA).
    15. Li, Fanlue & He, Ke & Wang, Yuejie & Zhang, Junbiao, 2021. "Does Indoor Air Pollution from Solid Fuels Influence the Mental Health of Rural Residents? Evidence from China," 2021 Conference, August 17-31, 2021, Virtual 315024, International Association of Agricultural Economists.
    16. Han, Yang & Wei, Jianwen & Zhao, Yandong, 2021. "Long-term effects of housing damage on survivors’ health in rural China: Evidence from a survey 10 Years after the 2008 Wenchuan earthquake," Social Science & Medicine, Elsevier, vol. 270(C).
    17. Sinha, Aakanksha & McRoy, Ruth G. & Berkman, Barbara & Sutherland, Melissa, 2017. "Drivers of change: Examining the effects of gender equality on child nutrition," Children and Youth Services Review, Elsevier, vol. 76(C), pages 203-212.
    18. Xinming Du, 2023. "Symptom or Culprit? Social Media, Air Pollution, and Violence," CESifo Working Paper Series 10296, CESifo.
    19. Lili Li & Araz Taeihagh & Si Ying Tan, 2023. "A scoping review of the impacts of COVID-19 physical distancing measures on vulnerable population groups," Nature Communications, Nature, vol. 14(1), pages 1-19, December.
    20. Thorsten Kneip & Gerrit Bauer & Steffen Reinhold, 2014. "Direct and Indirect Effects of Unilateral Divorce Law on Marital Stability," Demography, Springer;Population Association of America (PAA), vol. 51(6), pages 2103-2126, December.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:311:y:2022:i:c:s0277953622006256. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.