Category: Publications

The association between socioeconomic status and pandemic influenza: Systematic review and meta-analysis (plos.org)

Background: The objective of this study was to document whether and to what extent there is an association between socioeconomic status (SES) and disease outcomes in the last five influenza pandemics.

Methods/principle findings: The review included studies published in English, Danish, Norwegian and Swedish. Records were identified through systematic literature searches in six databases. We summarized results narratively and through meta-analytic strategies. Only studies for the 1918 and 2009 pandemics were identified. Of 14 studies on the 2009 pandemic including data on both medical and social risk factors, after controlling for medical risk factors 8 demonstrated independent impact of SES. In the random effect analysis of 46 estimates from 35 studies we found a pooled mean odds ratio of 1.4 (95% CI: 1.2–1.7, p < 0.001), comparing the lowest to the highest SES, but with substantial effect heterogeneity across studies,–reflecting differences in outcome measures and definitions of case and control samples. Analyses by pandemic period (1918 or 2009) and by level of SES measure (individual or ecological) indicated no differences along these dimensions. Studies using healthy controls tended to document that low SES was associated with worse influenza outcome, and studies using infected controls find low SES associated with more severe outcomes. A few studies compared severe outcomes (ICU or death) to hospital admissions but these did not find significant SES associations in any direction. Studies with more unusual comparisons (e.g., pandemic vs seasonal influenza, seasonal influenza vs other patient groups) reported no or negative non-significant associations.

Conclusions/significance: We found that SES was significantly associated with pandemic influenza outcomes with people of lower SES having the highest disease burden in both 1918 and 2009. To prepare for future pandemics, we must consider social vulnerability. The protocol for this study has been registered in PROSPERO (ref. no 87922) and has been published Mamelund et al. (2019).

We at PANSOC have been co-authoring a preprint that might help answer that question using 100 years of data from three countries including Sweden, Switzerland and Spain. We looked at age adjusted monthly estimates of excess mortality to show that in 2020 these countries recorded highest monthly excess and all-cause mortality levels driven by an infectious disease since the 1918 pandemic.

The preprint can be downloaded here 37204759 (medrxiv.org)

This new study by our new post-doc Margarida Pereira suggests that the economic crisis in 2008 enhanced the social inequalities regarding childhood obesity in Portugal. These results aid the development of evidence-based strategies to lessen the social inequities in health outcomes created by the crisis.

The paper is published in the journal Public Health and can be found here: The economic crisis impact on the body mass index of children living in distinct urban environments – ScienceDirect

En stor del av Norges befolkning kan jobbe hjemmefra, men vi har også mange ansatte i Norge som ikke utøver yrket sitt foran PC-en. For de fleste av disse er ikke hjemmekontor et alternativ. Ulike yrker har dermed ulike forutsetninger for å kunne følge smittevernrådene som sosial distansering i jobben. I en ny artikkel skrevet av Mari Holm Ingelsrud (som del av NFR-prosjektet CorRisk), ser hun på hvem som har og ikke har hatt mulighet for å bruke hjemmekontor som smitteverntiltak.

Les hele artikkellen her fra side 14: ramazzini-01.2021.pdf (legeforeningen.no)

You can read the paper here: Social Disparities in Adopting Non-pharmaceutical Interventions During COVID-19 – Svenn-Erik Mamelund, Jessica Dimka, Nan Zou Bakkeli, 2021 (sagepub.com)

In the absence of vaccines to fight the COVID-19 pandemic, in 2020 governments had to respond by rely on non-pharmaceutical interventions (NPIs). Socioeconomic inequalities likely influenced the uptake of NPIs. Using Norwegian survey data, we study whether income was associated with increased handwashing, keeping 1 m distance, using facemasks increased use of home office, and less use of public transportation. Except for using facemasks and less public transportation in a non-work context, all analyzed NPIs showed an independent positive association with income. Social disparities in NPI uptake may be important drivers of higher risks of disease outcomes for people of lower socioeconomic status.

The Centre leader, Svenn-Erik Mamelund, and co-centre leader, Jessica Dimka, has published an invited comment article in Scandinavian Journal of Public Health.

The comment is basically explaining the core idea of PANSOC. Here is a quote from the article:

“During pandemics like COVID-19, socioeconomic inequalities produce disparities in both disease outcomes & potential negative consequences of control measures. Preparedness and response plans must address social & medical risk factors”.

You can read the article in full here: Social inequalities in infectious diseases – Svenn-Erik Mamelund, Jessica Dimka, 2021 (sagepub.com)