Impact of Socioeconomic Deprivation on the Local Spread of COVID-19 Cases Mediated by the Effect of Seasons and Restrictive Public Health Measures: A Retrospective Observational Study in Apulia Region, Italy

Nicola Bartolomeo (), Massimo Giotta, Silvio Tafuri and Paolo Trerotoli
Additional contact information
Nicola Bartolomeo: Interdisciplinary Department of Medicine, University of Bari Aldo Moro, 70121 Bari, Italy
Massimo Giotta: Interdisciplinary Department of Medicine, University of Bari Aldo Moro, 70121 Bari, Italy
Silvio Tafuri: Interdisciplinary Department of Medicine, University of Bari Aldo Moro, 70121 Bari, Italy
Paolo Trerotoli: Interdisciplinary Department of Medicine, University of Bari Aldo Moro, 70121 Bari, Italy

IJERPH, 2022, vol. 19, issue 18, 1-16

Abstract: The aim of this study was to investigate the spatiotemporal association between socioeconomic deprivation and the incidence of COVID-19 and how this association changes through the seasons due to the existence of restrictive public health measures. A retrospective observational study was conducted among COVID-19 cases that occurred in the Apulia region from 29 February 2020 to 31 December 2021, dividing the period into four phases with different levels of restrictions. A generalized estimating equation (GEE) model was applied to test the independent effect of deprivation on the incidence of COVID-19, taking into account age, sex, and regional incidence as possible confounding effects and covariates, such as season and levels of restrictions, as possible modifying effects. The highest incidence was in areas with a very high deprivation index (DI) in winter. During total lockdown, no rate ratio between areas with different levels of DI was significant, while during soft lockdown, areas with very high DI were more at risk than all other areas. The effects of social inequalities on the incidence of COVID-19 changed in association with the seasons and restrictions on public health. Disadvantaged areas showed a higher incidence of COVID-19 in the cold seasons and in the phases of soft lockdown.

Keywords: COVID-19; social inequalities; deprivation index; incidence; restrictive public health measures; local spread; generalized estimating equation model (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
https://www.mdpi.com/1660-4601/19/18/11410/pdf (application/pdf)
https://www.mdpi.com/1660-4601/19/18/11410/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:19:y:2022:i:18:p:11410-:d:911848

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().