Socio-Economic Factors Associated with Ethnic Disparities in SARS-CoV-2 Infection and Hospitalization

Alessio Gili, Marta Caminiti (), Chiara Lupi, Salvatore Zichichi, Ilaria Minicucci, Patrizio Pezzotti, Chiara Primieri, Carla Bietta and Fabrizio Stracci
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Alessio Gili: Public Health Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
Marta Caminiti: Public Health Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
Chiara Lupi: Public Health Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
Salvatore Zichichi: Public Health Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
Ilaria Minicucci: Public Health Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy
Patrizio Pezzotti: Department of Infectious Diseases, Istituto Superiore di Sanità, 00162 Rome, Italy
Chiara Primieri: Epidemiology Unit, Department of Preventive Medicine, Local Health Unit 1, 06126 Perugia, Italy
Carla Bietta: Epidemiology Unit, Department of Preventive Medicine, Local Health Unit 1, 06126 Perugia, Italy
Fabrizio Stracci: Public Health Section, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy

IJERPH, 2023, vol. 20, issue 15, 1-15

Abstract: Background: There is evidence that non-Italians presented higher incidence of infection and worse health outcomes if compared to native populations in the COVID-19 pandemic. The aim of the study was to compare Italian- and non-Italian-born health outcomes, accounting for socio-economic levels. Methods: We analyzed data relative to 906,463 people in Umbria (Italy) from 21 February 2020 to 31 May 2021. We considered the National Deprivation Index, the Urban–Rural Municipalities Index and the Human Development Index (HDI) of the country of birth. We used a multilevel logistic regression model to explore the influence of these factors on SARS-CoV-2 infection and hospitalization rates. Diagnosis in the 48 h preceding admission was an indicator of late diagnosis among hospitalized cases. Results: Overall, 54,448 persons tested positive (6%), and 9.7% of them were hospitalized. The risk of hospital admission was higher among non-Italians and was inversely related to the HDI of the country of birth. A diagnosis within 48 h before hospitalization was more frequent among non-Italians and correlated to the HDI level. Conclusions: COVID-19 had unequal health outcomes among the population in Umbria. Reduced access to primary care services in the non-Italian group could explain our findings. Policies on immigrants' access to primary healthcare need to be improved.

Keywords: COVID-19; Italian; non-Italians; Umbria; hospitalization; HDI; deprivation index (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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