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Background Racialized and low income communities face disproportionally high rates of coronavirus 2019 (COVID-19) infection and death. However, data on inequities in COVID-19 across granular categories of socio-demographic characteristics is more sparse. Methods Neighbourhood-level counts of COVID-19 cases and deaths in Ontario, Canada recorded as of July 28th, 2020 were extracted from provincial and local reportable infectious disease surveillance systems. Associations between COVID-19 incidence and mortality and 18 neighbourhood-level measures of immigration, race, housing and socio-economic characteristics were estimated with Poisson generalized linear mixed models. Housing characteristic variables were subsequently added to models to explore if housing may have a confounding influence on the relationships between immigration, race, and socio-economic status and COVID-19...

The covid-19 pandemic has exposed the longstanding structural drivers of health inequities, such as precarious and adverse working conditions, growing economic disparities, and anti-democratic political processes and institutions. These important determinants of health have interlinked with class, ethnicity, gender, education level, and other factors during covid-19 to exacerbate existing social vulnerabilities in society. Numerous warnings of the dangers of inequity have emerged over the past decades. The Alma Ata declaration convincingly argued that “health for all” could be achieved only through a New International Economic Order and people’s participation in decisions affecting their community’s health.1 These principles were affirmed in the report of the Commission on the Social Determinants of Health2 and the 2008 World Health Report.3 The commission proposed...

In recent decades, there has been an intensification of the socioeconomic and environmental drivers of pandemics, including ecosystem conversion, meat consumption, urbanization, and connectivity among cities and countries. This paper reviews how these four systemic drivers help explain the dynamics of the COVID-19 pandemic and other recent emerging infectious diseases, and the policies that can be adopted to mitigate their risks. Land-use change and meat consumption increase the likelihood of pathogen spillover from animals to people. The risk that such zoonotic outbreaks will then spread to become pandemics is magnified by growing urban populations and the networks of trade and travel within and among countries. Zoonotic spillover can be mitigated through habitat protection and restrictions on the wildlife trade. Containing infectious disease spread requires a high degree of...

1. IntroductionThe World Health Organization has declared the novel coronavirus disease of 2019 (COVID-19) a global pandemic, as it has spread rapidly with high fatality rates across the world [1]. The European region, including the United Kingdom (UK), has been severely affected by the coronavirus outbreak, with waves of death and confirmed cases. The virus has shown that it respects no borders; however, it does affect people unequally. Consolidated evidence has indicated increased vulnerability to the virus among the most socially and economically disadvantaged, and COVID-19 has disproportionately affected these populations’ health and well-being across the world [2,3,4].Recent studies on inequalities in COVID-19 have highlighted multiple factors contributing to the differential vulnerability to the infection and the consequences of the disease [5,6]. Inequalities in...

To design better measures to contain the Covid-19 epidemics, it is relevant to know whether socioeconomic factors are associated with a higher risk of death by Covid-19. This work estimates the effects of individual socioeconomic characteristics on the risk of death by Covid-19. Logistic models were estimated to assess the effect of socioeconomic characteristics (income, race/ethnicity, schooling, occupation and economic activity) on the risk of death from Covid-19. For this purpose, Covid-19 individual death records in Rio de Janeiro state, Brazil were combined with the Annual Register of Social Information, which contains socioeconomic information about formal workers. Workers employed in establishments in the health and public safety sectors present a risk of dying 2.46 and 2.25 times higher than those employed in other activities. Non-white people, men, and those who work in the...

It is now established that across the United States, minoritized populations have borne a disproportionate burden from coronavirus disease 2019 (COVID-19). However, little is known about the interaction among a county’s racial/ethnic composition, its level of income inequality, political factors, and COVID-19 outcomes in the population. To quantify the association of economic inequality, racial/ethnic composition, political factors, and state health care policy with the incidence and mortality burden associated with COVID-19. This cross-sectional study used data from the 3142 counties in the 50 US states and for Washington, DC. Data on the first 200 days of the COVID-19 pandemic, from the first confirmed US case on January 22 to August 8, 2020, were gathered from the Centers for Disease Control and Prevention and USAFacts.org, the US Census Bureau, the American Community Survey,...

This Essay reflects on how socio-spatial inequalities and geographic situations condition the COVID-19 pandemic in Brazil, as well as actions to deal with the pandemic, with arguments backed by the literature. Socio-spatial inequality is defined as a process and structural condition of a territory marked by inherited and updated vulnerabilities, resulting from a relationship of exploitation, spoliation, and oppression in the current period of globalization. The authors argue that the COVID-19 pandemic can have more serious repercussions in contexts of greater socio-spatial inequality, with systemic and chronic deepening of the economic and social crises in places. Still, actions matter, including collaboration between different groups, institutions, and sectors. The analysis of geographic situation contributes to understanding the inherited territory and different experiences with...

This paper examines the different socio-economic determinants of the fatalities associated with the COVID-19 pandemic globally in social determinants of health frameworks. It adapts the Poisson pseudo-maximum-likelihood (PPML) and the quantile regression techniques to effectively exploit the non-linear estimates of the data in order to derive non-biased point estimates at each quantile and make interquantile comparisons. This is particularly useful in recommending which societal variables become most significant at catastrophic levels of a pandemic like COVID-19 when existing health systems become overwhelmed. These estimators are applied to panel data for 196 countries over days of infection from the first recorded case. The COVID-19-related data is from Our World in Data, and the socio-economic variables are from the World Bank’s World Development Indicators. The results establish...

The evidence of racial health disparities is profound. Much attention has been given to the disparity in maternal morbidity and mortality experienced by Black mothers. The disparity in Black lives lost from coronavirus disease 2019 (COVID-19) has further highlighted the disparity in health outcomes for Black people. Although COVID-19 is a new disease, the reason for the health disparity is the same as in maternal morbidity and mortality: implicit bias and structural racism. Implicit bias among health care professionals leads to disparities in how health care is delivered. Generations of structural racism perpetuated through racial residential segregation, economic suppression, and health care inequality have normalized the poorer health outcomes for Black Americans. It is easy to dismiss these issues as someone else’s problem, because health care professionals often fail to...

The coronavirus disease 2019 (COVID-19) has resulted in an enormous dislocation of society especially in South Africa. The South African government has imposed a number of measures aimed at controlling the pandemic, chief being a nationwide lockdown. This has resulted in income loss for individuals and firms, with vulnerable populations (low earners, those in informal and precarious employment, etc.) more likely to be adversely affected through job losses and the resulting income loss. Income loss will likely result in reduced ability to access healthcare and a nutritious diet, thus adversely affecting health outcomes. Given the foregoing, we hypothesize that the economic dislocation caused by the coronavirus will disproportionately affect the health of the poor. Using the fifth wave of the National Income Dynamics Study (NIDS) dataset conducted in 2017 and the first wave of the...