ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2022
Geographic concentration of SARS-CoV-2 cases by social determinants of health in metropolitan areas in Canada: a cross-sectional study.
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Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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33 citing papers in PubMed.
- Beyond healthcare access: social deprivation and COVID-19 outcomes in dialysis patients in the provence-alpes-côte d'Azur region, France.BMC infectious diseases · 2026Article
- Challenges Facing Canadian Long-Term Care Homes and Retirement Homes During the COVID-19 Pandemic.Canadian geriatrics journal : CGJ · 2025Article
- COVID-19 impacts on the breast cancer care pathway among systemically marginalized communities in Ontario.Cancer causes & control : CCC · 2025Article
- The COVID-19 pandemic's impact on sexually transmitted infections and the modifying role of public health funding: an interrupted time series study.Journal of public health (Oxford, England) · 2025Article
- COVID-19 in Rural Ontario Communities: Exploring Women's Mental Health During a Pandemic.International journal of environmental research and public health · 2025Article
- A Cross-Sectional Study of COVID-19 Knowledge, Attitudes, and Practices Among Black Communities in the Greater Toronto Area.Journal of racial and ethnic health disparities · 2025Article
- A Canadian multi-province study of COVID-19 vaccine coverage along area-level social determinants in 2021.Public health in practice (Oxford, England) · 2025Article
- The burden of COVID-19 care in community and academic intensive care units in Ontario, Canada: a retrospective cohort study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2025Article
- Building Responsive Intersectoral Initiatives for Newcomers in Toronto: Learning from Service Providers' Experiences in the Context of COVID‑19.Annals of global health · 2025Article
- Associations between social determinants of health and COVID-19 outcomes by variants of concern: a Bayesian spatiotemporal analysis.BMJ public health · 2025Article
- Article
- The association of combinations of social factors and SARs-CoV-2 infection: A retrospective population-based cohort study in Ontario, 2020-2021.Dialogues in health · 2024Article
- Community versus academic hospital community-acquired pneumonia patients: a nested cohort study.Pneumonia (Nathan Qld.) · 2024Article
- Canada's approach to SARS-CoV-2 sero-surveillance: Lessons learned for routine surveillance and future pandemics.Canadian journal of public health = Revue canadienne de sante publique · 2024Article
- Canada's provincial COVID-19 pandemic modelling efforts: A review of mathematical models and their impacts on the responses.Canadian journal of public health = Revue canadienne de sante publique · 2024Review
- SARS-CoV-2 seroprevalence in Nova Scotia blood donors.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2024Article
- Cohort profile: the British Columbia COVID-19 Cohort (BCC19C)-a dynamic, linked population-based cohort.Frontiers in public health · 2024Article
- Mobility changes following COVID-19 stay-at-home policies varied by socioeconomic measures: An observational study in Ontario, Canada.PLOS global public health · 2024Article
- COVID-19 vaccine effectiveness by HIV status and history of injection drug use: a test-negative analysis.Journal of the International AIDS Society · 2023Article
- Learning from intersectoral initiatives to respond to the needs of refugees, asylum seekers, and migrants without status in the context of COVID-19 in Quebec and Ontario: a qualitative multiple case study protocol.Health research policy and systems · 2023Article
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Authors and funding
16 authors.
Yiqing XiaDepartment of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont.
Huiting MaDepartment of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont.
Gary MoloneyDepartment of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont.
Héctor A Velásquez GarcíaDepartment of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont.
Monica SirskiDepartment of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont.
Naveed Z JanjuaDepartment of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont.
David VickersDepartment of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont.
Tyler WilliamsonDepartment of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont.
Alan KatzDepartment of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont.
Kristy YiuDepartment of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont.
Rafal KustraDepartment of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont.
David L BuckeridgeDepartment of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont.
Marc BrissonDepartment of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont.
Stefan D BaralDepartment of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont.
Sharmistha MishraDepartment of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont. sharmistha.mishra@utoronto.ca.
Mathieu Maheu-GirouxDepartment of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUnderstanding inequalities in SARS-CoV-2 transmission associated with the social determinants of health could help the development of effective mitigation strategies that are responsive to local transmission dynamics. This study aims to quantify social determinants of geographic concentration of SARS-CoV-2 cases across 16 census metropolitan areas (hereafter, cities) in 4 Canadian provinces, British Columbia, Manitoba, Ontario and Quebec.
methodsWe used surveillance data on confirmed SARS-CoV-2 cases and census data for social determinants at the level of the dissemination area (DA). We calculated Gini coefficients to determine the overall geographic heterogeneity of confirmed cases of SARS-CoV-2 in each city, and calculated Gini covariance coefficients to determine each city's heterogeneity by each social determinant (income, education, housing density and proportions of visible minorities, recent immigrants and essential workers). We visualized heterogeneity using Lorenz (concentration) curves.
resultsWe observed geographic concentration of SARS-CoV-2 cases in cities, as half of the cumulative cases were concentrated in DAs containing 21%-35% of their population, with the greatest geographic heterogeneity in Ontario cities (Gini coefficients 0.32-0.47), followed by British Columbia (0.23-0.36), Manitoba (0.32) and Quebec (0.28-0.37). Cases were disproportionately concentrated in areas with lower income and educational attainment, and in areas with a higher proportion of visible minorities, recent immigrants, high-density housing and essential workers. Although a consistent feature across cities was concentration by the proportion of visible minorities, the magnitude of concentration by social determinant varied across cities.
interpretationGeographic concentration of SARS-CoV-2 cases was observed in all of the included cities, but the pattern by social determinants varied. Geographically prioritized allocation of resources and services should be tailored to the local drivers of inequalities in transmission in response to the resurgence of SARS-CoV-2.
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CanadaCitiesCOVID-19Cross-Sectional StudiesDemographyHumansSARS-CoV-2Social Determinants of HealthSocioeconomic Factors
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