ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Differential Patterns by Area-Level Social Determinants of Health in Coronavirus Disease 2019 (COVID-19)-Related Mortality and Non-COVID-19 Mortality: A Population-Based Study of 11.8 Million People in Ontario, Canada.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed.
- Correlation of COVID-19 Mortality with Socioeconomic Status, Air Quality, and Housing Density.Thoracic research and practice · 2026Article
- Examining the interaction between area-level immunity coverage and individual-level immunity to help quantify indirect herd benefits: a population-based retrospective cohort study of COVID-19 diagnoses and deaths.American journal of epidemiology · 2026Article
- Collecting Accurate and Robust Equity (CARE) data: an analysis of a pilot quality improvement initiative in ambulatory settings.BMJ open quality · 2026Article
- The mediating role of SARS-CoV-2 variants between income and hospitalization due to COVID-19: a period-based mediation analysis.American journal of epidemiology · 2025Article
- Population-Based Matched Cohort Study of COVID-19 Healthcare Costs, Ontario, Canada.Emerging infectious diseases · 2025Article
- Article
- Early COVID-19 and protection from Omicron in a highly vaccinated population in Ontario, Canada: a matched prospective cohort study.BMC infectious diseases · 2025Article
- Associations between social determinants of health and COVID-19 outcomes by variants of concern: a Bayesian spatiotemporal analysis.BMJ public health · 2025Article
- Associations of County-Level Social Determinants of Health with COVID-19 Related Hospitalization Among People with HIV: A Retrospective Analysis of the U.S. National COVID Cohort Collaborative (N3C).AIDS and behavior · 2024Article
- The Clinical Severity of COVID-19 Variants of Concern: Retrospective Population-Based Analysis.JMIR public health and surveillance · 2024Article
- Neighborhood-Level Burden of Social Risk Factors on Respiratory Syncytial Virus Hospitalization in Ontario, Canada, 2016-2019.Open forum infectious diseases · 2024Article
- Increased mortality in socioeconomic disadvantaged municipalities during the first phase of the COVID-19 pandemic in Lombardy region.European journal of public health · 2024Article
- Social determinants of health during and after coronavirus: a qualitative study.BMC public health · 2024Article
- Variability in excess deaths across countries with different vulnerability during 2020-2023.Proceedings of the National Academy of Sciences of the United States of America · 2023Article
- Smoke and Spike: Benzo[a]pyrene Enhances SARS-CoV-2 Infection by Boosting NR4A2-Induced ACE2 and TMPRSS2 Expression.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2023Article
- Article
- Neighbourhood-level socioeconomic status and prevalence of teacher-reported health disorders among Canadian kindergarten children.Frontiers in public health · 2023Article
- Which Curve Are We Flattening? The Disproportionate Impact of COVID-19 Among Economically Marginalized Communities in Ontario, Canada, Was Unchanged From Wild-Type to Omicron.Open forum infectious diseases · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundSocial determinants of health (SDOH) have been associated with coronavirus disease 2019 (COVID-19) outcomes. We examined patterns in COVID-19-related mortality by SDOH and compared these patterns to those for non-COVID-19 mortality.
methodsResidents of Ontario, Canada, aged ≥20 years were followed from 1 March 2020 to 2 March 2021. COVID-19-related death was defined as death within 30 days following or 7 days prior to a positive COVID-19 test. Area-level SDOH from the 2016 census included median household income; proportion with diploma or higher educational attainment; proportion essential workers, racially minoritized groups, recent immigrants, apartment buildings, and high-density housing; and average household size. We examined associations between SDOH and COVID-19-related mortality, and non-COVID-19 mortality using cause-specific hazard models.
resultsOf 11 810 255 individuals, we observed 3880 COVID-19-related deaths and 88 107 non-COVID-19 deaths. After accounting for demographics, baseline health, and other area-level SDOH, the following were associated with increased hazards of COVID-19-related death (hazard ratio [95% confidence interval]: lower income (1.30 [1.04-1.62]), lower educational attainment (1.27 [1.07-1.52]), higher proportions essential workers (1.28 [1.05-1.57]), racially minoritized groups (1.42 [1.08-1.87]), apartment buildings (1.25 [1.07-1.46]), and large vs medium household size (1.30 [1.12-1.50]). Areas with higher proportion racially minoritized groups were associated with a lower hazard of non-COVID-19 mortality (0.88 [0.84-0.92]).
conclusionsArea-level SDOH are associated with COVID-19-related mortality after accounting for demographic and clinical factors. COVID-19 has reversed patterns of lower non-COVID-19 mortality among racially minoritized groups. Pandemic responses should include strategies to address disproportionate risks and inequitable coverage of preventive interventions associated with SDOH.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.