ArticleFrontiers in public health2023
Social deprivation and SARS-CoV-2 testing: a population-based analysis in a highly contrasted southern France region.
Article in Frontiers in public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Article
- Socioeconomic inequalities and the COVID-19 pandemic in France: Territorial analyzes based on epidemic wave and metropolitan area.PloS one · 2026Article
- Distribution and determinants of COVID-19 seroprevalence in a hard-to-access health district in Mali.PLOS global public health · 2025Article
- Geographical coverage of SARS-CoV-2 screening and care centers in Haiti: what do national surveillance data tell us?BMC public health · 2024Article
- COVID-19 vaccination at a hospital in Paris: Spatial analyses and inverse equity hypothesis.Public health in practice (Oxford, England) · 2024Article
- The impact of health inequity on spatial variation of COVID-19 transmission in England.PLoS computational biology · 2024Article
- Reviving health mediation during the COVID-19 crisis and beyond: an implementation study in deprived neighbourhoods of Marseille, France.Frontiers in public health · 2024Article
- Spatial distribution of SARS-CoV-2 incidence, social inequality, housing conditions, and density in South-Eastern France: keys for future epidemics.Frontiers in public health · 2024Article
- Geoepidemiological perspective on COVID-19 pandemic review, an insight into the global impact.Frontiers in public health · 2023Review
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10 authors.
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Abstract
Background: Testing was the cornerstone of the COVID-19 epidemic response in most countries until vaccination became available for the general population. Social inequalities generally affect access to healthcare and health behaviors, and COVID-19 was rapidly shown to impact deprived population more drastically. In support of the regional health agency in Provence-Alpes-Côte d'Azur (PACA) in South-Eastern France, we analyzed the relationship between testing rate and socio-demographic characteristics of the population, to identify gaps in testing coverage and improve targeting of response strategies. Methods: We conducted an ecological analysis of SARS-CoV-2/COVID-19 testing rate in the PACA region, based on data aggregated at the finest spatial resolution available in France (IRIS) and by periods defined by public health implemented measures and major epidemiological changes. Using general census data, population density, and specific deprivation indices, we used principal component analysis followed by hierarchical clustering to define profiles describing local socio-demographic characteristics. We analyzed the association between these profiles and testing rates in a generalized additive multilevel model, adjusting for access to healthcare, presence of a retirement home, and the age profile of the population. Results: We identified 6 socio-demographic profiles across the 2,306 analyzed IRIS spatial units: privileged, remote, intermediate, downtown, deprived, and very deprived (ordered by increasing social deprivation index). Profiles also ranged from rural (remote) to high density urban areas (downtown, very deprived). From July 2020 to December 2021, we analyzed SARS-CoV-2/COVID-19 testing rate over 10 periods. Testing rates fluctuated strongly but were highest in privileged and downtown areas, and lowest in very deprived ones. The lowest adjusted testing rate ratios (aTRR) between privileged (reference) and other profiles occurred after implementation of a mandatory healthpass for many leisure activities in July 2021. Periods of contextual testing near Christmas displayed the largest aTRR, especially during the last periods of 2021 after the end of free convenience testing for unvaccinated individuals. Conclusion: We characterized in-depth local heterogeneity and temporal trends in testing rates and identified areas and circumstances associated with low testing rates, which the regional health agency targeted specifically for the deployment of health mediation activities.
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