Evidence map›Paper›PMID 39739247›Full record

Observational studyCanadian journal of public health = Revue canadienne de sante publique2025

The association between neighbourhood marginalization and SARS-CoV-2 outcomes in patients presenting to emergency departments.

Ivy Cheng, Rhonda J Rosychuk, David Seonguk Yeom, Ray L Jewett, Iwona A Bielska, Jake Hayward, Jaspreet Khangura, Rohit Mohindra, Megan Landes, Jeffrey P Hau and 6 more

Abstract readObservational Study
In one paragraph

Observational study in Canadian journal of public health = Revue canadienne de sante publique, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Ivy ChengDepartment of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. ivy.cheng@sunnybrook.ca.ORCID http://orcid.org/0000-0001-7740-9558
Rhonda J RosychukDepartment of Pediatrics, University of Alberta, Edmonton, AB, Canada.
David Seonguk YeomDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Ray L JewettDepartment of Geography and Planning, University of Toronto, Toronto, ON, Canada.
Iwona A BielskaDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
Jake HaywardDepartment of Emergency Medicine, University of Alberta, Edmonton, AB, Canada.
Jaspreet KhanguraDepartment of Emergency Medicine, University of Alberta, Edmonton, AB, Canada.
Rohit MohindraDivision of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada.
Megan LandesDivision of Emergency Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
Jeffrey P HauDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Christiaan H RigholtVaccine and Drug Evaluation Centre, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Murdoch LeeiesDepartment of Emergency Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Jennifer GrantDivisions of Medical Microbiology and Infectious Diseases, University of British Columbia, Vancouver, BC, Canada.
Steven C BrooksDepartments of Emergency Medicine and Public Health Sciences, Queen's University, Kingston, ON, Canada.
Corinne M HohlDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN) Investigators

Funding

CIHR 447679CIHR 464947CIHR 466880Fondation du CHU de Québec Octroi No. 4007Genome British Columbia COV024Genome British Columbia VAC007Ontario Ministry of Colleges and Universities C-655-2129Public Health Agency of Canada/COVID-19 Immunity Task Force 2122-HQ-00054Saskatchewan Health Research Foundation 5357
6 · The paper itself

Abstract

objectiveSocial and economic marginalizations have been associated with inferior health outcomes in Canada. Our objective was to describe the relationship between neighbourhood marginalization and COVID-19 outcomes among patients presenting to Canadian emergency departments (ED).

methodsWe conducted an observational study among consecutive COVID-19 patients recruited from 47 hospitals participating in the Canadian COVID-19 ED Rapid Response Network (CCEDRRN) between March 3, 2020, and July 24, 2022. We linked data with the Canadian Marginalization Index (CAN-Marg). We used multivariable, multi-level logistic regression models to understand the association between dimensions of neighbourhood marginalization, and severe COVID-19 and in-hospital mortality.

resultsThere were 55,588 eligible patients. Those from neighbourhoods with a higher proportion of recent immigrants (OR = 0.86 per unit increase [0.81, 0.92]), lower workforce participation (OR = 0.84 per unit increase [0.75, 0.94]), and more housing insecurity (OR = 0.81 per unit increase [0.77, 0.86]) were less likely to present to EDs with severe COVID-19. However, patients from materially marginalized neighbourhoods had increased odds of dying in hospital (OR = 1.19 per unit increase [95% CI 1.09, 1.30]) compared to patients from less materially marginalized neighbourhoods. Patients living in neighbourhoods with a higher proportion of recent immigrants (OR = 0.83 per unit increase [0.78, 0.91]) and lower participation in the workforce (OR = 0.77 per unit increase [0.66, 0.87]) experienced lower odds of dying.

conclusionDespite no association with severe COVID-19 at ED presentation, the only marginalization domain associated with in-hospital mortality was material deprivation. Our findings present insights on ED-seeking behaviour, hospital access, and care that population studies could not.

Indexed as

COVID-19Emergency Service, HospitalNeighborhood CharacteristicsResidence CharacteristicsSocial MarginalizationAdultAgedCanadaFemaleHospital MortalityHumansMaleMiddle AgedCOVID-19Emergency departmentEquityNeighbourhood marginalizationOutcomesSARS-CoV-2

Identifiers

PMID39739247
PMCPMC12684827

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.