{"id":2016,"date":"2022-05-05T00:00:00","date_gmt":"2022-05-05T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/bring-the-hoses-to-where-the-fire-is-differential-impacts-of-marginalization-and-socioeconomic-status-on-covid-19-case-counts-and-healthcare-costs\/"},"modified":"2023-06-14T19:18:57","modified_gmt":"2023-06-14T23:18:57","slug":"bring-the-hoses-to-where-the-fire-is-differential-impacts-of-marginalization-and-socioeconomic-status-on-covid-19-case-counts-and-healthcare-costs","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/bring-the-hoses-to-where-the-fire-is-differential-impacts-of-marginalization-and-socioeconomic-status-on-covid-19-case-counts-and-healthcare-costs\/","title":{"rendered":"\u00ab\u00a0Bring the hoses to where the fire is!\u00a0\u00bb: differential impacts of marginalization and socioeconomic status on COVID-19 case counts and healthcare costs"},"content":{"rendered":"<p><strong>Objectives<\/strong> &#x2014; Local health leaders and the Director General of the World Health Organization alike have observed that COVID-19 &#x201c;does not discriminate.&#x201d; Nevertheless, the disproportionate representation of people of low socioeconomic status among those infected resembles discrimination. This population-based retrospective cohort study examined COVID-19 case counts and publicly funded healthcare costs in Ontario, Canada, with a focus on marginalization.<\/p>\n<p><strong>Methods<\/strong>  &#x2014; Individuals with their first positive severe acute respiratory syndrome coronavirus 2 test from January 1, 2020 to June 30, 2020, were linked to administrative databases and matched to negative\/untested controls. Mean net (COVID-19&#x2013;attributable) costs were estimated for 30 days before and after diagnosis, and differences among strata of age, sex, comorbidity, and measures of marginalization were assessed using analysis of variance tests.<\/p>\n<p><strong>Results<\/strong>  &#x2014; We included 28 893 COVID-19 cases (mean age 54 years, 56% female). Most cases remained in the community (20 545, 71.1%) or in long-term care facilities (4478, 15.5%), whereas 944 (3.3%) and 2926 (10.1%) were hospitalized, with and without intensive care unit, respectively.<\/p>\n<p>Case counts were skewed across marginalization strata with 2 to 7 times more cases in neighborhoods with low income, high material deprivation, and highest ethnic concentration.<\/p>\n<p>Mean net costs after diagnosis were higher for males (&#x24;4752 vs &#x24;2520 for females) and for cases with higher comorbidity (&#x24;1394-&#x24;7751) (both <em>P<\/em> &lt; .001) but were similar across levels of most marginalization dimensions (range &#x24;3232-&#x24;3737, all <em>P<\/em> &#x2265; .19).<\/p>\n<p><strong>Conclusions<\/strong>  &#x2014; This study suggests that allocating resources unequally to marginalized individuals may improve equality in outcomes. It highlights the importance of reducing risk of COVID-19 infection among marginalized individuals to reduce overall costs and increase system capacity.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Objectives &#x2014; Local health leaders and the Director General of the World Health Organization alike have observed that COVID-19 &#x201c;does not discriminate.&#x201d; Nevertheless, the disproportionate representation of people of low socioeconomic status among those infected resembles discrimination. This population-based retrospective cohort study examined COVID-19 case counts and publicly funded healthcare costs in Ontario, Canada, with [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[],"migration-helper-qa-sample-set":[],"class_list":["post-2016","journal_article","type-journal_article","status-publish","hentry"],"acf":{"citation":"Cheung DC, Bremner KE, Tsui TCO, Croxford R, Lapointe-Shaw L, Del Giudice L, Mendlowitz A, Perlis N, Pataky RE, Teckle P, Zeitouny S, Wong WWL, Sander B, Peacock S, Krahn MD, Kulkarni GS, Mulder C. <em>Value Health<\/em>. 2022; 25(8):1307-16. Epub 2022 May 5.","source_url":"https:\/\/www.valueinhealthjournal.com\/article\/S1098-3015(22)00185-1\/fulltext","ices_scientist":[1287,1120,1362,1147,21592],"site":[6733],"research_program":[6746],"news_release":[],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"276E633A-A36D-4133-8C00-01E7F433698E","sitecore_item_name":"Bring-the-hoses-to-where-the-fire-is-differential-impacts-of-marginalization","sitecore_field_values":"{\n  \"Title\": \"\"Bring the hoses to where the fire is!\": differential impacts of marginalization and socioeconomic status on COVID-19 case counts and healthcare costs\",\n  \"Short title\": \"\"Bring the hoses to where the fire is!\":\",\n  \"Summary\": \"This study highlights the importance of reducing risk of COVID-19 infection among marginalized individuals to reduce overall costs and increase system capacity.\",\n  \"Citation\": \"<p>Cheung DC, Bremner KE, Tsui TCO, Croxford R, Lapointe-Shaw L, Del Giudice L, Mendlowitz A, Perlis N, Pataky RE, Teckle P, Zeitouny S, Wong WWL, Sander B, Peacock S, Krahn MD, Kulkarni GS, Mulder C. <em>Value Health<\/em>. 2022; 25(8):1307-16. Epub 2022 May 5. DOI: <a href=\"https:\/\/doi.org\/10.1016\/j.jval.2022.03.019\" title=\"opens external link\">https:\/\/doi.org\/10.1016\/j.jval.2022.03.019<\/a><\/p>\",\n  \"Abstract\": \"<p><strong>Objectives<\/strong> &mdash; Local health leaders and the Director General of the World Health Organization alike have observed that COVID-19 &ldquo;does not discriminate.&rdquo; Nevertheless, the disproportionate representation of people of low socioeconomic status among those infected resembles discrimination. This population-based retrospective cohort study examined COVID-19 case counts and publicly funded healthcare costs in Ontario, Canada, with a focus on marginalization.<\/p>n<p><strong>Methods<\/strong>  &mdash; Individuals with their first positive severe acute respiratory syndrome coronavirus 2 test from January 1, 2020 to June 30, 2020, were linked to administrative databases and matched to negative\/untested controls. Mean net (COVID-19&ndash;attributable) costs were estimated for 30 days before and after diagnosis, and differences among strata of age, sex, comorbidity, and measures of marginalization were assessed using analysis of variance tests.<\/p>n<p><strong>Results<\/strong>  &mdash; We included 28 893 COVID-19 cases (mean age 54 years, 56% female). Most cases remained in the community (20 545, 71.1%) or in long-term care facilities (4478, 15.5%), whereas 944 (3.3%) and 2926 (10.1%) were hospitalized, with and without intensive care unit, respectively.<\/p>n<p>Case counts were skewed across marginalization strata with 2 to 7 times more cases in neighborhoods with low income, high material deprivation, and highest ethnic concentration.<\/p>n<p>Mean net costs after diagnosis were higher for males ($4752 vs $2520 for females) and for cases with higher comorbidity ($1394-$7751) (both <em>P<\/em> &lt; .001) but were similar across levels of most marginalization dimensions (range $3232-$3737, all <em>P<\/em> &ge; .19).<\/p>n<p><strong>Conclusions<\/strong>  &mdash; This study suggests that allocating resources unequally to marginalized individuals may improve equality in outcomes. It highlights the importance of reducing risk of COVID-19 infection among marginalized individuals to reduce overall costs and increase system capacity.<\/p>n<p><a href=\"https:\/\/www.valueinhealthjournal.com\/article\/S1098-3015(22)00185-1\/fulltext\" title=\"opens external link\">View full text<\/a><\/p>\",\n  \"Research Programs\": \"{CFE36C89-C969-4C23-B5E4-1BA9E5BDC273}\",\n  \"ICES Locations\": \"{4FCAABBA-14A5-42E6-8F33-BC6C2F1D9908}\",\n  \"ICES Scientists\": \"{A3C3238A-B34E-4000-B958-1FBB6D623873}|{024ADCCC-FC92-4FE6-8E39-FF61A7CBDA25}|{9F428E7D-3E0F-4597-84DC-22EE87D1A845}|{9EB22F72-67F1-409E-AB1B-D1C045367A84}|{9564D1CB-B35F-4CEC-9144-23097BB45807}\",\n  \"Posted Date\": \"20220505T000000\",\n  \"Show on Publications Landing Page\": \"1\"\n}","previous_url":"https:\/\/www.ices.on.ca\/Publications\/Journal-Articles\/2022\/May\/Bring-the-hoses-to-where-the-fire-is-differential-impacts-of-marginalization"},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | &quot;Bring the hoses to where the fire is!&quot;: differential impacts of marginalization and socioeconomic status on COVID-19 case counts and healthcare costs<\/title>\n<meta name=\"description\" content=\"Objectives &#x2014; Local health leaders and the Director General of the World Health Organization alike have observed that COVID-19 &#x201c;does not\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/bring-the-hoses-to-where-the-fire-is-differential-impacts-of-marginalization-and-socioeconomic-status-on-covid-19-case-counts-and-healthcare-costs\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ICES | &quot;Bring the hoses to where the fire is!&quot;: differential impacts of marginalization and socioeconomic status on COVID-19 case counts and healthcare costs\" \/>\n<meta property=\"og:description\" content=\"Objectives &#x2014; Local health leaders and the Director General of the World Health Organization alike have observed that COVID-19 &#x201c;does not\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/bring-the-hoses-to-where-the-fire-is-differential-impacts-of-marginalization-and-socioeconomic-status-on-covid-19-case-counts-and-healthcare-costs\/\" \/>\n<meta property=\"og:site_name\" content=\"ICES\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/ICESOntario\/\" \/>\n<meta property=\"article:modified_time\" content=\"2023-06-14T23:18:57+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.ices.on.ca\/wp-content\/uploads\/2024\/11\/ic-es-data-discovery-better-health-logo.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/bring-the-hoses-to-where-the-fire-is-differential-impacts-of-marginalization-and-socioeconomic-status-on-covid-19-case-counts-and-healthcare-costs\\\/\",\"url\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/publications\\\/journal-articles\\\/bring-the-hoses-to-where-the-fire-is-differential-impacts-of-marginalization-and-socioeconomic-status-on-covid-19-case-counts-and-healthcare-costs\\\/\",\"name\":\"ICES | \\\"Bring the hoses to where the fire is!\\\": differential impacts of marginalization and socioeconomic status on COVID-19 case counts and healthcare costs\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.ices.on.ca\\\/fr\\\/#website\"},\"datePublished\":\"2022-05-05T04:00:00+00:00\",\"dateModified\":\"2023-06-14T23:18:57+00:00\",\"description\":\"Objectives &#x2014; 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