{"id":21607,"date":"2025-03-07T09:48:07","date_gmt":"2025-03-07T14:48:07","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=21607"},"modified":"2025-03-19T14:39:33","modified_gmt":"2025-03-19T18:39:33","slug":"social-inequalities-in-covid-19-death-by-area-level-income-in-11-2-million-people-in-ontario-canada-patterns-over-time-and-the-mediating-role-of-vaccination","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/social-inequalities-in-covid-19-death-by-area-level-income-in-11-2-million-people-in-ontario-canada-patterns-over-time-and-the-mediating-role-of-vaccination\/","title":{"rendered":"Social inequalities in COVID-19 death by area-level income in 11.2 million people in Ontario, Canada: patterns over time and the mediating role of vaccination"},"content":{"rendered":"<p>Knowledge of patterns in COVID-19 deaths by area-level income over time and the mediating role of vaccination in inequality patterns remains limited. We used data from a population-based retrospective cohort of 11,248,572 adults in Ontario, Canada. Cause-specific hazard models were used examine the relationship between income 2016 Census at the dissemination area level) and COVID-19 deaths between March-1-2020 and January-30-2022, stratified by wave. We used regression-based causal mediation analyses to examine the mediating role of vaccination in the relationship between income and COVID-19 deaths during waves4 &amp; 5. After accounting for demographics, baseline health, and other social determinants of health, inequalities in COVID-19 deaths by income persisted over time (hazard ratios[95% confidence intervals] comparing lowest-income vs. highest-income quintiles were 1.37[0.98-1.92] for wave-1, 1.21[0.99-1.48] for wave-2, 1.55[1.22-1.96] for wave-3, and 1.57[1.15-2.15] for waves4 &amp; 5). By the start of wave four, 7,534,259(67.7%) of those alive were vaccinated, with lower odds of vaccination in the lowest-income vs. highest-income quintiles (0.71[0.70-0.71]). This inequality in vaccination accounted for 56.9%[22.5%-91.3%] of inequalities in COVID-19 deaths between individuals in the lowest-income vs. highest-income quintiles. Efforts are needed to address vaccination gaps and residual heightened risks associated with lower income to improve health equity in COVID-19 outcomes.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Knowledge of patterns in COVID-19 deaths by area-level income over time and the mediating role of vaccination in inequality patterns remains limited. We used data from a population-based retrospective cohort of 11,248,572 adults in Ontario, Canada. Cause-specific hazard models were used examine the relationship between income 2016 Census at the dissemination area level) and COVID-19 [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[20,39,35],"migration-helper-qa-sample-set":[],"class_list":["post-21607","journal_article","type-journal_article","status-publish","hentry","topic-health-and-health-care-inequality","topic-infectious-diseases","topic-public-health"],"acf":{"citation":"Wang L, Swayze S, Bodner K, Calzavara A, Harrigan SP, Siddiqi A, Baral SD, Austin PC, Smylie J, Koh M, Sbihi H, Sander B, Kwong JC, Mishra S. <em>Am J Epidemiol<\/em>. 2025; Mar 7 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1093\/aje\/kwaf051","ices_scientist":[1385,1367,1140,1362,1149,1320],"site":[6733],"research_program":[6745],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Social inequalities in COVID-19 death by area-level income in 11.2 million people in Ontario, Canada: patterns over time and the mediating role of vaccination<\/title>\n<meta name=\"description\" content=\"Knowledge of patterns in COVID-19 deaths by area-level income over time and the mediating role of vaccination in inequality patterns remains limited. 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