Social inequalities and dynamics of the early COVID-19 epidemic: a prospective cohort study in France

Autor: Nathalie Bajos, François Beck, Nathalie Lydié, Claude Martin, Florence Jusot, Laurence Meyer, Rémy Slama, Josiane Warszawski, Jeanna-eve Franck, Emilie Counil, Ariane Pailhé, Alexis Spire, Guillaume Bagein, Muriel Barlet, Aude Leduc FlorenceJusot, Delphine Rahib NicolasPaliod, Philippe Raynaud, Alexandra Rouquette, Patrick Sicard
Přispěvatelé: Institut de Recherche Interdisciplinaire sur les enjeux Sociaux - sciences sociales, politique, santé (IRIS), École des hautes études en sciences sociales (EHESS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Sorbonne Paris Nord, Institut national d'études démographiques (INED), Université Paris Dauphine-PSL, Université Paris sciences et lettres (PSL), Laboratoire d'Economie de Dauphine (LEDa), Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Paris Dauphine-PSL, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), Centre de Recherches sur l'Action Politique en Europe (ARENES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), École des Hautes Études en Santé Publique [EHESP] (EHESP), Santé publique France - French National Public Health Agency [Saint-Maurice, France], Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), AP-HP. Université Paris Saclay, INSERM (Institut National de la Sante et de la Recherche Medicale) Institut National de la Sante et de la Recherche Medicale (Inserm), French Ministry for Research, Drees (Direction de la Recherche, des Etudes, de l'Evaluation et des Statistiques), European Research Council under the European Union's Horizon 2020 research and innovation program [856478], Université Paris-Saclay, EpiCoV study group: Nathalie Bajos, Josiane Warszawski, Guillaume Bagein, Muriel Barlet, François Beck, Emilie Counil, Aude Leduc FlorenceJusot, Nathalie Lydie, Claude Martin, Laurence Meyer, Ariane Pailhé, Delphine Rahib NicolasPaliod, Philippe Raynaud, Alexandra Rouquette, Patrick Sicard, Rémy Slama, Alexis Spire, Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Sorbonne Paris Cité (USPC)-École des hautes études en sciences sociales (EHESS)-Université Paris 13 (UP13), Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire [Grenoble] (CHU)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Université de Rennes (UR)-Institut d'Études Politiques [IEP] - Rennes-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Centre National de la Recherche Scientifique (CNRS), Spire, Alexis
Jazyk: angličtina
Rok vydání: 2021
Předmět:
INFECTIOUS_DISEASES
[SHS.SOCIO] Humanities and Social Sciences/Sociology
Epidemiology
Population
HEALTH_INEQUALITY
EPIDEMICS
Social class
Cohort Studies
03 medical and health sciences
social medicine
0302 clinical medicine
Social medicine
Medicine
Humans
Social inequality
030212 general & internal medicine
Prospective Studies
education
Socioeconomic status
Pandemics
education.field_of_study
SOCIAL_INEQUALITY
030505 public health
[SHS.SOCIO]Humanities and Social Sciences/Sociology
business.industry
SARS-CoV-2
public health
COVID-19
General Medicine
Ageusia
[SHS.SCIPO]Humanities and Social Sciences/Political science
3. Good health
COHORT_ANALYSIS
Socioeconomic Factors
Cohort
Communicable Disease Control
Female
France
medicine.symptom
0305 other medical science
business
Cohort study
Demography
Zdroj: BMJ Open
BMJ Open, BMJ Publishing Group, 2021, 11 (11), pp.e052888. ⟨10.1136/bmjopen-2021-052888⟩
BMJ Open, Vol 11, Iss 11 (2021)
BMJ Open, 2021, 11 (11), pp.e052888. ⟨10.1136/bmjopen-2021-052888⟩
ISSN: 2044-6055
DOI: 10.1136/bmjopen-2021-052888⟩
Popis: ObjectiveAlthough social inequalities in COVID-19 mortality by race, gender and socioeconomic status are well documented, less is known about social disparities in infection rates and their shift over time. We aim to study the evolution of social disparities in infection at the early stage of the epidemic in France with regard to the policies implemented.DesignRandom population-based prospective cohort.SettingFrom May to June 2020 in France.ParticipantsAdults included in the Epidémiologie et Conditions de Vie cohort (n=77 588).Main outcome measuresSelf-reported anosmia and/or ageusia in three categories: no symptom, during the first epidemic peak (in March 2020) or thereafter (during lockdown).ResultsIn all, 2052 participants (1.53%) reported anosmia/ageusia. The social distribution of exposure factors (density of place of residence, overcrowded housing and working outside the home) was described. Multinomial regressions were used to identify changes in social variables (gender, class and race) associated with symptoms of anosmia/ageusia. Women were more likely to report symptoms during the peak and after. Racialised minorities accumulated more exposure risk factors than the mainstream population and were at higher risk of anosmia/ageusia during the peak and after. By contrast, senior executive professionals were the least exposed to the virus with the lower rate of working outside the home during lockdown. They were more affected than lower social classes at the peak of the epidemic, but this effect disappeared after the peak.ConclusionThe shift in the social profile of the epidemic was related to a shift in exposure factors under the implementation of a stringent stay-at-home order. Our study shows the importance to consider in a dynamic way the gender, socioeconomic and race direct and indirect effects of the COVID-19 pandemic, notably to implement policies that do not widen health inequalities.
Databáze: OpenAIRE
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