Socio-economic characteristics impact on covid-19 mortality in region Västra Götaland.

Abstract: Background: There is a well establish association between low socio-economic status and health outcomes in general. To mitigate the impact of covid-19 there is a need to identify vulnerable groups, and to create methods that can do that in real-time as the virus-spread progress in the society. Aim: To examine if there are differences in mortality between different DeSO-areas in Västra Götaland according to these areas socio-economic characteristics. The second aim was to examine if DeSO-areas can be used in surveillance purpose and which variables that are relevant in that case. Materials and methods: Confirmed covid-19 case in region Västra Götaland between 26th February 2020 and 18th April 2021 was linked to different residential socio-economic characteristics (quintiles of income, low education, foreign born and categories of population density) based on Demographic Statistics Area (DeSO) data. Results: Older age and male sex was associated with covid-19 mortality. Income-level was the only of the DeSO variables that remained significant through the fully adjusted model. Living in areas in the lowest income quintile was associated with increased covid-19 mortality (hazard ratio: 1.83; 95 CI 1,358 - 2,467) compared to those that lives in the area within the highest income quintile. Conclusion: Living in a low-income area is associated with an increased risk of death in covid-19. This DeSo variable capture the socio-economic factors that is associated with covid-19 mortality on an aggregated level. The results are in accordance to other studies based on individual-level data suggesting that aggregated information from DeSO-areas are useful and relevant to identify vulnerable groups for covid-19. Linking cases to DeSO-data can give better keys to understand the progress of the virus-spread in the society. Implications: To emphasize the importance that covid-19 vaccination and other protective measures like testing and contact tracing are accessible irrespective of barriers that comes with social inequalities and deprivation. The Swedish surveillance system for notifiable diseases should be linked to socio-economic data.