{"title":"Inequality in mortality according to regional deprivation during the COVID-19 pandemic.","authors":"Min Hui Moon, Min-Hyeok Choi, Young Gyu Ko","doi":"10.4178/epih.e2025022","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Vulnerability to coronavirus disease 2019 (COVID-19) is significantly greater in regions with lower socioeconomic status. However, detailed analyses of regional socioeconomic disparities have rarely been conducted in South Korea. This study aimed to identify and compare mortality inequalities associated with regional socioeconomic status across different areas of South Korea during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Using cause-of-death statistics from 2020 to 2022, we calculated age-standardized mortality rates (ASMRs) for total mortality, COVID-19 mortality, and pneumonia mortality. The socioeconomic status of each region was assessed using the regional deprivation index. Additionally, we calculated the rate difference (RD), rate ratio (RR), slope index of inequality (SII), and relative index of inequality (RII) for each socioeconomic level to examine the extent of mortality inequality and its temporal changes. These analyses were stratified by sex and urban-rural classification.</p><p><strong>Results: </strong>The total mortality rate, as well as COVID-19-specific and pneumonia-specific mortality rates, increased during the COVID-19 pandemic. The ASMR for COVID-19 was higher in rural areas (ASMR, 27.79), which have lower healthcare accessibility, compared to urban areas (ASMR, 26.63). However, mortality inequality indicators for COVID-19 were more pronounced in urban areas compared to rural areas (SII [urban: 2.72; rural: -0.05], RII [urban: 0.10; rural: 0.00]). Notably, significant inequalities were observed among men residing in urban areas.</p><p><strong>Conclusion: </strong>In disaster situations such as the COVID-19 pandemic, it is essential to implement strategies aimed at reducing overall mortality rates and addressing regional socioeconomic inequalities.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2025022"},"PeriodicalIF":2.2000,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Epidemiology and Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4178/epih.e2025022","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: Vulnerability to coronavirus disease 2019 (COVID-19) is significantly greater in regions with lower socioeconomic status. However, detailed analyses of regional socioeconomic disparities have rarely been conducted in South Korea. This study aimed to identify and compare mortality inequalities associated with regional socioeconomic status across different areas of South Korea during the COVID-19 pandemic.
Methods: Using cause-of-death statistics from 2020 to 2022, we calculated age-standardized mortality rates (ASMRs) for total mortality, COVID-19 mortality, and pneumonia mortality. The socioeconomic status of each region was assessed using the regional deprivation index. Additionally, we calculated the rate difference (RD), rate ratio (RR), slope index of inequality (SII), and relative index of inequality (RII) for each socioeconomic level to examine the extent of mortality inequality and its temporal changes. These analyses were stratified by sex and urban-rural classification.
Results: The total mortality rate, as well as COVID-19-specific and pneumonia-specific mortality rates, increased during the COVID-19 pandemic. The ASMR for COVID-19 was higher in rural areas (ASMR, 27.79), which have lower healthcare accessibility, compared to urban areas (ASMR, 26.63). However, mortality inequality indicators for COVID-19 were more pronounced in urban areas compared to rural areas (SII [urban: 2.72; rural: -0.05], RII [urban: 0.10; rural: 0.00]). Notably, significant inequalities were observed among men residing in urban areas.
Conclusion: In disaster situations such as the COVID-19 pandemic, it is essential to implement strategies aimed at reducing overall mortality rates and addressing regional socioeconomic inequalities.
在社会经济地位较低的地区,对2019冠状病毒病(COVID-19)的易感性明显更高。然而,韩国很少对地区社会经济差异进行详细的分析。本研究旨在确定和比较韩国不同地区在COVID-19大流行期间与区域社会经济地位相关的死亡率不平等。方法:利用2020 - 2022年的死因统计数据,计算总死亡率、COVID-19死亡率和肺炎死亡率的年龄标准化死亡率(ASMRs)。利用区域剥夺指数对各区域的社会经济状况进行了评估。此外,我们计算了每个社会经济水平的比率差(rate difference, RD)、比率比(rate ratio, RR)、不平等斜率指数(slope index of inequality, SII)和相对不平等指数(relative index of inequality, RII),以检验死亡率不平等的程度及其时间变化。这些分析按性别和城乡分类进行分层。结果:在2019冠状病毒病大流行期间,总死亡率、COVID-19特异性死亡率和肺炎特异性死亡率均呈上升趋势。农村地区COVID-19的ASMR(27.79)高于城市地区(26.63),农村地区的医疗可及性较低。然而,与农村地区相比,2019冠状病毒病死亡率不平等指标在城市地区更为明显(SII[城市:2.72;农村:-0.05],RII[城市:0.10;农村:0.00])。值得注意的是,居住在城市地区的男子之间存在着严重的不平等。结论:在COVID-19大流行等灾害情况下,实施旨在降低总体死亡率和解决区域社会经济不平等问题的战略至关重要。
期刊介绍:
Epidemiology and Health (epiH) is an electronic journal publishing papers in all areas of epidemiology and public health. It is indexed on PubMed Central and the scope is wide-ranging: including descriptive, analytical and molecular epidemiology; primary preventive measures; screening approaches and secondary prevention; clinical epidemiology; and all aspects of communicable and non-communicable diseases prevention. The epiH publishes original research, and also welcomes review articles and meta-analyses, cohort profiles and data profiles, epidemic and case investigations, descriptions and applications of new methods, and discussions of research theory or public health policy. We give special consideration to papers from developing countries.