Deprivation and exposure to public activities during the COVID-19 pandemic in England and Wales
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Abstract
Differential exposure to public activities may contribute to stark deprivation-related inequalities in SARS-CoV-2 infection and outcomes but has not been directly investigated. We set out to investigate whether participants in Virus Watch—a large community cohort study based in England and Wales—reported differential exposure to public activities and non-household contacts during the autumn–winter phase of the COVID-19 pandemic according to postcode-level socioeconomic deprivation.
Methods
Participants (n=20 120–25 228 across surveys) reported their daily activities during 3 weekly periods in late November 2020, late December 2020 and mid-February 2021. Deprivation was quantified based on participants’ residential postcode using English or Welsh Index of Multiple Deprivation quintiles. We used Poisson mixed-effect models with robust standard errors to estimate the relationship between deprivation and risk of exposure to public activities during each survey period.
Results
Relative to participants in the least deprived areas, participants in the most deprived areas exhibited elevated risk of exposure to vehicle sharing (adjusted risk ratio (aRR) range across time points: 1.73–8.52), public transport (aRR: 3.13–5.73), work or education outside of the household (aRR: 1.09–1.21), essential shops (aRR: 1.09–1.13) and non-household contacts (aRR: 1.15–1.19) across multiple survey periods.
Conclusion
Differential exposure to essential public activities—such as attending workplaces and visiting essential shops—is likely to contribute to inequalities in infection risk and outcomes. Public health interventions to reduce exposure during essential activities and financial and practical support to enable low-paid workers to stay at home during periods of intense transmission may reduce COVID-related inequalities.
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SciScore for 10.1101/2021.04.26.21255732: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: Eligibility criteria were: residence in England or Wales, informed consent or assent provided by all household members, internet access and an email address, at least one household member able to complete surveys in English, and household size between 0-6 household members (due to survey infrastructure limitations)
IRB: Ethics and Consent: The Virus Watch study was approved by the Hampstead NHS Health Research Authority Ethics Committee: 20/HRA/2320, and conformed to the ethical standards set out in the Declaration of Helsinki.Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
SciScore for 10.1101/2021.04.26.21255732: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: Eligibility criteria were: residence in England or Wales, informed consent or assent provided by all household members, internet access and an email address, at least one household member able to complete surveys in English, and household size between 0-6 household members (due to survey infrastructure limitations)
IRB: Ethics and Consent: The Virus Watch study was approved by the Hampstead NHS Health Research Authority Ethics Committee: 20/HRA/2320, and conformed to the ethical standards set out in the Declaration of Helsinki.Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:A further limitation was the inability to quantify infection risk associated with each activity due to insufficient data. This will be the focus of future work when additional virological and serological outcome data are available. Quantifying the number and intensity of contacts per setting and any risk mitigation strategies were also beyond the scope of these surveys. Despite relevant age-stratified analysis, we were not able to directly distinguish between workplace and education settings in the current study. IMD is also an area-level measure and may not always reflect individuals’ socioeconomic position. Further investigation into the influence of individual-level indicators of socio-economic position including occupation and education is warranted, as is investigation into the interrelationship between deprivation, ethnicity, and infection risk. Investigating workplace attendance by occupation is also an important area for further investigation given differential exposure to workplace/education settings for adults. In the UK, lockdown and social distancing measures appear to have reduced contacts and mobility in public locations compared to pre-pandemic levels21–23; however, the current findings suggest that deprivation-related differences in exposure to essential public activities are consistently present during periods of stringent regulations. These findings are consistent with a USA-based study24 that constructed granular spatio-temporal mobility networks based on m...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- No funding statement was detected.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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