Social inequalities and dynamics of the early COVID-19 epidemic: a prospective cohort study in France
Nathalie Bajos
(1)
,
Emilie Counil
(2)
,
Jeanna-Eve Franck
(1)
,
Florence Jusot
(3)
,
Ariane Pailhé
(2)
,
Alexis Spire
(1)
,
Claude Martin
(4, 5)
,
Nathalie Lydie
(6)
,
Remy Slama
(7)
,
Laurence Meyer
(8)
,
Josiane Warszawski
(8)
1
IRIS -
Institut de Recherche Interdisciplinaire sur les enjeux Sociaux - sciences sociales, politique, santé
2 INED - Institut national d'études démographiques
3 Université Paris Dauphine-PSL
4 ARENES - Arènes: politique, santé publique, environnement, médias
5 EHESP - École des Hautes Études en Santé Publique [EHESP]
6 Santé publique France - French National Public Health Agency [Saint-Maurice, France]
7 IAB - Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble)
8 Université Paris-Saclay
2 INED - Institut national d'études démographiques
3 Université Paris Dauphine-PSL
4 ARENES - Arènes: politique, santé publique, environnement, médias
5 EHESP - École des Hautes Études en Santé Publique [EHESP]
6 Santé publique France - French National Public Health Agency [Saint-Maurice, France]
7 IAB - Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble)
8 Université Paris-Saclay
Nathalie Bajos
- Fonction : Auteur
- PersonId : 872835
Emilie Counil
- Fonction : Auteur
- PersonId : 19905
- IdHAL : emilie-counil
- ORCID : 0000-0002-8527-4662
- IdRef : 233622187
Jeanna-Eve Franck
- Fonction : Auteur
- PersonId : 776417
- ORCID : 0000-0002-3585-8643
Alexis Spire
- Fonction : Auteur
- PersonId : 735839
- IdHAL : alexis-spire
- ORCID : 0000-0002-2589-9804
Claude Martin
- Fonction : Auteur
- PersonId : 4439
- IdHAL : claude-martin
- ORCID : 0000-0001-6110-0580
- IdRef : 02878295X
Remy Slama
- Fonction : Auteur
- PersonId : 11249
- IdHAL : remy-slama
- ORCID : 0000-0002-8980-8529
- IdRef : 088095169
Laurence Meyer
- Fonction : Auteur
- PersonId : 756223
- ORCID : 0000-0001-5707-2062
- IdRef : 077686659
Résumé
Objective Although 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. Design Random population-based prospective cohort. Setting From May to June 2020 in France. Participants Adults included in the Epidémiologie et Conditions de Vie cohort (n=77 588). Main outcome measures Self-reported anosmia and/ or ageusia in three categories: no symptom, during the first epidemic peak (in March 2020) or thereafter (during lockdown). Results In 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. Conclusion The 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.
Domaines
SociologieFormat du dépôt | Fichier |
---|---|
Type de dépôt | Article dans une revue |
Titre |
en
Social inequalities and dynamics of the early COVID-19 epidemic: a prospective cohort study in France
|
Résumé |
en
Objective Although 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. Design Random population-based prospective cohort. Setting From May to June 2020 in France. Participants Adults included in the Epidémiologie et Conditions de Vie cohort (n=77 588). Main outcome measures Self-reported anosmia and/ or ageusia in three categories: no symptom, during the first epidemic peak (in March 2020) or thereafter (during lockdown). Results In 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. Conclusion The 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.
|
Auteur(s) |
Nathalie Bajos
1
, Emilie Counil
2
, Jeanna-Eve Franck
1
, Florence Jusot
3
, Ariane Pailhé
2
, Alexis Spire
1
, Claude Martin
4, 5
, Nathalie Lydie
6
, Remy Slama
7
, Laurence Meyer
8
, Josiane Warszawski
8
1
IRIS -
Institut de Recherche Interdisciplinaire sur les enjeux Sociaux - sciences sociales, politique, santé
( 1001018 )
- IRIS - CAMPUS CONDORCET, Bâtiment Recherche Sud, 5 cours des Humanités 93322 Aubervilliers cedex (France)
IRIS - Université Sorbonne Paris Nord, UFR SMBH, 74 rue Marcel Cachin 93017 Bobigny cedex (France)
- France
2
INED -
Institut national d'études démographiques
( 57627 )
- Campus Condorcet
9, cours des Humanités - CS 50004
93322 Aubervilliers Cedex
- France
3
Université Paris Dauphine-PSL
( 300302 )
- Place du Maréchal de Lattre de Tassigny
75775 PARIS Cedex 16
- France
4
ARENES -
Arènes: politique, santé publique, environnement, médias
( 2577 )
- 104 Bvd Duchesse Anne 35700 RENNES
- France
5
EHESP -
École des Hautes Études en Santé Publique [EHESP]
( 301986 )
- 15, avenue du Pr. Léon Bernard - 35043 Rennes Cedex
- France
6
Santé publique France - French National Public Health Agency [Saint-Maurice, France]
( 461591 )
- Santé publique France (siège social)
12, rue du Val d'Osne 94415 Saint-Maurice cedex
- France
7
IAB -
Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble)
( 1043222 )
- Institut pour l'Avancée des Biosciences
Centre de Recherche UGA / Inserm U 1209 / CNRS UMR 5309
Site Santé - Allée des Alpes
38700 La Tronche
- France
8
Université Paris-Saclay
( 419361 )
- Bâtiment Bréguet, 3 Rue Joliot Curie 2e ét, 91190 Gif-sur-Yvette
- France
|
Langue du document |
Anglais
|
Nom de la revue |
|
Vulgarisation |
Non
|
Comité de lecture |
Oui
|
Audience |
Internationale
|
Date de publication |
2021-11
|
Volume |
11
|
Numéro |
11
|
Page/Identifiant |
e052888
|
Licence |
Paternité - Pas d'utilisation commerciale
|
Collaboration/Projet |
|
Domaine(s) |
|
DOI | 10.1136/bmjopen-2021-052888 |
Pubmed Id | 34764173 |
PubMed Central | PMC8587531 |
Origine :
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