COVID-19 income of (im)migrants in a valencian hospital: a retrospective longitudinal study of medical records

e202307060

Authors

  • Ulises López González Servicio de Medicina Preventiva; Hospital Universitario Doctor Peset. Valencia. España. https://orcid.org/0000-0002-1054-025X
  • Cristina Giménez Lozano Servicio de Medicina Preventiva; Hospital Universitario Doctor Peset. Valencia. España. https://orcid.org/0000-0001-6782-8820
  • Irene García Bellvis Servicio de Medicina Familiar y Comunitaria; Hospital Doctor Peset. Valencia. España.
  • Ángela Esteban Hurtado Servicio de Medicina Nuclear; Hospital Universitario Doctor Peset. Valencia. España.. https://orcid.org/0000-0002-0385-2722
  • Paulina Cárcamo Ibarra Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valencia. Valencia. España. https://orcid.org/0000-0001-9669-0461
  • Ana María Míguez Santillán Servicio de Medicina Preventiva; Hospital Universitario Doctor Peset. Valencia. España.
  • Daniel Bautista Rentero Servicio de Medicina Preventiva; Hospital Universitario Doctor Peset. Valencia. España.

Keywords:

COVID-19, Social Determinants of Health, Hospitalization, Emigrants and immigrants

Abstract

BACKGROUND // Social determinants of health (SDH) refer to the circumstances in which people are born, grow, work, live and age, including the wider set of forces and systems that influence living conditions. SDH produce patterns of disease distribution in societies. There is no reason to believe that this is not the case for COVID-19. The aim of this study was to analyse the time course of hospital admissions for COVID-19 in 2020 among individuals according to their country of origin.
METHODS // A retrospective longitudinal study was conducted using the medical records of individuals hospitalised at the Doctor Peset Hospital in Valencia. The cases were divided into those from a European Union country (community cases) and those from other countries (non-community cases). Differences between groups were analysed using the chi-squared test and Student’s t-test. A multiple logistic regression model was used to examine the association between hospitalisation and mortality. The strength of associations between country of origin and the variables of mortality and hospital admission rate were assessed using Odds Ratio (OR). A significance level of p-value<0.05 was set.
RESULTS // 22.4% of the sample were people of non-Community origin. Of these, 78.3% were from Latin American countries. The mean age of the non-community individuals was approximately seventeen years younger (95% CI 15.2-19.7; p-value<0.01). Within the first six months of the year, 40.2% of community cases and 14.6% of non-community cases were hospitalised. The odds of hospitalisation in the second half of the year were three times higher for non-community cases (OR 3.7; 95% CI 1.9-7.4, p-value<0.01).
CONCLUSIONS // There may have been a higher likelihood of infection among the foreign population during the second half of 2020. The social stratum occupied by migrants may lead to differential exposure, possibly related to the measures implemented to contain the pandemic.

Downloads

Download data is not yet available.

References

World Health Organization. A conceptual framework for action on the social determinants of health. Genève, Switzerland: World Health Organization; 2010.

Kelly MP, Stewart E, Morgan A, Killoran A, Fischer A, Threlfall A, Bonnefoy J. A conceptual framework for public health: NICE’s emerging approach. Public Health. 2009 Jan;123(1):e14-20. doi: https://dx.doi.org/10.1016/j.puhe.2008.10.031

Graham H. Social determinants and their unequal distribution: clarifying policy understandings. Milbank Q. 2004;82(1):101-24. doi: https://dx.doi.org/10.1111/j.0887-378x.2004.00303.x

Krieger N. Proximal, distal, and the politics of causation: what’s level got to do with it? Am J Public Health. 2008 Feb;98(2):221-30. doi: https://dx.doi.org/10.2105/AJPH.2007.111278

Hertzman C. Putting the concept of biological embedding in historical perspective. Proc Natl Acad Sci USA. 2012 Oct 16;109 Suppl 2(Suppl 2):17160-7. doi: https://dx.doi.org/10.1073/pnas.1202203109

Mattos Dos Santos R. Isolation, social stress, low socioeconomic status and its relationship to immune response in Covid-19 pandemic context. Brain Behav Immun Health. 2020 Aug;7:100103. doi: https://dx.doi.org/10.1016/j.bbih.2020.100103

Marmot M, Friel S, Bell R, Houweling TA, Taylor S; Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet. 2008 Nov 8;372(9650):1661-9. doi: https://dx.doi.org/10.1016/S0140-6736(08)61690-6

Alcendor DJ. Racial Disparities-Associated COVID-19 Mortality among Minority Populations in the US. J Clin Med. 2020 Jul 30;9(8):2442. doi: https://dx.doi.org/10.3390/jcm9082442

Baqui P, Bica I, Marra V, Ercole A, Van der Schaar M. Ethnic and regional variations in hospital mortality from COVID-19 in Brazil: a cross-sectional observational study. Lancet Glob Health. 2020 Aug;8(8):e1018-e1026. doi: https://dx.doi.org/10.1016/S2214-109X(20)30285-0

Webb Hooper M, Nápoles AM, Pérez-Stable EJ. COVID-19 and Racial/Ethnic Disparities. JAMA. 2020 Jun 23;323(24):2466-2467. doi: https://dx.doi.org/10.1001/jama.2020.8598

Baah FO, Teitelman AM, Riegel B. Marginalization: Conceptualizing patient vulnerabilities in the framework of social determinants of health-An integrative review. Nurs Inq. 2019 Jan;26(1):e12268. doi: https://dx.doi.org/10.1111/nin.12268

Cunningham TJ, Croft JB, Liu Y, Lu H, Eke PI, Giles WH. Vital Signs: Racial Disparities in Age-Specific Mortality Among Blacks or African Americans-United States, 1999-2015. MMWR Morb Mortal Wkly Rep. 2017 May 5;66(17):444-456. doi: https://dx.doi.org/10.15585/mmwr.mm6617e1. Erratum in: MMWR Morb Mortal Wkly Rep. 2017 May 12;66(18):490.

Lassale C, Gaye B, Hamer M, Gale CR, Batty GD. Ethnic disparities in hospitalisation for COVID-19 in England: The role of socioeconomic factors, mental health, and inflammatory and pro-inflammatory factors in a community-based cohort study. Brain Behav Immun. 2020 Aug;88:44-49. doi: https://dx.doi.org/10.1016/j.bbi.2020.05.074

Pool MS, Agyemang CO, Smalbrugge M. Interventions to improve social determinants of health among elderly ethnic minority groups: a review. Eur J Public Health. 2017 Dec 1;27(6):1048-1054. doi: https://dx.doi.org/10.1093/eurpub/ckx178

Soyemi K, Medina-Marino A, Sinkowitz-Cochran R et al. Disparities among 2009 pandemic influenza A (H1N1) hospital admissions: a mixed methods analysis-Illinois, April-December 2009. PLoS One. 2014;9:e84380. doi: https://dx.doi.org/10.1371/journal.pone.0084380

Cronología de la respuesta de la OMS a la COVID-19 [Internet]. Who.int. [consultado 19 nov 2021]. Disponible en: https://www.who.int/es/news/item/29-06-2020-covidtimeline

Islamoska S, Petersen JH, Benfield T, Norredam M. (2022). Socioeconomic and demographic risk factors in COVID-19 hospitalization among immigrants and ethnic minorities. En European Journal of Public Health (Vol. 32, Número 2, pp. 302-310). doi: https://dx.doi.org/10.1093/eurpub/ckab186

Krouse HJ. (2020). COVID-19 and the Widening Gap in Health Inequity. En Otolaryngology-Head and Neck Surgery (United States) (Vol. 163, Número 1, pp. 65-66). doi: https://dx.doi.org/10.1177/0194599820926463

Labberton AS, Godøy A, Elgersma IH, Strand BH, Telle K, Arnesen T, Nygård KM, Indseth T. (2022). SARS-CoV-2 infections and hospitalisations among immigrants in Norwaysignificance of occupation, household crowding, education, household income and medical risk: A nationwide register study. En Scandinavian Journal of Public Health (Vol. 50, Número 6, pp. 772-781). doi: https://dx.doi.org/10.1177/14034948221075029

Marmot M, Bell R. Fair society, healthy lives. Public Health. 2012 Sep;126 Suppl 1:S4-S10. doi: https://dx.doi.org/10.1016/j.puhe.2012.05.014

Carethers JM. Insights into Disparities Observed with COVID-19. J Intern Med. 2020 Nov 8. doi: https://dx.doi.org/10.1111/joim.13199

Kalyanaraman Marcello R, Dolle J, Grami S, Adule R, Li Z, Tatem K, Anyaogu C, Ayinla R, Boma N, Brady T, Cosme-Thormann BF, Ford K, Gaither K, Kanter M, Kessler S, Kristal RB, Lieber JJ, Mukherjee V, Rizzo V, Rowell M, Stevens D, Sydney E, Wallach A, Chokshi DA, Davis N. Characteristics and Outcomes of COVID-19 Patients in New York City’s Public Hospital System. PLoS One. 2020 Dec 17;15(12):e0243027. doi: https://dx.doi.org/10.1101/2020.05.29.20086645

Bilan N, Dastranji A, Ghalehgolab Behbahani A. Comparison of the spo2/fio2 ratio and the pao2/fio2 ratio in patients with acute lung injury or acute respiratory distress syndrome. J Cardiovasc Thorac Res. 2015;7(1):28-31. doi: https://dx.doi.org/10.15171/jcvtr.2014.06

Ritchie H, Mathieu E, Rodés-Guirao L, Appel C, Giattino C, Ortiz-Ospina E et al. Coronavirus Pandemic (COVID-19). Our World in Data [Internet]. 2020 [consultado 19 nov 2021]; Disponible en: https://ourworldindata.org/coronavirus-data

Khalatbari-Soltani S, Cumming RC, Delpierre C, Kelly-Irving M. Importance of collecting data on socioeconomic determinants from the early stage of the COVID-19 outbreak onwards. J Epidemiol Community Health. 2020 Aug;74(8):620-623. doi: https://dx.doi.org/10.1136/jech-2020-214297

INE. Instituto Nacional de Estadística [Internet]. Ine.es. [consultado 19 nov 2021]. Disponible en: https://www.ine.es/

Sistema de Información en Salud Pública (SISP), Direcció General de Salut Pública, Generalitat Valenciana [Internet]. Gva.es. [consultado 19 nov 2021]. Disponible en: http://www.sp.san.gva.es/eolas.jsp?PASARELA_EOLAS_WEBCLIENT_JSP_RECARGA=%23%23MTOEOLAS_URL_ID%23%23arbolActividadesConsultasEjecutar.jsp&Opcion=SANPSSISPEOLAS&Nivel=1&MenuSup=SANMS50000&CodPunto=3416&menuRaizPortal=SANMS50000&Idioma=es&CodPor=121

Gustafsson PE, San Sebastian M, Fonseca-Rodriguez O, Fors Connolly AM. Inequitable impact of infection: social gradients in severe COVID-19 outcomes among all confirmed SARS-CoV-2 cases during the first pandemic wave in Sweden. J Epidemiol Community Health. 2021 Sep 15:jech-2021-216778. doi: https://dx.doi.org/10.1136/jech-2021-216778

Mackey K, Ayers CK, Kondo KK, Saha S, Advani SM, Young S, Spencer H, Rusek M, Anderson J, Veazie S, Smith M, Kansagara D. Racial and Ethnic Disparities in COVID-19-Related Infections, Hospitalizations, and Deaths: A Systematic Review. Ann Intern Med. 2021 Mar;174(3):362-373. doi: https://dx.doi.org/10.7326/M20-6306

Wadhera RK, Wadhera P, Gaba P, Figueroa JF, Joynt Maddox KE, Yeh RW, Shen C. Variation in COVID-19 Hospitalizations and Deaths Across New York City Boroughs. JAMA. 2020 Jun 2;323(21):2192-2195. doi: https://dx.doi.org/10.1001/jama.2020.7197

Podewils LJ, Burket TL, Mettenbrink C, Steiner A, Seidel A, Scott K, Cervantes L, Hasnain-Wynia R. Disproportionate Incidence of COVID-19 Infection, Hospitalizations, and Deaths Among Persons Identifying as Hispanic or Latino-Denver, Colorado March-October 2020. MMWR Morb Mortal Wkly Rep. 2020 Dec 4;69(48):1812-1816. doi: https://dx.doi.org/10.15585/mmwr.mm6948a3

Gálvez-Iniesta GF. Extranjeros, sin papeles e imprescindibles: Una fotografía de la inmigración irregular en España [Internet]. Porcausa.org. [consultado 19 nov 2021]. Disponible en: https://porcausa.org/wp-content/uploads/2020/07/RetratodelairregularidadporCausa.pdf

Wang Z, Zheutlin A, Kao YH, Ayers K, Gross S, Kovatch P, Nirenberg S, Charney A, Nadkarni G, De Freitas JK, O’Reilly P, Just A, Horowitz C, Martin G, Branch A, Glicksberg BS, Charney D, Reich D, Oh WK, Schadt E, Chen R, Li L. Hospitalised COVID-19 patients of the Mount Sinai Health System: a retrospective observational study using the electronic medical records. BMJ Open. 2020 Oct 26;10(10):e040441. doi: https://dx.doi.org/10.1136/bmjopen-2020-040441

Dominguez K, Penman-Aguilar A, Chang MH, Moonesinghe R, Castellanos T, Rodriguez-Lainz A, Schieber R; Centers for Disease Control and Prevention (CDC). Vital signs: leading causes of death, prevalence of diseases and risk factors, and use of health services among Hispanics in the United States - 2009-2013. MMWR Morb Mortal Wkly Rep. 2015 May 8;64(17):469-78. Erratum en: MMWR Morb Mortal Wkly Rep. 2015 Oct 16;64(40):1153.

BOE-A-2020-3692. Real Decreto 463/2020, de 14 de marzo, por el que se declara el estado de alarma para la gestión de la situación de crisis sanitaria ocasionada por el COVID-19 [Internet]. Boe.es. [consultado 19 nov 2021]. Disponible en: https://www.boe.es/buscar/doc.php?id=BOE-A-2020-3692

BOE-A-2020-5767. Real Decreto 555/2020, de 5 de junio, por el que se prorroga el estado de alarma declarado por el Real Decreto 463/2020, de 14 de marzo, por el que se declara el estado de alarma para la gestión de la situación de crisis sanitaria ocasionada por el COVID-19 [Internet]. Boe.es. [consultado 19 nov 2021]. Disponible en: https://www.boe.es/buscar/doc.php?id=BOE-A-2020-5767

Fases de desconfinamiento en la Comunidad Valenciana - Conselleria de Sanidad Universal y Salud Pública [Internet]. Gva.es. [consultado 19 nov 2021]. Disponible en: https://coronavirus.san.gva.es/es/consejos-desconfinamiento

O’Sullivan TL, Phillips KP. From SARS to pandemic influenza: the framing of high-risk populations. Nat Hazards 2019;98:103-117. doi: https://dx.doi.org/10.1007/s11069-019-03584-6

Avance Anuario de Estadísticas 2020. NIPO: 117-20-049-3. Ministerio de Trabajo y Economía Social [Internet]. Gob.es. [consultado 19 nov 2021]. Disponible en: https://www.mites.gob.es/es/estadisticas/anuarios/2020/index.htm

Published

2023-07-05

How to Cite

1.
López González U, Giménez Lozano C, García Bellvis I, Esteban Hurtado Ángela, Cárcamo Ibarra P, Míguez Santillán AM, et al. COVID-19 income of (im)migrants in a valencian hospital: a retrospective longitudinal study of medical records: e202307060. Rev Esp Salud Pública [Internet]. 2023 Jul. 5 [cited 2024 Nov. 16];97:14 páginas. Available from: https://ojs.sanidad.gob.es/index.php/resp/article/view/140