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. 2021 Apr;46(2):292-297.
doi: 10.1007/s10900-020-00887-9.

Social Determinants of Health and Risk of SARS-CoV-2 Infection in Community-Dwelling Older Adults Living in a Rural Latin American Setting

Oscar H Del Brutto  1   2 , Robertino M Mera  3 , Bettsy Y Recalde  4 , Aldo F Costa  4
Affiliations

Social Determinants of Health and Risk of SARS-CoV-2 Infection in Community-Dwelling Older Adults Living in a Rural Latin American Setting

Oscar H Del Brutto et al. J Community Health. 2021 Apr.

Abstract

High social risk, as measured by the social determinants of health (SDH), may increase the risk of SARS-CoV-2 infection. However, this association has not been studied in rural communities. Using the Atahualpa Project cohort, we aimed to assess the association between SDH and SARS-CoV-2 seropositivity in community-dwelling older adults living in rural Ecuador. SARS-CoV-2 antibodies were determined in 319 individuals aged ≥ 60 years that completed a validated field instrument to assess their social risk before the introduction of this novel pandemic. Multivariate models were fitted to assess the independent association between SDH-and each of their components-and SARS-CoV-2 seropositivity, after adjusting for relevant covariates. According to the Gijon scale, 102 (32%) individuals had a high social risk (≥ 10 points). A total of 141 (44%) individuals were seropositive to SARS-CoV-2. A fully-adjusted logistic regression model showed an independent) association between social risk and SARS-CoV-2 positivity (OR 1.15; 95% CI 1.04-1.27; p = 0.008). For every unit of the total SDH score, the odds of SARS-CoV-2 seropositivity increased 15% (95% CI 3.7-27%). In addition, multivariate models showed that the individual component of SDH more strongly associated with SARS-CoV-2 seropositivity was housing, which suggested that lack of basic home facilities may increase the risk of SARS-CoV-2 infection. Knowledge on the association between high social risk and SARS-CoV-2 infection is indispensable for the development of cost-effective preventive strategies for controlling modifiable factors that are in the path of SARS-CoV-2 infection among older adults living in underserved communities.

Keywords: Older adults; Rural communities; SARS-CoV-2; Social determinants of health.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Backyards of several houses in Atahualpa showing open latrines due to lack of in-house flushing toilet systems
See this image and copyright information in PMC

References

    1. Retrieved July 2, 2020, from https://www.worldometers.info/coronavirus/.
    1. Zhao Z, Li X, Liu F, Zhu C, Ma C, Wang L. Prediction of the COVID-19 spread in African countries and implications for prevention and control: A case study in South Africa, Egypt, Algeria, Nigeria, Senegal and Kenia. The Science of the Total Environment. 2020;729:138959. doi: 10.1016/j.scitotenv.2020.138959. - DOI - PMC - PubMed
    1. Caicedo-Ochoa Y, Rebellón-Sánchez DE, Peñaloza-Rallón M, Cortés-Motta HF, Méndez-Fandiño YR. Effective reproductive number estimation for initial stage of COVID-19 pandemic in Latin American countries. International Journal of Infectious Diseases. 2020;95:316–318. doi: 10.1016/j.ijid.2020.04.069. - DOI - PMC - PubMed
    1. Cimerman S, Chebado A, Arns-da-Cunha C, Rodríguez-Morales AJ. Deep impact of COVID-19 in the healthcare of Latin America: The case of Brazil. The Brazilian Journal of Infectious Diseases. 2020;24(2):93–95. doi: 10.1016/j.bjid.2020.04.005. - DOI - PMC - PubMed
    1. Miller MJ, Loaiza JR, Takyar A, Gilman RH. COVID-19 in Latin America: Novel transmission dynamics for a global pandemic? PLoS Neglected Tropical Diseases. 2020;14:e0008265. doi: 10.1371/journal.pntd.0008265. - DOI - PMC - PubMed

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