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. 2021 Feb 23;28(2):taaa159.
doi: 10.1093/jtm/taaa159.

Health equity considerations in COVID-19: geospatial network analysis of the COVID-19 outbreak in the migrant population in Singapore

Huso Yi  1 , Shu Tian Ng  1 , Aysha Farwin  1 , Amanda Pei Ting Low  1 , Cheng Mun Chang  1 , Jeremy Lim  1
Affiliations

Health equity considerations in COVID-19: geospatial network analysis of the COVID-19 outbreak in the migrant population in Singapore

Huso Yi et al. J Travel Med. .

Abstract

Background: Low-wage dormitory-dwelling migrant workers in Singapore were disproportionately affected by coronavirus disease 2019 (COVID-19) infection. This was attributed to communal living in high-density and unhygienic dormitory settings and a lack of inclusive protection systems. However, little is known about the roles of social and geospatial networks in COVID-19 transmission. The study examined the networks of non-work-related activities among migrant workers to inform the development of lockdown exit strategies and future pandemic preparedness.

Methods: A population-based survey was conducted with 509 migrant workers across the nation, and it assessed dormitory attributes, social ties, physical and mental health status, COVID-19-related variables and mobility patterns using a grid-based network questionnaire. Mobility paths from dormitories were presented based on purposes of visit. Two-mode social networks examined the structures and positions of networks between workers and visit areas with individual attributes.

Results: COVID-19 risk exposure was associated with the density of dormitory, social ties and visit areas. The migrant worker hub in the city centre was the most frequently visited for essential services of grocery shopping and remittance, followed by south central areas mainly for social gathering. The hub was positioned as the core with the highest degree of centrality with a cluster of workers exposed to COVID-19.

Conclusions: Social and geospatial networks of migrant workers should be considered in the implementation of lockdown exit strategies while addressing the improvement of living conditions and monitoring systems. Essential services, like remittance and grocery shopping at affordable prices, need to be provided near to dormitories to minimize excess gatherings.

Keywords: COVID-19; Singapore; health inequity; lockdown exit strategy; migrant workers; mobility patterns; social and geospatial networks; social determinants of health.

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Figures

Figure 1
Figure 1
Locations of 43 PBDs by COVID-19 isolation (n = 25) and recruitment
Figure 2
Figure 2
Mobility patterns by frequency (F) and density of purpose (G, R, S)
Figure 3
Figure 3
Mobility paths from dormitories to destinations (a) overall, (b) grocery shopping, (c) remittance and (d) social gathering
Figure 4
Figure 4
Two-mode social networks between actors (migrant workers) and designations of visit with centralities of D (degree), C (closeness) and B (betweenness)
Figure 5
Figure 5
Two-mode social networks with attributes: social ties with (a) migrant worker friends and (b) locals, (c) have a grocery market near to dormitory and (d) have a friend(s) infected by COVID-19
See this image and copyright information in PMC

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