Poverty and survival from COVID-19 in Mexico

Abstract

Background: Recent evidence points to the relevance of poverty and inequality as factors affecting the spread and mortality of the COVID-19 pandemic in Latin America. This study aimed to determine whether COVID-19 patients living in Mexican municipalities with high levels of poverty have a lower survival compared with those living in municipalities with low levels.

Methods: Retrospective cohort study. Secondary data was used to define the exposure (multidimensional poverty level) and outcome (survival time) among patients diagnosed with COVID-19 between 27 February and 1 July 2020. Crude and adjusted hazard ratios (HR) from Cox regression were computed.

Results: Nearly 250 000 COVID-19 patients were included. Mortality was 12.3% reaching 59.3% in patients with ≥1 comorbidities. Multivariate survival analyses revealed that individuals living in municipalities with extreme poverty had 9% higher risk of dying at any given time proportionally to those living in municipalities classified as not poor (HR 1.09; 95% CI 1.06-1.12). The survival gap widened with the follow-up time up to the third to fourth weeks after diagnosis.

Conclusion: Evidence suggests that the poorest population groups have a lower survival from COVID-19. Thus, combating extreme poverty should be a central preventive strategy.

Keywords: COVID-19; Mexico; mortality; pandemic; poverty; survival analysis.

Fig. 1

Survival curves for patients diagnosed with COVID-19 between 26 February and 1 July 2020, by poverty levels in Mexico (n = 227 132).