Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec;113(6):878-886.
doi: 10.17269/s41997-022-00684-y. Epub 2022 Aug 15.

Effect of the COVID-19 pandemic on the socioeconomic composition of emergency department presentations

Daniel Hanscom  1 , Daniel J Dutton  2
Affiliations

Effect of the COVID-19 pandemic on the socioeconomic composition of emergency department presentations

Daniel Hanscom et al. Can J Public Health. 2022 Dec.

Abstract
in English, French

Objectives: This study highlights how socioeconomic trends in the emergency department (ED) for low-acuity visits change with the onset of COVID-19, identifies societal inequities exacerbated by the pandemic, and demonstrates the geographical regions where these inequities occur.

Methods: We accessed 1,285,000 ED visits from 12 different facilities across New Brunswick from January 2017 to October 2020. Using a deprivation index developed by Statistics Canada as a measure of socioeconomic status, and controlling for additional factors, we perform a logistic regression to determine the influence of the COVID-19 pandemic on low-acuity visits of individuals from the most deprived quintile (Q5). We constructed a heat map of New Brunswick to highlight regions of high deprivation.

Results: The proportion of Q5 individuals in the ethnocultural composition domain accessing the ED for low-acuity visits increased from 22.91% to 24.72% with the onset of the pandemic. Our logistic regression showed the log odds of being considered Q5 in the ethnocultural composition domain when visiting the ED for a low-acuity reason increased by 6.3% if the visit occurred during the pandemic, and increased by 101.6% if the visit occurred in one of the 3 major regions of New Brunswick.

Conclusion: Individuals visiting EDs for low-acuity reasons during the COVID-19 pandemic were more likely to be from the most diverse quintile in the ethnocultural domain, and the inequities were concentrated in the most urban regions in New Brunswick. This demonstrates that urban areas are where inequities are disproportionately faced for ethnically diverse individuals and demonstrates where policies could be focused.

RéSUMé: OBJECTIFS: Notre étude montre l’évolution des tendances socioéconomiques des visites aux services d’urgence (SU) pour des affections mineures avec l’apparition de la COVID-19 et indique les iniquités sociétales exacerbées par la pandémie et les régions géographiques où ces iniquités se manifestent. MéTHODE: Nous avons eu accès à 1 285 000 visites aux SU de 12 établissements du Nouveau-Brunswick entre janvier 2017 et octobre 2020. À l’aide d’un indice de défavorisation élaboré par Statistique Canada pour mesurer le statut socioéconomique et après avoir apporté des ajustements pour tenir compte des effets d’autres facteurs, nous avons effectué une analyse de régression logistique pour déterminer l’influence de la pandémie de COVID-19 sur les visites de personnes du quintile le plus défavorisé (Q5) pour des affections mineures. Nous avons construit une carte de densité du Nouveau-Brunswick pour représenter les régions très défavorisées. RéSULTATS: La proportion de personnes du Q5 dans le domaine de la composition ethnoculturelle ayant visité les SU pour des affections mineures est passée de 22,91 % à 24,72 % après le début de la pandémie. Selon notre analyse de régression logistique, la probabilité logarithmique pour une personne ayant visité les SU pour une affection mineure d’être considérée comme faisant partie du Q5 dans le domaine de la composition ethnoculturelle augmentait de 6,3 % si la visite avait eu lieu durant la pandémie, et elle augmentait de 101,6 % si la visite avait eu lieu dans l’une des trois grandes régions du Nouveau-Brunswick. CONCLUSION: Les personnes ayant visité les SU pour des affections mineures durant la pandémie de COVID-19 étaient plus susceptibles d’appartenir au quintile le plus diversifié dans le domaine ethnoculturel, et les iniquités étaient concentrées dans les régions les plus urbaines du Nouveau-Brunswick. L’étude démontre que c’est dans les agglomérations urbaines que les personnes d’origines ethniques diverses font face à des iniquités démesurées, et elle indique où les politiques pourraient être ciblées.

Keywords: COVID-19; Canada; Emergency department; Social determinants of health; Socioeconomic status.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Percentage of low-acuity Q5 visits (triage levels 4 and 5) over time for each domain of deprivation. The red vertical line represents March 11, 2020, the date considered the beginning of the COVID-19 pandemic in New Brunswick
Fig. 2
Fig. 2
Map of New Brunswick with a scale representing the proportion of ethnocultural composition Q5 emergency department visits of that region for all triage levels. Regions are represented by forward sortation areas (FSAs), the first 3 digits of a postal code. Circled regions represent the 3 major urban areas in New Brunswick
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Ahmed S, Shommu NS, Rumana N, Barron GRS, Wicklum S, Turin TC. Barriers to access of primary healthcare by immigrant populations in Canada: A literature review. Journal of Immigrant and Minority Health. 2016;18(6):1522–1540. doi: 10.1007/s10903-015-0276-z. - DOI - PubMed
    1. Canadian Institute for Health Information. (2021). COVID-19 hospitalization and emergency department statistics. Data table. https://www.cihi.ca/en/covid-19-hospitalization-and-emergency-department.... Accessed 29 October 2021.
    1. CTV News. (2021). Don’t avoid going to the ER because of pandemic, Canadians urged. https://www.ctvnews.ca/health/don-t-avoid-going-to-the-er-because-of-pan.... Accessed 12 October 2021.
    1. Gkiouleka A, Huijts T, Beckfield J, Bambra C. Understanding the micro and macro politics of health: Inequalities, intersectionality & institutions - A research agenda. Social Science & Medicine. 2018;200:92–98. doi: 10.1016/j.socscimed.2018.01.025. - DOI - PubMed
    1. Glazier RH, Green ME, Wu FC, Frymire E, Kopp A, Kiran T. Shifts in office and virtual primary care during the early COVID-19 pandemic in Ontario, Canada. CMAJ. 2021;193(6):E200–E210. doi: 10.1503/cmaj.202303. - DOI - PMC - PubMed

Publication types