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. 2023 Jul 24;22(1):136.
doi: 10.1186/s12939-023-01933-3.

Social inequalities in mental and physical health derived from the COVID-19 pandemic in Spain beyond SARS-CoV-2 infection

Isabel Moreira  1   2 , Montse Ferrer  3   4   5 , Gemma Vilagut  1   6 , Philippe Mortier  1   6 , Mireia Felez-Nobrega  7 , Joan Domènech-Abella  7   8 , Josep-Maria Haro #  7   8   9 , Jordi Alonso #  1   6   10
Affiliations

Social inequalities in mental and physical health derived from the COVID-19 pandemic in Spain beyond SARS-CoV-2 infection

Isabel Moreira et al. Int J Equity Health. .

Erratum in

Abstract

Background: Understanding the impact of the COVID-19 crisis on health involves conducting longitudinal studies to evaluate the inequalities that may have been exacerbated by the pandemic. The purpose of this study was to estimate differences in physical and mental health derived from the COVID-19 pandemic, beyond SARS-CoV-2 infection, in the Spanish general population according to the participants' level of education; and to assess the evolution of these differences from June 2020 (just after the lockdown) to nine months later (February-March 2021).

Methods: This is a longitudinal prospective study of a representative sample of non-institutionalized Spanish adults, through computer-assisted telephone interviews. Mobility, self-care, usual activities, pain/discomfort and anxiety/depression problems were measured with EQ-5D-5L. Prevalence ratio (PR) between high and low education levels and adjusted PR were estimated by Poisson regression models. Analyses were stratified by gender.

Results: A total of 2,000 participants answered both surveys. Individuals with low level of education reported more health problems in both genders, and absolute inequalities remained quite constant (mobility and self-care problems) or decreased (pain/discomfort and anxiety/depression problems). The greatest relative inequalities were observed just after the lockdown, with age-adjusted PR ranging from 1.31 (95%CI 1.08-1.59) for women and 1.34 (95%CI 1.05-1.69) for men in pain/discomfort to 2.59 (95%CI 0.98-6.81) for women and 4.03 (95%CI 1.52-10.70) for men in self-care; aPR decreased after nine months for most dimensions.

Conclusions: Prevalence of health problems increased during the COVID-19 pandemic in all education groups, but the increase was higher in women and men with a high level of education, suggesting that its impact appeared later in this group. Further analysis on the role of governmental economic aid given to vulnerable people might shed light on this evolution.

Keywords: COVID-19; EQ-5D-5L; Health inequalities; Indirect impact.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Unweighted prevalence (and 95% confidence intervals) of health problems reported in each EQ-5D-5L dimension, stratified by gender. Participants with a high level of education are represented in the light grey bar, while those with a low level of education are shown in dark grey
Fig. 2
Fig. 2
Crude and age-adjusted prevalence ratios (and 95% confidence intervals) of health problems reported in each EQ-5D-5L dimension among participants with a low level of education compared to those with a high level of education, stratified by gender
Fig. 3
Fig. 3
Poisson regression models of having mobility problems: adjusted prevalence ratios (aPR) and 95% confidence intervals compared to the reference (Ref) category. The aPR for the category ‘other working status’ in men could not be estimated due to low numbers
Fig. 4
Fig. 4
Poisson regression models of having problems in usual activities: adjusted prevalence ratios and 95% confidence intervals compared to the reference (Ref) category
Fig. 5
Fig. 5
Poisson regression models of problems regarding having pain / discomfort: adjusted prevalence ratios and 95% confidence intervals compared to the reference (Ref) category
Fig. 6
Fig. 6
Poisson regression models of having anxiety / depression problems: adjusted prevalence ratios and 95% confidence intervals compared to the reference (Ref) category
See this image and copyright information in PMC

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