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KMID : 1044620220550020144
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Journal of Preventive Medicine and Public Health
2022 Volume.55 No. 2 p.144 ~ p.152
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Social and Policy Determinants of COVID-19 Infection Across 23 Countries: An Ecological Study
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Kim Kyung-Sik
Jeung Young-Do
Choi Jeoung-Bin
Park Sue-K.
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Abstract
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Objectives: This study aimed to identify the social and policy determinants of coronavirus disease 2019 (COVID-19) infection across 23 countries.
Methods: COVID-19 indicators (incidence, mortality, and fatality) for each country were calculated by direct and indirect standardization. Multivariable regression analyses were used to identify the social and policy determinants of COVID-19 infection.
Results: A higher number of doctors per population was related to lower incidence, mortality, and fatality rates of COVID-19 in 23 countries (β=?0.672, ?0.445, and ?0.564, respectively). The number of nurses/midwives per population was associated with lower mortality and fatality rates of COVID-19 in 23 countries (β=?0.215 and ?0.372, respectively). Strengthening of policy restriction indicators, such as restrictions of public gatherings, was related to lower COVID-19 incidence (β=?0.423). A national Bacillus Calmette?Guerin vaccination policy conducted among special groups or in the past was associated with a higher incidence of COVID-19 in 23 countries (β=0.341). The proportion of the elderly population (aged over 70 years) was related to higher mortality and fatality rates (β=0.209 and 0.350, respectively), and income support was associated with mortality and fatality rates (β=?0.362 and ?0.449, respectively).
Conclusions: These findings do not imply causality because this was a country-based correlation study. However, COVID-19 transmission can be influenced by social and policy determinants such as integrated health systems and policy responses to COVID-19. Various social and policy determinants should be considered when planning responses to COVID-19.
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KEYWORD
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COVID-19, Social determinants of health, Health policy
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