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Korean Society for Preventive Medicine, Journal of Preventive Medicine and Public Health, 2(55), p. 144-152, 2022

DOI: 10.3961/jpmph.21.396

Korean Society for Preventive Medicine, Journal of Preventive Medicine and Public Health, 3(55), p. 308-309, 2022

DOI: 10.3961/jpmph.22.171

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Social and Policy Determinants of COVID-19 Infection Across 23 Countries: An Ecological Study

Journal article published in 2022 by Kyungsik Kim ORCID, Young-Do Jeung ORCID, Jeoungbin Choi ORCID, Sue K. Park ORCID
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Preprint: policy unknown
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Postprint: policy unknown
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Published version: policy unknown
Data provided by SHERPA/RoMEO

Abstract

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–Guérin 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.