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Cited by 77Health disparities and outcomesCOVID-19 Clinical Research StudiesCOVID-19 epidemiological studies

The income gradient in COVID-19 mortality and hospitalisation: An observational study with social security administrative records in Mexico

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Arceo-Gomez, Eva O., Campos-Vazquez, Raymundo M., Esquivel, Gerardo, Alcaraz, Eduardo, Martinez, Luis A., Lopez, Norma G.·2022·The Lancet Regional Health - Americas
DOI 10.1016/j.lana.2021.100115PMC PMC8578731
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Abstract

BACKGROUND: The COVID-19 pandemic revealed large structural inequalities that led to disparities in health outcomes related to socioeconomic status. So far, most of the evidence is based on aggregated data or simulations with individual data, which point to various possible mechanisms behind the association. To date, there have been no studies regarding an income gradient in COVID-19 mortality based on individual-level data and adjusting for comorbidities or access to healthcare. METHODS: In this paper, we use linked employee-patient data for patients tested for COVID-19 at the Mexican Institute of Social Security. We estimate the association of the probability of dying with income centiles, using a probit estimation and adjusting for COVID-19 diagnosis, sociodemographic variables, and comorbidities. FINDINGS: After controlling for all these variables, we find that persons in the lowest income decile still had a probability of dying from COVID-19 five times greater than those at the top decile. INTERPRETATION: Our results imply that the association between income and COVID outcomes is not explained by the prevalence of comorbidities or by a lack of access to healthcare among the low-income population. FUNDING: This study was not supported by any external funding source.

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Cited by

Sorted by citations

Authors
Arceo-Gomez, E. O., Campos-Vazquez, R. M., Esquivel, G., Alcaraz, E., Martinez, L. A., & Lopez, N. G.
Affiliations
  • Bank of Mexico (MX)
  • Mexican Social Security Institute (MX)
ORCID
Venue
The Lancet Regional Health - Americas
Publisher
Elsevier BV
Published
2022-02
Volume
6
Pages
100115
ISSN
2667-193X (ISSN-L)
DOI
10.1016/j.lana.2021.100115
PMC
PMC8578731
OpenAlex
W3214698469
Cited by
77
References
1
Citations by year
2026: 1 · 2025: 9 · 2024: 10 · 2023: 36 · 2022: 21
FWCI
9.25
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Regional Health - Americas (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Instituto Mexicano del Seguro Social
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
Keywords
COVID-19 mortality, income gradient, socioeconomic inequalities in health, health disparities, comorbidities, health care access, hospitalization, low-income populations

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