Socioeconomic Patterns of COVID-19 Clusters in Low-Incidence City, Hong Kong.
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ABSTRACT:
SUBMITTER: Chung GKK
PROVIDER: S-EPMC8544972 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The COVID-19 outbreak has necessitated a critical review of urban transportation and its role in society against the backdrop of an exogenous shock. This article extends the transportation literature regarding community responses to the COVID-19 pandemic and what lessons can be obtained from the case of Hong Kong in 2020. Individual behavior and collective responsibility are considered crucial to ensure both personal and community wellbeing in a pandemic context. Trends in government policies, the number of infectious cases, and community mobility are examined using multiple data sources. The mobility changes that occurred during the state of emergency are revealed by a time-series analysis of variables that measure both the epidemiological severity level and government stringency. The results demonstrate a high response capability of the local government, inhabitants, and communities. Communities in Hong Kong are found to have reacted faster than the implementation of health interventions, whereas the government policies effectively reduced the number of infection cases. The ways in which community action are vital to empower flexible and adaptive community responses are also explored. The results indicate that voluntary community involvement constitutes a necessary condition to help inform and reshape future transport policy and response strategies to mitigate the pandemic.
| S-EPMC8026218 | biostudies-literature
Project description:The COVID-19 pandemic exposes and amplifies pre-existing inequalities even in places with relatively well-controlled outbreaks such as Hong Kong. This study aimed to explore whether the socioeconomically disadvantaged fare worse via various types of worry in terms of their mental health and well-being. Between September and October 2020, 1067 adults in Hong Kong were recruited via a cross-sectional population-wide telephone survey. The inter-relationship between deprivation, types of worry, mental health disorders, and subjective well-being was assessed using structural equation modelling. Results showed significant total effects of deprivation on worries about being infected (p = 0.002), economic activities and livelihood (p < 0.001), and personal savings (p < 0.001), as well as mental health disorders (p < 0.001) and subjective well-being (p < 0.001). Specifically, worry about economic activities and livelihood partly mediated the total effect of deprivation on mental health disorders (p = 0.004), whereas worry about personal savings and worry about economic activities and livelihood partially mediated the total effect of deprivation on subjective well-being (p = 0.007 and 0.002, respectively). Socioeconomic inequality, particularly in mental health and well-being, could be exacerbated via people's economic concerns during the pandemic, which was largely induced by the COVID-19 containment measures rather than the pandemic per se given the relatively low COVID-19 incidence in Hong Kong.
| S-EPMC8633192 | biostudies-literature
Project description:The severity of COVID-19 infections could be exacerbated by the epidemic of chronic diseases and underlying inequalities in social determinants of health. Nonetheless, there is scanty evidence in regions with a relatively well-controlled outbreak. This study examined the socioeconomic patterning of COVID-19 severity and its effect modification with multimorbidity in Hong Kong. 3074 local COVID-19 cases diagnosed from 5 July to 31 October 2020 were analyzed and followed up until 30 November 2020. Data on residential addresses, socio-demographic background, COVID-19 clinical conditions, and pre-existing chronic diseases of confirmed cases were retrieved from the Centre for Health Protection and the Hospital Authority. Results showed that, despite an independent adverse impact of multimorbidity on COVID-19 severity (aOR = 2.35 [95% CI = 1.72-3.19]), it varied across the socioeconomic ladder, with no significant risk among those living in the wealthiest areas (aOR = 0.80 [0.32-2.02]). Also, no significant association of the area-level income-poverty rate with severe COVID-19 was observed. In conclusion, the socioeconomic patterning of severe COVID-19 was mild in Hong Kong. Nonetheless, socioeconomic position interacted with multimorbidity to determine COVID-19 severity with a mitigated risk among the socioeconomically advantaged. Plausible explanations include the underlying socioeconomic inequalities in chronic disease management and the equity impact of the public-private dual-track healthcare system.
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Project description:BackgroundGiven the dynamism and heterogeneity of COVID-19 transmission patterns, determining the most effective yet timely strategies for specific regions remains a severe challenge for public health decision-makers.MethodsIn this work, we proposed a spatiotemporal connectivity analysis method for discovering transmission patterns across geographic locations and age-groups throughout different COVID-19 outbreak phases. First, we constructed the transmission networks of the confirmed cases during different phases by considering the spatiotemporal connectivity of any two cases. Then, for each case and those cases immediately pointed from it, we characterized the corresponding cross-district/population transmission pattern by counting their district-to-district and age-to-age occurrences. By summating the cross-district/population transmission patterns of all cases during a given period, we obtained the aggregated cross-district and cross-population transmission patterns.FindingsWe conducted a region-wide comprehensive retrospective study in Hong Kong based on the complete data report of COVID-19 cases, covering all 18 districts between January 23, 2020, and January 8, 2021 (https://data.gov.hk/en-data/dataset/hk-dh-chpsebcddr-novel-infectious-agent). The spatiotemporal connectivity analysis clearly unveiled the quantitative differences among various outbreak waves in their transmission scales, durations, and patterns. Moreover, for the statistically similar waves, their cross-district/population transmission patterns could be quite different (e.g., the cross-district transmission of the fourth wave was more diverse than that of the third wave, while the transmission over age-groups of the fourth wave was more concentrated than that of the third wave). At an overall level, super-spreader individuals (highly connected cases in the transmission networks) were usually concentrated in only a few districts (2 out of 18 in our study) or age-groups (3 out of 11 in our study).InterpretationWith the discovered cross-district or cross-population transmission patterns, all of the waves of COVID-19 outbreaks in Hong Kong can be systematically scrutinized. Among all districts, quite a few (e.g., the Yau Tsim Mong district) were instrumental in spreading the virus throughout the pandemic. Aside from being exceptionally densely populated, these districts were also social-economic centers. With a variety of situated public venues, such as restaurants and singing/dancing clubs, these districts played host to all kinds of social gathering events, thereby providing opportunities for widespread and rapid transmission of the virus. Thus, these districts should be given the highest priority when deploying district-specific social distancing or intervention strategies, such as lockdown and stringent mandatory coronavirus testing for identifying and obstructing the chain of transmission. We also observed that most of the reported cases and the highly connected cases were middle-aged and elderly people (40- to 69-year-olds). People in these age-groups were active in various public places and social activities, and thus had high chances of being infected by or infecting others.FundingGeneral research fund of the Hong Kong research grants council.
| S-EPMC8179759 | biostudies-literature
Project description:BackgroundeHealth literacy can potentially facilitate web-based information seeking and taking informed measures.ObjectiveThis study aimed to evaluate socioeconomic disparities in eHealth literacy and seeking of web-based information on COVID-19, and their associations with COVID-19 preventive behaviors.MethodsThe COVID-19 Health Information Survey (CoVHIns), using telephonic (n=500) and web-based surveys (n=1001), was conducted among adults in Hong Kong in April 2020. The Chinese eHealth literacy scale (eHEALS; score range 8-40) was used to measure eHealth literacy. COVID-19 preventive behaviors included wearing surgical masks, wearing fabric masks, washing hands, social distancing, and adding water or bleach to the household drainage system. Adjusted beta coefficients and the slope indices of inequality for the eHEALS score by socioeconomic status, adjusted odds ratios (aORs) for seeking of web-based information on COVID-19 by socioeconomic status, and aORs for the high adherence to preventive behaviors by the eHEALS score and seeking of web-based information on COVID-19 were calculated.ResultsThe mean eHEALS score was 26.10 (SD 7.70). Age was inversely associated with the eHEALS score, but education and personal income were positively associated with the eHEALS score and seeking of web-based information on COVID-19 (for all, P for trend<.05). Participants who sought web-based information on COVID-19 showed high adherence to the practice of wearing surgical masks (aOR 1.56, 95% CI 1.15-2.13), washing hands (aOR 1.33, 95% CI 1.05-1.71), social distancing (aOR 1.48, 95% CI 1.14-1.93), and adding water or bleach to the household drainage system (aOR 1.67, 95% CI 1.28-2.18). Those with the highest eHEALS score displayed high adherence to the practice of wearing surgical masks (aOR 3.84, 95% CI 1.63-9.05), washing hands (aOR 4.14, 95% CI 2.46-6.96), social distancing (aOR 2.25, 95% CI 1.39-3.65), and adding water or bleach to the household drainage system (aOR 1.94, 95% CI 1.19-3.16), compared to those with the lowest eHEALS score.ConclusionsChinese adults with a higher socioeconomic status had higher eHealth literacy and sought more web-based information on COVID-19; both these factors were associated with a high adherence to the guidelines for preventive behaviors during the COVID-19 pandemic.
| S-EPMC8048711 | biostudies-literature
Project description:During the early phase of the coronavirus disease epidemic in Hong Kong, 1,715 survey respondents reported high levels of perceived risk, mild anxiety, and adoption of personal-hygiene, travel-avoidance, and social-distancing measures. Widely adopted individual precautionary measures, coupled with early government actions, might slow transmission early in the outbreak.
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Project description:Smoking is a major cause of health inequities. However, sociodemographic differences in adolescent tobacco use are unclear. In a territory-wide school-based anonymous survey in 2018/19, we investigated tobacco use and sociodemographic correlates in 33,991 students (mean age 14.8 ± 1.9 years) in Hong Kong. Tobacco use prevalence and current-ever use ratios by sociodemographic factors were calculated. Generalised linear mixed models were used in association analyses. Current use was highest for cigarettes (3.2%), closely followed by alternative tobacco products (3.0%). Current-ever use ratios were highest for heated tobacco products (HTPs, 0.60), followed by nicotine e-cigarettes (0.52), waterpipe (0.51), and cigarettes (0.35). Use prevalence and current-ever use ratios of all products showed curvilinear relations with perceived family affluence (P values < 0.01), being highest in the richest families. Tobacco use was also associated with more senior grades, the lowest parental education, and boys, but current-ever use ratios of HTPs and waterpipe were higher in girls (P values < 0.05). The results suggested that adolescent ever users of nicotine-containing alternative tobacco products were more likely to keep using them than cigarettes, and the richest adolescents were at the highest risks of tobacco use. Diverse tobacco control measures are needed to improve health equity, especially on alternative tobacco products.
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