Journal of Preventive Medicine and Public Health

  • 제55권2호
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  • Pages.144-152
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  • 2022
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  • 1975-8375(pISSN)
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  • 2233-4521(eISSN)
대한예방의학회 (The Korean Society for Preventive Medicine)
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Social and Policy Determinants of COVID-19 Infection Across 23 Countries: An Ecological Study

  • Kim, Kyungsik (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Jeung, Young-Do (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Choi, Jeoungbin (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Park, Sue K. (Department of Preventive Medicine, Seoul National University College of Medicine)
  • 투고 : 2021.07.15
  • 심사 : 2022.01.10
  • 발행 : 2022.03.31
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초록

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.

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과제정보

This study was supported by a grant from Seoul National University Hospital (2021).

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