Low-income neighbourhood was a key determinant of severe COVID-19 incidence during the first wave of the epidemic in Paris

Abstract

Background: Previous studies have demonstrated that socioeconomic factors are associated with COVID-19 incidence. In this study, we analysed a broad range of socioeconomic indicators in relation to hospitalised cases in the Paris area.

Methods: We extracted 303 socioeconomic indicators from French census data for 855 residential units in Paris and assessed their association with COVID-19 hospitalisation risk.

Findings: The indicators most associated with hospitalisation risk were the third decile of population income (OR=9.10, 95% CI 4.98 to 18.39), followed by the primary residence rate (OR=5.87, 95% CI 3.46 to 10.61), rate of active workers in unskilled occupations (OR=5.04, 95% CI 3.03 to 8.85) and rate of women over 15 years old with no diploma (OR=5.04, 95% CI 3.03 to 8.85). Of note, population demographics were considerably less associated with hospitalisation risk. Among these indicators, the rate of women aged between 45 and 59 years (OR=2.17, 95% CI 1.40 to 3.44) exhibited the greatest level of association, whereas population density was not associated. Overall, 86% of COVID-19 hospitalised cases occurred within the 45% most deprived areas.

Interpretation: Studying a broad range of socioeconomic indicators using census data and hospitalisation data as a readily available and large resource can provide real-time indirect information on populations with a high incidence of COVID-19.

Keywords: COVID-19; cohort studies; communicable diseases; deprivation; healthcare disparities.