Sociodemographic characteristics and COVID-19 testing rates : spatiotemporal patterns and impact of test accessibility in Sweden
(2023) In European Journal of Public Health- Abstract
BACKGROUND: Diagnostic testing is essential for disease surveillance and test-trace-isolate efforts. We aimed to investigate if residential area sociodemographic characteristics and test accessibility were associated with Coronavirus Disease 2019 (COVID-19) testing rates.
METHODS: We included 426 224 patient-initiated COVID-19 polymerase chain reaction tests from Uppsala County in Sweden from 24 June 2020 to 9 February 2022. Using Poisson regression analyses, we investigated if postal code area Care Need Index (CNI; median 1.0, IQR 0.8-1.4), a composite measure of sociodemographic factors used in Sweden to allocate primary healthcare resources, was associated with COVID-19 daily testing rates after adjustments for community... (More)
BACKGROUND: Diagnostic testing is essential for disease surveillance and test-trace-isolate efforts. We aimed to investigate if residential area sociodemographic characteristics and test accessibility were associated with Coronavirus Disease 2019 (COVID-19) testing rates.
METHODS: We included 426 224 patient-initiated COVID-19 polymerase chain reaction tests from Uppsala County in Sweden from 24 June 2020 to 9 February 2022. Using Poisson regression analyses, we investigated if postal code area Care Need Index (CNI; median 1.0, IQR 0.8-1.4), a composite measure of sociodemographic factors used in Sweden to allocate primary healthcare resources, was associated with COVID-19 daily testing rates after adjustments for community transmission. We assessed if the distance to testing station influenced testing, and performed a difference-in-difference-analysis of a new testing station targeting a disadvantaged neighbourhood.
RESULTS: We observed that CNI, i.e. primary healthcare need, was negatively associated with COVID-19 testing rates in inhabitants 5-69 years. More pronounced differences were noted across younger age groups and in Uppsala City, with test rate ratios in children (5-14 years) ranging from 0.56 (95% CI 0.47-0.67) to 0.87 (95% CI 0.80-0.93) across three pandemic waves. Longer distance to the nearest testing station was linked to lower testing rates, e.g. every additional 10 km was associated with a 10-18% decrease in inhabitants 15-29 years in Uppsala County. The opening of the targeted testing station was associated with increased testing, including twice as high testing rates in individuals aged 70-105, supporting an intervention effect.
CONCLUSIONS: Ensuring accessible testing across all residential areas constitutes a promising tool to decrease inequalities in testing.
(Less)
- author
- organization
-
- Genetic and Molecular Epidemiology (research group)
- eSSENCE: The e-Science Collaboration
- EXODIAB: Excellence of Diabetes Research in Sweden
- EPI@LUND (research group)
- Surgery and public health (research group)
- Centre for Economic Demography
- Division of Occupational and Environmental Medicine, Lund University
- EpiHealth: Epidemiology for Health
- publishing date
- 2023-11-27
- type
- Contribution to journal
- publication status
- epub
- subject
- in
- European Journal of Public Health
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85183183862
- pmid:38011903
- ISSN
- 1101-1262
- DOI
- 10.1093/eurpub/ckad209
- project
- Improved preparedness for future pandemics and other health crises through large-scale disease surveillance
- language
- English
- LU publication?
- yes
- additional info
- © The Author(s) 2023. Published by Oxford University Press on behalf of the European Public Health Association.
- id
- 00738ea3-7de4-4176-9c3a-7ba12cf9eda8
- date added to LUP
- 2023-11-28 13:41:02
- date last changed
- 2024-04-17 01:05:51
@article{00738ea3-7de4-4176-9c3a-7ba12cf9eda8, abstract = {{<p>BACKGROUND: Diagnostic testing is essential for disease surveillance and test-trace-isolate efforts. We aimed to investigate if residential area sociodemographic characteristics and test accessibility were associated with Coronavirus Disease 2019 (COVID-19) testing rates.</p><p>METHODS: We included 426 224 patient-initiated COVID-19 polymerase chain reaction tests from Uppsala County in Sweden from 24 June 2020 to 9 February 2022. Using Poisson regression analyses, we investigated if postal code area Care Need Index (CNI; median 1.0, IQR 0.8-1.4), a composite measure of sociodemographic factors used in Sweden to allocate primary healthcare resources, was associated with COVID-19 daily testing rates after adjustments for community transmission. We assessed if the distance to testing station influenced testing, and performed a difference-in-difference-analysis of a new testing station targeting a disadvantaged neighbourhood.</p><p>RESULTS: We observed that CNI, i.e. primary healthcare need, was negatively associated with COVID-19 testing rates in inhabitants 5-69 years. More pronounced differences were noted across younger age groups and in Uppsala City, with test rate ratios in children (5-14 years) ranging from 0.56 (95% CI 0.47-0.67) to 0.87 (95% CI 0.80-0.93) across three pandemic waves. Longer distance to the nearest testing station was linked to lower testing rates, e.g. every additional 10 km was associated with a 10-18% decrease in inhabitants 15-29 years in Uppsala County. The opening of the targeted testing station was associated with increased testing, including twice as high testing rates in individuals aged 70-105, supporting an intervention effect.</p><p>CONCLUSIONS: Ensuring accessible testing across all residential areas constitutes a promising tool to decrease inequalities in testing.</p>}}, author = {{Kennedy, Beatrice and Varotsis, Georgios and Hammar, Ulf and Nguyen, Diem and Carrasquilla, Germán D and van Zoest, Vera and Kristiansson, Robert S and Fitipaldi, Hugo and Dekkers, Koen F and Daivadanam, Meena and Martinell, Mats and Björk, Jonas and Fall, Tove}}, issn = {{1101-1262}}, language = {{eng}}, month = {{11}}, publisher = {{Oxford University Press}}, series = {{European Journal of Public Health}}, title = {{Sociodemographic characteristics and COVID-19 testing rates : spatiotemporal patterns and impact of test accessibility in Sweden}}, url = {{http://dx.doi.org/10.1093/eurpub/ckad209}}, doi = {{10.1093/eurpub/ckad209}}, year = {{2023}}, }