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Sociodemographic characteristics and COVID-19 testing rates : spatiotemporal patterns and impact of test accessibility in Sweden

Kennedy, Beatrice ; Varotsis, Georgios ; Hammar, Ulf ; Nguyen, Diem ; Carrasquilla, Germán D ; van Zoest, Vera ; Kristiansson, Robert S ; Fitipaldi, Hugo LU ; Dekkers, Koen F and Daivadanam, Meena , et al. (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.

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organization
publishing date
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}},
}