tetano
Editor, Senior Moderator
Eur J Public Health
. 2023 Nov 27:ckad209.
doi: 10.1093/eurpub/ckad209. Online ahead of print. Sociodemographic characteristics and COVID-19 testing rates: spatiotemporal patterns and impact of test accessibility in Sweden
Beatrice Kennedy[SUP] 1 [/SUP], Georgios Varotsis[SUP] 1 [/SUP], Ulf Hammar[SUP] 1 [/SUP], Diem Nguyen[SUP] 1 [/SUP], Germán D Carrasquilla[SUP] 2 [/SUP], Vera van Zoest[SUP] 3 4 [/SUP], Robert S Kristiansson[SUP] 5 [/SUP], Hugo Fitipaldi[SUP] 6 [/SUP], Koen F Dekkers[SUP] 1 [/SUP], Meena Daivadanam[SUP] 7 [/SUP], Mats Martinell[SUP] 5 [/SUP], Jonas Björk[SUP] 8 9 [/SUP], Tove Fall[SUP] 1 [/SUP]
Affiliations
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.
. 2023 Nov 27:ckad209.
doi: 10.1093/eurpub/ckad209. Online ahead of print. Sociodemographic characteristics and COVID-19 testing rates: spatiotemporal patterns and impact of test accessibility in Sweden
Beatrice Kennedy[SUP] 1 [/SUP], Georgios Varotsis[SUP] 1 [/SUP], Ulf Hammar[SUP] 1 [/SUP], Diem Nguyen[SUP] 1 [/SUP], Germán D Carrasquilla[SUP] 2 [/SUP], Vera van Zoest[SUP] 3 4 [/SUP], Robert S Kristiansson[SUP] 5 [/SUP], Hugo Fitipaldi[SUP] 6 [/SUP], Koen F Dekkers[SUP] 1 [/SUP], Meena Daivadanam[SUP] 7 [/SUP], Mats Martinell[SUP] 5 [/SUP], Jonas Björk[SUP] 8 9 [/SUP], Tove Fall[SUP] 1 [/SUP]
Affiliations
- PMID: 38011903
- DOI: 10.1093/eurpub/ckad209
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.