Geographical Pattern of COVID-19-Related Outcomes over the Pandemic Period in France: A Nationwide Socio-Environmental Study - Département Méthodes quantitatives en santé publique Accéder directement au contenu
Article Dans Une Revue International Journal of Environmental Research and Public Health Année : 2021

Geographical Pattern of COVID-19-Related Outcomes over the Pandemic Period in France: A Nationwide Socio-Environmental Study

Résumé

Background: Several studies have investigated the implication of air pollution and somesocial determinants on COVID-19-related outcomes, but none of them assessed the implication ofspatial repartition of the socio-environmental determinants on geographic variations of COVID-19 related outcomes. Understanding spatial heterogeneity in relation to the socio-environmentaldeterminant and COVID-19-related outcomes is central to target interventions toward a vulnerablepopulation. Objectives: To determine the spatial variability of COVID-19 related outcomes amongthe elderly in France at the department level. We also aimed to assess whether a geographic patternof Covid-19 may be partially explained by spatial distribution of both long-term exposure to airpollution and deprived living conditions. Methods: This study considered four health events relatedto COVID-19 infection over the period of 18 March and 02 December 2020: (i) hospitalization,(ii) cases in intensive health care in the hospital, (iii) death in the hospital, and (iv) hospitalizedpatients recovered and returned back home. We used the percentage of household living in anovercrowding housing to characterize the living conditions and long-term exposure to NO2to analysethe implication of air pollution. Using a spatial scan statistic approach, a Poisson cluster analysismethod based on a likelihood ratio test and Monte Carlo replications was applied to identify high-riskclusters of a COVID-19-related outcome. Result: our results revealed that all the outcomes relatedto COVID-19 infection investigated were not randomly distributed in France with a statisticallysignificant cluster of high risk located in Eastern France of the hospitalization, cases in the intensivehealth care at the hospital, death in the hospital, and recovered and returned back home compared tothe rest of France (relative risk, RR = 1.28,p-value = 0.001, RR = 3.05,p= 0.001, RR = 2.94,p= 0.001,RR = 2.51,p= 0.001, respectively). After adjustments for socio-environmental determinants, the crudecluster shifts according to different scenarios suggested that both the overcrowding housing level andlong-term exposure to largely NO2explain the spatial distribution of COVID-19-related outcomes.Conclusions: Our findings suggest that the geographic pattern of COVID-19-related outcomes islargely explained by socio-spatial distribution of long-term exposure to NO2. However, to betterunderstand spatial variations of COVID-19-related outcomes, it would be necessary to investigateand adjust it for other determinants. Thus, the current sanitary crisis reminds us of how unequal weall are in facing this disease.
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Dates et versions

hal-03145179 , version 1 (08-06-2021)

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Séverine Deguen, Wahida Kihal-Talantikite. Geographical Pattern of COVID-19-Related Outcomes over the Pandemic Period in France: A Nationwide Socio-Environmental Study. International Journal of Environmental Research and Public Health, 2021, 18 (4), pp.1824. ⟨10.3390/ijerph18041824⟩. ⟨hal-03145179⟩
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