Differential Impacts of Multimorbidity on COVID-19 Severity across the Socioeconomic Ladder in Hong Kong : A Syndemic Perspective

Research output: Journal Publications and Reviews (RGC: 21, 22, 62)21_Publication in refereed journalpeer-review

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Author(s)

  • Gary Ka-Ki Chung
  • Yat-Hang Chan
  • Terry Cheuk-Fung Yip
  • Hon-Ming Ma
  • Grace Lai-Hung Wong
  • Roger Yat-Nork Chung
  • Hung Wong
  • Samuel Yeung-Shan Wong
  • Eng Kiong Yeoh
  • Michael Marmot
  • Jean Woo

Detail(s)

Original languageEnglish
Article number8168
Journal / PublicationInternational Journal of Environmental Research and Public Health
Volume18
Issue number15
Online published2 Aug 2021
Publication statusPublished - Aug 2021

Link(s)

Abstract

The severity of COVID-19 infections could be exacerbated by the epidemic of chronic diseases and underlying inequalities in social determinants of health. Nonetheless, there is scanty evidence in regions with a relatively well-controlled outbreak. This study examined the socioeconomic patterning of COVID-19 severity and its effect modification with multimorbidity in Hong Kong. 3074 local COVID-19 cases diagnosed from 5 July to 31 October 2020 were analyzed and followed up until 30 November 2020. Data on residential addresses, socio-demographic background, COVID-19 clinical conditions, and pre-existing chronic diseases of confirmed cases were retrieved from the Centre for Health Protection and the Hospital Authority. Results showed that, despite an independent adverse impact of multimorbidity on COVID-19 severity (aOR = 2.35 [95% CI = 1.72–3.19]), it varied across the socioeconomic ladder, with no significant risk among those living in the wealthiest areas (aOR = 0.80 [0.32–2.02]). Also, no significant association of the area-level income-poverty rate with severe COVID-19 was observed. In conclusion, the socioeconomic patterning of severe COVID-19 was mild in Hong Kong. Nonetheless, socioeconomic position interacted with multimorbidity to determine COVID-19 severity with a mitigated risk among the socioeconomically advantaged. Plausible explanations include the underlying socioeconomic inequalities in chronic disease management and the equity impact of the public-private dual-track healthcare system.

Research Area(s)

  • COVID-19, multimorbidity, socioeconomic inequalities, Hong Kong

Citation Format(s)

Differential Impacts of Multimorbidity on COVID-19 Severity across the Socioeconomic Ladder in Hong Kong : A Syndemic Perspective. / Chung, Gary Ka-Ki; Chan, Siu-Ming; Chan, Yat-Hang; Yip, Terry Cheuk-Fung; Ma, Hon-Ming; Wong, Grace Lai-Hung; Chung, Roger Yat-Nork; Wong, Hung; Wong, Samuel Yeung-Shan; Yeoh, Eng Kiong; Marmot, Michael; Woo, Jean.

In: International Journal of Environmental Research and Public Health, Vol. 18, No. 15, 8168, 08.2021.

Research output: Journal Publications and Reviews (RGC: 21, 22, 62)21_Publication in refereed journalpeer-review

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