Abstract
BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has posed a major challenge to health, economic and political systems around the world. Understanding the socioeconomic, demographic and health determinants affecting the pandemic is of interest to stakeholders. The purpose of this ecological study is to analyse the effect of the different socioeconomic, demographic and healthcare determinants on the mortality rate and estimated cumulative incidence of COVID-19 first wave in the Spanish regions.MethodsFrom the available data of the 17 Spanish regions (Autonomous Communities), we have carried out an ecological study through multivariate linear regression using ordinary least squares. To do this, we conducted an analysis using two distinct dependent variables: the logarithm of mortality rate per 1,000,000 inhabitants and the estimated cumulative incidence. The study has 12 explanatory variables.ResultsAfter applying the backward stepwise multivariate analysis, we obtained a model with nine significant variables at different levels for mortality rate and a model with seven significant variables for estimated cumulative incidence. Among them, six variables are statistically significant and of the same sign in both models: “Nursing homes beds”, “Proportion of care homes over 100 beds”, “Log GDP per capita”, “Aeroplane passengers”, “Proportion of urban people”, and the dummy variable “Island region”.ConclusionsThe different socioeconomic, demographic and healthcare determinants of each region have a significant effect on the mortality rate and estimated cumulative incidence of COVID-19 in territories where the measures initially adopted to control the pandemic have been identical.
Highlights
The coronavirus disease 2019 (COVID-19) pandemic has posed a major challenge to health, economic and political systems around the world
The impact of the pandemic in Spain has not been similar in all its regions, with significant differences in mortality rates and cumulative incidence depending on the geographical location
In the aforementioned model 6, the variables “Nursing home beds per 100 elderly people”, “Aeroplane passengers”, “Island region” “Log Gross Domestic Product (GDP) per capita”, “Proportion of nursing homes >100 beds”, “Proportion of urban population” and “Proportion of elderly people” are statistically significant at different levels. In this ecological study, we have evaluated the impact of the different determinants at regional level that have influenced the degree of mortality rate and estimated cumulative incidence in the first wave of COVID-19 in Spain, assuming that the systems of surveillance and control of the pandemic, carried out by the national government, have been identical in all regions
Summary
The coronavirus disease 2019 (COVID-19) pandemic has posed a major challenge to health, economic and political systems around the world. Understanding the socioeconomic, demographic and health determinants affecting the pandemic is of interest to stakeholders The purpose of this ecological study is to analyse the effect of the different socioeconomic, demographic and healthcare determinants on the mortality rate and estimated cumulative incidence of COVID-19 first wave in the Spanish regions. The national government is responsible for defining both public health policy and legal framework for all its territories in a comprehensive manner, so that the measures adopted to contain and mitigate the effects of the pandemic have been applied uniformly in all Spanish regions; it corresponds to the central government to take general economic and social measures for the country as a whole. Every Autonomous Community has its own social and economic determinants, which are the result of its degree of economic and social development, geographical location, natural resources and local history
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