Please use this identifier to cite or link to this item: http://conacyt.repositorioinstitucional.mx/jspui/handle/1000/7846
Comprehensive evaluation of the impact of sociodemographic inequalities on adverse outcomes and excess mortality during the COVID-19 pandemic in Mexico City
Jessica Márquez Sánchez
MARCO VILLANUEVA REZA
ARMANDO GONZALEZ DIAZ
Neftali Eduardo Antonio Villa
Luisa Fernández Chirino
Julio Pisanty-Alatorre
Javier Mancilla-Galindo
Ashuin Kammar-García
Arsenio Vargas Vázquez
Carlos Fermín Martínez
Alejandro Márquez Salinas
Enrique Cañedo Guerra
Jessica Paola Bahena López
Máximo Ernesto Jaramillo Molina
Luis Miguel Gutiérrez Robledo
Omar Yaxmehen Bello-Chavolla
Acceso Abierto
Atribución-NoComercial-SinDerivadas
https://doi.org/10.1101/2021.03.11.21253402
The impact of the COVID-19 pandemic in Mexico City has been sharp, as several social inequalities coexist with chronic comorbidities. Here, we conducted an in-depth evaluation of the impact of social, municipal, and individual factors on the COVID-19 pandemic in working-age population living in Mexico City. To this end, we used data from the National Epidemiological Surveillance System; furthermore, we used a multidimensional metric, the social lag index (DISLI), to evaluate its interaction with mean urban population density (MUPD) and its impact on COVID-19 rates. Influence DISLI and MUPD on the effect of vehicular mobility policies on COVID-19 rates were also tested. Finally, we assessed the influence of MUPD and DISLI on discrepancies of COVID-19 and non-COVID-19 excess mortality compared with death certificates from the General Civil Registry. We detected vulnerable groups who belonged to economically active sectors and who experienced increased risk of adverse COVID-19 outcomes. The impact of social inequalities transcends individuals and has significant effects at a municipality level, with and interaction between DISLI and MUPD. Marginalized municipalities with high population density experienced an accentuated risk for adverse COVID-19 outcomes. Additionally, policies to reduce vehicular mobility had differential impacts across marginalized municipalities. Finally, we report an under-registry of COVID-19 deaths and significant excess mortality associated with non-COVID-19 deaths closely related to MUPD/DISLI in an ambulatory setting, which could be a negative externality of hospital reconversion. In conclusion, social, individual, and municipality-wide factors played a significant role in shaping the course of the COVID-19 pandemic in Mexico City
Medrxiv
12-03-2021
Preimpreso
medrxiv.org/
Inglés
VIRUS RESPIRATORIOS
Appears in Collections:Artículos científicos

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