Sociodemographic characteristics and COVID-19 testing rates: spatiotemporal patterns and impact of test accessibility in Sweden
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Sociodemographic characteristics and COVID-19 testing rates : spatiotemporal patterns and impact of test accessibility in Sweden. / Kennedy, Beatrice; Varotsis, Georgios; Hammar, Ulf; Nguyen, Diem; Carrasquilla, Germán D; van Zoest, Vera; Kristiansson, Robert S; Fitipaldi, Hugo; Dekkers, Koen F; Daivadanam, Meena; Martinell, Mats; Björk, Jonas; Fall, Tove.
In: European Journal of Public Health, Vol. 34, No. 1, 2024, p. 14-21.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Sociodemographic characteristics and COVID-19 testing rates
T2 - spatiotemporal patterns and impact of test accessibility in Sweden
AU - Kennedy, Beatrice
AU - Varotsis, Georgios
AU - Hammar, Ulf
AU - Nguyen, Diem
AU - Carrasquilla, Germán D
AU - van Zoest, Vera
AU - Kristiansson, Robert S
AU - Fitipaldi, Hugo
AU - Dekkers, Koen F
AU - Daivadanam, Meena
AU - Martinell, Mats
AU - Björk, Jonas
AU - Fall, Tove
N1 - © The Author(s) 2023. Published by Oxford University Press on behalf of the European Public Health Association.
PY - 2024
Y1 - 2024
N2 - 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.
AB - 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.
U2 - 10.1093/eurpub/ckad209
DO - 10.1093/eurpub/ckad209
M3 - Journal article
C2 - 38011903
VL - 34
SP - 14
EP - 21
JO - European Journal of Public Health
JF - European Journal of Public Health
SN - 1101-1262
IS - 1
ER -
ID: 376906354