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Lopes S, Soares P, Gama A, Pedro AR, Moniz M, Laires P, Goes AR, Nunes C, Dias S. Association between perception of COVID-19 risk, confidence in health services and avoidance of emergency department visits: results from a community-based survey in Portugal. BMJ Open 2022; 12:e058600. [PMID: 35803630 PMCID: PMC9271839 DOI: 10.1136/bmjopen-2021-058600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To examine the association between the perception of COVID-19 risk, confidence in health services and avoidance of emergency department (ED) visits in Portugal during the COVID-19 pandemic. DESIGN Community-based, cross-sectional survey. SETTING Volunteer sample that completed the online survey between April 2020 and May 2021. PARTICIPANTS 987 participants who perceived needing ED care. Of those, 242 reported avoiding ED visits. OUTCOME MEASURES Logistic regression models for ED avoidance were conducted to estimate the effect of risk perception and confidence in health services, adjusted for sociodemographics, health status and time. RESULTS The adjusted odds for ED avoidance were higher for participants lacking confidence in health service response to non-COVID-19 conditions (adjusted OR: 6.39; 95% CI 3.19 to 12.82) and COVID-19 (1.81; 1.19 to 2.77) and lower for those perceiving a low risk of being infected at a health provider (0.16; 0.07 to 0.38). CONCLUSION In our sample, confidence in health services and risk perception of infection at a health provider were associated with the decision to avoid the ED. These results suggest that policymakers and care providers need to mitigate the negative consequences of delayed healthcare; be aware of the implications of distrust and fear from those in need of healthcare and provide equally distributed safe alternatives to ED care.
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Affiliation(s)
- Sílvia Lopes
- NOVA National School of Public Health, Public Health Research Center, NOVA University Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University Lisbon, Lisbon, Portugal
| | - Patrícia Soares
- NOVA National School of Public Health, Public Health Research Center, NOVA University Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University Lisbon, Lisbon, Portugal
| | - Ana Gama
- NOVA National School of Public Health, Public Health Research Center, NOVA University Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University Lisbon, Lisbon, Portugal
| | - Ana Rita Pedro
- NOVA National School of Public Health, Public Health Research Center, NOVA University Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University Lisbon, Lisbon, Portugal
| | - Marta Moniz
- NOVA National School of Public Health, Public Health Research Center, NOVA University Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University Lisbon, Lisbon, Portugal
| | - Pedro Laires
- NOVA National School of Public Health, Public Health Research Center, NOVA University Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University Lisbon, Lisbon, Portugal
| | - Ana Rita Goes
- NOVA National School of Public Health, Public Health Research Center, NOVA University Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University Lisbon, Lisbon, Portugal
| | - Carla Nunes
- NOVA National School of Public Health, Public Health Research Center, NOVA University Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University Lisbon, Lisbon, Portugal
| | - Sónia Dias
- NOVA National School of Public Health, Public Health Research Center, NOVA University Lisbon, Lisbon, Portugal
- Comprehensive Health Research Center, NOVA University Lisbon, Lisbon, Portugal
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de Noronha N, Moniz M, Gama A, Laires PA, Goes AR, Pedro AR, Dias S, Soares P, Nunes C. Non-adherence to COVID-19 lockdown: who are they? A cross-sectional study in Portugal. Public Health 2022; 211:5-13. [PMID: 35988506 PMCID: PMC9271418 DOI: 10.1016/j.puhe.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 06/21/2022] [Accepted: 07/04/2022] [Indexed: 11/15/2022]
Abstract
Objectives The SARS-CoV-2 virus has spread worldwide, leading governments to implement mitigation measures. Understanding the reluctance to adhere to non-pharmacological interventions might help promote adherence to these measures. This study aimed to identify factors associated with non-adherence to the first lockdown in Portugal. Study design Cross-sectional study. Methods This study used data from a Portuguese community-based survey entitled ‘COVID-19 Barometer: Social Opinion’. Data were collected on risk perception, health status and social experiences using a snowball sampling technique. The event of interest corresponded to participants who reported not staying home during the lockdown period, serving as a proxy for non-adherence to lockdown. Logistic regression was used to identify factors associated with non-adherence to the first lockdown. Results Responses from 133,601 individual questionnaires that were completed during the first week of the first lockdown in 2020 were analysed. A minority of participants (5.6%) reported non-adherence to lockdown (i.e. leaving home for reasons other than essential situations). Working in the workplace was the factor with the strongest association of non-adherence to the lockdown. Several other factors were also associated with non-adherence to the first lockdown; namely, being a man, being a student, having a low level of education, having a low income, living alone or with a high-infection-risk professional (e.g. doctor, nurse, pharmaceutical, health technician, firefighter, police officer, military, essential services worker), perceiving the risk of getting COVID-19 to be high, not having social support in case of infection, feeling agitated, sad or anxious every day, and considering the preventive measures to be unimportant or inadequate. Conclusions Non-adherence to lockdown was associated with socio-economic, trust and perception factors. Future research should investigate the mechanisms underlying these associations to help identify the population groups who are most at risk of non-adherence.
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Affiliation(s)
- N de Noronha
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal.
| | - M Moniz
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - A Gama
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - P A Laires
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - A R Goes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - A R Pedro
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - S Dias
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - P Soares
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - C Nunes
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal
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Gomes IA, Soares P, Rocha JV, Gama A, Laires PA, Moniz M, Pedro AR, Dias S, Goes AR, Leite A, Nunes C. Factors Associated with COVID-19 Vaccine Hesitancy after Implementation of a Mass Vaccination Campaign. Vaccines (Basel) 2022; 10:vaccines10020281. [PMID: 35214739 PMCID: PMC8879669 DOI: 10.3390/vaccines10020281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/29/2022] [Accepted: 02/07/2022] [Indexed: 01/27/2023] Open
Abstract
An online cross-sectional study on COVID-19 vaccination adhesion was conducted in Portugal nine months after vaccination rollout (September–November 2021). Logistic regression was used to identify factors associated with hesitancy to take the COVID-19 vaccine in the community-based survey, “COVID-19 Barometer: Social Opinion”. Hesitancy was 11%; however, of those, 60.5% stated that they intended to take the vaccine. Hesitancy was associated with factors such as lower monthly household income; no intention of taking the flu vaccine this year; perceived reasonable health status; having two or more diseases; low confidence in the health service response; worse perception of the adequacy of anti-COVID-19 government measures; low or no perceived risk of getting COVID-19; feeling agitated, anxious or sad some days; and lack of trust in the safety and efficacy of the vaccines. Confidence in vaccines, namely against COVID-19, is paramount for public health and should be monitored during vaccination rollout. Clear communication of the risks and benefits of vaccination needs improvement to increase adherence and public confidence.
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Affiliation(s)
- Inês Afonso Gomes
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
- Laboratórios Pfizer Lda., Lagoas Park, 2740-271 Porto Salvo, Portugal
- Correspondence:
| | - Patricia Soares
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - João Victor Rocha
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Ana Gama
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Pedro Almeida Laires
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Marta Moniz
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Ana Rita Pedro
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Sónia Dias
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Ana Rita Goes
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Andreia Leite
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Carla Nunes
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (P.S.); (J.V.R.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (S.D.); (A.R.G.); (A.L.); (C.N.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
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How Did the COVID-19 Pandemic Affect Migrant Populations in Lisbon, Portugal? A Study on Perceived Effects on Health and Economic Condition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031786. [PMID: 35162809 PMCID: PMC8835335 DOI: 10.3390/ijerph19031786] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/26/2022] [Accepted: 02/01/2022] [Indexed: 12/18/2022]
Abstract
Increasing evidence on the effects of the COVID-19 pandemic suggests that its social and health impacts are being disproportionately shouldered by socioeconomically disadvantaged populations, including migrants. Knowledge of how these populations are experiencing the COVID-19 crisis is scarce. We examined the effects of the pandemic on the perceived individual financial situation and health condition of migrants in Lisbon, Portugal, and described the most affected subgroups. A cross-sectional survey was conducted with a diverse community-based sample of 1126 migrants. A worsening of their financial situation since the pandemic was reported by 55.6% of the participants and a worsening of their health condition by 19.9%. A worsened financial situation was most often reported by those ≥45 years old and with a lower income (<EUR 650). Likewise, a worsened health condition was most often reported by older and lower-income migrants, as well as by women and those with a lower level of education. Migration-related factors such as length of stay and migration status were not associated with worsened health conditions. Socioeconomic characteristics appear to be more important when assessing differences in perceived effects of the pandemic among migrants. The social impact of the pandemic both exacerbates economic and gender inequalities and may lead to worse health conditions within the population in the medium and long terms.
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Gil JD, Aguiar PMV, Azeredo-Lopes S, Soares P, Moura HS, Arcêncio RA, Goes ARO, Gama A, Pedro ARS, Nunes C, Moniz AMF, Laires P, Dias SF, Souza RM, Pinto LW, Abrantes A. Physical Distancing and Mental Well-Being in Youth Population of Portugal and Brazil during the COVID-19 Pandemic. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2022. [DOI: 10.1159/000525248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
<b><i>Background:</i></b> The COVID-19 pandemic may affect youth’s physical and mental well-being, partially because of the countries’ rules to contain the virus from spreading. However, there is still uncertainty about the impact of physical distancing on youth’s mental health. We aimed to estimate the prevalence of feeling agitated, anxious, down, sad, or low mood (FNF) due to physical distance measures and verify which factors are associated with young Portuguese and Brazilian people. <b><i>Methods:</i></b> We used cross-sectional data from the instrument “COVID-19 Barometer: Social Opinion” in Portugal (March 2020 and September 2021) and from “COVID-19 Social Thermometer” in Brazil (August 2020 to April 2021); these surveys included data regarding the health and socioeconomic impact on the population. The health and sociodemographic variables of the two countries were summarized as absolute and relative frequencies. A multivariable logistic regression model was fit by country to estimate the relation between FNF and selected variables of interest. <b><i>Results:</i></b> Approximately 36% of the sample studied reported anxiety, agitation, sadness, or low mood almost every day in Portugal and 52% in Brazil due to physical distancing. In Portugal, having more than two comorbidities represented a greater chance of experiencing FNF every day or almost every day (odds ratio [OR] = 1.51 [CI: 1.22–1.87]) than those without comorbidities. In contrast, having a university education level represented a protector factor (OR = 0.76 [CI: 0.67–0.88]). In Brazil, being unemployed increased the chance of FNF compared to students (OR = 11.2). <b><i>Conclusions:</i></b> Physical distancing measures have impacted the mental well-being of the young population in Portugal and Brazil. The countries must make a quick effort to attend to and protect young people’s well-being and mental health in the changing context of the current pandemic.
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Soares P, Leite A, Esteves S, Gama A, Laires PA, Moniz M, Pedro AR, Santos CM, Goes AR, Nunes C, Dias S. Factors Associated with the Patient's Decision to Avoid Healthcare during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13239. [PMID: 34948847 PMCID: PMC8701299 DOI: 10.3390/ijerph182413239] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022]
Abstract
The COVID-19 pandemic has resulted in changes in healthcare use. This study aimed to identify factors associated with a patient's decision to avoid and/or delay healthcare during the COVID-19 pandemic. We used data from a community-based survey in Portugal from July 2020 to August 2021, "COVID-19 Barometer: Social Opinion", which included data regarding health services use, risk perception and confidence in health services. We framed our analysis under Andersen's Behavioural Model of Health Services Use and utilised Poisson regression to identify healthcare avoidance associated factors. Healthcare avoidance was high (44%). Higher prevalence of healthcare avoidance was found among women; participants who reported lower confidence in the healthcare system response to COVID-19 and non-COVID-19; lost income during the pandemic; experienced negative emotions due to physical distancing measures; answered the questionnaire before middle June 2021; and perceived having worse health, the measures implemented by the Government as inadequate, the information conveyed as unclear and confusing, a higher risk of getting COVID-19, a higher risk of complications and a higher risk of getting infected in a health institution. It is crucial to reassure the population that health services are safe. Health services should plan their recovery since delays in healthcare delivery can lead to increased or worsening morbidity, yielding economic and societal costs.
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Affiliation(s)
- Patrícia Soares
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.L.); (S.E.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (C.M.S.); (A.R.G.); (C.N.); (S.D.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Andreia Leite
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.L.); (S.E.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (C.M.S.); (A.R.G.); (C.N.); (S.D.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Sara Esteves
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.L.); (S.E.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (C.M.S.); (A.R.G.); (C.N.); (S.D.)
| | - Ana Gama
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.L.); (S.E.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (C.M.S.); (A.R.G.); (C.N.); (S.D.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Pedro Almeida Laires
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.L.); (S.E.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (C.M.S.); (A.R.G.); (C.N.); (S.D.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Marta Moniz
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.L.); (S.E.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (C.M.S.); (A.R.G.); (C.N.); (S.D.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Ana Rita Pedro
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.L.); (S.E.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (C.M.S.); (A.R.G.); (C.N.); (S.D.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Cristina Mendes Santos
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.L.); (S.E.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (C.M.S.); (A.R.G.); (C.N.); (S.D.)
| | - Ana Rita Goes
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.L.); (S.E.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (C.M.S.); (A.R.G.); (C.N.); (S.D.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Carla Nunes
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.L.); (S.E.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (C.M.S.); (A.R.G.); (C.N.); (S.D.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
| | - Sónia Dias
- Comprehensive Health Research Center, Universidade NOVA de Lisboa, Campo Mártires da Pátria 130, 1169-056 Lisboa, Portugal; (A.L.); (S.E.); (A.G.); (P.A.L.); (M.M.); (A.R.P.); (C.M.S.); (A.R.G.); (C.N.); (S.D.)
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
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Gama A, Alves J, Costa D, Laires PA, Soares P, Pedro AR, Moniz M, Solinho L, Nunes C, Dias S. Double jeopardy from the COVID-19 pandemic: risk of exposure and income loss in Portugal. Int J Equity Health 2021; 20:231. [PMID: 34670581 PMCID: PMC8527282 DOI: 10.1186/s12939-021-01569-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increasing evidence indicates that the first wave of the COVID-19 pandemic had immediate health and social impact, disproportionately affecting certain socioeconomic groups. Assessing inequalities in risk of exposure and in adversities faced during the pandemic is critical to inform targeted actions that effectively prevent disproportionate spread and reduce social and health inequities. This study examines i) the socioeconomic and mental health characteristics of individuals working in the workplace, thus at increased risk of COVID-19 exposure, and ii) individual income losses resulting from the pandemic across socioeconomic subgroups of a working population, during the first confinement in Portugal. METHODS This study uses data from 'COVID-19 Barometer: Social Opinion', a community-based online survey in Portugal. The sample for analysis comprised n = 129,078 workers. Logistic regressions were performed to estimate the adjusted odds ratios (AOR) of factors associated with working in the workplace during the confinement period and with having lost income due to the pandemic. RESULTS Over a third of the participants reported working in the workplace during the first confinement. This was more likely among those with lower income [AOR = 2.93 (2.64-3.25)], lower education [AOR = 3.17 (3.04-3.30)] and working as employee [AOR = 1.09 (1.04-1.15)]. Working in the workplace was positively associated with frequent feelings of agitation, anxiety or sadness [AOR = 1.14 (1.09-1.20)] and perception of high risk of infection [AOR = 11.06 (10.53-11.61)]. About 43% of the respondents reported having lost income due to the pandemic. The economic consequences affected greatly the groups at increased risk of COVID-19 exposure, namely those with lower education [AOR = 1.36 (1.19-1.56)] and lower income [AOR = 3.13 (2.47-3.96)]. CONCLUSIONS The social gradient in risk of exposure and in economic impact of the pandemic can result in an accumulated vulnerability for socioeconomic deprived populations. The COVID-19 pandemic seems to have a double effect in these groups, contributing to heightened disparities and poor health outcomes, including in mental health. Protecting the most vulnerable populations is key to prevent the spread of the disease and mitigate the deepening of social and health disparities. Action is needed to develop policies and more extensive measures for reducing disproportionate experiences of adversity from the COVID-19 pandemic among most vulnerable populations.
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Affiliation(s)
- Ana Gama
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal. .,Comprehensive Health Research Centre (CHRC), Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal.
| | - Joana Alves
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
| | - Daniela Costa
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
| | - Pedro A Laires
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
| | - Patrícia Soares
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
| | - Ana Rita Pedro
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
| | - Marta Moniz
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
| | - Luísa Solinho
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal
| | - Carla Nunes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
| | - Sónia Dias
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Campo Mártires da Pátria 130, 1169-056, Lisbon, Portugal
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