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Sociodemographic characteristics and COVID-19 testing rates: spatiotemporal patterns and impact of test accessibility in Sweden
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.ORCID iD: 0000-0002-0066-4814
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.ORCID iD: 0000-0002-3320-2448
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.ORCID iD: 0000-0002-9680-5772
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2024 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 34, no 1, p. 14-21Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Oxford University Press, 2024. Vol. 34, no 1, p. 14-21
National Category
Public Health, Global Health, Social Medicine and Epidemiology Infectious Medicine
Identifiers
URN: urn:nbn:se:uu:diva-528378DOI: 10.1093/eurpub/ckad209ISI: 001108908000001PubMedID: 38011903OAI: oai:DiVA.org:uu-528378DiVA, id: diva2:1859256
Part of project
SNIC 2.0: Swedish National Infrastructure for Computing, Swedish Research CouncilImproved preparedness for future pandemics and other health crises through large-scale disease surveillance (2.5), Vinnova
Funder
Vinnova, 2020-03173Swedish Research Council, 2022-06725Swedish Research Council, 2018-05973Region UppsalaNational Academic Infrastructure for Supercomputing in Sweden (NAISS), sens2020559Swedish National Infrastructure for Computing (SNIC), sens2020559UPPMAXVinnova, 2021-02648Available from: 2024-05-21 Created: 2024-05-21 Last updated: 2024-05-21Bibliographically approved

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Kennedy, BeatriceVarotsis, GeorgiosHammar, UlfNguyen, Diemvan Zoest, VeraKristiansson, Robert S.Dekkers, Koen F.Daivadanam, MeenaMartinell, MatsFall, Tove

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Kennedy, BeatriceVarotsis, GeorgiosHammar, UlfNguyen, Diemvan Zoest, VeraKristiansson, Robert S.Fitipaldi, HugoDekkers, Koen F.Daivadanam, MeenaMartinell, MatsFall, Tove
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Molecular epidemiologyScience for Life Laboratory, SciLifeLabComputer SystemsDivision of Systems and ControlAutomatic controlHealth Services ResearchInternational Child Health and NutritionFamily Medicine and Preventive Medicine
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European Journal of Public Health
Public Health, Global Health, Social Medicine and EpidemiologyInfectious Medicine

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