COVID-19 infection rates found to be a third higher in more deprived areas

The ESRI, in collaboration with Pobal, has launched a report examining the health impacts of the COVID-19 pandemic on people living in disadvantaged areas in Ireland.

The report, titled ‘COVID-19 Infection Rates and Social Disadvantage in Ireland: An Area-Level Analysis’, examines the extent to which COVID-19 infection rates and ICU admission rates are associated with area-level deprivation in Ireland.

Key findings:

  • COVID-19 infection rates were more than a third higher in the most deprived areas relative to more affluent areas.
  • In addition to area-level deprivation, areas with communal establishments, and areas with higher shares of residents who are Irish Travellers also had higher COVID-19 infection rates. Communal establishments can include nursing homes, direct provision centres or anywhere where there is a congregated living environment.
  • Area-level deprivation did not directly relate to ICU admission rates. However, areas with communal establishments, with higher shares of some racial and ethnic minority groups, and areas with poorer health among the infected, all had higher rates of ICU admission. These area-level factors are all correlated with area-level deprivation. Therefore, while area-level deprivation does not directly impact ICU admission rates it appears to be having an indirect impact through these other area-level characteristics.
  • This research suggests that markers of deprivation, such as overcrowding, reduced access to private sanitation facilities, jobs that aren’t suitable for remote working and a reliance on public transport all facilitate the spread and transmission of the virus, putting already disadvantaged communities at heightened health risk.

Policy Implications:

Future pandemic planning should consider pre-existing spatial inequalities and pre-existing health inequalities (and the relationship between the two), especially amongst minority groups.

Consideration should also be given to the presence of communal establishments in areas and their potential impact on infection transmission. These locations may require additional health resources and a tailored public health strategy which considers risk factors such as age and the presence of underlying conditions.

Finally, an all-island approach should also be considered given the higher infection rates around the border regardless of deprivation.

Speaking at the launch of the report, on behalf of Pobal who commissioned this research, Anna Shakespeare, CEO said:

“In Pobal, we believe that evidence, data and analysis are critical to the creation of a more equal and inclusive society. In line with our new Research Strategy, Pobal is committed to bringing forward timely and relevant research that has practical application for policy. This report adds to the extensive literature on the social determinants of health, providing further evidence that those who are most marginalised and disadvantaged experience the worst health outcomes. The COVID-19 Inquiry offers a unique opportunity to take stock and consider pandemic planning for the future – at Pobal, we believe targeted and tailored place-based approaches could be of significant value.”

The author of the report, Dr Anne Devlin, ESRI, commented:

“The findings of this report highlight differences in how COVID-19 infection manifested across Ireland, particularly about area-level deprivation. We find higher rates of infection in the most deprived areas. Furthermore, infection rates and ICU admission rates were higher in areas with higher shares of minority groups. Higher COVID-19 infection rates in certain areas are likely to be driven by a multitude of reasons such as the jobs people do, reliance on public transport, higher occupancy in homes, and poorer health pre-pandemic.

There are important lessons here about the importance of pre-existing health and other inequalities during a pandemic. We also find higher COVID-19 infection rates in areas close to the porous border with Northern Ireland. There are numerous important implications for policymakers in terms of planning for potential future pandemics or other widespread health shocks.”