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ToolsFonseca de Freitas, Daniela, Bhui, Kamaldeep, Clesse, Christophe, Zahid, Uzma, Mooney, Roisin, Joury, Easter, Hayes, Richard D. and Khondoker, Mizanur (2025) A syndemic approach to the study of Covid-19-related death: A cohort study using UK Biobank data. Journal of Public Health, 47 (1). e77-e85. ISSN 1741-3842
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Abstract
Background: The Covid-19 pandemic showed higher infection, severity and death rates among those living in poorer socioeconomic conditions. We use syndemic theory to guide the analyses to investigate the impact of social adversity and multiple long-term conditions (MLTC) on Covid-19 mortality. Methods: The study sample comprised 154 725 UK Biobank participants. Structural equation modeling was used to investigate pathways between traumatic events, economic deprivation, unhealthy behaviors, MLTC, for Covid-19 mortality. Cox regression analysis was used to investigate MLTC and Covid-19 mortality. We also tested effect modification by traumatic events, economic deprivation and unhealthy behaviors. Results: Covid-19 mortality (n = 186) was directly explained by overall level of MLTC. Economic deprivation and unhealthy behaviors contributed to Covid-19 death indirectly via their negative impact on MLTC. The risk for Covid-19 mortality grew exponentially for every quintile of predicted scores of MLTC. The presence of traumatic events, economic deprivation or unhealthy behaviors did not modify the impact of MLTC on Covid-19 mortality. Conclusions: Results suggest a serially causal pathway between economic deprivation and unhealthy behaviors leading to MLTC, which increased the risk of Covid-19 mortality. Policies to tackle the social determinants of health and to mitigate the negative impact of multimorbidity are needed.
| Item Type: | Article |
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| Additional Information: | Data availability statement: UK Biobank data are available for further studies. Please see http://www.ukbiobank.ac.uk/using-the-resource/. Funding: This work was supported by the Lankelly Chase Foundation, which funded the emerging work of the Synergi Collaborative Centre (a 5-year national initiative to build a knowledge hub on ethnic inequalities and multiple disadvantages in severe mental illness in the UK). DFF and RDH received funding from the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre; as such, this study represents independent research partly funded by the NIHR Maudsley Biomedical Research Centre at South London and Maudsley National Health Service Foundation Trust and King’s College London. The views expressed are those of the authors and not those of the funders of the study. The funders of the study had no role in study design, data collection, data analysis, data interpretation, writing of the manuscript or in the decision to submit it for publication. |
| Uncontrolled Keywords: | covid-19,epidemics,ethnic minority,healthcare disparities,mortality,multimorbidity,public health,syndemics,public health, environmental and occupational health,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2739 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Science > Research Groups > Norwich Epidemiology Centre Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre Faculty of Science > Research Groups > Statistics Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Medicine and Health Sciences > Research Centres > Population Health |
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| Depositing User: | LivePure Connector |
| Date Deposited: | 16 Jun 2025 10:30 |
| Last Modified: | 22 Jun 2025 06:30 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/99508 |
| DOI: | 10.1093/pubmed/fdae310 |
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