88 Association between area level material deprivation and incidence of hospitalization among children with SARS-CoV-2 in Montreal
Bibliographic record
Abstract
Abstract Background Although sociodemographic factors have been linked with SARS-CoV-2 infection and hospitalizations in adults, there are little data on the association between sociodemographic characteristics and SARS-CoV-2-related hospitalization in children. Objectives The objective of this study was to determine the association between area-level material deprivation and incidence of hospitalization with SARS-CoV-2 among children. Design/Methods We conducted a retrospective cohort study of all children (0-17 years of age) with a PCR-confirmed SARS-CoV-2 infection between March 1, 2020, and May 31, 2021, at a tertiary care pediatric hospital. Data were collected through chart review and included age, sex, and postal code. Postal codes were then assigned a dissemination area-level material deprivation score, measured via the Pampalon Material Deprivation Index (PMDI) quintiles. The Pampalon Material Deprivation Index (PMDI) uses postal codes to describe factors related to material deprivation obtained from the Canadian census, which are proxies for individual data in a geographic area. Specifically, the PMDI integrates data regarding (i) the proportion of persons without a high school diploma; (ii) the employment-to-population ratio; (iii) average personal income which is aggregated at the dissemination area level. We examined the association between PMDI quintiles and hospitalization using Poisson regression. Results During the study period, 964 children had a positive PCR-confirmed SARS-CoV-2 test and 124 were hospitalized due to SARS-CoV-2 infection. Children from the most deprived PMDI quintile represented 31.6% of positive cases and 40.7% of hospitalizations (Figure 1 and 2). Both in bivariate and multivariable regression analyses, there was evidence of greater proportion of positive test results in the most deprived PMDI quintile (Quintile 5) compared to the least deprived quintile (Quintile 1) (rate ratio 1.77, 95%CI: 1.36; 2.62) (Table 1). The incidence of hospitalization due to SARS-CoV-2 infection was 2.42 times greater in the most deprived quintile compared to the least deprived quintile (95%CI: 1.33; 4.41) (table 1). In a post-hoc analysis, the risk for severe disease appeared higher for children living in Q5 areas relative to other areas but the difference did not reach statistical significance. Conclusion In conclusion, in this study we found evidence that Canadian children living in neighbourhoods with high material deprivation had a higher incidence of infection and hospitalizations related to SARS-Cov-2 compared to children living in neighbourhoods with less material deprivation. Public health authorities should take these disparities into account when devising public health policy and interventions especially at this crucial point in the pandemic. Special efforts should be deployed to protect children from these more disadvantaged areas, especially as vaccination is not yet available to a majority of children.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".