Socioeconomic disparity and the risk of contracting COVID-19 in South Korea: an NHIS-COVID-19 database cohort study

Abstract

Background: The relationship between socioeconomic status and the risk of contracting coronavirus disease (COVID-19) remains controversial. We aimed to investigate whether socioeconomic status affected the risk of contracting COVID-19 in the South Korean population. Methods: The NHIS-COVID-19 database cohort was used in this population-based study. We collected the data of COVID-19 patients who were diagnosed between January 1, 2020 and June 4, 2020 and those of the control population. The income levels of all individuals as of February 2020 were extracted, and study participants were classified into four groups based on quartiles: Q1 (the lowest) to Q4 (the highest). Data were statistically analyzed using multivariable logistic regression modeling. Results: In total, 122,040 individuals—7669 and 114,371 individuals in the COVID-19 and control groups, respectively—were included in the final analysis. The multivariable logistic regression model showed that the Q1 group had a 1.19-fold higher risk of contracting COVID-19 than the Q4 group, whereas the Q2 and Q3 groups showed no significant differences. In the 20–39 years age group, compared with the Q4 group, the Q3 and Q2 groups showed 11 and 22% lower risks of contracting COVID-19, respectively. In the ≥60 years age group, compared with the Q4 group, the Q1, Q2, and Q3 groups showed a 1.39-, 1.29-, and 1.14-fold higher risks of COVID-19, respectively. Conclusions: Lower socioeconomic status was associated with a higher risk of contracting COVID-19 in South Korea. This association was more evident in the older population (age ≥ 60 years), whereas both lower and higher socioeconomic statuses were associated with higher risks of contracting COVID-19 in the young adult population (in the 20–39 year age group). Strategies for the prevention of COVID-19 should focus on individuals of lower socioeconomic status and on young adults of higher and lower socioeconomic status.