Urban-rural disparities in COVID-19 hospitalisations and mortality: a population-based study on national surveillance data from Germany and Italy

The interplay between individual characteristics, hospitalisation, and regional factors for urban-rural disparities in COVID-19 mortality have received limited attention. To fill this gap, we use national surveillance data collected by the European Centre for Disease Prevention and Control and we estimate the association between COVID-19 mortality and the individuals’ age, sex, hospitalisation status, population density, share of the population over the age of 60, and pandemic wave across urban, intermediate and rural territories. We find that in what type of territory individuals live (urban-intermediate-rural) accounts for a significant difference in their probability of dying given SARS-COV-2 infection, with urban residents particularly disadvantaged compared to rural residents. Hospitalisation is a key factor in this relationship. For those living in rural areas, the risk of dying is lower than in urban areas but only if hospitalisation was not needed. Indeed, for those who were hospitalised in rural areas the risk of dying was higher than in urban areas.

BIGNAMI Simona;  FERRACCIOLI Federico;  RICCETTI Nicola;  GOMEZ RAMIREZ Jaime;  GHIO Daniela;  STILIANAKIS Nikolaos; 

2024-05-08

PUBLIC LIBRARY SCIENCE

JRC135159

1932-6203 (online),   

https://doi.org/10.1371/journal.pone.0301325,    https://publications.jrc.ec.europa.eu/repository/handle/JRC135159,   

10.1371/journal.pone.0301325 (online),