Unemployment and COVID-19-related mortality: a historical cohort study of 50,000 COVID-19 patients in Fars, Iran

Mirahmadizadeh Alireza; Badeleh shamooshaki Mohammad  Taghi; Dadvar Amineh; Moradian Mohammad  javad; Aryaie Mohammad

doi:10.4178/epih.e2022032

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자료유형: 학술저널

저자정보: Mirahmadizadeh Alireza (Non-Communicable Diseases Research Center Shiraz University of Medical Sciences) Badeleh shamooshaki Mohammad Taghi (Depatment of Health Psychology Golestan University of Medical Science) Dadvar Amineh (Shiraz University of Medical Sciences) Moradian Mohammad javad (Trauma Research Center Shahid Rajaee (Emtiaz) Trauma Hospital Shiraz University of Medical Science) Aryaie Mohammad (Department of Epidemiology School of Health Shiraz University of Medical Sciences)

저널정보: 한국역학회 Epidemiology and Health Epidemiology and Health Vol.44

발행연도: 2022.1

수록면: 1 - 5 (5page)

DOI: 10.4178/epih.e2022032

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OBJECTIVES: Previous studies have estimated the risk of death associated with unemployment in the coronavirus disease 2019 (COVID-19) pandemic, but no studies have examined unemployment before COVID-19 infection as a risk factor for COVID-19-related mortality. Thus, this study aimed to investigate COVID-19 mortality among this population. METHODS: Data on 50,038 people aged 25-59 years were collected from 38 agencies in Fars Province, Iran, from February 2020 to July 2021. Follow-up lasted from participants’ diagnosis with COVID-19 based on the results of a reverse transcription-polymerase chain reaction test to participants’ death or the end of the study period. The association between unemployment and COVID-19-related mortality was estimated using the Poisson regression method, and a sensitivity analysis was conducted to calculate the E-value. RESULTS: Unemployment was associated with a 2.41-fold (95% confidence interval [CI], 2.01 to 2.90) higher age-adjusted and sex-adjusted risk of COVID-19-related mortality. The adjusted Poisson regression analysis showed 8.82 (95% CI, 6.42 to 12.11), 2.84 (95% CI, 1.90 to 4.24), and 1.58 (95% CI, 1.24 to 2.01) times higher risks of COVID-19-related mortality among unemployed people aged 25-39 years, 40-49 years, and 50-59 years, respectively, than among their employed counterparts. Unemployment increased the risk of COVID-19 mortality by 3.31 (95% CI, 2.31 to 4.74) and 2.30 (95% CI, 1.86 to 2.84) times in female and male, respectively. The E-value was 3.43, reflecting the minimum strength of confounding required to shift the association between unemployment and COVID-19-related mortality toward the null. CONCLUSIONS: Unemployment prior to COVID-19 infection increased the risk of COVID-19-related mortality. COVID19-related mortality disproportionately impacted unemployed women and younger unemployed people.

#Unemployment #COVID-19 #Mortality #Iran

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