Abstract
Introduction. The COVID-19 pandemic has exerted unprecedented pressure on health systems, revealing inequalities on a world scale. One of the concerns over this period has been the possible inequality of access for diagnostic tests related to the economic resources of the population. In this study, we analyze the results of tests for COVID-19 detection in Bogotá and their relationship with income levels. Methods. Ecological research with SIVIGILA reports was carried out between March 6 to July 1, 2020, for positive and negative COVID-19 test records. The statistical description of the quantitative and qualitative variables and bivariate analysis were performed. Additionally, the Gini coefficient was calculated based on the Lorenz Curve. Results. The study included 44,300 records. The tests were conducted mainly on men (51.4%) and from the highest strata 4, 5, and 6 (53.5%). Similarly, the Gini Coefficient showed inequality in access by comparing socioeconomic strata. Conclusions. The analysis show inequality in access to the diagnostic tests for SARS-CoV-2, with the highest strata having more access associated with greater purchasing power.
Kawachi I, Subramanian SV, Almeida-Filho N. A glossary for health inequalities. J Epidemiol Community Health. 2002;56(9):647-652. http://dx.doi.org/10.1136/jech.56.9.647
Wilder-Smith A, Freedman DO. Isolation, quarantine, social distancing and community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak. J Travel Med. 2020;27(2). https://academic.oup.com/jtm/article/27/2/taaa020/5735321
Irlacher M, Koch M. Working from home, wages, and regional inequality in the light of COVID-19. Rochester, NY: Social Science Research Network; 2020. Report No. ID 3582329. https://papers.ssrn.com/abstract=3582329
Beaunoyer E, Dupéré S, Guitton MJ. COVID-19 and digital inequalities: Reciprocal impacts and mitigation strategies. Comput Hum Behav. 2020;111:106424. https://doi.org/10.1016/j.chb.2020.106424
Bowleg L. We’re not all in this together: On COVID-19, intersectionality, and structural inequality. Am J Public Health. 2020;110(7):917. https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2020.305766
Long run consequences of the COVID-19 pandemic on social inequality. UNDP. https://www.latinamerica.undp.org/content/rblac/en/home/blog/2020/consecuencias-de-la-pandemia-del-covid-19-en-las-desigualdades-s.html
Krieger N. Theories for social epidemiology in the 21st century: An ecosocial perspective. Int J Epidemiol. 2001;30(4):668-677. https://ibs.colorado.edu/jessor/psych7536-805/readings/krieger-2001_TheoriesforSocialEpidemiology.pdf
Nel P, Righarts M. Natural Disasters and the Risk of Violent Civil Conflict. Int Stud Q. 2008;52(1):159-185. https://www.jstor.org/stable/29734228?seq=1
Ahmed F, Ahmed N, Pissarides C, Stiglitz J. Why inequality could spread COVID-19. Lancet Public Health. 2020;5(5):e240. https://doi.org/10.1016/S2468-2667(20)30085-2
Abbasi K. Health inequalities: death by political means. BMJ. 2020;368. https://www.bmj.com/content/368/bmj.m755
Rodríguez Hernández JM. Aspectos sociales que pueden incidir en la pandemia. El rol de la salud pública y la epidemiología. Rev Univ Ind Santander. 2020;52:181-182. https://revistas.uis.edu.co/index.php/revistasaluduis/article/view/10935
Comisión Económica para América Latina y el Caribe-CEPAL. El desafío social en tiempos del COVID-19. 2020. https://www.cepal.org/es/publicaciones/45527-desafio-social-tiempos-covid-19
Mejia-Lancheros C, Lachaud J. Addressing social determinants of health: Reopen the debate and the implications for the health and overall well-being of Colombian people. Av En Enferm. 2020;38(2):135-139. https://doi.org/10.15446/av.enferm.v38n2.85241
Nuevo coronavirus 2019. https://www.who.int/es/emergencies/diseases/novel-coronavirus-2019
Dorn A van, Cooney RE, Sabin ML. COVID-19 exacerbating inequalities in the US. Lancet Lond Engl. 2020;395(10232):1243-1244. https://doi.org/10.1016/S0140-6736(20)30893-X
Coronavirus (COVID-19) Testing - Statistics and Research. Our World in Data. https://ourworldindata.org/coronavirus-testing
Coronavirus Colombia. https://www.ins.gov.co/Noticias/Paginas/Coronavirus.aspx
Regidor E. Measures of health inequalities: Part 1. J Epidemiol Community Health. 2004;58(10):858-861. https://doi.org/10.1136/jech.2003.015347
DANE. Gran Encuesta Integrada de Hogares (GEIH) 2019. Bogotá D.C.: DANE. http://microdatos.dane.gov.co/index.php/catalog/599/get_microdata
Suarez-Alvarez MM, Pham D-T, Prostov MY, Prostov YI. Statistical approach to normalization of feature vectors and clustering of mixed datasets. Proc R Soc Math Phys Eng Sci. 2012;468(2145):2630-2651. https://royalsocietypublishing.org/doi/10.1098/rspa.2011.0704
DANE. Encuesta Multipropósito (EM) 2014. Bogotá D.C.: DANE. https://www.dane.gov.co/index.php/estadisticas-por-tema/pobreza-y-condiciones-de-vida/encuesta-multiproposito/encuesta-multiproposito-2014#:~:text=La%20Encuesta%20Multiprop%C3%B3sito%20incluye%20los,de%20Bogot%C3%A1%20para%20el%202014.
Thomsen JL. Methods for analysing recurrent events in health care data. Examples from admissions in Ebeltoft Health Promotion Project. Fam Pract. 2006;23(4):407-413. https://academic.oup.com/fampra/article-lookup/doi/10.1093/fampra/cml012
Schneider MC, Castillo-Salgado C, Bacallao J, Loyola E, Mujica OJ et al. Métodos de medición de las desigualdades de salud. Rev Panam Salud Pública. 2002;12:398-414. https://www.scielosp.org/article/rpsp/2002.v12n6/398-414/es/
Arcaya MC, Arcaya AL, Subramanian SV. Inequalities in health: definitions, concepts, and theories. Glob Health Action. 2015;8(1):27106. https://doi.org/10.3402/gha.v8.27106
Krouse HJ. COVID-19 and the widening gap in health inequity. Otolaryngol Neck Surg. 5 de mayo de 2020; https://journals.sagepub.com/doi/10.1177/0194599820926463?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed
Patel JA, Nielsen FBH, Badiani AA, Assi S, Unadkat VA, Patel B, et al. Poverty, inequality and COVID-19: the forgotten vulnerable. Public Health. 2020;183:110-111. https://doi.org/10.1016/j.puhe.2020.05.006
Schmitt-Grohé S, Teoh K, Uribe M. COVID-19: Testing inequality in New York City. 2020.
Smith JA, Judd J. COVID-19: Vulnerability and the power of privilege in a pandemic. Health Promot J Austr. 2020;31(2):158-160. https://doi.org/10.1002/hpja.333
Kristen JA, Zijun S, Romanelli R, Lockhart S, Smits K et al. Disparities In outcomes among COVID-19 patients in a large health care system in Californ. Health Aff (Millwood). 2020;39(7):1253-1262. https://doi.org/10.1377/hlthaff.2020.00598

This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2022 Jeadran Nevardo Malagón-Rojas, Edgar Antonio Ibáñez Pinilla, Yesith Guillermo Toloza Pérez, Eliana Téllez, Julia Almentero, Eliana Parra, Luisa Lagos, Diana Walteros, Marcela Mercado