Spatial variations of COVID-19 risk by age in Toronto, Canada

Submitted: 19 April 2022
Accepted: 2 July 2022
Published: 20 July 2022
Abstract Views: 637
PDF: 259
Appendix: 111
HTML: 90
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

The risk of coronavirus disease 2019 (COVID-19) may vary by age, biological, socioeconomic, behavioural and logistical reasons may be attributed to these variations. In Toronto, Canada, the aging population has been severely impacted, accounting for 92% of all COVID-19 deaths. Four age groups: 60-69 years, 70-79 years, 80-89 years and ≥90 years in Toronto neighbourhoods were investigated for clustering tendencies using space-time statistics. Cohen’s Kappa coefficient was computed to assess variations in risk by neighbourhood between different age groups. The findings suggest that knowledge of health risks and health behaviour varied by age across neighbourhoods in Toronto. Therefore, understanding the socioecological context of the communities and targeting age-appropriate intervention strategies is important for planning an effective mechanism for controlling the disease.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Adedokun OA, Burgess WD, 2012. Analysis of paired dichotomous data: a gentle introduction to the McNemar Test in SPSS. J Multidiscip Res 8:125-31.
Alsan M, Stantcheva S, Yang D, Cutler D, 2020. Disparities in coronavirus 2019 reported incidence, knowledge, and behavior among US adults. JAMA Netw Open 3:e2012403. DOI: https://doi.org/10.1001/jamanetworkopen.2020.12403
Barber SJ, Kim H, 2021. COVID-19 worries and behavior changes in older and younger men and women. J Gerontol B Psychol Sci Soc Sci 76:e17-e23. DOI: https://doi.org/10.1093/geronb/gbaa068
Public Health Agency of Canada, 2020. COVID-19 daily epidemiology update. Available from: https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html?stat=num&measure=total&map=hr#a2
Canning D, Karra M, Dayalu R, Guo M, Bloom DE, 2020. The association between age, COVID-19 symptoms, and social distancing behavior in the United States. medRxiv 2020.04.19.20065219. DOI: https://doi.org/10.1101/2020.04.19.20065219
Channer NS, Hartt M, Biglieri S, 2020. Aging-in-place and the spatial distribution of older adult vulnerability in Canada. Appl Geogr 125:102357. DOI: https://doi.org/10.1016/j.apgeog.2020.102357
Chen Y, Klein SL, Garibaldi BT, Li H, Wu C, Osevala NM, Li T, Margolick JB, Pawelec G, Leng SX, 2021. Aging in COVID-19: Vulnerability, immunity and intervention. Ageing Res Rev 65:101205. DOI: https://doi.org/10.1016/j.arr.2020.101205
Chen ZL, Zhang Q, Lu Y, Guo ZM, Zhang X, Zhang WJ, Guo C, Liao CH, Li QL, Han XH, Lu JH, 2020. Distribution of the COVID-19 epidemic and correlation with population emigration from Wuhan, China. Chin Med J. [Epub ahead of print]. DOI: https://doi.org/10.1101/2020.02.10.20021824
Chowell G, Rothenberg R, 2018. Spatial infectious disease epidemiology: On the cusp. BMC Med 16:192. DOI: https://doi.org/10.1186/s12916-018-1184-6
City of Toronto, 2020a. Coronavirus disease 2019 (COVID-19): epidemiology update. Available from: https://www.toronto.ca/home/covid-19/covid-19-latest-city-of-toronto-news/covid-19-status-of-cases-in-toronto/
City of Toronto, 2020b. Toronto neighbourhood profiles. Available from: https://www.toronto.ca/city-government/data-research-maps/neighbourhoods-communities/neighbourhood-profiles/
City of Toronto, 2020c. COVID-19: vaccines. Available from: https://www.toronto.ca/home/covid-19/covid-19-vaccines/
City of Toronto, 2021a. Toronto at a Glance. Available from: https://www.toronto.ca/city-government/data-research-maps/toronto-at-a-glance/
City of Toronto, 2021c. COVID-19: where to get vaccinated. Available from: https://www.toronto.ca/home/covid-19/covid-19-vaccines/covid-19-how-to-get-vaccinated/
City of Toronto, 2021d. City of Toronto announces new Team Toronto Mobile Strategy to bring vaccines directly to residents. Available from: https://www.toronto.ca/news/city-of-toronto-announces-new-team-toronto-mobile-strategy-to-bring-vaccines-directly-to-residents/
City of Toronto, 2022. COVID-19 Cases in Toronto, Open Data Catalogue. Available from: https://open.toronto.ca/dataset/covid-19-cases-in-toronto/
City of Toronto, C. of, 2021. COVID-19: pop-up immunization clinics. Available from: https://www.toronto.ca/home/covid-19/covid-19-vaccines/covid-19-how-to-get-vaccinated/covid-19-pop-up-immunization-clinics/
Cohen J, 1960. A Coefficient of Agreement for Nominal Scales. Edu Psychol Meas 20:37-46. DOI: https://doi.org/10.1177/001316446002000104
Davies NG, Klepac P, Liu Y, Prem K, Jit M, Eggo RM, 2020. Age-dependent effects in the transmission and control of COVID-19 epidemics. Nat Med 26:1205-11. DOI: https://doi.org/10.1038/s41591-020-0962-9
Golden J, Conroy RM, Bruce I, Denihan A, Greene E, Kirby M, Lawlor BA, 2011. The spectrum of worry in the community-dwelling elderly. Aging Ment Health 15:985-94. DOI: https://doi.org/10.1080/13607863.2011.583621
Ho FK, Petermann-Rocha F, Gray SR, Jani BD, Katikireddi SV, Niedzwiedz CL, Foster H, Hastie CE, Mackay, DF, Gill JMR, O’Donnell C, Welsh P, Mair F, Sattar N, Celis-Morales CA, Pell JP, 2020. Is older age associated with COVID-19 mortality in the absence of other risk factors? General population cohort study of 470,034 participants. PLoS One 15:e0241824. DOI: https://doi.org/10.1371/journal.pone.0241824
Hoffmann C, Wolf E, 2021. Older age groups and country-specific case fatality rates of COVID-19 in Europe, USA and Canada. Infection 49:111-6. DOI: https://doi.org/10.1007/s15010-020-01538-w
Kim S, Castro MC, 2020. Spatiotemporal pattern of COVID-19 and government response in South Korea (as of May 31, 2020). Int J Infect Dis 98:328-33. DOI: https://doi.org/10.1016/j.ijid.2020.07.004
Kulldorff M, Information Management Services Inc, 2009. SaTScan v9.3: Software for the spatial and space-time scan statistics. StatScan, Boston, MA, USA.
Landis JR, Koch GG, 1977. The measurement of observer agreement for categorical data. Biometrics 33:159-74. DOI: https://doi.org/10.2307/2529310
Mahajan RK, Paul G, Mahajan R, Gautam PL, Paul B, 2020. Systemic manifestations of COVID-19. J Anaesthesiol Clin Pharmacol 36:435-42. DOI: https://doi.org/10.4103/joacp.JOACP_359_20
Masrur A, Yu M, Luo W, Dewan A, 2020. Space-time patterns, change, and propagation of covid-19 risk relative to the intervention scenarios in Bangladesh. Int J Environ Res 17:5911. DOI: https://doi.org/10.3390/ijerph17165911
Mueller AL, McNamara MS, Sinclair DA, 2020. Why does COVID-19 disproportionately affect older people? Aging (Albany NY) 12:9959-81. DOI: https://doi.org/10.18632/aging.103344
Ngui AN, Apparicio P, Fleury MJ, Lesage A, Grégoire JP, Moisan J, Vanasse A, 2013. Spatio-temporal clustering of the incidence of schizophrenia in Quebec, Canada from 2004 to 2007. Spat Spatio-temporal Epidemiol 6:37-47. DOI: https://doi.org/10.1016/j.sste.2013.05.003
O’Brien J, Du KY, Peng C, 2020. Incidence, clinical features, and outcomes of COVID-19 in Canada: impact of sex and age. J Ovarian Res 13:137. DOI: https://doi.org/10.1186/s13048-020-00734-4
Piel FB, Fecht D, Hodgson S, Blangiardo M, Toledano M, Hansell AL, Elliott P, 2020. Small-area methods for investigation of environment and health. Int J Epidemiol 49:686-99. DOI: https://doi.org/10.1093/ije/dyaa006
Politi J, Martín-Sánchez M, Mercuriali L, Borras-Bermejo B, Lopez-Contreras J, Vilella A, Villar J, Barcelona C, Orcau A, Olalla PG, Rius C, 2021. Epidemiological characteristics and outcomes of COVID-19 cases: mortality inequalities by socioeconomic status, Barcelona, Spain, February 24 to May 4 2020. Euro Surveill 26:2001138. DOI: https://doi.org/10.2807/1560-7917.ES.2021.26.20.2001138
Public Health Agency of Canada, 2020. COVID-19 daily epidemiology update. Available from: https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html
Rao H, Shi X, Zhang X, 2017. Using the Kulldorff’s scan statistical analysis to detect spatio-temporal clusters of tuberculosis in Qinghai Province, China, 2009-2016. BMC Infect Dis 17:578. DOI: https://doi.org/10.1186/s12879-017-2643-y
Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW, Barnaby DP, Becker LB, Chelico JD, Cohen SL, Cookingham J, Coppa K, Diefenbach MA, Dominello AJ, Duer-Hefele J, Falzon L, Gitlin J, Hajizadeh N, Harvin TG, Hirschwerk DA, Kim EJ, Kozel ZM, Marrast LM, Mogavero JN, Osorio GA, Qiu M, Zanos TP, 2020. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City Area. JAMA 323:2052-9. DOI: https://doi.org/10.1001/jama.2020.6775
Santesmasses D, Castro JP, Zenin AA, Shindyapina AV, Gerashchenko MV, Zhang B, Kerepesi C, Yim SH, Fedichev PO, Gladyshev VN, 2020. COVID-19 is an emergent disease of aging. medRxiv. DOI: https://doi.org/10.1101/2020.04.15.20060095
Sarrouh M, Bowden O, 2021. Seniors over 80 have lower vaccination rates in Toronto and Peel than other age groups: How groups are working to change that. Available from: https://www.thestar.com/news/gta/2021/05/25/seniors-over-80-have-lower-vaccination-rates-in-toronto-and-peel-than-other-age-groups-how-groups-are-working-to-change-that.html
Sasaki S, Sato A, Tanabe Y, Matsuoka S, Adachi A, Kayano T, Yamazaki H, Matsuno Y, Miyake A, Watanabe T, 2021. Associations between socioeconomic status, social participation, and physical activity in older people during the COVID-19 pandemic: a cross-sectional study in a Northern Japanese City. Int J Environ Res 18:1477. DOI: https://doi.org/10.3390/ijerph18041477
Schwartz KL, Murti M, Finkelstein M, Leis JA, Fitzgerald-Husek A, Bourns L, Meghani H, Saunders A, Allen V, Yaffe B, 2020. Lack of COVID-19 transmission on an international flight. CMAJ 192:E410. DOI: https://doi.org/10.1503/cmaj.75015
Science Table Ontario, 2022. Ontario COVID-19 Science Advisory Table. Available from: https://covid19-sciencetable.ca/wp-content/uploads/2021/05/Update-on-COVID-19-Projections_2021.05.20_English-2.pdf
Shim E, 2021. Regional variability in COVID-19 case fatality rate in Canada, February-December 2020. Int J of Environ Res 18:1839. DOI: https://doi.org/10.3390/ijerph18041839
Sinclair AJ, Abdelhafiz AH, 2020. Age, frailty and diabetes - triple jeopardy for vulnerability to COVID-19 infection. EClin Med 22:100343. DOI: https://doi.org/10.1016/j.eclinm.2020.100343
Strang P, Fürst P, Schultz T, 2020. Excess deaths from COVID-19 correlate with age and socioeconomic status. A database study in the Stockholm region. Ups J Med Sci 125:297-304. DOI: https://doi.org/10.1080/03009734.2020.1828513
Temgoua MN, Endomba FT, Nkeck JR, Kenfack GU, Tochie JN, Essouma M, 2020. Coronavirus disease 2019 (COVID-19) as a multi-systemic disease and its impact in low and middle-income countries (LMICs). SN Compr Clin Med 2:1377-87. DOI: https://doi.org/10.1007/s42399-020-00417-7
Verity R, Okell LC, Dorigatti I, Winskill P, Whittaker C, Imai N, Cuomo-Dannenburg G, Thompson H, Walker PGT, Fu H, Dighe A, Griffin JT, Baguelin M, Bhatia S, Boonyasiri A, Cori A, Cucunubá Z, FitzJohn R, Gaythorpe K, Green W, Hamlet A, Hinsley W, Laydon D, Nedjati-Gilani G, Riley S, van Elsland S, Volz E, Wang H, Wang Y, Xi X, Donnelly CA, Ghani AC, Ferguson NM, 2020. Estimates of the severity of coronavirus disease 2019: a model-based analysis. Lancet Infect Dis 6:669-77. DOI: https://doi.org/10.1016/S1473-3099(20)30243-7
Verma AA, Hora T, Jung HY, Fralick M, Malecki SL, Lapointe-Shaw L, Weinerman A, Tang T, Kwan JL, Liu JJ, Rawal S, Chan TCY, Cheung AM, Rosella LC, Ghassemi M, Herridge M, Mamdani M, Razak F, 2021. Characteristics and outcomes of hospital admissions for COVID-19 and influenza in the Toronto area. CMAJ 193:E410-8. DOI: https://doi.org/10.1503/cmaj.202795
Wang L, Ramroop S, 2018. Geographic disparities in accessing community pharmacies among vulnerable populations in the Greater Toronto Area. Can J Public Health 109:821-32. DOI: https://doi.org/10.17269/s41997-018-0110-1
WHO, 2021. World Health Organization: COVID-19 dashboard. Available from: https://covid19.who.int/
Wingert A, Pillay J, Gates M, Guitard S, Rahman S, Beck A, Vandermeer B, Hartling L, 2021. Risk factors for severity of COVID-19: a rapid review to inform vaccine prioritisation in Canada. BMJ Open 11:e044684. DOI: https://doi.org/10.1136/bmjopen-2020-044684
Wu Z, McGoogan JM, 2020. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China. JAMA 323:1239-42. DOI: https://doi.org/10.1001/jama.2020.2648

How to Cite

Nazia, N. (2022). Spatial variations of COVID-19 risk by age in Toronto, Canada. Geospatial Health, 17(s1). https://doi.org/10.4081/gh.2022.1100