Social inequality in COVID-19-related morbidity and mortality during the first three waves of the pandemic in Denmark: a nationwide register-based cohort study, 2020–22
Year: 2026
Type: article
Study design: Observational Study
Abstract: This nationwide cohort study aimed to examine social inequality in coronavirus disease 2019 (COVID-19)-related morbidity and mortality in Denmark during the first three pandemic waves using different individual-level measures of socioeconomic position. Additionally, the study aimed to investigate potential changes in social inequality in COVID-19-related morbidity and mortality throughout the pandemic. The cohort comprised the total Danish population. Individual-level, linkable register data were extracted and analysed for all residents of Denmark across the first three pandemic waves (26 February 2020-15 April 2022). Poisson regression of incidence rates (IR) was performed to compare COVID-19-related morbidity and mortality rates between individuals grouped according to length of educational, household income, and employment status. Social inequality in COVID-19-related hospitalization, ICU admission, and mortality was observed across the three measures of socioeconomic position. The social inequality in COVID-19-related hospitalization and ICU admission increased throughout the pandemic. The incidence rate ratio (IRR) for COVID-19-related hospitalization for individuals with elementary vs. long education increased from 0.93 [95% confidence interval (CI): 0.83-1.05] in wave 1 to 1.75 (1.67-1.84) in wave 3. The corresponding changes in IRRs for low vs. high household income and unemployed vs. employed individuals were 0.87 (0.75-1.01) to 1.83 (1.71-1.95) and 1.04 (0.86-1.25) to 3.23 (3.02-3.45), respectively. Social inequality in COVID-19-related morbidity changed during the pandemic. Interventions that reduce differential vulnerability to and consequences of COVID-19 between groups defined by socioeconomic position seem to be increasingly important as pandemics evolve.
Institution: University of Southern Denmark
Language: English
Subfield: Health
Field: Social Sciences
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $3,181
OpenAlex ID: W7224894025