Data Insight: Inequalities in severe COVID-19 outcomes in Wales, 2020 to 2022

This ADR Wales Data Insight examines the impact of confounding factors on severe health outcomes, comparing inequalities in COVID-19 related hospitalisations, critical care admissions and deaths during the first two years of the COVID-19 pandemic. 

We examine how much socioeconomic inequalities are explained by factors such as underlying health conditions, demographic characteristics, and health related behaviours to further understand the drivers of health inequalities in Wales.

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Main findings

• The risk associated with all COVID-19 related severe outcomes increased for those in the most deprived WIMD group (quintile) compared to the least deprived.
• Individuals living in the most deprived areas of Wales were 1.47 times more likely to die from COVID-19, 1.69 times more likely to be admitted to hospital care (due to COVID-19), and almost twice (1.75) as likely to be admitted to critical care than those in the least deprived.
• Generally, as the level of deprivation increased, so did the risk of COVID-19 related severe outcomes. However, when controlling for confounding factors, such as Smoking history, Body Mass Index and Ethnic Group we found minimal differences between the middle WIMD groups (quintiles) for COVID-19 related deaths and critical care admissions.
• For COVID-19 related hospitalisations, there is still a clear socioeconomic impact in risk of admission after controlling for other identified factors.
• Having a higher Body Mass Index, living in an urban city and town, having a history of cardiovascular disease or smoking, being clinically extremely vulnerable, and being of a non-white ethnicity resulted in an increased risk for most COVID-19 related severe outcomes.

Why it matters

This research builds on existing research findings, broadening the knowledge around the impact of mediating factors on socioeconomic health inequalities. We hope that this research can contribute to future pandemic preparedness and the formation of policies to address health inequalities.

From a policy perspective, celebrating diversity and moving to eliminate inequality in all its forms is one of the overarching wellbeing objectives of the Welsh Government’s Programme for Government. In addition, the Wellbeing of Future Generations Act also sets out Health and Equality as two main policy goals.