The impact of contextual socioeconomic and demographic characteristics of residents on COVID-19 outcomes during public health restrictions in Sydney, Australia

Objective: To investigate the impact of contextual socioeconomic and demographic characteristics of residents on COVID-19 outcomes during public health measures. Methods: Aggregated data from the NSW Notifiable Conditions Information Management System linked to Australian Census data, by periods of strict and relaxed measures, were used. Results: During strict measures, residents of areas of lower socioeconomic status (SES) had a higher risk of infection, with the lowest areas having greater risk compared with the highest areas ((hazard ratio (HR)) 7.15, 95% confidence interval (CI) 6.24-8.19). The risk of infection was lower for those aged 40 and over and was higher for males (HR 1.34, 95% CI 1.27-1.40); those in living in areas with larger household sizes (HR 1.56, 95% CI 36-1.78); and individuals in areas with a large proportion of residents born in South Asia (HR 1.18; 95% CI 1.07-1.29), South East Asia (HR 1.20, 95% CI 1.07-1.36) and the Middle East and North Africa (HR 1.67, 95% CI 1.47-1.90). During relaxed restrictions, the impact of variables attenuated but remained significant. Conclusions: Minorities, those residing in lower SES areas and those living in larger households had worse COVID-19 outcomes during strict public health measures. Implications for Public Health: Decision-makers should tailor services to avoid inequities.