In France, the first pandemic peak fell disproportionately on the most disadvantaged, as they were overrepresented in contaminations and in developing severe forms of the virus. At that time, and especially during lockdown, the French healthcare system was severely disrupted and limited. The issue of social differences in the use of healthcare by people experiencing symptoms of Covid arose.
The aim of this study was to determine if the use of health care services was likely to contribute to widen Covid social inequalities. Use of health care services was classified in three categories: 1 no consultation, 2 out-of-hospital consultation s and 3 in-hospital consultation s. We estimated odds ratio of utilization of health care using multinomial regressions, adjusted on social factors age, gender, class, ethno-racial status, social class, standard of living and education , contextual variables, health variables, and symptoms characteristics.
Altogether, Use of health care services was strongly associated with social position2: the most disadvantaged social groups and racially minoritized immigrants were more likely to use health care, particularly for in-hospital consultation s. The highest utilization of health care were found among older adults OR 9. To conclude, we found that the use of health care services counteracted the potential impact of social inequalities in exposure and infection to the Covid This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Additional information can be addressed to the corresponding author Nathalie Bajos, nathalie. The funders facilitated data acquisition but had no role in the design, analysis, interpretation, or writing. There was no additional external funding received for this study. Competing interests: The authors have declared that no competing interests exist.
In France, like in many other countries, the first Covid pandemic peak March βJune revealed significant social inequalities in health [ 1 β 4 ]. The pandemic fell disproportionately on the most disadvantaged. Lower social class and racially minoritized groups were more exposed to contamination risks [ 5 ], and more often contracted severe forms of the virus [ 6 ], along with older individuals [ 7 ]. Thus, there is a need to analyze the medical care that these groups received when contracting the virus.
