Modeling the role of healthcare access inequalities in epidemic outcomes
Urban areas, with large and dense populations, offer conditions that favor the emergence and spread of certain infectious diseases. One common feature of urban populations is the existence of large socioeconomic inequalities which are often mirrored by disparities in access to healthcare. Recent emp...
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| Language: | English |
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AIMS Press
2016-06-01
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| Series: | Mathematical Biosciences and Engineering |
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| Online Access: | https://www.aimspress.com/article/doi/10.3934/mbe.2016028 |
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| author | Oscar Patterson-Lomba Muntaser Safan Sherry Towers Jay Taylor |
| author_facet | Oscar Patterson-Lomba Muntaser Safan Sherry Towers Jay Taylor |
| author_sort | Oscar Patterson-Lomba |
| collection | DOAJ |
| description | Urban areas, with large and dense populations, offer conditions that favor the emergence and spread of certain infectious diseases. One common feature of urban populations is the existence of large socioeconomic inequalities which are often mirrored by disparities in access to healthcare. Recent empirical evidence suggests that higher levels of socioeconomic inequalities are associated with worsened public health outcomes, including higher rates of sexually transmitted diseases (STD's) and lower life expectancy. However, the reasons for these associations are still speculative. Here we formulate a mathematical model to study the effect of healthcare disparities on the spread of an infectious disease that does not confer lasting immunity, such as is true of certain STD's. Using a simple epidemic model of a population divided into two groups that differ in their recovery rates due to different levels of access to healthcare, we find that both the basic reproductive number ($\mathcal{R}_{0}$) of the disease and its endemic prevalence are increasing functions of the disparity between the two groups, in agreement with empirical evidence. Unexpectedly, this can be true even when the fraction of the population with better access to healthcare is increased if this is offset by reduced access within the disadvantaged group. Extending our model to more than two groups with different levels of access to healthcare, we find that increasing the variance of recovery rates among groups, while keeping the mean recovery rate constant, also increases $\mathcal{R}_{0}$ and disease prevalence. In addition, we show that these conclusions are sensitive to how we quantify the inequalities in our model, underscoring the importance of basing analyses on appropriate measures of inequalities. These insights shed light on the possible impact that increasing levels of inequalities in healthcare access can have on epidemic outcomes, while offering plausible explanations for the observed empirical patterns. |
| format | Article |
| id | doaj-art-bbad7e32e35e4de98fec55152b0ef278 |
| institution | Kabale University |
| issn | 1551-0018 |
| language | English |
| publishDate | 2016-06-01 |
| publisher | AIMS Press |
| record_format | Article |
| series | Mathematical Biosciences and Engineering |
| spelling | doaj-art-bbad7e32e35e4de98fec55152b0ef2782025-01-24T02:36:57ZengAIMS PressMathematical Biosciences and Engineering1551-00182016-06-011351011104110.3934/mbe.2016028Modeling the role of healthcare access inequalities in epidemic outcomesOscar Patterson-Lomba0Muntaser Safan1Sherry Towers2Jay Taylor3Harvard T.H. Chan School of Public Health, Department of Biostatistics, Boston, MASAL MCMSC, School of Human Evolution and Social Change, Arizona State University, Tempe, AZSAL MCMSC, School of Human Evolution and Social Change, Arizona State University, Tempe, AZSchool of Mathematical and Statistical Sciences, Arizona State University, Tempe, AZUrban areas, with large and dense populations, offer conditions that favor the emergence and spread of certain infectious diseases. One common feature of urban populations is the existence of large socioeconomic inequalities which are often mirrored by disparities in access to healthcare. Recent empirical evidence suggests that higher levels of socioeconomic inequalities are associated with worsened public health outcomes, including higher rates of sexually transmitted diseases (STD's) and lower life expectancy. However, the reasons for these associations are still speculative. Here we formulate a mathematical model to study the effect of healthcare disparities on the spread of an infectious disease that does not confer lasting immunity, such as is true of certain STD's. Using a simple epidemic model of a population divided into two groups that differ in their recovery rates due to different levels of access to healthcare, we find that both the basic reproductive number ($\mathcal{R}_{0}$) of the disease and its endemic prevalence are increasing functions of the disparity between the two groups, in agreement with empirical evidence. Unexpectedly, this can be true even when the fraction of the population with better access to healthcare is increased if this is offset by reduced access within the disadvantaged group. Extending our model to more than two groups with different levels of access to healthcare, we find that increasing the variance of recovery rates among groups, while keeping the mean recovery rate constant, also increases $\mathcal{R}_{0}$ and disease prevalence. In addition, we show that these conclusions are sensitive to how we quantify the inequalities in our model, underscoring the importance of basing analyses on appropriate measures of inequalities. These insights shed light on the possible impact that increasing levels of inequalities in healthcare access can have on epidemic outcomes, while offering plausible explanations for the observed empirical patterns.https://www.aimspress.com/article/doi/10.3934/mbe.2016028epidemic outcomes.urbanizationhealthcare access inequalities |
| spellingShingle | Oscar Patterson-Lomba Muntaser Safan Sherry Towers Jay Taylor Modeling the role of healthcare access inequalities in epidemic outcomes Mathematical Biosciences and Engineering epidemic outcomes. urbanization healthcare access inequalities |
| title | Modeling the role of healthcare access inequalities in epidemic outcomes |
| title_full | Modeling the role of healthcare access inequalities in epidemic outcomes |
| title_fullStr | Modeling the role of healthcare access inequalities in epidemic outcomes |
| title_full_unstemmed | Modeling the role of healthcare access inequalities in epidemic outcomes |
| title_short | Modeling the role of healthcare access inequalities in epidemic outcomes |
| title_sort | modeling the role of healthcare access inequalities in epidemic outcomes |
| topic | epidemic outcomes. urbanization healthcare access inequalities |
| url | https://www.aimspress.com/article/doi/10.3934/mbe.2016028 |
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