@article{fdi:010097114,
  title = {{S}ocioeconomic inequalities and the {COVID}-19 pandemic in {F}rance : territorial analyzes based on epidemic wave and metropolitan area},
  author = {{C}anton, {L}. and {S}chalkwijk, {P}. and {L}andier, {J}ordi and {R}ebaudet, {S}. and {M}osnier, {E}. and {H}andschumacher, {P}ascal and {N}auleau, {S}. and {M}alfait, {P}. and {L}aunay, {L}. and {D}elpierre, {C}. and {K}elly-{I}rving, {M}. and {S}maili, {S}. and {V}andentorren, {S}. and {G}audart, {J}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {P}revious studies have highlighted the relationship between socioeconomic inequalities and the general population's risk of contracting or dying from {COVID}-19 during the 2020-2023 pandemic. {I}n {F}rance, socioeconomic inequalities vary across metropolitan areas; few studies have investigated whether this variation explains the spatial disparities observed in {COVID}-19 incidence and testing rates during the pandemic. {W}e examined the relationship between socioeconomic profiles and these two rates across all 22 metropolitan areas in {F}rance for eight of the country's nine epidemic waves. {M}ethods {F}or each metropolitan area, we used socioeconomic variables from census data to define socioeconomic profiles through principal component clustering. {W}e then used spatialized generalised additive mixed models to analyze associations between these profiles and both testing and incidence rates, for each epidemic wave from {J}uly 2020 to {M}arch 2023. {F}inally, we performed meta-regressions to study the distribution of testing and incidence rate ratios among the various socioeconomically deprived and privileged profiles within each of the 22 metropolitan areas, according to {COVID}-19 vaccination rate. {R}esults {T}esting rates were lower in socioeconomically deprived metropolitan areas than in privileged ones, except during wave 4 ({J}uly-{O}ctober-2021), when testing rates were more similar. {I}ncidence rates were higher in deprived areas (waves 2-4, {J}uly-2020 to {O}ctober-2021), but this pattern reversed between waves 6-9 ({M}arch-2022 to {M}arch-2023). {M}eta-regressions indicated that high vaccination coverage was associated with a narrower gap in testing between deprived and privileged areas. {M}oreover, for each metropolitan area, the higher the level of deprivation in a zone within the deprived profile, the greater the deprived-privileged gap in under-testing. {C}onclusions {T}he impact of socioeconomic inequalities on testing and incidence patterns during the {COVID}-19 pandemic in each metropolitan area in {F}rance was driven by the most deprived zones; this impact varied across epidemic waves. {H}igher vaccination rates and government health measures (lockdowns, mandatory health pass) may have reduced this variation.},
  keywords = {{FRANCE}},
  booktitle = {},
  journal = {{PL}o{S} {O}ne},
  volume = {21},
  numero = {5},
  pages = {e0348201 [21 p.]},
  year = {2026},
  DOI = {10.1371/journal.pone.0348201},
  URL = {https://www.documentation.ird.fr/hor/fdi:010097114},
}