Interaction effects of the COVID-19 pandemic and regional deprivation on self-rated health: a cross-sectional study

Abstract

Background: Recent studies have attempted to analyze the changes in self-rated health (SRH) during the coronavirus disease 2019 (COVID-19) pandemic. However, the results have been inconsistent. Notably, SRH is subjective, and responses may vary across and within countries because of sociocultural differences. Thus, we aimed to examine whether the interaction effects between the COVID-19 pandemic and regional deprivation influenced SRH in South Korea.

Methods: The study population comprised 877,778 participants from the Korea Community Health Survey. The data were collected from 2018 to 2021. Multiple regression analysis was employed to determine the relationship between SRH and the interaction between the COVID-19 pandemic status and the socioeconomic level of residential areas.

Results: The post-pandemic groups (odds ratio [OR] = 2.25, P < .0001; OR = 2.29, P < .0001) had significantly higher odds of reporting favorable SRH than the pre-pandemic groups (OR = 0.96, P < .0001). However, the difference in ORs based on regional socioeconomic status was small.

Conclusions: SRH showed an overall increase in the post-pandemic groups relative to that in the disadvantaged pre-pandemic group. Possible reasons include changes in individuals' health perceptions through social comparison and the effective implementation of COVID-19 containment measures in South Korea. This paradoxical phenomenon has been named the "Eye of the Hurricane," as the vast majority of people who had not been infected by the virus may have viewed their health situation more favorably than they ordinarily would.