Table 1.
Characteristics of Overall Community-Dwelling Adults in Ontario, Canada, and Those Who Died Related to Coronavirus Disease 2019 and Other Causes
| Characteristic | Number of Individuals Residing in Ontario as of 1 March 2020 | Number of COVID-19–related Deathsa Between 1 March 2020 and 2 March 2021 | Number of Non–COVID-19 Deathsb Between 1 March 2020 and 2 March 2021 |
|---|---|---|---|
| Total | 11 810 255 | 3880 | 88 107 |
| Age (median, interquartile range), yc | 48 (34–62) | 81 (72–88) | 77 (65–86) |
| Age category, yc | |||
| ȃ20–34 | 3 143 764 (26.6%) | 23 (0.6%) | 2289 (2.6%) |
| ȃ35–49 | 3 009 493 (25.5%) | 84 (2.2%) | 4149 (4.7%) |
| ȃ50–64 | 3 099 010 (26.2%) | 399 (10.3%) | 14 334 (16.3%) |
| ȃ65–74 | 1 487 522 (12.6%) | 710 (18.3%) | 17 897 (20.3%) |
| ȃ75–84 | 769 255 (6.5%) | 1140 (29.4%) | 22 900 (26.0%) |
| ȃ85+ | 301 211 (2.6%) | 1524 (39.3%) | 26 538 (30.1%) |
| Male | 5 777 603 (48.9%) | 2249 (58.0%) | 48 501 (55.0%) |
| Residing in a rural aread | 1 192 569 (10.1%) | 138 (3.6%) | 11 614 (13.2%) |
| Comorbiditye | |||
| ȃAsthma | 1 750 679 (14.8%) | 752 (19.4%) | 14 671 (16.7%) |
| ȃChronic obstructive pulmonary disease | 290 131 (2.5%) | 643 (16.6%) | 17 064 (19.4%) |
| ȃHypertension | 3 085 359 (26.1%) | 3205 (82.6%) | 63 356 (71.9%) |
| ȃDiabetes | 1 471 040 (12.5%) | 1847 (47.6%) | 32 328 (36.7%) |
| ȃCongestive heart failure | 264 194 (2.2%) | 988 (25.5%) | 22 696 (25.8%) |
| ȃDementia or frailty score >15f | 164 518 (1.4%) | 1215 (31.3%) | 18 742 (21.3%) |
| ȃCancerg | 242 667 (2.1%) | 235 (6.1%) | 15 663 (17.8%) |
| ȃChronic kidney diseaseh | |||
| ȃȃWith no recent dialysis | 277 564 (2.4%) | 937 (24.1%) | 16 286 (18.5%) |
| ȃȃWith recent (last 3 mo) dialysis | 11 131 (0.1%) | 95 (2.4%) | 1723 (2.0%) |
| ȃImmunocompromisedi | 89 318 (0.8%) | 130 (3.4%) | 3997 (4.5%) |
| ȃAdvanced liver diseasej | 86 612 (0.7%) | 103 (2.7%) | 4337 (4.9%) |
| ȃCardiac ischemic diseasek | 359 120 (3.0%) | 707 (18.2%) | 15 166 (17.2%) |
| ȃIschemic stroke or transient ischemic attackl | 112 634 (1.0%) | 370 (9.5%) | 6994 (7.9%) |
| Hospital admissions, past 3 y | |||
| ȃ0 | 10 278 277 (87.0%) | 1934 (49.8%) | 40 188 (45.6%) |
| ȃ1 | 1 112 902 (9.4%) | 856 (22.1%) | 20 623 (23.4%) |
| ȃ2 | 265 192 (2.2%) | 503 (13.0%) | 11 539 (13.1%) |
| ȃ3 or more | 153 884 (1.3%) | 587 (15.1%) | 15 757 (17.9%) |
| Outpatient physician visits, past y | |||
| ȃ0–1 | 4 054 472 (34.3%) | 313 (8.1%) | 10 673 (12.1%) |
| ȃ2–4 | 3 111 063 (26.3%) | 608 (15.7%) | 13 598 (15.4%) |
| ȃ5–8 | 2 320 703 (19.6%) | 882 (22.7%) | 16 897 (19.2%) |
| ȃ9–14 | 1 429 868 (12.1%) | 926 (23.9%) | 18 545 (21.0%) |
| ȃ15 or more | 894 149 (7.6%) | 1151 (29.7%) | 28 394 (32.2%) |
| Income quintile (1 = highest)m,n | |||
| ȃ1 | 2 351 451 (19.9%) | 479 (12.3%) | 14 152 (16.1%) |
| ȃ2 | 2 343 768 (19.8%) | 552 (14.2%) | 14 613 (16.6%) |
| ȃ3 | 2 364 379 (20.0%) | 776 (20.0%) | 17 011 (19.3%) |
| ȃ4 | 2 337 045 (19.8%) | 933 (24.0%) | 19 418 (22.0%) |
| ȃ5 | 2 301 617 (19.5%) | 1120 (28.9%) | 22 469 (25.5%) |
| ȃMissing | 111 995 (0.9%) | 20 (0.5%) | 444 (0.5%) |
| Educational attainment quintile (1 = highest)m,o | |||
| ȃ1 | 2 490 287 (21.1%) | 638 (16.4%) | 14 904 (16.9%) |
| ȃ2 | 2 513 154 (21.3%) | 781 (20.1%) | 17 337 (19.7%) |
| ȃ3 | 2 443 398 (20.7%) | 729 (18.8%) | 17 755 (20.2%) |
| ȃ4 | 2 260 406 (19.1%) | 846 (21.8%) | 19 110 (21.7%) |
| ȃ5 | 1 970 234 (16.7%) | 852 (22.0%) | 18 328 (20.8%) |
| ȃMissing | 132 776 (1.1%) | 34 (0.9%) | 673 (0.8%) |
| Proportion essential workers quintile (1 = lowest)m,p | |||
| ȃ1 | 2 533 697 (21.5%) | 705 (18.2%) | 14 830 (16.8%) |
| ȃ2 | 2 592 332 (21.9%) | 780 (20.1%) | 17 367 (19.7%) |
| ȃ3 | 2 315 922 (19.6%) | 760 (19.6%) | 18 453 (20.9%) |
| ȃ4 | 2 217 021 (18.8%) | 794 (20.5%) | 18 163 (20.6%) |
| ȃ5 | 2 018 450 (17.1%) | 807 (20.8%) | 18 620 (21.1%) |
| ȃMissing | 132 833 (1.1%) | 34 (0.9%) | 674 (0.8%) |
| Proportion racially minoritized groups quintile(1 = lowest)m,q | |||
| ȃ1 | 1 826 634 (15.5%) | 260 (6.7%) | 18 046 (20.5%) |
| ȃ2 | 1 954 891 (16.6%) | 454 (11.7%) | 18 424 (20.9%) |
| ȃ3 | 2 105 986 (17.8%) | 666 (17.2%) | 17 568 (19.9%) |
| ȃ4 | 2 564 575 (21.7%) | 964 (24.8%) | 16 729 (19.0%) |
| ȃ5 | 3 225 565 (27.3%) | 1502 (38.7%) | 16 672 (18.9%) |
| ȃMissing | 132 604 (1.1%) | 34 (0.9%) | 668 (0.8%) |
| Proportion recent immigrants (1 = lowest)m,r | |||
| ȃ1 | 5 983 539 (50.7%) | 1499 (38.6%) | 52 336 (59.4%) |
| ȃ2 | 2 412 998 (20.4%) | 880 (22.7%) | 16 208 (18.4%) |
| ȃ3 | 3 236 805 (27.4%) | 1464 (37.7%) | 18 402 (20.9%) |
| ȃMissing | 176 913 (1.5%) | 37 (1.0%) | 1161 (1.3%) |
| Proportion apartment buildings (1 = lowest)m,s | |||
| ȃ1 | 6 605 697 (55.9%) | 1613 (41.6%) | 42 666 (48.4%) |
| ȃ2 | 2 120 840 (18.0%) | 687 (17.7%) | 18 576 (21.1%) |
| ȃ3 | 2 944 390 (24.9%) | 1545 (39.8%) | 26 093 (29.6%) |
| ȃMissing | 139 328 (1.2%) | 35 (0.9%) | 772 (0.9%) |
| Average household size quintile (1 = lowest)m,t | |||
| ȃ1 | 2 325 763 (19.7%) | 1028 (26.5%) | 25 171 (28.6%) |
| ȃ2 | 2 064 823 (17.5%) | 571 (14.7%) | 19 138 (21.7%) |
| ȃ3 | 1 582 415 (13.4%) | 405 (10.4%) | 12 471 (14.2%) |
| ȃ4 | 2 722 878 (23.1%) | 861 (22.2%) | 17 930 (20.4%) |
| ȃ5 | 2 975 277 (25.2%) | 980 (25.3%) | 12 625 (14.3%) |
| ȃMissing | 139 099 (1.2%) | 35 (0.9%) | 772 (0.9%) |
| Proportion high-density housing (1 = lowest)m,u | |||
| ȃ1 | 3 983 354 (33.7%) | 1018 (26.2%) | 31 975 (36.3%) |
| ȃ2 | 2 559 526 (21.7%) | 675 (17.4%) | 20 016 (22.7%) |
| ȃ3 | 2 289 131 (19.4%) | 722 (18.6%) | 15 862 (18.0%) |
| ȃ4 | 2 679 342 (22.7%) | 1370 (35.3%) | 17 732 (20.1%) |
| ȃMissing | 298 902 (2.5%) | 95 (2.4%) | 2522 (2.9%) |
Databases used for creation of individual-level characteristics included the following: Discharge Abstract Database, National Ambulatory Care Reporting System, Ontario Health Insurance Plan provider billings, Ontario Drug Benefits Plan, Continuing Care Reporting System, Canadian Organ Replacement Registry, and Ontario Cancer Registry.
Abbreviation: COVID-19, coronavirus disease 2019.
Death within 30 days following or 7 days prior to a laboratory-confirmed positive COVID-19 test.
Death without a laboratory-confirmed positive COVID-19 test. We did not include those who died more than 7 days prior or 30 days after a positive COVID-19 test in our definition of non–COVID-19 death, as we aimed to determine patterns of mortality by area-level social determinants of health without COVID-19 in our secondary outcome, limiting the assessment of the potential longer-term impact of COVID-19 on the outcome.
Age as of 1 March 2020.
We defined rural as being located outside the commuting zone of a city with a population >10 000 [32].
The look-back window for comorbidities was since 1991, unless otherwise specified.
Frailty score >15 in the last 5 years.
Treatment in last 6 months or diagnosis in last year.
Diagnosis in the last 5 years.
Immunocompromised defined as diagnosed with human immunodeficiency virus (regardless of CD4 count) between 1991 and present, or had an organ or bone marrow transplant, or had another immunodeficient condition in the last 20 years.
Advanced liver disease defined as diagnosis of cirrhosis or decompensated cirrhosis.
Diagnosis in last 5 years or had a procedure in last 20 years.
Inpatient diagnosis in the last 20 years.
Area-level variables at the level of the census dissemination area.
Income quintile has variable cutoff values in each city or census area in order to take cost of living into account. A census dissemination area being in quintile 1 means it is among the highest 20% of dissemination areas in its city by median household income.
First quintile represents areas with 0%–4.1% of people aged 25–64 years without a diploma; second quintile, 4.1%–7.5%; third quintile, 7.5%–11.4%; fourth quintile, 11.4%–17.1%; and fifth quintile, 17.1%–94.3%.
First quintile represents 0%–32.5% of working people in the area who self-identified as working in an essential job, including sales, trades, manufacturing, and agriculture; second quintile, 32.5%–42.3%; third quintile, 42.3%–49.8%; fourth quintile, 50.0%–57.5%; and fifth quintile, 57.5%–114.3%.
First quintile represents 0%–2.2% of people in the area who self-identified as racially minoritized groups; second quintile, 2.2%–7.5%; third quintile: 7.5%–18.7%; fourth quintile, 18.7%–43.5%; and fifth quintile, 43.5%–100%.
First category represents 0%–2.1% of people in the area being recent immigrants who came to Canada within the last 5 years; second category, 2.1%–4.7%; and third category, 4.7%–41.2%. The high frequency of zeros permitted the creation of only 3 categories (ie, the lower 3 quintiles combined and the fourth and fifth quintiles).
First category, 0%–7.3% of buildings in the area are apartment buildings; second category, 7.4%–37.7%; and third category, 37.7%–100%. The high frequency of zeros permitted the creation of only 3 categories (ie, the lower 3 quintiles combined and the fourth and fifth quintiles).
First quintile represents 0–2.1 people/dwelling; second quintile, 2.2–2.4; third quintile, 2.5–2.6; fourth quintile, 2.7–3; and fifth quintile, 3.1–5.7.
First category represents 0%–2.6% of households are considered high-density housing; second category, 2.7%–5.2%; third category, 5.3%–8.7%; fourth category, >8.7%. The high frequency of zeros permitted the creation of only 4 categories (the lower 2 quintiles combined); “housing density/housing suitability” refers to whether a private household is “living in suitable accommodations” according to the National Occupancy Standard, that is, whether the dwelling has enough bedrooms for the size and composition of the household. A household is deemed to be living in suitable accommodations (non–high-density housing) if its dwelling has enough bedrooms, as calculated using the National Occupancy Standard.