Socioeconomic determinants of protective behaviors and contact patterns in the post-COVID-19 pandemic era: A cross-sectional study in Italy

Socioeconomic inequalities significantly influence infectious disease outcomes, as seen with COVID-19, but the pathways through which socioeconomic conditions affect transmission dynamics remain unclear. To address this, we conducted a survey representative of the Italian population, stratified by age, gender, geographical area, city size, employment status, and education level. The survey's final aim was to estimate differences in contact and protective behaviors across various population strata, both of which are crucial for understanding transmission dynamics. Our initial insights based on the survey indicate that years after the pandemic began, the perceived impact of COVID-19 on professional, economic, social, and psychological dimensions varied across socioeconomic strata, extending beyond the epidemiological outcomes. This reinforces the need for approaches that systematically consider socioeconomic determinants. In this context, using generalized linear models, we identified associations between socioeconomic factors and vaccination status for both COVID-19 and influenza, as well as the influence of socioeconomic conditions on mask-wearing and social distancing. Importantly, we also observed differences in contact behaviors based on employment status while education level did not show a significant association. These findings highlight the complex interplay of socioeconomic and demographic factors in shaping protective behavior and contact patterns. Understanding these dynamics can contribute to the improvement of epidemic models and better guide public health efforts for at-risk groups.