This paper aims to understand the relationship between area level deprivation and monthly COVID-19 cases in England in response to government policy throughout 2020. The response variable is monthly reported COVID-19 cases at the Middle Super Output Area (MSOA) level by Public Health England, with Index of Multiple Deprivation (IMD), ethnicity (percentage of the population across 5 ethnicity categories) and the percentage of the population older than 70 years old and time as predictors. A GEE population-averaged panel-data model was employed to model trends in monthly COVID-19 cases with the population of each MSOA included as the exposure variable. Area level deprivation is significantly associated with COVID-19 cases from March 2020; however, this relationship is reversed in December 2020. Follow up analysis found that this reversal was maintained when controlling for the novel COVID-19 variant outbreak in the South East of England. This analysis indicates that changes in the role of deprivation and monthly reported COVID-19 over time cases may be linked to two government policies: (1) the premature easing of national restrictions in July 2020 when cases were still high in the most deprived areas in England and (2) the introduction of a regional tiered system in October predominantly in the North of England. The analysis adds to the evidence showing that deprivation is a key driver of COVID-19 outcomes and highlights the unintended negative impact of government policy.

本文旨在了解整个 2020 年英国响应政府政策的区域级剥夺与每月 COVID-19 病例之间的关系。响应变量是公共卫生部门每月报告的中超输出区 (MSOA) 级别的 COVID-19 病例英格兰，以多重剥夺指数 (IMD)、种族（5 个种族类别的人口百分比）和 70 岁以上人口的百分比和时间作为预测因素。采用 GEE 人口平均面板数据模型对每月 COVID-19 病例的趋势进行建模，并将每个 MSOA 的人口作为暴露变量。从 2020 年 3 月开始，地区级剥夺与 COVID-19 病例显着相关；然而，这种关系在 2020 年 12 月发生逆转。后续分析发现，在控制英格兰东南部的新型 COVID-19 变体爆发时，这种逆转得以维持。该分析表明，随着时间的推移，剥夺和每月报告的 COVID-19 病例的作用发生变化可能与两项政府政策有关：(1) 2020 年 7 月国家限制过早放松，当时美国最贫困地区的病例仍然很高英格兰和 (2) 于 10 月引入了区域分层系统，主要是在英格兰北部。该分析增加了表明剥夺是 COVID-19 结果的关键驱动因素的证据，并强调了政府政策的意外负面影响。该分析表明，随着时间的推移，剥夺和每月报告的 COVID-19 病例的作用发生变化可能与两项政府政策有关：(1) 2020 年 7 月国家限制过早放松，当时美国最贫困地区的病例仍然很高英格兰和 (2) 于 10 月引入了区域分层系统，主要是在英格兰北部。该分析增加了表明剥夺是 COVID-19 结果的关键驱动因素的证据，并强调了政府政策的意外负面影响。该分析表明，随着时间的推移，剥夺和每月报告的 COVID-19 病例的作用发生变化可能与两项政府政策有关：(1) 2020 年 7 月国家限制过早放松，当时美国最贫困地区的病例仍然很高英格兰和 (2) 于 10 月引入了区域分层系统，主要是在英格兰北部。该分析增加了表明剥夺是 COVID-19 结果的关键驱动因素的证据，并强调了政府政策的意外负面影响。