Bibliothèque complète

Background The COVID-19 pandemic has had a disproportionate impact on residents of long-term care facilities or nursing homes, characterized by significantly higher infection and mortality rates than in the general population. Previous research has highlighted significant disparities in COVID-19 outcomes, particularly among ethnic minorities. This study examines the association between belonging to a minority language community and COVID-19 infection rates in LTCFs in Ontario, Canada, at both the individual and facility levels. Methods We conducted a population-based retrospective cohort study of 85,367 LTC home residents in Ontario between January 15, 2019, and March 30, 2020, which we followed until March 31, 2021, using data from the Continuing Care Reporting System. We defined resident language (obtained from routine assessments in nursing homes) as English (Anglophone), French (Francophone), or other (Allophone), and we calculated a weighted average of languages spoken by residents in each LTC facility to determine the linguistic environment of the LTC facility. We calculated incidence rates of COVID-19 for each linguistic group, and we fitted multilevel logistic regression models to assess the main factors influencing the risk of COVID-19 infection, to account for individual-level and facility-level linguistic factors. Results The overall incidence of COVID-19 was 14.8%. The incidence of COVID-19 was higher among Allophones (23.6%) compared to Anglophones (13.1%) and Francophones (12.2%). Allophones in English homes (22.5%) showed significantly higher incidence rates compared to Anglophones (13.1%) and Francophones (11.0%) in these same homes. After adjusting for sociodemographic and clinical characteristics, the risk of COVID-19 remained significantly higher for Allophones compared to Anglophones (aOR 1.14, 95% CI 1.05–1.22), while residents living in language-discordant nursing homes had a non-significantly higher risk of COVID-19 (aOR 1.07, 95% CI 0.99–1.14). Conclusions Over the first two waves of the COVID-19 pandemic, the risk of COVID-19 infection in nursing homes was highest among residents whose primary language was a language other than English or French. The results of our study show that COVID-19 disproportionately affected populations living in minority linguistic communities. These findings may help informing public health interventions aimed at addressing the language barriers in long-term care in Ontario, and across Canada.