{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T05:04:53Z","timestamp":1777352693187,"version":"3.51.4"},"update-to":[{"DOI":"10.1371\/journal.pcbi.1013262","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000}}],"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fondo per la ricerca in campo economico e sociale","award":["FRES2021_0000002"],"award-info":[{"award-number":["FRES2021_0000002"]}]}],"content-domain":{"domain":["www.ploscompbiol.org"],"crossmark-restriction":false},"short-container-title":["PLoS Comput Biol"],"abstract":"<jats:p>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\u2019s 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 vary 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.<\/jats:p>","DOI":"10.1371\/journal.pcbi.1013262","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T17:45:01Z","timestamp":1754329501000},"page":"e1013262","update-policy":"https:\/\/doi.org\/10.1371\/journal.pcbi.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Socioeconomic determinants of protective behaviors and contact patterns in the post-COVID-19 pandemic era: A cross-sectional study in Italy"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3068-5111","authenticated-orcid":true,"given":"Michele","family":"Tizzani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3085-8641","authenticated-orcid":true,"given":"Laetitia","family":"Gauvin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"issue":"9","key":"pcbi.1013262.ref001","article-title":"The association between socioeconomic status and pandemic influenza: systematic review and meta-analysis","volume":"16","author":"S-E Mamelund","year":"2021","journal-title":"PLoS One."},{"issue":"5","key":"pcbi.1013262.ref002","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-042212","article-title":"Understanding the influence of socioeconomic status on the association between combinations of lifestyle factors and adverse health outcomes: a systematic review protocol","volume":"11","author":"H Foster","year":"2021","journal-title":"BMJ Open."},{"issue":"3","key":"pcbi.1013262.ref003","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(17)30058-X","article-title":"Socioeconomic status and non-communicable disease behavioural risk factors in low-income and lower-middle-income countries: a systematic review","volume":"5","author":"L Allen","year":"2017","journal-title":"Lancet Glob Health."},{"issue":"3","key":"pcbi.1013262.ref004","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(17)30054-2","article-title":"Socioeconomic status and risk factors for non-communicable diseases in low-income and lower-middle-income countries","volume":"5","author":"S Stringhini","year":"2017","journal-title":"Lancet Glob Health."},{"key":"pcbi.1013262.ref005","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1186\/s12889-015-2227-y","article-title":"Socioeconomic inequalities in non-communicable diseases and their risk factors: an overview of systematic reviews","volume":"15","author":"I Sommer","year":"2015","journal-title":"BMC Public Health."},{"issue":"1","key":"pcbi.1013262.ref006","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1038\/s41598-023-28013-4","article-title":"Association between socio-economic status and non-communicable disease risk in young adults from Kenya, South Africa, and the United Kingdom","volume":"13","author":"A Mtintsilana","year":"2023","journal-title":"Sci Rep."},{"issue":"21","key":"pcbi.1013262.ref007","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1001\/jama.279.21.1703","article-title":"Socioeconomic factors, health behaviors, and mortality: results from a nationally representative prospective study of US adults","volume":"279","author":"PM Lantz","year":"1998","journal-title":"JAMA."},{"issue":"1","key":"pcbi.1013262.ref008","doi-asserted-by":"crossref","first-page":"3118","DOI":"10.1038\/s41467-021-23404-5","article-title":"Impacts of social distancing policies on mobility and COVID-19 case growth in the US","volume":"12","author":"GA Wellenius","year":"2021","journal-title":"Nat Commun."},{"issue":"33","key":"pcbi.1013262.ref009","doi-asserted-by":"crossref","first-page":"19873","DOI":"10.1073\/pnas.2009033117","article-title":"Timing social distancing to avert unmanageable COVID-19 hospital surges","volume":"117","author":"D Duque","year":"2020","journal-title":"Proc Natl Acad Sci U S A."},{"issue":"1","key":"pcbi.1013262.ref010","doi-asserted-by":"crossref","first-page":"1523","DOI":"10.1186\/s12889-023-16405-0","article-title":"Socio-demographic characteristics associated with COVID-19 vaccination uptake in Switzerland: longitudinal analysis of the CoMix study","volume":"23","author":"ML Reichmuth","year":"2023","journal-title":"BMC Public Health."},{"issue":"1","key":"pcbi.1013262.ref011","doi-asserted-by":"crossref","first-page":"2316","DOI":"10.1186\/s12889-022-14774-6","article-title":"Socioeconomic differences in COVID-19 infection, hospitalisation and mortality in urban areas in a region in the South of Europe","volume":"22","author":"NF Fern\u00e1ndez-Mart\u00ednez","year":"2022","journal-title":"BMC Public Health."},{"issue":"1","key":"pcbi.1013262.ref012","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1186\/s12879-022-07274-w","article-title":"The fine-scale associations between socioeconomic status, density, functionality, and spread of COVID-19 within a high-density city","volume":"22","author":"A Zhang","year":"2022","journal-title":"BMC Infect Dis."},{"issue":"3","key":"pcbi.1013262.ref013","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1177\/0020731421994842","article-title":"Assessing the impact of individual characteristics and neighborhood socioeconomic status during the COVID-19 pandemic in the provinces of Milan and Lodi","volume":"51","author":"D Consolazio","year":"2021","journal-title":"Int J Health Serv."},{"issue":"12","key":"pcbi.1013262.ref014","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0244535","article-title":"Demographic and socio-economic factors, and healthcare resource indicators associated with the rapid spread of COVID-19 in Northern Italy: an ecological study","volume":"15","author":"A Buja","year":"2020","journal-title":"PLoS One."},{"key":"pcbi.1013262.ref015","doi-asserted-by":"crossref","first-page":"102642","DOI":"10.1016\/j.healthplace.2021.102642","article-title":"Socioeconomic patterns, COVID-19 outcomes before, during and after the lockdown in Italy 2020","volume":"71","author":"A Mateo-Urdiales","year":"2021","journal-title":"Health Place."},{"key":"pcbi.1013262.ref016","unstructured":"Decree M. COVID-19, the official gazette publishes the new ministerial decree (DPCM). 2020. https:\/\/www.salute.gov.it\/portale\/nuovocoronavirus\/dettaglioNotizieNuovoCoronavirus.jsp?lingua=english&menu=notizie&p=dalministero&id=5154"},{"issue":"1","key":"pcbi.1013262.ref017","doi-asserted-by":"crossref","first-page":"4570","DOI":"10.1038\/s41467-021-24832-z","article-title":"Impact of tiered restrictions on human activities and the epidemiology of the second wave of COVID-19 in Italy","volume":"12","author":"M Manica","year":"2021","journal-title":"Nat Commun."},{"issue":"1","key":"pcbi.1013262.ref018","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1186\/s12889-023-15846-x","article-title":"Impact of tiered measures on social contact and mixing patterns of in Italy during the second wave of COVID-19","volume":"23","author":"M Tizzani","year":"2023","journal-title":"BMC Public Health."},{"issue":"181","key":"pcbi.1013262.ref019","doi-asserted-by":"crossref","first-page":"20210092","DOI":"10.1098\/rsif.2021.0092","article-title":"Socio-economic determinants of mobility responses during the first wave of COVID-19 in Italy: from provinces to neighbourhoods","volume":"18","author":"L Gauvin","year":"2021","journal-title":"J R Soc Interface."},{"issue":"1","key":"pcbi.1013262.ref020","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1186\/s12879-023-08214-y","article-title":"Social contact patterns during the COVID-19 pandemic in 21 European countries - evidence from a two-year study","volume":"23","author":"KLM Wong","year":"2023","journal-title":"BMC Infect Dis."},{"issue":"6","key":"pcbi.1013262.ref021","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1097\/EDE.0000000000001412","article-title":"Rapid Review of Social Contact Patterns During the COVID-19 Pandemic","volume":"32","author":"CY Liu","year":"2021","journal-title":"Epidemiology."},{"issue":"3","key":"pcbi.1013262.ref022","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.0050074","article-title":"Social contacts and mixing patterns relevant to the spread of infectious diseases","volume":"5","author":"J Mossong","year":"2008","journal-title":"PLoS Med."},{"issue":"9","key":"pcbi.1013262.ref023","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pcbi.1002673","article-title":"Inferring the structure of social contacts from demographic data in the analysis of infectious diseases spread","volume":"8","author":"L Fumanelli","year":"2012","journal-title":"PLoS Comput Biol."},{"issue":"1","key":"pcbi.1013262.ref024","doi-asserted-by":"crossref","first-page":"4137","DOI":"10.1038\/s41467-024-48332-y","article-title":"Importance of social inequalities to contact patterns, vaccine uptake, and epidemic dynamics","volume":"15","author":"A Manna","year":"2024","journal-title":"Nat Commun."},{"key":"pcbi.1013262.ref025","doi-asserted-by":"crossref","first-page":"100778","DOI":"10.1016\/j.epidem.2024.100778","article-title":"Social contact patterns following the COVID-19 pandemic: a snapshot of post-pandemic behaviour from the CoMix study","volume":"48","author":"CI Jarvis","year":"2024","journal-title":"Epidemics."},{"issue":"41","key":"pcbi.1013262.ref026","doi-asserted-by":"crossref","DOI":"10.1126\/sciadv.adk4606","article-title":"Generalized contact matrices allow integrating socioeconomic variables into epidemic models","volume":"10","author":"A Manna","year":"2024","journal-title":"Sci Adv."},{"issue":"1","key":"pcbi.1013262.ref027","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1515\/slgr-2015-0020","article-title":"REC: just radical enough","volume":"41","author":"E Myin","year":"2015","journal-title":"Studies in Logic, Grammar and Rhetoric."},{"issue":"3","key":"pcbi.1013262.ref028","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1177\/8756479308317006","article-title":"Measures of association: how to choose?","volume":"24","author":"H Khamis","year":"2008","journal-title":"Journal of Diagnostic Medical Sonography."},{"issue":"4","key":"pcbi.1013262.ref029","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.2307\/2532457","article-title":"Assessing proportionality in the proportional odds model for ordinal logistic regression","volume":"46","author":"R Brant","year":"1990","journal-title":"Biometrics."},{"key":"pcbi.1013262.ref030","doi-asserted-by":"crossref","unstructured":"Venables WN, Ripley BD. Modern Applied Statistics with S. 4 ed. New York: Springer; 2002.","DOI":"10.1007\/978-0-387-21706-2"},{"issue":"15","key":"pcbi.1013262.ref031","doi-asserted-by":"crossref","DOI":"10.18637\/jss.v103.i15","article-title":"Bambi: a simple interface for fitting bayesian linear models in python","volume":"103","author":"T Capretto","year":"2022","journal-title":"J Stat Soft."},{"issue":"7","key":"pcbi.1013262.ref032","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1080\/13607863.2020.1856781","article-title":"Age-related differences in the perception of COVID-19 emergency during the Italian outbreak","volume":"25","author":"I Ceccato","year":"2021","journal-title":"Aging Ment Health."},{"issue":"2252","key":"pcbi.1013262.ref033","first-page":"20210232","article-title":"Epidemics on hypergraphs: spectral thresholds for extinction","volume":"477","author":"DJ Higham","year":"2021","journal-title":"Proc Math Phys Eng Sci."},{"issue":"5","key":"pcbi.1013262.ref034","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0283514","article-title":"The gender dimensions of mental health during the Covid-19 pandemic: a path analysis","volume":"18","author":"K Dotsikas","year":"2023","journal-title":"PLoS One."},{"key":"pcbi.1013262.ref035","doi-asserted-by":"crossref","first-page":"101119","DOI":"10.1016\/j.ehb.2022.101119","article-title":"Exploring the hidden impact of the Covid-19 pandemic: the role of urbanization","volume":"46","author":"KP Arin","year":"2022","journal-title":"Econ Hum Biol."},{"key":"pcbi.1013262.ref036","unstructured":"della Salute M. Report vaccini anti covid-19. Ministero della Salute. 2024. https:\/\/www.governo.it\/it\/cscovid19\/report-vaccini\/"},{"key":"pcbi.1013262.ref037","unstructured":"della Salute M. Dati coperture vaccinali influenza. 2024. https:\/\/www.salute.gov.it\/portale\/influenza\/dettaglioContenutiInfluenza.jsp?lingua=italiano&id=679&area=influenza&menu=vuoto#: :text=Dalla%20stagione%202015%2F16%20l,)%20nella%20stagione%202022%2F2023"},{"key":"pcbi.1013262.ref038","unstructured":"della Salute M. Come proteggersi dal Covid-19. 2024. https:\/\/www.salute.gov.it\/portale\/nuovocoronavirus\/dettaglioFaqNuovoCoronavirus.jsp?lingua=italiano"},{"key":"pcbi.1013262.ref039","unstructured":"Bruin J. Stata programs for data analysis. 2011. https:\/\/stats.oarc.ucla.edu\/stata\/ado\/analysis\/"},{"issue":"10","key":"pcbi.1013262.ref040","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/S2215-0366(20)30308-4","article-title":"Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population","volume":"7","author":"M Pierce","year":"2020","journal-title":"Lancet Psychiatry."},{"issue":"2","key":"pcbi.1013262.ref041","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/ruso.12534","article-title":"Self-Employment, the COVID-19 Pandemic, and the Rural\u2013Urban Divide in the United States\u22c6","volume":"89","author":"SCH Mindes","year":"2024","journal-title":"Rural Sociology."},{"issue":"1","key":"pcbi.1013262.ref042","doi-asserted-by":"crossref","first-page":"2451","DOI":"10.1186\/s12889-022-14858-3","article-title":"Exploring the lived experience of mental health and coping during unemployment","volume":"22","author":"AF Arena","year":"2022","journal-title":"BMC Public Health."},{"issue":"1","key":"pcbi.1013262.ref043","doi-asserted-by":"crossref","first-page":"17945","DOI":"10.1038\/s41598-022-22994-4","article-title":"Psychological well-being during the COVID-19 pandemic in Italy assessed in a four-waves survey","volume":"12","author":"G de Girolamo","year":"2022","journal-title":"Sci Rep."},{"key":"pcbi.1013262.ref044","doi-asserted-by":"crossref","first-page":"100554","DOI":"10.1016\/j.jbef.2021.100554","article-title":"Loss of financial well-being in the COVID-19 pandemic: Does job stability make a difference?","volume":"31","author":"KM Vieira","year":"2021","journal-title":"J Behav Exp Finance."},{"issue":"2","key":"pcbi.1013262.ref045","doi-asserted-by":"crossref","DOI":"10.1093\/geroni\/igab015","article-title":"Network-exposure severity and self-protective behaviors: the case of COVID-19","volume":"5","author":"H Litwin","year":"2021","journal-title":"Innov Aging."},{"issue":"2","key":"pcbi.1013262.ref046","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1177\/1090198121989960","article-title":"The relation of threat level and age with protective behavior intentions during Covid-19 in Germany","volume":"48","author":"NC Lages","year":"2021","journal-title":"Health Educ Behav."},{"key":"pcbi.1013262.ref047","doi-asserted-by":"crossref","first-page":"561785","DOI":"10.3389\/fpsyg.2020.561785","article-title":"The AGE effect on protective behaviors during the COVID-19 outbreak: sociodemographic, perceptions and psychological accounts","volume":"11","author":"R Pasion","year":"2020","journal-title":"Front Psychol."},{"issue":"1","key":"pcbi.1013262.ref048","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1186\/s12879-021-06610-w","article-title":"Analyzing the demographic, spatial, and temporal factors influencing social contact patterns in U.S. and implications for infectious disease spread","volume":"21","author":"AM Dor\u00e9lien","year":"2021","journal-title":"BMC Infect Dis."},{"issue":"1","key":"pcbi.1013262.ref049","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1136\/oemed-2023-108931","article-title":"Potential contribution of vaccination uptake to occupational differences in risk of SARS-CoV-2: analysis of the ONS COVID-19 Infection Survey","volume":"81","author":"S Rhodes","year":"2024","journal-title":"Occupational and Environmental Medicine."},{"issue":"52","key":"pcbi.1013262.ref050","doi-asserted-by":"crossref","first-page":"7646","DOI":"10.1016\/j.vaccine.2022.10.080","article-title":"Occupation, worker vulnerability, and COVID-19 vaccination uptake: analysis of the virus watch prospective cohort study","volume":"40","author":"S Beale","year":"2022","journal-title":"Vaccine."},{"issue":"4","key":"pcbi.1013262.ref051","doi-asserted-by":"crossref","first-page":"160097","DOI":"10.1098\/rsos.160097","article-title":"Sex differences in social focus across the life cycle in humans","volume":"3","author":"K Bhattacharya","year":"2016","journal-title":"R Soc Open Sci."}],"updated-by":[{"DOI":"10.1371\/journal.pcbi.1013262","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000}}],"container-title":["PLOS Computational Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pcbi.1013262","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T17:51:45Z","timestamp":1754934705000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pcbi.1013262"}},"subtitle":[],"editor":[{"given":"Kat S.","family":"Rock","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,8,4]]},"references-count":51,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,4]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pcbi.1013262","relation":{"new_version":[{"id-type":"doi","id":"10.1371\/journal.pcbi.1013262","asserted-by":"object"}]},"ISSN":["1553-7358"],"issn-type":[{"value":"1553-7358","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,4]]}}}