51
|
Affiliation(s)
- Steven Woolf
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
52
|
Mehta NK, Myrskylä M. An Introduction to the Supplemental Issue on Why Does Health in the US Continue to Lag Behind. J Gerontol B Psychol Sci Soc Sci 2022; 77:S113-S116. [PMID: 35639914 PMCID: PMC9154252 DOI: 10.1093/geronb/gbac050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Neil K Mehta
- Department of Epidemiology, School of Public and Population Health, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Mikko Myrskylä
- Max Planck Institute for Demographic Research, Rostock, Germany
- Center for Social Data Science and Population Research Unit, University of Helsinki, Helsinki, Finland
| |
Collapse
|
53
|
Paglino E, Lundberg DJ, Cho A, Wasserman JA, Raquib R, Luck AN, Hempstead K, Bor J, Elo IT, Preston SH, Stokes AC. Excess all-cause mortality across counties in the United States, March 2020 to December 2021. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022. [PMID: 35547848 DOI: 10.1101/2022.06.29.222770652022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Official Covid-19 death counts have underestimated the mortality impact of the Covid-19 pandemic in the United States. Excess mortality, which compares observed deaths to deaths expected in the absence of the pandemic, is a useful measure for assessing the total effect of the pandemic on mortality levels. In the present study, we produce county-level estimates of excess mortality for 3,127 counties between March 2020 and December 2021. We fit two hierarchical linear models to county-level death rates from January 2015 to December 2019 and predict expected deaths for each month during the pandemic. We compare observed deaths to these estimates to obtain excess deaths for each county-month. An estimated 936,911 excess deaths occurred during 2020 and 2021, of which 171,168 (18.3%) were not assigned to Covid-19 on death certificates as an underlying cause of death. Urban counties in the Far West, Great Lakes, Mideast, and New England experienced a substantial mortality disadvantage in 2020, whereas rural counties in these regions had higher mortality in 2021. In the Southeast, Southwest, Rocky Mountain, and Plains regions, there was a rural mortality disadvantage in 2020, which was exacerbated in 2021. The proportion of excess deaths assigned to Covid-19 was lower in 2020 (76.3%) than in 2021 (87.0%), suggesting that a larger fraction of excess deaths was assigned to Covid-19 later in the pandemic. However, in rural areas and in the Southeast and Southwest a large share of excess deaths was still not assigned to Covid-19 during 2021. SIGNIFICANCE Deaths during the Covid-19 pandemic have been primarily monitored through death certificates containing reference to Covid-19. This approach has missed more than 170,000 deaths related to the pandemic between 2020 and 2021. While the ascertainment of Covid-19 deaths improved during 2021, the full effects of the pandemic still remained obscured in some regions. County-level estimates of excess mortality are useful for studying geographic inequities in the mortality burden associated with the pandemic and identifying specific regions where the full mortality burden was significantly underreported (i.e. Southeast). They can also be used to inform resource allocation decisions at the federal and state levels and encourage uptake of preventive measures in communities with low vaccine uptake.
Collapse
|
54
|
Gollust SE, Call KT, Moon JR, Cluxton B, Bailey Z. Designing and Implementing a Curriculum to Support Health Equity Research Leaders: The Interdisciplinary Research Leaders Experience. Front Public Health 2022; 10:876847. [PMID: 35646764 PMCID: PMC9136100 DOI: 10.3389/fpubh.2022.876847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/13/2022] [Indexed: 12/05/2022] Open
Abstract
Health inequities in the United States are well-documented. However, research that is focused on solutions, rather than just describing the problem, and research that is designed explicitly to inform needed policy and practice change, is still too rare. The Robert Wood Johnson Foundation Interdisciplinary Research Leaders (IRL) program launched in 2016 with the goal of filling this gap: to generate community-engaged research to catalyze policy action in communities, while promoting leadership among researchers and community partners. In this paper, we describe the creation and implementation of a curriculum for IRL program participants over the first 5 years of the program. The curriculum—spanning domains of leadership, policy, communication, community engagement, and research methodologies—was designed to cultivate leaders who use research evidence in their efforts to promote change to advance health equity in their communities. The curriculum components implemented by IRL might be applied to other educational programs or fellowships to amplify and accelerate the growth of leaders nationwide who can use research and action to respond to grave and ongoing threats to community health.
Collapse
Affiliation(s)
- Sarah E. Gollust
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, United States
- *Correspondence: Sarah E. Gollust
| | - Kathleen T. Call
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, United States
| | - J. Robin Moon
- Department of Health Policy and Management, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
| | | | - Zinzi Bailey
- Divisions of Medical Oncology and Epidemiology, Department of Medicine, Miller School of Medicine, University of Miami, Coral Gables, FL, United States
| |
Collapse
|
55
|
Affiliation(s)
- Steven H Woolf
- Center on Society and Health, Virginia Commonwealth University, Richmond
| |
Collapse
|
56
|
The 90 plus: longevity and COVID-19 survival. Mol Psychiatry 2022; 27:1936-1944. [PMID: 35136227 DOI: 10.1038/s41380-022-01461-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/11/2022] [Accepted: 01/20/2022] [Indexed: 11/08/2022]
Abstract
The world population is getting older and studies aiming to enhance our comprehension of the underlying mechanisms responsible for health span are of utmost interest for longevity and as a measure for health care. In this review, we summarized previous genetic association studies (GWAS) and next-generation sequencing (NGS) of elderly cohorts. We also present the updated hypothesis for the aging process, together with the factors associated with healthy aging. We discuss the relevance of studying older individuals and build databanks to characterize the presence and resistance against late-onset disorders. The identification of about 2 million novel variants in our cohort of more than 1000 elderly Brazilians illustrates the importance of studying highly admixed populations of non-European ancestry. Finally, the ascertainment of nonagenarians and particularly of centenarians who were recovered from COVID-19 or remained asymptomatic opens new avenues of research aiming to enhance our comprehension of biological mechanisms associated with resistance against pathogens.
Collapse
|
57
|
Abstract
This introduction to the Special Issue (SI) on COVID-19 and adverse social determinants of health (SDoH) provides theoretical and empirical context for featured articles. Existing disparities and inequities are highlighted and emerging research on disparities resulting from these and the COVID-19 pandemic are briefly reviewed. General disparities and inequities resulting from the COVID-19 pandemic are briefly conceptualized through the SDoH. Critical factors outlined by the SDoH framework parallel those discussed by the Centers for Disease Control and Prevention as well as those in a conceptual framework article also feature in this SI. Some of these consist of racism, exclusion, blocked opportunity, and socioeconomic status (SES), among others. Furthermore, we discuss broader social inequities, namely growing income and wealth inequality that undermine the health and wellbeing of the general population and ethnic minority groups in particular. Big Event theory is offered as an additional conceptual framework that can illuminate potential downstream negative impacts of the pandemic. Having provided summaries of featured articles in this SI, we make a call for researchers to engage in further theoretical and empirical work to identify the most critical SDOH to further the field of public health as well as related fields and inform policy.
Collapse
Affiliation(s)
- Saul G Alamilla
- Department of Psychological Science, Kennesaw State University
| | | |
Collapse
|
58
|
Abstract
IMPORTANCE Prior studies reported that US life expectancy decreased considerably in 2020 because of the COVID-19 pandemic, with estimates suggesting that the decreases were much larger among Hispanic and non-Hispanic Black populations than non-Hispanic White populations. Studies based on provisional data suggested that other high-income countries did not experience the large decrease in life expectancy observed in the US; this study sought to confirm these findings according to official death counts and to broaden the pool of comparison countries. OBJECTIVE To calculate changes in US life expectancy between 2019 and 2020 by sex, race, and ethnicity and to compare those outcomes with changes in other high-income countries. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study involved a simulation of life tables based on national death and population counts for the US and 21 other high-income countries in 2019 and 2020, by sex, including an analysis of US outcomes by race and ethnicity. Data were analyzed in January 2022. EXPOSURES Official death counts from the US and 21 peer countries. MAIN OUTCOMES AND MEASURES Life expectancy at birth and credible range (CR) based on 10% uncertainty. RESULTS Between 2019 and 2020, US life expectancy decreased by a mean of 1.87 years (CR, 1.70-2.03 years), with much larger decreases occurring in the Hispanic (3.70 years; CR, 3.53-3.87 years) and non-Hispanic Black (3.22 years; CR, 3.03-3.40 years) populations than in the non-Hispanic White population (1.38 years; CR, 1.21-1.54 years). The mean decrease in life expectancy among peer countries was 0.58 years (CR, 0.42-0.73 year) across all 21 countries. No peer country experienced decreases as large as those seen in the US. CONCLUSIONS AND RELEVANCE Official death counts confirm that US life expectancy decreased between 2019 and 2020 on a scale not seen in 21 peer countries, substantially widening the preexisting gap in life expectancy between the US and peer countries. The decrease in US life expectancy was experienced disproportionately by Hispanic and non-Hispanic Black populations, consistent with a larger history of racial and ethnic health inequities resulting from policies of exclusion and systemic racism. Policies to address the systemic causes of the US health disadvantage relative to peer countries and persistent racial and ethnic inequities are essential.
Collapse
Affiliation(s)
- Steven H. Woolf
- Center on Society and Health, Virginia Commonwealth University School of Medicine, Richmond
| | - Ryan K. Masters
- Department of Sociology, University of Colorado Boulder, Boulder
| | | |
Collapse
|
59
|
Lewis KN, Goudie A, Wilson JC, Tawiah E, Li J, Thompson JW. Inequities in Telehealth Use Associated with Payer Type During the COVID-19 Pandemic. Telemed J E Health 2022; 28:1564-1578. [PMID: 35363091 DOI: 10.1089/tmj.2021.0618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: The COVID-19 pandemic has prompted a shift in health care delivery and compelled a heavier reliance on telehealth. The objective of this study was to determine if differences in coverage policies by payer type resulted in differential telehealth use during the first 3 months of the COVID-19 pandemic. In this population-based cohort study of low-income Arkansans, Medicaid beneficiaries enrolled in the traditional Primary Care Case Management (PCCM) program were compared with Medicaid beneficiaries covered through premium assistance in private Qualified Health Plans (QHPs). Methods: A retrospective review was conducted of insurance claims records from June 1, 2019, to June 30, 2020, for synchronous telehealth and mobile health (m-health) visits, as well as other forms of telehealth. To establish the baseline equivalence of enrollees in the two groups, propensity score matching design was used on demographic and geographic characteristics, Charlson Comorbidity Index, broadband availability, and prior service utilization. Results: Compared with enrollees in the PCCM program, Medicaid expansion enrollees in QHPs had higher odds of having had at least one telehealth visit (adjusted odds ratio [aOR] = 1.35, 95% confidence interval [CI]: 1.29-1.42) during the early phase of the COVID-19 pandemic. Categorizing utilizations by domain, QHP enrollees were more likely to use synchronous telehealth (aOR = 1.31; 95% CI: 1.25-1.37) and m-health (aOR = 5.91; 95% CI: 4.25-8.21). A higher proportion of QHP enrollees also had at least one mental or behavioral health telehealth session (aOR = 1.13; 95% CI: 1.07-1.19). Conclusions: Our study demonstrated that within low-income populations, payer type was associated with inequitable access to telehealth during the early phase of the COVID-19 pandemic.
Collapse
Affiliation(s)
- Kanna N Lewis
- Department of Family and Preventive Medicine, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Arkansas Center for Health Improvement, Little Rock, Arkansas, USA
| | - Anthony Goudie
- Arkansas Center for Health Improvement, Little Rock, Arkansas, USA
- College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jonathan C Wilson
- Arkansas Center for Health Improvement, Little Rock, Arkansas, USA
- College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Edward Tawiah
- Arkansas Center for Health Improvement, Little Rock, Arkansas, USA
| | - Jialiang Li
- Arkansas Center for Health Improvement, Little Rock, Arkansas, USA
| | - Joseph W Thompson
- Department of Family and Preventive Medicine, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| |
Collapse
|
60
|
Wang MTM, Niederer RL, McGhee CNJ, Danesh-Meyer HV. COVID-19 Vaccination and The Eye. Am J Ophthalmol 2022; 240:79-98. [PMID: 35227700 PMCID: PMC8875854 DOI: 10.1016/j.ajo.2022.02.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/12/2022] [Accepted: 02/17/2022] [Indexed: 11/18/2022]
Abstract
Purpose To summarize the current evidence on COVID-19 vaccine-associated ocular adverse events. Design Narrative literature review. Methods The literature search was conducted in August 2021 using 4 electronic databases: MEDLINE, EMBASE, PubMed, and the Cochrane Database of Systematic Reviews. Population-based pharmacovigilance surveillance data were retrieved from all governmental agencies participating in the World Health Organization (WHO) Programme for International Drug Monitoring with publicly available online adverse event databases in English. Results A small number of case reports have documented uveitis flares and acute corneal graft rejection occurring within the first 3 weeks following immunization, while isolated cases of optic neuropathies, retinal conditions, scleritis, and herpetic eye disease have also been highlighted. However, data from population-based pharmacovigilance surveillance systems suggest that the prevalence of vaccination-associated ocular adverse events are very rare. Conclusions Vaccination-associated ocular adverse events are rare, and there is currently no substantive evidence to counterweigh the overwhelming benefits of COVID-19 immunization in patients with pre-existing ophthalmic conditions.
Collapse
Affiliation(s)
- Michael T M Wang
- From Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Rachael L Niederer
- From Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Charles N J McGhee
- From Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Helen V Danesh-Meyer
- From Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
| |
Collapse
|
61
|
Barbieri M. Socioeconomic Disparities Do Not Explain the U.S. International Disadvantage in Mortality. J Gerontol B Psychol Sci Soc Sci 2022; 77:S158-S166. [PMID: 35192708 PMCID: PMC9154277 DOI: 10.1093/geronb/gbac030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The articles examines the contribution of internal socioeconomic disparities in mortality to the U.S. international disadvantage in life expectancy at birth. METHODS Using individual death records from the U.S. national vital statistics system for years 1982-2019 and data for other countries from the Human Mortality Database, we compare age-specific death rates and life expectancy between counties classified into 10 socioeconomic categories and 20 high-income countries. We also calculate the number of years of life lost in each socioeconomic decile in relation to the comparison set. RESULTS There is a clear and increasing socioeconomic gradient of mortality in the United States, but the growing divergence in internal mortality trends does not explain the rising gap between the country and its peers. In 2019, even American women in the most socioeconomically advantaged decile lived shorter lives, while only 10% of men in the most affluent decile fared better than their peers. The long-standing U.S. disadvantage in young adult mortality has been growing and the country's previous advantage in mortality at ages 75 years and older has virtually disappeared for all but for Americans in the most affluent counties. DISCUSSION The similar age pattern of differences in mortality rates between each socioeconomic deciles and the comparison group suggests that the underlying factors might be the same. The role of external causes (including drug overdoses) for middle-aged adults and a slowing down in progress to control cardiovascular diseases at older ages at the national level are consistent with this pattern.
Collapse
Affiliation(s)
- Magali Barbieri
- Address correspondence to: Magali Barbieri, PhD, Department of Demography, University of California, Berkeley, Berkeley, CA 94720-2120, USA. E-mail:
| |
Collapse
|
62
|
Parra PNB, Atanasov V, Whittle J, Meurer J, Luo QE, Zhang R, Black B. The Effect of the COVID-19 Pandemic on the Elderly: Population Fatality Rates, COVID Mortality Percentage, and Life Expectancy Loss. THE ELDER LAW JOURNAL 2022; 30:33-80. [PMID: 35936928 PMCID: PMC9351604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has disproportionately affected the elderly. This Article provides a detailed analysis of those effects, drawing primarily on individual-level mortality data covering almost three million persons aged 65+ in three Midwest states (Indiana, Illinois, and Wisconsin). We report sometimes surprising findings on population fatality rates ("PFR"), the ratio of COVID to non-COVID deaths, reported as a percentage, which we call the "Covid Mortality Percentage," and mean life expectancy loss ("LEL"). We examine how these COVID-19 outcomes vary with age, gender, race/ethnicity, socio-economic status, and time period during the pandemic. For all persons in the three Midwest areas, COVID PFR through year-end 2021 was 0.22%, mean years of life lost ("YLL") was 13.0 years, the COVID Mortality Percentage was 12.4%, and LEL was 0.028 years (eleven days). In contrast, for the elderly, PFR was 1.03%; YLL was 8.8 years, the COVID Mortality Percentage was 13.2%, and LEL was 0.091 years (thirty-four days). Controlling for gender, PFR and LEL were substantially higher for Blacks and Hispanics than for Whites at all ages. Racial/ethnic disparities for the elderly were large early in the pandemic but diminished later. Although COVID-19 mortality was much higher for the elderly, the COVID Mortality Percentage over the full pandemic period was only modestly higher for the elderly, at 13.2%, than for non-elderly adults aged 25-64, at 11.1%. Indeed, in 2021, this ratio was lower for the elderly than for the middle-aged, reflecting higher elderly vaccination rates.
Collapse
Affiliation(s)
| | | | | | | | | | - Ruohao Zhang
- Northwestern University, Kellogg School of Management
| | - Bernard Black
- Northwestern University, Pritzker School of Law and Kellogg School of Management
| |
Collapse
|
63
|
Pronk NP, Faghy MA. Causal systems mapping to promote healthy living for pandemic preparedness: a call to action for global public health. Int J Behav Nutr Phys Act 2022; 19:13. [PMID: 35130923 PMCID: PMC8822751 DOI: 10.1186/s12966-022-01255-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/10/2022] [Indexed: 11/24/2022] Open
Abstract
COVID-19 has severely impacted population health and well-being globally. Acknowledging that COVID-19 will not be the world’s last pandemic, improving healthy living factors (i.e., physical activity, healthful nutrition, healthy weight), which are important in mitigating negative outcomes of future infectious disease pandemics, should be prioritized. Although well-documented, promoting healthy living factors remains challenged by a lack of scalability and sustainability due, in part, to a mismatch between intervention focus on individual behavior change as opposed to recognizing complex and multifactorial causes that prevent people from living healthy lifestyles and maintaining them long-term (such as political will, economic benefits, urban planning, etc.). To recognize this complexity in promoting healthy living, we propose the application of systems science methods for the creation of a comprehensive causal systems map of healthy living factors in the context of COVID-19 to inform future pandemic preparedness. Generating such a map would benefit researchers, practitioners, and policy makers in multi-sector collaborative efforts to improve public health preparedness in the context of future pandemics in a scalable, sustainable, and equitable manner. This effort should be facilitated by a trusted and widely respected governing body with global reach.
Collapse
Affiliation(s)
- Nicolaas P Pronk
- HealthPartners Institute, 8170 33rd Avenue South, Minneapolis, MN, 55425, USA. .,Department of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA. .,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Mark A Faghy
- Human Sciences Research Centre, University of Derby, Derby, UK.,Department of Physical Therapy, College of Applied Sciences, University of Illinois at Chicago, Chicago, IL, USA
| |
Collapse
|
64
|
Affiliation(s)
- Nazrul Islam
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| |
Collapse
|
65
|
Abstract
BACKGROUND There has been little systematic research on the mortality impact of COVID-19 in the Native American population. OBJECTIVE We provide estimates of loss of life expectancy in 2020 and 2021 relative to 2019 for the Native American population. METHODS We use data on age-specific all-cause mortality rates from CDC WONDER and the 2019 life table recently released by the National Vital Statistics System for Native Americans to calculate life tables for the Native American population in 2020 and 2021 and to obtain estimates of life expectancy reductions during the COVID-19 pandemic. RESULTS The pandemic has set Native Americans further behind other major racial/ethnic groups in terms of life expectancy. The estimated loss in life expectancy at birth for Native Americans is 4.5 years in 2020 and 6.4 years in 2021 relative to 2019. CONCLUSIONS These results underscore the disproportionate share of deaths experienced by Native Americans: a loss in life expectancy at birth in 2020 that is more than three years above that for Whites and about 1.5 years above the losses for the Black and Latino populations. Despite a successful vaccination campaign among Native Americans, the estimated loss in life expectancy at birth in 2021 unexpectedly exceeds that in 2020. CONTRIBUTION The increased loss in life expectancy in 2021, despite higher vaccination rates than in other racial/ethnic groups, highlights the huge challenges faced by Native Americans in their efforts to control the deleterious consequences of the pandemic.
Collapse
|
66
|
Luck AN, Preston SH, Elo IT, Stokes AC. The unequal burden of the Covid-19 pandemic: Capturing racial/ethnic disparities in US cause-specific mortality. SSM Popul Health 2021; 17:101012. [PMID: 34961843 PMCID: PMC8697426 DOI: 10.1016/j.ssmph.2021.101012] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/22/2021] [Accepted: 12/18/2021] [Indexed: 11/24/2022] Open
Abstract
Despite a growing body of literature focused on racial/ethnic disparities in Covid-19 mortality, few previous studies have examined the pandemic's impact on 2020 cause-specific mortality by race and ethnicity. This paper documents changes in mortality by underlying cause of death and race/ethnicity between 2019 and 2020. Using age-standardized death rates, we attribute changes for Black, Hispanic, and White populations to various underlying causes of death and show how these racial and ethnic patterns vary by age and sex. We find that although Covid-19 death rates in 2020 were highest in the Hispanic community, Black individuals faced the largest increase in all-cause mortality between 2019 and 2020. Exceptionally large increases in mortality from heart disease, diabetes, and external causes of death accounted for the adverse trend in all-cause mortality within the Black population. Within Black and White populations, percentage increases in all-cause mortality were similar for men and women, as well as for ages 25–64 and 65+. Among the Hispanic population, however, percentage increases in mortality were greatest for working-aged men. These findings reveal that the overall impact of the pandemic on racial/ethnic disparities in mortality was much larger than that captured by official Covid-19 death counts alone.
Collapse
Affiliation(s)
- Anneliese N Luck
- Department of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Samuel H Preston
- Department of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Irma T Elo
- Department of Sociology and Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew C Stokes
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| |
Collapse
|
67
|
Dukhovnov D, Barbieri M. County-level socio-economic disparities in COVID-19 mortality in the USA. Int J Epidemiol 2021; 51:418-428. [PMID: 34957523 PMCID: PMC8755340 DOI: 10.1093/ije/dyab267] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/14/2021] [Indexed: 12/23/2022] Open
Abstract
Background Preliminary studies have suggested a link between socio-economic characteristics and COVID-19 mortality. Such studies have been carried out on particular geographies within the USA or selective data that do not represent the complete experience for 2020. Methods We estimated COVID-19 mortality rates, number of years of life lost to SARS-CoV-2 and reduction in life expectancy during each of the three pandemic waves in 2020 for 3144 US counties grouped into five socio-economic status categories, using daily death data from the Johns Hopkins University of Medicine and weekly mortality age structure from the Centers for Disease Control. Results During March–May 2020, COVID-19 mortality was highest in the most socio-economically advantaged quintile of counties and lowest in the two most-disadvantaged quintiles. The pattern reversed during June–August and widened by September–December, such that COVID-19 mortality rates were 2.58 times higher in the bottom than in the top quintile of counties. Differences in the number of years of life lost followed a similar pattern, ultimately resulting in 1.002 (1.000, 1.004) million years in the middle quintile to 1.381 (1.378, 1.384) million years of life lost in the first (most-disadvantaged) quintile during the whole year. Conclusions Diverging trajectories of COVID-19 mortality among the poor and affluent counties indicated a progressively higher rate of loss of life among socio-economically disadvantaged communities. Accounting for socio-economic disparities when allocating resources to control the spread of the infection and to reinforce local public health infrastructure would reduce inequities in the mortality burden of the disease.
Collapse
Affiliation(s)
- Denys Dukhovnov
- Department of Demography, University of California, Berkeley, CA, USA and
| | - Magali Barbieri
- Department of Demography, University of California, Berkeley, CA, USA and.,Mortality, Health, and Epidemiology, French National Institute for Demographic Studies (INED), Aubervilliers, Île de France, France
| |
Collapse
|
68
|
Logan AC, Berman BM, Prescott SL. Earth Dreams: Reimagining ARPA for Health of People, Places and Planet. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12788. [PMID: 34886514 PMCID: PMC8657388 DOI: 10.3390/ijerph182312788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/29/2021] [Accepted: 12/02/2021] [Indexed: 12/28/2022]
Abstract
Bold new approaches are urgently needed to overcome global health challenges. The proposed Advanced Research Projects Agency for Health (ARPA-H) is intended to provide rapid health breakthroughs. While new technologies for earlier disease detection and more effective treatment are critical, we urge equal attention be given to the wider (physical, emotional, social, political, and economic) environmental ecosystems driving the non-communicable disease (NCD) crisis in the first place. This requires an integrated, cross-sectoral vision that spans the interwoven connections affecting health across the scales of people, places, and planet. This wider "exposome" perspective considers biopsychosocial factors that promote resilience and reduce vulnerabilities of individuals and communities over time-the many variables driving health disparities. Since life course health is strongly determined by early life environments, early interventions should be prioritized as a matter of effectiveness and social justice. Here, we explore the origins of the Advanced Research Project Agency and point to its potential to build integrated solutions, with wisdom and ethical value systems as a compass. Since the planned ARPA-H is anticipated to spawn international collaborations, the imagined concept is of relevance to a broad audience of researchers. With appropriate input, the quest for health equity through personalized, precision medicine while deconstructing unacceptable structural inequities may be accelerated.
Collapse
Affiliation(s)
- Alan C. Logan
- Nova Institute for Health of People, Places and Planet, 1407 Fleet Street, Baltimore, MD 21231, USA; (A.C.L.); (B.M.B.)
| | - Brian M. Berman
- Nova Institute for Health of People, Places and Planet, 1407 Fleet Street, Baltimore, MD 21231, USA; (A.C.L.); (B.M.B.)
- Center for Integrative Medicine, Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Susan L. Prescott
- Nova Institute for Health of People, Places and Planet, 1407 Fleet Street, Baltimore, MD 21231, USA; (A.C.L.); (B.M.B.)
- Center for Integrative Medicine, Department of Family and Community Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
- inVIVO Planetary Health, Worldwide Universities Network (WUN), Baltimore, MD 21231, USA
- ORIGINS Project, Telethon Kids Institute, Perth Children’s Hospital, University of Western Australia, 15 Hospital Avenue, Nedlands, WE 6009, Australia
| |
Collapse
|
69
|
Califf RM. The Ecosystem to Support People with Heart Failure. J Card Fail 2021; 28:650-658. [PMID: 34752906 DOI: 10.1016/j.cardfail.2021.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 01/28/2023]
Affiliation(s)
- Robert M Califf
- Verily Life Sciences and Google Health (Alphabet), South San Francisco, California.
| |
Collapse
|
70
|
Islam N, Jdanov DA, Shkolnikov VM, Khunti K, Kawachi I, White M, Lewington S, Lacey B. Effects of covid-19 pandemic on life expectancy and premature mortality in 2020: time series analysis in 37 countries. BMJ 2021; 375:e066768. [PMID: 34732390 PMCID: PMC8564739 DOI: 10.1136/bmj-2021-066768] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To estimate the changes in life expectancy and years of life lost in 2020 associated with the covid-19 pandemic. DESIGN Time series analysis. SETTING 37 upper-middle and high income countries or regions with reliable and complete mortality data. PARTICIPANTS Annual all cause mortality data from the Human Mortality Database for 2005-20, harmonised and disaggregated by age and sex. MAIN OUTCOME MEASURES Reduction in life expectancy was estimated as the difference between observed and expected life expectancy in 2020 using the Lee-Carter model. Excess years of life lost were estimated as the difference between the observed and expected years of life lost in 2020 using the World Health Organization standard life table. RESULTS Reduction in life expectancy in men and women was observed in all the countries studied except New Zealand, Taiwan, and Norway, where there was a gain in life expectancy in 2020. No evidence was found of a change in life expectancy in Denmark, Iceland, and South Korea. The highest reduction in life expectancy was observed in Russia (men: -2.33, 95% confidence interval -2.50 to -2.17; women: -2.14, -2.25 to -2.03), the United States (men: -2.27, -2.39 to -2.15; women: -1.61, -1.70 to -1.51), Bulgaria (men: -1.96, -2.11 to -1.81; women: -1.37, -1.74 to -1.01), Lithuania (men: -1.83, -2.07 to -1.59; women: -1.21, -1.36 to -1.05), Chile (men: -1.64, -1.97 to -1.32; women: -0.88, -1.28 to -0.50), and Spain (men: -1.35, -1.53 to -1.18; women: -1.13, -1.37 to -0.90). Years of life lost in 2020 were higher than expected in all countries except Taiwan, New Zealand, Norway, Iceland, Denmark, and South Korea. In the remaining 31 countries, more than 222 million years of life were lost in 2020, which is 28.1 million (95% confidence interval 26.8m to 29.5m) years of life lost more than expected (17.3 million (16.8m to 17.8m) in men and 10.8 million (10.4m to 11.3m) in women). The highest excess years of life lost per 100 000 population were observed in Bulgaria (men: 7260, 95% confidence interval 6820 to 7710; women: 3730, 2740 to 4730), Russia (men: 7020, 6550 to 7480; women: 4760, 4530 to 4990), Lithuania (men: 5430, 4750 to 6070; women: 2640, 2310 to 2980), the US (men: 4350, 4170 to 4530; women: 2430, 2320 to 2550), Poland (men: 3830, 3540 to 4120; women: 1830, 1630 to 2040), and Hungary (men: 2770, 2490 to 3040; women: 1920, 1590 to 2240). The excess years of life lost were relatively low in people younger than 65 years, except in Russia, Bulgaria, Lithuania, and the US where the excess years of life lost was >2000 per 100 000. CONCLUSION More than 28 million excess years of life were lost in 2020 in 31 countries, with a higher rate in men than women. Excess years of life lost associated with the covid-19 pandemic in 2020 were more than five times higher than those associated with the seasonal influenza epidemic in 2015.
Collapse
Affiliation(s)
- Nazrul Islam
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Dmitri A Jdanov
- Max Planck Institute for Demographic Research, Rostock, Germany
- International Laboratory for Population and Health, National Research University Higher School of Economics, Moscow, Russian Federation
| | - Vladimir M Shkolnikov
- Max Planck Institute for Demographic Research, Rostock, Germany
- International Laboratory for Population and Health, National Research University Higher School of Economics, Moscow, Russian Federation
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
- NIHR Applied Research Collaboration-East Midlands, Leicester General Hospital, Leicester, UK
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Sarah Lewington
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ben Lacey
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
| |
Collapse
|
71
|
Manchanda R, Oxley S, Ghaem-Maghami S, Sundar S. COVID-19 and the impact on gynecologic cancer care. Int J Gynaecol Obstet 2021; 155 Suppl 1:94-101. [PMID: 34669200 PMCID: PMC9087539 DOI: 10.1002/ijgo.13868] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The COVID‐19 pandemic resulted in significant reconfiguration of gynecologic cancer services and care pathways across the globe, with a transformation of working practices. Services had to adapt to protect their vulnerable patients from infection, whilst providing care despite reduced resources/capacity and staffing. The international gynecologic cancer community introduced modified clinical care guidelines. Remote working, reduced hospital visiting, routine COVID‐testing, and use of COVID‐free surgical areas/hubs enabled the ongoing and safe delivery of complex cancer care, with priority levels for cancer treatments established to guide decision‐making by multidisciplinary tumor boards. Some 2.3 million cancer surgeries were delayed or cancelled during the first peak, with many patients reporting significant anxiety/concern for cancer progression and COVID infection. Although COVID trials were prioritized, recruitment to other cancer trials/research activity was significantly reduced. The impact of resultant protocol deviations on outcomes remains to be established. During the recovery healthcare services must maintain capacity and flexibility to manage future surges of infection, address the large backlog of patients with altered or delayed treatments, along with salvaging screening and prevention services. Training needs/mental well‐being of trainees need addressing and staff burnout prevented. Future research needs to fully evaluate the impact of COVID‐19 on long‐term patient outcomes. This article reviews the global changes introduced to gynecologic cancer care due to COVID‐19, and their impact on services and patients. Key lessons are considered for the recovery and future.
Collapse
Affiliation(s)
- Ranjit Manchanda
- Wolfson Institute of Preventive Medicine, Cancer Research UK Barts Centre, Queen Mary University of London, London, UK.,Department of Gynecological Oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK.,Faculty of Public Health and Policy, Department of Health Services Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Samuel Oxley
- Wolfson Institute of Preventive Medicine, Cancer Research UK Barts Centre, Queen Mary University of London, London, UK
| | - Sadaf Ghaem-Maghami
- Faculty of Medicine, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Sudha Sundar
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| |
Collapse
|
72
|
Kost GJ. DIAGNOSTIC STRATEGIES FOR ENDEMIC CORONAVIRUS DISEASE 2019 (COVID-19): RAPID ANTIGEN TESTS, REPEAT TESTING, AND PREVALENCE BOUNDARIES. Arch Pathol Lab Med 2021; 146:16-25. [PMID: 34551070 DOI: 10.5858/arpa.2021-0386-sa] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT - Coronavirus disease 2019 (COVID-19) rapid antigen tests generate intrinsically fast, inherently spatial, and immediately actionable results. They quickly confirm COVID-19, but weakly rule out infection. Test performance depends on prevalence and testing protocol. Both affect predictive values. OBJECTIVES - To use original mathematics and visual logistics for interpreting COVID-19 rapid antigen test performance patterns, gauge the influence of prevalence, and evaluate repeated testing. DESIGN - Mathematica and open access software helped graph relationships, perform recursive computations, and compare performance patterns. PubMed retrieved articles addressing endemic COVID-19. RESULTS - Tiered sensitivity/specificity comprise: T1) 90%/95%; T2) 95%/97.5%; and T3) 100%/≥99%, respectively. Performance of self- and home antigen tests with Food and Drug Administration Emergency Use Authorization peaks in low prevalence. Fall-off in performance appears with increasing prevalence because suboptimal sensitivity creates false negatives. The rate of false omissions limits clinical use because of prevalence boundaries based on tolerance for risk. Mathematical analysis supports testing twice to improve predictive values and extend prevalence boundaries nearly to levels of herd immunity. CONCLUSIONS - COVID-19 is quickly becoming endemic. Suboptimal sensitivity of rapid antigen tests limits performance in high prevalence. Risk of contagion in packed spaces (e.g., airplanes) might be avoided with dual testing 36 hours apart, allowing time for viral load to increase. Awareness of community prevalence and proof of improved performance with repeated testing will help manage COVID-19 risk, while meeting rapid decision-making needs for highly contagious and new variants (e.g., Delta). New COVID-19 variants call for high quality, low cost, readily accessible, fast, user friendly, and ubiquitous point-of-care testing.
Collapse
Affiliation(s)
- Gerald J Kost
- From the Department of Pathology and Laboratory Medicine, POCT•CTR, School of Medicine, University of California, Davis
| |
Collapse
|
73
|
Ibrahim SA, Pronovost PJ. Diagnostic Errors, Health Disparities, and Artificial Intelligence. JAMA HEALTH FORUM 2021; 2:e212430. [DOI: 10.1001/jamahealthforum.2021.2430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Said A. Ibrahim
- Division of Healthcare Delivery Science and Innovation, Weill Cornell Clinical and Translational Science Center, Weill Cornell Medicine, New York, New York
| | - Peter J. Pronovost
- Department of Anesthesiology and Critical Care Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio
| |
Collapse
|
74
|
Díaz-Olalla JM, Valero-Oteo I, Moreno-Vázquez S, Blasco-Novalbos G, Del Moral-Luque JA, Haro-León A. [Decline in life expectancy in Madrid's districts in 2020: its correlation with social determinants]. GACETA SANITARIA 2021; 36:309-316. [PMID: 34535343 DOI: 10.1016/j.gaceta.2021.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/23/2021] [Accepted: 07/28/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Estimating the decrease in life expectancy (LE) of the population of Madrid and its districts and its relationship with socioeconomic variables in the first year of the COVID-19 pandemic. METHOD Death records were obtained from the Municipal Register of inhabitants (Municipal Statistics Service). Based on Chiang II method, life expectancy at birth and at 65 years of age (LEB and LE65) were calculated, as well as their 95% confidence intervals both for men and women and their gross, net and minimum falls for each district in 2020 over 2019, their correlation with some socioeconomic variables distribution and the existence of multiple linear regression explicative models. RESULTS In 2020, deaths in Madrid increased by 46.1% compared with the previous year, the LEB was 79.31 years in men and 85.25 years in women, meaning a decrease of 3.67 and 2.56 years respectively (4.42% and 2.91%). All districts registered decreases in LE, with the largest decrease in men in Tetuan (4.72 years) and in women in Chamartín (3.91 years). The most affected were the southern districts, especially in men. Immigrant and people over 80 years old rates explained 24% of the drop in LE in men, using linear regression model. CONCLUSIONS The decrease in LE recorded in Madrid and its districts in 2020 is bigger than in Spain (1.6 years), takes us back to values of 2002 (LE65) and 2008 (LEB), has a sharper fall in the south and is territorially unequally distributed, according to socioeconomic variables and being associated with some of them.
Collapse
Affiliation(s)
| | | | | | - Gema Blasco-Novalbos
- Madrid Salud, Departamento de Evaluación y Calidad, Ayuntamiento de Madrid, Madrid, España
| | | | - Agustín Haro-León
- Madrid Salud, Departamento de Evaluación y Calidad, Ayuntamiento de Madrid, Madrid, España
| |
Collapse
|
75
|
Ayanian JZ. Community Health Centers Caring for Adults With Hypertension and Diabetes. JAMA HEALTH FORUM 2021; 2:e212678. [DOI: 10.1001/jamahealthforum.2021.2678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- John Z. Ayanian
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
- Editor in Chief, JAMA Health Forum
| |
Collapse
|
76
|
Impact of COVID-19 on excess mortality, life expectancy, and years of life lost in the United States. PLoS One 2021; 16:e0256835. [PMID: 34469474 PMCID: PMC8409675 DOI: 10.1371/journal.pone.0256835] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/16/2021] [Indexed: 11/19/2022] Open
Abstract
This paper quantifies the net impact (direct and indirect effects) of the pandemic on the United States population in 2020 using three metrics: excess deaths, life expectancy, and total years of life lost. The findings indicate there were 375,235 excess deaths, with 83% attributable to direct, and 17% attributable to indirect effects of COVID-19. The decrease in life expectancy was 1.67 years, translating to a reversion of 14 years in historical life expectancy gains. Total years of life lost in 2020 was 7,362,555 across the USA (73% directly attributable, 27% indirectly attributable to COVID-19), with considerable heterogeneity at the individual state level.
Collapse
|
77
|
Goldman N, Pebley AR, Lee K, Andrasfay T, Pratt B. Racial and ethnic differentials in COVID-19-related job exposures by occupational standing in the US. PLoS One 2021; 16:e0256085. [PMID: 34469440 PMCID: PMC8409606 DOI: 10.1371/journal.pone.0256085] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 07/29/2021] [Indexed: 12/19/2022] Open
Abstract
Researchers and journalists have argued that work-related factors may be partly responsible for disproportionate COVID-19 infection and death rates among vulnerable groups. We evaluate these issues by describing racial and ethnic differences in the likelihood of work-related exposure to COVID-19. We extend previous studies by considering 12 racial and ethnic groups and five types of potential occupational exposure to the virus: exposure to infection, physical proximity to others, face-to-face discussions, interactions with external customers and the public, and working indoors. Most importantly, we stratify our results by occupational standing, defined as the proportion of workers within each occupation with at least some college education. This measure serves as a proxy for whether workplaces and workers employ COVID-19-related risk reduction strategies. We use the 2018 American Community Survey to identify recent workers by occupation, and link 409 occupations to information on work context from the Occupational Information Network to identify potential COVID-related risk factors. We then examine the racial/ethnic distribution of all frontline workers and frontline workers at highest potential risk of COVID-19, by occupational standing and by sex. The results indicate that, contrary to expectation, White frontline workers are often overrepresented in high-risk jobs while Black and Latino frontline workers are generally underrepresented in these jobs. However, disaggregation of the results by occupational standing shows that, in contrast to Whites and several Asian groups, Latino and Black frontline workers are overrepresented in lower standing occupations overall and in lower standing occupations associated with high risk, and thus may be less likely to have adequate COVID-19 protections. Our findings suggest that greater work exposures likely contribute to a higher prevalence of COVID-19 among Latino and Black adults and underscore the need for measures to reduce potential exposure for workers in low standing occupations and for the development of programs outside the workplace.
Collapse
Affiliation(s)
- Noreen Goldman
- Office of Population Research, School of Public and International Affairs, Princeton University, Princeton, New Jersey, United States of America
| | - Anne R. Pebley
- California Center for Population Research, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California, United States of America
| | - Keunbok Lee
- California Center for Population Research, University of California Los Angeles, Los Angeles, California, United States of America
| | - Theresa Andrasfay
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, United States of America
| | - Boriana Pratt
- Office of Population Research, Princeton University, Princeton, New Jersey, United States of America
| |
Collapse
|
78
|
Cervantes L. Toward Equitable COVID-19 Vaccine Distribution-Building Trust and Investing in Social Services. JAMA Netw Open 2021; 4:e2127632. [PMID: 34591112 PMCID: PMC9332882 DOI: 10.1001/jamanetworkopen.2021.27632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Lilia Cervantes
- Division of Medicine, Denver Health, Denver, Colorado
- Office of Research, Denver Health, Denver, Colorado
- Department of Medicine, University of Colorado, Aurora
| |
Collapse
|
79
|
Relf MV, Holt L, Kirton C, Overstreet K, Ramos SR, Swanson B, Webel A. Race as a Research Variable: Should It be Retained or Discarded? J Assoc Nurses AIDS Care 2021; 32:531-533. [PMID: 35137718 PMCID: PMC10027358 DOI: 10.1097/jnc.0000000000000293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Michael V Relf
- Michael V. Relf, PhD, RN, AACRN, ANEF, FAAN, is the Editor-in-Chief of JANAC and Associate Dean for Global and Community Health Affairs, Duke University, School of Nursing and a Research Associate Professor, Duke Global Health Institute, Durham, North Carolina, USA. Lauren Holt, MSN, RN, is the Assistant Editor of JANAC and a PhD Student, Duke University, School of Nursing and Margolis Health Policy Fellow, Durham, North Carolina, USA. Carl A. Kirton, DNP, MBA, RN, AN, is an Associate Editor of JANAC and the Chief Nursing Officer, University Hospital, Newark, New Jersey, USA. Kristen Overstreet, BA, is the Managing Editor of JANAC , and Senior Partner, Origin Editorial, and Origin Reports, Arvada, Colorado, USA. S. Raquel Ramos, PhD, MBA, MSN, FNP-BC, is an Associate Editor of JANAC and an Assistant Professor at New York University, Rory Meyers College of Nursing, New York, New York, USA. Barbara Swanson, PhD, RN, FAAN, is a Deputy Editor of JANAC and Assistant Dean, Nursing Science Studies, and Professor, Department of Adult Health and Gerontological Nursing, Rush University, College of Nursing, Chicago, Illinois, USA. Allison Webel, PhD, RN, FAAN, is a Deputy Editor of JANAC , and Associate Dean for Research, and Professor, School of Nursing, University of Washington, Seattle, Washington, USA
| | | | | | | | | | | | | |
Collapse
|
80
|
Cohen PN. Disrupted Family Plans and Exacerbated Inequalities Associated With COVID-19 Pandemic. JAMA Netw Open 2021; 4:e2124399. [PMID: 34524444 DOI: 10.1001/jamanetworkopen.2021.24399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Philip N Cohen
- Department of Sociology, University of Maryland, College Park
- Maryland Population Research Center, University of Maryland, College Park
| |
Collapse
|
81
|
Affiliation(s)
- David Satcher
- Satcher Health Leadership Institute, Atlanta, Georgia
- Morehouse School of Medicine, Atlanta, Georgia
| | - Daniel E Dawes
- Satcher Health Leadership Institute, Atlanta, Georgia
- Morehouse School of Medicine, Atlanta, Georgia
| |
Collapse
|
82
|
|
83
|
Affiliation(s)
- Magali Barbieri
- Department of Demography, University of California, Berkeley, CA, USA
- French Institute for Demographic Studies (INED), Paris, France
| |
Collapse
|