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Ruvalcaba Y, Ruíz E, Berenstain N. A Study on Economic Stressors During the COVID-19 Pandemic Among Intimate Partner and Sexual Violence Survivors in the United States. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02090-1. [PMID: 38992204 DOI: 10.1007/s40615-024-02090-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 07/01/2024] [Accepted: 07/03/2024] [Indexed: 07/13/2024]
Abstract
Systemic racism and racialized poverty are socially produced structural determinants that shape health outcomes during infectious disease outbreaks. Public health emergencies compound vulnerabilities for survivors of intimate partner violence (IPV) and sexual violence (SV) and those who self-identify as people from racial and ethnic minority groups. We describe findings from an online survey designed to collect data on financial conditions faced by survivors of IPV and SV to understand these conditions during the COVID-19 pandemic. Our analyses were limited to a sample of women in the United States (91.4%, n = 523) who reported IPV or SV to whom we refer as survivors. We characterize the differences of economic stressors across White and aggregated categories of self-identified race, i.e., Black and Brown Latinx women and non-Black or non-Brown Latinx women of color, to highlight disparities between White and non-White populations in our sample. Logistic regressions were used to examine the relationships among racial categories, food insecurity, housing insecurity, and economic insecurity during the COVID-19 pandemic. Black and Brown Latinx women survivors were twice as likely as White women to report housing, financial, and economic insecurity during the COVID-19 pandemic. Approximately one-third of all survivors anticipated taking on more debt than they would want to cover their expenses due to COVID-19. The results of this study have implications for public health responses that involve coordinating economic relief measures among populations disparately affected by public health crises and disasters to ensure that the economic needs of the most impacted are addressed.
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Affiliation(s)
- Yanet Ruvalcaba
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Elena Ruíz
- Research Institute for Structural Change, Michigan State University, 479 W. Circle Dr., East Lansing, MI, 48824, USA
| | - Nora Berenstain
- Department of Philosophy, The University of Tennessee, 801 McClung Tower, Knoxville, TN, 37996, USA
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Nanaw J, Sherchan JS, Fernandez JR, Strassle PD, Powell W, Forde AT. Racial/ethnic differences in the associations between trust in the U.S. healthcare system and willingness to test for and vaccinate against COVID-19. BMC Public Health 2024; 24:1084. [PMID: 38641573 PMCID: PMC11027359 DOI: 10.1186/s12889-024-18526-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 04/04/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Trust in the healthcare system may impact adherence to recommended healthcare practices, including willingness to test for and vaccinate against COVID-19. This study examined racial/ethnic differences in the associations between trust in the U.S. healthcare system and willingness to test for and vaccinate against COVID-19 during the first year of the pandemic. METHODS This cross-sectional study used data from the REACH-US study, a nationally representative online survey conducted among a diverse sample of U.S. adults from January 26, 2021-March 3, 2021 (N = 5,121). Multivariable logistic regression estimated the associations between trust in the U.S. healthcare system (measured as "Always", "Most of the time", "Sometimes/Almost Never", and "Never") and willingness to test for COVID-19, and willingness to receive the COVID-19 vaccine. Racial/ethnic differences in these associations were examined using interaction terms and multigroup analyses. RESULTS Always trusting the U.S. healthcare system was highest among Hispanic/Latino Spanish Language Preference (24.9%) and Asian (16.7%) adults and lowest among Multiracial (8.7%) and Black/African American (10.7%) adults. Always trusting the U.S. healthcare system, compared to never, was associated with greater willingness to test for COVID-19 (AOR: 3.20, 95% CI: 2.38-4.30) and greater willingness to receive the COVID-19 vaccine (AOR: 2.68, 95% CI: 1.97-3.65). CONCLUSIONS Trust in the U.S. healthcare system was associated with greater willingness to test for COVID-19 and receive the COVID-19 vaccine, however, trust in the U.S. healthcare system was lower among most marginalized racial/ethnic groups. Efforts to establish a more equitable healthcare system that increases trust may encourage COVID-19 preventive behaviors.
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Affiliation(s)
- Judy Nanaw
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Juliana S Sherchan
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Jessica R Fernandez
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Paula D Strassle
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | | | - Allana T Forde
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
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Bade V, Schmitz H, Tawiah BB. Regional variations in vaccination against COVID-19 in Germany. PLoS One 2024; 19:e0296976. [PMID: 38635523 PMCID: PMC11025766 DOI: 10.1371/journal.pone.0296976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 12/25/2023] [Indexed: 04/20/2024] Open
Abstract
Vaccination willingness against COVID-19 is generally perceived as low. Moreover, there is large heterogeneity across and within countries. As a whole, Germany has average vaccination rates compared to other industrialized countries. However, vaccination rates in the 16 different German federal states differ by more than 20 percentage points. We describe variation in vaccination rates on the level of the 400 German counties using data on all vaccinations carried out until December 2022. Around 52-72% of that variation can be explained by regional differences in demographic characteristics, housing, education and political party preferences. We find indications that the remaining part may be due to differences in soft factors such as risk aversion, trust in the German government, trust in science, and beliefs in conspiracy theories regarding the origins of the Corona virus. We conclude that improving the trust in science and the fight against conspiracy theories may possibly be effective tools to improve vaccination rates and effectively fight pandemics.
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Affiliation(s)
| | - Hendrik Schmitz
- Paderborn University, Paderborn, Germany
- RWI – Leibniz Institute for Economic Research, Essen, Germany
- Leibniz Science Campus Ruhr, Essen, Germany
| | - Beatrice Baaba Tawiah
- Munich Research Institute for the Economics of Aging ans SHARE Analyses, Munich, Germany
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Keegan G, Zhu M, Paz M, Kang H, Patel A, Baig AA. Neighborhood-level factors associated with COVID-19 vaccination rates: a case study in Chicago. BMC Public Health 2024; 24:889. [PMID: 38528490 PMCID: PMC10962191 DOI: 10.1186/s12889-024-18352-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 03/13/2024] [Indexed: 03/27/2024] Open
Abstract
INTRODUCTION Chicago's deeply-rooted racial and socioeconomic residential segregation is a pattern mirrored in other major cities, making it a prototype for studying the uptake of public health interventions across the US. Residential segregation is related to availability of primary care, sense of community, and trust in the healthcare system, components which are essential in the response to crises like Covid-19 in which vaccine rollout was primarily community-based. We aimed to evaluate the association between rates of access to primary care and community-belonging with Covid-19 vaccination within Chicago's neighborhoods. METHODS Data from Chicago Department of Public Health (12/2020-6/2022) on Covid-19 vaccination rates, race/ethnicity (% Black and % Hispanic/Latinx residents), age (% >65), gender (% female), socioeconomic status (% below the federal poverty line), access to needed care rate, and rate of self-reported sense of community-belonging on the neighborhood level were analyzed. Linear mixed models (LMMs) were used to study the impact of variables on vaccination; each neighborhood was added as a random effect to account for with-community association. RESULTS The average Covid-19 vaccination rates across Chicago's neighborhoods was 79%, ranging from 37 to 100%, with median 81%. We found that Covid-19 vaccination rates were positively correlated with access to needed care (p < 0.001) and community-belonging (p < 0.001). Community areas that had lower vaccination rates had greater percentage of Black residents (p < 0.0001) and greater poverty rates (p < 0.0001). After adjusting for poverty, race, gender and age in the models, the association between vaccination rates and access to care or community-belonging were no longer significant, but % Black residents and poverty remained significant. CONCLUSIONS Though access to needed primary care and community-belonging are correlated with vaccination rates, this association was not significant when controlling for demographic factors. The association between poverty, race and vaccination status remained significant, indicating that socioeconomic and racial disparities across Chicago drive Covid-19 vaccine recommendation adherence regardless of care access. Understanding how poverty, and its intersectional relation to race and primary care access, affects vaccination should be a priority for public health efforts broadly.
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Affiliation(s)
- Grace Keegan
- Pritzker School of Medicine, University of Chicago, 5841 S. Maryland Ave. MC 2007, 60637, Chicago, IL, USA.
| | - Mengqi Zhu
- Department of Medicine, Section of General Internal Medicine, University of Chicago, Chicago, USA
| | - Maria Paz
- Pritzker School of Medicine, University of Chicago, 5841 S. Maryland Ave. MC 2007, 60637, Chicago, IL, USA
| | - Hyojung Kang
- Department of Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Ajanta Patel
- Chicago Department of Public Health, Chicago, IL, USA
| | - Arshiya A Baig
- Department of Medicine, Section of General Internal Medicine, University of Chicago, Chicago, USA
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Russ S, Bennett N, van Wijngaarden E, Hill E, Liu Y. Influence of Community Determinants on Barriers and Facilitators to COVID-19 Vaccine Uptake: Regional Stakeholders' Perspectives. Vaccine 2024; 42:1160-1167. [PMID: 38272763 DOI: 10.1016/j.vaccine.2024.01.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/29/2023] [Accepted: 01/13/2024] [Indexed: 01/27/2024]
Abstract
Our study objective was to explore possible pathways by which neighborhood-level characteristics drive COVID-19 vaccination among communities experiencing health inequity and disparities. To do so, we conducted semi-structured qualitative interviews with stakeholders in the Finger Lakes region of New York between November 2022 through January 2023. Using a pre-developed interview guide informed by the Health Belief Model, we elicited county health commissioner, medical professional and community-health partner's perspectives regarding the impact community determinants have on shaping barriers to and facilitators of COVID-19 vaccine uptake, as well as recommended solutions for ensuring health equity in future vaccination efforts. Fifteen stakeholders were interviewed, of which 40% were county health commissioners, 27% hospital executives and 33% community-health organization partners. We identified diverse perceived and logistical barriers to COVID-19 vaccination that emerged as sub-themes including perceived risks outweighing the benefits of vaccination, concerns of vaccine safety, distrust stemming from changing scientific knowledge surrounding the vaccines, mistrust of the medical system, and challenges with transportation to and registering for vaccine appointments. Stakeholders reported these barriers were linked to the racial diversity, poverty, political conservatism, and availability of health care of the communities where they reported these were experienced. Notable solutions for improving equitable vaccination included facilitating structural access to vaccination and engaging community trusted messengers. Perceived and experienced barriers to COVID-19 vaccination may differ based upon the social, racial and economic composition of neighboring communities. Strategies for ensuring health equity in future vaccination campaigns should specifically target prevalent barriers based upon the community composition.
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Affiliation(s)
- Savanah Russ
- Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, 265 Crittenden Boulevard, Rochester, NY 14642, United States; Center for Community Health and Prevention, University of Rochester School of Medicine and Dentistry, 46 Prince Street, Rochester, NY 14607, United States.
| | - Nancy Bennett
- Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, 265 Crittenden Boulevard, Rochester, NY 14642, United States; Center for Community Health and Prevention, University of Rochester School of Medicine and Dentistry, 46 Prince Street, Rochester, NY 14607, United States
| | - Edwin van Wijngaarden
- Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, 265 Crittenden Boulevard, Rochester, NY 14642, United States
| | - Elaine Hill
- Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, 265 Crittenden Boulevard, Rochester, NY 14642, United States
| | - Yu Liu
- Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, 265 Crittenden Boulevard, Rochester, NY 14642, United States
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Torres EC, Moreno M, Rivadeneira MF. Vaccination against COVID-19 and socioeconomic inequalities: A cross-sectional study in Ecuador. Vaccine X 2023; 15:100393. [PMID: 37767539 PMCID: PMC10520883 DOI: 10.1016/j.jvacx.2023.100393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/04/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
Background Equity in vaccination against COVID-19 is a public health concern. The objective of this study was to analyze socioeconomic inequalities related to vaccination for the first and second doses from primary series against COVID-19 in Ecuador. Methods Secondary database study in 12,743,507 respondents from 15 years and over. The COVID-19 section of the National Survey of Employment, Unemployment and Underemployment (ENEMDU) was analyzed. Socioeconomic characteristics and vaccination against COVID-19 were associated with the at least one dose and second dose. Poisson regressions for complex samples were obtained. Results As of the date of the survey, 87.3% of the sample (95% CI 86.7%-87.8%) had received at least one vaccine against COVID-19. A lower probability of having received at least one vaccine against COVID-19 was found in rural areas (PR 0.82, 95% CI 0.74-0.91), indigenous population (PR 0.43, 95% CI 0.29-0.64), no level of education (PR 0.25, 95% CI 0.14-0.43), and the lowest economic income (PR 0.42, 95% CI 0.35-0.52). A significantly lower probability of vaccination with two or more doses was found in rural vs urban area (PR 0.88, 95% CI 0.80-0.96), women vs men (PR 0.85, 95% CI 0.77-0.91), indigenous population vs white (PR 0.44, 95% CI 0.33-0.59) and individuals in the lowest income quartile vs highest income quartile (PR 0.48, 95% CI 0.42-0.55). Underemployment, population economically inactive (PR 0.77, 95% CI 0.67-0.88 and PR 0.71, 95% CI 0.61-0.83) and individuals with no level of education (PR 0.39, 95% CI 0.27-0.58) also were less likely to complete the primary phase of vaccination compared with individuals in the highest income quartile, employment and postgraduate level of education. Conclusions There were socioeconomic inequalities with the primary series of vaccine against COVID-19, with a greater disadvantage for rural residents, women, indigenous populations, lower economic income and lower levels of education.
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Affiliation(s)
- Eulalia C. Torres
- Facultad de Medicina, Maestría en Epidemiología para la Salud Pública, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
- Coordinación de Auditoria Médica, Hospital de Especialidades “José Carrasco Arteaga”, Cuenca, Ecuador
| | - Maribel Moreno
- Facultad de Medicina, Maestría en Epidemiología para la Salud Pública, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
- Coordinación de Gestión de Calidad, Hospital General de Ambato, Ecuador
| | - María F. Rivadeneira
- Facultad de Medicina, Maestría en Epidemiología para la Salud Pública, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
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Boing AF, Boing AC, Barberia L, Borges ME, Subramanian SV. The Brazilian vaccine divide: How some municipalities were left behind in the Covid-19 vaccine coverage. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002493. [PMID: 37948353 PMCID: PMC10637645 DOI: 10.1371/journal.pgph.0002493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/06/2023] [Indexed: 11/12/2023]
Abstract
This study aims to assess the progress of geographic, socioeconomic, and demographic disparities in Covid-19 vaccination coverage in Brazil over the first two years of the vaccination campaign. Data from the National Immunization Program Information System were used to estimate covid-19 vaccine coverage. Brazilian municipalities were divided into two groups based on their vaccine coverage for the booster dose. The first group comprised 20% of municipalities with the lowest coverage, while the second group (80% of municipalities) had higher coverage. The analysis was conducted separately for four age groups: 5-11, 12-17, 18-59, and 60+. Explanatory variables included socioeconomic and health services indicators. Crude and adjusted logistic regression models were used to estimate the probability of a municipality being among those with the worst vaccination coverage according to the categories of exploratory variables. Between January/2021 and December/2022, Brazil administered 448.2 million doses of the covid-19 vaccine. The booster vaccination coverage varied from 24.8% among adolescents to 79.7% among the elderly. The difference between the group with the highest and lowest coverage increased during the national vaccination campaign. Municipalities with lower education levels, higher proportion of Black population, higher Gini index, and worse health service indicators had a greater likelihood of having lower vaccination coverage. High and increasing levels of inequality in Covid-19 vaccination were observed in Brazil across all age groups during the vaccination campaign in 2021-2022.
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Affiliation(s)
| | | | | | | | - Sankaran Venkata Subramanian
- Professor at Department of Society, Human Development and Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States of America
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Guay M, Maquiling A, Chen R, Lavergne V, Baysac DJ, Dubé È, MacDonald SE, Driedger SM, Gilbert NL. Racial disparities in COVID-19 vaccination in Canada: results from the cross-sectional Canadian Community Health Survey. CMAJ Open 2023; 11:E1075-E1082. [PMID: 37989513 PMCID: PMC10681669 DOI: 10.9778/cmajo.20230026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Racial and ethnic disparities in COVID-19 vaccination coverage have been observed in Canada and in other countries. We aimed to compare vaccination coverage for at least 1 dose of a COVID-19 vaccine between First Nations people living off reserve and Métis, Black, Arab, Chinese, South Asian and White people. METHODS We used data collected between June 2021 and June 2022 by Statistics Canada's Canadian Community Health Survey, a large, nationally representative cross-sectional study. The analysis included 64 722 participants aged 18 years or older from the 10 provinces. We used a multiple logistic regression model to determine associations between vaccination status and race, controlling for collection period, region of residence, age, gender and education. RESULTS Nonvaccination against COVID-19 was more frequent in off-reserve First Nations people (adjusted odds ratio [OR] 1.8, 95% confidence interval [CI] 1.2-2.7) and Black people (adjusted OR 1.7, 95% CI 1.1-2.6), and less frequent among South Asian people (adjusted OR 0.3, 95% CI 0.1-0.7) compared to White people. INTERPRETATION This analysis showed significant inequalities in COVID-19 vaccine uptake between racial/ethnic populations in Canada. Further research is needed to understand the sociocultural, structural and systemic facilitators of and barriers to vaccination across racial groups, and to identify strategies that may improve vaccination uptake among First Nations and Black people.
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Affiliation(s)
- Mireille Guay
- Public Health Agency of Canada (Guay, Maquiling, Chen, Lavergne, Baysac, Gilbert), Ottawa, Ont.; Institut national de santé publique du Québec (Dubé); Département d'anthropologie (Dubé), Université Laval, Québec, Que.; Faculty of Nursing (MacDonald) and School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (Driedger), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; École de santé publique (Gilbert), Université de Montréal, Montréal, Que.
| | - Aubrey Maquiling
- Public Health Agency of Canada (Guay, Maquiling, Chen, Lavergne, Baysac, Gilbert), Ottawa, Ont.; Institut national de santé publique du Québec (Dubé); Département d'anthropologie (Dubé), Université Laval, Québec, Que.; Faculty of Nursing (MacDonald) and School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (Driedger), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; École de santé publique (Gilbert), Université de Montréal, Montréal, Que
| | - Ruoke Chen
- Public Health Agency of Canada (Guay, Maquiling, Chen, Lavergne, Baysac, Gilbert), Ottawa, Ont.; Institut national de santé publique du Québec (Dubé); Département d'anthropologie (Dubé), Université Laval, Québec, Que.; Faculty of Nursing (MacDonald) and School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (Driedger), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; École de santé publique (Gilbert), Université de Montréal, Montréal, Que
| | - Valérie Lavergne
- Public Health Agency of Canada (Guay, Maquiling, Chen, Lavergne, Baysac, Gilbert), Ottawa, Ont.; Institut national de santé publique du Québec (Dubé); Département d'anthropologie (Dubé), Université Laval, Québec, Que.; Faculty of Nursing (MacDonald) and School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (Driedger), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; École de santé publique (Gilbert), Université de Montréal, Montréal, Que
| | - Donalyne-Joy Baysac
- Public Health Agency of Canada (Guay, Maquiling, Chen, Lavergne, Baysac, Gilbert), Ottawa, Ont.; Institut national de santé publique du Québec (Dubé); Département d'anthropologie (Dubé), Université Laval, Québec, Que.; Faculty of Nursing (MacDonald) and School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (Driedger), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; École de santé publique (Gilbert), Université de Montréal, Montréal, Que
| | - Ève Dubé
- Public Health Agency of Canada (Guay, Maquiling, Chen, Lavergne, Baysac, Gilbert), Ottawa, Ont.; Institut national de santé publique du Québec (Dubé); Département d'anthropologie (Dubé), Université Laval, Québec, Que.; Faculty of Nursing (MacDonald) and School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (Driedger), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; École de santé publique (Gilbert), Université de Montréal, Montréal, Que
| | - Shannon E MacDonald
- Public Health Agency of Canada (Guay, Maquiling, Chen, Lavergne, Baysac, Gilbert), Ottawa, Ont.; Institut national de santé publique du Québec (Dubé); Département d'anthropologie (Dubé), Université Laval, Québec, Que.; Faculty of Nursing (MacDonald) and School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (Driedger), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; École de santé publique (Gilbert), Université de Montréal, Montréal, Que
| | - S Michelle Driedger
- Public Health Agency of Canada (Guay, Maquiling, Chen, Lavergne, Baysac, Gilbert), Ottawa, Ont.; Institut national de santé publique du Québec (Dubé); Département d'anthropologie (Dubé), Université Laval, Québec, Que.; Faculty of Nursing (MacDonald) and School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (Driedger), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; École de santé publique (Gilbert), Université de Montréal, Montréal, Que
| | - Nicolas L Gilbert
- Public Health Agency of Canada (Guay, Maquiling, Chen, Lavergne, Baysac, Gilbert), Ottawa, Ont.; Institut national de santé publique du Québec (Dubé); Département d'anthropologie (Dubé), Université Laval, Québec, Que.; Faculty of Nursing (MacDonald) and School of Public Health (MacDonald), University of Alberta, Edmonton, Alta.; Department of Community Health Sciences (Driedger), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; École de santé publique (Gilbert), Université de Montréal, Montréal, Que
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Freeman RE, Leary CS, Graham JM, Albers AN, Wehner BK, Daley MF, Newcomer SR. Geographic proximity to immunization providers and vaccine series completion among children ages 0-24 months. Vaccine 2023; 41:2773-2780. [PMID: 36964002 PMCID: PMC10229224 DOI: 10.1016/j.vaccine.2023.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVES In the U.S., vaccination coverage is lower in rural versus urban areas. Spatial accessibility to immunization services has been a suspected risk factor for undervaccination in rural children. Our objective was to identify whether geographic factors, including driving distance to immunization providers, were associated with completion of recommended childhood vaccinations. METHODS We analyzed records from Montana's immunization information system for children born 2015-2017. Using geolocated address data, we calculated distance in road miles from children's residences to the nearest immunization provider. A multivariable log-linked binomial mixed model was used to identify factors associated with completion of the combined 7-vaccine series by age 24 months. RESULTS Among 26,085 children, 16,503 (63.3%) completed the combined 7-vaccine series by age 24 months. Distance to the nearest immunization provider ranged from 0 to 81.0 miles (median = 1.7; IQR = 3.2), with the majority (92.1%) of children living within 10 miles of a provider. Long distances (>10 miles) to providers had modest associations with not completing the combined 7-vaccine series (adjusted prevalence ratio [aPR]: 0.97, 95% confidence interval [CI]: 0.96-0.99). After adjustment for other factors, children living in rural areas (measured by rural-urban commuting area) were significantly less likely to have completed the combined 7-vaccine series than children in metropolitan areas (aPR: 0.88, 95% CI: 0.85-0.92). CONCLUSIONS Long travel distances do not appear to be a major barrier to childhood vaccination in Montana. Other challenges, including limited resources for clinic-based strategies to promote timely vaccination and parental vaccine hesitancy, may have greater influence on rural childhood vaccination.
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Affiliation(s)
- Rain E Freeman
- Center for Population Health Research, University of Montana, Missoula, MT, United States; School of Public and Community Health Sciences, University of Montana, Missoula, MT, United States.
| | - Cindy S Leary
- Center for Population Health Research, University of Montana, Missoula, MT, United States; School of Public and Community Health Sciences, University of Montana, Missoula, MT, United States
| | - Jonathan M Graham
- Center for Population Health Research, University of Montana, Missoula, MT, United States; Department of Mathematical Sciences, University of Montana, Missoula, MT, United States
| | - Alexandria N Albers
- Center for Population Health Research, University of Montana, Missoula, MT, United States; School of Public and Community Health Sciences, University of Montana, Missoula, MT, United States
| | - Bekki K Wehner
- Montana Immunization Program, Department of Public Health and Human Services, Helena, MT, United States
| | - Matthew F Daley
- Kaiser Permanente Colorado, Institute for Health Research, Aurora, CO, United States; University of Colorado School of Medicine, Department of Pediatrics, Aurora, CO, United States
| | - Sophia R Newcomer
- Center for Population Health Research, University of Montana, Missoula, MT, United States; School of Public and Community Health Sciences, University of Montana, Missoula, MT, United States
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De Cos O, Castillo V, Cantarero D. The Role of Functional Urban Areas in the Spread of COVID-19 Omicron (Northern Spain). J Urban Health 2023; 100:314-326. [PMID: 36829090 PMCID: PMC9955519 DOI: 10.1007/s11524-023-00720-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 02/26/2023]
Abstract
This study focuses on the space-time patterns of the COVID-19 Omicron wave at a regional scale, using municipal data. We analyze the Basque Country and Cantabria, two adjacent regions in the north of Spain, which between them numbered 491,816 confirmed cases in their 358 municipalities from 15th November 2021 to 31st March 2022. The study seeks to determine the role of functional urban areas (FUAs) in the spread of the Omicron variant of the virus, using ESRI Technology (ArcGIS Pro) and applying intelligence location methods such as 3D-bins and emerging hot spots. Those methods help identify trends and types of problem area, such as hot spots, at municipal level. The results demonstrate that FUAs do not contain an over-concentration of COVID-19 cases, as their location coefficient is under 1.0 in relation to population. Nevertheless, FUAs do have an important role as drivers of spread in the upward curve of the Omicron wave. Significant hot spot patterns are found in 85.0% of FUA area, where 98.9% of FUA cases occur. The distribution of cases shows a spatially stationary linear correlation linked to demographically progressive areas (densely populated, young profile, and with more children per woman) which are well connected by highways and railroads. Based on this research, the proposed GIS methodology can be adapted to other case studies. Considering geo-prevention and WHO Health in All Policies approaches, the research findings reveal spatial patterns that can help policymakers in tackling the pandemic in future waves as society learns to live with the virus.
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Affiliation(s)
- Olga De Cos
- Department of Geography, Urban and Regional Planning, Universidad de Cantabria, 39005 Santander, Spain
- Research Group on Health Economics and Health Services Management – Valdecilla Biomedical Research Institute (IDIVAL), 39011 Santander, Spain
| | - Valentín Castillo
- Department of Geography, Urban and Regional Planning, Universidad de Cantabria, 39005 Santander, Spain
- Research Group on Health Economics and Health Services Management – Valdecilla Biomedical Research Institute (IDIVAL), 39011 Santander, Spain
| | - David Cantarero
- Research Group on Health Economics and Health Services Management – Valdecilla Biomedical Research Institute (IDIVAL), 39011 Santander, Spain
- Department of Economics, Universidad de Cantabria, 39005 Santander, Spain
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11
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Bergen N, Johns NE, Chang Blanc D, Hosseinpoor AR. Within-Country Inequality in COVID-19 Vaccination Coverage: A Scoping Review of Academic Literature. Vaccines (Basel) 2023; 11:517. [PMID: 36992101 PMCID: PMC10058740 DOI: 10.3390/vaccines11030517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
Since December 2020, COVID-19 vaccines have become increasingly available to populations around the globe. A growing body of research has characterised inequalities in COVID-19 vaccination coverage. This scoping review aims to locate, select and assess research articles that report on within-country inequalities in COVID-19 vaccination coverage, and to provide a preliminary overview of inequality trends for selected dimensions of inequality. We applied a systematic search strategy across electronic databases with no language or date restrictions. Our inclusion criteria specified research articles or reports that analysed inequality in COVID-19 vaccination coverage according to one or more socioeconomic, demographic or geographic dimension of inequality. We developed a data extraction template to compile findings. The scoping review was carried out using the PRISMA-ScR checklist. A total of 167 articles met our inclusion criteria, of which half (n = 83) were conducted in the United States. Articles focused on vaccine initiation, full vaccination and/or receipt of booster. Diverse dimensions of inequality were explored, most frequently relating to age (n = 127 articles), race/ethnicity (n = 117 articles) and sex/gender (n = 103 articles). Preliminary assessments of inequality trends showed higher coverage among older population groups, with mixed findings for sex/gender. Global research efforts should be expanded across settings to understand patterns of inequality and strengthen equity in vaccine policies, planning and implementation.
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Affiliation(s)
- Nicole Bergen
- Department of Data and Analytics, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland
| | - Nicole E. Johns
- Department of Data and Analytics, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland
| | - Diana Chang Blanc
- Department of Immunization, Vaccines and Biologicals, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland
| | - Ahmad Reza Hosseinpoor
- Department of Data and Analytics, World Health Organization, 20 Avenue Appia, 1211 Geneva, Switzerland
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12
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Martinez Leal I, Njoh J, Chen TA, Foreman-Hays F, Reed BC, Haley SA, Chavez K, Reitzel LR, Obasi EM. Exploring COVID-19 Vaccine Attitudes among Racially and Ethnically Minoritized Communities: Community Partners' and Residents' Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3372. [PMID: 36834067 PMCID: PMC9964615 DOI: 10.3390/ijerph20043372] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/11/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
COVID-19 has disproportionately affected Black, Indigenous, and People of Color (BIPOC) communities, yet rates of COVID-19 vaccination remain low among these groups. A qualitative study was undertaken to better understand the factors contributing to low vaccine acceptance among these communities. Seventeen focus groups were conducted in English and Spanish from 8/21 to 9/22, with representatives from five critical community sectors: (1) public health departments (n = 1); (2) Federally Qualified Health Centers (n = 2); (3) community-based organizations (n = 1); (4) faith-based organizations (n = 2); and (5) BIPOC residents in six high-risk, underserved communities in metropolitan Houston (n = 11), for a total of 79 participants, comprising 22 community partners and 57 community residents. A social-ecological model and anti-racism framework were adopted to guide data analysis using thematic analysis and constant comparison, which yielded five key themes: (1) legacy of structural racism: distrust and threat; (2) media misinformation: mass and social; (3) listening and adapting to community needs; (4) evolving attitudes towards vaccination; and (5) understanding alternative health belief systems. Although structural racism was a key driver of vaccine uptake, a notable finding indicated community residents' vaccine attitudes can be changed once they are confident of the protective benefits of vaccination. Study recommendations include adopting an explicitly anti-racist lens to: (1) listen to community members' needs and concerns, acknowledge their justified institutional distrust concerning vaccines, and learn community members' healthcare priorities to inform initiatives built on local data; (2) address misinformation via culturally informed, consistent messaging tailored to communal concerns and delivered by trusted local leaders through multimodal community forums; (3) take vaccines to where people live through pop-up clinics, churches, and community centers for distribution via trusted community members, with educational campaigns tailored to the needs of distinct communities; (4) establish vaccine equity task forces to continue developing sustainable policies, structures, programs and practices to address the structural issues driving vaccine and health inequities within BIPOC communities; and (5) continue investing in an effective infrastructure for healthcare education and delivery, essential for competently responding to the ongoing healthcare and other emergency crises that impact BIPOC communities to achieve racial justice and health equity in the US. Findings underscore the crucial need to provide culturally tailored health education and vaccination initiatives, focused on cultural humility, bidirectionality, and mutual respect to support vaccine re-evaluation.
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Affiliation(s)
- Isabel Martinez Leal
- Department of Health Disparities Research, MD Anderson Cancer Center, Houston, TX 77230, USA
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA
| | - Journa Njoh
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA
- HEALTH Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA
| | - Tzuan A. Chen
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA
- HEALTH Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA
| | - Faith Foreman-Hays
- Houston Health Department, 8000 North Stadium Dr., Houston, TX 77054, USA
| | - Brian C. Reed
- Department of Clinical Sciences, Tillman J. Fertitta Family College of Medicine, The University of Houston, 5055 Medical Circle, Houston, TX 77204, USA
| | - Sean A. Haley
- Center for Civic & Public Policy Improvement, 5445 Almeda Rd., Suite 504, Houston, TX 77004, USA
| | - Kerry Chavez
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA
- HEALTH Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA
| | - Lorraine R. Reitzel
- Department of Health Disparities Research, MD Anderson Cancer Center, Houston, TX 77230, USA
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA
| | - Ezemenari M. Obasi
- Department of Psychological, Health & Learning Sciences, The University of Houston, 3657 Cullen Blvd., Stephen Power Farish Hall, Houston, TX 77204, USA
- HEALTH Research Institute, The University of Houston, 4349 Martin Luther King Blvd., Houston, TX 77204, USA
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13
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Meng L, Masters NB, Lu PJ, Singleton JA, Kriss JL, Zhou T, Weiss D, Black CL. Cluster analysis of adults unvaccinated for COVID-19 based on behavioral and social factors, National Immunization Survey-Adult COVID Module, United States. Prev Med 2023; 167:107415. [PMID: 36596324 PMCID: PMC9804852 DOI: 10.1016/j.ypmed.2022.107415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 12/24/2022] [Accepted: 12/28/2022] [Indexed: 01/02/2023]
Abstract
By the end of 2021, approximately 15% of U.S. adults remained unvaccinated against COVID-19, and vaccination initiation rates had stagnated. We used unsupervised machine learning (K-means clustering) to identify clusters of unvaccinated respondents based on Behavioral and Social Drivers (BeSD) of COVID-19 vaccination and compared these clusters to vaccinated participants to better understand social/behavioral factors of non-vaccination. The National Immunization Survey Adult COVID Module collects data on U.S. adults from September 26-December 31,2021 (n = 187,756). Among all participants, 51.6% were male, with a mean age of 61 years, and the majority were non-Hispanic White (62.2%), followed by Hispanic (17.2%), Black (11.9%), and others (8.7%). K-means clustering procedure was used to classify unvaccinated participants into three clusters based on 9 survey BeSD items, including items assessing COVID-19 risk perception, social norms, vaccine confidence, and practical issues. Among unvaccinated adults (N = 23,397), 3 clusters were identified: the "Reachable" (23%), "Less reachable" (27%), and the "Least reachable" (50%). The least reachable cluster reported the lowest concern about COVID-19, mask-wearing behavior, perceived vaccine confidence, and were more likely to be male, non-Hispanic White, with no health conditions, from rural counties, have previously had COVID-19, and have not received a COVID-19 vaccine recommendation from a healthcare provider. This study identified, described, and compared the characteristics of the three unvaccinated subgroups. Public health practitioners, healthcare providers and community leaders can use these characteristics to better tailor messaging for each sub-population. Our findings may also help inform decisionmakers exploring possible policy interventions.
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Affiliation(s)
- Lu Meng
- CDC COVID-19 Response Team; General Dynamics Information Technology Inc., Falls Church, VA, United States of America.
| | - Nina B Masters
- CDC COVID-19 Response Team; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC; Epidemic Intelligence Service, CDC, Atlanta, GA, United States of America
| | - Peng-Jun Lu
- CDC COVID-19 Response Team; Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America
| | - James A Singleton
- CDC COVID-19 Response Team; Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America
| | - Jennifer L Kriss
- CDC COVID-19 Response Team; Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America
| | - Tianyi Zhou
- Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America; Leidos Inc., Atlanta, GA, United States of America
| | - Debora Weiss
- CDC COVID-19 Response Team; Division of State and Local Readiness, Center for Preparedness and Response, CDC
| | - Carla L Black
- CDC COVID-19 Response Team; Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, United States of America
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14
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Gaffney A, Woolhandler S, Bor J, McCormick D, Himmelstein DU. Community Health, Health Care Access, And COVID-19 Booster Uptake In Massachusetts. Health Aff (Millwood) 2023; 42:268-276. [PMID: 36745834 DOI: 10.1377/hlthaff.2022.00835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Booster vaccination offers vital protection against COVID-19, particularly for communities in which many people have chronic conditions. Although vaccination has been widely and freely available, people who have experienced barriers to care might be deterred from being vaccinated. We examined the relationship between COVID-19 booster uptake and small area-level demographics, chronic disease prevalence, and measures of health care access in 462 Massachusetts communities during the period September 2021-April 2022. Unadjusted analyses found that booster uptake was higher in older and wealthier areas, lower in areas with more Hispanic and Black residents, and lower in areas with a high prevalence of chronic conditions. In both unadjusted and adjusted analyses, uptake was lower in communities with more uninsured residents and those in which fewer residents received routine medical check-ups. Adjusted analyses found that areas with more vaccine providers and primary care physicians had higher booster uptake, but this association was not significant in unadjusted analyses. Results suggest a need for innovative outreach efforts, as well as structural changes such as expansion of health care coverage and universal access to care to mitigate the inequitable burden of COVID-19.
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Affiliation(s)
- Adam Gaffney
- Adam Gaffney , Harvard University and Cambridge Health Alliance, Cambridge, Massachusetts
| | - Steffie Woolhandler
- Steffie Woolhandler, City University of New York, New York, New York; Harvard University; and Cambridge Health Alliance
| | - Jacob Bor
- Jacob Bor, Boston University, Boston, Massachusetts
| | - Danny McCormick
- Danny McCormick, Harvard University and Cambridge Health Alliance
| | - David U Himmelstein
- David U. Himmelstein, City University of New York, Harvard University, and Cambridge Health Alliance
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15
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Thanik E, Harada K, Garland E, Bixby M, Bhatia J, Lopez R, Galvez S, Dayanov E, Vemuri K, Bush D, DeFelice NB. Impact of COVID-19 on pediatric asthma-related healthcare utilization in New York City: a community-based study. BMC Pediatr 2023; 23:41. [PMID: 36691011 PMCID: PMC9868511 DOI: 10.1186/s12887-023-03845-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 01/10/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND COVID-19 disproportionately affects families of low socioeconomic status and may worsen health disparities that existed prior to the pandemic. Asthma is a common chronic disease in children exacerbated by environmental exposures. METHODS A cross-sectional survey was conducted to understand the impact of the initial stage of the pandemic on environmental and social conditions, along with access to care for children with asthma in New York City (NYC). Participants were recruited from a community-based organization in East Harlem and a nearby academic Pediatric Pulmonary clinic and categorized as having either public or private insurance (n = 51). RESULTS Factors significantly associated with public compared to private insurance respectively were: increased reports of indoor asthma triggers (cockroach 76% vs 23%; mold 40% vs 12%), reduced income (72% vs 27%), and housing insecurity (32% vs 0%). Participants with public insurance were more likely to experience conditions less conducive to social distancing compared to respondents with private insurance, such as remaining in NYC (92% vs 38%) and using public transportation (44% vs 4%); families with private insurance also had greater access to remote work (81% vs 8%). Families with public insurance were significantly more likely to test positive for SARS-CoV-2 (48% vs 15%) but less likely to have gotten tested (76% vs 100%). Families with public insurance also reported greater challenges accessing office medical care and less access to telehealth, although not statistically significant (44% vs 19%; 68% vs 85%, respectively). CONCLUSIONS Findings highlight disproportionate burdens of the pandemic, and how these disparities affect children with asthma in urban environments.
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Affiliation(s)
- Erin Thanik
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA.
| | - Kaoru Harada
- Department of Medicine, Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elizabeth Garland
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA
| | - Moira Bixby
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA
| | - Jasmine Bhatia
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA
| | - Ray Lopez
- LSA Family Health Service, New York, NY, USA
| | | | - Elan Dayanov
- Graduate Program in Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Krishna Vemuri
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA
| | - Douglas Bush
- Department of Pediatrics, Division of Pulmonary, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nicholas B DeFelice
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA
- Department of Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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16
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Michael Gaddis S, Carey CM, DiRago NV. Changes over Time in COVID-19 Vaccination Inequalities in Eight Large U.S. Cities. SOCIUS : SOCIOLOGICAL RESEARCH FOR A DYNAMIC WORLD 2023; 9:23780231231161045. [PMID: 36945229 PMCID: PMC10020851 DOI: 10.1177/23780231231161045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
The authors estimate the associations between community socioeconomic composition and changes in coronavirus disease 2019 (COVID-19) vaccination levels in eight large cities at three time points. In March, communities with high socioeconomic status (SES) had significantly higher vaccination rates than low-SES communities. Between March and April, low-SES communities had significantly lower changes in percentage vaccinated than high-SES communities. Between April and May, this difference was not significant. Thus, the large vaccination gap between communities during restricted vaccine eligibility did not narrow when eligibility opened up. The link between COVID-19 vaccination and community disadvantage may lead to a bifurcated recovery whereby advantaged communities move on from the pandemic more quickly while disadvantaged communities continue to suffer.
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Affiliation(s)
- S. Michael Gaddis
- NWEA, Portland, OR, USA
- University of California, Los Angeles,
Los Angeles, CA, USA
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17
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Chowdhury N, Turin TC. Pre-existing health inequalities in vaccine uptake were exacerbated among ethnic communities during COVID-19 pandemic. Evid Based Nurs 2023; 26:22. [PMID: 35953270 DOI: 10.1136/ebnurs-2022-103565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2022] [Indexed: 01/17/2023]
Affiliation(s)
- Nashit Chowdhury
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tanvir C Turin
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada .,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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18
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Wu C. Racial concentration and dynamics of COVID-19 vaccination in the United States. SSM Popul Health 2022; 19:101198. [PMID: 35996681 PMCID: PMC9387067 DOI: 10.1016/j.ssmph.2022.101198] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/12/2022] [Accepted: 08/03/2022] [Indexed: 11/19/2022] Open
Abstract
This article considers how county-level concentrations of Asians, Blacks, Hispanics, and Whites are associated with COVID-19 vaccination differently. I argue that racially specific mechanisms-differential concentrations of social vulnerability and political ideology by race-are likely to create diverse associations between racial concentration and COVID-19 vaccination not only across racial groups but also within racial groups over time from early rollout to the time after COVID-19 vaccines became widely available. I test this argument by drawing on data from multiple sources that include county-level information on COVID-19 vaccination rates, racial population make-ups, and measures of political ideology and community vulnerability. Results show that the association between racial concentration and COVID-19 vaccination changes substantially across and within racial groups over time. Counties with higher percent of Asians and percent of Whites have higher vaccination rates at earlier time intervals whereas counties with higher percent of Latinos and percent of Blacks show lower vaccination rates. This trend flips at later dates for percent of Blacks, percent of Latinos, and percent of Whites. Results from multilevel regression models and mediation analysis controlling for vaccine hesitancy show that social vulnerability and political ideology are the underlying factors and their differential associations with diverse racial concentrations help create the racially specific and time-varying patterns.
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Affiliation(s)
- Cary Wu
- Department of Sociology, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada
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19
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Ning C, Wang H, Wu J, Chen Q, Pei H, Gao H. The COVID-19 Vaccination and Vaccine Inequity Worldwide: An Empirical Study Based on Global Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5267. [PMID: 35564661 PMCID: PMC9102773 DOI: 10.3390/ijerph19095267] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/18/2022] [Accepted: 04/24/2022] [Indexed: 12/19/2022]
Abstract
Vaccination is critical for controlling the COVID-19 pandemic. However, the progress of COVID-19 vaccination varies from different countries, and global vaccine inequity has been a worldwide public health issue. This study collected data from the Our World in Data COVID-19 vaccination data set between 13 December 2020 and 1 January 2022. The measurement reflecting the pandemic situation included New cases, New deaths, Hospital patients, ICU patients, and the Reproduction rate. Indicators for measuring the vaccination coverage included Total vaccinations per hundred and People vaccinated per hundred. The Human Development Index (HDI) measured the country's development level. Findings indicated that countries with higher HDI have more adequate vaccine resources, and global vaccine inequity exists. The study also found that vaccination significantly mitigates the pandemic, and reaching 70% immunization coverage can further control the epidemic. In addition, the emergence of Omicron variants makes the COVID-19 epidemic situation even worse, suggesting the importance and necessity of addressing vaccine inequity. The globe will face a greater challenge in controlling the pandemic if lower-vaccinated countries do not increase their vaccination coverage. Addressing the issue of vaccine inequity needs the cooperation of HIC, LMIC, public health departments, and vaccine producers. Moreover, the media has to contribute to effective public health communication by raising public perceptions of the COVID-19 pandemic, vaccination, and vaccine inequity.
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Affiliation(s)
- Chuanlin Ning
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai 200240, China;
| | - Han Wang
- School of Journalism and Communication, Jinan University, Guangzhou 510632, China;
| | - Jing Wu
- Faculty of Social Sciences, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Qinwei Chen
- School of Journalism and Communication, Nanjing Normal University, Nanjing 210097, China;
| | - Huacheng Pei
- School of Economics and Finance, Shanghai International Studies University, Shanghai 200083, China;
| | - Hao Gao
- School of Journalism and Communication, Nanjing Normal University, Nanjing 210097, China;
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