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Bemanian A, Mosser JF. Investigating the Spatial Accessibility and Coverage of the Pediatric COVID-19 Vaccine: An Ecologic Study of Regional Health Data. Vaccines (Basel) 2024; 12:545. [PMID: 38793796 PMCID: PMC11125658 DOI: 10.3390/vaccines12050545] [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: 04/22/2024] [Revised: 05/05/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
The COVID-19 pandemic presented the unique challenge of having to deliver novel vaccines during a public health crisis. For pediatric patients, it was further complicated by the delayed timeline for authorizing the vaccine and the differences in dosing/products depending on the patient's age. This paper investigates the relationship between the spatial accessibility and uptake of the COVID-19 vaccine in King County, WA, USA. Public data for COVID-19 vaccine sites were used to calculate spatial accessibility using an enhanced two-step floating catchment area (E2SFCA) technique. Spatial regression analyses were performed to look at the relationship between spatial accessibility and ZIP-code-level vaccination rates. The relationships of these data with other socioeconomic and demographic variables were calculated as well. Higher rates of vaccine accessibility and vaccine coverage were found in adolescent (12- to 17-year-old) individuals relative to school-age (5- to 11-year-old) individuals. Vaccine accessibility was positively associated with coverage in both age groups in the univariable analysis. This relationship was affected by neighborhood educational attainment. This paper demonstrates how measures such as E2SFCA can be used to calculate the accessibility of the COVID-19 vaccine in a region and provides insight into some of the ecological factors that affect COVID-19 vaccination rates.
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Affiliation(s)
- Amin Bemanian
- Department of Pediatrics, University of Washington, Seattle, WA 98105, USA;
- Seattle Children’s Hospital, Seattle, WA 98105, USA
- Institute for Health Metrics and Evaluation, Seattle, WA 98105, USA
| | - Jonathan F. Mosser
- Department of Pediatrics, University of Washington, Seattle, WA 98105, USA;
- Seattle Children’s Hospital, Seattle, WA 98105, USA
- Institute for Health Metrics and Evaluation, Seattle, WA 98105, USA
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McDonald-Lopez K, Murphy AK, Gould-Werth A, Griffin J, Bader MDM, Kovski N. A Driver in Health Outcomes: Developing Discrete Categories of Transportation Insecurity. Am J Epidemiol 2023; 192:1854-1863. [PMID: 37365831 PMCID: PMC10631295 DOI: 10.1093/aje/kwad145] [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: 10/19/2022] [Revised: 05/17/2023] [Accepted: 06/21/2023] [Indexed: 06/28/2023] Open
Abstract
Research suggests that transportation is an important social determinant of health, because the ability to get around is consequential for accessing health care and nutritious food and for making social connections. We used an inductive mixed-methods approach and a quantitative k-means clustering approach to identify 5 categories of transportation insecurity using the validated 16-item Transportation Security Index. The resulting 5-category measure distinguished among respondents with qualitatively different experiences of transportation insecurity. Analyzing data from 2018 that were representative of the US adult population aged 25 years or older, we demonstrated a nonparametric association between transportation insecurity and 2 different health measures (self-rated health and depressive symptoms). There was a threshold relationship between self-rated health and any level of transportation insecurity. High transportation insecurity had a very strong relationship with depressive symptoms. The categorical Transportation Security Index will be useful for clinicians who wish to screen for transportation-related barriers to health care. It will also facilitate research investigating the influence of transportation insecurity on health outcomes and provide the basis for interventions designed to address health disparities.
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Affiliation(s)
- Karina McDonald-Lopez
- Correspondence to Karina McDonald-Lopez, Department of Sociology, College of Literature, Science, and the Arts, University of Michigan, 500 South State Street #2005, Ann Arbor, MI 48109 | (e-mail: )
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Labban M, Chen CR, Frego N, Nguyen DD, Lipsitz SR, Reich AJ, Rebbeck TR, Choueiri TK, Kibel AS, Iyer HS, Trinh QD. Disparities in Travel-Related Barriers to Accessing Health Care From the 2017 National Household Travel Survey. JAMA Netw Open 2023; 6:e2325291. [PMID: 37498602 PMCID: PMC10375305 DOI: 10.1001/jamanetworkopen.2023.25291] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Abstract
Importance Geographic access, including mode of transportation, to health care facilities remains understudied. Objective To identify sociodemographic factors associated with public vs private transportation use to access health care and identify the respondent, trip, and community factors associated with longer distance and time traveled for health care visits. Design, Setting, and Participants This cross-sectional study used data from the 2017 National Household Travel Survey, including 16 760 trips or a nationally weighted estimate of 5 550 527 364 trips to seek care in the United States. Households that completed the recruitment and retrieval survey for all members aged 5 years and older were included. Data were analyzed between June and August 2022. Exposures Mode of transportation (private vs public transportation) used to seek care. Main Outcomes and Measures Survey-weighted multivariable logistic regression models were used to identify factors associated with public vs private transportation and self-reported distance and travel time. Then, for each income category, an interaction term of race and ethnicity with type of transportation was used to estimate the specific increase in travel burden associated with using public transportation compared a private vehicle for each race category. Results The sample included 12 092 households and 15 063 respondents (8500 respondents [56.4%] aged 51-75 years; 8930 [59.3%] females) who had trips for medical care, of whom 1028 respondents (6.9%) were Hispanic, 1164 respondents (7.8%) were non-Hispanic Black, and 11 957 respondents (79.7%) were non-Hispanic White. Factors associated with public transportation use included non-Hispanic Black race (compared with non-Hispanic White: adjusted odds ratio [aOR], 3.54 [95% CI, 1.90-6.61]; P < .001) and household income less than $25 000 (compared with ≥$100 000: aOR, 7.16 [95% CI, 3.50-14.68]; P < .001). The additional travel time associated with use of public transportation compared with private vehicle use varied by race and household income, with non-Hispanic Black respondents with income of $25 000 to $49 999 experiencing higher burden associated with public transportation (mean difference, 81.9 [95% CI, 48.5-115.3] minutes) than non-Hispanic White respondents with similar income (mean difference, 25.5 [95% CI, 17.5-33.5] minutes; P < .001). Conclusions and Relevance These findings suggest that certain racial, ethnic, and socioeconomically disadvantaged populations rely on public transportation to seek health care and that reducing delays associated with public transportation could improve care for these patients.
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Affiliation(s)
- Muhieddine Labban
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Nicola Frego
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Urology, IRCCS Humanitas Research Hospital, Milan, Italy
| | - David-Dan Nguyen
- Division of Urology, University of Toronto, Toronto, Ontario, Canada
| | - Stuart R Lipsitz
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Amanda J Reich
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Timothy R Rebbeck
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Epidemiology and Zhu Family Center for Global Cancer Prevention, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Toni K Choueiri
- Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Adam S Kibel
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Hari S Iyer
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts
- Section of Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick
| | - Quoc-Dien Trinh
- Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Chen H, Cao Y, Feng L, Zhao Q, Torres JRV. Understanding the spatial heterogeneity of COVID-19 vaccination uptake in England. BMC Public Health 2023; 23:895. [PMID: 37189026 PMCID: PMC10185460 DOI: 10.1186/s12889-023-15801-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 05/02/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Mass vaccination has been a key strategy in effectively containing global COVID-19 pandemic that posed unprecedented social and economic challenges to many countries. However, vaccination rates vary across space and socio-economic factors, and are likely to depend on the accessibility to vaccination services, which is under-researched in literature. This study aims to empirically identify the spatially heterogeneous relationship between COVID-19 vaccination rates and socio-economic factors in England. METHODS We investigated the percentage of over-18 fully vaccinated people at the small-area level across England up to 18 November 2021. We used multiscale geographically weighted regression (MGWR) to model the spatially heterogeneous relationship between vaccination rates and socio-economic determinants, including ethnic, age, economic, and accessibility factors. RESULTS This study indicates that the selected MGWR model can explain 83.2% of the total variance of vaccination rates. The variables exhibiting a positive association with vaccination rates in most areas include proportion of population over 40, car ownership, average household income, and spatial accessibility to vaccination. In contrast, population under 40, less deprived population, and black or mixed ethnicity are negatively associated with the vaccination rates. CONCLUSIONS Our findings indicate the importance of improving the spatial accessibility to vaccinations in developing regions and among specific population groups in order to promote COVID-19 vaccination.
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Affiliation(s)
- Huanfa Chen
- Centre for Advanced Spatial Analysis, University College London, London, UK
| | - Yanjia Cao
- Department of Geography, The University of Hong Kong, Hong Kong, China
| | - Lingru Feng
- Centre for Advanced Spatial Analysis, University College London, London, UK
- Chongqing Planning and Design Institute, Chongqing, China
- Key Laboratory of Monitoring, Evaluation and Early Warning of Territorial Spatial Planning Implementation, Ministry of Natural Resources, Chongqing, China
| | - Qunshan Zhao
- Urban Big Data Centre, School of Social & Political Sciences, University of Glasgow, Glasgow, UK
- Department of Urban Studies, University of Glasgow, Glasgow, UK
| | - José Rafael Verduzco Torres
- Urban Big Data Centre, School of Social & Political Sciences, University of Glasgow, Glasgow, UK
- Department of Urban Studies, University of Glasgow, Glasgow, UK
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Wang J, Kwan MP, Liu D, Peng X. Assessing the spatial distribution of and inequality in 15-minute PCR test site accessibility in Beijing and Guangzhou, China. APPLIED GEOGRAPHY (SEVENOAKS, ENGLAND) 2023; 154:102925. [PMID: 36941950 PMCID: PMC10017274 DOI: 10.1016/j.apgeog.2023.102925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/21/2023] [Accepted: 03/05/2023] [Indexed: 06/18/2023]
Abstract
China has been planning to construct SARS-CoV-2 antigen testing sites within a 15-min walk in most major cities to timely identify asymptomatic cases and stop the transmission of COVID-19. However, little is known about the spatial distribution of 15-min accessibility to PCR test sites. In this study, we analyze the spatial distribution of and inequality in 15-min accessibility to PCR test sites in two major Chinese cities (Beijing and Guangzhou) based on the cumulative-opportunity model. The results indicate that the current distribution of 15-min accessibility to PCR test sites is satisfactory when normal commuting is not disrupted. However, disruptions of normal commuting (e.g., due to work-from-home restrictions) can negatively influence 15-min accessibility to PCR test sites and increase its inequality. Our study provides policymakers with up-to-date knowledge about the spatial distribution of 15-min accessibility to PCR test sites, identifies the disadvantaged neighborhoods in terms of test site accessibility, and highlights the changes in accessibility and inequality because of travel disruptions.
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Affiliation(s)
- Jianying Wang
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Mei-Po Kwan
- Department of Geography and Resource Management, The Chinese University of Hong Kong, Sha Tin, Hong Kong
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Dong Liu
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Sha Tin, Hong Kong
- Institute of Future Cities, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Xia Peng
- Tourism College, Beijing Union University, Beijing, China
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Das M, Dutta B, Roy U, Das S, Rath S. Spatial accessibility modeling to healthcare facilities in the case of health shocks of Midnapore municipality, India. GEOJOURNAL 2023:1-24. [PMID: 38625266 PMCID: PMC9919752 DOI: 10.1007/s10708-023-10838-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/30/2023] [Indexed: 04/17/2024]
Abstract
This research aims to identify the accessibility of the entire population, especially the slum population to existing healthcare facilities (HCF) as well as the slum neighborhoods having low geographic accessibility, and finally, to provide an analytical model for the people living in areas that are outside the coverage range of existing healthcare facilities (HCF) across the study area. Spatial data has been collected and used based on the road network, elevation, location of HCF, municipal boundary, slum point, and satellite images from various sources. Also, non-spatial data such as socioeconomic variables are collected from questionnaires survey within a particular period. The spatial analysis tool like as near, network analysis, and predictive analysis in the ArcGIS platform was used to examine geographic accessibility. The results of the spatial analysis show that the distribution of public healthcare facility centers in the study area has not been uniformly distributed. Across 84% of areas in the study area have sound spatial accessibility with traveling time coverage is about 12 min. However, 16% of areas have a traveling time of 12 to 30 min under low accessibility with existing slum neighborhoods. Therefore, the low spatial accessibility areas are demanding new healthcare facilities in the study area. The Analytical Hierarchy Process (AHP) is employed to find the most optimal and efficient locational suitability for building new healthcare facility centers. The finding of AHP analysis for site suitability of healthcare facilities revealed five major classes as most suitable (2%), suitable (5%), moderate (35%), poor (54%), and very poor (4%) in the study area. Moreover, the realistic framework of this study helps to measure geographic accessibility and suitability in any geographical area.
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Affiliation(s)
- Manas Das
- Dept. of Remote Sensing and GIS, Vidyasagar University, Midnapore, West Bengal 721102 India
| | - Bikash Dutta
- Assistant Professor, Dept. of Geography, Nistarini College, Purulia, West Bengal 723101 India
| | - Utpal Roy
- Associate Professor, Dept. of Geography, University of Calcutta, Kolkata, West Bengal 700073 India
| | - Sutapa Das
- Dept. of Economics, Vidyasagar University, Midnapore, West Bengal 721102 India
| | - Sutapa Rath
- Dept. of Geography, Vidyasagar University, Midnapore, West Bengal 721102 India
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Apolonio JS, da Silva Júnior RT, Cuzzuol BR, Araújo GRL, Marques HS, Barcelos IDS, Santos LKDS, Malheiro LH, Lima de Souza Gonçalves V, Freire de Melo F. Syndemic aspects between COVID-19 pandemic and social inequalities. World J Methodol 2022; 12:350-364. [PMID: 36186746 PMCID: PMC9516541 DOI: 10.5662/wjm.v12.i5.350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 06/22/2022] [Accepted: 07/25/2022] [Indexed: 02/08/2023] Open
Abstract
Although the coronavirus disease 2019 (COVID-19) pandemic has reached all over the world population, it has demonstrated a heterogeneous impact on different populations. The most vulnerable communities which coexist daily with the social inequalities like low access to hygiene and personal protection products, crowded residences, and higher levels of chronic diseases have a higher risk of contact and the spread of infection, beyond unfavorable clinical outcomes. The elevation of the risk of infection exposure can be related to gender due to the presence of a larger contingent of women in essential services, as well as frontline and cleaning professionals who regardless of gender have the greatest exposure to the virus. Such exposures can contribute to the development of fear of contaminating themselves or their family members associated also with the work stress, both of which are related to the emergence of mental disturbances in these populations. Furthermore, conditions of unsanitary living and low socioeconomic status, populations at war, pre-existing social barriers, and ethnicity have contributed to more impact of the pandemic both in the exposure to the virus and access to health services, COVID-19 management, and management of other pathologies. At the same time, factors such as the closing of non-essential services, the loss of jobs, and the increase in household spending aggravated the social vulnerabilities and impacted the family economy. Lastly, the COVID-19 pandemic contributed still more to the impact on women's health since it propitiated a favorable environment for increasing domestic violence rates, through the segregation of women from social life, and increasing the time of the victims with their aggressors.
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Affiliation(s)
- Jonathan Santos Apolonio
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Vitória da Conquista 45029-094, Bahia, Brazil
| | | | - Beatriz Rocha Cuzzuol
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Glauber Rocha Lima Araújo
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Hanna Santos Marques
- Universidade Estadual do Sudoeste da Bahia, Campus Vitória da Conquista, Vitória da Conquista 45083-900, Bahia, Brazil
| | - Isadora de Souza Barcelos
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Luana Kauany de Sá Santos
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Luciano Hasimoto Malheiro
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Vitória da Conquista 45029-094, Bahia, Brazil
| | | | - Fabrício Freire de Melo
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Vitória da Conquista 45029-094, Bahia, Brazil
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