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Martin HR, Hu N, Liu Q, Bastida Rodriguez JA, Gieseken S, Johnson A, Enrione E, Trepka MJ, Brown DR, Marty AM, Sales Martinez S, Campa A, Roldan EO, Hernandez Suarez Y, Barbieri M, Palacios C, Bursac Z, Baum MK. Disability and COVID-19: Challenges, testing, vaccination, and postponement and avoidance of medical care among minoritized communities. Disabil Health J 2024; 17:101571. [PMID: 38071138 PMCID: PMC10999341 DOI: 10.1016/j.dhjo.2023.101571] [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] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 04/09/2024]
Abstract
BACKGROUND People with disabilities face heightened vulnerability to COVID-19. OBJECTIVE This study investigated (1) the relationships between disability and COVID-19-related challenges, testing, vaccination, and infection and (2) predictors of loss of healthcare coverage and postponement and avoidance of medical care during the pandemic. METHODS This cross-sectional study was conducted in Miami, Florida, between March 2021 and February 2022 as part of the NIH Rapid Acceleration of Diagnostics-Underserved Populations initiative. Disability was defined using a standard measure that assesses six universal functions. Participants reported sociodemographic data, COVID-19 testing, infection history, challenges, and healthcare history. Vaccinations were confirmed with medical records and COVID-19 positivity was assessed using real-time reverse transcription-polymerase chain reaction. Statistical analyses included multivariable logistic regression. RESULTS Among 1,689 participants with a median age of 57.0, 50.6% were male, and 48.9% were non-Hispanic Black. Disability was associated with greater odds of all assessed COVID-19 challenges: healthcare (aOR:1.60; 95% CI:1.23-2.07), housing (aOR:2.15; 95% CI:1.62-2.87), insufficient food (aOR:1.97; 95% CI:1.54-2.52), water scarcity (aOR:2.33; 95% CI:1.60-3.37), medications (aOR:2.04; 95% CI:1.51-2.77), and transportation (aOR:2.56; 95% CI:1.95-3.36). Those reporting employment disability were less likely to have received COVID-19 testing (81.1% vs. 85.3%, p = 0.026) or to have history of COVID-19 positivity (aOR:0.63; 95% CI:0.44-0.92). Disability predicted avoidance (aOR:2.76; 95% CI:1.95-3.91) and postponement (aOR: 2.24; 95% CI:1.72-2.91) of medical care. CONCLUSIONS Disability is associated with higher odds of COVID-19 challenges and postponement and avoidance of medical care. Those reporting employment disability had a lower likelihood of COVID-19 testing. Public health responses to healthcare crises should prioritize the special challenges of people living with disabilities.
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Affiliation(s)
- Haley R Martin
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Dietetics and Nutrition, 11200 SW 8th Street, AHC5, Miami, FL, 33199, United States.
| | - Nan Hu
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Biostatistics, 11200 SW 8th Street, AHC5, Miami, FL, 33199, United States.
| | - Qingyun Liu
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Dietetics and Nutrition, 11200 SW 8th Street, AHC5, Miami, FL, 33199, United States.
| | - Jose A Bastida Rodriguez
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Dietetics and Nutrition, 11200 SW 8th Street, AHC5, Miami, FL, 33199, United States.
| | - Stephanie Gieseken
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Dietetics and Nutrition, 11200 SW 8th Street, AHC5, Miami, FL, 33199, United States.
| | - Angelique Johnson
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Dietetics and Nutrition, 11200 SW 8th Street, AHC5, Miami, FL, 33199, United States.
| | - Evelyn Enrione
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Dietetics and Nutrition, 11200 SW 8th Street, AHC5, Miami, FL, 33199, United States.
| | - Mary Jo Trepka
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Epidemiology, 11200 SW 8th Street, AHC5, Miami, FL, 33199, United States.
| | - David R Brown
- Florida International University, Herbert Wertheim College of Medicine, 11200 SW 8th Street, AHC2, Miami, FL, 33199, United States.
| | - Aileen M Marty
- Florida International University, Herbert Wertheim College of Medicine, 11200 SW 8th Street, AHC2, Miami, FL, 33199, United States.
| | - Sabrina Sales Martinez
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Dietetics and Nutrition, 11200 SW 8th Street, AHC5, Miami, FL, 33199, United States.
| | - Adriana Campa
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Dietetics and Nutrition, 11200 SW 8th Street, AHC5, Miami, FL, 33199, United States.
| | - Eneida O Roldan
- Florida International University, Herbert Wertheim College of Medicine, 11200 SW 8th Street, AHC2, Miami, FL, 33199, United States.
| | - Yolangel Hernandez Suarez
- Florida International University, Herbert Wertheim College of Medicine, 11200 SW 8th Street, AHC2, Miami, FL, 33199, United States.
| | - Manuel Barbieri
- Florida International University, College of Arts, Sciences & Education, Department of Biological Sciences, 11200 SW 8th Street, OE 167, Miami, FL, 33199, United States.
| | - Cristina Palacios
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Dietetics and Nutrition, 11200 SW 8th Street, AHC5, Miami, FL, 33199, United States.
| | - Zoran Bursac
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Biostatistics, 11200 SW 8th Street, AHC5, Miami, FL, 33199, United States.
| | - Marianna K Baum
- Florida International University, Robert Stempel College of Public Health and Social Work, Department of Dietetics and Nutrition, 11200 SW 8th Street, AHC5, Miami, FL, 33199, United States.
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Smeds MR, Cheng TW, King E, Williams M, Farber A, Chitalia VC, Siracuse JJ. Characterization of long-term survival in Medicare patients undergoing arteriovenous hemodialysis access. J Vasc Surg 2024; 79:925-930. [PMID: 38237702 DOI: 10.1016/j.jvs.2023.12.031] [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: 09/22/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 02/17/2024]
Abstract
BACKGROUND Patients undergoing arteriovenous (AV) access creation for hemodialysis often have significant comorbidities. Our goal was to quantify the long-term survival and associated risks factors for long-term mortality in these patients to aid in optimization of goals and expectations. METHODS The Vascular Implant Surveillance and Interventional Outcomes Network Vascular Quality Initiative Medicare linked data was used to assess long-term survival in the HD registry. Demographics, comorbidities, and interventions were recorded. Because the majority of hemodialysis patients are provided Medicare, Medicare linkage was used to obtain survival data. Multivariable analysis was used to identify independent associations with mortality. RESULTS There were 13,945 AV access patients analyzed including 10,872 (78%) AV fistulas and 3073 (22%) AV grafts. The median age was 67 years and 56% of patients were male. Approximately one-third had a prior AV access and 44.7% had prior tunneled dialysis catheters. Patients receiving an AV fistula, compared with AV grafts, were more often younger, male, White, obese, independently ambulatory, preoperatively living at home, and less often have a prior AV access and tunneled dialysis catheters (P < .05 for all). The 5-year mortality overall was 62.9% with 61.2% for AV fistulas and 68.8% for AV grafts (P < .001). On multivariable analysis for 5 year mortality, nonambulatory status (hazard ratio [HR], 1.67; 95% confidence interval [CI], 1.53-1.83; P < .001), lower extremity access (HR, 1.67; 95% CI, 1.35-2.05; P < .001), human immunodeficiency virus or acquired immunodeficiency syndrome (HR, 1.44; 95% CI, 1.13-1.82; P < .001), White race (HR, 1.43; 95% CI, 1.35-1.51; P < .001), congestive heart failure (HR, 1.33; 95% CI, 1.26-1.41; P < .001), chronic obstructive pulmonary disease (HR, 1.23; 95% CI, 1.15-1.31; P < .001), and AV graft placement (HR, 1.12; 95% CI, 1.02-1.23, P = .016) were most associated with poor survival. Factors associated with improved survival were never smoking (HR, .73; 95% CI, 0.67-0.79; P < .001), prior/quit smoking (HR, .78; 95% CI, 0.72-0.84; P < .001), preoperative home living (HR, .75; 95% CI, 0.68-0.83; P < .001), and hypertension (HR, .89; 95% CI, 0.8-0.99; P = .03). CONCLUSIONS Long-term survival in Medicare patients undergoing AV access creation is poor with nearly two-thirds of patients having died at 5 years. There are many modifiable risk factors that may improve survival in these patients and give an opportunity for transplantation.
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Affiliation(s)
- Matthew R Smeds
- Division of Vascular and Endovascular Surgery, St. Louis University, St. Louis, MO
| | - Thomas W Cheng
- Division of Vascular and Endovascular Surgery, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA; Division of Vascular and Endovascular Surgery, Dartmouth Medical School, Lebanon, NH
| | - Elizabeth King
- Division of Vascular and Endovascular Surgery, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA
| | - Michael Williams
- Division of Vascular and Endovascular Surgery, St. Louis University, St. Louis, MO
| | - Alik Farber
- Division of Vascular and Endovascular Surgery, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA
| | - Vipul C Chitalia
- Division of Vascular and Endovascular Surgery, Dartmouth Medical School, Lebanon, NH
| | - Jeffrey J Siracuse
- Division of Vascular and Endovascular Surgery, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA.
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McMaughan DJ, Mulcahy A, McGehee A, Streed CG, Wallisch AM, Kurth NK, Hall JP. Gender Diversity, Disability, and Well-Being: Impact of Delayed and Foregone Care Because of COVID-19. LGBT Health 2024; 11:210-218. [PMID: 38060697 DOI: 10.1089/lgbt.2022.0385] [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] [Indexed: 04/07/2024] Open
Abstract
Purpose: This study explored the impact of delayed and foregone care due to COVID-19 on well-being among disabled and gender diverse adults. Methods: Using data from the 2021 National Survey on Health and Disability and logistic regression modeling we assessed the impact of delayed or foregone care due to COVID-19 on well-being among disabled people (n = 1638), with comparisons between cisgender (n = 1538) and gender diverse (n = 100) people with disabilities. We report odds ratios (OR) and confidence intervals (CI). Results: Disabled people reported high rates of delayed (79.36%) and foregone (67.83%) care and subsequent negative effects on well-being (72.07%). Gender diverse disabled people were over four times more likely to have delayed any care (OR 4.45, 95% CI 1.86-10.77) and three times more likely to have foregone any care (OR 3.14, 95% CI 1.71-5.79) due to COVID-19 compared to cisgender disabled people. They were three times more likely to report any negative impact on their health and well-being because of delayed and foregone care (OR 2.78, 95% CI 1.43-5.39). Conclusion: The COVID-19 pandemic affected the health care utilization of disabled people, resulting in high rates of delayed care, foregone care, and negative impacts on well-being. These effects were intensified at the intersection of disability and marginalized gender identity, with gender diverse disabled people having higher odds of delayed and foregone care and negative effects on well-being, including physical health, mental health, pain levels, and overall level of functioning.
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Affiliation(s)
- Darcy Jones McMaughan
- School of Community Health Sciences, Counseling, and Counseling Psychology, College of Education and Human Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Abby Mulcahy
- Center to Improve Veteran Involvement in Care, Portland VA Healthcare System, Portland, Oregon, USA
| | - Amy McGehee
- Department of Human Development and Family Science, College of Education and Human Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Carl G Streed
- Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Anna Marie Wallisch
- Juniper Gardens Children's Project, University of Kansas, Kansas City, Kansas, USA
| | - Noelle K Kurth
- University of Kansas Institute for Health and Disability Policy Studies, Life Span Institute, Lawrence, Kansas, USA
| | - Jean P Hall
- University of Kansas Institute for Health and Disability Policy Studies, Life Span Institute, Lawrence, Kansas, USA
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Chakraborty J, Grineski SE, Collins TW, Aun JJ. Disparities in adverse impacts of the COVID-19 pandemic by disability status in metropolitan Texas. J Public Health (Oxf) 2024; 46:e60-e64. [PMID: 37934958 DOI: 10.1093/pubmed/fdad209] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 10/07/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND This article addresses the urgent need for more evidence-based research using primary data to document how the COVID-19 pandemic affected the health and social wellbeing of disabled individuals. Our study sought to determine if adults with disabilities, and with specific types of disability, were more likely to suffer adverse health and social impacts related to COVID-19 than nondisabled adults in metropolitan Texas, during the first 18 months of the pandemic. METHODS We collected primary data from randomly selected residents in eight Texas metropolitan areas through a bilingual telephone survey in July 2021. Statistical analysis comprised multivariable generalized estimating equations that control for relevant sociodemographic and COVID-related risk factors, and spatial clustering. RESULTS Disabled survey respondents had been more adversely affected by COVID-19 than nondisabled respondents, in terms of mental and physical health, health care access, living conditions and social life. Significant disparities were also found for almost all COVID-19 impacts when the disabled category was disaggregated by disability type. Respondents experiencing cognitive and independent living difficulties were negatively impacted in all five areas of life examined. CONCLUSIONS Findings emphasize the need to consider a wide range of impacts associated with the COVID-19 pandemic that negatively affect the health and social wellbeing of disabled persons, as well as develop disability-inclusive policies that provide adequate protections.
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Affiliation(s)
- J Chakraborty
- Department of Sociology & Anthropology, The University of Texas at El Paso, El Paso, TX 79968, USA
| | - S E Grineski
- Department of Sociology, University of Utah, Salt Lake City, UT 84112, USA
| | - T W Collins
- Department of Geography, University of Utah, Salt Lake City, UT 84112, USA
| | - J J Aun
- Department of Sociology & Anthropology, The University of Texas at El Paso, El Paso, TX 79968, USA
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5
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Landes SD, Turk MA. Health equity for people with intellectual and developmental disability requires vast improvements to data collection: Lessons from the COVID-19 pandemic. Disabil Health J 2024; 17:101539. [PMID: 37783651 DOI: 10.1016/j.dhjo.2023.101539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 08/31/2023] [Accepted: 09/06/2023] [Indexed: 10/04/2023]
Abstract
The COVID-19 pandemic drastically underscored the lack of proper health surveillance for people with intellectual and developmental disability (IDD) in the USA. This data equity failure resulted in researchers having to rely on nontraditional data sources to develop an understanding of how this population was faring during the pandemic. To begin addressing this data equity concern, in this commentary, we (1) discuss the difficulties in accessing data during the pandemic specifically related to people with IDD; (2) provide guidance regarding how existing data can be used to examine COVID-19 outcomes for people with IDD; and (3) provide recommendations for improving data collection for people with IDD in light of lessons learned during the pandemic. In sum, the data currently available to examine COVID-19 as well as other health outcomes among people with IDD are severely limited, compromising the ability to both understand and address health disparities among this population.
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Affiliation(s)
- Scott D Landes
- Department of Sociology and Aging Studies Institute, Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, NY 13244, USA.
| | - Margaret A Turk
- Department of Physical Medicine & Rehabilitation, SUNY Upstate Medical University, Syracuse, NY 13210, USA
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Liu L, Silva Almodóvar A, Nahata MC. Medication adherence in Medicare-enrolled older adults with asthma and chronic obstructive pulmonary disease before and during COVID-19 pandemic. Ther Adv Chronic Dis 2023; 14:20406223231205796. [PMID: 37822769 PMCID: PMC10563468 DOI: 10.1177/20406223231205796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 09/19/2023] [Indexed: 10/13/2023] Open
Abstract
Background Medication adherence in Medicare-enrolled older adults with asthma and chronic obstructive pulmonary disease (COPD) before and during the coronavirus disease 2019 (COVID-19) pandemic is unknown. Objectives To evaluate medication adherence and determinants of high adherence before and during the COVID-19 pandemic in this population. Design Retrospective cohort study. Methods The proportion of days covered (PDC) reflected medication adherence from January to July 2019 and from January to July 2020. Patients <65 years of age, with COPD or asthma alone, or with cystic fibrosis were excluded. Paired t tests were used to assess adherence changes. Logistic regression explored association of age, sex, diagnosis of depression, number of medications, medication-related problems, prescribers, pharmacies, controller medication classes, albuterol rescue inhaler fills, oral corticosteroid fills, and having a 90-day supply with high adherence (PDC ⩾ 80%). Results This analysis included 989 patients. In this cohort, 61.2% of patients received oral corticosteroids. Over 60% of patients had ⩾3 rescue fills in both 2019 and 2020. Medication adherence to controller medications significantly decreased for all controller medications (p < 0.001) in 2020. In 2019 and 2020, number of controller medication classes and having a 90-day supply were associated with high adherence (p < 0.001). In 2019, variables associated with high adherence also included number of medication-related problems and having ⩾3 albuterol rescue inhalers (p < 0.001). Conclusion Medication adherence to controllers significantly decreased during the pandemic among older adults with asthma and COPD. Patients with multiple controller classes and a 90-day supply were more likely to be highly adherent. A 90-day supply of medications should be used to facilitate access to medication during the pandemic. Healthcare professionals should assess medication adherence, resolve the barriers of adherence and medication-related problems to achieve desired clinical outcomes among older adults with both asthma and COPD.
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Affiliation(s)
- Ligang Liu
- Institute of Therapeutic Innovations and Outcomes (ITIO), College of Pharmacy, The Ohio State University, Columbus, Ohio, USA
| | - Armando Silva Almodóvar
- Institute of Therapeutic Innovations and Outcomes (ITIO), College of Pharmacy, The Ohio State University, Columbus, Ohio, USA
| | - Milap C. Nahata
- Institute of Therapeutic Innovations and Outcomes (ITIO), College of Pharmacy, The Ohio State University, 500 West 12th Ave, Columbus, OH 43210, USA
- College of Medicine, The Ohio State University, Columbus, Ohio, US
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Samuel LJ, Zhu J, Dwivedi P, Stuart EA, Szanton SL, Li Q, Thorpe RJ, Reed NS, Swenor BK. Food insecurity gaps in the Supplemental Nutrition Assistance Program based on disability status. Disabil Health J 2023; 16:101486. [PMID: 37353370 PMCID: PMC10527001 DOI: 10.1016/j.dhjo.2023.101486] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/23/2023] [Accepted: 05/28/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Households including someone with disabilities experience disproportionately high food insecurity rates and likely face disproportionate barriers accessing Supplemental Nutrition Assistance Program (SNAP) benefits. OBJECTIVE This article aims to examine the role of SNAP with regard to food insecurity disparities based on disability status. METHODS Modified Poisson regression models examined food insecurity risk based on disability status (household includes no one with disabilities vs. those with work-limiting disabilities or non-work-limiting disabilities) among 2018 Survey of Income and Program Participation households eligible for SNAP (income ≤130% of the poverty threshold). Weighted estimates were used to account for the study design and non-response. RESULTS Households including someone with work-limiting disabilities were more than twice as likely to be food insecure than households including no one with disabilities (PR = 2.16, 95% CI: 1.90, 2.45); households including someone with non-work-limiting disabilities were 65% more likely (PR = 1.65, 95% CI: 1.39, 1.95). However, disparities were more pronounced among households not participating in SNAP (PR = 2.67, 95% CI: 2.22, 3.23 for work-limiting disabilities and PR = 1.86, 95% CI: 1.44, 2.40 for non-work-limiting disabilities) than SNAP-participating households (PR = 1.71, 95% CI: 1.45, 2.03 and PR = 1.46, 95% CI: 1.17, 1.82, respectively). Approximately 4.2 million low-income U.S. households including someone with disabilities are food insecure. Of these, 1.4 million were not participating in SNAP and another 2.8 million households were food insecure despite participating in SNAP. CONCLUSIONS Access to SNAP benefits is not proportionate to the scale of food insecurity among households that include people with disabilities. Action is needed to strengthen food assistance for those with disabilities.
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Affiliation(s)
| | - Jiafeng Zhu
- Johns Hopkins Bloomberg School of Public Health, USA.
| | | | | | - Sarah L Szanton
- Johns Hopkins School of Nursing, Public Health, and Medicine, USA.
| | - Qiwei Li
- Johns Hopkins School of Nursing, USA.
| | | | | | - Bonnielin K Swenor
- The Johns Hopkins Disability Health Research Center, Johns Hopkins School of Nursing, USA.
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Taylor HB, Hughes RB, Gonzalez D, Bhattarai M, Robinson-Whelen S. Psychosocial Impacts of the COVID-19 Pandemic on Women with Spinal Cord Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6387. [PMID: 37510619 PMCID: PMC10378759 DOI: 10.3390/ijerph20146387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/30/2023]
Abstract
This study represents the first known research addressing the impact of the COVID-19 pandemic on women with spinal cord injury (SCI) in the United States. Women in this population face unique barriers that put them at elevated risk for compromised quality of life, risk that was magnified by physical and social restrictions imposed during the pandemic. This qualitative study examined the perceptions of women with SCI and the effect of the pandemic on their lives. The predominantly White and relatively well-educated sample of 105 women with traumatic SCI was diverse in age, injury characteristics, and geographic representation. Recruited across the USA, participants in an online psychological health intervention trial were asked to respond to the item, "Please tell us how COVID-19 has affected you and your life", administered May-October, 2020. An overall sentiment rating of impact was coded as well as the impact of COVID-19 on eight individual themes: Physical Health, Mental Health, Social Health, Activities of Daily Living, Exercise, Work, Activities Outside the Home, and Activities at Home. Sentiment responses were rated as positive, negative, a mixture of positive and negative impacts, or neutral impact. Participants described the overall impact of COVID-19 as negative (54%), positive (10%), mixed (21%) or neutral (15%). Sentiment ratings to individual themes were also described. Our findings highlight the importance of providing access to disability-sensitive and affordable support, resources, and interventions for women with SCI, especially during a public health crisis.
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Affiliation(s)
- Heather B. Taylor
- TIRR Memorial Hermann, Houston, TX 77030, USA
- Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center, Houston, TX 77054, USA
| | - Rosemary B. Hughes
- Rural Institute for Inclusive Communities, University of Montana, Missoula, MT 59812, USA
| | | | | | - Susan Robinson-Whelen
- TIRR Memorial Hermann, Houston, TX 77030, USA
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA
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Tanislav C, Rosenbauer J, Kostev K. The COVID-19 Pandemic Enhanced the Decade-Long Trend of the Decreasing Utilization of Antibiotics. Antibiotics (Basel) 2023; 12:antibiotics12050927. [PMID: 37237830 DOI: 10.3390/antibiotics12050927] [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: 04/03/2023] [Revised: 05/04/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
PURPOSE/INTRODUCTION A decline in antibiotic (AB) prescriptions was reported during the coronavirus 2019 (COVID-19) pandemic. Therefore, we investigated AB utilization during the COVID-19 pandemic using data from a large database in Germany. METHODS AB prescriptions in the Disease Analyzer database (IQVIA) were analyzed for each year between 2011 and 2021. Descriptive statistics were used to assess developments in relation to age group, sex, and antibacterial substances. Infection incidence rates were also investigated. RESULTS In total, 1,165,642 patients received antibiotic prescriptions during the entire study period (mean age: 51.8; SD: 18.4 years; 55.3% females). AB prescriptions started to decline in 2015 (505 patients per practice), and this development persisted until 2021 (2020: 300 patients per practice and 2021: 266 patients per practice). The sharpest drop was observed in 2020 and occurred in both women and men (27.4% and 30.1%). In the youngest age group (≤30), the decrease was -56%, while in the age group >70, it was -38%. The number of patients with prescriptions for fluoroquinolones dropped the most, falling from 117 in 2015 to 35 in 2021 (-70%), followed by macrolides (-56%) and tetracyclines (-56%). In 2021, 46% fewer patients were diagnosed with acute lower respiratory infections, 19% fewer with chronic lower respiratory diseases, and just 10% fewer with diseases of the urinary system. CONCLUSION AB prescriptions decreased more in the first year (2020) of the COVID-19 pandemic than infectious diseases did. While the factor of older age influenced this trend negatively, it remained unaffected by the factor of sex and the selected antibacterial substance.
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Affiliation(s)
- Christian Tanislav
- Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling Siegen, Wichernstrasse 40, 57074 Siegen, Germany
| | - Josef Rosenbauer
- Department of Geriatrics and Neurology, Diakonie Hospital Jung Stilling Siegen, Wichernstrasse 40, 57074 Siegen, Germany
| | - Karel Kostev
- Epidemiology, IQVIA, 60549 Frankfurt am Main, Germany
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10
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Streuli S, Garfein RS, Gaines T, Fielding-Miller R. COVID-19 disproportionately impacts access to basic needs among households with disabled members. Disabil Health J 2023; 16:101443. [PMID: 36764843 PMCID: PMC9851949 DOI: 10.1016/j.dhjo.2023.101443] [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: 08/09/2022] [Revised: 12/19/2022] [Accepted: 01/13/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND The COVID-19 pandemic has disproportionately impacted disabled people, especially those who are members of marginalized communities that were already denied access to the resources and opportunities necessary to ensure health equity before the pandemic. OBJECTIVE Compare COVID-19 impact on basic needs access among households with and without disabled adults. METHODS An online survey was distributed to households with children enrolled in one of 30 socially vulnerable elementary or middle schools in San Diego County, California. We measured disability using the single-item Global Activities Limitations Indicator. We measured pandemic impacts on basic needs access using the RADx-UP common data elements toolkit. We then assessed number of impact items reported by household disability using multivariable linear regression, adjusting for household income, household size, education, parent gender, and child's ethnicity. RESULTS Of 304 participants, 41% had at least one disabled household member. Participants reporting a disabled household member were more likely to report challenges accessing basic needs, such as food, housing, healthcare, transportation, medication, and stable income during the pandemic (all p < 0.05). Difficulty accessing basic needs was significantly associated with household income and parent gender in the final regression model. CONCLUSIONS Households with a disabled member were significantly more likely to experience difficulty accessing basic needs during the COVID-19 pandemic. This has important implications for the disproportionate impact of COVID-19 on disabled people, especially those from low-income communities that already face barriers to accessing resources. To improve COVID-19 outcomes for disabled people, we must focus on meeting their basic needs.
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Affiliation(s)
- Samantha Streuli
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego. 9500 Gilman Drive, La Jolla CA 92093, USA.
| | - Richard S Garfein
- Department of Medicine, Division of Global Public Health, University of California San Diego. 9500 Gilman Drive, La Jolla CA 92093, USA.
| | - Tommi Gaines
- Department of Medicine, Division of Global Public Health, University of California San Diego. 9500 Gilman Drive, La Jolla CA 92093, USA.
| | - Rebecca Fielding-Miller
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego. 9500 Gilman Drive, La Jolla CA 92093, USA.
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Hernández-Vásquez A, Bartra Reátegui A, Sánchez-Dávila K, Vargas-Fernández R. Association between Disability and Unmet Food Needs in the Venezuelan Migrant and Refugee Population: Analysis of a Population-Based Survey, 2022. Nutrients 2023; 15:nu15071663. [PMID: 37049502 PMCID: PMC10097386 DOI: 10.3390/nu15071663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
In Peru, Venezuelan migrants and refugees have been exposed to food shortages before their emigration. This problem could have worse outcomes in vulnerable populations (such as people with disabilities); however, the literature on the basic needs of this population is still scarce. The objective was to determine the association between the presence of disability and the unmet need for access to food in the household of the Venezuelan migrant and refugee population residing in Peru. A cross-sectional study was conducted using data from the Second Survey of the Venezuelan Population Residing in Peru (ENPOVE 2022). The outcome variable was unmet need for food, while the independent variable was the presence of disability. Poisson log generalized linear regression models (crude and adjusted for potential confounding variables) were fitted to evaluate the association between the variables of interest, reporting prevalence ratios (PR) and 95% confidence intervals (CIs). A total of 7739 migrants and refugees from Venezuela were included. The proportion of unmet need for access to food in the household was 45.2%, while the proportion of disability was 2.1%. People with disabilities were found to be more likely to have an unmet need for access to food at home (adjusted PR [aPR]: 1.25; 95% CI: 1.08–1.46; p = 0.003). According to our findings, almost half of Venezuelan households were found to have an unmet need for access to food. In addition, Venezuelan migrants and refugees with disabilities were more likely to have an unmet need for this basic need.
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Affiliation(s)
- Akram Hernández-Vásquez
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima 15046, Peru
- Correspondence:
| | - Alicia Bartra Reátegui
- Vicerrectorado de Investigación, Universidad Nacional de San Martín, Tarapoto 22201, Peru; (A.B.R.); (K.S.-D.)
| | - Keller Sánchez-Dávila
- Vicerrectorado de Investigación, Universidad Nacional de San Martín, Tarapoto 22201, Peru; (A.B.R.); (K.S.-D.)
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Bhatt KJ, Schulder T, Rudenstine S, McNeal K, Ettman CK, Galea S. Understanding the Mental Health Impact of the COVID-19 Pandemic Among Individuals With Chronic Illness. Psychol Rep 2023:332941231164338. [PMID: 36932930 PMCID: PMC10028451 DOI: 10.1177/00332941231164338] [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: 03/19/2023]
Abstract
People with chronic illnesses are vulnerable to stress and psychopathology during population-level disasters, as a subset of individuals with disabilities. We aimed to examine the relationships between chronic illness, cumulative and specific stressors, and probable depression, probable anxiety, and post-traumatic stress in an under-resourced urban population in New York City during the COVID-19 pandemic. Using cross-sectional survey data collected in April 2020, we utilized bivariate chi-square analyses and multivariable logistic regression models to estimate differences in and adjusted odds of stressor endorsement and diagnostic prevalence between people with and without chronic illness. We also assessed effect modification of the relationship between stressor exposure and psychopathology by chronic illness status. Compared to people without chronic illness, those who reported having a chronic illness experienced increased odds of probable depression, probable anxiety, and post-traumatic stress. They were also more likely to report high cumulative COVID-19-related stress exposure, death of someone close to them due to coronavirus or COVID-19, family problems, feeling alone, supply shortages, and financial problems. Chronic illness was found to be an effect modifier in the relationship between the death of someone close due to coronavirus or COVID-19 and probable depression and between household job loss and probable anxiety.
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Affiliation(s)
- Krish J Bhatt
- Mailman School of Public Health, 33638Columbia University, New York, NY, USA
| | - Talia Schulder
- City University of New York, 14770The City College of New York, New York, NY, USA
| | - Sasha Rudenstine
- City University of New York, 14770The City College of New York, New York, NY, USA
| | - Kat McNeal
- City University of New York, 14770The City College of New York, New York, NY, USA
| | | | - Sandro Galea
- School of Public Health, 1846Boston University, Boston, MA, USA
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13
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Turk MA, Mitra M. Disparities, agendas, and policies: Is disability included? Disabil Health J 2022; 15:101355. [PMID: 35868716 DOI: 10.1016/j.dhjo.2022.101355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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