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Fernandez SB, Dawit R, Nawfal ES, Ward MK, Ramirez-Ortiz D, Sheehan DM, Trepka MJ. Psychosocial and socioeconomic changes among low-income people with HIV during the COVID-19 pandemic in Miami-Dade County, Florida: racial/ethnic and gender differences. HIV Res Clin Pract 2024; 25:2363129. [PMID: 38907537 PMCID: PMC11256985 DOI: 10.1080/25787489.2024.2363129] [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: 03/12/2024] [Accepted: 05/29/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND COVID-19 profoundly and uniquely impacted people with HIV. People with HIV experienced significant psychosocial and socioeconomic impacts, yet a limited amount of research has explored potential differences across gender and racial/ethnic groups of people with HIV. OBJECTIVE The objective of this study was to examine psychosocial and socioeconomic stressors related to the COVID-19 pandemic among a diverse sample of people with HIV in South Florida and to determine if the types of stressors varied across gender and racial/ethnic groups. METHODS We analyzed data from a cross-sectional survey with Miami-Dade County, Ryan White Program recipients. Outcomes included mental health, socioeconomic, drug/alcohol, and care responsibility/social support changes. Weighted descriptive analyses provided an overview of stressors by gender and racial/ethnic group and logistic regressions estimated associations between demographics and stressors. RESULTS Among 291 participants, 39% were Non-Hispanic Black, 18% were Haitian, and 43% were Hispanic. Adjusting for age, sex, language, and foreign-born status, Hispanics were more likely to report several worsened mental health (i.e. increased loneliness, anxiety) and socioeconomic stressors (i.e. decreased income). Spanish speakers were more likely to report not getting the social support they needed. Women were more likely to report spending more time caring for children. CONCLUSIONS Findings highlight ways in which cultural and gender expectations impacted experiences across people with HIV and suggest strategies to inform interventions and resources during lingering and future public health emergencies. Results suggest that public health emergencies have different impacts on different communities. Without acknowledging and responding to differences, we risk losing strides towards progress in health equity.
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Affiliation(s)
- Sofia B. Fernandez
- School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Research Center for Minority Institutions, Florida International University, Miami, FL, USA
| | - Rahel Dawit
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Ekpereka Sandra Nawfal
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Melissa K. Ward
- Research Center for Minority Institutions, Florida International University, Miami, FL, USA
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Daisy Ramirez-Ortiz
- Research Center for Minority Institutions, Florida International University, Miami, FL, USA
| | - Diana M. Sheehan
- Research Center for Minority Institutions, Florida International University, Miami, FL, USA
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, Miami, FL, USA
| | - Mary Jo Trepka
- Research Center for Minority Institutions, Florida International University, Miami, FL, USA
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
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Khorsand S, Geller C, Eyre A, Abi Haidar H, Chen H, Lacombe C, Kabir M, Mclellan A. "Like an umbrella, protecting me from the rain until I get to my destination": Evaluating the implementation of a tailored primary care model for urban marginalized populations. BMC PRIMARY CARE 2024; 25:347. [PMID: 39342088 PMCID: PMC11437737 DOI: 10.1186/s12875-024-02563-6] [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: 10/27/2023] [Accepted: 08/05/2024] [Indexed: 10/01/2024]
Abstract
BACKGROUND Improving health equity and access to the highest possible standard of health care is a key issue of social accountability. Centretown Community Health Centre in Ottawa, Canada has iteratively developed a program to target and serve marginalized and complex populations since 1999. The program implementation was evaluated using a validated implementation framework. METHODS Quantitative and qualitative data were collected through a health records extraction (n = 570), a client complexity assessment tool (n = 74), semi-structured interviews with clients and key stakeholders (n = 41), and a structured client satisfaction survey (n = 30). Data were analyzed using descriptive statistics and inductive thematic analysis. RESULTS Five hundred and seventy unique clients were seen between November 1-30, 2021. A third of clients (34%) did not have a provincial health card for access to universal health care services, and most (68%) were homeless or a resident of rooming houses. Most clients who reported their income (92%) were at or below Canada's official poverty line. The total mean complexity score for clients seen over a one-month period (n = 74) was 16.68 (SD 6.75) where a total score of at least 13 of 33 is perceived to be a threshold for client biopsychosocial complexity. Clients gained the majority of their total score from the Social support assessment component of the tool. Clients (n = 31) and key informants (n = 10) highlighted the importance of building relationships with this population, providing wrap-around care, and providing low-barrier care as major strength to the Urban Health program (UH). Key areas for improvement included the need to: i) increase staff diversity, ii) expand program hours and availability, and iii) improve access to harm reduction services. Clients appeared to be highly satisfied with the program, rating the program an average total score of 18.50 out of 20. CONCLUSIONS The program appears to serve marginalized and complex clients and seems well-received by the community. Our findings have relevance for other health care organizations seeking to better serve marginalized and medically and socially complex individuals and families in their communities.
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Affiliation(s)
- Soha Khorsand
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Carol Geller
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, 201-600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
- Centretown Community Health Centre, Ottawa, ON, Canada
| | - Alison Eyre
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, 201-600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
- Centretown Community Health Centre, Ottawa, ON, Canada
| | - Hounaida Abi Haidar
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, 201-600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - Haifeng Chen
- Centretown Community Health Centre, Ottawa, ON, Canada
| | - Corina Lacombe
- Department of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Monisha Kabir
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, 201-600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | - Andrew Mclellan
- Department of Family Medicine, Faculty of Medicine, University of Ottawa, 201-600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada.
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.
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Hernandez Barrios Y, Perez Chacon D, Molina Gomez Y, Gryseels C, Verdonck K, Peeters Grietens K, Nieto-Sanchez C. Using a Syndemics Perspective to (Re)Conceptualize Vulnerability during the COVID-19 Pandemic: A Scoping Review. Trop Med Infect Dis 2024; 9:189. [PMID: 39195627 PMCID: PMC11360217 DOI: 10.3390/tropicalmed9080189] [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: 05/30/2024] [Revised: 08/02/2024] [Accepted: 08/12/2024] [Indexed: 08/29/2024] Open
Abstract
Syndemics theory has been applied to study interactions between biomedical and social factors leading to the clustering of diseases. Because syndemics theory focuses on interactions that enhance risk, the concept of vulnerability is central to this approach. We conducted a scoping review to better understand how this theoretical framework helped to define, operationalize, and tackle issues of vulnerability during the COVID-19 pandemic. Original research, reviews, and opinion pieces elaborating on syndemics, vulnerability, and COVID-19, published between December 2019 and October 2022 and available from PubMed, were eligible. We analyzed 40 records and identified three framings of syndemics operating during this period: (1) interactions between COVID-19, diseases/health conditions, and specific social factors; (2) interactions between COVID-19 and social determinants of health; and (3) impacts of COVID-19 on specific populations. Emerging conceptualizations described vulnerability to COVID-19 as a systemic issue, explained the impact of COVID-19 control measures on increased vulnerability, and presented COVID-19 as a syndemic on its own. However, this theory's potential for deepening our understanding of vulnerability during this pandemic was constrained by superficial explorations of the interactions between biomedical and social spheres, and insufficient theoretical and methodological support from the social sciences.
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Affiliation(s)
- Yisel Hernandez Barrios
- Institute of Tropical Medicine Pedro Kourí, Havana 11400, Cuba or (Y.H.B.); or (D.P.C.); or (Y.M.G.)
| | - Dennis Perez Chacon
- Institute of Tropical Medicine Pedro Kourí, Havana 11400, Cuba or (Y.H.B.); or (D.P.C.); or (Y.M.G.)
| | - Yosiel Molina Gomez
- Institute of Tropical Medicine Pedro Kourí, Havana 11400, Cuba or (Y.H.B.); or (D.P.C.); or (Y.M.G.)
| | - Charlotte Gryseels
- Institute of Tropical Medicine—Antwerp, Nationalestraat 155, 2000 Antwerp, Belgium; (C.G.); (K.V.); (K.P.G.)
| | - Kristien Verdonck
- Institute of Tropical Medicine—Antwerp, Nationalestraat 155, 2000 Antwerp, Belgium; (C.G.); (K.V.); (K.P.G.)
| | - Koen Peeters Grietens
- Institute of Tropical Medicine—Antwerp, Nationalestraat 155, 2000 Antwerp, Belgium; (C.G.); (K.V.); (K.P.G.)
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8501, Japan
| | - Claudia Nieto-Sanchez
- Institute of Tropical Medicine—Antwerp, Nationalestraat 155, 2000 Antwerp, Belgium; (C.G.); (K.V.); (K.P.G.)
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Shillington KJ, Burke SM, Mantler T, Irwin JD. "I do think that accessibility is a really major thing that has come [out] of [the] pandemic": The lived experiences of resilience and health-related quality of life among a diverse sample of graduate students during the COVID-19 pandemic. PLoS One 2024; 19:e0309171. [PMID: 39163403 PMCID: PMC11335158 DOI: 10.1371/journal.pone.0309171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 08/06/2024] [Indexed: 08/22/2024] Open
Abstract
The COVID-19 pandemic has negatively impacted the mental health and wellbeing of post-secondary students. Resilience has been found to serve as a protective factor against mental distress among students during the pandemic. Despite the plethora of research that exists on post-secondary students during this crisis, most studies exploring students' health and resilience are quantitative and lack diversity. To date, the lived experiences of health-related quality of life (HRQOL) and resilience among graduate students representing diversity in age, gender, ethnicity, parental status, university, degree, and faculty during the COVID-19 pandemic remain unknown. As a part of a larger study, the purpose of this qualitative paper was to understand the lived experiences of resilience and HRQOL among a diverse sample of graduate students approximately 18 months into the COVID-19 pandemic in Ontario, Canada. A total of 14 students participated in semi-structured interviews exploring HRQOL domains, factors that supported/undermined participants' resilience, challenges/barriers to being resilient, and participants' inner strength. Thematic analysis revealed 5 themes: (1) cultural influences on resilience; (2) the role of privilege/power in shaping resilience; (3) how life stage and past experiences support resilience; (4) how the COVID-19 pandemic has undermined the resilience of equity-deserving groups; and (5) the role of disability/chronic pain. This work presents a unique dichotomy between how the COVID-19 pandemic has disrupted the lives of some graduate students, while simultaneously creating opportunities for others to thrive. Findings from this work underscore the importance of creating inclusive and accessible educational spaces to support graduate students' resilience and HRQOL currently, and in times of crisis.
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Affiliation(s)
- Katie J. Shillington
- Health and Rehabilitation Sciences, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
- Department of Neurobiology, University of California San Diego, San Diego, California, United States of America
- Center for Empathy and Social Justice in Human Health, T. Denny Sanford Institute for Empathy and Compassion, University of California San Diego, San Diego, California, United States of America
- Department of Psychology, Faculty of Science, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Shauna M. Burke
- Health and Rehabilitation Sciences, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
- School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
- Children’s Health Research Institute, London, Ontario, Canada
| | - Tara Mantler
- Health and Rehabilitation Sciences, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
- School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
| | - Jennifer D. Irwin
- Health and Rehabilitation Sciences, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
- School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
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Albright J, Fok M, DeLucia EA, Scarpa A. A Qualitative Examination of the Impact of COVID-19 on Transition Services for Autistic Youth. J Autism Dev Disord 2024; 54:3028-3042. [PMID: 37222966 PMCID: PMC10206570 DOI: 10.1007/s10803-023-06009-3] [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] [Accepted: 05/01/2023] [Indexed: 05/25/2023]
Abstract
The coronavirus (COVID-19) pandemic has caused widespread disturbances in many human and social service programs. Several studies have examined special education programming adaptations since the onset of the pandemic; however, there has yet to be documentation of pandemic-related changes to transition programming and the impact of these changes for autistic youth. The purpose of this qualitative study was to examine changes in transition programming for autistic youth amid the changing educational landscape. We conducted 12 interviews with caregivers (n = 5) and school providers (n = 7) about transition programming for autistic youth and the COVID-19 impact to these services. The pandemic had positive and negative effects on many aspects of transition programming, including student-focused planning, student development, interagency and interdisciplinary collaboration, family involvement, and program structure and attributes. Elucidation of the ways that the COVID-19 pandemic impacted transition programming from the perspectives of multiple stakeholders has important implications for school personnel and can help to inform the future directions for the field of transition programming research.
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Affiliation(s)
- Jordan Albright
- Center for Mental Health, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, USA.
| | - Megan Fok
- Department of Psychology, Virginia Tech, Blacksburg, VA, USA
- Virginia Tech Autism Clinic & Center for Autism Research, Virginia Tech, Blacksburg, VA, USA
| | - Elizabeth A DeLucia
- Department of Psychology, Virginia Tech, Blacksburg, VA, USA
- Virginia Tech Autism Clinic & Center for Autism Research, Virginia Tech, Blacksburg, VA, USA
| | - Angela Scarpa
- Department of Psychology, Virginia Tech, Blacksburg, VA, USA
- Virginia Tech Autism Clinic & Center for Autism Research, Virginia Tech, Blacksburg, VA, USA
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Li L, Sullivan A, Musah A, Stavrianaki K, Wood CE, Baker P, Kostkova P. Resilience during lockdown: a longitudinal study investigating changes in behaviour and attitudes among older females during COVID-19 lockdown in the UK. BMC Public Health 2024; 24:1967. [PMID: 39044166 PMCID: PMC11267972 DOI: 10.1186/s12889-024-19480-z] [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: 02/01/2024] [Accepted: 07/15/2024] [Indexed: 07/25/2024] Open
Abstract
In order to slow the spread of COVID-19, on March 23, 2020, a strict lockdown was implemented in the UK. This was followed by alternating periods of less restrictive lockdowns until most public health restrictions were lifted in the summer of 2021. While these measures were necessary, they significantly affected people's daily activities, lifestyles, and mental well-being.This paper presents a longitudinal research study that focused on females aged 55 + in the UK, aiming to understand how COVID-19 and the subsequent 15-month period of lockdowns affected their lifestyles and emotions. The study collected data through online surveys, where respondents reported the frequency and mode of access to activities, and their positive and negative emotional experiences during distinct study phases that encompassed both lockdown and less strict periods.In contrast to previous studies highlighting vulnerabilities for females and the elderly during lockdowns, this research found that the studied group maintained an overall positive outlook throughout the study period and successfully adapted to the lockdowns by increasing their engagement in certain activities, in particular, activities like 'getting active'. In addition, our findings indicate rapid adaptive behaviour change towards many online activities, such as cultural activities. However, the study also revealed negative emotions and a decrease in some activities during the second lockdown in 2020 and the subsequent lockdowns in 2021, underscoring the challenges inherent in prolonged periods of confinement. In addition, the study found negative affect associated with some activities, including working and studying from home.The findings provide valuable insights into how females aged over 55 coped with stressful circumstances, which can inform the development of resilient and mental health-conscious public health policies and responses in preparation for future pandemics or other hazards.
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Affiliation(s)
- Lan Li
- UCL Centre for Digital Public Health in Emergencies (dPHE), Department for Risk and Disaster Reduction, University College London, London, WC1E 6BT, UK.
| | - Ava Sullivan
- UCL Centre for Digital Public Health in Emergencies (dPHE), Department for Risk and Disaster Reduction, University College London, London, WC1E 6BT, UK
- EcoHealth Alliance, New York, USA
| | - Anwar Musah
- UCL Centre for Digital Public Health in Emergencies (dPHE), Department for Risk and Disaster Reduction, University College London, London, WC1E 6BT, UK
- Department of Geography, University College London, London, UK
| | - Katerina Stavrianaki
- UCL Centre for Digital Public Health in Emergencies (dPHE), Department for Risk and Disaster Reduction, University College London, London, WC1E 6BT, UK
- Department of Statistical Science, University College London, London, UK
| | - Caroline E Wood
- UCL Centre for Digital Public Health in Emergencies (dPHE), Department for Risk and Disaster Reduction, University College London, London, WC1E 6BT, UK
| | - Philip Baker
- UCL Centre for Digital Public Health in Emergencies (dPHE), Department for Risk and Disaster Reduction, University College London, London, WC1E 6BT, UK
- Crisis Response, British Red Cross, London, UK
| | - Patty Kostkova
- UCL Centre for Digital Public Health in Emergencies (dPHE), Department for Risk and Disaster Reduction, University College London, London, WC1E 6BT, UK
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Sharma S, El-Alfi V, Greene D. Maintaining and Improving Virtual Call Centers for Public Health: The CUNY Recovery Corps Experience. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024:00124784-990000000-00266. [PMID: 38865213 DOI: 10.1097/phh.0000000000001959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
CONTEXT In the early stages of the COVID-19 pandemic in New York City, individuals who tested positive, exposed contacts, and their families faced significant challenges in accessing essential resources for successful quarantine and isolation. These resources included alternative housing, food access, grocery delivery, missed wage assistance, transportation for household members, medical care, and more. PROGRAM The City University of New York (CUNY) Recovery Corps emerged as an innovative virtual resource navigation service to connect New Yorkers to essential resources and later to vaccinations, treatment, and services for Long COVID. The program prioritized reaching people living in underserved and under-resourced neighborhoods. Over 3 years, it made a substantial impact, reaching 374 728 New Yorkers and connecting 135 147 to crucial resources. IMPLEMENTATION Implementing a successful virtual navigation center amidst a global pandemic posed unique challenges. It required well-established systems to provide services, manage staff, build community, and both assure and improve service quality. EVALUATION Continuous quality assurance and process improvement efforts resulted in a nearly 10-point increase in successful client-resource connections program-wide, with individual navigators showing improvements of up to 20%. Staff-led initiatives, such as population-specific resource guides and incentive awards, boosted morale and cohesion. Providing continuous professional development opportunities and requested training including trauma-informed care, self-care, and strategies for managing grief contributed to staff retention and improved client interactions. DISCUSSION The CUNY Recovery Corps provides a blueprint for setting up navigation services for emergency response and supporting health and social services. The current paper delves into the intensive quality improvement efforts, program management infrastructure, and staff support that made this program a success. By applying these lessons on establishing and maintaining a virtual call center prioritizing the client's well-being and staff strengths, policymakers and social service leaders can effectively address various health and social service needs proactively rather than rebuilding after each disaster.
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Affiliation(s)
- Srividhya Sharma
- Author Affiliations: Center for Innovation in Mental Health (Dr Sharma); City University of New York Graduate School of Public Health and Health Policy, New York, New York (Ms El-Alfi and Dr Greene)
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James SA, Chen S, Dang JH, Hall S, Campbell JE, Chen MS, Doescher MP. Changes in alcohol consumption and binge drinking during the COVID-19 pandemic among American Indians residing in California and Oklahoma. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:371-381. [PMID: 38843382 PMCID: PMC11305900 DOI: 10.1080/00952990.2024.2344482] [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: 09/28/2023] [Revised: 03/29/2024] [Accepted: 04/09/2024] [Indexed: 06/27/2024]
Abstract
Background: This study explored the increased quantity and frequency of alcohol use in the American Indian (AI) population during the COVID-19 pandemic.Objectives: The aims of this study were to explore possible associations between covariables and both binge drinking and alcohol consumption during COVID-19.Methods: This cross-sectional survey study analyzed data from a sample of AI individuals (63% female) residing in California (n = 411) and Oklahoma (n = 657) between October 2020-January 2021. Analysis included summary statistics and multivariable logistic regression, including a variety of socio-economic, COVID-19 concern, and tobacco and marijuana use variables.Results: One or more alcohol binge episodes were reported between October 2020-January 2021 in 19.3% of participants and elevated overall alcohol consumption was reported by 21.6% of participants. Higher odds of elevated alcohol consumption occurred in women and those following more social distancing measures. The odds of binge drinking or elevated alcohol consumption in those using both marijuana and tobacco (aOR/ adjusted odds ratio:18.9, 95% CI = 8.5, 42.2, and aOR:3.9, 95% CI = 1.7, 8.6, respectively) were higher compared to those using neither. Similarly, the odds of binge drinking or elevated alcohol consumption in those using tobacco only (aOR:4.7, 95% CI = 2.9, 7.7 and aOR: 2.0, 95% CI = 1.1, 3.5, respectively) were higher compared to those using neither.Conclusions: This study found high rates of alcohol use and bingeing during the COVID-19 pandemic. Offering collaborative, culturally sensitive, and affordable support services are important components of intervention and preparation for future stressful events on local, as well as global levels.
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Affiliation(s)
- Shirley A James
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Sixia Chen
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Julie Ht Dang
- Department of Public Health Sciences, Division of Health Policy and Management, University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Spencer Hall
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Janis E Campbell
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Moon S Chen
- Department of Internal Medicine, Division of Hematology and Oncology, University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Mark P Doescher
- Stephenson Cancer Center, College of Medicine, Department of Family and Preventive Medicine, University of Oklahoma College of Health Science Center, Oklahoma City, OK, USA
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Chu GM, Almklov E, Wang C, McLean CL, Pittman JOE, Lang AJ. Relationships among race, ethnicity, and gender and whole health among U.S. veterans. Psychol Serv 2024; 21:294-304. [PMID: 37824243 PMCID: PMC11009376 DOI: 10.1037/ser0000807] [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] [Indexed: 10/14/2023]
Abstract
Racial, ethnic, and gender health care disparities in the United States are well-documented and stretch across the lifespan. Even in large integrated health care systems such as Veteran Health Administration, which are designed to provide equality in care, social and economic disparities persist, and limit patients' achievement of health goals across multiple domains. We explore Veterans' Whole Health priorities among Veteran demographic groups. Participants who were enrolling in Veteran Health Administration provided demographics and Whole Health priorities using eScreening, a web-based self-assessment tool. Veterans had similar health care goals regardless of demographic characteristics but differences were noted in current health appraisals. Non-White and women Veterans reported worse health-relevant functioning. Black Veterans were more likely to endorse a low rating for their personal development/relationships. Multiracial Veterans were more likely to endorse a low rating of their surroundings. Asian Veterans were less likely to provide a high rating of their surroundings. Women Veterans reported lower appraisals for body and personal development but higher appraisals of professional care. Results indicated that demographic factors such as race and gender, and to a lesser extent ethnicity, were associated with health disparities. The Whole Health model provides a holistic framework for addressing these disparities. These findings may inform more culturally sensitive care and enhance Veteran Health Administration equal access initiatives. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | - Erin Almklov
- VA San Diego Healthcare System
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System
| | | | - Caitlin L. McLean
- VA San Diego Healthcare System
- Department of Psychiatry, University of California, San Diego
| | - James O. E. Pittman
- VA San Diego Healthcare System
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System
- Department of Psychiatry, University of California, San Diego
| | - Ariel J. Lang
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System
- Department of Psychiatry, University of California, San Diego
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego
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Sullivan SM, Sullivan JM, Orey D, Baptist NK. Racial Differences in Feelings of Distress during the COVID-19 Pandemic and John Henryism Active Coping in the United States: Results from a National Survey. SOCIAL SCIENCE QUARTERLY 2024; 105:514-527. [PMID: 39309452 PMCID: PMC11412620 DOI: 10.1111/ssqu.13354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/25/2024]
Abstract
Objective To examine whether John Henryism Active Coping (JHAC) is a protective risk factor for distress during the COVID-19 pandemic and whether this association differs by race/ethnicity. Methods Data were collected as part of the 2020 National Blair Center Poll. Higher scores on JHAC measured a greater behavioral predisposition to cope actively and persistently with difficult psychosocial stressors and barriers of everyday life. Results High JHAC was associated with lower odds for feeling worried and for feeling afraid when thinking about COVID-19. These associations differed across race/ethnicity such that having a greater JHAC behavioral predisposition to coping was inversely associated with feelings of distress when thinking about the COVID-19 pandemic only among Whites and Hispanics, but not among African Americans. Conclusion Our findings have important implications as the COVID-19 pandemic continues into 2022 and psychological distress may linger and increase due to unprecedented economic and social impacts.
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Affiliation(s)
- Samaah M Sullivan
- Department of Epidemiology; Human Genetics, and Environmental Science; University of Texas Health Sciences Center, Houston, Texas, USA
| | - Jas M Sullivan
- Department of Psychology, Political Science and African American Studies, Louisiana State University, Baton Rouge, Louisiana, USA
| | - D'Andra Orey
- Department of Political Science, Jackson State University, Jackson, Mississippi, USA
| | - Najja Kofi Baptist
- Department of Political Science, University of Arkansas, Fayetteville, Arkansas, USA
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Obiakor GC, Banta JE, Sinclair RG, Baba Djara M, Mataya R, Wiafe S. The Impact of Social Determinants of Maternal Mental Health in Marginalized Mothers. J Womens Health (Larchmt) 2024; 33:650-661. [PMID: 38662499 DOI: 10.1089/jwh.2022.0137] [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: 05/29/2024] Open
Abstract
Background: A deeper understanding of the key determinants of maternal mental health is important for improving care for women, especially women who are at an economic disadvantage. Objectives: To explore the associations of select social determinants: access, social support, and stress, with the onset of antepartum depression in low-income mothers. Participants: The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing, population-based surveillance system with selected data from 2016 to 2019, establishing a randomly selected sample of women with a recent live birth at most 4 months postdelivery, between 1,300 and 3,400 women per state (n ∼ 162,558). Methods: In this cross-sectional study, the phase 8 PRAMS was adapted to measure social support, access, stress, and their relationships with the onset of antepartum depression in low-income mothers. To assess low-income marginalization, a threshold was established based on income levels within 130% of the federal poverty level; antepartum (n ∼ 41,289). Results: The defined access, social support, and stress factors showed a statistically significant association with the onset of antepartum depression among low-income mothers. Of women in this sample, 22.6% indicated antepartum depression (p < 0.001; R2 = 0.066). Negative social support indicators were associated with an increased likelihood of antepartum depression; 3.71 increased odds of depression for abuse during pregnancy, and 0.79 decreased odds with positive acknowledgment of paternity. Access indicator terms showed an association with the decreased likelihood of antepartum depression through breastfeeding information support (Info from Baby Doc, odds ratio [OR] = 0.86), prenatal care utilization (12+ visits, OR = 0.82), and specific insurance type (insurance by job, OR = 0.82). All instances of stressful life events showed an increased likelihood of depression during pregnancy (for majority of stressful life events: OR >1.12). Conclusions: Economically marginalized mothers face unmet social and health care needs leading to poorer outcomes during pregnancy. These findings provide additional support for improved policy and public health efforts, such as assessment, education, and interventions, to decrease prevalence and improve treatment for antepartum depression among marginalized mothers.
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Affiliation(s)
- Gina C Obiakor
- Department of Health Policy and Leadership, School of Public Health, Loma Linda University, Loma Linda, California, USA
| | - Jim E Banta
- Department of Health Policy and Leadership, School of Public Health, Loma Linda University, Loma Linda, California, USA
| | - Ryan G Sinclair
- Department of Environmental Health, School of Public Health, Loma Linda University, Loma Linda, California, USA
| | - Monita Baba Djara
- Department of Global Health, School of Public Health, Loma Linda University, Loma Linda, California, USA
| | - Ronald Mataya
- Department of Global Health, School of Public Health, Loma Linda University, Loma Linda, California, USA
| | - Seth Wiafe
- Department of Health Policy and Leadership, School of Public Health, Loma Linda University, Loma Linda, California, USA
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12
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Romem S, Katusic M, Wi CI, Hentz R, Lynch BA. A retrospective cohort study analyzing the changes in early childhood development during the COVID-19 pandemic. Early Hum Dev 2024; 192:105991. [PMID: 38552329 DOI: 10.1016/j.earlhumdev.2024.105991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 05/04/2024]
Abstract
OBJECTIVE To investigate early childhood development (ECD) outcomes in different subgroups before and during the COVID-19 pandemic. STUDY DESIGN A retrospective cohort study of children 3-58 months of age whose caregivers completed a Survey of Well-being of Young Children (SWYC) as part of a well child visit (WCC). The data were divided into two phases: pre-pandemic (September 2018 - February 2020), and during pandemic (September 2020 - February 2022). The difference in the proportion of forms with Meets Expectations interpreted scores on the SWYC Developmental Milestones pre-pandemic versus during the pandemic timeframe overall and among subgroups were reported. Hypotheses were tested using logistic regression with repeated measures. RESULTS 14,550 patients were included in the sample for analysis with 52,558 SWYC form observations. There was no difference in the odds of a Meets Expectations interpreted score before and after the pandemic for the entire sample, OR 0.99 (95 % CI: 0.94-1.04). There was evidence of decreased odds of an interpreted score of Meets Expectations for the following subgroups: male, Hispanic/Latino ethnicity, ages of 24, 30 or 36 months at WCC, Medicaid insurance, 2nd HOUSES Quartile, requiring interpreter, single parent household, young maternal age, maternal substance abuse, and race identified as Native Hawaiian/Pacific Islander, American Indian/Native Alaskan or Other. CONCLUSION Decreased odds of meeting developmental milestones during the pandemic were evident in certain high risk sub-groups revealing unequal distribution of suboptimal developmental outcomes within our population during the pandemic that may be exacerbating existing inequities impacting development in children.
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Affiliation(s)
- Sahar Romem
- Division of Pediatric Hospital Medicine; Mayo Clinic, 200 First St SW, Rochester, MN, 55905, United States of America.
| | - Maja Katusic
- Division of Developmental and Behavioral Pediatrics; Mayo Clinic, 200 First St SW, Rochester, MN, 55905, United States of America.
| | - Chung-Il Wi
- Division of Community Pediatric and Adolescent Medicine; Mayo Clinic, 200 First St SW, Rochester, MN, 55905, United States of America.
| | - Roland Hentz
- Division of Clinical Trials and Biostatistics; Mayo Clinic, 200 First St SW, Rochester, MN, 55905, United States of America.
| | - Brian A Lynch
- Division of Community Pediatric and Adolescent Medicine; Mayo Clinic, 200 First St SW, Rochester, MN, 55905, United States of America.
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Ormiston CK, Strassle PD, Boyd E, Williams F. Discrimination is associated with depression, anxiety, and loneliness symptoms among Asian and Pacific Islander adults during COVID-19 Pandemic. Sci Rep 2024; 14:9417. [PMID: 38658790 PMCID: PMC11043456 DOI: 10.1038/s41598-024-59543-0] [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: 03/26/2024] [Accepted: 04/11/2024] [Indexed: 04/26/2024] Open
Abstract
In the United States, Asian and Pacific Islander (A/PI) communities have faced significant discrimination and stigma during the COVID-19 pandemic. We assessed the association between discrimination and depression, anxiety, and loneliness symptoms among Asian or Pacific Islander adults (n = 543) using data from a 116-item nationally distributed online survey of adults (≥ 18 years old) in the United States conducted between 5/2021-1/2022. Discrimination was assessed using the 5-item Everyday Discrimination Scale. Anxiety, depression, and loneliness symptoms were assessed using the 2-item Generalized Anxiety Disorder, 2-item Patient Health Questionnaire, and UCLA Loneliness Scale-Short form, respectively. We used multivariable logistic regression to estimate the association between discrimination and mental health. Overall, 42.7% of participants reported experiencing discrimination once a month or more. Compared with no discrimination, experiencing discrimination once a month was associated with increased odds of anxiety (Adjusted Odds Ratio [aOR] = 2.60, 95% CI = 1.38-4.77), depression (aOR = 2.58, 95% CI = 1.46-4.56), and loneliness (aOR = 2.86, 95% CI = 1.75-4.67). Experiencing discrimination once a week or more was associated with even higher odds of anxiety (aOR = 6.90, 95% CI = 3.71-12.83), depression, (aOR = 6.96, 95% CI = 3.80-12.74), and loneliness (aOR = 6.91, 95% CI = 3.38-13.00). Discrimination is detrimental to mental health, even at relatively low frequencies; however, more frequent discrimination was associated with worse mental health symptoms. Public health interventions and programs targeting anti-A/PI hate and reducing A/PI mental health burden are urgently needed.
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Affiliation(s)
- Cameron K Ormiston
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 11545 Rockville Pike, Rockville, MD, 20852, USA
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paula D Strassle
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 11545 Rockville Pike, Rockville, MD, 20852, USA
| | - Eric Boyd
- Information Management Services, Inc., Calverton, MD, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, 11545 Rockville Pike, Rockville, MD, 20852, USA.
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14
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Meo SA, Alotaibi M, Meo MZS, Meo MOS, Hamid M. Medical knowledge of ChatGPT in public health, infectious diseases, COVID-19 pandemic, and vaccines: multiple choice questions examination based performance. Front Public Health 2024; 12:1360597. [PMID: 38711764 PMCID: PMC11073538 DOI: 10.3389/fpubh.2024.1360597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/02/2024] [Indexed: 05/08/2024] Open
Abstract
Background At the beginning of the year 2023, the Chatbot Generative Pre-Trained Transformer (ChatGPT) gained remarkable attention from the public. There is a great discussion about ChatGPT and its knowledge in medical sciences, however, literature is lacking to evaluate the ChatGPT knowledge level in public health. Therefore, this study investigates the knowledge of ChatGPT in public health, infectious diseases, the COVID-19 pandemic, and its vaccines. Methods Multiple Choice Questions (MCQs) bank was established. The question's contents were reviewed and confirmed that the questions were appropriate to the contents. The MCQs were based on the case scenario, with four sub-stems, with a single correct answer. From the MCQs bank, 60 MCQs we selected, 30 MCQs were from public health, and infectious diseases topics, 17 MCQs were from the COVID-19 pandemic, and 13 MCQs were on COVID-19 vaccines. Each MCQ was manually entered, and tasks were given to determine the knowledge level of ChatGPT on MCQs. Results Out of a total of 60 MCQs in public health, infectious diseases, the COVID-19 pandemic, and vaccines, ChatGPT attempted all the MCQs and obtained 17/30 (56.66%) marks in public health, infectious diseases, 15/17 (88.23%) in COVID-19, and 12/13 (92.30%) marks in COVID-19 vaccines MCQs, with an overall score of 44/60 (73.33%). The observed results of the correct answers in each section were significantly higher (p = 0.001). The ChatGPT obtained satisfactory grades in all three domains of public health, infectious diseases, and COVID-19 pandemic-allied examination. Conclusion ChatGPT has satisfactory knowledge of public health, infectious diseases, the COVID-19 pandemic, and its vaccines. In future, ChatGPT may assist medical educators, academicians, and healthcare professionals in providing a better understanding of public health, infectious diseases, the COVID-19 pandemic, and vaccines.
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Affiliation(s)
- Sultan Ayoub Meo
- Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Metib Alotaibi
- Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Mashhood Hamid
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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15
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Whitfield C, Liu Y, Anwar M. Impact of COVID-19 Pandemic on Social Determinants of Health Issues of Marginalized Black and Asian Communities: A Social Media Analysis Empowered by Natural Language Processing. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01996-0. [PMID: 38625665 DOI: 10.1007/s40615-024-01996-0] [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: 12/02/2023] [Revised: 04/02/2024] [Accepted: 04/07/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE This study aims to understand the impact of the COVID-19 pandemic on social determinants of health (SDOH) of marginalized racial/ethnic US population groups, specifically African Americans and Asians, by leveraging natural language processing (NLP) and machine learning (ML) techniques on race-related spatiotemporal social media text data. Specifically, this study establishes the extent to which Latent Dirichlet Allocation (LDA) and Gibbs Sampling Dirichlet Multinomial Mixture (GSDMM)-based topic modeling determines social determinants of health (SDOH) categories, and how adequately custom named-entity recognition (NER) detects key SDOH factors from a race/ethnicity-related Reddit data corpus. METHODS In this study, we collected race/ethnicity-specific data from 5 location subreddits including New York City, NY; Los Angeles, CA; Chicago, IL; Philadelphia, PA; and Houston, TX from March to December 2019 (before COVID-19 pandemic) and from March to December 2020 (during COVID-19 pandemic). Next, we applied methods from natural language processing and machine learning to analyze SDOH issues from extracted Reddit comments and conversation threads using feature engineering, topic modeling, and custom named-entity recognition (NER). RESULTS Topic modeling identified 35 SDOH-related topics. The SDOH-based custom NER analyses revealed that the COVID-19 pandemic significantly impacted SDOH issues of marginalized Black and Asian communities. On average, the Social and Community Context (SCC) category of SDOH had the highest percent increase (366%) from the pre-pandemic period to the pandemic period across all locations and population groups. Some of the detected SCC issues were racism, protests, arrests, immigration, police brutality, hate crime, white supremacy, and discrimination. CONCLUSION Reddit social media platform can be an alternative source to assess the SDOH issues of marginalized Black and Asian communities during the COVID-19 pandemic. By employing NLP/ML techniques such as LDA/GSDMM-based topic modeling and custom NER on a race/ethnicity-specific Reddit corpus, we uncovered various SDOH issues affecting marginalized Black and Asian communities that were significantly worsened during the COVID-19 pandemic. As a result of conducting this research, we recommend that researchers, healthcare providers, and governments utilize social media and collaboratively formulate responses and policies that will address SDOH issues during public health crises.
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Affiliation(s)
| | - Yang Liu
- North Carolina A&T State University, Greensboro, NC, 27411, USA
| | - Mohd Anwar
- North Carolina A&T State University, Greensboro, NC, 27411, USA.
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16
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Naidoo M, Shephard W, Kambewe I, Mtshali N, Cope S, Rubio FA, Rasella D. Incorporating social vulnerability in infectious disease mathematical modelling: a scoping review. BMC Med 2024; 22:125. [PMID: 38500147 PMCID: PMC10949739 DOI: 10.1186/s12916-024-03333-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 03/04/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Highlighted by the rise of COVID-19, climate change, and conflict, socially vulnerable populations are least resilient to disaster. In infectious disease management, mathematical models are a commonly used tool. Researchers should include social vulnerability in models to strengthen their utility in reflecting real-world dynamics. We conducted a scoping review to evaluate how researchers have incorporated social vulnerability into infectious disease mathematical models. METHODS The methodology followed the Joanna Briggs Institute and updated Arksey and O'Malley frameworks, verified by the PRISMA-ScR checklist. PubMed, Clarivate Web of Science, Scopus, EBSCO Africa Wide Information, and Cochrane Library were systematically searched for peer-reviewed published articles. Screening and extracting data were done by two independent researchers. RESULTS Of 4075 results, 89 articles were identified. Two-thirds of articles used a compartmental model (n = 58, 65.2%), with a quarter using agent-based models (n = 24, 27.0%). Overall, routine indicators, namely age and sex, were among the most frequently used measures (n = 42, 12.3%; n = 22, 6.4%, respectively). Only one measure related to culture and social behaviour (0.3%). For compartmental models, researchers commonly constructed distinct models for each level of a social vulnerability measure and included new parameters or influenced standard parameters in model equations (n = 30, 51.7%). For all agent-based models, characteristics were assigned to hosts (n = 24, 100.0%), with most models including age, contact behaviour, and/or sex (n = 18, 75.0%; n = 14, 53.3%; n = 10, 41.7%, respectively). CONCLUSIONS Given the importance of equitable and effective infectious disease management, there is potential to further the field. Our findings demonstrate that social vulnerability is not considered holistically. There is a focus on incorporating routine demographic indicators but important cultural and social behaviours that impact health outcomes are excluded. It is crucial to develop models that foreground social vulnerability to not only design more equitable interventions, but also to develop more effective infectious disease control and elimination strategies. Furthermore, this study revealed the lack of transparency around data sources, inconsistent reporting, lack of collaboration with local experts, and limited studies focused on modelling cultural indicators. These challenges are priorities for future research.
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Affiliation(s)
- Megan Naidoo
- The Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, C/ del Rosselló, Barcelona, 171, 08036, Spain.
| | - Whitney Shephard
- The Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, C/ del Rosselló, Barcelona, 171, 08036, Spain
| | - Innocensia Kambewe
- The Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, C/ del Rosselló, Barcelona, 171, 08036, Spain
| | - Nokuthula Mtshali
- The Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, C/ del Rosselló, Barcelona, 171, 08036, Spain
| | - Sky Cope
- The Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, C/ del Rosselló, Barcelona, 171, 08036, Spain
| | - Felipe Alves Rubio
- The Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, C/ del Rosselló, Barcelona, 171, 08036, Spain
| | - Davide Rasella
- The Barcelona Institute for Global Health, Hospital Clínic, University of Barcelona, C/ del Rosselló, Barcelona, 171, 08036, Spain
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17
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Xie QW, Fan XL, Luo X, Chang Q. Mechanisms underlying the relationship between the intersectionality of multiple social identities with depression among US adults: A population-based study on the mediating roles of lifestyle behaviors. J Affect Disord 2024; 349:384-393. [PMID: 38211749 DOI: 10.1016/j.jad.2024.01.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/27/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Despite substantial efforts to investigate the inequalities in mental health among people with marginalized identities, most research has concentrated on single social identities rather than complete persons. The current study aimed to explore the mechanisms underlying the relationship between the intersectionality of multiple social identities with depression among US adults. METHODS Data for this study came from the National Health and Nutrition Examination Survey waves between 2015 and 2018, including a total of 11,268 US adults. A latent class analysis (LCA) was conducted to identify latent subpopulations based on sex, race/ethnicity, immigrant status, disability, household income, employment status, and education level. Interclass differences in lifestyle factors and depression were examined. Multiple mediation analysis was used to examine the mediating roles of lifestyle behaviors. RESULTS LCA identified four potential subpopulations: "least marginalized", "immigrant minorities", "disabled, less-educated non-workers", and "low-income minorities" groups. There was enormous heterogeneity in mental health among immigrant minority individuals. The "disabled, less-educated non-workers" group had the highest rates of depression; in contrast, the "immigrant minorities" group had the best mental health, even better than that of the "least marginalized" group. Distributions of lifestyle factors followed a similar pattern. In addition, lifestyle behaviors significantly mediated the relationship between intersectional social identities and depression. LIMITATIONS The cross-sectional design prevented establishment of the causality of relationships. CONCLUSIONS This study suggests that applying a person-centered approach is important when examining intersectional inequalities in mental health and highlights the effects of structural social hierarchies on individuals' health behaviors and mental health.
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Affiliation(s)
- Qian-Wen Xie
- Department of Social Welfare and Risk Management, School of Public Affairs, Zhejiang University, Hangzhou, China; Research Center for Common Prosperity, Future Regional Development Laboratory, Innovation Center of Yangtze River Delta, Zhejiang University, Jiaxing, China; Center of Social Welfare and Governance, Zhejiang University, Hangzhou, China; Institute for Common Prosperity and Development, Zhejiang University, Hangzhou, China
| | - Xu Li Fan
- Department of Social Welfare and Risk Management, School of Public Affairs, Zhejiang University, Hangzhou, China
| | - Xiangyan Luo
- Department of Social Welfare and Risk Management, School of Public Affairs, Zhejiang University, Hangzhou, China
| | - Qingsong Chang
- School of Sociology and Anthropology, Xiamen University, Xiamen City, China.
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Pfeffer R, Barrick K, Galvan T, Marfori FM, Williams SA. "I'd Rather Be Broke Than Harmed": A Qualitative Analysis of the Experiences of People Engaged in Commercial Sex Work During the COVID-19 Pandemic. Public Health Rep 2024:333549241236079. [PMID: 38459790 DOI: 10.1177/00333549241236079] [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: 03/10/2024] Open
Abstract
OBJECTIVES People involved in commercial sex work during the COVID-19 pandemic, particularly those compelled to sell sex, faced multiple challenges to their safety and well-being. We explored, in real time, the impact of the COVID-19 pandemic on people involved in commercial sex work and the broader commercial sex industry. METHODS Using a participatory action research approach, we interviewed 159 English- and Spanish-speaking adults who had engaged in commercial sex work under the direction of a third party in Sacramento County, California, within the past 5 years (approximately 2017-2022). As part of a larger study, our interview protocol included 1 question about the COVID-19 pandemic: "Has COVID-19 changed anything about your experience with sex work?" We transcribed and analyzed interviews using QSR-NVivo, a qualitative coding software. RESULTS Participants described the effects of increased isolation, decreased demand, difficulty accessing social services, fear of contracting COVID-19, difficulty in following public health guidance on social distancing and wearing face masks, and how the pandemic resulted in some people entering or exiting commercial sex work. Most participants were familiar with recommended public health safety measures, but lack of agency and financial need limited their ability to comply with all recommendations. A lack of access to social services added stress to those most in need of emergency housing or substance use treatment and left them vulnerable to continued abuse. CONCLUSIONS Stress and financial insecurity generally increased among people involved in commercial sex work during the pandemic, and no efforts were made to understand and mitigate the hardships that this population faced. Future research should address how to maintain social service availability during times of public health emergencies and other crises.
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Affiliation(s)
- Rebecca Pfeffer
- Justice Practice Area, RTI International, Research Triangle Park, NC, USA
| | - Kelle Barrick
- Justice Practice Area, RTI International, Research Triangle Park, NC, USA
| | - Terri Galvan
- Community Against Sexual Harm, Sacramento, CA, USA
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Ekhtiari S, Pincus D, Croxford R, Gatley JM, Khoshbin A, Atrey A, Paterson JM, Ravi B. Impact of the coronavirus disease 2019 pandemic on equity of access to hip and knee replacements: a population-level study. INTERNATIONAL ORTHOPAEDICS 2024; 48:635-642. [PMID: 38012311 DOI: 10.1007/s00264-023-06042-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023]
Abstract
PURPOSE The COVID-19 pandemic had innumerable impacts on healthcare delivery. In Canada, this included limitations on inpatient capacity, which resulted in an increased focus on outpatient surgery for non-emergent cases such as joint replacements. The objective of this study was to assess whether the pandemic and the shift towards outpatient surgery had an impact on access to joint replacement for marginalized patients. METHODS Data from Ontario's administrative healthcare databases were obtained for all patients undergoing an elective hip or knee replacement between January 1, 2018 and August 31, 2021. All surgeries performed before March 15, 2020 were classified as "pre-COVID," while all procedures performed after that date were classified as "post-COVID." The Ontario Marginalization Index domains were used to analyze proportion of marginalized patients undergoing surgery pre- and post-COVID. RESULTS A total of 102,743 patients were included-42,812 hip replacements and 59,931 knee replacements. There was a significant shift towards outpatient surgery during the post-COVID period (1.1% of all cases pre-COVID to 13.2% post-COVID, p < 0.001). In the post-COVID cohort, there were significantly fewer patients from some marginalized groups, as well as fewer patients with certain co-morbidities, such as congestive heart failure and chronic obstructive pulmonary disease. CONCLUSION The most important finding of this population-level database study is that, compared to before the COVID-19 pandemic, there has been a change in the profile of patients undergoing hip and knee replacements in Ontario, specifically across a range of indicators. Fewer marginalized patients are undergoing joint replacement surgery since the COVID-19 pandemic. Further monitoring of access to joint replacement surgery is required in order to ensure that surgery is provided to those who are most in need.
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Affiliation(s)
- Seper Ekhtiari
- Addenbrooke's - Cambridge University Hospitals, University of Cambridge, Cambridge, UK.
- Division of Orthopaedic Surgery, Sinai Health, University of Toronto, 476B-600 University Ave, Toronto, ON, M5G 1X5, Canada.
| | - Daniel Pincus
- Department of Surgery, Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario, Canada
- Division of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | | | | | - Amir Khoshbin
- ICES, Toronto, Ontario, Canada
- Division of Orthopaedic Surgery, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Amit Atrey
- ICES, Toronto, Ontario, Canada
- Division of Orthopaedic Surgery, St. Michael's Hospital, Toronto, Ontario, Canada
| | | | - Bheeshma Ravi
- Department of Surgery, Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario, Canada
- Division of Orthopaedic Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
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20
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Eliason EL, Agostino J, MacDougall H. Social Determinants and Perinatal Hardships During the COVID-19 Pandemic. J Womens Health (Larchmt) 2024; 33:371-378. [PMID: 38011003 PMCID: PMC10924118 DOI: 10.1089/jwh.2023.0290] [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: 11/29/2023] Open
Abstract
Background: This study examined perinatal experiences of pandemic-related hardships and disparities by race/ethnicity, income, insurance type at childbirth, and urban/rural residency. Materials and Methods: We used cross-sectional survey data from the 2020 Pregnancy Risk Assessment Monitoring System COVID-19 supplement in 26 states, the District of Columbia, and New York City to explore: (1) job loss or cut work hours/pay, (2) having to move/relocate or becoming homeless, (3) problems paying the rent, mortgage, or bills, or (4) worries that food would run out. We estimated the prevalence of outcomes overall and by race/ethnicity, income, insurance, and urban/rural residency. We used weighted multivariable logistic regression models to calculate adjusted predicted probabilities. Results: Due to the COVID-19 pandemic, 31.9% of respondents reported losing their job or having a cut in work hours or pay, 11.2% of respondents had to move/relocate or became homeless, 21.8% had problems paying the rent, mortgage, or bills, and 16.86% reported worries that food would run out. Compared to overall, rates of all hardships were higher among respondents who were non-Hispanic Black, Hispanic, uninsured, or Medicaid insured. The adjusted predicted probability of employment instability, financial hardships, and food insecurity was significantly higher among non-Hispanic Black respondents and respondents who were uninsured. The adjusted predicted probability of all hardships was significantly higher among respondents with Medicaid. Conclusions: Black, Medicaid-insured, and uninsured respondents were particularly vulnerable to perinatal hardships during COVID-19. Our results suggest a need to alleviate the overall and disparate consequences of hardships for individuals who gave birth during the COVID-19 pandemic.
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Affiliation(s)
- Erica L. Eliason
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Jasmine Agostino
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Hannah MacDougall
- School of Social Work, University of Minnesota, Minneapolis, Minnesota, USA
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21
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Fernández JS. Threading a decolonial feminist response to COVID-19: One community psychologist's reflection on the assemblages of violence. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 73:191-205. [PMID: 37042808 DOI: 10.1002/ajcp.12662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 07/01/2022] [Accepted: 01/21/2023] [Indexed: 06/19/2023]
Abstract
To challenge and interrogate the assemblages of violence produced by racial capitalism, and exacerbated by the COVID-19 pandemic, community psychologists must engage in a transdisciplinary critical ethically reflexive practice. In this reflexive essay, or first-person account, I offer a decolonial feminist response to COVID-19 that draws strength from the writings of three women of Color decolonial and postcolonial feminist thinkers: Gloria E. Anzaldúa, Sylvia Wynter, and Arundhati Roy. Through their writings I share my reflections on the sociopolitical moment associated with COVID-19. Of importance, I argue in support of engaging a decolonial feminist standpoint to understand the inequitable and dehumanizing conditions under COVID-19, and the possibilities for transformative justice. I offer this reflexive essay with the intention of summoning community psychology and community psychologists to look toward transdisciplinarity, such as that which characterizes a decolonial standpoint and feminist epistemologies. Writings oriented toward imagination, relationality, and borderland ways of thinking that are outside, in-between or within, the self and the collective "we" can offer valuable guidance. The invitation toward a transdisciplinary critical ethically reflexive practice calls us to bear witness to movements for social justice; to leverage our personal, professional and institutional resources to support communities in struggle. A decolonial feminist standpoint guided by the words of Anzaldúa, Wynter, and Roy can cultivate liberatory conditions that can materialize as racial freedom, community wellbeing, and societal thriving.
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Hoke MK, Long AM. Human biology and the study of precarity: How the intersection of uncertainty and inequality is taking us to new extremes. Am J Hum Biol 2024; 36:e24018. [PMID: 38053455 DOI: 10.1002/ajhb.24018] [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: 07/26/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 12/07/2023] Open
Abstract
Inequality represents an extreme environment to which humans must respond. One phenomenon that contributes to this growing extreme is precarity or the intersection of uncertainty and some form of inequality. While precarity has an important intellectual history in the fields of sociology and sociocultural anthropology, it has not been well studied in the field of human biology. Rather human biologists have engaged with the study of closely related concepts such as uncertainty and resource insecurity. In this article, we propose that human biology take on the study of precarity as a novel way of investigating inequality. We first provide a brief intellectual history of precarity which is followed by a review of research on uncertainty and resource security in human biology which, while not exhaustive, illustrates some key gaps that precarity may aid us in addressing. We then review some of the pathways through which precarity comes to affect human biology and health and some of the evidence for why the unpredictable nature of precarity may make it a unique physiological stress. A case study based on research in Nuñoa, Peru provides an important example of how precarity can elucidate the influences of health in an extreme setting, albeit with insights that apply more broadly. We conclude that precarity holds important potential for the study of human biology, including helping us more effectively operationalize and study uncertainty, encouraging us to explore the predictability of resources and stressors, and reminding us to think about the intersectional nature of stressors.
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Affiliation(s)
- Morgan K Hoke
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Anneliese M Long
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Goddard JA, Pagnotta VF, Duncan MJ, Sudiyono M, Pickett W, Leatherdale ST, Patte KA. A prospective study of financial worry, mental health changes and the moderating effect of social support among Canadian adolescents during the COVID-19 pandemic. Health Promot Chronic Dis Prev Can 2024; 44:101-111. [PMID: 38501681 DOI: 10.24095/hpcdp.44.3.04] [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: 03/20/2024]
Abstract
INTRODUCTION The COVID-19 pandemic intensified the impact of risk factors for adolescent mental health, including financial worry. Social support has shown to protect from negative mental health during times of stress. We examined the effect of financial worry on changes in anxiety and depression symptoms among Canadian adolescents prior to and during the pandemic, and assessed whether social support from family and friends moderated any changes. METHODS We analyzed 2-year linked data from the 2018/19 (pre-pandemic) and 2020/21 (during-pandemic) waves of the COMPASS study, with reports from 12 995 Canadian secondary school students. A series of multilevel linear regressions were conducted to examine the main hypotheses under study. RESULTS Students scored an average (SD) of 7.2 (5.8) on the anxiety (GAD-7) and 10.0 (6.5) on the depression (CESD-10) scales; 16.1% reported they experienced financial worry during the pandemic. Financial worry was a strong and significant predictor of increased anxiety scores (+1.7 score between those reporting "true/mostly true" versus "false/mostly false") during the pandemic, but not for depression scores. Low family and friend support were associated with anxiety, and low family support was associated with depression. No significant interactions were detected between social support and financial worry. CONCLUSIONS Pandemic-related financial worry was significantly associated with anxiety in our large sample of Canadian adolescents. Clinical and public health initiatives should be aware of adolescents' financial worry and its associations with anxiety during times of crisis.
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Affiliation(s)
- Jessica A Goddard
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Valerie F Pagnotta
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Markus J Duncan
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Matthew Sudiyono
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - William Pickett
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Karen A Patte
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
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Heller DJ, Madden D, Berhane T, Bickell NA, Van Hyfte G, Miller S, Ozbek U, Lin JY, M Schwartz R, Lopez RA, Arniella G, Mayer V, Horowitz CR, Benn EK, Vangeepuram N. Emotional and Financial Stressors in New York City During the COVID-19 Pandemic: A Consecutive Cross-Sectional Analysis. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01921-5. [PMID: 38381324 PMCID: PMC11336030 DOI: 10.1007/s40615-024-01921-5] [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: 06/30/2023] [Revised: 01/17/2024] [Accepted: 01/20/2024] [Indexed: 02/22/2024]
Abstract
Mental and financial hardship during the COVID-19 pandemic in New York City was severe, but how vulnerable groups have been disproportionately impacted is incompletely understood. In partnership with community stakeholders, we administered a web-based survey to a convenience sample of New York City residents (18 + years) from May 2020 to April 2021 to evaluate their financial and emotional stressors. We analyzed outcomes by race, ethnicity, and education level. A total of 1854 adults completed the survey across three consecutive non-overlapping samples. Fifty-five percent identified other than non-Latinx White. Sixty-four percent reported emotional stress; 38%, 32%, and 32% reported symptoms of anxiety, depression, and post-traumatic stress disorder respectively; and 21% reported a large adverse financial impact. The leading unmet needs were mental health and food services (both 19%), and health services (18%). Need for both resources grew over time. Adverse financial impact directly correlated with presence of all four adverse mental health outcomes above. In multivariate analysis, non-White race and lack of college degree were associated with adverse financial impact, whereas LGBT identity and lack of college degree were associated with mental health impact. Throughout the COVID-19 pandemic, participants in this research demonstrated a large and growing mental and financial strain, disproportionately associated with lower education level, non-White race, and LGBT status. Our findings suggest an urgent need to differentially target COVID-19 mental health and resource support in New York City to persons in these vulnerable communities.
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Affiliation(s)
- David J Heller
- Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, USA.
| | - Devin Madden
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
| | - Timnit Berhane
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
| | - Nina A Bickell
- Institute for Health Equity Research (IHER), Icahn School of Medicine at Mount Sinai, New York, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Grace Van Hyfte
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
| | - Sarah Miller
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
| | - Umut Ozbek
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
| | - Jung-Yi Lin
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
| | | | - Robert A Lopez
- Treadwell Data, 2738 53rd Ave. SW, Seattle, WA, 98116, USA
| | - Guedy Arniella
- Institute for Family Health, 2006 Madison Avenue, New York, NY, 10035, USA
| | - Victoria Mayer
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
| | - Carol R Horowitz
- Institute for Health Equity Research (IHER), Icahn School of Medicine at Mount Sinai, New York, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Emma K Benn
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
| | - Nita Vangeepuram
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Place, New York, NY, 10029, USA
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Pinto RM, Hall E, Im V, Lee CA, Ethan Park S. Disruptions to HIV services due to the COVID pandemic in the USA: a state-level stakeholder perspective. BMC Health Serv Res 2024; 24:196. [PMID: 38350945 PMCID: PMC10865595 DOI: 10.1186/s12913-024-10609-9] [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: 04/01/2023] [Accepted: 01/17/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The United States envisions a 90% reduction in HIV infections by 2030. However, the COVID-19 pandemic disrupted the HIV continuum and disproportionately affected access to social and health services for people at the highest vulnerability. This study shows how stakeholders in the State of Michigan handled disruptions and their key recommendations. As a case study, this study adds to the literature about preparedness for future pandemics. METHODS We interviewed 33 statewide Michigan HIV/AIDS Council members-practitioners, researchers, and community representatives, guiding service planning, improvement, and resource allocations, measuring group cohesiveness using a tested scale. We measured group cohesiveness as a proxy for how individual opinions reflected those of the Council as a group. We used qualitative questions to assess: (1) how the COVID-19 pandemic disrupted HIV prevention; (2) how disruptions were handled; and (3) recommendation to help address disruptions now and in the future. Using thematic analysis, we coded the interviews. RESULTS We found a high degree of cohesiveness. Participants agreed that the pandemic disrupted HIV prevention services (e.g., HIV testing, PrEP education, referrals to primary care, etcetera) offered by community organizations, hospital clinics, and health departments across the state. In response, they developed online and curbside services to maintain HIV services, abate social isolation, and address structural issues like lack of food and public transportation. We organized results in four categories: (1) HIV service disruptions (e.g., "Housing for women and children who are fleeing a legal situation"); (2) Responses to disruptions (e.g., "Some of them, we would say, hey, weather permitting, we'll come out to your car"); (3) Minoritized groups disproportionately affected (e.g., "Especially in my community, to get people if there's ever a vaccine, Black people are going to be the last people to take it"); and (4) Recommendations (below). CONCLUSIONS The pandemic unsettled and further exacerbated every aspect of HIV service provision. The main recommendation was to overhaul communication systems between government and organizations offering HIV services to mitigate disruptions and improve the chances of achieving a 90% reduction.
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Affiliation(s)
- Rogério M Pinto
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI, USA.
| | - Evan Hall
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI, USA
| | - Vitalis Im
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI, USA
| | - Carol A Lee
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Sunggeun Ethan Park
- School of Social Work, University of Michigan, 1080 South University Avenue, Ann Arbor, MI, USA
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Hassan Salman F, Zainelabdin Mohamed Elmahdi Z, Elnour SMB. Psychological repercussions of COVID-19 on health care workers, Sudan. Int J Soc Psychiatry 2024; 70:182-189. [PMID: 37753906 DOI: 10.1177/00207640231199406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
Healthcare workers around the world were confronted with innumerable torments with the emergence of COVID-19. Amid the pandemic, frontline healthcare personnel serve crucial responsibilities and endure significant social, psychological and economic consequences. This cross-sectional study collected demographic data for 1 year from 385 healthcare officials from all the hospitals spread across the state of Khartoum to research the factors that affected the healthcare workers and doctors who were on the frontline to diagnose and treat the patients with potential or confirmed COVID-19. The degree of symptoms of depression, anxiety and insomnia was also assessed through validated measurement tools. The female participants showed more vulnerability to depression, anxiety and insomnia than their male counterparts. It was reported by the end of the study that the healthcare workers in Sudan are under immense psychological hazards.
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Xu Z, Peng Q, Song J, Zhang H, Wei D, Demongeot J, Zeng Q. Bioinformatic analysis of defective viral genomes in SARS-CoV-2 and its impact on population infection characteristics. Front Immunol 2024; 15:1341906. [PMID: 38348041 PMCID: PMC10859446 DOI: 10.3389/fimmu.2024.1341906] [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] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/12/2024] [Indexed: 02/15/2024] Open
Abstract
DVGs (Defective Viral Genomes) are prevalent in RNA virus infections. In this investigation, we conducted an analysis of high-throughput sequencing data and observed widespread presence of DVGs in SARS-CoV-2. Comparative analysis between SARS-CoV-2 and diverse DNA viruses revealed heightened susceptibility to damage and increased sequencing sample heterogeneity within the SARS-CoV-2 genome. Whole-genome sequencing depth variability analysis exhibited a higher coefficient of variation for SARS-CoV-2, while DVG analysis indicated a significant proportion of recombination sites, signifying notable genome heterogeneity and suggesting that a large proportion of assembled virus particles contain incomplete RNA sequences. Moreover, our investigation explored the sequencing depth and DVG content differences among various strains. Our findings revealed that as the virus evolves, there is a notable increase in the proportion of intact genomes within virus particles, as evidenced by third-generation sequencing data. Specifically, the proportion of intact genome in the Omicron strain surpassed that of the Delta and Alpha strains. This observation effectively elucidates the heightened infectiousness of the Omicron strain compared to the Delta and Alpha strains. We also postulate that this improvement in completeness stems from enhanced virus assembly capacity, as the Omicron strain can promptly facilitate the binding of RNA and capsid protein, thereby reducing the exposure time of vulnerable virus RNA in the host environment and significantly mitigating its degradation. Finally, employing mathematical modeling, we simulated the impact of DVG effects under varying environmental factors on infection characteristics and population evolution. Our findings provide an explanation for the close association between symptom severity and the extent of virus invasion, as well as the substantial disparity in population infection characteristics caused by the same strain under distinct environmental conditions. This study presents a novel approach for future virus research and vaccine development.
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Affiliation(s)
- Zhaobin Xu
- Department of Life Science, Dezhou University, Dezhou, China
| | - Qingzhi Peng
- Department of Life Science, Dezhou University, Dezhou, China
| | - Jian Song
- Department of Life Science, Dezhou University, Dezhou, China
| | - Hongmei Zhang
- Department of Life Science, Dezhou University, Dezhou, China
| | - Dongqing Wei
- State Key Laboratory of Microbial Metabolism, Shanghai-Islamabad-Belgrade Joint Innovation Center on Antibacterial Resistances, Shanghai Jiao Tong University, Shanghai, China
- Joint International Research Laboratory of Metabolic & Developmental Sciences and School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
- Zhongjing Research and Industrialization Institute of Chinese Medicine, Zhongguancun Scientific Park, Meixi, Nanyang, Henan, China
- Peng Cheng National Laboratory, Shenzhen, Guangdong, China
| | - Jacques Demongeot
- Laboratory AGEIS EA 7407, Team Tools for e-Gnosis Medical, Faculty of Medicine, University Grenoble Alpes (UGA), F-38700 La Tronche, France
| | - Qiangcheng Zeng
- Department of Life Science, Dezhou University, Dezhou, China
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Siddiq H, Teklehaimanot S, Williams J. An Observational Study Quantifying the Disproportionate Impact of COVID-19 Among Immigrant Adults, 2021 California Health Interview Survey. Public Health Rep 2024; 139:120-128. [PMID: 38018488 PMCID: PMC10905763 DOI: 10.1177/00333549231208485] [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] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVE Substantial data on COVID-19-related morbidity and mortality among medically underserved populations are available, yet data on the social impact of the COVID-19 pandemic among immigrants in the United States are limited. We identified COVID-19-related health and social disparities among US immigrants. METHODS We analyzed predictors of COVID-19-related health and social outcomes (including ever had or thought had COVID-19, vaccine uptake, risk-reduction behaviors, job loss, childcare difficulties, and difficulty paying rent) during the pandemic by citizenship status, using data from the 2021 California Health Interview Survey. The overall sample size included 24 453 US-born citizens, naturalized citizens, and noncitizens aged ≥18 years. We examined relationships between sociodemographic variables, including immigration-related factors, and COVID-19-related health and social outcomes using descriptive, bivariate, and multivariate logistic regression analysis. RESULTS When accounting for sociodemographic characteristics, noncitizens had higher odds than naturalized and US-born citizens of experiencing challenges during the COVID-19 pandemic, including difficulty paying rent (adjusted odds ratio [aOR] = 1.54; 95% CI, 1.47-2.42) and job loss (aOR = 1.43; 95%, CI, 1.14-1.79). At the bivariate level, noncitizens had the highest rate of ever had or thought had COVID-19 (24.7%) compared with US-born citizens (20.8%) and naturalized citizens (16.8%; all P < .001). Noncitizens also had a significantly higher likelihood of risk-reduction behaviors (eg, always wearing a face covering, getting vaccinated if available) than US-born citizens (P < .001). CONCLUSION These findings reveal the disproportionate impact of the COVID-19 pandemic among noncitizens and reflect limited socioeconomic resources, limited access to health care, and precarious employment among noncitizens in California during the pandemic. Citizenship status should be considered a critical immigration-related factor when examining disparities among immigrant populations.
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Affiliation(s)
- Hafifa Siddiq
- Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - James Williams
- Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
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Tesen H, Konno Y, Tateishi S, Mafune K, Tsuji M, Ando H, Nagata T, Matsugaki R, Yoshimura R, Fujino Y. A Cross-sectional Study on the Impact of Unfair Treatment Associated With COVID-19 Infection and Psychological Distress in Japanese Workers. J Occup Environ Med 2024; 66:51-55. [PMID: 37853631 DOI: 10.1097/jom.0000000000002994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
OBJECTIVE Psychological distress is commonly reported sequela in COVID-19-infected people. We investigated the association between experiencing COVID-19 infection and psychological distress in Japan. METHOD A total of 14,901 persons who participated in a follow-up survey in December 2022 were included in the analysis. Odds ratios and regression coefficients were estimated by statistical analysis, with history of COVID-19 infection as the independent variable and presence of psychological distress as the dependent variable. RESULT Experiencing COVID-19 infection was associated with psychological distress. In a model adjusted for "feeling treated unfairly," the association between infection experience and a high K6 score was significantly attenuated. CONCLUSIONS The results showed that the experience of COVID-19 infection is associated with psychological distress. Moreover, most cases of psychological distress among those who experienced COVID-19 infection can be at least partly explained by a perception of unfair treatment.
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Affiliation(s)
- Hirofumi Tesen
- From the Department of Psychiatry, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan (H.T., Y.K., R.Y.); Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan (Y.K., Y.F.); Department of Occupational Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan (S.T.); Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan (K.M.); Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan (M.T.); Department of Work Systems and Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan (H.A.); Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan (T.N.); and Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan (R.M.)
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Dang JHT, Chen S, Hall S, Campbell JE, Chen MS, Doescher MP. Tobacco and marijuana use during the COVID-19 pandemic lockdown among American Indians residing in California and Oklahoma. Tob Induc Dis 2023; 21:171. [PMID: 38125581 PMCID: PMC10731663 DOI: 10.18332/tid/174819] [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: 08/14/2023] [Revised: 10/21/2023] [Accepted: 11/04/2023] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION American Indian (AI) people experience a disproportionate tobacco and marijuana burden which may have been exacerbated by the COVID-19 pandemic. Little is known about the tobacco and marijuana habits of American Indian individuals during the COVID-19 pandemic. The objective of this study is to examine tobacco and marijuana use as well as change in use during the COVID-19 pandemic among the American Indian community. METHODS This cross-sectional study analyzes survey data from a convenience sample of American Indian individuals residing in California and Oklahoma and included adults with and without cancer that resided in both rural and urban areas (n=1068). RESULTS During October 2020 - January 2021, 36.0% of participants reported current use of tobacco products, 9.9% reported current use of marijuana products, and 23.7% reported increased use of tobacco and/or marijuana in the past 30 days, with no difference between those with cancer and those without cancer. Tobacco use was associated with marital status, age, employment status, COVID-19 exposure, COVID-19 beliefs, and alcohol consumption. Marijuana use was associated with COVID-19 beliefs, alcohol consumption, and income level. Increased tobacco and/or marijuana use was associated with baseline use of those products. Nearly a quarter of participants reported increased use of tobacco and/or marijuana products during the COVID-19 pandemic. CONCLUSIONS We observed high rates of tobacco use during the COVID-19 pandemic, consistent with other studies. Research is needed to examine whether tobacco and marijuana use will decrease to pre-pandemic levels post-pandemic or if these behaviors will persist post-pandemic. Given these findings, there is a pressing need to increase access to evidence-based tobacco and marijuana treatment services in the AI population post COVID-19 pandemic.
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Affiliation(s)
- Julie H T Dang
- Division of Health Policy and Management, Department of Public Health Sciences, School of Medicine, University of California, Davis, Sacramento, United States
| | - Sixia Chen
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, United States
| | - Spencer Hall
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, United States
| | - Janis E Campbell
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, United States
| | - Moon S Chen
- Division of Hematology and Oncology, Department of Internal Medicine, School of Medicine, University of California, Davis, Sacramento, United States
| | - Mark P Doescher
- Department of Family and Preventive Medicine, College of Medicine, University of Oklahoma College of Health Science Center, Oklahoma City, United States
- Stephenson Cancer Center, Oklahoma City, United States
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Onovbiona H, Quetsch L, Bradley R. Racial and Practical Barriers to Diagnostic and Treatment Services for Black Families of Autistic Youth: A Mixed-Method Exploration. J Autism Dev Disord 2023:10.1007/s10803-023-06166-5. [PMID: 38038872 DOI: 10.1007/s10803-023-06166-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2023] [Indexed: 12/02/2023]
Abstract
The present study explored the role race-related barriers and practical barriers to treatment participation play in treatment effectiveness and satisfaction among Black families with autistic youth using a mixed-method approach. In a sample of Black caregivers with autistic youth (N = 101), multiple regressions were conducted to examine the impact of reported racial and practical barriers on parental stress, treatment effectiveness, and treatment satisfaction. Caregivers provided further narratives on their experience navigating diagnostic and treatment services in qualitative interviews. The study demonstrated that Black caregivers of autistic youth are still encountering several racial and logistical barriers when seeking treatment and diagnostic services for their children. These barriers negatively impact caregiver stress and caregiver perceived treatment quality. Contrary to the barriers and stress experienced by Black caregivers, caregivers are generally satisfied with the treatments they are utilizing and find them helpful. The narratives told by caregivers further elucidate the tumultuous experiences of Black caregivers as they seek diagnostic and treatment services for their children. An experience that may be worsened by family, professional, and systemic barriers, and can be improved by advocacy, acceptance, peer and community support, and increased knowledge. Black families of autistic youth call for increased compassion, support, training, and humility among professionals who serve autistic youth.
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Rudenstine S, McNeal K, Schulder T, Ettman CK, Hernandez M, Gvozdieva K, Galea S. Education is protective against depressive symptoms in the context of COVID-19. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2869-2875. [PMID: 34871526 DOI: 10.1080/07448481.2021.2002338] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 09/08/2021] [Accepted: 10/29/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study assessed current education stage (ie, undergraduate, graduate) as protective against depressive symptoms among a low socioeconomic status (SES) student population in a public university, in the context of COVID-19-related stressors. PARTICIPANTS Participants were students at The City University of New York (CUNY) during the Spring 2020. METHODS Demographic data, symptom severity, and current educational stage were collected via an online university-wide survey between April 8, 2020 and May 2, 2020. RESULTS The prevalence of probable depression was lower amongst persons who reported being currently in a more advanced educational stage compared to people currently in a lower educational stage. COVID-19-related stressor exposure was the largest predictor of depressive symptoms, followed by demographics and current education stage. CONCLUSIONS Current education stage is related to depressive symptoms during COVID-19. Pandemic-related educational disruptions and shifts to remote learning may limit educational achievement for low-SES student populations creating further threats to these students' health.
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Affiliation(s)
- Sasha Rudenstine
- Department of Psychology, City College of New York, New York, New York, USA
| | - Kat McNeal
- Department of Psychology, City College of New York, New York, New York, USA
| | - Talia Schulder
- Department of Psychology, City College of New York, New York, New York, USA
| | | | - Michelle Hernandez
- Department of Psychology, City College of New York, New York, New York, USA
| | - Kseniia Gvozdieva
- Department of Psychology, City College of New York, New York, New York, USA
| | - Sandro Galea
- School of Public Health, Boston University, Boston, Massachusetts, USA
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Mojtahedi Z, Yoo J, Kim P, Kim Y, Shen JJ, Wang BL. Changes in characteristics of inpatient respiratory conditions from 2019 to 2021 (before and during the COVID-19 pandemic). Front Public Health 2023; 11:1268321. [PMID: 38026399 PMCID: PMC10665887 DOI: 10.3389/fpubh.2023.1268321] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Background The COVID-19 pandemic has resulted in an increase in the number of individuals with respiratory conditions that require hospitalization, posing new challenges for the healthcare system. Recent respiratory condition studies have been focused on the COVID-19 period, with no comparison of respiratory conditions before and during the pandemic. This study aimed to examine hospital-setting respiratory conditions regarding potential changes in length of stay (LOS), mortality, and total charge, as well as socioeconomic disparities before and during the pandemic. Methods The study employed a pooled cross-sectional design based on the State Inpatient Data Nevada for 2019 (prior to the COVID-19 pandemic) and 2020-2021 (during the pandemic) and investigated all respiratory conditions, identified by the International Classification of Disease, 10th Revision codes (n = 227,338). Descriptive analyses were carried out for the three years. Generalized linear regression models were used for multivariable analyses. Outcome measures were hospital LOS, mortality, and total charges. Results A total of 227,338 hospitalizations with a respiratory condition were included. Hospitalizations with a respiratory condition increased from 65,896 in 2019 to 80,423 in 2020 and 81,018 in 2021. The average LOS also increased from 7.9 days in 2019 to 8.8 days in 2020 but decreased to 8.1 days in 2021; hospital mortality among patients with respiratory conditions increased from 7.7% in 2019 to 10.2% but decreased to 9.6% in 2021; and the total charges per discharge were $159,119, $162,151, and $161,733 from 2019 to 2021, respectively (after adjustment for the inflation rate). Hispanic, Asian, and other race patients with respiratory conditions were 1-3 times more likely than white patients to have higher mortality and LOS. Medicaid patients and non-White patients were predictors of a higher respiratory-related hospital total charge. Conclusion Demographic and socioeconomic factors were significantly associated with respiratory-related hospital utilization in terms of LOS, mortality, and total charge.
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Affiliation(s)
- Zahra Mojtahedi
- Department of Healthcare Administration and Policy, School of Public Health, University of Nevada, Las Vegas, NV, United States
| | - Ji Yoo
- School of Medicine, University of Nevada, Las Vegas, NV, United States
| | - Pearl Kim
- Department of Healthcare Administration and Policy, School of Public Health, University of Nevada, Las Vegas, NV, United States
| | - Yonsu Kim
- Department of Healthcare Administration and Policy, School of Public Health, University of Nevada, Las Vegas, NV, United States
| | - Jay J. Shen
- Department of Healthcare Administration and Policy, School of Public Health, University of Nevada, Las Vegas, NV, United States
| | - Bing-Long Wang
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Min J, Hein KE, Medlin AR, Mullins-Sweatt SN. Prevalence rate trends of borderline personality disorder symptoms and self-injurious behaviors in college students from 2017 to 2021. Psychiatry Res 2023; 329:115526. [PMID: 37839319 DOI: 10.1016/j.psychres.2023.115526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/30/2023] [Accepted: 10/02/2023] [Indexed: 10/17/2023]
Abstract
The current study examines the prevalence rates of borderline personality disorder (BPD) symptoms and nonsuicidal self-injury (NSSI) behaviors amongst college students over a five-year period, including pre- and during the COVID pandemic. Online prescreener surveys were completed by undergraduate students (n = 12,756) attending a large Southern Plains University every semester from Spring of 2017 to Spring of 2021. The percentage of students with NSSI history and significant BPD symptoms were visualized by semester to examine trends over time. A series of logistic regressions and negative binomial regressions were conducted on NSSI history and BPD symptoms to examine whether the endorsement rates have been increasing over time and to compare before and during COVID pandemic. There was an increasing trend of NSSI rates and significant BPD symptoms over time for all sexes. Furthermore, there was a steeper increase in BPD symptoms specifically in female students over the last five years. Additionally, there was a significant increase in odds of elevated BPD symptoms and NSSI behaviors in the college students enrolled during the COVID pandemic compared with pre-COVID. Overall, there has been an increasing trend in BPD symptoms and NSSI rates over the last few years, including during the COVID pandemic.
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Affiliation(s)
- Jiwon Min
- Department of Psychology, Oklahoma State University, Stillwater, USA.
| | - Katherine E Hein
- Department of Psychology, Oklahoma State University, Stillwater, USA
| | - Austin R Medlin
- Department of Health & Wellness Design, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
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Al-Hroub A, Reis S, Madaus J, Shuayb I. Editorial: Serving vulnerable and marginalized populations in social and educational contexts. Front Psychol 2023; 14:1310260. [PMID: 37965651 PMCID: PMC10642171 DOI: 10.3389/fpsyg.2023.1310260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 10/16/2023] [Indexed: 11/16/2023] Open
Affiliation(s)
- Anies Al-Hroub
- Department of Education, American University of Beirut, Beirut, Lebanon
| | - Sally Reis
- Neag School of Education, University of Connecticut, Storrs, CT, United States
| | - Joseph Madaus
- Neag School of Education, University of Connecticut, Storrs, CT, United States
| | - Itab Shuayb
- Neag School of Education, University of Cambridge, Cambridge, United Kingdom
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Vallée A. Geoepidemiological perspective on COVID-19 pandemic review, an insight into the global impact. Front Public Health 2023; 11:1242891. [PMID: 37927887 PMCID: PMC10620809 DOI: 10.3389/fpubh.2023.1242891] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
The COVID-19 pandemic showed major impacts, on societies worldwide, challenging healthcare systems, economies, and daily life of people. Geoepidemiology, an emerging field that combines geography and epidemiology, has played a vital role in understanding and combatting the spread of the virus. This interdisciplinary approach has provided insights into the spatial patterns, risk factors, and transmission dynamics of the COVID-19 pandemic at different scales, from local communities to global populations. Spatial patterns have revealed variations in incidence rates, with urban-rural divides and regional hotspots playing significant roles. Cross-border transmission has highlighted the importance of travel restrictions and coordinated public health responses. Risk factors such as age, underlying health conditions, socioeconomic factors, occupation, demographics, and behavior have influenced vulnerability and outcomes. Geoepidemiology has also provided insights into the transmissibility and spread of COVID-19, emphasizing the importance of asymptomatic and pre-symptomatic transmission, super-spreading events, and the impact of variants. Geoepidemiology should be vital in understanding and responding to evolving new viral challenges of this and future pandemics.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology and Public Health, Foch Hospital, Suresnes, France
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Bleckmann C, Leyendecker B, Busch J. Sexual and Gender Minorities Facing the Coronavirus Pandemic: A Systematic Review of the Distinctive Psychosocial and Health-Related Impact. JOURNAL OF HOMOSEXUALITY 2023; 70:2741-2762. [PMID: 35576127 DOI: 10.1080/00918369.2022.2074335] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Sexual and gender minorities (SGM) constitute vulnerable groups in many countries. Thus, they might be affected to a different extent than heterosexual and cisgender individuals by the Coronavirus pandemic. This systematic review aimed to summarize the state of international research on the mental and physical health-related as well as socioeconomic effects of the Coronavirus pandemic on SGM individuals. Following the PRISMA protocol, we identified 35 publications, including different article formats. We considered minority stress theory and intersectionality in synthesizing the reviewed literature. Our key finding implicates that both minority- and pandemic-specific adversities have increased the vulnerabilities of SGM individuals during the Coronavirus pandemic. Minority-specific stressors include discrimination experiences, poorer mental and physical health, and fewer socioeconomic resources. Pandemic-specific challenges such as the deferral and delay of medication or school closing have exposed certain SGM subgroups (transgender individuals, young SGM) to particularly high risk. Moreover, the reviewed evidence suggests distinctive interactive effects of minority-specific stressors with pandemic-specific challenges (e.g., being forced to stay close to rejecting others during lockdown periods). A significant share of the included literature was US-based, while research from other countries remained scarce. The specific mechanisms still deserve to be better understood to protect SGM in future crises, especially during pandemics.
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Affiliation(s)
- Clara Bleckmann
- Child and Family Research, Ruhr-University Bochum, Bochum, Germany
| | | | - Julian Busch
- Child and Family Research, Ruhr-University Bochum, Bochum, Germany
- Center for Research on Education and School Development, TU Dortmund University, Dortmund, Germany
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Cross FL, Wileden L, Buyuktur AG, Platt J, Morenoff JD, Aramburu J, Militzer M, Esqueda AP, Movva P, Zhao Z, Sawant K, Valbuena F, Bailey S, Israel B, Marsh EE, Woolford SJ. MICEAL Black and Latinx Perspectives on COVID-19 Vaccination: A Mixed-Methods Examination. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01815-y. [PMID: 37815755 DOI: 10.1007/s40615-023-01815-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/19/2023] [Accepted: 09/19/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVES To describe the differences and similarities in perceptions and attitudes regarding COVID-19 vaccination among Black and Latinx Michiganders. METHODS Utilizing a convergent mixed-methods approach, forty interviews were conducted with 24 Black and 16 Latinx community members between December 2020 and June 2021 across four Michigan counties disproportionately affected by COVID-19. Survey data were collected from a representative sample of 1598 individuals living in Detroit between January and March 2021. RESULTS Vaccine hesitancy was a more prevalent theme among Black interview participants than Latinx participants. Trust in experts and vaccine access were significantly more influential in the decision to vaccinate for Latinx residents compared to Black residents. Latinx individuals reported greater intention to receive a COVID-19 vaccine compared to Black respondents. Multinomial logit models revealed that 30% of Black participants expressed hesitancy about the COVID-19 vaccine compared to 10% of Latinx respondents. CONCLUSIONS AND IMPLICATIONS This study provides a deeper understanding of key differences and similarities in vaccine acceptance/hesitancy across race/ethnicity. The findings can enhance health interventions and outcomes by informing the development of culturally responsive practices tailored to specific communities.
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Affiliation(s)
- Fernanda L Cross
- School of Social Work, University of Michigan, Ann Arbor, MI, USA.
| | - Lydia Wileden
- Mansueto Institute for Urban Innovation, Division of the Social Sciences, University of Chicago, Chicago, IL, USA
| | - Ayse G Buyuktur
- School of Information, University of Michigan, Ann Arbor, MI, USA
| | - Jodyn Platt
- Department of Learning Health Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Jeffrey D Morenoff
- Gerald R. Ford School of Public Policy, Department of Sociology, and Population Studies Center, University of Michigan, Ann Arbor, MI, USA
| | - Jasmin Aramburu
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Maria Militzer
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | - Pranati Movva
- College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Ziyu Zhao
- Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Kashmira Sawant
- School of Information, University of Michigan, Ann Arbor, MI, USA
| | - Felix Valbuena
- Community Health and Social Services Center, Detroit, MI, USA
| | - Sarah Bailey
- Michigan Institute for Clinical & Health Research, University of Michigan, Ann Arbor, MI, USA
| | - Barbara Israel
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Erica E Marsh
- Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Susan J Woolford
- Susan B Meister Child Health Evaluation and Research Center, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
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Cai J, Bidulescu A. Trends in unmet health care needs among adults in the U.S., 2019-2021. Prev Med 2023; 175:107699. [PMID: 37690672 DOI: 10.1016/j.ypmed.2023.107699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 09/03/2023] [Accepted: 09/06/2023] [Indexed: 09/12/2023]
Abstract
To examine recent trends in unmet health care needs among US adults, cross-sectional data of 93,047 adults from 2019 to 2021 National Health Interview Survey were analyzed. The weighted prevalence and changes in prevalence of cost-related or COVID-19-related unmet health care needs were estimated, first overall and then stratified by socio-demographic characteristics. The prevalence of cost-related unmet health care needs was 8.3% (95% CI: 7.8%, 8.8%) in 2019, which significantly decreased to 6.6% (95% CI: 6.2%, 7.0%) in 2020 and 6.1% (95% CI: 5.7%, 6.4%) in 2021. Across most socio-demographic groups, the prevalence of cost-related unmet health care needs significantly decreased between 2019 and 2020 (absolute changes ranged from -7.4% to -1%) and between 2019 and 2021 (absolute changes ranged from -10.5% to -1.2%), with significant reductions among uninsured adults, adults below the federal poverty level, and Hispanics. The prevalence of COVID-19-related unmet health care needs was 15.7% (95% CI: 14.9%, 16.4%) in 2020, which decreased to 11.9% (95% CI: 11.5%, 12.4%) in 2021. The prevalence of COVID-19-related unmet health care needs significantly decreased across most socio-demographic groups between 2020 and 2021 (absolute changes ranged from -4.9% to -2.4%), with significant reductions among the older, the unemployed, non-Hispanic Black adults, and adults with education level ≥ college. Overall, a modest decrease in the prevalence of both cost-related and COVID-19-related unmet health care needs was observed between 2019 and 2021. However, the fact that over 10% of US adults had unmet health care needs because of the COVID-19 pandemic is still concerning, warranting continued surveillance.
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Affiliation(s)
- Jiahui Cai
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, United States.
| | - Aurelian Bidulescu
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, United States
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Johnson KF, Hood KB, Moreno O, Fuentes L, Williams CD, Vassileva J, Amstadter AB, Dick DM. COVID-19-Induced Inequalities and Mental Health: Testing the Moderating Roles of Self-rated Health and Race/Ethnicity. J Racial Ethn Health Disparities 2023; 10:2093-2103. [PMID: 36018451 PMCID: PMC9415252 DOI: 10.1007/s40615-022-01389-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 06/20/2022] [Accepted: 08/05/2022] [Indexed: 11/05/2022]
Abstract
This study examines the relationship among COVID-19-induced social, economic, and educational inequalities on mental health (i.e., anxiety and depression). This study also examines if levels of self-rated health (SRH) moderate the relationship (i.e., COVID-induced inequalities [CII] and mental health), as well as examines the racial/ethnic group differences among 567 young adults in the mid-Atlantic region. Using a moderation model, results indicate that CII were significantly related to depression (b = .221, t(554) = 4.59, p = .000) and anxiety (b = .140, t(555) = 3.23, p = .001). SRH and race/ethnicity also moderated both relationships. At above-average SRH (i.e., moderator), higher CII were also significantly related to lower anxiety (Asian young adults only) and lower depression (Asian and White young adults only). Overall, SRH and race/ethnicity are important factors in the mental health impact of COVID-19 on young adults.
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Affiliation(s)
- Kaprea F Johnson
- Department of Educational Studies, The Ohio State University, Columbus, OH, USA
| | - Kristina B Hood
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin Street, Richmond, VA, 23284-2018, USA.
| | - Oswaldo Moreno
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin Street, Richmond, VA, 23284-2018, USA
| | - Lisa Fuentes
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin Street, Richmond, VA, 23284-2018, USA
| | - Chelsea Derlan Williams
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin Street, Richmond, VA, 23284-2018, USA
| | - Jasmin Vassileva
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin Street, Richmond, VA, 23284-2018, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Ananda B Amstadter
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin Street, Richmond, VA, 23284-2018, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Danielle M Dick
- Department of Psychology, Virginia Commonwealth University, 806 W Franklin Street, Richmond, VA, 23284-2018, USA
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Reigada LC, Kaighobadi F, Niwa EY, Ahmed T, Carlson DJ, Shane J. An intersectional examination of the impact of COVID-stress and discrimination on college students' resilience and mental health. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-11. [PMID: 37722811 DOI: 10.1080/07448481.2023.2249104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 08/09/2023] [Indexed: 09/20/2023]
Abstract
Objective: To investigate the impact of COVID-stress and discrimination on mental health among a group of diverse college students using an intersectional framework. Participants: One thousand six hundred seventy-one undergraduate students (Mage = 20.42, SD = 2.74) were recruited from nine college campuses. Methods: Participants completed an online questionnaire assessing mental health symptoms, COVID-stress, and in-school discrimination. Hierarchical regressions and multi-group SEM path analysis were conducted to examine differences across intersectional identities. Results: Female-identifying students reported higher COVID-stress, anxiety and depressive symptoms, and lower resilience compared to males. COVID-stress and discrimination were highest among certain minoritized student groups. Using an intersectional framework, more COVID-stress and discrimination were associated with increased anxiety for almost all women of color. Unexpectedly, COVID-stress predicted anxiety symptoms for almost all male intersectional groups. Conclusions: Findings reaffirm the intersectional framework and highlight significant disparities in how students experience COVID-stress, discrimination, and mental health outcomes along dimensions of gender and race/ethnicity.
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Affiliation(s)
- Laura C Reigada
- Department of Psychology, Brooklyn College, City University of New York, Brooklyn, New York, USA
- Department of Psychology, The Graduate Center, City University of New York, Brooklyn, New York, USA
| | - Farnaz Kaighobadi
- Department of Psychology, Bronx Community College, City University of New York, Bronx, New York, USA
| | - Erika Y Niwa
- Department of Psychology, Brooklyn College, City University of New York, Brooklyn, New York, USA
- Department of Psychology, The Graduate Center, City University of New York, Brooklyn, New York, USA
| | - Tanzina Ahmed
- Department of Psychology, Kingsborough Community College, City University of New York, Brooklyn, New York, USA
| | - Daniel J Carlson
- Department of Psychology, Brooklyn College, City University of New York, Brooklyn, New York, USA
| | - Jacob Shane
- Department of Psychology, Brooklyn College, City University of New York, Brooklyn, New York, USA
- Department of Psychology, The Graduate Center, City University of New York, Brooklyn, New York, USA
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Smith MH, Broscoe M, Chakraborty P, Hill J, Hood R, McGowan M, Bessett D, Norris AH. COVID-19 and abortion in the Ohio River Valley: A case study of Kentucky, Ohio, and West Virginia. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2023; 55:178-191. [PMID: 37571959 DOI: 10.1363/psrh.12244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
INTRODUCTION During early stages of COVID-19 in the United States, government representatives in Kentucky, Ohio, and West Virginia restricted or threatened to restrict abortion care under elective surgery bans. We examined how abortion utilization changed in these states. METHODOLOGY We examined COVID-19 abortion-related state policies implemented in March and April 2020 using publicly available sources. We analyzed data on abortions by method and gestation and experiences of facility staff, using a survey of 14 facilities. We assessed abortions that took place in February-June 2020 and February-June 2021. RESULTS In February-June 2020 the monthly average abortion count was 1916; 863 (45%) were medication abortions and 229 (12%) were ≥14 weeks gestation. Of 1959 abortions performed across all three states in April 2020, 1319 (67%) were medication abortions and 231 (12%) were ≥14 weeks gestation. The shift toward medication abortion that took place in April 2020 was not observed in April 2021. Although the total abortion count in the three-state region remained steady, West Virginia had the greatest decline in total abortions, Ohio experienced a shift from instrumentation to medication abortions, and Kentucky saw little change. Staff reported increased stress from concerns over health and safety and increased scrutiny by the state and anti-abortion protesters. DISCUSSION Although abortion provision continued in this region, policy changes restricting abortion in Ohio and West Virginia resulted in a decrease in first trimester instrumentation abortions, an overall shift toward medication abortion care, and an increase in stress among facility staff during the early phase of COVID-19.
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Affiliation(s)
- Mikaela H Smith
- Division of Epidemiology, College of Public Health, Ohio State University, Columbus, Ohio, USA
| | - Molly Broscoe
- Department of Sociology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Payal Chakraborty
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jessie Hill
- Case Western Reserve University School of Law, Cleveland, Ohio, USA
| | - Robert Hood
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Michelle McGowan
- Biomedical Ethics Research Program, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
- Department of Women's, Gender & Sexuality Studies, University of Cincinnati, Cincinnati, Ohio, USA
| | - Danielle Bessett
- Department of Sociology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Alison H Norris
- Division of Epidemiology, College of Public Health, Ohio State University, Columbus, Ohio, USA
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Ejezie CL, Savas LS, Durand C, Shegog R, Cuccaro P. The prevalence of human papillomavirus vaccination among racial and ethnic minority adolescents during the COVID-19 pandemic. JNCI Cancer Spectr 2023; 7:pkad065. [PMID: 37651597 PMCID: PMC10521629 DOI: 10.1093/jncics/pkad065] [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: 05/30/2023] [Revised: 07/03/2023] [Accepted: 08/24/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) vaccination among adolescents has steadily improved over the past several years. However, research conducted to determine whether the COVID-19 pandemic disrupted this positive trend in HPV vaccine initiation among racial and ethnic minority adolescents is limited. Therefore, this study was conducted to determine if the COVID-19 pandemic and the resulting changes in the US health-care sector affected the increasing HPV vaccine initiation among non-Hispanic Black and Hispanic adolescents aged 13-17 years. METHODS Using a cross-sectional design to examine data from the National Immunization Survey-Teen (2019-2021), logistic regression and moderation analysis were used to model race-specific variations in HPV vaccine initiation (n = 49 031). Two-sided P values of up to .05 were considered statistically significant. RESULTS Hispanic (adjusted odds ratio [AOR] = 1.35, 95% confidence interval [CI] = 1.16 to 1.57) and non-Hispanic Black (AOR = 1.29, 95% CI = 1.10 to 1.51) adolescents had higher odds of HPV vaccine initiation than did non-Hispanic White adolescents. Additionally, the odds of HPV vaccine initiation were higher in 2021 (AOR = 1.22, 95% CI = 1.08 to 1.38) than in 2019. Other variables-age, region, sex, insurance status, and poverty status-were also associated with HPV vaccine initiation. CONCLUSION These findings demonstrate that during the COVID-19 pandemic, racial and ethnic minorities had higher odds of receiving the HPV vaccine. Therefore, more research of the impact of the pandemic on HPV vaccine initiation among non-Hispanic White and racial and ethnic minority adolescents is needed.
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Affiliation(s)
- Chinenye Lynette Ejezie
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, TX, USA
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lara S Savas
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, TX, USA
| | - Casey Durand
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, TX, USA
| | - Ross Shegog
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, TX, USA
| | - Paula Cuccaro
- Department of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Houston, TX, USA
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Park C, Delgado C, Irfan A. Perspectives on the Doctor of Public Health (DrPH) education among students and alumni in the United States: a cross-sectional national online survey. BMC Public Health 2023; 23:1558. [PMID: 37587431 PMCID: PMC10428527 DOI: 10.1186/s12889-023-16402-3] [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: 02/06/2023] [Accepted: 07/27/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND This study explored the current and desired identity of the DrPH degree, focusing on whether the competencies set by the Council on Education for Public Health (CEPH) adequately prepare DrPH graduates for effective public health practice. Additionally, the study investigated the necessity of standardization in DrPH training, referring to a consensus-driven approach that equips future public health practitioners with practical skillsets applicable in real-world scenarios. METHODS A national cross-sectional online survey titled "National DrPH leaders & practitioners needs assessment" was conducted from November 2020 to February 2021. The survey was based on a self-report by DrPH students and DrPH professionals, consisting of the following two main components: (1) how their DrPH training aligns with CEPH competencies and (2) how they perceive the identity of the DrPH degree. Convenience sampling was used to collect the data, which may have limited representation for all DrPH institutions in the United States. RESULTS A total of 222 participants (140 current DrPH students and 82 alumni) completed the survey. The mean of the 10-point Likert scale for the degree to which the DrPH training aligns with 26 CEPH competencies (1: not at all - 10: absolutely) ranged from 6.3 (SD: 2.78) to 7.96 (SD: 2.16). The majority of participants (191/222, 86.04%) were satisfied with the knowledge and skills reflected in their training based on the CEPH competencies. However, more than half of the participants (117/222, 52.70%) sought additional professional development/training outside their institutions. DrPH leaders and practitioners faced barriers where the value of their work might not be fully recognized and endorsed. Participants indicated that the DrPH education should be further distinguished from the PhD education. CONCLUSIONS The DrPH degree holds significant value within the academic sphere of public health practice in the United States. However, its distinction from PhD programs poses a challenge for employers and organizations in the field, requiring attention from higher education programs. By solidifying the DrPH's identity, graduates can effectively address diverse public health issues and contribute to creating a safe and healthy environment, including addressing the challenges posed by the COVID-19 pandemic.
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Affiliation(s)
- Chulwoo Park
- Department of Public Health and Recreation, San José State University, San Jose, CA, USA.
| | | | - Ans Irfan
- Department of Environmental and Occupational Health, The George Washington University, Washington D.C, USA
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Humphries DL, Sodipo M, Jackson SD. The intersectionality-based policy analysis framework: demonstrating utility through application to the pre-vaccine U.S. COVID-19 policy response. Front Public Health 2023; 11:1040851. [PMID: 37655290 PMCID: PMC10466398 DOI: 10.3389/fpubh.2023.1040851] [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: 09/09/2022] [Accepted: 07/28/2023] [Indexed: 09/02/2023] Open
Abstract
Few guidelines exist for the development of socially responsible health policy, and frameworks that balance considerations of data, strategy, and equity are limited. The Intersectionality-Based Policy Analysis (IBPA) framework utilizes a structured questioning process to consider problems and policies, while applying guiding principles of equity, social justice, power, intersectionality, and diversity of knowledge and input. We apply the IBPA framework's guiding principles and questions to the pre-vaccine U.S. COVID-19 policy response. Results suggest the IBPA approach is a promising tool for integrating equity considerations in the development of policy solutions to urgent US public health challenges, including the COVID-19 pandemic. We found the IBPA framework particularly useful in differentiating between problems or policies and representations of problems or policies, and in considering the impacts of representations on different groups. The explicit inclusion of short-, medium- and long-term solutions is a reminder of the importance of holding a long-term vision of the equitable public health system we want while working towards immediate change.
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Affiliation(s)
| | - Michelle Sodipo
- Yale School of Public Health, New Haven, CT, United States
- Harvard T.H. Chan School of Public Health, Cambridge, MA, United States
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McCabe CJ, Rhew IC, Walukevich-Dienst K, Graupensperger S, Lee CM. Increased coping motives during the COVID-19 pandemic widen cannabis disparities between sexual minoritized and nonminoritized young adults: A bimonthly assessment of data preceding and spanning the pandemic. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:670-680. [PMID: 37307364 PMCID: PMC10524690 DOI: 10.1037/adb0000939] [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] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Since the start of the coronavirus pandemic, some U.S. adults have increased alcohol and cannabis use frequency to cope with distress. Among sexual minoritized young adults (SM YAs), coping-related use may be greater due to disproportionate negative social and financial consequences of the pandemic. Nonetheless, it remains unclear whether pandemic substance use has increased among SM YAs compared to non-SM YAs relative to prepandemic levels and whether heightened coping motives mediate these potential differences. METHOD A total of 563 YAs (18-24 years at baseline; 31.0% SM) provided survey data collected across 12 bimonthly assessments. Six assessments were measured in 2015 or 2016 and six across the coronavirus pandemic (2020-2021). Controlling for prepandemic assessments matched by calendar month, latent structural equation models examined group differences in alcohol and cannabis frequency and consequences across the COVID-19 period and tested coping motives as mediators of these differences. RESULTS Substance use and consequences were similar during the pandemic relative to prepandemic levels across groups. Nonetheless, compared to non-SM individuals, SM participants reported greater cannabis frequency, consequences, and cannabis coping motives during the pandemic independent of prepandemic levels. Cannabis use and consequences were each explained largely by coping motives during the pandemic among SM compared to non-SM YAs. These patterns were not found for alcohol outcomes. CONCLUSIONS The COVID-19 pandemic has widened cannabis disparities between SM and non-SM YAs, due in part to pandemic-related increases in coping motives. Responsive public policy is needed that may prevent and remit SM cannabis disparities during societal crises. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Connor J McCabe
- Department of Psychiatry, Center for the Study of Health and Risk Behaviors, University of Washington
| | - Isaac C Rhew
- Department of Psychiatry, Center for the Study of Health and Risk Behaviors, University of Washington
| | | | - Scott Graupensperger
- Department of Psychiatry, Center for the Study of Health and Risk Behaviors, University of Washington
| | - Christine M Lee
- Department of Psychiatry, Center for the Study of Health and Risk Behaviors, University of Washington
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Williams CD, DeLaney EN, Moreno O, Santana A, Fuentes L, Muñoz G, Elias MDJ, Johnson KF, Peterson RE, Hood KB, Vassileva J, Dick DM, Amstadter AB. Interactions between COVID-19 family home disruptions and relationships predicting college students' mental health over time. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2023; 37:592-602. [PMID: 37213173 PMCID: PMC10524332 DOI: 10.1037/fam0001085] [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] [Indexed: 05/23/2023]
Abstract
The present study tested whether family home disruptions during the COVID-19 pandemic in the Spring 2020 (Time 1; T1) informed mental health (i.e., posttraumatic stress disorder [PTSD], depressive, and anxiety symptoms) 7 months later in Fall 2020 at T2 and whether family relationship quality moderated relations. Multigroup path analysis models were used to test whether there were significant differences in relations by emerging adults' ethnic-racial backgrounds. Participants were 811 Black, Asian American, Latine, and White emerging adult college students (Mage = 19.95, SD = .33), and the majority (79.6%) who reported their gender identified as cisgender women. Results indicated that across all individuals, T1 family relationship quality moderated relations between T1 family home disruptions and T2 anxiety and depressive symptoms. At lower levels of T1 family relationship quality, family home disruptions predicted greater T2 depressive and anxiety symptoms. At higher levels of T1 family relationship quality, these relations were not significant. Findings highlight that family relationship quality is an important protective factor for diverse emerging adult college students. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Eryn N DeLaney
- Department of Psychology, Virginia Commonwealth University
| | - Oswaldo Moreno
- Department of Psychology, Virginia Commonwealth University
| | | | - Lisa Fuentes
- Department of Psychology, Virginia Commonwealth University
| | - Geovani Muñoz
- Department of Psychology, Virginia Commonwealth University
| | | | | | | | | | | | - Danielle M Dick
- Department of Human and Molecular Genetics, Virginia Commonwealth University
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Nomali M, Mehrdad N, Heidari ME, Ayati A, Yadegar A, Payab M, Olyaeemanesh A, Larijani B. Challenges and solutions in clinical research during the COVID-19 pandemic: A narrative review. Health Sci Rep 2023; 6:e1482. [PMID: 37554954 PMCID: PMC10404843 DOI: 10.1002/hsr2.1482] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/15/2023] [Accepted: 07/25/2023] [Indexed: 08/10/2023] Open
Abstract
Background and Aims The COVID-19 pandemic has presented significant challenges to clinical research, necessitating the adoption of innovative and remote methods to conduct studies. This study aimed to investigate these challenges and propose solutions for conducting clinical research during the pandemic. Methods A narrative review was conducted (approval ID: IR.AMS.REC.1401.029), utilizing keyword searches in PubMed and Web of Science (WOS) citation index expanded (SCI-EXPANDED) from January 2020 to January 2023. Keywords included COVID-19, clinical research, barriers, obstacles, facilitators and enablers. Results Out of 2508 records retrieved, 43 studies were reviewed, providing valuable insights into the challenges and corresponding solutions for conducting clinical research during the COVID-19 pandemic. The identified challenges were categorized into four main groups: issues related to researchers or investigators, issues related to participants and ethical concerns, administrative issues, and issues related to research implementation. To address these challenges, multiple strategies were proposed, including remote monitoring through phone or video visits, online data collection and interviews to minimize in-person contact, development of virtual platforms for participant interaction and questionnaire completion, consideration of financial incentives, adherence to essential criteria such as inclusion and exclusion parameters, participant compensation, and risk assessment for vulnerable patients. Conclusion The COVID-19 pandemic has significantly impacted clinical research, requiring the adaptation and enhancement of existing research structures. Although remote methods and electronic equipment have limitations, they hold promise as effective solutions during this challenging period.
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Affiliation(s)
- Mahin Nomali
- Department of Epidemiology and Biostatistics, School of Public HealthTehran University of Medical SciencesTehranIran
| | - Neda Mehrdad
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
- Nursing and Midwifery Care Research Center, Health Management Research InstituteIran University of Medical SciencesTehranIran
| | - Mohammad Eghbal Heidari
- Students' Scientific Research Center, School of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
| | - Aryan Ayati
- Tehran Heart Center, Cardiovascular Diseases Research InstituteTehran University of Medical SciencesTehranIran
| | - Amirhossein Yadegar
- Endocrinology and Metabolism Research Center (EMRC), Vali‐Asr HospitalTehran University of Medical SciencesTehranIran
| | - Moloud Payab
- Non‐Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
| | - Alireza Olyaeemanesh
- National Institute of Health ResearchTehran University of Medical SciencesTehranIran
- Health Equity Research Center (HERC)Tehran University of Medical Sciences (TUMS)TehranIran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
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Dionisi AM, Smith CJ, Dupré KE. Weathering the storm alone or together: Examining the impact of COVID-19 on sole and partnered working mothers. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:2408-2429. [PMID: 35353912 PMCID: PMC9088265 DOI: 10.1002/jcop.22829] [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: 06/18/2021] [Revised: 12/17/2021] [Accepted: 02/11/2022] [Indexed: 05/07/2023]
Abstract
Sole employed mothers and their families face numerous challenges. Yet, the unprecedented circumstances of the COVID-19 pandemic may be adding additional risk to the already precarious day-to-day reality of this population. Thus, we examine the implications of this crisis for the mental health and job-related well-being of both sole and partnered working mothers. Participants were 206 mothers who continued to work during the pandemic. A moderated mediation model was analyzed. Work-family conflict (WFC) during the pandemic differentially related to mothers' parenting stress, based on romantic partnership status; when mothers were sole parents, the relationship between WFC and parenting stress was exacerbated. Moreover, this stress mediated the relationship between WFC and both poor mental health and decreased work engagement for sole employed mothers. Findings broaden our understanding of the implications of the COVID-19 pandemic for sole and partnered employed mothers, and how this crisis may be increasing disparities between working sole-parent and dual-partner families.
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Siimsen I, Orru K, Naevestad TO, Nero K, Olson A, Kaal E, Meyer SF. Socio-economic outcomes of COVID-19 on the marginalised: Who have taken the hardest hit? INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2023; 93:103723. [PMID: 37200561 PMCID: PMC10155468 DOI: 10.1016/j.ijdrr.2023.103723] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 04/19/2023] [Accepted: 04/25/2023] [Indexed: 05/20/2023]
Abstract
This article aims to examine the socioeconomic outcomes of COVID-19 for socially marginalised people who are clients of social care organisations (e.g. people experiencing homelessness), and the factors influencing these outcomes. We tested the role of individual and socio-structural variables in determining socioeconomic outcomes based on a cross-sectional survey with 273 participants from eight European countries and 32 interviews and five workshops with managers and staff of social care organisations in ten European countries. 39% of the respondents agreed that the pandemic has had a negative effect on their income and access to shelter and food. The most common negative socio-economic outcome of the pandemic was loss of work (65% of respondents). According to multivariate regression analysis, variables such as being of a young age, being an immigrant/asylum seeker or residing in the country without documentation, living in your own home, and having (in)formal paid work as the main source of income are related to negative socio-economic outcomes following the COVID-19 pandemic. Factors such as individual psychological resilience and receiving social benefits as the main source of income tend to "protect" respondents from negative impacts. Qualitative results indicate that care organisations have been an important source of economic and psycho-social support, particularly significant in times of a huge surge in demand for services during the long-term crises of pandemic.
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Affiliation(s)
| | | | | | | | - Alexandra Olson
- The Salvation Army European Affairs Office, Brussels, Belgium
| | - Esta Kaal
- Tallinn University, Tallinn, Estonia
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