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Sadreameli SC, Coates A, Sheares BJ. Advocacy and Health Equity: The Role of the Pediatric Pulmonologist. Clin Chest Med 2024; 45:771-783. [PMID: 39069337 DOI: 10.1016/j.ccm.2024.02.024] [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: 07/30/2024]
Abstract
Pediatric pulmonologists have the expertise to be advocates in many areas that affect the respiratory health of children. This article provides an overview of selected advocacy topics related to health equity and provides key examples that can improve child respiratory health in the clinical encounter and beyond.
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Affiliation(s)
- Sara Christy Sadreameli
- Department of Pediatrics, Johns Hopkins University School of Medicine, 200 N. Wolfe Street, Room 3015, Baltimore, MD 21287, USA.
| | - Anne Coates
- Department of Pediatrics, Tufts University School of Medicine, 887 Congress Street, Suite 320, Portland, ME, USA
| | - Beverley J Sheares
- Department of Pediatrics, Yale School of Medicine, 1 Park Street, New Haven, CT 06504, USA
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Brown CO, Perez Y, Campa M, Sorto G, Sonik R, Taira BR. COVID-19 Disruptions to Social Care Delivery: A Qualitative Study in Two Large, Safety-Net Primary Care Clinics. J Gen Intern Med 2024:10.1007/s11606-024-08952-y. [PMID: 39060785 DOI: 10.1007/s11606-024-08952-y] [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: 12/16/2023] [Accepted: 07/11/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Social care integration refers to the incorporation of activities into health systems that assist patients with health-related social needs (HRSNs) that negatively impact the health outcomes of their patients, such as food insecurity or homelessness. Social care integration initiatives are becoming more common. The COVID-19 pandemic strained health systems while simultaneously increasing levels of unmet social needs. OBJECTIVE To describe the effects of the COVID-19 pandemic on established social care delivery in a primary care setting. DESIGN We used qualitative semi-structured interviews of stakeholders to assess barriers and facilitators to social care delivery in the primary care setting during the COVID-19 health emergency. Data was analyzed using a hybrid inductive/deductive thematic analysis approach with both the Consolidated Framework for Implementation Research (CFIR) and the Screen-Navigate-Connect-Address-Evaluate model of social care integration. SETTING Two safety-net, hospital-based primary care clinics with established screening for food insecurity, homelessness, and legal needs. PARTICIPANTS Six physicians, six nurses, six members of the social work team (clinical social workers and medical case workers), six community health workers, and six patients (total N = 30) completed interviews. RESULTS Four major themes were identified. (1) A strained workforce experienced challenges confronting increased levels of HRSNs. (2) Vulnerable populations experienced a disproportionate negative impact in coping with effects of the COVID-19 pandemic on HRSNs. (3) COVID-19 protections compounded social isolation but did not extinguish the sense of community. (4) Fluctuations in the social service landscape led to variable experiences. CONCLUSIONS The COVID-19 pandemic disrupted established social care delivery in a primary care setting. Many of the lessons learned about challenges to social care delivery when health systems are strained are important considerations that can inform efforts to expand social care delivery.
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Affiliation(s)
| | | | | | - Gerson Sorto
- Neighborhood Legal Services of Los Angeles, Pacoima, CA, USA
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3
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Salimi N, Gere B, Shahab A. State-Federal Vocational Rehabilitation Services, Demographic Characteristics and Employment Outcomes for Native Americans with Mental Illnesses. Community Ment Health J 2024; 60:442-456. [PMID: 37828363 DOI: 10.1007/s10597-023-01191-1] [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: 02/24/2023] [Accepted: 09/13/2023] [Indexed: 10/14/2023]
Abstract
There were 9.7 million Native Americans (American Indian, Alaska Native-AI/AN- these acronyms will be used interchangeably with Native Americans throughout the paper) in 2019 comprising 2.9% of the U.S. population. Native American populations have disproportionately higher rates of mental illnesses compared to other racial groups in the U.S. Mental health is a significant public health concern for this population, impacting different areas of their lives including employment. Additionally, Native Americans continue to experience significant disparities in access to Vocational Rehabilitation (VR) services and have poor employment outcomes. However, little is known about the relationships among demographic factors, vocational rehabilitation services, and employment outcomes of Native Americans with mental illness. Consequently, the current study examined how demographic factors and VR services are related to successful employment outcomes for Native American VR clients with mental illnesses using data from the Rehabilitation Services Administration (RSA) program year (2019) Case Service Report (9-11). Both descriptive analysis and data mining approaches were used to answer the research questions. Chi-square Automatic Interaction Detector (CHAID) analysis was used to determine which of the VR services could best predict the successful employment outcome of Native Americans with mental illness. The findings of the data mining approach revealed that among all the vocational rehabilitation services, job placement assistance was the strongest predictor of successful employment among Native American clients with mental illnesses. The second most important service predicting successful employment for those who received job placement assistance was shown to be maintenance. Implications for rehabilitation counselors and future research are discussed.
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Affiliation(s)
- Nahal Salimi
- Rehabilitation Counseling & Disability Services, School of Interdisciplinary Health Professions, College of Health & Human Sciences, Northern Illinois University, 353 Wirtz Hall, DeKalb, IL, 60115, USA.
| | - Bryan Gere
- Department of Rehabilitation, School of Pharmacy and Health Professions, University of Maryland Eastern Shore, Hazel Hall #1109, Princess Anne, MD, 21853, USA
| | - Amin Shahab
- Department of Computer Science and Operations Research, Université de Montréal, Québec City, Canada
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Sandoval MN, Mikhail JL, Fink MK, Tortolero GA, Cao T, Ramphul R, Husain J, Boerwinkle E. Social determinants of health predict readmission following COVID-19 hospitalization: a health information exchange-based retrospective cohort study. Front Public Health 2024; 12:1352240. [PMID: 38601493 PMCID: PMC11004289 DOI: 10.3389/fpubh.2024.1352240] [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: 12/07/2023] [Accepted: 03/15/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction Since February 2020, over 104 million people in the United States have been diagnosed with SARS-CoV-2 infection, or COVID-19, with over 8.5 million reported in the state of Texas. This study analyzed social determinants of health as predictors for readmission among COVID-19 patients in Southeast Texas, United States. Methods A retrospective cohort study was conducted investigating demographic and clinical risk factors for 30, 60, and 90-day readmission outcomes among adult patients with a COVID-19-associated inpatient hospitalization encounter within a regional health information exchange between February 1, 2020, to December 1, 2022. Results and discussion In this cohort of 91,007 adult patients with a COVID-19-associated hospitalization, over 21% were readmitted to the hospital within 90 days (n = 19,679), and 13% were readmitted within 30 days (n = 11,912). In logistic regression analyses, Hispanic and non-Hispanic Asian patients were less likely to be readmitted within 90 days (adjusted odds ratio [aOR]: 0.8, 95% confidence interval [CI]: 0.7-0.9, and aOR: 0.8, 95% CI: 0.8-0.8), while non-Hispanic Black patients were more likely to be readmitted (aOR: 1.1, 95% CI: 1.0-1.1, p = 0.002), compared to non-Hispanic White patients. Area deprivation index displayed a clear dose-response relationship to readmission: patients living in the most disadvantaged neighborhoods were more likely to be readmitted within 30 (aOR: 1.1, 95% CI: 1.0-1.2), 60 (aOR: 1.1, 95% CI: 1.2-1.2), and 90 days (aOR: 1.2, 95% CI: 1.1-1.2), compared to patients from the least disadvantaged neighborhoods. Our findings demonstrate the lasting impact of COVID-19, especially among members of marginalized communities, and the increasing burden of COVID-19 morbidity on the healthcare system.
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Affiliation(s)
- Micaela N. Sandoval
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| | | | | | - Guillermo A. Tortolero
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| | - Tru Cao
- Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| | - Ryan Ramphul
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| | - Junaid Husain
- Greater Houston HealthConnect, Houston, TX, United States
| | - Eric Boerwinkle
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
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5
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Adhikari B, Abdia Y, Ringa N, Clemens F, Mak S, Rose C, Janjua NZ, Otterstatter M, Irvine MA. Visible minority status and occupation were associated with increased COVID-19 infection in Greater Vancouver British Columbia between June and November 2020: an ecological study. Front Public Health 2024; 12:1336038. [PMID: 38481842 PMCID: PMC10935735 DOI: 10.3389/fpubh.2024.1336038] [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: 11/13/2023] [Accepted: 02/16/2024] [Indexed: 05/12/2024] Open
Abstract
Background The COVID-19 pandemic has highlighted health disparities, especially among specific population groups. This study examines the spatial relationship between the proportion of visible minorities (VM), occupation types and COVID-19 infection in the Greater Vancouver region of British Columbia, Canada. Methods Provincial COVID-19 case data between June 24, 2020, and November 7, 2020, were aggregated by census dissemination area and linked with sociodemographic data from the Canadian 2016 census. Bayesian spatial Poisson regression models were used to examine the association between proportion of visible minorities, occupation types and COVID-19 infection. Models were adjusted for COVID-19 testing rates and other sociodemographic factors. Relative risk (RR) and 95% Credible Intervals (95% CrI) were calculated. Results We found an inverse relationship between the proportion of the Chinese population and risk of COVID-19 infection (RR = 0.98 95% CrI = 0.96, 0.99), whereas an increased risk was observed for the proportions of the South Asian group (RR = 1.10, 95% CrI = 1.08, 1.12), and Other Visible Minority group (RR = 1.06, 95% CrI = 1.04, 1.08). Similarly, a higher proportion of frontline workers (RR = 1.05, 95% CrI = 1.04, 1.07) was associated with higher infection risk compared to non-frontline. Conclusion Despite adjustments for testing, housing, occupation, and other social economic status variables, there is still a substantial association between the proportion of visible minorities, occupation types, and the risk of acquiring COVID-19 infection in British Columbia. This ecological analysis highlights the existing disparities in the burden of diseases among different visible minority populations and occupation types.
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Affiliation(s)
| | | | - Notice Ringa
- BC Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | | | - Sunny Mak
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - Caren Rose
- BC Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Naveed Z. Janjua
- BC Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Michael Otterstatter
- BC Centre for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Michael A. Irvine
- BC Centre for Disease Control, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
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6
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Okelo SO, Chesley CF, Riley I, Diaz AA, Collishaw K, Schnapp LM, Thakur N. Accelerating Action: Roadmap for the American Thoracic Society to Address Oppression and Health Inequity in Pulmonary and Critical Care Medicine. Ann Am Thorac Soc 2024; 21:17-26. [PMID: 37934586 DOI: 10.1513/annalsats.202305-412ps] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 11/07/2023] [Indexed: 11/08/2023] Open
Affiliation(s)
- Sande O Okelo
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, University of California, Los Angeles, Los Angeles, California
| | - Christopher F Chesley
- Division of Pulmonary and Critical Care Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Isaretta Riley
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Duke University, Durham, North Carolina
| | - Alejandro A Diaz
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Lynn M Schnapp
- American Thoracic Society, New York, New York
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | - Neeta Thakur
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California; and
- Health Equity and Diversity Committee, American Thoracic Society, New York, New York
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7
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Zeng C, Zhang J, Li Z, Sun X, Ning H, Yang X, Weissman S, Olatosi B, Li X. Residential Segregation and County-Level COVID-19 Booster Coverage in the Deep South: Surveillance Report and Ecological Study. JMIR Public Health Surveill 2023; 9:e44257. [PMID: 38051568 DOI: 10.2196/44257] [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: 11/17/2022] [Revised: 09/17/2023] [Accepted: 10/27/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND COVID-19 had a greater impact in the Deep South compared with other regions in the United States. While vaccination remains a top priority for all eligible individuals, data regarding the progress of booster coverage in the Deep South and how the coverage varies by county and age are sparse. Despite existing evidence of racial and ethnic disparities in COVID-19 vaccinations at the individual level, there is an urgent need for evidence at the population level. Such information could highlight vulnerable communities and guide future health care policy-making and resource allocation. OBJECTIVE We aimed to evaluate county-level COVID-19 booster coverage by age group in the Deep South and explore its association with residential segregation. METHODS An ecological study was conducted at the population level by integrating COVID-19 vaccine surveillance data, residential segregation index, and county-level factors across the 418 counties of 5 Deep South states from December 15, 2021, to October 19, 2022. We analyzed the cumulative percentages of county-level COVID-19 booster uptake by age group (eg, 12 to 17 years, 18 to 64 years, and at least 65 years) by the end of the study period. The longitudinal relationships were examined between residential segregation, the interaction of time and residential segregation, and COVID-19 booster coverage using the Poisson model. RESULTS As of October 19, 2022, among the 418 counties, the median of booster uptake was 40% (IQR 37.8%-43%). Compared with older adults (ie, at least 65 years; median 63.1%, IQR 59.5%-66.5%), youth (ie, 12 to 17 years; median 14.1%, IQR 11.3%-17.4%) and adults (ie, 18 to 64 years; median 33.4%, IQR 30.5%-36.5%) had lower percentages of booster uptake. There was geospatial heterogeneity in the county-level COVID-19 booster coverage. We found that higher segregated counties had lower percentages of booster coverage. Such relationships attenuated as time increased. The findings were consistent across the age groups. CONCLUSIONS The progress of county-level COVID-19 booster coverage in the Deep South was slow and varied by age group. Residential segregation precluded the county-level COVID-19 booster coverage across age groups. Future efforts regarding vaccination strategies should focus on youth and adults. Health care facilities and resources are needed in racial and ethnic minority communities.
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Affiliation(s)
- Chengbo Zeng
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
- Big Data Health Science Center, University of South Carolina, Columbia, SC, United States
| | - Jiajia Zhang
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
- Big Data Health Science Center, University of South Carolina, Columbia, SC, United States
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Zhenlong Li
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
- Big Data Health Science Center, University of South Carolina, Columbia, SC, United States
- Geoinformation and Big Data Research Laboratory, Department of Geography, College of Arts and Sciences, University of South Carolina, Columbia, SC, United States
| | - Xiaowen Sun
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
- Big Data Health Science Center, University of South Carolina, Columbia, SC, United States
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Huan Ning
- Big Data Health Science Center, University of South Carolina, Columbia, SC, United States
- Geoinformation and Big Data Research Laboratory, Department of Geography, College of Arts and Sciences, University of South Carolina, Columbia, SC, United States
| | - Xueying Yang
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
- Big Data Health Science Center, University of South Carolina, Columbia, SC, United States
| | - Sharon Weissman
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
- Department of Internal Medicine, School of Medicine, University of South Carolina, Columbia, SC, United States
| | - Bankole Olatosi
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
- Big Data Health Science Center, University of South Carolina, Columbia, SC, United States
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Columbia, SC, United States
- Big Data Health Science Center, University of South Carolina, Columbia, SC, United States
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Elias A, Ben J. Pandemic Racism: Lessons on the Nature, Structures, and Trajectories of Racism During COVID-19. JOURNAL OF BIOETHICAL INQUIRY 2023; 20:617-623. [PMID: 37917295 PMCID: PMC10942924 DOI: 10.1007/s11673-023-10312-0] [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: 08/01/2023] [Accepted: 10/10/2023] [Indexed: 11/04/2023]
Abstract
The COVID-19 pandemic has been one of the most acute global crises in recent history, which profoundly impacted the world across many dimensions. During this period, racism manifested in ways specifically related to the pandemic, including xenophobic sentiments, racial attacks, discriminatory policies, and disparate outcomes across racial/ethnic groups. This paper examines some of the pressing questions about pandemic racism and inequity. We review what research has revealed about the nature and manifestations of racism, the entrenchment of structural racism, and trajectories of racism during COVID-19.
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Affiliation(s)
- A Elias
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, 221 Burwood HWY, Burwood, Victoria, 3125, Australia.
| | - J Ben
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, 221 Burwood HWY, Burwood, Victoria, 3125, Australia
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Kirchoff C, Penn A, Wang W, Babino R, De La Rosa M, Cano MA, Sanchez M. COVID-19 Vaccine Acceptance Among Latino/a Immigrants: The Role of Collective Responsibility and Confidence. J Immigr Minor Health 2023; 25:1246-1253. [PMID: 37402075 DOI: 10.1007/s10903-023-01513-1] [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] [Accepted: 06/14/2023] [Indexed: 07/05/2023]
Abstract
Research on COVID-19 vaccine hesitancy has been sparse among Latino/a immigrants, a population at high risk for infection. This exploratory study examines rates of vaccine acceptance and its association with psychological antecedents of vaccination among Latino/a immigrants. A cross-sectional telephone survey on perceptions of COVID-19 was administered between October 2020 to February 2021 in South Florida to 200 adult Latino/a immigrants. Descriptive statistics, bivariate analysis, and logistic regression were employed to determine the influence of independent variables on vaccine acceptance. Most participants indicated a willingness to get vaccinated. Participants with higher confidence (aOR = 10.2, 95% CI: 4.8-21.8) and collective responsibility scores were (aOR = 3.1, 95%CI:1.3-6.9) more likely to report vaccine acceptance than those with lower scores. No other psychological antecedents or demographic variables were significantly associated with vaccine acceptance. Study results provide insights into motivating factors for vaccination that can inform culturally tailored education campaigns to increase vaccine acceptability in this population.
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Affiliation(s)
- C Kirchoff
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., AHC5, Miami, FL, 33199, USA
| | - A Penn
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., AHC5, Miami, FL, 33199, USA.
| | - W Wang
- Center for Research on U.S. Latinos HIV/AIDS and Drug Abuse, Florida International University, 11200 SW 8th St., AHC5, Miami, FL, 33199, USA
| | - R Babino
- Center for Research on U.S. Latinos HIV/AIDS and Drug Abuse, Florida International University, 11200 SW 8th St., AHC5, Miami, FL, 33199, USA
| | - M De La Rosa
- Center for Research on U.S. Latinos HIV/AIDS and Drug Abuse, Florida International University, 11200 SW 8th St., AHC5, Miami, FL, 33199, USA
- School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., AHC5, Miami, FL, 33199, USA
| | - M A Cano
- Center for Research on U.S. Latinos HIV/AIDS and Drug Abuse, Florida International University, 11200 SW 8th St., AHC5, Miami, FL, 33199, USA
- School of Public Health, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
| | - M Sanchez
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th St., AHC5, Miami, FL, 33199, USA
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Georgeades C, Collings AT, Farazi M, Bergner C, Fallat ME, Minneci PC, Speck KE, Van Arendonk KJ, Deans KJ, Falcone RA, Foley DS, Fraser JD, Gadepalli SK, Keller MS, Kotagal M, Landman MP, Leys CM, Markel TA, Rubalcava NS, St Peter SD, Sato TT, Flynn-O'Brien KT. Relationship between the COVID-19 pandemic and structural inequalities within the pediatric trauma population. Inj Epidemiol 2023; 10:62. [PMID: 38017506 PMCID: PMC10683076 DOI: 10.1186/s40621-023-00475-0] [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: 01/16/2023] [Accepted: 11/22/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic disrupted social, political, and economic life across the world, shining a light on the vulnerability of many communities. The objective of this study was to assess injury patterns before and after implementation of stay-at-home orders (SHOs) between White children and children of color and across varying levels of vulnerability based upon children's home residence. METHODS A multi-institutional retrospective study was conducted evaluating patients < 18 years with traumatic injuries. A "Control" cohort from an averaged March-September 2016-2019 time period was compared to patients injured after SHO initiation-September 2020 ("COVID" cohort). Interactions between race/ethnicity or social vulnerability index (SVI), a marker of neighborhood vulnerability and socioeconomic status, and the COVID-19 timeframe with regard to the outcomes of interest were assessed using likelihood ratio Chi-square tests. Differences in injury intent, type, and mechanism were then stratified and explored by race/ethnicity and SVI separately. RESULTS A total of 47,385 patients met study inclusion. Significant interactions existed between race/ethnicity and the COVID-19 SHO period for intent (p < 0.001) and mechanism of injury (p < 0.001). There was also significant interaction between SVI and the COVID-19 SHO period for mechanism of injury (p = 0.01). Children of color experienced a significant increase in intentional (COVID 16.4% vs. Control 13.7%, p = 0.03) and firearm (COVID 9.0% vs. Control 5.2%, p < 0.001) injuries, but no change was seen among White children. Children from the most vulnerable neighborhoods suffered an increase in firearm injuries (COVID 11.1% vs. Control 6.1%, p = 0.001) with children from the least vulnerable neighborhoods having no change. All-terrain vehicle (ATV) and bicycle crashes increased for children of color (COVID 2.0% vs. Control 1.1%, p = 0.04 for ATV; COVID 6.7% vs. Control 4.8%, p = 0.02 for bicycle) and White children (COVID 9.6% vs. Control 6.2%, p < 0.001 for ATV; COVID 8.8% vs. Control 5.8%, p < 0.001 for bicycle). CONCLUSIONS In contrast to White children and children from neighborhoods of lower vulnerability, children of color and children living in higher vulnerability neighborhoods experienced an increase in intentional and firearm-related injuries during the COVID-19 pandemic. Understanding inequities in trauma burden during times of stress is critical to directing resources and targeting intervention strategies.
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Affiliation(s)
- Christina Georgeades
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
- Division of Pediatric Surgery, Medical College of Wisconsin, Children's Corporate Center, Suite C320, 999 N 92Nd St, Milwaukee, WI, 53226, USA.
| | | | - Manzur Farazi
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
- Division of Pediatric Surgery, Medical College of Wisconsin, Children's Corporate Center, Suite C320, 999 N 92Nd St, Milwaukee, WI, 53226, USA
| | - Carisa Bergner
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
- Division of Pediatric Surgery, Medical College of Wisconsin, Children's Corporate Center, Suite C320, 999 N 92Nd St, Milwaukee, WI, 53226, USA
| | - Mary E Fallat
- Norton Children's Hospital, Louisville, KY, USA
- Hiram C. Polk Jr., Department of Surgery, University of Louisville, Louisville, KY, USA
| | - Peter C Minneci
- Center for Surgical Outcomes Research, Abigail Wexner Research Institute and Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - K Elizabeth Speck
- Division of Pediatric Surgery, Mott Children's Hospital, Ann Arbor, MI, USA
| | - Kyle J Van Arendonk
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
- Division of Pediatric Surgery, Medical College of Wisconsin, Children's Corporate Center, Suite C320, 999 N 92Nd St, Milwaukee, WI, 53226, USA
| | - Katherine J Deans
- Department of Surgery, Nemours Children's Health Delaware Valley, Wilmington, DE, USA
| | - Richard A Falcone
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - David S Foley
- Norton Children's Hospital, Louisville, KY, USA
- Hiram C. Polk Jr., Department of Surgery, University of Louisville, Louisville, KY, USA
| | - Jason D Fraser
- Department of Surgery, Children's Mercy Hospital, Kansas City, MO, USA
| | - Samir K Gadepalli
- Division of Pediatric Surgery, Mott Children's Hospital, Ann Arbor, MI, USA
| | - Martin S Keller
- Division of Pediatric Surgery, Washington University School of Medicine, St Louis, MO, USA
| | - Meera Kotagal
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Charles M Leys
- Division of Pediatric Surgery, Department of Surgery, University of Wisconsin, Madison, WI, USA
| | - Troy A Markel
- Department of Surgery, Indiana University, Indianapolis, IN, USA
| | - Nathan S Rubalcava
- Division of Pediatric Surgery, Mott Children's Hospital, Ann Arbor, MI, USA
| | - Shawn D St Peter
- Department of Surgery, Children's Mercy Hospital, Kansas City, MO, USA
| | - Thomas T Sato
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
- Division of Pediatric Surgery, Medical College of Wisconsin, Children's Corporate Center, Suite C320, 999 N 92Nd St, Milwaukee, WI, 53226, USA
| | - Katherine T Flynn-O'Brien
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
- Division of Pediatric Surgery, Medical College of Wisconsin, Children's Corporate Center, Suite C320, 999 N 92Nd St, Milwaukee, WI, 53226, USA
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11
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Ahn BA, Guan A, Woo BKP. Letter re: Socioeconomic and Cultural Influence on Child Abuse Rates During the COVID-19 Pandemic. Am Surg 2023; 89:5032-5033. [PMID: 35920720 PMCID: PMC9353311 DOI: 10.1177/00031348221117044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Brianna A Ahn
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, USA
| | - Angel Guan
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, USA
| | - Benjamin K P Woo
- Department of Psychiatry & Biobehavioral Science, University of California, Los Angeles, CA, USA
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12
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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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13
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Gao C, Sanchez KM, Lovinsky-Desir S. Structural and Social Determinants of Inequitable Environmental Exposures in the United States. Clin Chest Med 2023; 44:451-467. [PMID: 37517826 DOI: 10.1016/j.ccm.2023.03.002] [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: 08/01/2023]
Abstract
American Indian (AI)/Alaskan Natives, African Americans, and Latino Americans have disproportionally high exposure to harmful environmental conditions as a consequence of unjust laws and policies, systemic racism, residential segregation, and discrimination. In this review, we draw connections between historical policies and social movements in the United States' history that have been rooted in racism and classism, leading to social isolation and marginalization of AIs, African Americans, and Latino Americans. We then discuss the structural factors that stem from the aforementioned inequities and that contribute to the inequitable distribution of environmental hazards.
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Affiliation(s)
- Courtney Gao
- Columbia University Vagelos College of Physicians and Surgeons, 3959 Broadway, CHC 7-701, New York, NY, USA
| | - Kimberly M Sanchez
- Columbia University Vagelos College of Physicians and Surgeons, 3959 Broadway, CHC 7-701, New York, NY, USA
| | - Stephanie Lovinsky-Desir
- Pulmonary Division, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, 3959 Broadway, CHC 7-701, New York, NY 10032, USA.
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14
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Abstract
The current approach for the management of pulmonary arterial hypertension (PAH) relies on data gathered from clinical trials and large registries. However, there is concern that minorities including Black, Indigenous, and People of Color are underrepresented in these trials and registries, making current data not generalizable to these groups of patients. Hence, it is important to discuss the significance of race/ethnicity and socioeconomic factors in patients with PAH. Here, we review the current knowledge on health care disparities in PAH. We also propose future steps in the global task of assuring justice and equality in access to pulmonary hypertension health care.
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Affiliation(s)
- Roberto J Bernardo
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Oklahoma Health Sciences Center, 800 Stanton L. Young Boulevard, Suite 8400, Oklahoma City, OK 73104, USA
| | - Vinicio A de Jesus Perez
- Division of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Grant S140B, Stanford, CA 94305, USA; Vera Moulton Wall Center for Pulmonary Disease at Stanford University, Stanford, CA, USA.
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15
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Cox H, Gebru Y, Horter L, Palomeque FS, Myers K, Stowell D, Easterling T, de Noguera NS, Medina-Forrester A, Bravo J, Pérez S, Chaparro J, Ekpo LLP, Cranford H, Santibañez S, Valencia D. New York State, New York City, New Jersey, Puerto Rico, and the US Virgin Islands' Health Department Experiences Promoting Health Equity During the Initial COVID-19 Omicron Variant Period, 2021-2022. Health Secur 2023; 21:S25-S34. [PMID: 37590481 PMCID: PMC10818041 DOI: 10.1089/hs.2023.0001] [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: 01/03/2023] [Revised: 05/23/2023] [Accepted: 06/03/2023] [Indexed: 08/19/2023] Open
Abstract
In this case study, we aim to understand how health departments in 5 US jurisdictions addressed health inequities and implemented strategies to reach populations disproportionately affected by COVID-19 during the initial Omicron variant period. We used qualitative methods to examine health department experiences during the initial Omicron surge, from November 2021 to April 2022, assessing successful interventions, barriers, and lessons learned from efforts to promote health equity. Our findings indicate that government leadership supported prioritizing health equity from the beginning of the pandemic, seeing it as a need and vital part of the response framework. All jurisdictions acknowledged the historical trauma and distrust of the government. Health departments found that collaborating and communicating with trusted community leaders helped mitigate public distrust. Having partnerships, resources, and infrastructure in place before the pandemic facilitated the establishment of equity-focused COVID-19 response activities. Finally, misinformation about COVID-19 was a challenge for all jurisdictions. Addressing the needs of diverse populations involves community-informed decisionmaking, diversity of thought, and delivery measures that are tailored to the community. It is imperative to expand efforts to reduce and eliminate health inequities to ensure that individuals and communities recover equitably from the effects of COVID-19.
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Affiliation(s)
- Heidi Cox
- Heidi Cox, MPH, is a Public Health Analyst; in the Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Yonathan Gebru
- Yonathan Gebru, MPH, is a Public Health Advisor; in the Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Libby Horter
- Libby Horter, MPH, is a Data Manager; in the Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Francisco S. Palomeque
- Francisco S. Palomeque, MPH, is a Health Scientist, Division of State and Local Readiness, National Center for Emerging and Zoonotic Infectious Diseases, CDC, Atlanta, GA
| | - Kristopher Myers
- Kristopher Myers, PhD, was a Consultant Data Manager, State, Tribal, Local, and Territorial Support Task Force, CDC, Atlanta, GA. He is currently a Data Manager, Goldbelt, C6, LLC, Chesapeake, VA
| | - Daniel Stowell
- Daniel Stowell, MPH, is a Public Health Analyst, Center for Global Health, CDC, Atlanta, GA
| | - Torian Easterling
- Torian Easterling, MD, PhD, is First Deputy Commissioner and Chief Equity Officer, New York City Department of Health and Mental Hygiene, New York, NY
| | - Nayeli Salazar de Noguera
- Nayeli Salazar de Noguera, PhD, is a Program Management Officer, the New Jersey Department of Health, Trenton, NJ
| | - Amanda Medina-Forrester
- Amanda Medina-Forrester, MPH, is Executive Director of Office of Minority and Multicultural Health; the New Jersey Department of Health, Trenton, NJ
| | - Josely Bravo
- Josely Bravo, MPH, is a COVID-19 Vaccine Equity Official; the Puerto Rico Department of Health, San Juan, PR
| | - Siomara Pérez
- Siomara Pérez, DrPH, is a Project Manager; the Puerto Rico Department of Health, San Juan, PR
| | - Jaikiz Chaparro
- Jaikis Chaparro, MSW, is Director of Health Equity Program; the Puerto Rico Department of Health, San Juan, PR
| | - Lisa La Place Ekpo
- Lisa La Place Ekpo, DrPH, is Epidemiologists, US Virgin Islands Department of Health, Saint Thomas, USVI
| | - Hannah Cranford
- Hannah Cranford, MPH, is Epidemiologists, US Virgin Islands Department of Health, Saint Thomas, USVI
| | - Scott Santibañez
- Scott Santibañez, MD, MPHTM, is Chief Medical Officer and Associate Director for Science; in the Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention (CDC), Atlanta, GA
| | - Diana Valencia
- Diana Valencia, MS, is a Health Scientist; in the Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention (CDC), Atlanta, GA
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16
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Villalobos BT, Hernandez Rodriguez J. How did Latinxs near the U.S.-Mexico border fare during the COVID-19 pandemic? A snapshot of anxiety, depression, and posttraumatic stress symptoms. Front Psychol 2023; 14:1241603. [PMID: 37663358 PMCID: PMC10471481 DOI: 10.3389/fpsyg.2023.1241603] [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: 06/16/2023] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction The current study documented levels of anxiety, depression, posttraumatic stress, and COVID-19 fears and impacts among Latinxs living near the U.S.-Mexico border during the COVID-19 pandemic. Methods Participants of this cross-sectional study were 305 Latinx adults living in the Rio Grande Valley (RGV) who completed an online survey between June and November 2020. Results About half of participants scored above the cut-off for anxiety (50.2%; GAD-7 scores ≥10) and depression (48.8%; PHQ-9 scores ≥10), and more than a quarter of participants showed clinical levels of posttraumatic stress (27.3%; PCL-5 scores ≥31). Latinxs reported on average 22 types of negative pandemic life impacts on the Epidemic-Pandemic Impacts Inventory. Endorsement of mental health symptoms, severity of COVID-19 fears, and COVID-related life impacts varied based on several demographic characteristics including gender, marital status, educational attainment, employment, income, insurance coverage, vulnerability to COVID-19, and essential worker status. Discussion Overall, the cross-sectional results of this study revealed that RGV Latinx residents experienced high levels of psychological distress during the pandemic. Results suggest that Latinx women were most affected by the psychological consequences of the pandemic. More research is needed with communities living near the U.S.-Mexico border as they may be particularly vulnerable to mental health problems during the pandemic.
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Affiliation(s)
- Bianca T. Villalobos
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, TX, United States
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17
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Salgin L, Ayers LO, Burola ML, Engler AM, Osuna A, Gay L, Cain K, Stadnick N, Rabin B, Zaslavsky I, Laurent LC, Tukey R, Seifert M. Perceived COVID-19 risk and testing experiences in the San Ysidro U.S./Mexico border region. Transl Behav Med 2023; 13:432-441. [PMID: 36999822 PMCID: PMC10314726 DOI: 10.1093/tbm/ibac120] [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: 04/01/2023] Open
Abstract
Racial and ethnic disparities in COVID-19 incidence are pronounced in underserved U.S./Mexico border communities. Working and living environments in these communities can lead to increased risk of COVID-19 infection and transmission, and this increased risk is exacerbated by lack of access to testing. As part of designing a community and culturally tailored COVID-19 testing program, we surveyed community members in the San Ysidro border region. The purpose of our study was to characterize knowledge, attitudes, and beliefs of prenatal patients, prenatal caregivers, and pediatric caregivers at a Federally Qualified Health Center (FHQC) in the San Ysidro region regarding perceived risk of COVID-19 infection and access to testing. A cross-sectional survey was used to collect information on experiences accessing COVID-19 testing and perceived risk of COVID-19 infection within San Ysidro between December 29, 2020 and April 2, 2021. A total of 179 surveys were analyzed. Most participants identified as female (85%) and as Mexican/Mexican American (75%). Over half (56%) were between the age of 25 and 34 years old. Perceived Risk: 37% reported moderate to high risk of COVID-19 infection, whereas 50% reported their risk low to none. Testing Experience: Approximately 68% reported previously being tested for COVID-19. Among those tested, 97% reported having very easy or easy access to testing. Reasons for not testing included limited appointment availability, cost, not feeling sick, and concern about risk of infection while at a testing facility. This study is an important first step to understand the COVID-19 risk perceptions and testing access among patients and community members living near the U.S./Mexico border in San Ysidro, California.
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Affiliation(s)
- Linda Salgin
- San Ysidro Health, San Diego, CA, USA
- San Diego State University/University of California San Diego Joint Doctoral Program in Public Health, San Diego, CA, USA
| | - Lawrence O Ayers
- University of California, San Diego Department of Obstetrics, Gynecology, and Reproductive Sciences, San Diego, CA, USA
| | - Maria-Linda Burola
- University of California, San Diego Department of Obstetrics, Gynecology, and Reproductive Sciences, San Diego, CA, USA
| | - Anne-Marie Engler
- University of California, San Diego Department of Obstetrics, Gynecology, and Reproductive Sciences, San Diego, CA, USA
| | | | - Luis Gay
- San Ysidro Health, San Diego, CA, USA
| | - Kelli Cain
- University of California, San Diego, Herbert Wertheim School of Public Health and Human Longevity Science, San Diego, CA, USA
| | - Nicole Stadnick
- University of California San Diego, Department of Psychiatry, San Diego, CA, USA
- University of California, San Diego Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center, San Diego, CA, USA
- Child and Adolescent Services Research Center, San Diego, CA, USA
| | - Borsika Rabin
- University of California, San Diego, Herbert Wertheim School of Public Health and Human Longevity Science, San Diego, CA, USA
- University of California, San Diego Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center, San Diego, CA, USA
| | - Ilya Zaslavsky
- University of California San Diego, Spatial Information Systems Lab, San Diego Supercomputer Center, San Diego, CA, USA
| | - Louise C Laurent
- University of California, San Diego Department of Obstetrics, Gynecology, and Reproductive Sciences, San Diego, CA, USA
| | - Robert Tukey
- University of California San Diego, Department of Chemistry and Biochemistry, San Diego, CA, USA
| | - Marva Seifert
- University of California San Diego, Division of Pulmonary and Critical Care Medicine, San Diego, CA, USA
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18
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Zhu K, Wang S, Yue Y, Smith BA, Zhang ZF, Freudenheim JL, Niu Z, Zhang J, Smith E, Ye J, Cao Y, Zhang J, Hennessy DA, Lei L, Mu L. Disparities in insecurity, social support, and family relationships in association with poor mental health among US adults during the COVID-19 pandemic. Sci Rep 2023; 13:9731. [PMID: 37322075 PMCID: PMC10272217 DOI: 10.1038/s41598-023-35981-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/26/2023] [Indexed: 06/17/2023] Open
Abstract
The COVID-19 pandemic has had a significant impact on mental health. Identifying risk factors and susceptible subgroups will guide efforts to address mental health concerns during the pandemic and long-term management and monitoring after the pandemic. We aimed to examine associations of insecurity (concerns about food, health insurance, and/or money), social support, and change in family relationships with poor mental health and to explore disparities in these associations. An online survey was collected from 3952 US adults between May and August 2020. Symptoms of anxiety, depression, stress, and trauma-related disorders were assessed by the Generalized Anxiety Disorder 7-item scale, the Patient Health Questionnaire-9, the Perceived Stress Scale-4, and the Primary Care Post-Traumatic Stress Disorder Screen, respectively. Social support was measured by the Oslo Social Support Scale. Logistic regression was used and stratified analyses by age, race/ethnicity, and sex were performed. We found a higher prevalence of poor mental health among those who were younger, female, with lower socioeconomic status, and racial/ethnic minorities. Participants who were worried about money, health insurance, or food had higher odds of symptoms of anxiety (OR = 3.74, 95% CI: 3.06-4.56), depression (OR = 3.20, 95% CI: 2.67-3.84), stress (OR = 3.08, 95% CI: 2.67-3.57), and trauma-related disorders (OR = 2.93, 95% CI: 2.42-3.55) compared to those who were not. Compared to poor social support, moderate and strong social support was associated with lower odds of all four symptoms. Participants who had changes in relationships with parents, children, or significant others had worse mental health. Our findings identified groups at higher risk for poor mental health, which offers insights for implementing targeted interventions.
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Affiliation(s)
- Kexin Zhu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Siyi Wang
- Department of Psychology, Vassar College, Poughkeepsie, NY, USA
| | - Yihua Yue
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Beth A Smith
- Department of Psychiatry and Pediatrics, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Zuo-Feng Zhang
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jo L Freudenheim
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Zhongzheng Niu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | | | | | - Joshua Ye
- The Quarry Lane School, Dublin, CA, USA
| | - Ying Cao
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Jie Zhang
- Department of Sociology, State University of New York Buffalo State, Buffalo, NY, USA
| | - Dwight A Hennessy
- Department of Psychology, State University of New York Buffalo State, Buffalo, NY, USA
| | - Lijian Lei
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Lina Mu
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA.
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19
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Diaz AA, Thakur N, Celedón JC. Lessons Learned from Health Disparities in Coronavirus Disease-2019 in the United States. Clin Chest Med 2023; 44:425-434. [PMID: 37085230 PMCID: PMC9678822 DOI: 10.1016/j.ccm.2022.11.021] [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: 11/23/2022]
Abstract
In the United States, the coronavirus disease-2019 (COVID-19) pandemic has disproportionally affected Black, Latinx, and Indigenous populations, immigrants, and economically disadvantaged individuals. Such historically marginalized groups are more often employed in low-wage jobs without health insurance and have higher rates of infection, hospitalization, and death from COVID-19 than non-Latinx White individuals. Mistrust in the health care system, language barriers, and limited health literacy have hindered vaccination rates in minorities, further exacerbating health disparities rooted in structural, institutional, and socioeconomic inequities. In this article, we discuss the lessons learned over the last 2 years and how to mitigate health disparities moving forward.
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Affiliation(s)
- Alejandro A Diaz
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
| | - Neeta Thakur
- Department of Medicine, University of California at San Francisco, 505 Parnassus Avenue, Box 0841, San Francisco, CA 94143, USA
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, Suite 9130, Rangos Building, 4401 Penn Avenue, Pittsburgh, PA 15224, USA
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20
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Quan C, Clark N, Costigan CL, Murphy J, Li M, David A, Ganesan S, Guzder J, Cross B. JBI systematic review protocol of text/opinions on how to best collect race-based data in healthcare contexts. BMJ Open 2023; 13:e069753. [PMID: 37192794 DOI: 10.1136/bmjopen-2022-069753] [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] [Indexed: 05/18/2023] Open
Abstract
INTRODUCTION Racialized population groups have worse health outcomes across the world compared with non-racialized populations. Evidence suggests that collecting race-based data should be done to mitigate racism as a barrier to health equity, and to amplify community voices, promote transparency, accountability, and shared governance of data. However, limited evidence exists on the best ways to collect race-based data in healthcare contexts. This systematic review aims to synthesize opinions and texts on the best practices for collecting race-based data in healthcare contexts. METHODS AND ANALYSES We will use the Joanna Briggs Institute (JBI) method for synthesizing text and opinions. JBI is a global leader in evidence-based healthcare and provides guidelines for systematic reviews. The search strategy will locate both published and unpublished papers in English in CINAHL, Medline, PsycINFO, Scopus and Web of Science from 1 January 2013 to 1 January 2023, as well as unpublished studies and grey literature of relevant government and research websites using Google and ProQuest Dissertations and Theses. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement methodology for systematic reviews of text and opinion will be applied, including screening and appraisal of the evidence by two independent reviewers and data extraction using JBI's Narrative, Opinion, Text, Assessment, Review Instrument. This JBI systematic review of opinion and text will address gaps in knowledge about the best ways to collect race-based data in healthcare. Improvements in race-based data collection, may be related to structural policies that address racism in healthcare. Community participation may also be used to increase knowledge about collecting race-based data. ETHICS AND DISSEMINATION The systematic review does not involve human subjects. Findings will be disseminated through a peer-reviewed publication in JBI evidence synthesis, conferences and media. PROSPERO REGISTRATION NUMBER CRD42022368270.
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Affiliation(s)
- Cindy Quan
- Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Nancy Clark
- School of Nursing, University of Victoria, Victoria, British Columbia, Canada
| | | | - Jill Murphy
- Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael Li
- Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Anita David
- Lived Experience Strategic Advisor, BC Mental Health and Substance Use Services, Vancouver, British Columbia, Canada
| | - Soma Ganesan
- Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jaswant Guzder
- Division of Social and Cultural Psychiatry, McGill University, Montreal, Québec, Canada
| | - Barbara Cross
- Vancouver General Hospital, Vancouver, British Columbia, Canada
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21
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Wonderly K. Multilayer Solutions to Inequities During the COVID-19 Pandemic. Prev Chronic Dis 2023; 20:E35. [PMID: 37141183 PMCID: PMC10159336 DOI: 10.5888/pcd20.220354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Affiliation(s)
- Krista Wonderly
- Wayne State University College of Nursing, 5557 Cass Ave, Detroit, MI 48202
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22
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An TJ, Kim N, King AH, Panzarini B, Little BP, Goiffon RJ, Meyersohn N, Garrana S, Stowell J, Saini S, Ghoshhajra BB, Hedgire S, Succi MD. Trends in coronary calcium score and coronary CT angiography imaging volume during the COVID-19 pandemic. Curr Probl Diagn Radiol 2023; 52:175-179. [PMID: 36473800 PMCID: PMC9673185 DOI: 10.1067/j.cpradiol.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/10/2022] [Accepted: 11/14/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The COVID-19 pandemic disrupted the delivery of preventative care and management of acute diseases. This study assesses the effect of the COVID-19 pandemic on coronary calcium score and coronary CT angiography imaging volume. MATERIALS AND METHODS A single institution retrospective review of consecutive patients presenting for coronary calcium score or coronary CT angiography examinations between January 1, 2020 to January 4, 2022 was performed. The weekly volume of calcium score and coronary CT angiogram exams were compared. RESULTS In total, 1,817 coronary calcium score CT and 5,895 coronary CT angiogram examinations were performed. The average weekly volume of coronary CTA and coronary calcium score CT exams decreased by up to 83% and 100%, respectively, during the COVID-19 peak period compared to baseline (P < 0.0001). The post-COVID recovery through 2020 saw weekly coronary CTA volumes rebound to 86% of baseline (P = 0.024), while coronary calcium score CT volumes remained muted at only a 53% recovery (P < 0.001). In 2021, coronary CTA imaging eclipsed pre-COVID rates (P = 0.012), however coronary calcium score CT volume only reached 67% of baseline (P < 0.001). CONCLUSIONS A significant decrease in both coronary CTA and coronary calcium score CT volume occurred during the peak-COVID-19 period. In 2020 and 2021, coronary CTA imaging eventually superseded baseline rates, while coronary calcium score CT volumes only reached two thirds of baseline. These findings highlight the importance of resumption of screening exams and should prompt clinicians to be aware of potential undertreatment of patients with coronary artery disease.
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Affiliation(s)
- Thomas J An
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA
| | - Nicole Kim
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA
| | - Alexander H King
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA
| | - Bruno Panzarini
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA
| | - Brent P Little
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Reece J Goiffon
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Nandini Meyersohn
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Sherief Garrana
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Justin Stowell
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Sanjay Saini
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA
| | - Brian B Ghoshhajra
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Sandeep Hedgire
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Marc D Succi
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA.
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23
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Chebli P, Adsul P, Kranick J, Rohweder CL, Risendal BC, Bilenduke E, Williams R, Wheeler S, Kwon SC, Trinh-Shevrin C. Principles to operationalize equity in cancer research and health outcomes: lessons learned from the cancer prevention and control research network. Cancer Causes Control 2023; 34:371-387. [PMID: 36781715 PMCID: PMC9925365 DOI: 10.1007/s10552-023-01668-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/09/2023] [Indexed: 02/15/2023]
Abstract
Reflecting their commitment to advancing health equity, the Cancer Prevention and Control Research Network (CPCRN) established a Health Equity Workgroup to identify and distill guiding principles rooted in health equity, community-engaged participatory research (CBPR), social determinants of health, and racial equity frameworks to guide its collective work. The Health Equity Workgroup utilized a multi-phase, participatory consensus-building approach to: (1) identify recurrent themes in health and racial equity frameworks; (2) capture perspectives on and experiences with health equity research among CPCRN members through an online survey; (3) engage in activities to discuss and refine the guiding principles; and (4) collect case examples of operationalizing equity principles in cancer research. Representatives from all CPCRN centers endorsed nine core principles to guide the Network's strategic plan: (1) Engage in power-sharing and capacity building with partners; (2) Address community priorities through community engagement and co-creation of research; (3) Explore and address the systems and structural root causes of cancer disparities; (4) Build a system of accountability between research and community partners; (5) Establish transparent relationships with community partners; (6) Prioritize the sustainability of research benefits for community partners; (7) Center racial equity in cancer prevention and control research; (8) Engage in equitable data collection, analysis, interpretation, and dissemination practices; and (9) Integrate knowledge translation, implementation, and dissemination into research plans. Dissemination products, such as toolkits and technical assistance workshops, reflecting these principles will foster knowledge transfer to intentionally integrate health and racial equity principles in cancer prevention and control research.
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Affiliation(s)
- Perla Chebli
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, 180 Madison Avenue, 8th Fl. #8-21A, New York, NY, 10016, USA.
| | - Prajakta Adsul
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
- Cancer Control and Populations Sciences Research Program, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Julie Kranick
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, 180 Madison Avenue, 8th Fl. #8-21A, New York, NY, 10016, USA
| | - Catherine L Rohweder
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Betsy C Risendal
- Colorado School of Public Health, University of Colorado Cancer Center, Aurora, CO, USA
| | - Emily Bilenduke
- Department of Psychology Denver, University of Colorado Denver, Denver, CO, USA
| | - Rebecca Williams
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stephanie Wheeler
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Simona C Kwon
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, 180 Madison Avenue, 8th Fl. #8-21A, New York, NY, 10016, USA
| | - Chau Trinh-Shevrin
- Department of Population Health, Section for Health Equity, NYU Grossman School of Medicine, 180 Madison Avenue, 8th Fl. #8-21A, New York, NY, 10016, USA
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24
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Ignacio M, Oesterle S, Mercado M, Carver A, Lopez G, Wolfersteig W, Ayers S, Ki S, Hamm K, Parthasarathy S, Berryhill A, Evans L, Sabo S, Doubeni C. Narratives from African American/Black, American Indian/Alaska Native, and Hispanic/Latinx community members in Arizona to enhance COVID-19 vaccine and vaccination uptake. J Behav Med 2023; 46:140-152. [PMID: 35322313 PMCID: PMC8942760 DOI: 10.1007/s10865-022-00300-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/15/2022] [Indexed: 12/25/2022]
Abstract
The state of Arizona has experienced one of the highest novel coronavirus disease 2019 (COVID-19) positivity test rates in the United States with disproportionally higher case rates and deaths among African-American/Black (AA/B), American Indian/Alaska Native (Native), and Hispanic/Latinx (HLX) individuals. To reduce disparities and promote health equity, researchers from Arizona State University, Mayo Clinic in Arizona, Northern Arizona University, and the University of Arizona formed a partnership with community organizations to conduct state-wide community-engaged research and outreach. This report describes results from 34 virtually-held focus groups and supplemental survey responses conducted with 153 AA/B, HLX, and Native community members across Arizona to understand factors associated with COVID-19 vaccine hesitancy and confidence. Focus groups revealed common themes of vaccine hesitancy stemming from past experiences of research abuses (e.g., Tuskegee syphilis experiment) as well as group-specific factors. Across all focus groups, participants strongly recommended the use of brief, narrative vaccination testimonials from local officials, community members, and faith leaders to increase trust in science, vaccine confidence and to promote uptake.
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Affiliation(s)
- Matt Ignacio
- Southwest Interdiciplinary Research Center, School of Social Work, Arizona State University, University Center, 411 N Central Ave #800, Phoenix, AZ, 85006, USA.
| | - Sabrina Oesterle
- Southwest Interdiciplinary Research Center, School of Social Work, Arizona State University, University Center, 411 N Central Ave #800, Phoenix, AZ, 85006, USA
| | - Micaela Mercado
- Southwest Interdiciplinary Research Center, School of Social Work, Arizona State University, University Center, 411 N Central Ave #800, Phoenix, AZ, 85006, USA
| | - Ann Carver
- Southwest Interdiciplinary Research Center, School of Social Work, Arizona State University, University Center, 411 N Central Ave #800, Phoenix, AZ, 85006, USA
| | - Gilberto Lopez
- School of Transborder Studies, Arizona State University, Phoenix, AZ, USA
| | - Wendy Wolfersteig
- Southwest Interdiciplinary Research Center, School of Social Work, Arizona State University, University Center, 411 N Central Ave #800, Phoenix, AZ, 85006, USA
| | - Stephanie Ayers
- Southwest Interdiciplinary Research Center, School of Social Work, Arizona State University, University Center, 411 N Central Ave #800, Phoenix, AZ, 85006, USA
| | - Seol Ki
- Southwest Interdiciplinary Research Center, School of Social Work, Arizona State University, University Center, 411 N Central Ave #800, Phoenix, AZ, 85006, USA
| | - Kathryn Hamm
- Southwest Interdiciplinary Research Center, School of Social Work, Arizona State University, University Center, 411 N Central Ave #800, Phoenix, AZ, 85006, USA
| | - Sairam Parthasarathy
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Adam Berryhill
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Linnea Evans
- Center for Health Equity Research, Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Samantha Sabo
- Center for Health Equity Research, Department of Health Sciences, Northern Arizona University, Flagstaff, AZ, USA
| | - Chyke Doubeni
- Department of Family Medicine, Center for Health Equity and Community Engagement Research, Mayo Clinic, Rochester, MN, USA
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25
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Martin PP, Lewis RK, Guzmán BL. Racial reckoning, resistance, and the revolution: A call to community psychology to move forward. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 71:3-7. [PMID: 36797981 DOI: 10.1002/ajcp.12658] [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: 12/23/2022] [Revised: 12/27/2022] [Accepted: 01/09/2023] [Indexed: 05/07/2023]
Abstract
This article introduces a special issue of the American Journal of Community Psychology that features racial reckoning, resistance and the revolution in the context of a syndemic, the historical subjugation of communities of Color (COC) to racial hierarchies and the coronavirus (COVID-19). More specifically, this special issue underscores the need for community psychology and other allied disciplines to address this syndemic facing COC. The special issue delivers on the stories of the lived experiences from researchers and community members as it relates to COVID-19 and COC. Twelve articles are illuminated to challenge the field to create social change.
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Affiliation(s)
- Pamela P Martin
- Clinical-Community Psychology Program, Barnwell College, University of South Carolina, Columbia, South Carolina, USA
| | - Rhonda K Lewis
- Department of Psychology, Service-Learning Faculty Fellow, Society for Community Research and Action Fellow, Wichita State University, Wichita, Kansas, USA
| | - Bianca L Guzmán
- Pathway Programs Office, Office of the President, California State University, Los Angeles, California, USA
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26
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Cohen C, Rinot Levavi L. A Game-Theory-Based Approach to Promoting Health Policy among Minorities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4335. [PMID: 36901344 PMCID: PMC10001858 DOI: 10.3390/ijerph20054335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 02/23/2023] [Accepted: 02/25/2023] [Indexed: 06/18/2023]
Abstract
The importance of designing policy measures that government and other public bodies apply to different populations has been escalating in recent decades. This study seeks the best way to induce conservative minority groups to cooperate with healthcare policy. The case study focuses on the Bedouin population of Israel and its willingness to accept COVID-19 vaccination. The study is based on vaccination data from the Israel Ministry of Health for the country's entire Bedouin population, twenty-four semi-structured in-depth interviews with relevant key stakeholders, and the use of game-theory tools to profile the players, the utility functions, and various equilibrium combinations. By comparing the groups and integrating game-theory tools into the process, we reveal variables that may affect healthcare processes among conservative minority communities. Finally, cross-tabulating the results with the interview findings strengthens the insights and allows a culturally adjusted policy to be adopted. The different starting points of different minority populations have implications for the design of requisite policies in both the short and the long terms. The analysis of the game allowed us to indicate the strategy that policymakers should adopt in consideration of variables that should be taken into account in order to improve cooperation and the ability to apply policy. To increase vaccination rates among conservative minority communities in general and the Bedouin population in particular, trust in the government must be increased in the long term. In the short term, trust in the medical profession must be increased, and also health literacy.
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27
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Luo X, Wang S, Pu H, Long C, Ren Z, Lai Y. Knowledge mapping and research trends of the social determinants of health (SDoH): a scientometric analysis. REVIEWS ON ENVIRONMENTAL HEALTH 2023; 0:reveh-2022-0186. [PMID: 36746438 DOI: 10.1515/reveh-2022-0186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/22/2023] [Indexed: 06/18/2023]
Abstract
Social determinants of health (SDoH) play an essential role in the risk of developing diseases or medical disorders. Conducting a comprehensive retrospective analysis is necessary to better understand the development status, research hotspots, and development trends of SDoH research. The bibliometric analysis method is applied based on CiteSpace and VOS viewer to quantitatively analyze and visually review the articles published in the field of SDoH from Web of Science core databases from 2000 to 2021. We quantitatively analyzed the author, institution, and other basic information to probe the development of SDoH and then visually investigated the high-frequency keywords, burst keywords, and keyword clusters to understand better the evolution of hotspots and development directions of SDoH during the study period. Health inequality is the main keyword of the SDoH field, and disease burden is expected to maintain a hotspot in recent years. Further, research methodologies could be improved to explain how upstream SDoH influences human lived experience. Additionally, the SDoH field needs to utilize the horizons of the multidisciplinary approach to consider and discuss sustainable development issues to offer implications for health improvement policy and interventions.
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Affiliation(s)
- Xiaoyi Luo
- Chongqing Technology and Business University, Chongqing, China
| | - Shaobin Wang
- Institute of Geographic Sciences and Natural Resources Research CAS, Beijing, China
| | - Haixia Pu
- Chongqing Technology and Business University, Chongqing, China
| | - Chunfeng Long
- Chongqing Technology and Business University, Chongqing, China
| | - Zhoupeng Ren
- Institute of Geographic Sciences and Natural Resources Research CAS, Beijing, China
| | - Yingsi Lai
- Sun Yat-Sen University, Guangzhou, China
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28
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Colvin KM, Camara KS, Adams LS, Sarpong AP, Fuller DG, Peck SE, Ramos AS, Acevedo AL, Badume MA, Briggs SLA, Chukwurah TN, Davila-Gutierrez Z, Ewing JA, Frempong JO, Garrett AA, Grampp SJ, Gillespie JW, Herrera EJ, Horsford SME, Maddox EJ, Pelaez JC, Quartey OL, Rodriguez F, Vasquez LA, Piper BJ, Gowtham S. Profiles of COVID-19 vaccine hesitancy by race and ethnicity in eastern Pennsylvania. PLoS One 2023; 18:e0280245. [PMID: 36745588 PMCID: PMC9901750 DOI: 10.1371/journal.pone.0280245] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/23/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Throughout US history, chronic and infectious diseases have severely impacted minority communities due to a lack of accessibility to quality healthcare and accurate information, as well as underlying racism. These fault lines in the care of minority communities in the US have been further exacerbated by the rise of the COVID-19 pandemic. This study examined the factors associated with COVID-19 vaccine hesitancy by race and ethnicity, particularly among African American and Latinx communities in Eastern Pennsylvania (PA). METHODS Survey data was collected in July 2021 in Philadelphia, Scranton, Wilkes-Barre, and Hazleton, PA. The 203 participants (38.7% Black, 27.5% Latinx) completed the 28-question survey of COVID-19 vaccination attitudes in either English or Spanish. RESULT Out of the 203 participants, 181 participants met all the inclusion criteria, including completed surveys; of these participants, over three-fifths (63.5%) were acceptant of the COVID-19 vaccine whereas the remainder (36.5%) were hesitant. Binary logistic regression results showed that age, concern for vaccine efficacy, race, knowledge on the vaccine, and belief that the COVID-19 virus is serious significantly influenced COVID-19 vaccine hesitancy. Minorities were more likely to be hesitant toward vaccination (OR: 2.8, 95% CI: 1.1, 6.8) than non-Hispanic whites. Those who believed the COVID-19 vaccine was ineffective (OR: 8.3, 95% CI: 3.8, 18.2), and that the virus is not serious (OR: 8.3, 95% CI: 1.1, 61.8) showed the greatest odds of hesitancy. CONCLUSIONS Minority status, age less than 45 years, misinformation about seriousness of COVID-19 illness, and concern about vaccine efficacy were contributing factors of COVID-19 vaccine hesitancy. Therefore, understanding and addressing the barriers to COVID-19 vaccination in minority groups is essential to decreasing transmission and controlling this pandemic, and will provide lessons on how to implement public health measures in future pandemics.
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Affiliation(s)
- Kenya M. Colvin
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, United States of America
| | - Kennedy S. Camara
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, United States of America
| | - Latasha S. Adams
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, United States of America
| | - Adline P. Sarpong
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, United States of America
| | - Danielle G. Fuller
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, United States of America
| | - Sadie E. Peck
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, United States of America
| | - Anthony S. Ramos
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, United States of America
| | - Ariana L. Acevedo
- Wilkes University, Wilkes-Barre, Pennsylvania, United States of America
| | - Meless A. Badume
- Swarthmore College, Swarthmore, Pennsylvania, United States of America
| | | | | | | | - James A. Ewing
- Temple University, Philadelphia, Pennsylvania, United States of America
| | | | - Amirah A. Garrett
- Temple University, Philadelphia, Pennsylvania, United States of America
| | - Steven J. Grampp
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, United States of America
| | | | | | - Shantia M. E. Horsford
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, United States of America
| | - Emis J. Maddox
- University of Scranton, Scranton, Pennsylvania, United States of America
| | - John C. Pelaez
- Susquehanna University, Selinsgrove, Pennsylvania, United States of America
| | - Olivia L. Quartey
- Temple University, Philadelphia, Pennsylvania, United States of America
| | - Fanny Rodriguez
- University of Scranton, Scranton, Pennsylvania, United States of America
| | - Luis A. Vasquez
- University of Scranton, Scranton, Pennsylvania, United States of America
| | - Brian J. Piper
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, United States of America
- Center for Pharmacy Innovation and Outcomes, Geisinger Precision Health Center, Forty Fort, Pennsylvania, United States of America
| | - Swathi Gowtham
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, United States of America
- Department of Pediatrics, Pediatric Infectious Diseases, Geisinger Medical Center, Danville, Pennsylvania, United States of America
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29
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Goyal P, Schenck E, Wu Y, Zhang Y, Visaria A, Orlander D, Xi W, Díaz I, Morozyuk D, Weiner M, Kaushal R, Banerjee S. Influence of social deprivation index on in-hospital outcomes of COVID-19. Sci Rep 2023; 13:1746. [PMID: 36720999 PMCID: PMC9887560 DOI: 10.1038/s41598-023-28362-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 01/17/2023] [Indexed: 02/01/2023] Open
Abstract
While it is known that social deprivation index (SDI) plays an important role on risk for acquiring Coronavirus Disease 2019 (COVID-19), the impact of SDI on in-hospital outcomes such as intubation and mortality are less well-characterized. We analyzed electronic health record data of adults hospitalized with confirmed COVID-19 between March 1, 2020 and February 8, 2021 from the INSIGHT Clinical Research Network (CRN). To compute the SDI (exposure variable), we linked clinical data using patient's residential zip-code with social data at zip-code tabulation area. SDI is a composite of seven socioeconomic characteristics determinants at the zip-code level. For this analysis, we categorized SDI into quintiles. The two outcomes of interest were in-hospital intubation and mortality. For each outcome, we examined logistic regression and random forests to determine incremental value of SDI in predicting outcomes. We studied 30,016 included COVID-19 patients. In a logistic regression model for intubation, a model including demographics, comorbidity, and vitals had an Area under the receiver operating characteristic curve (AUROC) = 0.73 (95% CI 0.70-0.75); the addition of SDI did not improve prediction [AUROC = 0.73 (95% CI 0.71-0.75)]. In a logistic regression model for in-hospital mortality, demographics, comorbidity, and vitals had an AUROC = 0.80 (95% CI 0.79-0.82); the addition of SDI in Model 2 did not improve prediction [AUROC = 0.81 (95% CI 0.79-0.82)]. Random forests revealed similar findings. SDI did not provide incremental improvement in predicting in-hospital intubation or mortality. SDI plays an important role on who acquires COVID-19 and its severity; but once hospitalized, SDI appears less important.
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Affiliation(s)
- Parag Goyal
- Department of Medicine, Weill Cornell Medical College, 1320 York Avenue, New York, NY, 10021, USA.,NewYork-Presbyterian Hospital, 525 East 68th Street, New York, NY, 10065, USA
| | - Edward Schenck
- Department of Medicine, Weill Cornell Medical College, 1320 York Avenue, New York, NY, 10021, USA.,NewYork-Presbyterian Hospital, 525 East 68th Street, New York, NY, 10065, USA
| | - Yiyuan Wu
- Department of Population Health Sciences, Weill Cornell Medical College, 425 East 61St Street, New York, NY, 10065, USA
| | - Yongkang Zhang
- Department of Population Health Sciences, Weill Cornell Medical College, 425 East 61St Street, New York, NY, 10065, USA
| | - Aayush Visaria
- Center for Pharmacoepidemiology and Treatment Sciences, Rutgers Institute for Health, Health Care Policy, and Aging Research, New Brunswick, NJ, USA
| | - Duncan Orlander
- Department of Population Health Sciences, Weill Cornell Medical College, 425 East 61St Street, New York, NY, 10065, USA
| | - Wenna Xi
- Department of Population Health Sciences, Weill Cornell Medical College, 425 East 61St Street, New York, NY, 10065, USA
| | - Iván Díaz
- Department of Population Health Sciences, Weill Cornell Medical College, 425 East 61St Street, New York, NY, 10065, USA
| | - Dmitry Morozyuk
- Department of Population Health Sciences, Weill Cornell Medical College, 425 East 61St Street, New York, NY, 10065, USA
| | - Mark Weiner
- Department of Population Health Sciences, Weill Cornell Medical College, 425 East 61St Street, New York, NY, 10065, USA
| | - Rainu Kaushal
- Department of Medicine, Weill Cornell Medical College, 1320 York Avenue, New York, NY, 10021, USA.,NewYork-Presbyterian Hospital, 525 East 68th Street, New York, NY, 10065, USA.,Department of Population Health Sciences, Weill Cornell Medical College, 425 East 61St Street, New York, NY, 10065, USA.,Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA
| | - Samprit Banerjee
- Department of Population Health Sciences, Weill Cornell Medical College, 425 East 61St Street, New York, NY, 10065, USA. .,, New York, USA.
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30
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Peña JM, Schwartz MR, Hernandez-Vallant A, Sanchez GR. Social and structural determinants of COVID-19 vaccine uptake among racial and ethnic groups. J Behav Med 2023; 46:129-139. [PMID: 36652085 PMCID: PMC9846662 DOI: 10.1007/s10865-023-00393-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/04/2023] [Indexed: 01/19/2023]
Abstract
Latino, Black, American Indian/Alaska Native (AI/AN), and Native Hawaiian or Other Pacific Islander people have the highest hospitalizations and death rates from COVID-19. Social inequalities have exacerbated COVID-19 related health disparities. This study examines social and structural determinants of COVID-19 vaccine uptake. Results from logistic regressions suggest Latino and Black people were less likely to be vaccinated. People that did not have health insurance, a primary care doctor and were unemployed were more than 30% less likely to be vaccinated for COVID-19. Greater perceived health inequalities in one's neighborhood and perceived racial/ethnic discrimination were associated with a decreased odds in being vaccinated. People that suffered the loss of a household member from COVID-19 were three times more likely to have been vaccinated. Establishing policies that will increase access to health insurance and create jobs with living wages may have lasting impacts. Furthermore, collaboration with local and national community organizations can enhance the development of sustainable solutions.
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Affiliation(s)
- Juan M. Peña
- Department of Psychology Albuquerque, The University of New Mexico, 2001 Redondo S Dr, Albuquerque, 87106 NM USA ,Center for Social Policy, The University of New Mexico Albuquerque, Albuquerque, NM USA
| | - Matthew R. Schwartz
- Center for Social Policy, The University of New Mexico Albuquerque, Albuquerque, NM USA ,Department of Internal Medicine, The University of New Mexico, Albuquerque, NM USA
| | - Alexandra Hernandez-Vallant
- Department of Psychology Albuquerque, The University of New Mexico, 2001 Redondo S Dr, Albuquerque, 87106 NM USA ,Center for Social Policy, The University of New Mexico Albuquerque, Albuquerque, NM USA ,Center of Alcohol, The University of New Mexico, Substance Use, and Addictions, Albuquerque, NM USA
| | - Gabriel R. Sanchez
- Center for Social Policy, The University of New Mexico Albuquerque, Albuquerque, NM USA ,Department of Political Science, The University of New Mexico, Albuquerque, NM USA
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31
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Abascal Miguel L, Christian C, Accurso EC, Najmabadi A, Athavale P, Diala JA, Sachdev D, Philip S, Reid MJ, Handley MA. Barriers and Enablers to COVID-19 Vaccination in San Francisco's Spanish-Speaking Population. GLOBAL IMPLEMENTATION RESEARCH AND APPLICATIONS 2023; 3:56-66. [PMID: 36647398 PMCID: PMC9833024 DOI: 10.1007/s43477-023-00071-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 12/30/2022] [Indexed: 01/13/2023]
Abstract
Populations at high risk for COVID-19- including Spanish speakers-may face additional barriers to obtaining COVID-19 vaccinations; by understanding their challenges, we can create more equitable vaccine interventions. In this study, we used interviews to identify barriers and enablers to COVID-19 vaccine uptake among participants in the San Francisco Department of Public Health contact tracing program. Data analysis employed Capability, Opportunity, Motivation Behavior model (COM-B) and the Behavior Change Wheel framework as guides to target barriers with interventions and supporting policies. This paper presents data from interviews focused on COVID-19 vaccine uptake that was part of a project to improve COVID-19 preventive behaviors in San Francisco. We completed seventeen interviews between February and May 2021; six (35%) were completed in English and 11 (65%) in Spanish. Barriers to vaccine uptake included an unprepared health system, fear of side effects, limited knowledge, and conflicting information. Behavioral factors influencing vaccine uptake were mainly related to physical opportunity, automatic motivation, and psychological capability. Interventions that could address the most significant number of barriers included education, enablement, and environmental restructuring. Finally, communication and marketing policies that use diverse multi-lingual social media and environmental planning that includes accessible vaccine sites for people with disabilities, literacy barriers, and limited English proficiency could significantly increase vaccination. Public health departments should tailor interventions to high-risk populations by understanding the specific barriers they face. This exploratory study suggests how implementation science can provide frameworks to achieve this.
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Affiliation(s)
- Lucía Abascal Miguel
- Institute for Global Health Sciences, University of California, 550 16th St, San Francisco, CA 94158 USA
| | - Canice Christian
- Institute for Global Health Sciences, University of California, 550 16th St, San Francisco, CA 94158 USA ,Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco, CA USA
| | - Erin C. Accurso
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA USA
| | | | - Priyanka Athavale
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA USA
| | - Jody A. Diala
- Institute for Global Health Sciences, University of California, 550 16th St, San Francisco, CA 94158 USA
| | - Darpun Sachdev
- San Francisco Department of Public Health, San Francisco, CA USA
| | - Susan Philip
- San Francisco Department of Public Health, San Francisco, CA USA
| | - Michael J. Reid
- Institute for Global Health Sciences, University of California, 550 16th St, San Francisco, CA 94158 USA ,School of Medicine, University of California, San Francisco, CA USA ,Division of HIV, Infectious Diseases and Global Medicine, University of California, San Francisco, CA USA
| | - Margaret A. Handley
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA USA ,PRISE Center (Partnerships in Research in Implementation Science for Equity), University of California, San Francisco, CA USA
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Martinez A, Thakur N. Structural Racism and the Social Determinants of Health in Asthma. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1426:101-115. [PMID: 37464118 DOI: 10.1007/978-3-031-32259-4_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Asthma prevalence and morbidity are disproportionately higher among minoritized communities in the United States. Racial and ethnic disparities in asthma result from complex interactions across biological, environmental, and social factors. Asthma is considered a complex heterogeneous disease consisting of different phenotypes, some of which may be more common in individuals impacted by the downstream effects of structural racism and lack of access to the social determinants of health. Structural racism across generations has created and reinforced inequitable systems through policies and practices which are embedded in the economic, educational, health care, and justice systems (Bailey et al., N Engl J Med 384(8):768-773, 2021; Bailey et al., Lancet 389:1453-1463, 2017; Williams et al., Annu Rev Public Health 40:105-125, 2019). This manifests in an inequitable distribution of resources and the social determinants of health affecting an individual's physical and social environment (Bailey et al., Lancet 389:1453-1463, 2017; Thakur et al., Am J Respir Crit Care Med 202:943-949, 2020; Martinez et al., J Allergy Clin Immunol 148(5):1112-1120, 2021). In this chapter, we outline how inequity in housing, zoning laws, urban planning, education, employment, healthcare access, and healthcare delivery is linked to higher asthma prevalence and morbidity. We also describe the role that chronic physiologic stress has on asthma by enhancing neuroimmune and immunologic responses to environmental exposures. Interventions aimed at addressing the physical or social environment of an individual or community have been shown to improve asthma outcomes in patients at higher risk of severe disease.
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Affiliation(s)
- Adali Martinez
- Division of Pulmonary, Allergy, Critical Care and Sleep, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Neeta Thakur
- Division of Pulmonary, Allergy, Critical Care and Sleep, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
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Rose JA, Menon AA, Hino T, Hata A, Nishino M, Lynch DA, Rosas IO, El-Chemaly S, Raby BA, Ash SY, Choi B, Washko GR, Silverman EK, Cho MH, Hatabu H, Putman RK, Hunninghake GM. Suspected Interstitial Lung Disease in COPDGene Study. Am J Respir Crit Care Med 2023; 207:60-68. [PMID: 35930450 PMCID: PMC9952869 DOI: 10.1164/rccm.202203-0550oc] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 08/04/2022] [Indexed: 02/03/2023] Open
Abstract
Rationale: Although interstitial lung abnormalities (ILA), specific patterns of incidentally-detected abnormal density on computed tomography, have been associated with abnormal lung function and increased mortality, it is unclear if a subset with incidental interstitial lung disease (ILD) accounts for these adverse consequences. Objectives: To define the prevalence and risk factors of suspected ILD and assess outcomes. Methods: Suspected ILD was evaluated in the COPDGene (Chronic Obstructive Pulmonary Disease Genetic Epidemiology) study, defined as ILA and at least one additional criterion: definite fibrosis on computed tomography, FVC less than 80% predicted, or DLCO less than 70% predicted. Multivariable linear, longitudinal, and Cox proportional hazards regression models were used to assess associations with St. George's Respiratory Questionnaire, 6-minute-walk test, supplemental oxygen use, respiratory exacerbations, and mortality. Measurements and Main Results: Of 4,361 participants with available data, 239 (5%) had evidence for suspected ILD, whereas 204 (5%) had ILA without suspected ILD. In multivariable analyses, suspected ILD was associated with increased St. George's Respiratory Questionnaire score (mean difference [MD], 3.9 points; 95% confidence interval [CI], 0.6-7.1; P = 0.02), reduced 6-minute-walk test (MD, -35 m; 95% CI, -56 m to -13 m; P = 0.002), greater supplemental oxygen use (odds ratio [OR], 2.3; 95% CI, 1.1-5.1; P = 0.03) and severe respiratory exacerbations (OR, 2.9; 95% CI, 1.1-7.5; P = 0.03), and higher mortality (hazard ratio, 2.4; 95% CI, 1.2-4.6; P = 0.01) compared with ILA without suspected ILD. Risk factors associated with suspected ILD included self-identified Black race (OR, 2.0; 95% CI, 1.1-3.3; P = 0.01) and pack-years smoking history (OR, 1.2; 95% CI, 1.1-1.3; P = 0.0005). Conclusions: Suspected ILD is present in half of those with ILA in COPDGene and is associated with exercise decrements and increased symptoms, supplemental oxygen use, severe respiratory exacerbations, and mortality.
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Affiliation(s)
| | | | | | - Akinori Hata
- Department of Radiology, Osaka University, Osaka, Japan
| | | | | | - Ivan O. Rosas
- Pulmonary Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, Texas; and
| | | | - Benjamin A. Raby
- Division of Pulmonary Medicine, Boston Children’s Hospital, Boston, Massachusetts
| | | | - Bina Choi
- Pulmonary and Critical Care Division
| | | | - Edwin K. Silverman
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Michael H. Cho
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
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Thomson J, Richardson T, Auger KA, Brady PW, Hall M, Hartley D, Schondelmeyer AC, Shah SS. Impact of the COVID-19 pandemic on hospitalizations of children with neurologic impairment. J Hosp Med 2023; 18:33-42. [PMID: 36504483 PMCID: PMC9877577 DOI: 10.1002/jhm.13021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 10/20/2022] [Accepted: 10/27/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Children with neurologic impairment (NI) are frequently hospitalized for infectious and noninfectious illnesses. The early period of the COVID-19 pandemic was associated with overall lower pediatric hospitalization rates, particularly for respiratory infections, but the effect on utilization for children with NI is unknown. METHOD This multicenter retrospective cohort study included hospitalizations of children 1-18 years of age with NI diagnosis codes from 49 children's hospitals. We calculated the percent change in the median weekly hospitalization volumes and the hospitalization resource intensity score (H-RISK), comparing the early-COVID era (March 15, 2020 to December 31, 2020) with the pre-COVID era (same timeframe of 2017-2019). Percent change was calculated over the entire study period as well as within three seasonal time periods (spring, summer, and fall/winter). Differences between infectious and noninfectious admission diagnoses were also examined. RESULTS Compared with the pre-COVID era, there was a 14.4% decrease (interquartile range [IQR]: -33.8, -11.7) in the weekly median number of hospitalizations in the early-COVID era; the weekly median H-RISK score was 11.7% greater (IQR: 8.9, 14.9). Hospitalizations decreased for both noninfectious (-11.6%, IQR: -30.0, -8.0) and infectious (-35.5%, IQR: -51.1, -31.3) illnesses in the early-COVID era. This decrease was the largest in spring 2020 and continued throughout 2020. CONCLUSIONS For children with NI, there was a substantial and significant decrease in hospitalizations for infectious and noninfectious diagnoses but an increase in illness severity during the early-COVID era compared with the pre-COVID era. Our data suggest a need to reconsider current thresholds for hospitalization and identify opportunities to support and guide families through certain illnesses without hospitalization.
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Affiliation(s)
- Joanna Thomson
- Cincinnati Children's Hospital Medical CenterDivision of Hospital MedicineCincinnatiOhioUSA
- James M. Anderson Center for Health Systems ExcellenceCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
- Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOhioUSA
| | | | - Katherine A. Auger
- Cincinnati Children's Hospital Medical CenterDivision of Hospital MedicineCincinnatiOhioUSA
- James M. Anderson Center for Health Systems ExcellenceCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
- Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOhioUSA
| | - Patrick W. Brady
- Cincinnati Children's Hospital Medical CenterDivision of Hospital MedicineCincinnatiOhioUSA
- James M. Anderson Center for Health Systems ExcellenceCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
- Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOhioUSA
| | - Matt Hall
- Children's Hospital AssociationLenexaKansasUSA
| | - David Hartley
- James M. Anderson Center for Health Systems ExcellenceCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
- Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOhioUSA
| | - Amanda C. Schondelmeyer
- Cincinnati Children's Hospital Medical CenterDivision of Hospital MedicineCincinnatiOhioUSA
- James M. Anderson Center for Health Systems ExcellenceCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
- Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOhioUSA
| | - Samir S. Shah
- Cincinnati Children's Hospital Medical CenterDivision of Hospital MedicineCincinnatiOhioUSA
- Department of PediatricsUniversity of Cincinnati College of MedicineCincinnatiOhioUSA
- Cincinnati Children's Hospital Medical CenterDivision of Infectious DiseasesCincinnatiOhioUSA
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Barboza G, Angulski K, Hines L, Brown P. Variability in Opioid-Related Drug Overdoses, Social Distancing, and Area-Level Deprivation during the COVID-19 Pandemic: a Bayesian Spatiotemporal Analysis. J Urban Health 2022; 99:873-886. [PMID: 36068454 PMCID: PMC9447988 DOI: 10.1007/s11524-022-00675-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2022] [Indexed: 11/03/2022]
Abstract
Monitoring the spatial and temporal course of opioid-related drug overdose mortality is a key public health determinant. Despite previous studies exploring the evolution of drug-related fatalities following the stay-at-home mandates during the COVID-19 pandemic, little is known about the spatiotemporal dynamics that mitigation efforts had on overdose deaths. The purpose of this study was to describe the spatial and temporal dynamics of overdose death relative risk using a 4-week interval over a span of 5 months following the implementation of the COVID-19 lockdown in the city of Chicago, IL. A Bayesian space-time model was used to produce posterior risk estimates and exceedance probabilities of opioid-related overdose deaths controlling for measures of area-level deprivation and stay-at-home mandates. We found that area-level temporal risk and inequalities in drug overdose mortality increased significantly in the initial months of the pandemic. We further found that a change in the area-level deprivation from the first to the fourth quintile increased the relative risk of a drug overdose risk by 44.5%. The social distancing index measuring the proportion of persons who stayed at home in each census block group was not associated with drug overdose mortality. We conclude by highlighting the importance of contextualizing the spatial and temporal risk in overdose mortality for implementing effective and safe harm reduction strategies during a global pandemic.
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Affiliation(s)
- Gia Barboza
- College of Public Health and the College of Social Work, The Ohio State University, Columbus, OH, USA.
| | - Kate Angulski
- University of Colorado Colorado Springs, Colorado Springs, CO, USA
| | - Lisa Hines
- University of Colorado Colorado Springs, Colorado Springs, CO, USA
| | - Philip Brown
- University of Colorado Colorado Springs, Colorado Springs, CO, USA
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Budd EL, McWhirter EH, De Anda S, Mauricio AM, Mueller MV, Cioffi CC, Nash A, Van Brocklin K, Yarris K, Jackson A, Terral H, García JIR, Cresko WA, DeGarmo DS, Leve LD. Development and design of a culturally tailored intervention to address COVID-19 disparities among Oregon's Latinx communities: A community case study. Front Public Health 2022; 10:962862. [PMID: 36211681 PMCID: PMC9541743 DOI: 10.3389/fpubh.2022.962862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 09/05/2022] [Indexed: 02/05/2023] Open
Abstract
Background Latinx communities are disproportionately affected by COVID-19 compared with non-Latinx White communities in Oregon and much of the United States. The COVID-19 pandemic presents a critical and urgent need to reach Latinx communities with innovative, culturally tailored outreach and health promotion interventions to reduce viral transmission and address disparities. The aims of this case study are to (1) outline the collaborative development of a culturally and trauma-informed COVID-19 preventive intervention for Latinx communities; (2) describe essential intervention elements; and (3) summarize strengths and lessons learned for future applications. Methods Between June 2020 and January 2021, a multidisciplinary team of researchers and Latinx-serving partners engaged in the following intervention development activities: a scientific literature review, a survey of 67 Latinx residents attending public testing events, interviews with 13 leaders of community-based organizations serving Latinx residents, and bi-weekly consultations with the project's Public Health and Community Services Team and a regional Community and Scientific Advisory Board. After launching the intervention in the field in February 2021, bi-weekly meetings with interventionists continuously informed minor iterative refinements through present day. Results The resulting intervention, Promotores de Salud, includes outreach and brief health education. Bilingual, trauma-informed trainings and materials reflect the lived experiences, cultural values, needs, and concerns of Latinx communities. Interventionists (21 Promotores) were Latinx residents from nine Oregon counties where the intervention was delivered. Conclusions Sharing development and intervention details with public health researchers and practitioners facilitates intervention uptake and replication to optimize the public health effect in Oregon's Latinx communities and beyond.
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Affiliation(s)
- Elizabeth L. Budd
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Ellen Hawley McWhirter
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States
| | - Stephanie De Anda
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR, United States
| | - Anne Marie Mauricio
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Maryanne V. Mueller
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Camille C. Cioffi
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Ashley Nash
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Kelsey Van Brocklin
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Kristin Yarris
- Department of Global Studies, Center for Global Health, University of Oregon, Eugene, OR, United States
| | - Arriell Jackson
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States
| | - Heather Terral
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | | | | | - William A. Cresko
- Institute of Ecology and Evolution, University of Oregon, Eugene, OR, United States
- Presidential Initiative in Data Science, University of Oregon, Eugene, OR, United States
| | - David S. DeGarmo
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Leslie D. Leve
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, United States
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
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Buro AW, Roman Candelaria K, Bailey R, Luna F, Albizu-Jacob A, Stern M, Redwine L. Exploration of Multilevel Barriers and Strategies That Affected Early COVID-19 Vaccination and Testing in Rural Latino Communities in Southwest Florida. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11785. [PMID: 36142059 PMCID: PMC9517188 DOI: 10.3390/ijerph191811785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has disproportionately impacted multiple racial and ethnic minority groups, including Latinos residing in rural communities. Low rates of vaccination and testing combined with social determinants of health have contributed significantly to this disparate impact. Given the needs and constraints unique to rural Latino migrant and immigrant communities, this qualitative study examined multilevel barriers and strategies that affect COVID-19 vaccination and testing uptake among these communities in southwest Florida. Four focus groups (n = 25) were conducted between March and April 2021 with various key stakeholders, including rural Latino community members, local leaders, and community health workers ('Promotoras de Salud'). Themes that aligned with barriers to COVID-19 vaccination and testing included fear, lack of control, misinformation, lack of accessibility, and institutional/policy issues; themes that aligned with strategies to improve COVID-19 vaccination and testing uptake included faith, taking care of self, and community and family resilience. Recommendations for improving future pandemic responses for rural Latino communities include incorporating multiple levels of intervention, such as consideration of the role of the family, involving trusted community members, and ensuring the development and implementation of fair and consistent policies.
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Affiliation(s)
- Acadia W. Buro
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33617, USA
| | - Kevin Roman Candelaria
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL 33612, USA
| | | | | | - Alexandra Albizu-Jacob
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL 33612, USA
| | - Marilyn Stern
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33617, USA
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL 33612, USA
| | - Laura Redwine
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL 33612, USA
- Department of Family Medicine and Community Health, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
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Park MB, Ranabhat CL. COVID-19 trends, public restrictions policies and vaccination status by economic ranking of countries: a longitudinal study from 110 countries. Arch Public Health 2022; 80:197. [PMID: 35999620 PMCID: PMC9398898 DOI: 10.1186/s13690-022-00936-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 07/17/2022] [Indexed: 11/15/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has transitioned to a third phase and many variants have been originated. There has been millions of lives loss as well as billions in economic loss. The morbidity and mortality for COVID-19 varies by country. There were different preventive approaches and public restrictions policies have been applied to control the COVID-19 impacts and usually measured by Stringency Index. This study aimed to explore the COVID-19 trend, public restriction policies and vaccination status with economic ranking of countries. Methods We received open access data from Our World in Data. Data from 210 countries were available. Countries (n = 110) data related to testing, which is a key variable in the present study, were included for the analysis and remaining 100 countries were excluded due to incomplete data. The analysis period was set between January 22, 2020 (when COVID-19 was first officially reported) and December 28, 2021. All analyses were stratified by year and the World Bank income group. To analyze the associations among the major variables, we used a longitudinal fixed-effects model. Results Out of the 110 countries included in our analysis, there were 9 (8.18%), 25 (22.72%), 31 (28.18%), and 45 (40.90%) countries from low income countries (LIC), low and middle income countries (LMIC), upper middle income countries (UMIC) and high income countries (HIC) respectively. New case per million was similar in LMIC, UMIC and HIC but lower in LIC. The number of new COVID-19 test were reduced in HIC and LMIC but similar in UMIC and LIC. Stringency Index was negligible in LIC and similar in LMIC, UMIC and HIC. New positivity rate increased in LMIC and UMIC. The daily incidence rate was positively correlated with the daily mortality rate in both 2020 and 2021. In 2020, Stringency Index was positive in LIC and HIC but a negative association in LMIC and in 2021 there was a positive association between UMIC and HIC. Vaccination coverage did not appear to change with mortality in 2021. Conclusion New COVID-19 cases, tests, vaccinations, positivity rates, and Stringency indices were low in LIC and highest in UMIC. Our findings suggest that the available resources of COVID-19 pandemic would be allocated by need of countries; LIC and UMIC.
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Benson OM, Whitson ML. The protective role of sense of community and access to resources on college student stress and COVID-19-related daily life disruptions. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:2746-2764. [PMID: 35142379 PMCID: PMC9088248 DOI: 10.1002/jcop.22817] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/23/2021] [Accepted: 01/31/2022] [Indexed: 05/30/2023]
Abstract
The aim of our study was to understand more about how college students have been impacted by the pandemic and how their universities can better support them by emphasizing protective factors that build resilience. The protective factors we explored were sense of community, perceived adequacy of resources, and perceived social support.We conducted an online survey, which was administered to 296 (70.4% female and Mage = 20.34) students from a private Northeastern University in the United States. There were gender and class year differences found after analysis. In addition, sense of community and perceived adequacy were found to be statistically significant. There were gender and class year differences found after analysis. In addition, sense of community and perceived adequacy were found to be statistically significant. Overall, our findings highlight the importance of sense of community and access to resources as protective factors in mitigating stress and coronavirus disease 2019-related disruptions to daily life among college students, particularly for female students who report more adverse outcomes.
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Lee H, Andrasfay T, Riley A, Wu Q, Crimmins E. Do social determinants of health explain racial/ethnic disparities in COVID-19 infection? Soc Sci Med 2022; 306:115098. [PMID: 35759973 PMCID: PMC9162789 DOI: 10.1016/j.socscimed.2022.115098] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 05/27/2022] [Accepted: 05/29/2022] [Indexed: 02/04/2023]
Abstract
Racial/ethnic minorities have experienced higher COVID-19 infection rates than whites, but it is unclear how individual-level housing, occupational, behavioral, and socioeconomic conditions contribute to these disparities in a nationally representative sample. In this study, we assess the extent to which social determinants of health contribute to racial/ethnic differences in COVID-19 infection. Data are from the Understanding America Study's Understanding Coronavirus in America survey (UAS COVID-19 waves 7-29). UAS COVID-19 is one of the only nationally representative longitudinal data sources that collects information on household, work, and social behavioral context during the pandemic. We analyze onset of COVID-19 cases, defined as a positive test or a diagnosis of COVID-19 from a healthcare provider since the previous survey wave, over a year of follow-up (June 2020-July 2021). We consider educational attainment, economic resources, work arrangements, household size, and social distancing as key social factors that may be structured by racism. Cox hazard models indicate that Hispanic people have 48% higher risk of experiencing a COVID-19 infection than whites after adjustment for age, sex, local infection rate, and comorbidities, but we do not observe a higher risk of COVID-19 among Black respondents. Controlling for engagement in any large or small social gathering increases the hazard ratio for Hispanics by 9%, suggesting that had Hispanics had the same social engagement patterns as whites, they may have had even higher risk of COVID-19. Other social determinants-lower educational attainment, working away from home, and number of coresidents-all independently predict higher risk of COVID-19, but do not explain why Hispanic Americans have higher COVID-19 infection risk than whites.
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Affiliation(s)
- Haena Lee
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
| | - Theresa Andrasfay
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Alicia Riley
- Department of Sociology, University of California Santa Cruz, Santa Cruz, CA, USA
| | - Qiao Wu
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Eileen Crimmins
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
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Medical Mistrust, Perceived Discrimination, and Race: a Longitudinal Analysis of Predictors of COVID-19 Vaccine Hesitancy in US Adults. J Racial Ethn Health Disparities 2022:10.1007/s40615-022-01368-6. [PMID: 35913543 PMCID: PMC9341411 DOI: 10.1007/s40615-022-01368-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 11/05/2022]
Abstract
The current manuscript has two aims. First, we examined whether race and ethnicity, perceived discrimination, medical mistrust, and other demographic factors were predictors of COVID-19 vaccine hesitancy and vaccine behavior. Second, we sought to assess whether medical mistrust and perceived discrimination mediate the relationship between race and ethnicity and vaccine behavior. Specifically, we hypothesized that individuals of color had increased COVID-19 vaccine hesitancy as compared to White individuals and perceived discrimination and medical mistrust mediated this relationship. Results revealed that when accounting for sociodemographic characteristics and COVID-19-related variables those with greater medical mistrust were more likely to have vaccine hesitancy. Additionally, after accounting for medical mistrust, Black non-Hispanic/Black Hispanic/White Hispanic individuals had lower odds of having the COVID-19 vaccine compared to White non-Hispanic individuals. Furthermore, combined perceived discrimination and medical mistrust indirectly mediated the relationship between race and ethnicity and having the COVID-19 vaccine. The findings of this study indicate the need for public health efforts to address sentiments of medical mistrust and experiences of perceived discrimination when combating COVID-19 vaccine hesitancy, especially within communities of color.
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De Ramos IP, Lazo M, Schnake-Mahl A, Li R, Martinez-Donate AP, Roux AVD, Bilal U. COVID-19 Outcomes Among the Hispanic Population of 27 Large US Cities, 2020-2021. Am J Public Health 2022; 112:1034-1044. [PMID: 35588187 PMCID: PMC9222469 DOI: 10.2105/ajph.2022.306809] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2022] [Indexed: 11/04/2022]
Abstract
Objectives. To examine racial/ethnic disparities in COVID-19 outcomes between Hispanics and Whites across 27 US jurisdictions whose health departments are members of the Big Cities Health Coalition (BCHC). Methods. Using surveillance data from the BCHC COVID-19 dashboard as of mid-June 2021, we computed crude incidence, age-adjusted hospitalization and mortality, and full vaccination coverage rates for Hispanics and Whites by city. We estimated relative and absolute disparities cumulatively and for 2020 and 2021 and explored associations between city-level social vulnerability and the magnitude of disparities. Results. In most of the cities with available COVID-19 incidence data, rates among Hispanics were 2.2 to 6.7 times higher than those among Whites. In all cities, Hispanics had higher age-adjusted hospitalization (1.5-8.6 times as high) and mortality (1.4-6.2 times as high) rates. Hispanics had lower vaccination coverage in all but 1 city. Disparities in incidence and hospitalizations narrowed in 2021, whereas disparities in mortality remained similar. Disparities in incidence, hospitalization, mortality, and vaccination rates were wider in cities with lower social vulnerability. Conclusions. A deeper exploration of racial/ethnic disparities in COVID-19 outcomes is essential to understand and prevent disparities among marginalized communities. (Am J Public Health. 2022;112(7): 1034-1044. https://doi.org/10.2105/AJPH.2022.306809).
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Affiliation(s)
- Isabel P De Ramos
- Isabel P. De Ramos, Mariana Lazo, Alina Schnake-Mahl, Ran Li, Ana V. Diez Roux, and Usama Bilal are with the Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Ana P. Martinez-Donate is with the Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University
| | - Mariana Lazo
- Isabel P. De Ramos, Mariana Lazo, Alina Schnake-Mahl, Ran Li, Ana V. Diez Roux, and Usama Bilal are with the Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Ana P. Martinez-Donate is with the Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University
| | - Alina Schnake-Mahl
- Isabel P. De Ramos, Mariana Lazo, Alina Schnake-Mahl, Ran Li, Ana V. Diez Roux, and Usama Bilal are with the Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Ana P. Martinez-Donate is with the Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University
| | - Ran Li
- Isabel P. De Ramos, Mariana Lazo, Alina Schnake-Mahl, Ran Li, Ana V. Diez Roux, and Usama Bilal are with the Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Ana P. Martinez-Donate is with the Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University
| | - Ana P Martinez-Donate
- Isabel P. De Ramos, Mariana Lazo, Alina Schnake-Mahl, Ran Li, Ana V. Diez Roux, and Usama Bilal are with the Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Ana P. Martinez-Donate is with the Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University
| | - Ana V Diez Roux
- Isabel P. De Ramos, Mariana Lazo, Alina Schnake-Mahl, Ran Li, Ana V. Diez Roux, and Usama Bilal are with the Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Ana P. Martinez-Donate is with the Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University
| | - Usama Bilal
- Isabel P. De Ramos, Mariana Lazo, Alina Schnake-Mahl, Ran Li, Ana V. Diez Roux, and Usama Bilal are with the Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA. Ana P. Martinez-Donate is with the Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University
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The effects of contracting Covid-19 on cognitive failures at work: implications for task performance and turnover intentions. Sci Rep 2022; 12:8826. [PMID: 35614311 PMCID: PMC9130967 DOI: 10.1038/s41598-022-13051-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/19/2022] [Indexed: 11/08/2022] Open
Abstract
Individuals who contract Covid-19 often experience problems with memory, attention, and concentration, even after recovering from the initial illness. In the current manuscript, we argue that these symptoms are likely to manifest as cognitive failures in the workplace. Downstream, cognitive failures were expected to be associated with decreased task performance and increased turnover intentions. We collected data from a sample of working adults who either had (n = 45) or had not (n = 49) contracted Covid-19 at least one month prior to the study. Both groups were matched on key demographic characteristics. As anticipated, individuals who had contracted Covid-19 reported significantly more cognitive failures at work, relative to individuals who did not. More so, having contracted Covid-19 had significant indirect effects on task performance and turnover intentions via cognitive failure. These results indicate that beyond physical harm, Covid-19 can also have a detrimental influence on an individual's capacity to perform at work.
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Zeng C, Zhang J, Li Z, Sun X, Yang X, Olatosi B, Weissman S, Li X. Population Mobility and Aging Accelerate the Transmission of Coronavirus Disease 2019 in the Deep South: A County-Level Longitudinal Analysis. Clin Infect Dis 2022; 74:e1-e3. [PMID: 35568472 PMCID: PMC9107377 DOI: 10.1093/cid/ciac050] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Population mobility and aging at local areas contributed to the geospatial disparities in the coronavirus disease 2019 (COVID-19) transmission among 418 counties in the Deep South. In predicting the incidence of COVID-19, a significant interaction was found between mobility and the proportion of older adults. Effective disease control measures should be tailored to vulnerable communities.
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Affiliation(s)
- Chengbo Zeng
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,University of South Carolina Big Data Health Science Center, Columbia, South Carolina, USA
| | - Jiajia Zhang
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,University of South Carolina Big Data Health Science Center, Columbia, South Carolina, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Zhenlong Li
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,University of South Carolina Big Data Health Science Center, Columbia, South Carolina, USA.,Geoinformation and Big Data Research Laboratory, Department of Geography, College of Arts and Sciences, University of South Carolina, Columbia, South Carolina, USA
| | - Xiaowen Sun
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,University of South Carolina Big Data Health Science Center, Columbia, South Carolina, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Xueying Yang
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,University of South Carolina Big Data Health Science Center, Columbia, South Carolina, USA
| | - Bankole Olatosi
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,University of South Carolina Big Data Health Science Center, Columbia, South Carolina, USA.,Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Sharon Weissman
- University of South Carolina Big Data Health Science Center, Columbia, South Carolina, USA.,Department of Internal Medicine, School of Medicine, University of South Carolina, Columbia, South Carolina, USA
| | - Xiaoming Li
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,University of South Carolina Big Data Health Science Center, Columbia, South Carolina, USA
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Noh HS, Han S, Choi YJ. Who spends more to combat COVID-19 social risks and why? INTERNATIONAL JOURNAL OF SOCIAL WELFARE 2022; 31:IJSW12535. [PMID: 35599724 PMCID: PMC9111726 DOI: 10.1111/ijsw.12535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 03/23/2022] [Accepted: 03/30/2022] [Indexed: 06/15/2023]
Abstract
COVID-19 has gone beyond a public health crisis and poses a serious threat to people's livelihoods. In response to the growing employment and income crisis, most OECD countries have introduced various policies and programs to alleviate rapidly rising social risks and stabilise people's livelihoods. However, these measures vary, with some governments spending only 1% of GDP in 2020, while others spent more than 10%. We conducted a multiple regression analysis to examine factors associated with the level of additional social spending in 31 OECD countries. The results indicate that lower generosity of unemployment benefits was associated with additional social policy spending. However, contrary to the hypothesis, higher additional spending was found among countries with higher levels of government debt. We ended with policy recommendations.
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Affiliation(s)
- Hye Sang Noh
- Institute for Welfare State ResearchYonsei UniversitySeoulRepublic of Korea
| | - Seon‐hoe Han
- Institute for Welfare State ResearchYonsei UniversitySeoulRepublic of Korea
| | - Young Jun Choi
- Department of Public AdministrationYonsei UniversitySeoulRepublic of Korea
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Abstract
Health promotion has long aspired for a world where all people can live to their full potential. Yet, COVID-19 illuminates dramatically different consequences for populations bearing heavy burdens of systemic disadvantage within countries and between the Global South and Global North. Many months of pandemic is entrenching inequities that reveal themselves in the vastly differential distribution of hospitalization and mortality, for example, among racialized groups in the USA. Amplified awareness of the intimate relationship between health, social structures, and economy opens a window of opportunity to act on decades of global commitments to prioritize health equity. Choices to act (or not act) are likely to accelerate already vast inequities within and between countries as rapidly as the COVID-19 pandemic itself. Recognizing the inherently global nature of this pandemic, this article explores how determinants of equity are embedded in global responses to it, arguing that these determinants will critically shape our global futures. This article aims to stimulate dialogue about equity-centered health promoting action during a pandemic, using the Canadian Coalition for Global Health Research (CCGHR) Principles for Global Health Research to examine equity considerations at a time of pandemic. Attentiveness to power and the relationship between political economy and health are argued as central to identifying and examining issues of equity. This article invites dialogue about how equity-centered planning, decision-making and action could leverage this massive disruption to society to spark a more hopeful, just, and humane collective future.
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Affiliation(s)
- Katrina M Plamondon
- School of Nursing, Faculty of Health & Social Development, University of British Columbia, 1147 Research Road, Kelowna, BC V1V 1V7, Canada
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47
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Xia Y, Ma H, Moloney G, Velásquez García HA, Sirski M, Janjua NZ, Vickers D, Williamson T, Katz A, Yiu K, Kustra R, Buckeridge DL, Brisson M, Baral SD, Mishra S, Maheu-Giroux M. Geographic concentration of SARS-CoV-2 cases by social determinants of health in metropolitan areas in Canada: a cross-sectional study. CMAJ 2022; 194:E195-E204. [PMID: 35165131 PMCID: PMC8900797 DOI: 10.1503/cmaj.211249] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 12/27/2022] Open
Abstract
Background: Understanding inequalities in SARS-CoV-2 transmission associated with the social determinants of health could help the development of effective mitigation strategies that are responsive to local transmission dynamics. This study aims to quantify social determinants of geographic concentration of SARS-CoV-2 cases across 16 census metropolitan areas (hereafter, cities) in 4 Canadian provinces, British Columbia, Manitoba, Ontario and Quebec. Methods: We used surveillance data on confirmed SARS-CoV-2 cases and census data for social determinants at the level of the dissemination area (DA). We calculated Gini coefficients to determine the overall geographic heterogeneity of confirmed cases of SARS-CoV-2 in each city, and calculated Gini covariance coefficients to determine each city’s heterogeneity by each social determinant (income, education, housing density and proportions of visible minorities, recent immigrants and essential workers). We visualized heterogeneity using Lorenz (concentration) curves. Results: We observed geographic concentration of SARS-CoV-2 cases in cities, as half of the cumulative cases were concentrated in DAs containing 21%–35% of their population, with the greatest geographic heterogeneity in Ontario cities (Gini coefficients 0.32–0.47), followed by British Columbia (0.23–0.36), Manitoba (0.32) and Quebec (0.28–0.37). Cases were disproportionately concentrated in areas with lower income and educational attainment, and in areas with a higher proportion of visible minorities, recent immigrants, high-density housing and essential workers. Although a consistent feature across cities was concentration by the proportion of visible minorities, the magnitude of concentration by social determinant varied across cities. Interpretation: Geographic concentration of SARS-CoV-2 cases was observed in all of the included cities, but the pattern by social determinants varied. Geographically prioritized allocation of resources and services should be tailored to the local drivers of inequalities in transmission in response to the resurgence of SARS-CoV-2.
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Affiliation(s)
- Yiqing Xia
- Department of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont
| | - Huiting Ma
- Department of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont
| | - Gary Moloney
- Department of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont
| | - Héctor A Velásquez García
- Department of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont
| | - Monica Sirski
- Department of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont
| | - Naveed Z Janjua
- Department of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont
| | - David Vickers
- Department of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont
| | - Tyler Williamson
- Department of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont
| | - Alan Katz
- Department of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont
| | - Kristy Yiu
- Department of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont
| | - Rafal Kustra
- Department of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont
| | - David L Buckeridge
- Department of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont
| | - Marc Brisson
- Department of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont
| | - Stefan D Baral
- Department of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont
| | - Sharmistha Mishra
- Department of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont.
| | - Mathieu Maheu-Giroux
- Department of Epidemiology and Biostatistics (Xia, Buckeridge, Maheu-Giroux), School of Population and Global Health, McGill University, Montréal, Que.; MAP Centre for Urban Health Solutions (Xia, Ma, Moloney, Yiu, Mishra), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; School of Population and Public Health (Velásquez García, Janjua), University of British Columbia; British Columbia Centre for Disease Control (Velásquez García, Janjua), Vancouver, BC; Departments of Community Health Sciences and Family Medicine (Sirski, Katz), Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man.; Department of Community Health Sciences (Vickers, Williamson) and Centre for Health Informatics (Williamson), University of Calgary, Calgary, Alta.; Dalla Lana School of Public Health (Kustra), University of Toronto, Toronto, Ont.; Département de médecine sociale et préventive (Brisson), Faculté de médecine, Université Laval, Québec, Que.; Department of Epidemiology (Baral), Johns Hopkins School of Public Health, Baltimore, Md.; Division of Infectious Diseases (Mishra), Department of Medicine, University of Toronto, Toronto, Ont
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48
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Wang Q, Lung DC, Chan PT, Jia W, Dung CH, Miao T, Huang J, Chen W, Wang Z, Leung KM, Xu P, Lin Z, Wong D, Tse H, Ying Wong SC, Choi GKY, To KKW, Cheng VCC, Yuen KY, Li Y. High attack rate in a Tong Lau house outbreak of COVID-19 with subdivided units in Hong Kong. Interface Focus 2022; 12:20210063. [PMID: 35261729 PMCID: PMC8831081 DOI: 10.1098/rsfs.2021.0063] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/08/2021] [Indexed: 12/11/2022] Open
Abstract
Poor housing conditions are known to be associated with infectious diseases such as high Coronavirus disease 2019 (COVID-19) incidences. Transmission causes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in poor housing conditions can be complex. An understanding of the exact mechanism of transmission can help to pinpoint contributing environmental issues. Here, we investigated a Hong Kong COVID-19 outbreak in early 2021 in four traditional Tong Lau houses with subdivided units. There are more than 80 subdivided units of less than 20 m2 floor area each on average. With a total of 34 confirmed COVID-19 cases, the outbreak had an attack rate of 25.4%, being one of the highest attack rates observed in Hong Kong, and ranked among the highest attack rates in reported outbreaks internationally. Tracer gas leakage and decay measurements were performed in the drainage system and in the subdivided units to determine the transport of infectious aerosols by the owner-modified sophisticated wastewater drainage pipe networks and the poor ventilation conditions in some subdivided units. The results show that the outbreak was probably due to multiple transmission routes, i.e. by the drainage pipe spread of stack aerosols, which is enhanced by poor ventilation in the subdivided units.
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Affiliation(s)
- Qun Wang
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - David Christopher Lung
- Department of Pathology, Hong Kong Children's Hospital, Hong Kong SAR, People's Republic of China
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong SAR, People's Republic of China
| | - Pak-To Chan
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Wei Jia
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Chung-Hin Dung
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Te Miao
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Jianxiang Huang
- Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Wenzhao Chen
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Zixuan Wang
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Kai-Ming Leung
- Environmental Protection Department, Hong Kong SAR, People's Republic of China
| | - Pengcheng Xu
- Institute of Applied Mathematics, Academy of Mathematics and Systems Sciences, Chinese Academy of Sciences, Beijing, People's Republic of China
| | - Zhang Lin
- Division of Building Science and Technology, City University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Daniel Wong
- Estates office, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Herman Tse
- Department of Pathology, Hong Kong Children's Hospital, Hong Kong SAR, People's Republic of China
| | - Sally Cheuk Ying Wong
- Department of Pathology, Hong Kong Children's Hospital, Hong Kong SAR, People's Republic of China
| | - Garnet Kwan-Yue Choi
- Department of Pathology, Hong Kong Children's Hospital, Hong Kong SAR, People's Republic of China
| | - Kelvin Kai-Wang To
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | | | - Kwok-Yung Yuen
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong SAR, People's Republic of China
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49
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D’Agostino EM, Haroz EE, Linde S, Layer M, Green M, Ko LK. School-Academic Partnerships in Support of Safe Return to Schools During the COVID-19 Pandemic. Pediatrics 2022; 149:e2021054268C. [PMID: 34737180 PMCID: PMC9647737 DOI: 10.1542/peds.2021-054268c] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 02/03/2023] Open
Abstract
Safely returning underserved youth to school during the coronavirus disease 2019 (COVID-19) pandemic through diagnostic testing and health education is imperative to mitigate the ongoing negative impact of COVID-19 and reduce health inequalities in underserved communities. The Rapid Acceleration of Diagnostics-Underserved Populations program is a consortium of research projects across the United States funded by the National Institutes of Health to understand the factors associated with the disproportionate burden of the pandemic among underserved populations and to leverage mitigation strategies, including diagnostic testing, with a focus on reducing health disparities. In this article, we provide an overview and introduce the articles from 8 Rapid Acceleration of Diagnostics-Underserved Populations projects featured in the supplement "Navigating a Pandemic in the K-12 Setting: Keeping Our School Communities Safe" published in Pediatrics. These projects funded in the program's first phase focus on COVID-19 diagnostic testing approaches for youth and employees at schools in underserved communities to support safe in-person learning. In the articles comprising the supplement, researchers present barriers and facilitators of the community engagement process necessary to establish school-academic partnerships. These efforts showcase school-based implementation testing strategies during the COVID-19 pandemic but are translatable to tackling other challenges related to reducing health disparities.
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Affiliation(s)
- Emily M. D’Agostino
- Departments of Orthopaedic Surgery
- Population Health Sciences, School of Medicine, Duke University, Durham, North Carolina
| | - Emily E. Haroz
- Johns Hopkins Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Sandra Linde
- Astria Sunnyside Hospital, Sunnyside, Washington
| | - Marcus Layer
- Duke Clinical Research Institute, Durham, North Carolina
| | - Melissa Green
- Center for Health Equity Research, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Linda K. Ko
- University of Washington, Seattle, Washington
- Fred Hutchinson Cancer Research Center, Seattle, Washington
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50
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Impact of the COVID-19 Pandemic on the Pediatric Hospital Visits: Evidence from the State of Florida. Pediatr Rep 2022; 14:58-70. [PMID: 35225879 PMCID: PMC8883905 DOI: 10.3390/pediatric14010010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/07/2022] [Accepted: 01/12/2022] [Indexed: 12/28/2022] Open
Abstract
Although early evidence reported a substantial decline in pediatric hospital visits during COVID-19, it is unclear whether the decline varied across different counties, particularly in designated Medically Underserved Areas (MUA). The objective of this study is to explore the state-wide impact of COVID-19 on pediatric hospital visit patterns, including the economic burden and MUA communities. We conducted a retrospective observational study of pediatric hospital visits using the Florida State all-payer Emergency Department (ED) and Inpatient dataset during the pandemic (April-September 2020) and the same period in 2019. Pediatric Treat-and-Release ED and inpatient visit rates were compared by patient demographics, socioeconomic, diagnosis, MUA status, and hospital characteristics. Pediatric hospital visits in Florida decreased by 53.7% (62.3% in April-June, 44.2% in July-September) during the pandemic. The Treat-and-Release ED and inpatient visits varied up to 5- and 3-fold, respectively, across counties. However, changes in hospital visits across MUA counties were similar compared with non-MUA counties except for lower Treat-and-Release ED volume in April-May. The disproportional decrease in visits was notable for the underserved population, including Hispanic and African American children; Medicaid coverages; non-children's hospitals; and diagnosed with respiratory diseases, appendicitis, and sickle-cell. Florida Hospitals experienced a USD 1.37 billion (average USD 8.3 million) decline in charges across the study period in 2020. Disproportionate decrease in hospital visits, particularly in the underserved population, suggest a combined effect of the persistent challenge of care access and changes in healthcare-seeking behavior during the pandemic. These findings suggest that providers and policymakers should emphasize alternative interventions/programs ensuring adequate care during the pandemic, particularly for high-risk children.
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