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Adekoya N, Chang MH, Wortham J, Truman BI. Disparities in Rates of Death From HIV or Tuberculosis Before Age 65 Years, by Race, Ethnicity, and Sex, United States, 2011-2020. Public Health Rep 2023:333549231213328. [PMID: 38111105 DOI: 10.1177/00333549231213328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023] Open
Abstract
OBJECTIVE Death from tuberculosis or HIV among people from racial and ethnic minority groups who are aged <65 years is a public health concern. We describe age-adjusted, absolute, and relative death rates from HIV or tuberculosis from 2011 through 2020 by sex, race, and ethnicity among US residents. METHODS We used mortality data from the Centers for Disease Control and Prevention online data system on deaths from multiple causes from 2011 through 2020 to calculate age-adjusted death rates and absolute and relative disparities in rates of death by sex, race, and ethnicity. We calculated corresponding 95% CIs for all rates and determined significance at P < .05 by using z tests. RESULTS For tuberculosis, when compared with non-Hispanic White residents, non-Hispanic American Indian or Alaska Native residents had the highest level of disparity in rate of death (666.7%). Similarly, as compared with non-Hispanic White female residents, American Indian or Alaska Native female residents had a high relative disparity in death from tuberculosis (620.0%). For HIV, the age-adjusted death rate was more than 8 times higher among non-Hispanic Black residents than among non-Hispanic White residents, and the relative disparity was 735.1%. When compared with non-Hispanic White female residents, Black female residents had a high relative disparity in death from HIV (1529.2%). CONCLUSION Large disparities in rates of death from tuberculosis or HIV among US residents aged <65 years based on sex, race, and ethnicity indicate an ongoing unmet need for effective interventions. Intervention strategies are needed to address disparities in rates of death and infection among racial and ethnic minority populations.
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Affiliation(s)
- Nelson Adekoya
- National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Man-Huei Chang
- National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jonathan Wortham
- National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Benedict I Truman
- National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Langwerden RJ, Ibañez GE, Contreras-Pérez ME, Contreras HA, Rivero ML, Charles SC, Morris SL, Campa AL, Wagner EF, Hospital MM. A Qualitative Exploration of COVID-19 Vaccine Hesitancy Among Hispanic/Latine and African American and Black Middle-Aged and Older Adults in South Florida. Health Equity 2023; 7:166-177. [PMID: 36942313 PMCID: PMC10024580 DOI: 10.1089/heq.2022.0144] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2023] [Indexed: 03/12/2023] Open
Abstract
Racial and ethnic health disparities are more conspicuous in the United States since the start of the coronavirus disease 2019 (COVID-19) pandemic. While the urgency of these disparities was already alarming, the pandemic has exacerbated longstanding issues in health equity, disproportionate impacts, and social determinants of health. Vaccine hesitancy was a crucial factor during the U.S. COVID-19 vaccination campaign. We conducted a qualitative exploration of vaccine hesitancy through thematic analysis of four focus groups with Hispanic/Latine and African American/Black adults and senior citizens (N=23). The focus groups were conducted between February and April of 2021, in both English and Spanish. All participants (mean age=66.2, female 78.3%) were recruited by community-based organizations in the South Florida area. We explored six categories: (1) barriers to prevention and preventive behaviors, (2) barriers to vaccination against COVID-19, (3) facilitators of prevention and preventative behaviors, (4) facilitators of vaccination against COVID-19, (5) trusted sources of information, and (6) suggested macrolevel measures. These categories are discussed vis-à-vis COVID-19 disparities among racial and ethnic minorities. Implications for public health policy and future vaccination campaigns are outlined and discussed.
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Affiliation(s)
- Robbert J. Langwerden
- Community-Based Research Institute, Florida International University, Miami, Florida, USA
- Research Center in a Minority Institution, Florida International University, Miami, Florida, USA
- Address correspondence to: Robbert J. Langwerden, MSc, Community-Based Research Institute, Florida International University, 11200 SW 8th Street, Academic Health Center 5, Miami, FL 33199, USA,
| | - Gladys E. Ibañez
- Department of Epidemiology, Florida International University, Miami, Florida, USA
| | - María Eugenia Contreras-Pérez
- Community-Based Research Institute, Florida International University, Miami, Florida, USA
- Research Center in a Minority Institution, Florida International University, Miami, Florida, USA
- Robert Stempel School of Social Work, Florida International University, Miami, Florida, USA
| | - Haby Abraham Contreras
- Department of Dietetics and Nutrition, Florida International University, Miami, Florida, USA
| | - Maria Luzardo Rivero
- Department of Dietetics and Nutrition, Florida International University, Miami, Florida, USA
| | - Sara C. Charles
- Community-Based Research Institute, Florida International University, Miami, Florida, USA
- Research Center in a Minority Institution, Florida International University, Miami, Florida, USA
| | - Staci L. Morris
- Community-Based Research Institute, Florida International University, Miami, Florida, USA
- Research Center in a Minority Institution, Florida International University, Miami, Florida, USA
- Robert Stempel School of Social Work, Florida International University, Miami, Florida, USA
| | - Adriana L. Campa
- Institutional Review Board, Florida International University, Miami, Florida, USA
| | - Eric F. Wagner
- Community-Based Research Institute, Florida International University, Miami, Florida, USA
- Research Center in a Minority Institution, Florida International University, Miami, Florida, USA
- Robert Stempel School of Social Work, Florida International University, Miami, Florida, USA
| | - Michelle M. Hospital
- Community-Based Research Institute, Florida International University, Miami, Florida, USA
- Research Center in a Minority Institution, Florida International University, Miami, Florida, USA
- Department of Biostatistics, Florida International University, Miami, Florida, USA
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Falla-Aliabadi S, Heydari A, Fatemi F, Yoshany N, Lotfi MH, Sarsangi A, Hanna F. Impact of social and cultural factors on incidence, transmission and control of Coronavirus disease in Iran: a qualitative study. BMC Public Health 2022; 22:2352. [PMID: 36522718 PMCID: PMC9753076 DOI: 10.1186/s12889-022-14805-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 12/05/2022] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION COVID-19 pandemic has had mixed reactions from nations, people and governments about ways to cope with, prevent and control the disease. The current study identifies social, cultural and policy factors affecting the incidence and control of Coronavirus disease in Iran. METHODS A qualitative study consists of content analysis as well as the views of 20 experienced and knowledgeable subjects specialized in social and cultural health management. The data were gathered using three semi-structured interviews and then continued by 17 semi-structured interviews. Data analysis was done using Graneheim approach. After each interview, the recorded audio files transcript and reviewed. Then codes extracted and divided to categories and sub-categories. RESULTS There are distinct social and cultural factors in coping with Coronavirus disease. These consisted of three categories of governance, individual and community related factors. A total of 17 subcategories and 215 primary codes that were extracted from the text of interviews as variables of the study and in relation to the research question. Ten subdomains of governance including vaccination, political issues, knowledge, support services, administrative services, transportation, health and treatment, culturalization, legislation and, managerial and financial policies impacted the spread and mitigation of the pandemic at various levels. CONCLUSION The management of pandemics requires a comprehensive capacity for identifying and determining social and cultural criteria. A healthy partnership between governments and the community may be required to remove unnecessary obstacles that hinder public health attempt to alleviate the risk. The obtained criteria and indicators from this study may be utilized by policy makers in an attempt to strengthen protocols for mitigating pandemics. Further studies may be warranted to confirm these findings.
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Affiliation(s)
- Saeed Falla-Aliabadi
- Department of Health in Emergencies and Disasters, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Accident Prevention and Crisis Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ahad Heydari
- Department of Health in Disaster and Emergencies, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Farin Fatemi
- Social Determinant of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Nooshin Yoshany
- Department of Health education and Promotion, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hasan Lotfi
- Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Alireza Sarsangi
- GIS and Remote Sensing Department, University of Tehran, Tehran, Iran
| | - Fahad Hanna
- Program of Public Health, Torrens University Australia, Melbourne, VIC Australia
- Higher Education College, Chisholm Institute, Dandenong, VIC Australia
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Habibdoust A, Tatar M, Wilson FA. Estimating Excess Deaths by Race/Ethnicity in the State of California During the COVID-19 Pandemic. J Racial Ethn Health Disparities 2022:10.1007/s40615-022-01349-9. [PMID: 35818019 PMCID: PMC9273689 DOI: 10.1007/s40615-022-01349-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/01/2022] [Accepted: 06/14/2022] [Indexed: 11/17/2022]
Abstract
Introduction To examine excess mortality among minorities in California during the COVID-19 pandemic. Methods Using seasonal autoregressive integrated moving average time series, we estimated counterfactual total deaths using historical data (2014–2019) of all-cause mortality by race/ethnicity. Estimates were compared to pandemic mortality trends (January 2020 to January 2021) to predict excess deaths during the pandemic for each race/ethnic group. Results Our findings show a significant disparity among minority excess deaths, including 7892 (24.6% increase), 4903 (20.4%), 30,186 (47.7%), and 22,027 (12.6%) excess deaths, including deaths identified as COVID-19-related, for Asian, Black, Hispanic, and White non-Hispanic individuals, respectively. Estimated increases in all-cause deaths excluding COVID-19 deaths were 1331, 1436, 3009, and 5194 for Asian, Black, Hispanic, and White non-Hispanic individuals, respectively. However, the rate of excess deaths excluding COVID-19 recorded deaths per 100 k was disproportionately high for Black (66 per 100 k) compared to White non-Hispanic (36 per 100 k). The rates for Asians and Hispanics were 23 and 19 per 100 k. Conclusions Our findings emphasize the importance of targeted policies for minority populations to lessen the disproportionate impact of COVID-19 on their communities.
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Affiliation(s)
- Amir Habibdoust
- Department of Economics and Accounting, University of Guilan, Persian Gulf Highway, Rasht, Iran.
| | - Moosa Tatar
- Center for Value-Based Care Research, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Fernando A Wilson
- Matheson Center for Health Care Studies, University of Utah, Salt Lake City, UT, 84108, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA.,Department of Economics, University of Utah, Salt Lake City, UT, USA
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Langwerden RJ, Wagner EF, Hospital MM, Morris SL, Cueto V, Carrasquillo O, Charles SC, Perez KR, Contreras-Pérez ME, Campa AL. A Latent Profile Analysis of COVID-19 Trusted Sources of Information among Racial and Ethnic Minorities in South Florida. Vaccines (Basel) 2022; 10:545. [PMID: 35455294 PMCID: PMC9031496 DOI: 10.3390/vaccines10040545] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 12/23/2022] Open
Abstract
By the spring of 2021, most of the adult U.S. population became eligible to receive a COVID-19 vaccine. Yet, by the summer of 2021, the vaccination rate stagnated. Given the immense impact COVID-19 has had on society and individuals, and the surge of new variant strains of the virus, it remains urgent to better understand barriers to vaccination, including the impact of variations in trusted sources of COVID-19 information. The goal of the present study was to conduct a cross-sectional, community-engaged, and person-centered study of trusted sources of COVID-19 information using latent profile analysis (LPA). The aims were to (1) identify the number and nature of profiles of trusted sources of COVID-19 information, and (2) determine whether the trust profiles were predictive of COVID-19 vaccination attitudes and various demographic categories. Participants included mostly racial and ethnic minority individuals (82.4%) recruited by various community-based agencies in South Florida. The LPA evidenced an optimal 3-class solution characterized by low (n = 80)-, medium (n = 147)-, and high (n = 52)-trust profiles, with high trust statistically significantly predictive of vaccination willingness. The profiles identified could be important targets for public health dissemination efforts to reduce vaccine hesitancy and increase COVID-19 vaccination uptake. The general level of trust in COVID-19 information sources was found to be an important factor in predicting COVID-19 vaccination willingness.
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Affiliation(s)
- Robbert J. Langwerden
- Community-Based Research Institute, Florida International University, Miami, FL 33199, USA; (E.F.W.); (M.M.H.); (S.L.M.); (S.C.C.); (K.R.P.); (M.E.C.-P.)
- Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA;
| | - Eric F. Wagner
- Community-Based Research Institute, Florida International University, Miami, FL 33199, USA; (E.F.W.); (M.M.H.); (S.L.M.); (S.C.C.); (K.R.P.); (M.E.C.-P.)
- Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA;
- Robert Stempel School of Public Health & Social Work, Florida International University, Miami, FL 33199, USA
| | - Michelle M. Hospital
- Community-Based Research Institute, Florida International University, Miami, FL 33199, USA; (E.F.W.); (M.M.H.); (S.L.M.); (S.C.C.); (K.R.P.); (M.E.C.-P.)
- Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA;
- Department of Biostatistics, Florida International University, Miami, FL 33199, USA
| | - Staci L. Morris
- Community-Based Research Institute, Florida International University, Miami, FL 33199, USA; (E.F.W.); (M.M.H.); (S.L.M.); (S.C.C.); (K.R.P.); (M.E.C.-P.)
- Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA;
- Robert Stempel School of Public Health & Social Work, Florida International University, Miami, FL 33199, USA
| | - Victor Cueto
- Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (V.C.); (O.C.)
| | - Olveen Carrasquillo
- Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (V.C.); (O.C.)
| | - Sara C. Charles
- Community-Based Research Institute, Florida International University, Miami, FL 33199, USA; (E.F.W.); (M.M.H.); (S.L.M.); (S.C.C.); (K.R.P.); (M.E.C.-P.)
- Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA;
| | - Katherine R. Perez
- Community-Based Research Institute, Florida International University, Miami, FL 33199, USA; (E.F.W.); (M.M.H.); (S.L.M.); (S.C.C.); (K.R.P.); (M.E.C.-P.)
- Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA;
| | - María Eugenia Contreras-Pérez
- Community-Based Research Institute, Florida International University, Miami, FL 33199, USA; (E.F.W.); (M.M.H.); (S.L.M.); (S.C.C.); (K.R.P.); (M.E.C.-P.)
- Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA;
| | - Adriana L. Campa
- Research Center in a Minority Institution, Florida International University, Miami, FL 33199, USA;
- Department of Dietetics and Nutrition, Florida International University, Miami, FL 33199, USA
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