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Horiike R, Itatani T, Nakai H, Nishioka D, Kataoka A, Ito Y. Using Spatial Scan Statistics and Geographic Information Systems to Detect Monthly Human Mobility Clusters and Analyze Cluster Area Characteristics. JMA J 2024; 7:319-327. [PMID: 39114599 PMCID: PMC11301033 DOI: 10.31662/jmaj.2023-0208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/26/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction This study evaluated the detection of monthly human mobility clusters and characteristics of cluster areas before the coronavirus disease 2019 (COVID-19) outbreak using spatial epidemiological methods, namely, spatial scan statistics and geographic information systems (GIS). Methods The research area covers approximately 10.3 km2, with a population of about 350,000 people. Analysis was conducted using open data, with the exception of one dataset. Human mobility and population data were used on a 1-km mesh scale, and business location data were used to examine the area characteristics. Data from January to December 2019 were utilized to detect human mobility clusters before the COVID-19 pandemic. Spatial scan statistics were performed using SaTScan to calculate relative risk (RR). The detected clusters and other data were visualized in QGIS to explore the features of the cluster areas. Results Spatial scan statistics identified 33 clusters. The detailed analysis focused on clusters with an RR exceeding 1.5. Meshes with an RR over 1.5 included one with clusters for 1 year which is identified in all months of the year, one with clusters for 9 months, three with clusters for 6 months, three with clusters for 3 months, and four with clusters for 1 month. September had the highest number of clusters (eight), followed by April and November (seven each). The remaining months had five or six clusters. Characteristically, the cluster areas included the vicinity of railway stations, densely populated business areas, ball game fields, and large-scale construction sites. Conclusions Statistical analysis of human mobility clusters using open data and open-source tools is crucial for the advancement of evidence-based policymaking based on scientific facts, not only for novel infectious diseases but also for existing ones, such as influenza.
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Affiliation(s)
- Ryo Horiike
- Department of Public Health Nursing, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Tomoya Itatani
- Division of Home Care Nursing, Department of Fundamental and Community Nursing Science, School of Nursing, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Hisao Nakai
- Faculty of Nursing, University of Kochi, Kochi, Japan
| | - Daisuke Nishioka
- Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Aoi Kataoka
- Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, Osaka, Japan
- Division of Molecular Epidemiology, Department of Future Medicine Sciences, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Yuri Ito
- Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, Osaka, Japan
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Gharaibeh A, Gharaibeh MA, Bataineh S, Kecerová AM. Exploring the Spatial and Temporal Patterns of Children and Adolescents with COVID-19 Infections in Slovakia during March 2020 to July 2022. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:931. [PMID: 38929548 PMCID: PMC11205471 DOI: 10.3390/medicina60060931] [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: 04/16/2024] [Revised: 05/11/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024]
Abstract
Background and Objectives: The COVID-19 pandemic has had a significant global impact, necessitating a comprehensive understanding of its spatiotemporal patterns. The objective of this study is to explore the spatial and temporal patterns of COVID-19 infections among five age groups (<1, 1-4, 5-9, 10-14, and 15-19 years) in 72 districts of Slovakia on a quarterly basis from March 2020 to July 2022. Material and Methods: During the study period, a total of 393,429 confirmed PCR cases of COVID-19 or positive antigen tests were recorded across all studied age groups. The analysis examined the spatiotemporal spread of COVID infections per quarter, from September 2021 to May 2022. Additionally, data on hospitalizations, intensive care unit (ICU) admissions, pulmonary ventilation (PV), and death cases were analyzed. Results: The highest number of COVID-19 infections occurred between September 2021 and May 2022, particularly in the 10-14-year-old group (68,695 cases), followed by the 15-19-year-old group (62,232 cases), while the lowest incidence was observed in the <1-year-old group (1235 cases). Out of the total confirmed PCR cases, 18,886 individuals required hospitalization, 456 needed ICU admission, 402 received pulmonary ventilation, and only 16 died. The analysis of total daily confirmed PCR cases for all regions showed two major peaks on 12 December 2021 (6114 cases) and 1 February 2022 (3889 cases). Spatial mapping revealed that during December 2021 to February 2022, the highest number of infections in all age groups were concentrated mainly in Bratislava. Moreover, temporal trends of infections within each age group, considering monthly and yearly variations, exhibited distinct spatial patterns, indicating localized outbreaks in specific regions. Conclusions: The spatial and temporal patterns of COVID-19 infections among different age groups in Slovakia showed a higher number of infections in the 10-14-year-old age group, mainly occurring in urban districts. The temporal pattern of the spread of the virus to neighboring urban and rural districts reflected the movement of infected individuals. Hospitalizations, ICU and PV admissions, and deaths were relatively low. The study highlights the need for more proactive measures to contain outbreaks promptly and ensure the resilience of healthcare systems against future pandemics.
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Affiliation(s)
- Ahmad Gharaibeh
- Teaching Department of Orthopaedics Musculoskeletal Trauma, Faculty of Medicine, University Hospital of Louise Pasteur, Pavel Jozef Safarik University, 040 11 Košice, Slovakia
| | - Mamoun A. Gharaibeh
- Department of Natural Resources and the Environment, Faculty of Agriculture, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Siham Bataineh
- Department of Civil Engineering, Faculty of Engineering, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan;
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Noppert GA, Clarke P, Hoover A, Kubale J, Melendez R, Duchowny K, Hegde ST. State variation in neighborhood COVID-19 burden across the United States. COMMUNICATIONS MEDICINE 2024; 4:36. [PMID: 38429552 PMCID: PMC10907669 DOI: 10.1038/s43856-024-00459-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 02/12/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND A lack of fine, spatially-resolute case data for the U.S. has prevented the examination of how COVID-19 infection burden has been distributed across neighborhoods, a key determinant of both risk and resilience. Without more spatially resolute data, efforts to identify and mitigate the long-term fallout from COVID-19 in vulnerable communities will remain difficult to quantify and intervene on. METHODS We leveraged spatially-referenced data from 21 states collated through the COVID Neighborhood Project to examine the distribution of COVID-19 cases across neighborhoods and states in the U.S. We also linked the COVID-19 case data with data on the neighborhood social environment from the National Neighborhood Data Archive. We then estimated correlations between neighborhood COVID-19 burden and features of the neighborhood social environment. RESULTS We find that the distribution of COVID-19 at the neighborhood-level varies within and between states. The median case count per neighborhood (coefficient of variation (CV)) in Wisconsin is 3078.52 (0.17) per 10,000 population, indicating a more homogenous distribution of COVID-19 burden, whereas in Vermont the median case count per neighborhood (CV) is 810.98 (0.84) per 10,000 population. We also find that correlations between features of the neighborhood social environment and burden vary in magnitude and direction by state. CONCLUSIONS Our findings underscore the importance that local contexts may play when addressing the long-term social and economic fallout communities will face from COVID-19.
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Affiliation(s)
- Grace A Noppert
- Institute for Social Research, University of Michigan, Ann Arbor, USA.
| | - Philippa Clarke
- Institute for Social Research, University of Michigan, Ann Arbor, USA
| | - Andrew Hoover
- Institute for Social Research, University of Michigan, Ann Arbor, USA
| | - John Kubale
- Institute for Social Research, University of Michigan, Ann Arbor, USA
| | - Robert Melendez
- Institute for Social Research, University of Michigan, Ann Arbor, USA
| | - Kate Duchowny
- Institute for Social Research, University of Michigan, Ann Arbor, USA
| | - Sonia T Hegde
- Department of Epidemiology, Johns Hopkins University, Baltimore, USA
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Alphonso SR, Andrews MR, Regan SD, Shishkov A, Cantor JH, Powell-Wiley TM, Tamura K. Geospatially clustered low COVID-19 vaccine rates among adolescents in socially vulnerable US counties. Prev Med Rep 2024; 37:102545. [PMID: 38186659 PMCID: PMC10767486 DOI: 10.1016/j.pmedr.2023.102545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024] Open
Abstract
COVID-19 vaccinations are widely available across the United States (U.S.), yet little is known about the spatial clustering of COVID-19 vaccinations. This study aimed to test for geospatial clustering of COVID-19 vaccine rates among adolescents aged 12-17 across the U.S. counties and to compare these clustering patterns by sociodemographic characteristics. County-level data on COVID-19 vaccinations and sociodemographic characteristics were obtained from the COVID-19 Community Profile Report up to April 14, 2022. A total of 3,108 counties were included in the analysis. Global Moran's I statistic and Anselin Local Moran's analysis were used, and clustering patterns were compared to sociodemographic variables using t-tests. Counties with low COVID-19 vaccinated clusters were more likely, when compared to unclustered counties, to have higher numbers of individuals in poverty and uninsured individuals, and higher values of Social Vulnerability Index (SVI) and COVID-19 Community Vulnerability Index (CCVI). While high COVID-19 vaccinated clusters, compared to neighboring counties, had lower numbers of Black population, individuals in poverty, and uninsured individuals, and lower values of SVI and CCVI, but a higher number of Hispanic population. This study emphasizes the importance of addressing systemic barriers, such as poverty and lack of health insurance, which were found to be associated with low COVID-19 vaccination coverage.
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Affiliation(s)
- Sophie R. Alphonso
- Socio-Spatial Determinants of Health (SSDH) Laboratory, Population and Community Health Sciences Branch, Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Marcus R. Andrews
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Seann D. Regan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Alyssa Shishkov
- Socio-Spatial Determinants of Health (SSDH) Laboratory, Population and Community Health Sciences Branch, Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | | | - Tiffany M. Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Kosuke Tamura
- Socio-Spatial Determinants of Health (SSDH) Laboratory, Population and Community Health Sciences Branch, Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
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Richard DM, Gazmararian JA, Greenhouse A, Khakharia A, Phillips LS, Waller LA. Space-time clustering of COVID-19 cases in the United States veteran population. Ann Epidemiol 2023; 87:9-16. [PMID: 37742880 DOI: 10.1016/j.annepidem.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/30/2023] [Accepted: 09/17/2023] [Indexed: 09/26/2023]
Abstract
PURPOSE To assess the distribution and clustering of coronavirus disease 2019 (COVID-19) testing and incidence over space and time, U.S. Department of Veteran's Affairs (VA) data were used to describe where and when veterans experienced highest proportions of test positivity. METHODS Data for 6,342,455 veterans who utilized VA services between January 1, 2018, and September 30, 2021, were assessed for COVID-19 testing and test positivity. Testing and positivity proportions by county were mapped and focused-cluster tests identified significant clustering around VA facilities. Spatial cluster analysis also identified where and when veterans experienced highest proportions of test positivity. RESULTS Within the veterans study population and our time window, 21.3% received at least one COVID-19 test, and 20.4% of those tested had at least one positive test. There was statistically significant clustering of testing around VA facilities, revealing regional variation in testing practices. Veterans experienced highest test positivity proportions between November 2020 and January 2021 in a cluster of states in the Midwest, compared to those who received testing outside of the identified cluster (RR: 3.45). CONCLUSIONS Findings reflect broad regional trends in COVID-19 positivity which can inform VA policy and resource allocation. Additional analysis is needed to understand patterns during Delta and Omicron variant periods.
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Affiliation(s)
- Danielle M Richard
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
| | - Julie A Gazmararian
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Alyssa Greenhouse
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Anjali Khakharia
- Atlanta Veteran's Affairs Medical Center, Decatur, GA; Department of Medicine and Geriatrics, Emory University School of Medicine, Atlanta, GA
| | - Lawrence S Phillips
- Atlanta Veteran's Affairs Medical Center, Decatur, GA; Division of Endocrinology, Metabolism, and Nutrition, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Lance A Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA
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Shishkov A, Andrews MR, Alphonso SR, Deng Y, Moniruzzaman M, Cantor JH, Tamura K. County-Level Sociodemographic Characteristics and Availability of COVID-19 Therapeutic Drugs. JAMA Netw Open 2023; 6:e2334763. [PMID: 37728929 PMCID: PMC10512099 DOI: 10.1001/jamanetworkopen.2023.34763] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
This cross-sectional study examines access to COVID-19 treatments in US counties by race and ethnicity, poverty rate, uninsured rate, and other population and community characteristics.
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Affiliation(s)
- Alyssa Shishkov
- Socio-Spatial Determinants of Health (SSDH) Laboratory, Population and Community Health Sciences Branch, Division of Intramural Research, the National Institute on Minority Health and Health Disparities, the National Institutes of Health, Bethesda, Maryland
| | - Marcus R. Andrews
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor
| | - Sophie R. Alphonso
- Socio-Spatial Determinants of Health (SSDH) Laboratory, Population and Community Health Sciences Branch, Division of Intramural Research, the National Institute on Minority Health and Health Disparities, the National Institutes of Health, Bethesda, Maryland
| | - Yangyang Deng
- Socio-Spatial Determinants of Health (SSDH) Laboratory, Population and Community Health Sciences Branch, Division of Intramural Research, the National Institute on Minority Health and Health Disparities, the National Institutes of Health, Bethesda, Maryland
| | - Mohammad Moniruzzaman
- Socio-Spatial Determinants of Health (SSDH) Laboratory, Population and Community Health Sciences Branch, Division of Intramural Research, the National Institute on Minority Health and Health Disparities, the National Institutes of Health, Bethesda, Maryland
| | | | - Kosuke Tamura
- Socio-Spatial Determinants of Health (SSDH) Laboratory, Population and Community Health Sciences Branch, Division of Intramural Research, the National Institute on Minority Health and Health Disparities, the National Institutes of Health, Bethesda, Maryland
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Xu S, Li H, Wang J, Lu L, Dai Z. Relationship between meteorological factors and mortality in patients with coronavirus disease 2019: A cross-sectional study. Heliyon 2023; 9:e18565. [PMID: 37576230 PMCID: PMC10412992 DOI: 10.1016/j.heliyon.2023.e18565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 07/16/2023] [Accepted: 07/20/2023] [Indexed: 08/15/2023] Open
Abstract
Background Recent studies on COVID-19 have demonstrated that poverty, comorbidities, race/ethnicity, population density, mobility, hygiene and use of masks are some of the important correlates of COVID-19 outcomes. In fact, weather conditions also play an important role in enhancing or eradicating health issues. Based on Chinese experience, the development of SARS and COVID-19 is partially associated with alterations in climate that align with the seasonal shifts of the "24 solar terms." However, the applicability of this pattern to other countries, particularly the United States, which has the highest global incidence and mortality rates, remains subject to ongoing investigation. We need to find more evidence to in the U.S. states verify the relationship between meteorological factors and COVID-19 outcomes to provide epidemiological and environmental support for the COVID-19 pandemic prevention and resource preservation. Objective To evaluate the relationship between meteorological factors and Coronavirus Disease 2019 (COVID-19) mortality. Methods We conducted an ecological cross-sectional study to evaluate the relationship between meteorological factors (maximum temperature, minimum temperature, humidity, wind speed, precipitation, atmospheric pressure) and COVID-19 mortality. This retrospective observational study examines mortality rates among COVID-19 patients in the three US states, California, Texas, and New York, with the highest fatality numbers, between March 7, 2020 and March 7, 2021. The study draws upon data sourced from the publicly accessible Dryad database. The daily corresponding meteorological conditions were retrieved from the National Oceanic and Atmospheric Administration Global Meteorological website (https://www.ncei.noaa.gov/maps/hourly/). This study employed multivariate linear regression analysis to assess the correlation between six meteorological factors and COVID-19 mortality. Gaussian distribution models were utilized to generate smooth curves for examining the linear association between maximum or minimum temperature and mortality. Additionally, breakpoint analysis was conducted to evaluate the threshold effect of temperature. Results We found that the death toll of patients with COVID-19 decreased with an increase in the highest and lowest ambient temperatures (p < 0.001). In our study, we observed a seasonal difference in mortality rates, with a higher number of deaths occurring during winter months, particularly in January and February. However, mortality rates decreased significantly in March. Notably, we found no statistically significant correlation between relative humidity, average precipitation, and average wind speed with COVID-19 mortality (all p > 0.05). Daily COVID-19 death was negatively correlated with the maximum temperature (β = -22, 95% CI, -26.2 to -17.79 -, p < 0.01), while the maximum temperature was below 30 °C. Similarly, the number of deaths was negatively correlated with the minimum temperature (β = -27.46, 95% CI, -31.48 to -23.45, p < 0.01), when the minimum temperature was below 8 °C. Our study found a significant association between temperature and COVID-19 mortality, with every 1 °C increase in maximum or minimum temperature resulting in a decrease of 22 and 27 deceased cases, respectively. The relationship between atmospheric pressure and COVID-19 mortality was not fully elucidated due to its complex interaction with maximum temperature. Conclusions This empirical study adds to the existing body of research on the impact of climate factors on COVID-19 prevention and resource allocation. Policymakers and health scientists may find these findings useful in conjunction with other social factors when making decisions related to COVID-19 prevention and resource allocation.
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Affiliation(s)
- Shanshan Xu
- Office of Infection Management, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210029, China
| | - Haibo Li
- Division of Birth Cohort Study, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, 350001, China
| | - Juan Wang
- Musculoskeletal Pain Rehabilitation Department, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450002, China
| | - Lin Lu
- Department of Trade Union, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210029, China
| | - Zhengxiang Dai
- Office of Infection Management, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210029, China
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Noppert GA, Clarke P, Hoover A, Kubale J, Melendez R, Duchowny K, Hegde ST. State Variation in Neighborhood COVID-19 Burden: Findings from the COVID Neighborhood Project. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.19.23290222. [PMID: 37293100 PMCID: PMC10246150 DOI: 10.1101/2023.05.19.23290222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A lack of fine, spatially-resolute case data for the U.S. has prevented the examination of how COVID-19 burden has been distributed across neighborhoods, a known geographic unit of both risk and resilience, and is hampering efforts to identify and mitigate the long-term fallout from COVID-19 in vulnerable communities. Using spatially-referenced data from 21 states at the ZIP code or census tract level, we documented how the distribution of COVID-19 at the neighborhood-level varies significantly within and between states. The median case count per neighborhood (IQR) in Oregon was 3,608 (2,487) per 100,000 population, indicating a more homogenous distribution of COVID-19 burden, whereas in Vermont the median case count per neighborhood (IQR) was 8,142 (11,031) per 100,000. We also found that the association between features of the neighborhood social environment and burden varied in magnitude and direction by state. Our findings underscore the importance of local contexts when addressing the long-term social and economic fallout communities will face from COVID-19.
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Affiliation(s)
| | | | - Andrew Hoover
- Institute for Social Research, University of Michigan
| | - John Kubale
- Institute for Social Research, University of Michigan
| | | | - Kate Duchowny
- Institute for Social Research, University of Michigan
| | - Sonia T Hegde
- Department of Epidemiology, Johns Hopkins University
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Demanelis K, Rosenzweig M, Robertson LB, Low CA, Daniels S, Abujaradeh H, Simon B, Bovbjerg DH, Diergaarde B. Impact of the COVID-19 pandemic on cancer patients in western Pennsylvania: rural-urban disparities. Cancer Causes Control 2023; 34:595-609. [PMID: 37129763 PMCID: PMC10153039 DOI: 10.1007/s10552-023-01696-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 03/31/2023] [Indexed: 05/03/2023]
Abstract
PURPOSE Disparities in cancer care persist between patients living in rural versus urban areas. The COVID-19 pandemic may have impacted concerns related to care and personal health differently in rural cancer patients. Using survey data collected from cancer patients in western Pennsylvania, we examined pandemic-related distress, concerns related to cancer care, impact on personal health, and the extent to which these differed by urban-rural residence. METHODS Patients filled out an initial survey in August-December 2020; a second survey was completed in March 2021. The following patient concerns related to the pandemic were evaluated: threat of COVID-19 to their health, pandemic-related distress, perceptions of cancer care, and vaccine hesitancy. Multivariable logistic regression models were used to examine relationships between these outcomes and urban-rural residence as well as patient-related factors, including anxiety symptoms and social support. RESULTS The study sample included 1,980 patients, 17% resided in rural areas. COVID-19 represented a major or catastrophic threat to personal health for 39.7% of rural and 49.0% of urban patients (p = 0.0017). Patients with high general anxiety were 10-times more likely to experience pandemic-related distress (p < 0.001). In the follow-up survey (n = 983), vaccine hesitancy was twice as prevalent among rural patients compared to urban (p = 0.012). CONCLUSIONS The extent to which perceptions of the threat of COVD-19 to personal health and vaccine hesitancy exacerbates rural-urban disparities in cancer care and prognosis warrants further study. Cancer patients may be vulnerable to heightened anxiety and distress triggered by the pandemic.
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Affiliation(s)
- Kathryn Demanelis
- School of Medicine, Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA.
- UPMC Hillman Cancer Center, 5114 Centre Ave, Pittsburgh, PA, 15232, USA.
| | - Margaret Rosenzweig
- UPMC Hillman Cancer Center, 5114 Centre Ave, Pittsburgh, PA, 15232, USA
- School of Nursing, Department of Acute and Tertiary Care, University of Pittsburgh, Pittsburgh, PA, USA
| | - Linda B Robertson
- School of Medicine, Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA
- UPMC Hillman Cancer Center, 5114 Centre Ave, Pittsburgh, PA, 15232, USA
| | - Carissa A Low
- School of Medicine, Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA
- UPMC Hillman Cancer Center, 5114 Centre Ave, Pittsburgh, PA, 15232, USA
| | - Shayla Daniels
- School of Nursing, Department of Acute and Tertiary Care, University of Pittsburgh, Pittsburgh, PA, USA
| | - Hiba Abujaradeh
- School of Nursing, Department of Acute and Tertiary Care, University of Pittsburgh, Pittsburgh, PA, USA
| | - Beth Simon
- UPMC Hillman Cancer Center, 5114 Centre Ave, Pittsburgh, PA, 15232, USA
| | - Dana H Bovbjerg
- UPMC Hillman Cancer Center, 5114 Centre Ave, Pittsburgh, PA, 15232, USA
- School of Medicine, Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brenda Diergaarde
- UPMC Hillman Cancer Center, 5114 Centre Ave, Pittsburgh, PA, 15232, USA
- School of Public Health, Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA
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Tang IW, Vieira VM, Shearer E. Effect of socioeconomic factors during the early COVID-19 pandemic: a spatial analysis. BMC Public Health 2022; 22:1212. [PMID: 35715743 PMCID: PMC9205762 DOI: 10.1186/s12889-022-13618-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background Spatial variability of COVID-19 cases may suggest geographic disparities of social determinants of health. Spatial analyses of population-level data may provide insight on factors that may contribute to COVID-19 transmission, hospitalization, and death. Methods Generalized additive models were used to map COVID-19 risk from March 2020 to February 2021 in Orange County (OC), California. We geocoded and analyzed 221,843 cases to OC census tracts within a Poisson framework while smoothing over census tract centroids. Location was randomly permuted 1000 times to test for randomness. We also separated the analyses temporally to observe if risk changed over time. COVID-19 cases, hospitalizations, and deaths were mapped across OC while adjusting for population-level demographic data in crude and adjusted models. Results Risk for COVID-19 cases, hospitalizations, and deaths were statistically significant in northern OC. Adjustment for demographic data substantially decreased spatial risk, but areas remained statistically significant. Inclusion of location within our models considerably decreased the magnitude of risk compared to univariate models. However, percent minority (adjusted RR: 1.06, 95%CI: 1.06, 1.07), average household size (aRR: 1.06, 95%CI: 1.05, 1.07), and percent service industry (aRR: 1.05, 95%CI: 1.04, 1.06) remained significantly associated with COVID-19 risk in adjusted spatial models. In addition, areas of risk did not change between surges and risk ratios were similar for hospitalizations and deaths. Conclusion Significant risk factors and areas of increased risk were identified in OC in our adjusted models and suggests that social and environmental factors contribute to the spread of COVID-19 within communities. Areas in north OC remained significant despite adjustment, but risk substantially decreased. Additional investigation of risk factors may provide insight on how to protect vulnerable populations in future infectious disease outbreaks.
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Affiliation(s)
- Ian W Tang
- Department of Environmental and Occupational Health, Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, 100 Theory Drive, Irvine, CA, 92617, USA. .,Communicable Disease Control Division, Orange County Health Care Agency, Santa Ana, USA.
| | - Verónica M Vieira
- Department of Environmental and Occupational Health, Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, 100 Theory Drive, Irvine, CA, 92617, USA
| | - Eric Shearer
- Communicable Disease Control Division, Orange County Health Care Agency, Santa Ana, USA
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A Model for Highly Fluctuating Spatio-Temporal Infection Data, with Applications to the COVID Epidemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116669. [PMID: 35682250 PMCID: PMC9179960 DOI: 10.3390/ijerph19116669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/21/2022]
Abstract
Spatio-temporal models need to address specific features of spatio-temporal infection data, such as periods of stable infection levels (endemicity), followed by epidemic phases, as well as infection spread from neighbouring areas. In this paper, we consider a mixture-link model for infection counts that allows alternation between epidemic phases (possibly multiple) and stable endemicity, with higher AR1 coefficients in epidemic phases. This is a form of regime-switching, allowing for non-stationarity in infection levels. We adopt a generalised Poisson model appropriate to the infection count data and avoid transformations (e.g., differencing) to alternative metrics, which have been adopted in many studies. We allow for neighbourhood spillover in infection, which is also governed by adaptive regime-switching. Compared to existing models, the observational (in-sample) model is expected to better reflect the balance between epidemic and endemic tendencies, and short-term extrapolations are likely to be improved. Two case study applications involve COVID area-time data, one for 32 London boroughs (and 96 weeks) since the start of the COVID epidemic, the other for a shorter time span focusing on the epidemic phase in 144 areas of Southeast England associated with the Alpha variant. In both applications, the proposed methods produce a better in-sample fit and out-of-sample short term predictions. The spatial dynamic implications are highlighted in the case studies.
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Soares RR. The evolving field of Big Data: understanding geographic information systems analysis and its transformative potential in ophthalmic research. Curr Opin Ophthalmol 2022; 33:188-194. [PMID: 35220329 DOI: 10.1097/icu.0000000000000839] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review to is to highlight alternative uses of Big Data in the pursuit of ophthalmologic public health. In particular, we highlight geographic information systems (GIS) analysis as a type of Big Data, summarize various GIS methods, and enumerate sources of geographic data. RECENT FINDINGS The recent implementation of the IRIS Registry Data, has expanded our real-world knowledge of ophthalmology in the United States. Such innovations in Big Data allow us to better define ophthalmic diseases, treatments, and outcomes for underserved individuals and subpopulations. One underutilized source of Big Data entails use of geographic information to evaluate geographic heterogeneity and access across the United States. SUMMARY GIS and Big Data allow for refined epidemiologic estimates of eye disease for specific communities. In particular, how GIS can enable researchers to examine disparities in access to ophthalmic care is reviewed. GIS best practices and some data sources for GIS in ophthalmology are also summarized.
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Affiliation(s)
- Rebecca Russ Soares
- Retina Service, Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Gohari K, Kazemnejad A, Sheidaei A, Hajari S. Clustering of countries according to the COVID-19 incidence and mortality rates. BMC Public Health 2022; 22:632. [PMID: 35365101 PMCID: PMC8972710 DOI: 10.1186/s12889-022-13086-z] [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: 11/21/2021] [Accepted: 03/28/2022] [Indexed: 12/15/2022] Open
Abstract
Background Two years after the beginning of the COVID-19 pandemic on December 29, 2021, there have been 281,808,270 confirmed cases of COVID-19, including 5,411,759 deaths. This information belongs to almost 216 Countries, areas, or territories facing COVID-19. The disease trend was not homogeneous across these locations, and studying this variation is a crucial source of information for policymakers and researchers. Therefore, we address different patterns in mortality and incidence of COVID-19 across countries using a clustering approach. Methods The daily records of new cases and deaths of 216 countries were available on the WHO online COVID-19 dashboard. We used a three-step approach for identifying longitudinal patterns of change in quantitative COVID-19 incidence and mortality rates. At the first, we calculated 27 summary measurements for each trajectory. Then we used factor analysis as a dimension reduction method to capture the correlation between measurements. Finally, we applied a K-means algorithm on the factor scores and clustered the trajectories. Results We determined three different patterns for the trajectories of COVID-19 incidence and the three different ones for mortality rates. According to incidence rates, among 206 countries the 133 (64.56) countries belong to the second cluster, and 15 (7.28%) and 58 (28.16%) belong to the first and 3rd clusters, respectively. All clusters seem to show an increased rate in the study period, but there are several different patterns. The first one exhibited a mild increasing trend; however, the 3rd and the second clusters followed the severe and moderate increasing trend. According to mortality clusters, the frequency of sets is 37 (18.22%) for the first cluster with moderate increases, 157 (77.34%) for the second one with a mild rise, and 9 (4.34%) for the 3rd one with severe increase. Conclusions We determined that besides all variations within the countries, the pattern of a contagious disease follows three different trajectories. This variation looks to be a function of the government’s health policies more than geographical distribution. Comparing this trajectory to others declares that death is highly related to the nature of epidemy.
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Affiliation(s)
- Kimiya Gohari
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, P.O. BOX 14115-111, Tehran, Iran
| | - Anoshirvan Kazemnejad
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, P.O. BOX 14115-111, Tehran, Iran.
| | - Ali Sheidaei
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sarah Hajari
- Department of Computer Science, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
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Lee SJ, Park JH, Cha SM, Kim D. A Regional Economy’s Resistance to the COVID-19 Shock: Sales Revenues of Micro-, Small-, and Medium-Sized Enterprises in South Korea. INTERNATIONAL JOURNAL OF DISASTER RISK SCIENCE 2022; 13:190-198. [PMCID: PMC8919359 DOI: 10.1007/s13753-022-00402-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/27/2022] [Indexed: 06/18/2023]
Abstract
The coronavirus disease 2019 (COVID-19) is a global pandemic that has heavily impacted not only the health sector, but also the economic sector in general. Many countries have projected a negative economic impact, and the effect on micro-, small-, and medium-sized enterprises (MSMEs) is predicted to be significantly large. This study estimated the regional resistance of MSME sales revenues and identified the regional economic factors that affect resistance by analyzing South Korea, a country with one of the lowest economic impact projections from COVID-19. Resistance was estimated by comparing sales revenues and changes in resistance observed during the early COVID-19 period to those recorded in the same weeks (weeks 6 to 9) of 2019. The factors that affect regional resistance were determined by conducting robust regression and spatial regression analyses. The results show that the number of confirmed COVID-19 cases, a direct risk factor, is negatively related to regional resilience, while diversity is positively related to regional resistance. To improve the regional resistance against uncertain events, this study recommends increased diversity among regional industrial structures to reduce the duration of the early shock of an unexpected adverse event.
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Affiliation(s)
- Seong-Jin Lee
- Department of Public Policy and Management, Pusan National University, Busan, 46241 South Korea
| | - Joong-Hoo Park
- Department of Urban Planning and Engineering, Pusan National University, Busan, 46241 South Korea
| | - Seung-Min Cha
- Department of Urban Planning and Engineering, Pusan National University, Busan, 46241 South Korea
| | - Donghyun Kim
- Department of Urban Planning and Engineering, Pusan National University, Busan, 46241 South Korea
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