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Sabado-Liwag MD, Kwan PP, Okihiro M, Sy A, Tsoh JY, Juarez R, Choi J, Martorell C, McElfish PA. Asian American and Native Hawaiian and Pacific Islander Visibility and Data Equity: Insights From NIH RADx-UP. Am J Public Health 2024; 114:S354-S359. [PMID: 38547462 PMCID: PMC11111332 DOI: 10.2105/ajph.2024.307590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2024] [Indexed: 05/24/2024]
Affiliation(s)
- Melanie D Sabado-Liwag
- Melanie D. Sabado-Liwag is with the Department of Public Health, California State University, Los Angeles. Patchareeya P. Kwan is with the Department of Health Sciences, California State University, Northridge. May Okihiro is with the Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu. Angela Sy is with Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A. Burns School of Medicine, University of Hawai'i. Janice Y. Tsoh is the with the Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco. Ruben Juarez is with the Department of Economics and University of Hawai'i Economic Research Organization, University of Hawai'i. JiWon Choi is with the Department of Social and Behavioral Sciences/Institute for Health and Aging, School of Nursing, University of California, San Francisco. Chanchanit Martorell is with the Thai Community Development Center, Los Angeles. Pearl A. McElfish is with the College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale
| | - Patchareeya P Kwan
- Melanie D. Sabado-Liwag is with the Department of Public Health, California State University, Los Angeles. Patchareeya P. Kwan is with the Department of Health Sciences, California State University, Northridge. May Okihiro is with the Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu. Angela Sy is with Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A. Burns School of Medicine, University of Hawai'i. Janice Y. Tsoh is the with the Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco. Ruben Juarez is with the Department of Economics and University of Hawai'i Economic Research Organization, University of Hawai'i. JiWon Choi is with the Department of Social and Behavioral Sciences/Institute for Health and Aging, School of Nursing, University of California, San Francisco. Chanchanit Martorell is with the Thai Community Development Center, Los Angeles. Pearl A. McElfish is with the College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale
| | - May Okihiro
- Melanie D. Sabado-Liwag is with the Department of Public Health, California State University, Los Angeles. Patchareeya P. Kwan is with the Department of Health Sciences, California State University, Northridge. May Okihiro is with the Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu. Angela Sy is with Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A. Burns School of Medicine, University of Hawai'i. Janice Y. Tsoh is the with the Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco. Ruben Juarez is with the Department of Economics and University of Hawai'i Economic Research Organization, University of Hawai'i. JiWon Choi is with the Department of Social and Behavioral Sciences/Institute for Health and Aging, School of Nursing, University of California, San Francisco. Chanchanit Martorell is with the Thai Community Development Center, Los Angeles. Pearl A. McElfish is with the College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale
| | - Angela Sy
- Melanie D. Sabado-Liwag is with the Department of Public Health, California State University, Los Angeles. Patchareeya P. Kwan is with the Department of Health Sciences, California State University, Northridge. May Okihiro is with the Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu. Angela Sy is with Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A. Burns School of Medicine, University of Hawai'i. Janice Y. Tsoh is the with the Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco. Ruben Juarez is with the Department of Economics and University of Hawai'i Economic Research Organization, University of Hawai'i. JiWon Choi is with the Department of Social and Behavioral Sciences/Institute for Health and Aging, School of Nursing, University of California, San Francisco. Chanchanit Martorell is with the Thai Community Development Center, Los Angeles. Pearl A. McElfish is with the College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale
| | - Janice Y Tsoh
- Melanie D. Sabado-Liwag is with the Department of Public Health, California State University, Los Angeles. Patchareeya P. Kwan is with the Department of Health Sciences, California State University, Northridge. May Okihiro is with the Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu. Angela Sy is with Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A. Burns School of Medicine, University of Hawai'i. Janice Y. Tsoh is the with the Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco. Ruben Juarez is with the Department of Economics and University of Hawai'i Economic Research Organization, University of Hawai'i. JiWon Choi is with the Department of Social and Behavioral Sciences/Institute for Health and Aging, School of Nursing, University of California, San Francisco. Chanchanit Martorell is with the Thai Community Development Center, Los Angeles. Pearl A. McElfish is with the College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale
| | - Ruben Juarez
- Melanie D. Sabado-Liwag is with the Department of Public Health, California State University, Los Angeles. Patchareeya P. Kwan is with the Department of Health Sciences, California State University, Northridge. May Okihiro is with the Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu. Angela Sy is with Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A. Burns School of Medicine, University of Hawai'i. Janice Y. Tsoh is the with the Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco. Ruben Juarez is with the Department of Economics and University of Hawai'i Economic Research Organization, University of Hawai'i. JiWon Choi is with the Department of Social and Behavioral Sciences/Institute for Health and Aging, School of Nursing, University of California, San Francisco. Chanchanit Martorell is with the Thai Community Development Center, Los Angeles. Pearl A. McElfish is with the College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale
| | - JiWon Choi
- Melanie D. Sabado-Liwag is with the Department of Public Health, California State University, Los Angeles. Patchareeya P. Kwan is with the Department of Health Sciences, California State University, Northridge. May Okihiro is with the Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu. Angela Sy is with Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A. Burns School of Medicine, University of Hawai'i. Janice Y. Tsoh is the with the Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco. Ruben Juarez is with the Department of Economics and University of Hawai'i Economic Research Organization, University of Hawai'i. JiWon Choi is with the Department of Social and Behavioral Sciences/Institute for Health and Aging, School of Nursing, University of California, San Francisco. Chanchanit Martorell is with the Thai Community Development Center, Los Angeles. Pearl A. McElfish is with the College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale
| | - Chanchanit Martorell
- Melanie D. Sabado-Liwag is with the Department of Public Health, California State University, Los Angeles. Patchareeya P. Kwan is with the Department of Health Sciences, California State University, Northridge. May Okihiro is with the Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu. Angela Sy is with Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A. Burns School of Medicine, University of Hawai'i. Janice Y. Tsoh is the with the Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco. Ruben Juarez is with the Department of Economics and University of Hawai'i Economic Research Organization, University of Hawai'i. JiWon Choi is with the Department of Social and Behavioral Sciences/Institute for Health and Aging, School of Nursing, University of California, San Francisco. Chanchanit Martorell is with the Thai Community Development Center, Los Angeles. Pearl A. McElfish is with the College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale
| | - Pearl A McElfish
- Melanie D. Sabado-Liwag is with the Department of Public Health, California State University, Los Angeles. Patchareeya P. Kwan is with the Department of Health Sciences, California State University, Northridge. May Okihiro is with the Department of Pediatrics, John A. Burns School of Medicine, University of Hawai'i, Honolulu. Angela Sy is with Department of Tropical Medicine, Medical Microbiology, and Pharmacology, John A. Burns School of Medicine, University of Hawai'i. Janice Y. Tsoh is the with the Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco. Ruben Juarez is with the Department of Economics and University of Hawai'i Economic Research Organization, University of Hawai'i. JiWon Choi is with the Department of Social and Behavioral Sciences/Institute for Health and Aging, School of Nursing, University of California, San Francisco. Chanchanit Martorell is with the Thai Community Development Center, Los Angeles. Pearl A. McElfish is with the College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale
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Morgan ER, Dillard D, Lofgren E, Maddison BK, Riklon S, McElfish P, Sinclair K. Moana: Alternate surveillance for COVID-19 in a Unique Population (MASC-UP). Contemp Clin Trials Commun 2024; 37:101246. [PMID: 38222877 PMCID: PMC10784670 DOI: 10.1016/j.conctc.2023.101246] [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: 08/15/2023] [Revised: 11/20/2023] [Accepted: 12/17/2023] [Indexed: 01/16/2024] Open
Abstract
Objective Create a longitudinal, multi-modal and multi-level surveillance cohort that targets early detection of symptomatic and asymptomatic COVID-19 cases among Native Hawaiian and Pacific Islander adults in the Continental US and identify effective modalities for participatory disease surveillance and sustainably integrate them into ongoing COVID-19 and other public health surveillance efforts. Materials and methods We recruited cohorts from three sites: Federal Way, WA; Springdale, AR; and remotely. Participants received a survey that included demographic characteristics and questions regarding COVID-19. Participants completed symptom checks via text message every month and recorded their temperature daily using a Kinsa smart thermometer. Results Recruitment and data collection is ongoing. Presently, 441 adults have consented to participate. One-third of participants were classified as essential workers during the pandemic. Discussion Over the past 18 months, we have improved our strategies to elicit better data from participants and have learned from some of the weaknesses in our initial deployment of this type of surveillance system. Other limitations stem from historic inequities and barriers which limited Native Hawaiian and Pacific Island representation in academic and clinical environments. One manifestation of this was the limited ability to provide study materials and support in multiple languages. We hope that continued partnership with the community will allow further opportunities to help restore trust in academic and medical institutions, thus generating knowledge to advance health equity. Conclusion This participatory disease surveillance mechanism complements traditional surveillance systems by engaging underserved communities. We may also gain insights generalizable to other pathogens of concern.
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Affiliation(s)
- Erin R. Morgan
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA, USA
| | - Denise Dillard
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA, USA
| | - Eric Lofgren
- Paul G. Allen School for Global Health, College of Veterinary Medicine, Washington State University, Pullman, WA, USA
| | | | - Sheldon Riklon
- Department of Family and Preventive Medicine, University of Arkansas for the Medical Sciences, Fayetteville, AR, USA
| | - Pearl McElfish
- Department of Internal Medicine, University of Arkansas for the Medical Sciences, Fayetteville, AR, USA
| | - Ka`imi Sinclair
- Institute for Research and Education to Advance Community Health, College of Nursing, Washington State University, Seattle, WA, USA
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Burrage RL, Mills KJ, Coyaso HC, Gronowski CK, Godinet MT. Community Resilience and Cultural Responses in Crisis: Lessons Learned from Pacific Islander Responses to the COVID-19 Pandemic in the USA. J Racial Ethn Health Disparities 2024; 11:560-573. [PMID: 36849862 PMCID: PMC9970122 DOI: 10.1007/s40615-023-01541-5] [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: 10/05/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 03/01/2023]
Abstract
Pacific Islander communities in the USA experienced some of the most severe effects of the COVID-19 pandemic. This qualitative synthesis examines the literature on Pacific Islander community responses and lessons learned from COVID-19, using a systematic search that identified 28 articles with this focus. Thematic analysis was subsequently used to classify both documented efforts by Pacific Islander communities to respond to the pandemic, as well as lessons learned and best practices from research in this area. Results revealed multiple efforts to address the pandemic, including Pacific Islander grassroots approaches, government responses, inter-sector collaboration, and research. Results further emphasized the importance of culturally and linguistically responsive outreach and messaging; partnership, engagement, and capacity building; and changes in research and policy approaches to promote health equity. Future efforts to address public health crises should make the most of Pacific Islander cultural approaches to disaster response. To achieve this, government and other organizations that work with PI communities need to support the development of the PI leadership, healthcare and research workforces, and work with Pacific Islander communities to build long-term, sustainable, and trustworthy partnerships.
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Affiliation(s)
- Rachel L Burrage
- Department of Social Work, Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, USA.
| | - Kelsey J Mills
- Department of Social Work, Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, USA
| | - Hope C Coyaso
- Department of Social Work, Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, USA
| | - Chrisovolandou K Gronowski
- Department of Social Work, Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, USA
| | - Meripa T Godinet
- Department of Social Work, Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, USA
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Purvis RS, Moore R, Rojo MO, Riklon S, Alik E, Alik D, Maddison BK, McElfish PA. COVID-19 vaccine hesitancy among Marshallese in Northwest Arkansas (USA). J Public Health Res 2024; 13:22799036241231549. [PMID: 38440055 PMCID: PMC10910884 DOI: 10.1177/22799036241231549] [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: 01/10/2023] [Accepted: 01/23/2024] [Indexed: 03/06/2024] Open
Abstract
Background COVID-19 has disproportionately affected Pacific Islander communities, with disparities in the prevalence of infection, serious illness, and death compared to non-Hispanic whites in the US. Marshallese Pacific Islanders face significant COVID-19 disparities. Design and methods This exploratory study aimed to understand Marshallese community attitudes about the COVID-19 vaccine to identify and implement culturally relevant strategies to encourage vaccine uptake. Data were collected from 17 participants in three focus groups. Results Using content analysis, researchers identified two global themes: (1) barriers to vaccination and (2) facilitators of COVID-19 vaccine uptake. Within these themes, participants described fear, lack of knowledge about vaccines, negative perceptions of the COVID-19 vaccine, health concerns, and transportation as barriers to vaccination. Participants described several factors influencing vaccine behavior, including location of and personnel at vaccine clinics, vaccine experiences, the need for trusted information, positive perceptions, cultural leaders, and mandates. Conclusions The qualitative study makes a significant contribution as the first to report community perceptions and experiences related to the COVID-19 vaccine in Marshallese participants' own words. Findings show that cultural influencers and brokers are crucial bridges for public health messaging related to COVID-19 vaccination targeted to this vulnerable and underserved population. Culturally appropriate and effective public health messaging can help achieve vaccine equity and improve COVID-19-related health disparities in the Marshallese community.
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Affiliation(s)
- Rachel S Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Martha O Rojo
- College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sheldon Riklon
- College of Medicine, University of Arkansas for Medical Sciences, Fayetteville, AR, USA
| | - Eldon Alik
- Republic of the Marshall Islands Consulate, Springdale, AR, USA
| | - Derek Alik
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | | | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
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Amani B, Cabral A, Sharif MZ, Baptista SA, Le C, Perez AI, Ford CL. Rapid Assessment of COVID Evidence (RACE): Continuing Health Equity Research Beyond the Series. Ethn Dis 2024; 34:19-24. [PMID: 38854785 PMCID: PMC11156162 DOI: 10.18865/ed.34.1.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024] Open
Affiliation(s)
- Bita Amani
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA
| | - Alejandra Cabral
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA
| | - Mienah Z. Sharif
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA
- Department of Epidemiology, University of Washington, School of Public Health, Seattle, WA
| | - Shelby A. Baptista
- Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA
| | - Cindy Le
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA
| | - Adriana I. Perez
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA
| | - Chandra L. Ford
- COVID-19 Task Force on Racism & Equity, Center for the Study of Racism, Social Justice, and Health, UCLA Fielding School of Public Health, Los Angeles, CA
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Atlanta, GA
- Department of African American Studies, Emory College of Arts and Sciences, Atlanta, GA
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Lavinghouze SR, O’Toole TP, Petersen R. The Key to Pivoting and Adapting: Networked Partnerships, Long-Standing Relationships, and Functioning Program Infrastructure. Health Promot Pract 2023; 24:5S-9S. [PMID: 36707934 PMCID: PMC10947766 DOI: 10.1177/15248399221150781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
| | | | - Ruth Petersen
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Willis DE, Selig JP, Andersen JA, Hall S, Hallgren E, Williams M, Bryant-Moore K, McElfish PA. Hesitant but vaccinated: assessing COVID-19 vaccine hesitancy among the recently vaccinated. J Behav Med 2023; 46:15-24. [PMID: 35032254 PMCID: PMC8760868 DOI: 10.1007/s10865-021-00270-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/04/2021] [Indexed: 11/06/2022]
Abstract
We administered a survey during the fifteen-minute wait time after the COVID-19 vaccine was given (N = 1475) to examine attitudes towards COVID-19 vaccines among adults who were vaccinated in Arkansas between April 22nd and July 6th, 2021. We found 60% of those who had just been vaccinated reported some level of hesitancy, including 10% who reported being "very hesitant." Hesitancy was not evenly distributed across sociodemographic groups (age, sex, race/ethnicity, and education) and was associated with whether a non-English language is spoken in the home, health care coverage, and flu vaccination over the past five years in bivariate analysis. Generalized ordered logistic regression results reveal associations between the log-ordered odds of COVID-19 vaccine hesitancy and age, sex, race/ethnicity, health care coverage, health literacy, and flu vaccination over the past five years. Surprisingly, a prior COVID-19 diagnosis was not significantly associated with COVID-19 vaccine hesitancy. These results can inform health care and communication strategies. Further attention to "hesitant adopters" can provide insights into the process of overcoming vaccine hesitancy that are critical to vaccine uptake.
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Affiliation(s)
- Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jennifer A Andersen
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Spencer Hall
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Emily Hallgren
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Mark Williams
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Keneshia Bryant-Moore
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA.
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PONCE NINEZA, SHIMKHADA RITI, ADKINS‐JACKSON PARISB. Making Communities More Visible: Equity-Centered Data to Achieve Health Equity. Milbank Q 2023; 101:302-332. [PMID: 37096622 PMCID: PMC10126976 DOI: 10.1111/1468-0009.12605] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 11/18/2022] [Accepted: 01/06/2023] [Indexed: 04/26/2023] Open
Abstract
Policy Points Despite decades of research exposing health disparities between populations and communities in the US, health equity goals remain largely unfulfilled. We argue these failures call for applying an equity lens in the way we approach data systems, from collection and analysis to interpretation and distribution. Hence, health equity requires data equity. There is notable federal interest in policy changes and federal investments to improve health equity. With this, we outline the opportunities to align these health equity goals with data equity by improving the way communities are engaged and how population data are collected, analyzed, interpreted, made accessible, and distributed. Policy priority areas for data equity include increasing the use of disaggregated data, increasing the use of currently underused federal data, building capacity for equity assessments, developing partnerships between government and community, and increasing data accountability to the public.
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Affiliation(s)
- NINEZ A. PONCE
- Center for Health Policy ResearchUniversity of CaliforniaLos Angeles
- Los Angeles Fielding School of Public HealthUniversity of California
| | - RITI SHIMKHADA
- Center for Health Policy ResearchUniversity of CaliforniaLos Angeles
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Shobe MA, Hill S, Murphy-Erby Y, Fateh B, Wang H. Food Security in the Time of COVID-19 for a Marshallese Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3189. [PMID: 36833883 PMCID: PMC9962343 DOI: 10.3390/ijerph20043189] [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: 01/23/2023] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
Using an individual and family ecological systems model, we explored food security among a Marshallese cohort in Northwest Arkansas during the COVID-19 pandemic. We hypothesized that Marshallese households were experiencing high rates of food insecurity due to socioeconomic and systemic risk factors. Seventy-one Marshallese adults shared socioeconomic information about their household via an online survey. Descriptive results indicate that 91% of respondents report food insecurity. In terms of systemic barriers, almost half of Marshallese respondents do not have health insurance. Additionally, while most respondents report feeling calm, peaceful, and energetic, paradoxically, 81% report feeling depressed and downhearted at least some of the time. Logistic regression findings suggest that food insecurity is significantly related to education levels and household economic strain. These results are analogous with national findings, whereby non-native households are more likely to experience higher levels of food insecurity, lower rates of education, and higher economic strain than native households. As a collective community, the Marshallese could benefit from culturally responsive individual and family systems approaches for improving educational, social, financial, and health opportunities through workforce development, household income and asset development, and food security initiatives. Additional implications for policy, practice, and research are provided.
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Affiliation(s)
- Marcia A. Shobe
- IDEALS Institute, Division of Diversity, Equity, and Inclusion, University of Arkansas, Fayetteville, AR 72701, USA
| | - Sophie Hill
- Fulbright College of Arts & Sciences, University of Arkansas, Fayetteville, AR 72701, USA
| | - Yvette Murphy-Erby
- Fulbright College of Arts & Sciences, University of Arkansas, Fayetteville, AR 72701, USA
| | - Baqir Fateh
- IDEALS Institute, Division of Diversity, Equity, and Inclusion, University of Arkansas, Fayetteville, AR 72701, USA
| | - Haixia Wang
- IDEALS Institute, Division of Diversity, Equity, and Inclusion, University of Arkansas, Fayetteville, AR 72701, USA
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Subica AM, Aitaoto N, Li Q, Morey BN, Wu LT, Iwamoto DK, Guerrero EG, Moss HB. Assessing the Impact of COVID-19 on the Health of Native Hawaiian/Pacific Islander People in the United States, 2021. Public Health Rep 2023; 138:164-173. [PMID: 36113145 PMCID: PMC9482884 DOI: 10.1177/00333549221123579] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES Minimal research has assessed COVID-19's unique impact on the Native Hawaiian/Pacific Islander (NH/PI) population-an Indigenous-colonized racial group with social and health disparities that increase their risk for COVID-19 morbidity and mortality. To address this gap, we explored the scope of COVID-19 outcomes, vaccination status, and health in diverse NH/PI communities. METHODS NH/PI staff at partner organizations collected survey data from April through November 2021 from 319 community-dwelling NH/PI adults in 5 states with large NH/PI populations: Arkansas, California, Oregon, Utah, and Washington. Data were analyzed with descriptive statistics, Pearson χ2 tests, independent and paired t tests, and linear and logistic regression analyses. RESULTS During the COVID-19 pandemic, 30% of survey participants had contracted COVID-19, 16% had a close family member who died of the disease, and 64% reported COVID-19 vaccine uptake. Thirty percent reported fair/poor health, 21% currently smoked cigarettes, and 58% reported obesity. Survey participants reported heightened COVID-19-related psychosocial distress (mean score = 4.9 on 10-point scale), which was more likely when health outcomes (general health, sleep, obesity) were poor or a family member had died of COVID-19. Logistic regression indicated that age, experiencing COVID-19 distress, and past-year use of influenza vaccines were associated with higher odds of COVID-19 vaccine uptake (1.06, 1.18, and 7.58 times, respectively). CONCLUSIONS Our empirical findings highlight the acute and understudied negative impact of COVID-19 on NH/PI communities in the United States and suggest new avenues for improving NH/PI community health, vaccination, and recovery from COVID-19.
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Affiliation(s)
- Andrew M. Subica
- Department of Social Medicine, Population, and Public Health, School of Medicine, University of California, Riverside, Riverside, CA, USA
| | - Nia Aitaoto
- Pacific Islander Center of Primary Care Excellence, San Leandro, CA, USA
| | - Qiuxi Li
- Special Services for Groups, Los Angeles, CA, USA
| | - Brittany N. Morey
- Department of Health, Society, and Behavior, University of California, Irvine, Irvine, CA, USA
| | - Li-Tzy Wu
- School of Medicine, Duke University, Durham, NC, USA
| | - Derek K. Iwamoto
- Department of Psychology, University of Maryland, College Park, MD, USA
| | | | - Howard B. Moss
- Department of Social Medicine, Population, and Public Health, School of Medicine, University of California, Riverside, Riverside, CA, USA
- Department of Psychiatry, School of Medicine, University of California, Riverside, Riverside, CA, USA
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11
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McElfish PA, Purvis RS, Riklon S, Willis DE. Complicity in sociology and community-based participatory research with Marshallese. SOCIOLOGY OF HEALTH & ILLNESS 2022; 44 Suppl 1:142-157. [PMID: 35213055 DOI: 10.1111/1467-9566.13452] [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: 01/30/2021] [Revised: 01/28/2022] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
Complicity with colonialism can be reflected in a particular approach to research, whose interests it serves, and who has power or ownership over the research process. It can also be reflected in neglect, inaction or methodological erasure of groups historically subjected to domination by colonial empires. Social scientists have often failed to account for colonialism's role or the complicit role they have played. We provide a brief historical overview of colonialism in the Marshall Islands and the role social scientists-and their methodological and epistemological approaches-played in the US empire's expansion into the region. We discuss the tenets of Community Based Participatory Research (CBPR), setting the research agenda, co-direction of the research process, research team membership, collaboration challenges, and the action and outputs which have come from our team's health disparities research among the largest Marshallese population in the continental US. We argue CBPR is a promising but imperfect approach to guarding against complicity within medical sociology and situate our methodological approach within ongoing debates regarding objectivity and advocacy within sociology. We reflect on successes and shortcomings of our CBPR efforts to address health disparities among Marshallese, as well as how those successes and shortcomings overlap with questions of complicity.
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Affiliation(s)
- Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
| | - Rachel S Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
| | - Sheldon Riklon
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
| | - Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
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12
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Descriptive analysis of deaths associated with COVID-19 in Fiji, 15 April to 14 November 2021. Western Pac Surveill Response J 2022; 13:1-8. [PMID: 36817498 PMCID: PMC9912270 DOI: 10.5365/wpsar.2022.13.4.964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objective There is limited published information about deaths due to coronavirus disease 2019 (COVID-19) in Fiji, the World Health Organization's Western Pacific Region and low- and middle-income countries. This report descriptively analyses deaths directly associated with COVID-19 in Fiji by age group, sex, ethnicity, geographical location, vaccination status and place of death for the first 7 months of the 2021 community outbreak. Methods A retrospective analysis was conducted of deaths directly associated with COVID-19 that occurred from 15 April to 14 November 2021 in Fiji. Death rates per 100 000 population were calculated by using divisional population estimates obtained from medical zone nurses in 2021. Results A total of 1298 deaths relating to COVID-19 were reported, with 696 directly associated with COVID-19 and therefore included in the analysis. Of these, 71.1% (495) were reported from the Central Division, 54.6% (380) occurred among males, 75.6% (526) occurred among people of indigenous (iTaukei) ethnicity and 79.5% (553) occurred among people who were unvaccinated. Four deaths were classified as maternal deaths. The highest percentage of deaths occurred in those aged 370 years (44.3%, 308), and the majority of deaths (56.6%, 394) occurred at home. Discussion At-risk populations for COVID-19 mortality in Fiji include males, iTaukei peoples, and older (370 years) and unvaccinated individuals. A high proportion of deaths occurred either at home or during the first 2 days of hospital admission, potentially indicating both a reluctance to seek medical care and a health-care system that was stressed during the peak of the outbreak.
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13
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O’Toole TP, René Lavinghouze S, Pejavara A, Petersen R. State and Local Chronic Disease Programs Adapt and Pivot to Address Community Needs During the COVID-19 Pandemic: Examples From CDC Funded SPAN, REACH, and HOP Programs. Health Promot Pract 2022; 23:12S-20S. [DOI: 10.1177/15248399221116090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | - Anu Pejavara
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ruth Petersen
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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14
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Andersen JA, Willis DE, Malhis JR, Long CR, McElfish PA. The Association Between Education and Basic Needs Insecurity for Marshallese During the COVID-19 Pandemic. J Racial Ethn Health Disparities 2022; 9:1882-1887. [PMID: 34403123 PMCID: PMC8370049 DOI: 10.1007/s40615-021-01125-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/29/2021] [Accepted: 07/29/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this study was to explore the prevalence of basic needs insecurity and to examine the association between education and basic needs insecurity during the COVID-19 pandemic for Marshallese living in the USA. METHODS Survey data describing Marshallese experiences during the pandemic were analyzed using descriptive statistics and complementary log-log regression to test the association between education and basic needs insecurity. RESULTS Marshallese respondents reported no usual source of care (46%), less healthcare (22.3%), and difficulty obtaining medication (34.8%). Nearly 80% reported being food insecure, and 47.5% reported being housing insecure. Marshallese with a high school education or less had higher odds of reporting being food and housing insecure. DISCUSSION Basic needs insecurities are a serious threat to the health of Marshallese during the pandemic. Results from this study can inform interventions addressing food and housing insecurity, access to healthcare, and medication access for Marshallese communities.
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Affiliation(s)
- Jennifer A Andersen
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Avenue, Fayetteville, AR, 72703, USA
| | - Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Avenue, Fayetteville, AR, 72703, USA
| | - Joseph R Malhis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Avenue, Fayetteville, AR, 72703, USA
| | - Christopher R Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Avenue, Fayetteville, AR, 72703, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Avenue, Fayetteville, AR, 72703, USA.
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15
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Kurashima CK, Ng PK, Kendal-Wright CE. RAGE against the Machine: Can Increasing Our Understanding of RAGE Help Us to Battle SARS-CoV-2 Infection in Pregnancy? Int J Mol Sci 2022; 23:6359. [PMID: 35742804 PMCID: PMC9224312 DOI: 10.3390/ijms23126359] [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: 04/30/2022] [Revised: 06/02/2022] [Accepted: 06/05/2022] [Indexed: 12/05/2022] Open
Abstract
The receptor of advanced glycation end products (RAGE) is a receptor that is thought to be a key driver of inflammation in pregnancy, SARS-CoV-2, and also in the comorbidities that are known to aggravate these afflictions. In addition to this, vulnerable populations are particularly susceptible to the negative health outcomes when these afflictions are experienced in concert. RAGE binds a number of ligands produced by tissue damage and cellular stress, and its activation triggers the proinflammatory transcription factor Nuclear Factor Kappa B (NF-κB), with the subsequent generation of key proinflammatory cytokines. While this is important for fetal membrane weakening, RAGE is also activated at the end of pregnancy in the uterus, placenta, and cervix. The comorbidities of hypertension, cardiovascular disease, diabetes, and obesity are known to lead to poor pregnancy outcomes, and particularly in populations such as Native Hawaiians and Pacific Islanders. They have also been linked to RAGE activation when individuals are infected with SARS-CoV-2. Therefore, we propose that increasing our understanding of this receptor system will help us to understand how these various afflictions converge, how forms of RAGE could be used as a biomarker, and if its manipulation could be used to develop future therapeutic targets to help those at risk.
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Affiliation(s)
- Courtney K. Kurashima
- School of Natural Sciences and Mathematics, Chaminade University of Honolulu, Honolulu, HI 96816, USA; (C.K.K.); (P.K.N.)
| | - Po’okela K. Ng
- School of Natural Sciences and Mathematics, Chaminade University of Honolulu, Honolulu, HI 96816, USA; (C.K.K.); (P.K.N.)
| | - Claire E. Kendal-Wright
- School of Natural Sciences and Mathematics, Chaminade University of Honolulu, Honolulu, HI 96816, USA; (C.K.K.); (P.K.N.)
- Department of Obstetrics, Gynecology and Women’s Health, John A. Burns School of Medicine, University of Hawai’i, Honolulu, HI 96813, USA
- Department of Anatomy, Biochemistry and Physiology, John A. Burns School of Medicine, University of Hawai’i, Honolulu, HI 96813, USA
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16
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Purvis RS, Moore RA, Ayers BL, Felix HC, Riklon S, Andersen JA, Hudson JS, O'Connor G, Kelen M, Heely-Rolston LAN, Shields X, McElfish PA. Diabetes Self-Care Behaviors and Barriers to Clinical Care During COVID-19 Pandemic for Marshallese Adults. Sci Diabetes Self Manag Care 2022; 48:35-43. [PMID: 35023402 PMCID: PMC9082400 DOI: 10.1177/26350106211065390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of the study was to explore experiences of Marshallese adults related to diabetes self-care behaviors during the COVID-19 pandemic. METHODS A qualitative descriptive design was utilized to understand participants' diabetes self-care behaviors during the pandemic. Nine focus groups with 53 participants were held via videoconference and conducted in English, Marshallese, or a mixture of both languages. A priori codes based on diabetes self-care behaviors provided a framework for analyzing and summarizing participant experiences. RESULTS Both increases and decreases in healthy eating and exercise were described, with improvements in health behaviors attributed to health education messaging via social media. Participants reported increased stress and difficulty monitoring and managing glucose. Difficulty obtaining medication and difficulty seeing their health care provider regularly was reported and attributed to health care provider availability and lack of insurance due to job loss. CONCLUSIONS The study provides significant insight into the reach of health education campaigns via social media and provides important information about the reasons for delays in care, which extend beyond fear of contracting COVID-19 to structural issues.
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Affiliation(s)
- Rachel S Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas
| | - Ramey A Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas
| | - Britni L Ayers
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas
| | - Holly C Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Sheldon Riklon
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas
| | - Jennifer A Andersen
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas
| | - Jonell S Hudson
- College of Pharmacy, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas
| | - Gail O'Connor
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas
| | - Meetu Kelen
- West Hawaii Community Health Center, Kailua-Kona, Hawaii
| | | | - Xochitl Shields
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas
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17
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Kwan PP, Esmundo S, Rivas EA, Co DE, Sabado-Liwag M. Experiences and impacts of COVID-19 among Pacific Islanders in Los Angeles County. Ther Adv Infect Dis 2022; 9:20499361221093102. [PMID: 35494492 PMCID: PMC9052225 DOI: 10.1177/20499361221093102] [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: 10/18/2021] [Accepted: 03/05/2022] [Indexed: 11/24/2022] Open
Abstract
Objective To explore and document the experiences and impacts of COVID-19 among Pacific Islander (PI) adults living in Los Angeles County. Methods Study participants completed a brief online demographic questionnaire followed by a 45- to 60-min semi-structured one-on-one interview conducted via Zoom. Participants were asked about two main areas: (1) reasons for high rates of COVID-19 cases among the PI community and its impacts on their community and (2) the impacts of COVID-19 on them as individuals. Results A total of 14 PI adults, a majority of whom were females (76%) with an average age of 39.2 years took part in the study. Participants cited underlying medical conditions, overrepresentation in the essential workforce, multigeneration households, and the collectivistic culture of PIs as possible reasons for high rates of COVID-19 cases in their communities. Impacts of the pandemic included loss of jobs, loss of family and friends, and poor mental health which have been exacerbated by the pandemic. Conclusion This study documents the perspectives of PIs on why rates of COVID-19 are high in their community, their experiences with COVID-19 testing, and the impacts that the pandemic has had on themselves and their community. Findings from this study will assist public health professionals and health care providers in refining services and programs for the PI community.
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Affiliation(s)
- Patchareeya P. Kwan
- Department of Health Sciences, California State University, Northridge, 18111 Nordhoff Street, Northridge, CA 91330, USA
| | - Shenazar Esmundo
- Department of Health Sciences, California State University, Northridge, Northridge, CA, USA
| | - Eugenne Andrea Rivas
- Department of Health Sciences, California State University, Northridge, Northridge, CA, USA
| | - Danielle Erika Co
- Department of Health Sciences, California State University, Northridge, Northridge, CA, USA
| | - Melanie Sabado-Liwag
- Department of Public Health, California State University, Los Angeles, Los Angeles, CA, USA
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18
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McElfish PA, Rowland B, Porter A, Felix HC, Selig JP, Semingson J, Willis DE, Smith M, Riklon S, Alik E, Padilla-Ramos A, Jasso EY, Zohoori N. Use of Community-Based Participatory Research Partnerships to Reduce COVID-19 Disparities Among Marshallese Pacific Islander and Latino Communities - Benton and Washington Counties, Arkansas, April-December 2020. Prev Chronic Dis 2021; 18:E91. [PMID: 34618667 PMCID: PMC8522500 DOI: 10.5888/pcd18.210124] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Marshallese and Latino communities in Benton and Washington counties, Arkansas, were disproportionately affected by COVID-19. We evaluated the effectiveness of a comprehensive community-based intervention to reduce COVID-19 disparities in these communities. We examined all laboratory-confirmed COVID-19 cases in the 2 counties reported from April 6, 2020, through December 28, 2020. A 2-sample serial t test for rate change was used to evaluate changes in case rates before and after implementation of the intervention. After implementation, the proportions of cases among Marshallese and Latino residents declined substantially and began to align more closely with the proportions of these 2 populations in the 2 counties. Infection rates remained lower throughout the evaluation period, and weekly incidence also approximated Marshallese and Latino population proportions. Leveraging community partnerships and tailoring activities to specific communities can successfully reduce disparities in incidence among populations at high-risk for COVID-19 .
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Affiliation(s)
- Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas.,1125 N College Ave, Fayetteville, AR 72703.
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas
| | - Austin Porter
- Arkansas Department of Health, Little Rock, Arkansas
| | - Holly C Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | | | - Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas
| | | | - Sheldon Riklon
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas
| | - Eldon Alik
- Republic of the Marshall Islands Consulate, Springdale, Arkansas
| | - Alan Padilla-Ramos
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas
| | - Erika Y Jasso
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas
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19
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Quint JJ, Van Dyke ME, Maeda H, Worthington JK, Dela Cruz MR, Kaholokula JK, Matagi CE, Pirkle CM, Roberson EK, Sentell T, Watkins-Victorino L, Andrews CA, Center KE, Calanan RM, Clarke KE, Satter DE, Penman-Aguilar A, Parker EM, Kemble S. Disaggregating Data to Measure Racial Disparities in COVID-19 Outcomes and Guide Community Response - Hawaii, March 1, 2020-February 28, 2021. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2021; 70:1267-1273. [PMID: 34529634 PMCID: PMC8445382 DOI: 10.15585/mmwr.mm7037a1] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Native Hawaiian and Pacific Islander populations have been disproportionately affected by COVID-19 (1-3). Native Hawaiian, Pacific Islander, and Asian populations vary in language; cultural practices; and social, economic, and environmental experiences,† which can affect health outcomes (4).§ However, data from these populations are often aggregated in analyses. Although data aggregation is often used as an approach to increase sample size and statistical power when analyzing data from smaller population groups, it can limit the understanding of disparities among diverse Native Hawaiian, Pacific Islander, and Asian subpopulations¶ (4-7). To assess disparities in COVID-19 outcomes among Native Hawaiian, Pacific Islander, and Asian populations, a disaggregated, descriptive analysis, informed by recommendations from these communities,** was performed using race data from 21,005 COVID-19 cases and 449 COVID-19-associated deaths reported to the Hawaii State Department of Health (HDOH) during March 1, 2020-February 28, 2021.†† In Hawaii, COVID-19 incidence and mortality rates per 100,000 population were 1,477 and 32, respectively during this period. In analyses with race categories that were not mutually exclusive, including persons of one race alone or in combination with one or more races, Pacific Islander persons, who account for 5% of Hawaii's population, represented 22% of COVID-19 cases and deaths (COVID-19 incidence of 7,070 and mortality rate of 150). Native Hawaiian persons experienced an incidence of 1,181 and a mortality rate of 15. Among subcategories of Asian populations, the highest incidences were experienced by Filipino persons (1,247) and Vietnamese persons (1,200). Disaggregating Native Hawaiian, Pacific Islander, and Asian race data can aid in identifying racial disparities among specific subpopulations and highlights the importance of partnering with communities to develop culturally responsive outreach teams§§ and tailored public health interventions and vaccination campaigns to more effectively address health disparities.
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20
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Rehuher D, Hishinuma ES, Goebert DA, Palafox NA. A Historical and Contemporary Review of the Contextualization and Social Determinants of Health of Micronesian Migrants in the United States. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2021; 80:88-101. [PMID: 34661132 PMCID: PMC8504325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Hawai'i's Pacific Islander (PI) population has suffered a higher burden of coronavirus disease 2019 (COVID-19) infections, hospitalizations, and deaths compared to other groups in the state. The Hawai'i Emergency Management Agency Community Care Outreach Unit conducted an assessment across the state to gain an understanding of the impact of the COVID-19 pandemic on the health and social welfare of households. Survey data was collected from individuals across the state during a period of 3 weeks (August 12-September 5, 2020). The following are resulting recommendations from the Pacific Island community to mitigate the impact and disparities of the pandemic as immediate and medium-term structural requests: (1) ensure that Pacific Island communities are proactively represented in state and county committees that develop health interventions to ensure that relevant language and culturally tailored communications and strategies are included, (2) provide consistent funding and community centered support to ensure consistent COVID-19 impact services for the Pacific Island families, (3) enhance the capacity of PI health care navigators and interpreters through increased funding and program support, and (4) engage state policy makers immediately to understand and address the systemic structural barriers to health care and social services for Pacific Islanders in Hawai'i. These recommendations were developed to address the generational inequities and disparities that exist for Pacific islanders in Hawai'i which were exacerbated by the COVID-19 pandemic.
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Affiliation(s)
- Davis Rehuher
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (DR, ESH, DAG)
| | - Earl S. Hishinuma
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (DR, ESH, DAG)
| | - Deborah A. Goebert
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (DR, ESH, DAG)
| | - Neal A. Palafox
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (DR, ESH, DAG)
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21
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Moncla LH, Black A, DeBolt C, Lang M, Graff NR, Pérez-Osorio AC, Müller NF, Haselow D, Lindquist S, Bedford T. Repeated introductions and intensive community transmission fueled a mumps virus outbreak in Washington State. eLife 2021; 10:e66448. [PMID: 33871357 PMCID: PMC8079146 DOI: 10.7554/elife.66448] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/15/2021] [Indexed: 12/20/2022] Open
Abstract
In 2016/2017, Washington State experienced a mumps outbreak despite high childhood vaccination rates, with cases more frequently detected among school-aged children and members of the Marshallese community. We sequenced 166 mumps virus genomes collected in Washington and other US states, and traced mumps introductions and transmission within Washington. We uncover that mumps was introduced into Washington approximately 13 times, primarily from Arkansas, sparking multiple co-circulating transmission chains. Although age and vaccination status may have impacted transmission, our data set could not quantify their precise effects. Instead, the outbreak in Washington was overwhelmingly sustained by transmission within the Marshallese community. Our findings underscore the utility of genomic data to clarify epidemiologic factors driving transmission and pinpoint contact networks as critical for mumps transmission. These results imply that contact structures and historic disparities may leave populations at increased risk for respiratory virus disease even when a vaccine is effective and widely used.
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Affiliation(s)
- Louise H Moncla
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research CenterSeattleUnited States
| | - Allison Black
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research CenterSeattleUnited States
- Department of Epidemiology, University of WashingtonSeattleUnited States
| | - Chas DeBolt
- Office of Communicable Disease Epidemiology, Washington State Department of HealthShorelineUnited States
| | - Misty Lang
- Office of Communicable Disease Epidemiology, Washington State Department of HealthShorelineUnited States
| | - Nicholas R Graff
- Office of Communicable Disease Epidemiology, Washington State Department of HealthShorelineUnited States
| | - Ailyn C Pérez-Osorio
- Office of Communicable Disease Epidemiology, Washington State Department of HealthShorelineUnited States
| | - Nicola F Müller
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research CenterSeattleUnited States
| | - Dirk Haselow
- Arkansas Department of HealthLittle RockUnited States
| | - Scott Lindquist
- Office of Communicable Disease Epidemiology, Washington State Department of HealthShorelineUnited States
| | - Trevor Bedford
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research CenterSeattleUnited States
- Department of Epidemiology, University of WashingtonSeattleUnited States
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