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Winsper C, Bhattacharya R, Bhui K, Currie G, Edge D, Ellard D, Franklin D, Gill P, Gilbert S, Khan N, Miller R, Motala Z, Pinfold V, Sandhu H, Singh SP, Weich S, Giacco D. The impact of reduced routine community mental healthcare on people from minority ethnic groups during the COVID-19 pandemic: qualitative study of stakeholder perspectives. Br J Psychiatry 2024; 224:150-156. [PMID: 38344814 PMCID: PMC7615860 DOI: 10.1192/bjp.2024.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
BACKGROUND Enduring ethnic inequalities exist in mental healthcare. The COVID-19 pandemic has widened these. AIMS To explore stakeholder perspectives on how the COVID-19 pandemic has increased ethnic inequalities in mental healthcare. METHOD A qualitative interview study of four areas in England with 34 patients, 15 carers and 39 mental health professionals from National Health Service (NHS) and community organisations (July 2021 to July 2022). Framework analysis was used to develop a logic model of inter-relationships between pre-pandemic barriers and COVID-19 impacts. RESULTS Impacts were largely similar across sites, with some small variations (e.g. positive service impacts of higher ethnic diversity in area 2). Pre-pandemic barriers at individual level included mistrust and thus avoidance of services and at a service level included the dominance of a monocultural model, leading to poor communication, disengagement and alienation. During the pandemic remote service delivery, closure of community organisations and media scapegoating exacerbated existing barriers by worsening alienation and communication barriers, fuelling prejudice and division, and increasing mistrust in services. Some minority ethnic patients reported positive developments, experiencing empowerment through self-determination and creative activities. CONCLUSIONS During the COVID-19 pandemic some patients showed resilience and developed adaptations that could be nurtured by services. However, there has been a reduction in the availability of group-specific NHS and third-sector services in the community, exacerbating pre-existing barriers. As these developments are likely to have long-term consequences for minority ethnic groups' engagement with mental healthcare, they need to be addressed as a priority by the NHS and its partners.
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Affiliation(s)
- Catherine Winsper
- Department of Research and Innovation, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | | | - Kamaldeep Bhui
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Graeme Currie
- Warwick Business School, University of Warwick, Coventry, UK
| | - Dawn Edge
- Division of Psychology & Mental Health, University of Manchester, Manchester, UK
| | - David Ellard
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Donna Franklin
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Paramjit Gill
- Department of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Noreen Khan
- Department of Research and Innovation, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | - Robin Miller
- School of Social Policy, University of Birmingham, Birmingham, UK
| | - Zahra Motala
- Department of Sociology, University of Manchester, Manchester, UK
| | | | - Harbinder Sandhu
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Swaran P Singh
- Department of Research and Innovation, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK; and Department of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Scott Weich
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Domenico Giacco
- Department of Research and Innovation, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK; and Department of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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2
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Haderlein TP, Hamilton AB, Masheb RM, Mullur R, Lam CA, Washington DL. Racial and Ethnic Variation in Healthcare Utilization Before and During the COVID-19 Pandemic: Differential Effects for Overall Versus Telehealth Care. J Gen Intern Med 2024; 39:886-888. [PMID: 38228985 PMCID: PMC11043243 DOI: 10.1007/s11606-023-08592-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 12/28/2023] [Indexed: 01/18/2024]
Affiliation(s)
- Taona P Haderlein
- VHA HSR&D Center for the Study of Health Care Innovation, Implementation and Policy (CSHIIP), Greater Los Angeles VA Healthcare System, 11301 Wilshire Blvd, Bldg 206 (151), Los Angeles, CA, 90073, USA.
- Veterans Emergency Management Evaluation Center, U.S Department of Veterans Affairs, North Hills, CA, USA.
| | - Alison B Hamilton
- VHA HSR&D Center for the Study of Health Care Innovation, Implementation and Policy (CSHIIP), Greater Los Angeles VA Healthcare System, 11301 Wilshire Blvd, Bldg 206 (151), Los Angeles, CA, 90073, USA
- Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Robin M Masheb
- VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Rashmi Mullur
- Telehealth Service, VA Greater Los Angeles VA Healthcare System, Los Angeles, CA, USA
- Division of Endocrinology, Department of Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | | | - Donna L Washington
- VHA HSR&D Center for the Study of Health Care Innovation, Implementation and Policy (CSHIIP), Greater Los Angeles VA Healthcare System, 11301 Wilshire Blvd, Bldg 206 (151), Los Angeles, CA, 90073, USA
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
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3
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da Silva RV, Alves CEA, Montenario MR, Murray LR. Writing to Create, Mend, and Rebel: Three Reflections on Journaling as Escrevivência for Afro-Brazilian Public University Students During COVID-19. Cult Med Psychiatry 2024; 48:123-132. [PMID: 38607461 DOI: 10.1007/s11013-024-09849-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2024] [Indexed: 04/13/2024]
Affiliation(s)
- Renan Vicente da Silva
- Centro de Ciências da Saúde/Universidade Federal do Rio de Janeiro (CSS/UFRJ) - Center for Health Sciences/Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Hospital Regional do Medio Paraíba, Volta Redonda, Rio de Janeiro, Brazil
| | - Carlos Eduardo Assunção Alves
- Centro de Ciências da Saúde/Universidade Federal do Rio de Janeiro (CSS/UFRJ) - Center for Health Sciences/Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Faculdade de Medicina/Medical School, CSS/UFRJ, Rio de Janeiro, Brazil
| | - Mayana Ribeiro Montenario
- Centro de Ciências da Saúde/Universidade Federal do Rio de Janeiro (CSS/UFRJ) - Center for Health Sciences/Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Faculdade de Fisioterapia/School of Physical Therapy, CSS/UFRJ, Rio de Janeiro, Brazil
| | - Laura Rebecca Murray
- Núcleo de Estudos de Políticas Públicas em Direitos Humanos/Universidade Federal do Rio de Janeiro (NEPP-DH/UFRJ) - Center for Studies on Public Policies in Human Rights/Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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4
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Trok L, Jacobs NJ. Reaching Out from Lockdown: A Writing Group for Young Black South Africans. Cult Med Psychiatry 2024; 48:113-122. [PMID: 38478353 DOI: 10.1007/s11013-024-09850-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2024] [Indexed: 04/24/2024]
Affiliation(s)
| | - Nancy J Jacobs
- Department of History, Brown University, Providence, RI, USA.
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5
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Cecchi Dimeglio P, Fullilove RE, Cecchi C, Cabon Y, Rosenberg J. Predicting Covid-19 infection and death rates among E.U. minority populations in the absence of racially disaggregated data through the use of US data comparisons. Eur J Public Health 2024; 34:176-180. [PMID: 37713471 PMCID: PMC10843944 DOI: 10.1093/eurpub/ckad164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND The E.U.'s lack of racially disaggregated data impedes the formulation of effective interventions, and crises such as Covid-19 may continue to impact minorities more severely. Our predictive model offers insight into the disparate ways in which Covid-19 has likely impacted E.U. minorities and allows for the inference of differences in Covid-19 infection and death rates between E.U. minority and non-minority populations. METHODS Data covering Covid-19, social determinants of health and minority status were included from 1 March 2020 to 28 February 2021. A systematic comparison of US and E.U. states enabled the projection of Covid-19 infection and death rates for minorities and non-minorities in E.U. states. RESULTS The model predicted Covid-19 infection rates with 95-100% accuracy for 23 out of 28 E.U. states. Projections for Covid-19 infection and mortality rates among E.U. minority groups illustrate parallel trends to US rates. CONCLUSIONS Disparities in Covid-19 infection and death rates by minority status likely exist in patterns similar to those observed in US data. Policy Implications: Collecting data by race/ethnicity in the E.U. would help document health disparities and craft more targeted health interventions and mitigation strategies.
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Affiliation(s)
- Paola Cecchi Dimeglio
- Harvard Law School (Center on the Legal Profession) and Harvard Kennedy School (Women and Public Policy), Harvard University, Cambridge, MA, USA
| | - Robert E Fullilove
- Department of Sociomedical Sciences and Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Catherine Cecchi
- Société Francaise de Sante Publique and Société Francophone Santé Environnement, Montpellier, France
| | - Yann Cabon
- Behavioral Insights Institute, Cambridge, MA, USA
| | - Jessica Rosenberg
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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6
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Foster TB, Fernandez L, Porter SR, Pharris-Ciurej N. Racial and Ethnic Disparities in Excess All-Cause Mortality in the First Year of the COVID-19 Pandemic. Demography 2024; 61:59-85. [PMID: 38197462 DOI: 10.1215/00703370-11133943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Research on the COVID-19 pandemic in the United States has consistently found disproportionately high mortality among ethnoracial minorities, but reports differ with respect to the magnitude of mortality disparities and reach different conclusions regarding which groups were most impacted. We suggest that these variations stem from differences in the temporal scope of the mortality data used and difficulties inherent in measuring race and ethnicity. To circumvent these issues, we link Social Security Administration death records for 2010 through 2021 to decennial census and American Community Survey race and ethnicity responses. We use these linked data to estimate excess all-cause mortality for age-, sex-, race-, and ethnicity-specific subgroups and examine ethnoracial variation in excess mortality across states and over the course of the pandemic's first year. Results show that non-Hispanic American Indians and Alaska Natives experienced the highest excess mortality of any ethnoracial group in the first year of the pandemic, followed by Hispanics and non-Hispanic Blacks. Spatiotemporal and age-specific ethnoracial disparities suggest that the socioeconomic determinants driving health disparities prior to the pandemic were amplified and expressed in new ways in the pandemic's first year to disproportionately concentrate excess mortality among racial and ethnic minorities.
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Ruggeri K, Stock F, Haslam SA, Capraro V, Boggio P, Ellemers N, Cichocka A, Douglas KM, Rand DG, van der Linden S, Cikara M, Finkel EJ, Druckman JN, Wohl MJA, Petty RE, Tucker JA, Shariff A, Gelfand M, Packer D, Jetten J, Van Lange PAM, Pennycook G, Peters E, Baicker K, Crum A, Weeden KA, Napper L, Tabri N, Zaki J, Skitka L, Kitayama S, Mobbs D, Sunstein CR, Ashcroft-Jones S, Todsen AL, Hajian A, Verra S, Buehler V, Friedemann M, Hecht M, Mobarak RS, Karakasheva R, Tünte MR, Yeung SK, Rosenbaum RS, Lep Ž, Yamada Y, Hudson SKTJ, Macchia L, Soboleva I, Dimant E, Geiger SJ, Jarke H, Wingen T, Berkessel JB, Mareva S, McGill L, Papa F, Većkalov B, Afif Z, Buabang EK, Landman M, Tavera F, Andrews JL, Bursalıoğlu A, Zupan Z, Wagner L, Navajas J, Vranka M, Kasdan D, Chen P, Hudson KR, Novak LM, Teas P, Rachev NR, Galizzi MM, Milkman KL, Petrović M, Van Bavel JJ, Willer R. A synthesis of evidence for policy from behavioural science during COVID-19. Nature 2024; 625:134-147. [PMID: 38093007 PMCID: PMC10764287 DOI: 10.1038/s41586-023-06840-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/06/2023] [Indexed: 12/22/2023]
Abstract
Scientific evidence regularly guides policy decisions1, with behavioural science increasingly part of this process2. In April 2020, an influential paper3 proposed 19 policy recommendations ('claims') detailing how evidence from behavioural science could contribute to efforts to reduce impacts and end the COVID-19 pandemic. Here we assess 747 pandemic-related research articles that empirically investigated those claims. We report the scale of evidence and whether evidence supports them to indicate applicability for policymaking. Two independent teams, involving 72 reviewers, found evidence for 18 of 19 claims, with both teams finding evidence supporting 16 (89%) of those 18 claims. The strongest evidence supported claims that anticipated culture, polarization and misinformation would be associated with policy effectiveness. Claims suggesting trusted leaders and positive social norms increased adherence to behavioural interventions also had strong empirical support, as did appealing to social consensus or bipartisan agreement. Targeted language in messaging yielded mixed effects and there were no effects for highlighting individual benefits or protecting others. No available evidence existed to assess any distinct differences in effects between using the terms 'physical distancing' and 'social distancing'. Analysis of 463 papers containing data showed generally large samples; 418 involved human participants with a mean of 16,848 (median of 1,699). That statistical power underscored improved suitability of behavioural science research for informing policy decisions. Furthermore, by implementing a standardized approach to evidence selection and synthesis, we amplify broader implications for advancing scientific evidence in policy formulation and prioritization.
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Affiliation(s)
- Kai Ruggeri
- Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York City, NY, USA.
- Policy Research Group, Centre for Business Research, Judge Business School, University of Cambridge, Cambridge, UK.
- 274th ASOS, US Air Force/New York Air National Guard, Syracuse, NY, United States.
| | - Friederike Stock
- Center for Adaptive Rationality, Max Planck Institute for Human Development, Berlin, Germany
- Department of Psychology, Humboldt University of Berlin, Berlin, Germany
| | | | | | - Paulo Boggio
- Mackenzie Presbyterian University, São Paulo, Brazil
- National Institute of Science and Technology on Social and Affective Neuroscience, CNPq, São Paulo, Brazil
| | | | | | | | - David G Rand
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | | | - Eli J Finkel
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Kellogg School of Management, Northwestern University, Evanston, IL, USA
| | | | - Michael J A Wohl
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Richard E Petty
- Department of Psychology, Ohio State University, Columbus, OH, USA
| | - Joshua A Tucker
- Department of Politics & Center for Social Media and Politics, New York University, New York, NY, USA
| | - Azim Shariff
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - Jolanda Jetten
- University of Queensland, St Lucia, Queensland, Australia
| | - Paul A M Van Lange
- Institute for Brain and Behavior Amsterdam, Department of Experimental and Applied Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Global Faculty, Social and Economic Behavior, University of Cologne, Cologne, Germany
| | | | - Ellen Peters
- Center for Science Communication Research, School of Journalism and Communication, University of Oregon, Eugene, OR, USA
- Psychology Department, University of Oregon, Eugene, OR, USA
| | | | - Alia Crum
- Department of Psychology, Stanford University, Stanford, CA, USA
| | | | | | - Nassim Tabri
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | | | - Linda Skitka
- University of Illinois Chicago, Chicago, IL, USA
| | | | - Dean Mobbs
- Department of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, USA
- Computation and Neural Systems Program, California Institute of Technology, Pasadena, CA, USA
| | | | - Sarah Ashcroft-Jones
- Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York City, NY, USA
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Anna Louise Todsen
- Department of Social Policy and Evaluation, University of Oxford, Oxford, UK
| | | | | | | | | | - Marlene Hecht
- Center for Adaptive Rationality, Max Planck Institute for Human Development, Berlin, Germany
- Department of Psychology, Humboldt University of Berlin, Berlin, Germany
| | - Rayyan S Mobarak
- Department of Agricultural and Resource Economics, University of Maryland, College Park, MD, USA
| | | | - Markus R Tünte
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Siu Kit Yeung
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - R Shayna Rosenbaum
- Department of Psychology, York University, Toronto, Ontario, Canada
- Rotman Research Institute, Baycrest Academy for Research and Education, Toronto, Ontario, Canada
| | - Žan Lep
- Department of Psychology, Faculty of Arts, University of Ljubljana, Ljubljana, Slovenia
- Centre for Applied Epistemology, Educational Research Institute, Ljubljana, Slovenia
| | - Yuki Yamada
- Faculty of Arts and Science, Kyushu University, Fukuoka, Japan
| | | | | | | | - Eugen Dimant
- Center for Social Norms and Behavioral Dynamics, University of Pennsylvania, Philadelphia, PA, USA
- CESifo, Munich, Germany
| | - Sandra J Geiger
- Environmental Psychology, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Hannes Jarke
- Policy Research Group, Centre for Business Research, Judge Business School, University of Cambridge, Cambridge, UK
| | - Tobias Wingen
- University of Bonn, University Hospital Bonn, Institute of General Practice and Family Medicine, Bonn, Germany
| | - Jana B Berkessel
- Mannheim Centre for European Social Research, University of Mannheim, Mannheim, Germany
| | - Silvana Mareva
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Psychology Department, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Lucy McGill
- University College Dublin, Dublin, Ireland
- University of Groningen, Groningen, Netherlands
| | - Francesca Papa
- Organisation for Economic Co-operation and Development, Paris, France
| | | | | | - Eike K Buabang
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Marna Landman
- Gordon Institute of Business Science, University of Pretoria, Johannesburg, South Africa
| | - Felice Tavera
- Department of Psychology, University of Cologne, Cologne, Germany
| | - Jack L Andrews
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- University College, Oxford, UK
| | - Aslı Bursalıoğlu
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - Zorana Zupan
- Institute of Psychology, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
| | - Lisa Wagner
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Joaquín Navajas
- Laboratorio de Neurociencia, Universidad Torcuato Di Tella, Buenos Aires, Argentina
- Escuela de Negocios, Universidad Torcuato Di Tella, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | | | - David Kasdan
- Sungkyunkwan University, Seoul, Republic of Korea
| | - Patricia Chen
- University of Texas at Austin, Austin, TX, USA
- National University of Singapore, Singapore, Singapore
| | | | | | - Paul Teas
- University of Illinois Chicago, Chicago, IL, USA
| | - Nikolay R Rachev
- Department of General, Experimental, Developmental, and Health Psychology, Sofia University St. Kliment Ohridski, Sofia, Bulgaria
| | - Matteo M Galizzi
- Department of Psychological and Behavioural Science, London School of Economics, London, UK
| | | | - Marija Petrović
- Department of Psychology & Laboratory for Research of Individual Differences, Faculty of Philosophy, University of Belgrade, Belgrade, Serbia
| | - Jay J Van Bavel
- Department of Psychology & Center for Neural Science, New York University, New York, NY, USA
| | - Robb Willer
- Department of Sociology, Stanford University, Stanford, CA, USA
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Carlos Chavez FL, Sanchez D, Capielo Rosario C, Han S, Cerezo A, Cadenas GA. COVID-19 Economic and Academic Stress on Mexican American Adolescents' Psychological Distress: Parents as Essential Workers. J Clin Child Adolesc Psychol 2024; 53:37-51. [PMID: 37036440 DOI: 10.1080/15374416.2023.2191283] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
OBJECTIVES In a sample of Mexican American adolescents (N = 398; 51% females; aged 13-17), we examined the associations between psychological distress, COVID-19 household economic stress, COVID-19 academic stress, and whether these associations varied by adolescents' gender and by parents/caregivers' essential worker status. METHOD First, linear regression models assessed the main effects of household economic and academic stress on psychological distress. Second, the moderating effects of gender and parents/caregivers' essential worker status on the association between household economic and academic stress, and psychological distress were examined. Third, the three-way interaction effect of household economic stress, gender, and parents/caregivers' essential worker status on psychological distress as well as the three-way interaction effect of academic stress, gender, and parents/caregivers' essential worker status on psychological distress were calculated. RESULTS Household economic and academic stress were associated with psychological distress. However, these associations did not vary based on adolescents' gender or parents/caregivers' essential worker status. The three-way interaction for household economic stress, parents/caregivers' essential worker status, and gender for psychological distress was significant. Specifically, the effects of household economic stress on psychological distress was worse for boys than girls whose parents/caregivers were essential workers. Furthermore, the three-way interaction among academic stress, parents/caregivers' essential worker status, and gender was significant. Particularly, the effects of academic stress when grades were worse on adolescents' psychological distress was worse for boys than girls whose parents/caregivers were essential workers. CONCLUSION Parents/caregivers' essential worker status was salient among Mexican American adolescents' mental health outcomes during COVID-19, particularly for adolescent boys.
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Affiliation(s)
- Fiorella L Carlos Chavez
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University
| | - Delida Sanchez
- Department of Counseling, Higher Education, and Special Education, University of Maryland
| | | | - SeungYong Han
- Research Initiatives, Support & Engagement (R.I.S.E.). Edson College of Nursing and Health Innovation, Arizona State University
| | - Alison Cerezo
- Department of Counseling, Clinical, and School Psychology, University of California Santa Barbara
| | - German A Cadenas
- Department of Education & Human Services, College of Education, Lehigh University
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Cleaveland C, Anderson T, McNally K, Roess AA. Vaccine Attitudes and Uptake Among Latino Residents of a Former COVID-19 Hotspot. J Health Care Poor Underserved 2024; 35:316-340. [PMID: 38661873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Early in the COVID-19 pandemic, the Centers for Disease Control and Prevention identified Prince William County (PWC), Va. as a hotspot with a high disease rate among Latinos. This study uses spatial, survey, and qualitative data to understand attitudes towards vaccine uptake among PWC Latinos. A quantitative analysis (n=266) estimates the association for vaccine acceptance among Latinos. Next, qualitative interviews with Latinos (n=37) examine vaccine attitudes. Finally, a spatial analysis identifies clusters of social vulnerability and low vaccine uptake in PWC and adjacent counties. Our findings show that a substantial proportion of PWC Latinos had low vaccination rates as of December 2022, two years after the vaccine's release. Side effects and safety and approval concerns were cited in both the quantitative and qualitative studies. Persistent vaccine disparities are concerning given the high hospitalization and mortality rates that prevailed among Latinos early in the pandemic.
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Polo AJ, Solano-Martinez JE, Saldana L, Ramos AD, Herrera M, Ullrich T, DeMario M. The Epidemic of Internalizing Problems Among Latinx Adolescents Before and During the Coronavirus 2019 Pandemic. J Clin Child Adolesc Psychol 2024; 53:66-82. [PMID: 36998122 DOI: 10.1080/15374416.2023.2169925] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
OBJECTIVE Latinx youth exhibit disproportionately higher internalizing symptoms than their peers from other racial/ethnic groups. This study compares depression and anxiety symptoms between referred students of Latinx and non-Latinx backgrounds before and during the COVID-19 pandemic and examines key determinants within the Latinx sample. METHOD Data are analyzed from four academic years - two before and two during the pandemic - from 1220 5th through 8th grade students (Mage = 12.1; 59.6% female; 59.9% Latinx or mixed-Latinx) referred for services across 59 Chicago Public School District (CPS) elementary schools. Using the Children's Depression Inventory (CDI) and the Revised Child Anxiety and Depression Scale (RCADS), mean scores and risk levels for depression, social anxiety, and generalized anxiety are examined. RESULTS Higher internalizing risk and comorbidity rates were found in the second year of the pandemic, compared to pre-pandemic levels. Latinx students reported higher depression, social anxiety, and generalized anxiety symptoms than non-Latinx students. During the pandemic, more Latinx students were classified as having comorbid depression and anxiety, and scored in the clinical range for depression, generalized anxiety, and social anxiety than non-Latinx students. Within the Latinx sample, girls and gender non-conforming students reported the highest maladjustment. CONCLUSIONS Results highlight the pressing need to examine the long-term impact of COVID-19 on the mental health of Latinx children and adolescents, and to address their internalizing problems.
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11
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Capielo Rosario C, Carlos Chavez FL, Sanchez D, Torres L, Mattwig T, Pituch K. Mental Health Among Puerto Rican Adolescents Living in the United States During the COVID-19 Pandemic. J Clin Child Adolesc Psychol 2024; 53:52-65. [PMID: 38270576 DOI: 10.1080/15374416.2024.2301775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
OBJECTIVES The present study examined how different family level (family financial stress, family violence) and individual (food insecurity, gender, race) determinants of health were associated with mental health among Puerto Rican adolescents living in the U.S. during the COVID-19 pandemic. METHOD A sample consisting of 119 Puerto Rican adolescents, aged 13 to 17, was collected via Qualtrics Panels between November 2020 and January 2021. We examined the association between family financial stress experienced during the pandemic and psychological distress. We also evaluated whether the association between family financial stress and psychological distress was moderated by family violence, food insecurity, and the participant's gender and race. RESULTS Findings showed that food insecurity positively predicted psychological distress. Results also showed that participants' race moderated the association between family financial stress and psychological distress. Specifically, we found that while there was a significant positive association between family financial stress and psychological distress among Puerto Rican adolescents who identified as a racial minority, this association was nonsignificant among White Puerto Rican adolescents. CONCLUSION Our research highlights the significant role of COVID-19 related family financial stress and food insecurity on Puerto Rican adolescents' poor mental health during the COVID-19 pandemic.
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Affiliation(s)
| | | | - Delida Sanchez
- Department of Counseling, Higher Education, and Special Education, University of Maryland
| | | | | | - Keenan Pituch
- College of Nursing and Health Innovation, Arizona State University
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Neal WN, Schleicher EA, Baron K, Oster RA, Brown NI, Demark-Wahnefried W, Pisu M, Baskin ML, Parrish KB, Cole WW, Thirumalai M, Pekmezi DW. Impact of the COVID-19 Pandemic on Physical Activity among Mostly Older, Overweight Black Women Living in the Rural Alabama Black Belt. Int J Environ Res Public Health 2023; 20:7180. [PMID: 38131731 PMCID: PMC10743260 DOI: 10.3390/ijerph20247180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/08/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023]
Abstract
Despite well-documented global declines in physical activity (PA) during the COVID-19 pandemic, little is known regarding the specific impact among underserved, rural Alabama counties. This is concerning as this region was already disproportionately burdened by inactivity and related chronic diseases and was among the hardest hit by COVID-19. Thus, the current study examined the effect of COVID-19 on PA in four rural Alabama counties. An ancillary survey was administered between March 2020 and August 2021 to the first cohort (N = 171) of participants enrolled in a larger PA trial. Main outcomes of this survey included the perceived impact of COVID-19 on PA, leisure-time PA, and social cognitive theory (SCT) constructs at 3 months. Almost half of the participants reported being less active during the pandemic (49.7%) and endorsed that COVID-19 made PA more difficult (47.4%), citing concerns such as getting sick from exercising outside of the home (70.4%) and discomfort wearing a face mask while exercising (58%). Perceived COVID-19 impact on PA was significantly associated with education, household dependents, and gender (p's < 0.05). More women, parents, and college graduates reported that the COVID-19 pandemic made PA more difficult. Overall, there were no significant associations between PA, SCT constructs, or perceived COVID-19 impact on PA scores at 3 months. While the pandemic made PA difficult for many participants, these barriers were not associated with leisure-time PA levels or related theoretical mechanisms of action, which bodes well for the success of our ongoing intervention efforts and the resiliency of these communities.
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Affiliation(s)
- Whitney N. Neal
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (E.A.S.); (K.B.P.); (W.W.C.); (D.W.P.)
| | - Erica A. Schleicher
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (E.A.S.); (K.B.P.); (W.W.C.); (D.W.P.)
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (R.A.O.); (M.P.)
| | - Kerri Baron
- Capstone College of Nursing, University of Alabama, Tuscaloosa, AL 35487, USA;
| | - Robert A. Oster
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (R.A.O.); (M.P.)
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Nashira I. Brown
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612, USA;
| | - Wendy Demark-Wahnefried
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Maria Pisu
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (R.A.O.); (M.P.)
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Monica L. Baskin
- Department of Medicine, Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA 15260, USA;
| | - Kelsey B. Parrish
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (E.A.S.); (K.B.P.); (W.W.C.); (D.W.P.)
| | - William Walker Cole
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (E.A.S.); (K.B.P.); (W.W.C.); (D.W.P.)
| | - Mohanraj Thirumalai
- Health Services Administration, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Dori W. Pekmezi
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (E.A.S.); (K.B.P.); (W.W.C.); (D.W.P.)
- O’Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (R.A.O.); (M.P.)
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Rubens M, Ramamoorthy V, Saxena A, Zevallos JC, Pelaez JGR, Ahmed MA, Zhang Z, McGranaghan P, Chaparro S, Jimenez J. Racial difference in mortality among COVID-19 hospitalizations in California. Sci Rep 2023; 13:21378. [PMID: 38049452 PMCID: PMC10696031 DOI: 10.1038/s41598-023-47124-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/09/2023] [Indexed: 12/06/2023] Open
Abstract
In the US, racial disparities in hospital outcomes are well documented. We explored whether race was associated with all-cause in-hospital mortality and intensive care unit (ICU) admission among COVID-19 patients in California. This was a retrospective analysis of California State Inpatient Database during 2020. Hospitalizations ≥ 18 years of age for COVID-19 were included. Cox proportional hazards with mixed effects were used for associations between race and in-hospital mortality. Logistic regression was used for the association between race and ICU admission. Among 87,934 COVID-19 hospitalizations, majority were Hispanics (56.5%), followed by White (27.3%), Asian, Pacific Islander, Native American (9.9%), and Black (6.3%). Cox regression showed higher mortality risk among Hispanics, compared to Whites (hazard ratio, 0.91; 95% CI 0.87-0.96), Blacks (hazard ratio, 0.87; 95% CI 0.79-0.94), and Asian, Pacific Islander, Native American (hazard ratio, 0.89; 95% CI 0.83-0.95). Logistic regression showed that the odds of ICU admission were significantly higher among Hispanics, compared to Whites (OR, 1.70; 95% CI 1.67-1.74), Blacks (OR, 1.70; 95% CI 1.64-1.78), and Asian, Pacific Islander, Native American (OR, 1.82; 95% CI 1.76-1.89). We found significant disparities in mortality among COVID-19 hospitalizations in California. Hispanics were the worst affected with the highest mortality and ICU admission rates.
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Affiliation(s)
- Muni Rubens
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
- Universidad Espíritu Santo, Samborondón, Ecuador
| | | | - Anshul Saxena
- Center for Advanced Analytics, Baptist Health South Florida, Miami, FL, USA
| | - Juan Carlos Zevallos
- Miami Cardiac & Vascular Institute, Baptist Health South Florida, Miami, FL, USA
| | | | - Md Ashfaq Ahmed
- Center for Advanced Analytics, Baptist Health South Florida, Miami, FL, USA
| | - Zhenwei Zhang
- Center for Advanced Analytics, Baptist Health South Florida, Miami, FL, USA
| | - Peter McGranaghan
- Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA.
- Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 10117, Berlin, Germany.
- Advance Heart Failure and Pulmonary Hypertension, South Miami Hospital, Baptist Health South, Miami, FL, USA.
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.
| | - Sandra Chaparro
- Miami Cardiac & Vascular Institute, Baptist Health South Florida, Miami, FL, USA
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Javier Jimenez
- Miami Cardiac & Vascular Institute, Baptist Health South Florida, Miami, FL, USA.
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.
- Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
- Freie Universität Berlin and Humboldt Universität Zu Berlin, Augustenburger Platz 1, 10117, Berlin, Germany.
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Laurencin CT, Wu ZH, Grady JJ, Wu R, Murray MM, Slivinsky M. The Shift: COVID-19-Associated Deaths are Now Trending Lower Among Blacks and Hispanics Compared to Whites. J Racial Ethn Health Disparities 2023; 10:3188-3193. [PMID: 37857746 DOI: 10.1007/s40615-023-01823-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/25/2023] [Accepted: 09/28/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Throughout the coronavirus (COVID-19) pandemic, research revealed people of color were more likely to be infected, have severe illness, and die due to the virus. However, some areas in the USA are now reporting a new shift; lower Black and Hispanic COVID-19 mortality rates compared to their White counterparts. Research indicates that this shift is the result of COVID-19's impact on disparities by race. In this paper, we analyze death data to determine if the new shift has occurred locally. Specifically, we examined COVID-19 prevalence and related death data in Connecticut by comparing race/ethnicity through two periods of time: one before and one after the first case of the Omicron variant of COVID-19. METHODS This cross-sectional epidemiological analysis to examine cases and deaths by racial/ethnic status utilizes Connecticut data from March 2020 to February 2022. The following assumption is applied: expected pre-Omicron cases and deaths from March 5, 2020 to November 27, 2021 are equal to the number of cases and deaths during Omicron cases and deaths from November 28, 2021 to February 17, 2022. Race/ethnicity are operationalized as non-Hispanic White, non-Hispanic Black, and Hispanic. RESULTS Pre-Omicron (March 5, 2020 to November 27, 2021) compared to the monthly aged adjusted COVID-19 case rate for Whites (394/10,000 populations), Blacks had a higher rate (501/10,000 populations), and Hispanics had the highest (585/10,000 populations). During the Omicron period (November 28 to February 17, 2022), significant changes in COVID-19 case rates were observed in all three ethnic groups, but the biggest changes were observed in Hispanics, followed by Blacks, and then Whites. The rate ratios further showed a remarkable reduction of 47% in case rates (from 1.0 pre-Omicron and from 1.47 during Omicron, p < 0.0001) for Hispanics, when compared to that of Whites. While Blacks showed a significant, smaller reduction of 5% in case rates (from 1.27 pre-Omicron and from 1.22 during the Omicron, p < 0.001) when compared to Whites. Regarding COVID-19-related mortality, the racial differences were similar. CONCLUSIONS AND RELEVANCE By examining Connecticut's COVID-19 death and case data, this study identified the new shift that occurred locally. The current shift may be anchored in the evolution of the COVID-19 virus, public health guidelines/policies, and the degree to which populations have complied with public health recommendations.
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Affiliation(s)
- Cato T Laurencin
- Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut, 263 Farmington Avenue, Farmington, CT, USA.
- Raymond and , Beverly Sackler Center for Biomedical, Biological, Physical and Engineering Sciences, University of Connecticut Health, Farmington, CT, USA.
- Department of Chemical and Biomolecular Engineering, University of Connecticut, Storrs, CT, USA.
- Department of Orthopedic Surgery, University of Connecticut Health, Farmington, CT, USA.
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA.
- Department of Materials Science and Engineering, University of Connecticut, Storrs, CT, USA.
| | - Z Helen Wu
- Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut, 263 Farmington Avenue, Farmington, CT, USA
- Department of Psychiatry, University of Connecticut Health, Farmington, CT, USA
| | - James J Grady
- Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut, 263 Farmington Avenue, Farmington, CT, USA
- Department of Public Health Sciences, University of Connecticut Health, Farmington, CT, USA
| | - Rong Wu
- Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut, 263 Farmington Avenue, Farmington, CT, USA
| | - Marsha M Murray
- Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut, 263 Farmington Avenue, Farmington, CT, USA
| | - Michelle Slivinsky
- Cato T. Laurencin Institute for Regenerative Engineering, University of Connecticut, 263 Farmington Avenue, Farmington, CT, USA
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15
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Burns L, Hsu CY, Whisenant JG, Marmarelis ME, Presley CJ, Reckamp KL, Khan H, Jo Fidler M, Bestvina CM, Brahmer J, Puri S, Patel JD, Halmos B, Hirsch FR, Liu SV, Costa DB, Goldberg SB, Feldman LE, Mamdani H, Puc M, Mansfield AS, Islam N, Scilla KA, Garassino MC, Horn L, Peters S, Wakelee HA, Charlot M, Tapan U. Disparities in outcomes between Black and White patients in North America with thoracic malignancies and COVID-19 infection (TERAVOLT). Lung Cancer 2023; 186:107423. [PMID: 37995456 DOI: 10.1016/j.lungcan.2023.107423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/12/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Patients with thoracic malignancies who develop COVID-19 infection have a higher hospitalization rate compared to the general population and to those with other cancer types, but how this outcome differs by race and ethnicity is relatively understudied. METHODS The TERAVOLT database is an international, multi-center repository of cross-sectional and longitudinal data studying the impact of COVID-19 on individuals with thoracic malignancies. Patients from North America with thoracic malignancies and confirmed COVID-19 infection were included for this analysis of racial and ethnic disparities. Patients with missing race data or races and ethnicities with fewer than 50 patients were excluded from analysis. Multivariable analyses for endpoints of hospitalization and death were performed on these 471 patients. RESULTS Of the 471 patients, 73% were White and 27% were Black. The majority (90%) were non-Hispanic ethnicity, 5% were Hispanic, and 4% were missing ethnicity data. Black patients were more likely to have an Eastern Cooperative Oncology Group (ECOG) Performance Status ≥ 2 (p-value = 0.04). On multivariable analysis, Black patients were more likely than White patients to require hospitalization (Odds Ratio (OR): 1.69, 95% CI: 1.01-2.83, p-value = 0.044). These differences remained across different waves of the pandemic. However, no statistically significant difference in mortality was found between Black and White patients (OR 1.29, 95% CI: 0.69-2.40, p-value = 0.408). CONCLUSIONS Black patients with thoracic malignancies who acquire COVID-19 infection are at a significantly higher risk of hospitalization compared to White patients, but there is no significant difference in mortality. The underlying drivers of racial disparity among patients with thoracic malignancies and COVID-19 infection require ongoing investigation.
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Affiliation(s)
- Laura Burns
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine and Boston Medical Center, Boston, MA, USA.
| | - Chih-Yuan Hsu
- Department of Biostatistics, Vanderbilt University Medical Center, Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jennifer G Whisenant
- Department of Medicine (Hematology & Oncology), Vanderbilt University Medical Center, Nashville, TN, USA
| | - Melina E Marmarelis
- Division of Hematology and Oncology, Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Carolyn J Presley
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Karen L Reckamp
- Division of Medical Oncology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Hina Khan
- Division of Hematology and Oncology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Mary Jo Fidler
- Department of Hematology, Oncology, and Cell Therapy, Rush University Medical Center, Chicago, IL, USA
| | - Christine M Bestvina
- University of Chicago Comprehensive Cancer Center, Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Julie Brahmer
- Johns Hopkins Kimmel Cancer Center, Baltimore, MD, USA
| | - Sonam Puri
- Division of Medical Oncology, The Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah, USA
| | - Jyoti D Patel
- Division of Hematology and Oncology, Northwestern University, Chicago, IL, USA
| | - Balazs Halmos
- Division of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA
| | - Fred R Hirsch
- Center for Thoracic Oncology, Tisch Cancer Institute and Icahn School of Medicine Mount Sinai, New York, New York, USA
| | - Stephen V Liu
- Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
| | - Daniel B Costa
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Sarah B Goldberg
- Yale University School of Medicine and Yale Cancer Center, New Haven, Connecticut, USA
| | - Lawrence E Feldman
- Section of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Hirva Mamdani
- Department of Oncology, Karmanos Cancer Institute/Wayne State University, Detroit, MI, USA
| | - Matthew Puc
- Division of Thoracic Surgery, Virtua Health, Marlton, New Jersey, USA
| | - Aaron S Mansfield
- Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, MN, USA
| | - Nahida Islam
- The University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Katherine A Scilla
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Marina C Garassino
- University of Chicago Comprehensive Cancer Center, Department of Medicine, The University of Chicago, Chicago, IL, USA
| | - Leora Horn
- Vanderbilt Ingram Cancer Center, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Solange Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Heather A Wakelee
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford Cancer Institute, Stanford, CA, USA
| | - Marjory Charlot
- Division of Oncology, University of North Carolina School of Medicine and Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA
| | - Umit Tapan
- Section of Hematology & Medical Oncology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
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Slutske WS, Conner KL, Kirsch JA, Smith SS, Piasecki TM, Johnson AL, McCarthy DE, Nez Henderson P, Fiore MC. Explaining COVID-19 related mortality disparities in American Indians and Alaska Natives. Sci Rep 2023; 13:20974. [PMID: 38017023 PMCID: PMC10684501 DOI: 10.1038/s41598-023-48260-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/24/2023] [Indexed: 11/30/2023] Open
Abstract
American Indian and Alaska Native (AI/AN) individuals are more likely to die with COVID-19 than other groups, but there is limited empirical evidence to explain the cause of this inequity. The objective of this study was to determine whether medical comorbidities, area socioeconomic deprivation, or access to treatment can explain the greater COVID-19 related mortality among AI/AN individuals. The design was a retrospective cohort study of harmonized electronic health record data of all inpatients with COVID-19 from 21 United States health systems from February 2020 through January 2022. The mortality of AI/AN inpatients was compared to all Non-Hispanic White (NHW) inpatients and to a matched subsample of NHW inpatients. AI/AN inpatients were more likely to die during their hospitalization (13.2% versus 7.1%; odds ratio [OR] = 1.98, 95% confidence interval [CI] = 1.48, 2.65) than their matched NHW counterparts. After adjusting for comorbidities, area social deprivation, and access to treatment, the association between ethnicity and mortality was substantially reduced (OR 1.59, 95% CI 1.15, 2.22). The significant residual relation between AI/AN versus NHW status and mortality indicate that there are other important unmeasured factors that contribute to this inequity. This will be an important direction for future research.
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Affiliation(s)
- Wendy S Slutske
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Karen L Conner
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA.
| | - Julie A Kirsch
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Stevens S Smith
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Thomas M Piasecki
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Adrienne L Johnson
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Danielle E McCarthy
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Michael C Fiore
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
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Lee YJ, Lau SB, Bersamira CS, Yamauchi J. Anti-Asian Racism and COVID-19 Impact on Older Adults: The Voices of Social Workers. J Gerontol Soc Work 2023; 66:985-1004. [PMID: 37057815 DOI: 10.1080/01634372.2023.2202240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 04/08/2023] [Accepted: 04/10/2023] [Indexed: 06/19/2023]
Abstract
Heightened anti-Asian racism and hate crimes during the COVID-19 pandemic impacted older adults and the social workers who supported them. Yet, the experiences of Asian and Asian American (AAA) social workers are unknown. This study aimed to explore the perspectives and experiences of social workers focusing on the aging population during the anti-Asian racism climate and the COVID-19 pandemic. Guided by a qualitative approach, seventeen AAA social workers participated in semi-structured interviews. Based on thematic analysis, the following themes were identified: concerns about safety and discrimination, perceived service and support needs for older adults, and perceived generational gaps in advocacy. Social work practice, policy, and research implications are discussed.
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Affiliation(s)
- Yeonjung Jane Lee
- Department of Social Work, Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Sophia B Lau
- Department of Social Work, Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Clifford S Bersamira
- Department of Social Work, Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Jaron Yamauchi
- Department of Social Work, Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
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Singh JK, Duncan TK. Examining the Domestic Violence Crisis in Ventura County in the Wake of the COVID-19 Pandemic. Am Surg 2023; 89:4353-4359. [PMID: 35757933 PMCID: PMC9243968 DOI: 10.1177/00031348221111509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Domestic violence (DV) worsened during COVID-19 and Family Justice Centers (FJCs) were, even more so than before, a critical part of providing services to DV victims. This study characterizes the clinical and sociodemographic features of the clients that come to the Ventura County FJC (VCFJC) and examines the effect of COVID-19, thus informing awareness of services available to victims of DV. METHODS This was a retrospective cohort study utilizing the VCFJC database from 2019 to 2021. All client data normally collected was studied. A comparison of pre-COVID and post-COVID data was also conducted. RESULTS There were 3488 client entries. Clients were mostly female (79% [2755]; n = 3488), aged 25-40 (31.73% [1106]; n = 3448), white/Caucasian (44.42% [1531]; n = 3448) or Hispanic/Latinx (42.41% [1462]; n = 3448). Clients most often requested restraining orders (72.41% [2496]; n = 3448), and most commonly reported DV [physical] (47.90% [1651]; n = 3448). Most health-insured clients were covered by MediCal (45.06% [1231]; n = 2732). Pre- and post-COVID analysis showed the highest increases in DV [physical] (odds ratio = 1.26, P < .0007) and stalking/harassment (odds ratio = 2.45, P < .0007), and decreases in all Initial Service Request categories except one. DISCUSSION In serving clients affected by DV, FJCs are an important service for health care providers to be aware of. Post-COVID, clients reported DV and stalking/harassment at much higher percentages, which is consistent with national studies on the pandemic. The most alarming finding was the steep decrease in Initial Service Requests.Conclusion: This study shows the importance of collaboration and awareness of services, especially in a world of COVID-19.
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Affiliation(s)
- Jupneet K. Singh
- Massachusetts Institute of Technology, Cambridge, MA, USA
- Ventura County Family Justice Center, Ventura, CA, USA
| | - Thomas K. Duncan
- Department of Surgery, Ventura County Medical Center, Ventura, CA, USA
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19
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Lai S, Lu L, Shen C, Yan A, Lei Y, Zhou Z, Wang Y. Income loss and subsequent poor psychological well-being among the Chinese population during the early COVID-19 pandemic. Int J Equity Health 2023; 22:219. [PMID: 37848883 PMCID: PMC10583462 DOI: 10.1186/s12939-023-02022-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 09/22/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has had major ramifications for health and the economy at both the individual and collective levels. This study examined exogenous negative changes in household income and their implications on psychological well-being (PWB) among the Chinese population during the COVID-19 pandemic. METHODS Data were drawn from the early China COVID-19 Survey, a cross-sectional anonymous online survey administered to the general population in China. Self-reported PWB was measured using a 5-point Likert scale with five questions related to the participants' recent psychological state. Hierarchical multiple linear regression was employed to examine whether income loss during the COVID-19 pandemic was associated with poor psychological health. RESULTS This study included 8,428 adults, of which 90% had suffered from a moderate or severe loss of household income due to the early COVID-19 pandemic. Those who had experienced moderate or severe loss of income scored significantly lower on psychological well-being than those who did not experience income loss (19.96 or 18.07 vs. 21.46; P < 0.001); after controlling for confounders, income loss was negatively associated with PWB scores (moderate income loss: B = - 0.603, P < 0.001; severe income loss: B = - 1.261, P < 0.001). An interaction effect existed between the degree of income loss and pre-pandemic income groups. Specifically, participants in the middle-income group who had suffered severe income loss scored the lowest on PWB (B = - 1.529, P < 0.001). There was also a main effect on income loss, such that participants with varying degrees of income loss differed across five dimensions, including anhedonia, sleep problems, irritability or anger, difficulty with concentration, and repeated disturbing dreams related to COVID-19. CONCLUSIONS Income loss during the pandemic has had detrimental consequences on psychological well-being, and the magnitude of the impact of income loss on psychological well-being varied according to previous income levels. Future policy efforts should be directed toward improving the psychological well-being of the economically vulnerable and helping them recover from lost income in the shortest time possible.
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Affiliation(s)
- Sha Lai
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Li Lu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Chi Shen
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Alice Yan
- Division of Research Patient Care Services, Stanford Health Care, Palo Alto, CA, 94305, USA
| | - Yanjun Lei
- Department of Pathogenic Microbiology and Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University, Xi'an, China
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.
| | - Youfa Wang
- School of Public Health, Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, China.
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20
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Fernandez JR, Strassle PD, Richmond J, Mays VM, Forde AT. County-level barriers in the COVID-19 vaccine coverage index and their associations with willingness to receive the COVID-19 vaccine across racial/ethnic groups in the U.S. Front Public Health 2023; 11:1192748. [PMID: 37900019 PMCID: PMC10602638 DOI: 10.3389/fpubh.2023.1192748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 08/22/2023] [Indexed: 10/31/2023] Open
Abstract
Background County-level vaccination barriers (sociodemographic barriers, limited healthcare system resources, healthcare accessibility barriers, irregular healthcare seeking behaviors, history of low vaccination) may partially explain COVID-19 vaccination intentions among U.S. adults. This study examined whether county-level vaccination barriers varied across racial/ethnic groups in the U.S. and were associated with willingness to receive the COVID-19 vaccine. In addition, this study assessed whether these associations differed across racial/ethnic groups. Methods This study used data from the REACH-US study, a large online survey of U.S. adults (N = 5,475) completed from January 2021-March 2021. County-level vaccination barriers were measured using the COVID-19 Vaccine Coverage Index. Ordinal logistic regression estimated associations between race/ethnicity and county-level vaccination barriers and between county-level vaccination barriers and willingness to receive the COVID-19 vaccine. Models adjusted for covariates (age, gender, income, education, political ideology, health insurance, high-risk chronic health condition). Multigroup analysis estimated whether associations between barriers and willingness to receive the COVID-19 vaccine differed across racial/ethnic groups. Results American Indian/Alaska Native, Black/African American, Hispanic/Latino ELP [English Language Preference (ELP); Spanish Language Preference (SLP)], and Multiracial adults were more likely than White adults to live in counties with higher overall county-level vaccination barriers [Adjusted Odd Ratios (AORs):1.63-3.81]. Higher county-level vaccination barriers were generally associated with less willingness to receive the COVID-19 vaccine, yet associations were attenuated after adjusting for covariates. Trends differed across barriers and racial/ethnic groups. Higher sociodemographic barriers were associated with less willingness to receive the COVID-19 vaccine (AOR:0.78, 95% CI:0.64-0.94), whereas higher irregular care-seeking behavior was associated with greater willingness to receive the vaccine (AOR:1.20, 95% CI:1.04-1.39). Greater history of low vaccination was associated with less willingness to receive the COVID-19 vaccine among Black/African American adults (AOR:0.55, 95% CI:0.37-0.84), but greater willingness to receive the vaccine among American Indian/Alaska Native and Hispanic/Latino ELP adults (AOR:1.90, 95% CI:1.10-3.28; AOR:1.85, 95% CI:1.14-3.01). Discussion Future public health emergency vaccination programs should include planning and coverage efforts that account for structural barriers to preventive healthcare and their intersection with sociodemographic factors. Addressing structural barriers to COVID-19 treatment and preventive services is essential for reducing morbidity and mortality in future infectious disease outbreaks.
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Affiliation(s)
- Jessica R. Fernandez
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States
| | - Paula D. Strassle
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States
| | - Jennifer Richmond
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Vickie M. Mays
- Departments of Psychology and Health Policy and Management, UCLA Fielding School of Public Health and the UCLA BRITE Center for Science, Research and Policy, University of California, Los Angeles, Los Angeles, CA, United States
| | - Allana T. Forde
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, United States
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Wu XC, Yu Q, Yi Y, Maniscalco LS, Hsieh MC, Gruber D, Mendoza L, Subbiah S, Sokol T, Shrestha P, Chen VW, Mederos ET, Ochoa A. Effect of chronic disease on racial difference in COVID-19-associated hospitalization among cancer patients. J Natl Cancer Inst 2023; 115:1204-1212. [PMID: 37697664 PMCID: PMC10560601 DOI: 10.1093/jnci/djad150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Research indicates that Black cancer patients have higher rates of COVID-19 hospitalization than their White counterparts. However, the extent to which chronic diseases contribute to racial disparities remains uncertain. We aimed to quantify the effect of chronic diseases on racial disparity in COVID-19-associated hospitalization among cancer patients. METHODS We linked Louisiana Tumor Registry's data with statewide COVID-19 data and hospital in-patient discharge data to identify patients diagnosed with cancer in 2015-2019 who tested positive for COVID-19 in 2020 and those with COVID-19-associated hospitalization. Multivariable logistic regression and mediation methods based on linear structural equations were employed to assess the effects of the number of chronic diseases (0, 1-2, ≥3) and individual chronic diseases. RESULTS Of 6381 cancer patients who tested positive for COVID-19, 31.6% were non-Hispanic Black cancer patients. Compared with non-Hispanic White cancer patients, non-Hispanic Black cancer patients had a higher prevalence of chronic diseases (79.5% vs 66.0%) and higher COVID-19-associated hospitalization (27.2% vs 17.2%). The odds of COVID-19-associated hospitalization were 80% higher for non-Hispanic Black cancer patients than non-Hispanic White cancer patients (odds ratio = 1.80, 95% confidence interval = 1.59 to 2.04). After adjusting for age, sex, insurance, poverty, obesity, and cancer type, number of chronic diseases explained 37.8% of the racial disparity in COVID-19-associated hospitalization, and hypertension, diabetes, and chronic renal disease were the top 3 chronic diseases explaining 9.6%, 8.9%, and 7.3% of the racial disparity, respectively. CONCLUSION Chronic diseases played a substantial role in the racial disparity in COVID-19-associated hospitalization among cancer patients, especially hypertension, diabetes, and renal disease. Understanding and addressing the root causes are crucial for targeted interventions, policies, and health-care strategies to reduce racial disparity.
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Affiliation(s)
- Xiao-Cheng Wu
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Qingzhao Yu
- Biostatistics Program, School of Public Health, LSU Health, New Orleans, LA, USA
| | - Yong Yi
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Lauren S Maniscalco
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Mei-Chin Hsieh
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - DeAnn Gruber
- Bureau of Infectious Diseases, Office of Public Health, Louisiana Department of Health, New Orleans, LA, USA
| | - Lee Mendoza
- Bureau of Health Informatics, Office of Public Health, Louisiana Department of Health, New Orleans, LA, USA
| | - Suki Subbiah
- Section of Hematology-Oncology, School of Medicine, LSU Health, New Orleans, LA, USA
| | - Theresa Sokol
- Bureau of Infectious Diseases, Office of Public Health, Louisiana Department of Health, New Orleans, LA, USA
| | - Pratibha Shrestha
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Vivien W Chen
- Louisiana Tumor Registry, Epidemiology Program, School of Public Health, Louisiana State University (LSU) Health, New Orleans, LA, USA
| | - Eileen T Mederos
- LSU-LCMC Health Cancer Center, Department of Interdisciplinary Oncology, LSU Health, New Orleans, LA, USA
| | - Augusto Ochoa
- LSU-LCMC Health Cancer Center, Department of Interdisciplinary Oncology, LSU Health, New Orleans, LA, USA
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22
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Delafield R, Watkins-Victorino L, Quint JJ, Freitas SM, Kamaka M, Hostetter CJ, Matagi CE, Ku T, Kaholokula JK. No Kākou, Na Kākou - For Us, By Us: Native Hawaiians and Pacific Islanders Informing Race Data Collection Standards for Hawai'i. Hawaii J Health Soc Welf 2023; 82:73-76. [PMID: 37901657 PMCID: PMC10612412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
This article describes recommendations for standardized race data collection developed by the Hawai'i Native Hawaiian and Pacific Islander COVID-19 Response, Recovery, and Resilience Team (NHPI 3R Team). These recommendations attempt to address the expressed desires of Native Hawaiians and the diverse Pacific Islander communities in Hawai'i who seek greater visibility in data and research. The Native Hawaiian and Pacific Islander (NHPI) racial category is 1 of the 5 racial categories listed in the 1997 Statistical Policy Directive #15 issued by the Office of Management and Budget (OMB). The OMB directive sets the minimum standard for collection of race data in federal surveys, administrative forms, records, and other data collection. The NHPI 3R Team's recommendation provides a standard for detailed data collection that could improve smaller communities' ability to identify, advocate for, and address their own needs. The article also describes lessons learned through the collaborative and iterative process that was led by members and leaders of NHPI communities impacted by data driven decisions and policies. The NHPI 3R Team focused on expanding and standardizing race data collection as part of their COVID-19 response efforts, but implementation of the recommendations could produce benefits well beyond the pandemic.
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Affiliation(s)
- Rebecca Delafield
- John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (RD, MK, JKK)
| | | | | | - Sharde Mersberg Freitas
- Native Hawaiian Pacific Islander COVID-19 Response, Recovery, and Resiliency Team - Data and Research Committee, Honolulu, HI (SMF)
| | - Martina Kamaka
- John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (RD, MK, JKK)
| | | | | | - Tercia Ku
- Papa Ola Lōkahi, Honolulu, HI (JJQ, CEM, TK)
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23
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Jason K, Carr D, Chen Z. Race-Ethnic Differences in the Effects of COVID-19 on the Work, Stress, and Financial Outcomes of Older Adults. J Aging Health 2023; 35:749-760. [PMID: 36869728 PMCID: PMC9988627 DOI: 10.1177/08982643231159705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
OBJECTIVES This study investigates race-ethnic differences among older non-Hispanic Black, non-Hispanic White, and Hispanic adults' financial, employment, and stress consequences of COVID-19. METHODS We use data from the Health and Retirement Study, including the 2020 COVID-panel, to evaluate a sample of 2,929 adults using a combination of bivariate tests, OLS regression analysis, and moderation tests. RESULTS Hispanic and non-Hispanic Black older adults experienced more financial hardships, higher levels of COVID-19 stress, and higher rates of job loss associated with COVID-19 relative to their Non-Hispanic White counterparts. Non-Hispanic Black and Hispanic adults reported significantly higher levels of COVID-19 resilience resources, yet, these resources were not protective of the consequences of COVID-19. DISCUSSION Understanding how the experiences of managing and coping with COVID-19 stressors differ by race-ethnicity can better inform intervention design and support services.
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Affiliation(s)
- Kendra Jason
- Department of Sociology, UNC-Charlotte, Charlotte, NC, USA
| | - Dawn Carr
- Department of Sociology, Florida State University, Tallahassee, FL, USA
| | - Zhao Chen
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
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24
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Xu RH, Chan HH, Shi L, Li T, Wang D. Moderating Effect of eHealth Literacy on the Associations of Coronaphobia With Loneliness, Irritability, Depression, and Stigma in Chinese Young Adults: Bayesian Structural Equation Model Study. JMIR Public Health Surveill 2023; 9:e47556. [PMID: 37773621 PMCID: PMC10576235 DOI: 10.2196/47556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/21/2023] [Accepted: 08/24/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to an increase in known risk factors for mental health problems. Although medical information available through the internet and smartphones has greatly expanded, people's ability to seek, eschew, and use reliable web-based medical information and services to promote their mental health remains unknown. OBJECTIVE This study aims to explore the associations between coronaphobia and 4 frequently reported mental health problems, loneliness, irritability, depression, and stigma, during the COVID-19 pandemic and to assess the moderating effects of eHealth literacy (eHL) on the adjustment of these relationships in Chinese young adults. METHODS The data used in this study were collected from a web-based survey of the general Chinese population, aged between 18 and 30 years, conducted in China between December 2022 and January 2023. A nonprobability snowball sampling method was used for data collection. A Bayesian structural equation model (BSEM) using parameter expansion was used to estimate the moderating effect of eHL on the relationship between coronaphobia and psychological problems. The posterior mean and 95% highest density intervals (HDIs) were estimated. RESULTS A total of 4119 participants completed the questionnaire and provided valid responses. Among them, 64.4% (n=2653) were female and 58.7% (n=2417) were rural residents. All measures showed statistically significant but minor-to-moderate associations (correlation coefficients ranged from -0.04 to 0.65). Significant heterogeneity was observed between rural and urban residents at the eHL level, and coronaphobia was observed. The BSEM results demonstrated that eHL was a significant moderator in reducing the negative effects of coronaphobia on loneliness (posterior mean -0.0016, 95% HDI -0.0022 to -0.0011), depression (posterior mean -0.006, 95% HDI -0.0079 to -0.004), stigma (posterior mean -0.0052, 95% HDI -0.0068 to -0.0036), and irritability (posterior mean -0.0037, 95% HDI -0.0052 to -0.0022). The moderating effects of eHL varied across the rural and urban subsamples. CONCLUSIONS Using BSEM, this study demonstrated that improving eHL can significantly mitigate the negative effects of coronaphobia on 4 COVID-19-related mental health problems in Chinese young adults. Future eHL initiatives should target rural communities to ensure equal access to information and resources that can help protect their mental health during the pandemic.
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Affiliation(s)
- Richard Huan Xu
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Kowloon, China (Hong Kong)
| | - Ho Hin Chan
- Department of Applied Mathematics, Hong Kong Polytechnic University, Kowloon, China (Hong Kong)
| | - Lushaobo Shi
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Ting Li
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou, China
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25
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Ko JY, Pham H, Anglin O, Chai SJ, Alden NB, Meek J, Anderson EJ, Weigel A, Kohrman A, Lynfield R, Rudin D, Barney G, Bennett NM, Billing LM, Sutton M, Talbot HK, Swain A, Havers FP, Taylor CA. Vaccination Status and Trends in Adult Coronavirus Disease 2019-Associated Hospitalizations by Race and Ethnicity: March 2020-August 2022. Clin Infect Dis 2023; 77:827-838. [PMID: 37132204 PMCID: PMC11019819 DOI: 10.1093/cid/ciad266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 04/14/2023] [Accepted: 04/28/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND We sought to determine whether race/ethnicity disparities in severe coronavirus disease 2019 (COVID-19) outcomes persist in the era of vaccination. METHODS Population-based age-adjusted monthly rate ratios (RRs) of laboratory-confirmed COVID-19-associated hospitalizations were calculated among adult patients from the COVID-19-Associated Hospitalization Surveillance Network, March 2020 - August 2022 by race/ethnicity. Among randomly sampled patients July 2021 - August 2022, RRs for hospitalization, intensive care unit (ICU) admission, and in-hospital mortality were calculated for Hispanic, Black, American Indian/Alaskan Native (AI/AN), and Asian/Pacific Islander (API) persons vs White persons. RESULTS Based on data from 353 807 patients, hospitalization rates were higher among Hispanic, Black, and AI/AN vs White persons March 2020 - August 2022, yet the magnitude declined over time (for Hispanic persons, RR = 6.7; 95% confidence interval [CI], 6.5-7.1 in June 2020 vs RR < 2.0 after July 2021; for AI/AN persons, RR = 8.4; 95% CI, 8.2-8.7 in May 2020 vs RR < 2.0 after March 2022; and for Black persons RR = 5.3; 95% CI, 4.6-4.9 in July 2020 vs RR < 2.0 after February 2022; all P ≤ .001). Among 8706 sampled patients July 2021 - August 2022, hospitalization and ICU admission RRs were higher for Hispanic, Black, and AI/AN patients (range for both, 1.4-2.4) and lower for API (range for both, 0.6-0.9) vs White patients. All other race and ethnicity groups had higher in-hospital mortality rates vs White persons (RR range, 1.4-2.9). CONCLUSIONS Race/ethnicity disparities in COVID-19-associated hospitalizations declined but persist in the era of vaccination. Developing strategies to ensure equitable access to vaccination and treatment remains important.
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Affiliation(s)
- Jean Y Ko
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia, USA
- US Public Health Service Commissioned Corps, Rockville, Maryland, USA
| | - Huong Pham
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia, USA
| | - Onika Anglin
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia, USA
| | - Shua J Chai
- California Emerging Infections Program, Oakland, California, USA
- Career Epidemiology Field Officer Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nisha B Alden
- Colorado Department of Public Health and Environment, Denver, Colorado, USA
| | - James Meek
- Connecticut Emerging Infections Program, Yale School of Public Health, New Haven, Connecticut, USA
| | - Evan J Anderson
- Emory University School of Medicine, Atlanta, Georgia, USA
- Georgia Department of Public Health, Georgia Emerging Infections Program, Atlanta, Georgia, USA
- Atlanta Veterans Affairs Medical Center, Atlanta, Georgia, USA
| | - Andy Weigel
- Iowa Department of Public Health, Des Moines, Iowa, USA
| | - Alexander Kohrman
- Michigan Department of Health and Human Services, Lansing, Michigan, USA
| | - Ruth Lynfield
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Dominic Rudin
- New Mexico Emerging Infections Program, Albuquerque, New Mexico, USA
| | - Grant Barney
- New York State Department of Health, Albany, New York, USA
| | - Nancy M Bennett
- University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | | | - Melissa Sutton
- Public Health Division, Oregon Health Authority, Portland, Oregon, USA
| | - H Keipp Talbot
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ashley Swain
- Salt Lake County Health Department, Salt Lake City, Utah, USA
| | - Fiona P Havers
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia, USA
- US Public Health Service Commissioned Corps, Rockville, Maryland, USA
| | - Christopher A Taylor
- Centers for Disease Control and Prevention COVID-19 Response, Atlanta, Georgia, USA
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Duong KNC, Le LM, Veettil SK, Saidoung P, Wannaadisai W, Nelson RE, Friedrichs M, Jones BE, Pavia AT, Jones MM, Samore MH, Chaiyakunapruk N. Disparities in COVID-19 related outcomes in the United States by race and ethnicity pre-vaccination era: an umbrella review of meta-analyses. Front Public Health 2023; 11:1206988. [PMID: 37744476 PMCID: PMC10513444 DOI: 10.3389/fpubh.2023.1206988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/16/2023] [Indexed: 09/26/2023] Open
Abstract
Background Meta-analyses have investigated associations between race and ethnicity and COVID-19 outcomes. However, there is uncertainty about these associations' existence, magnitude, and level of evidence. We, therefore, aimed to synthesize, quantify, and grade the strength of evidence of race and ethnicity and COVID-19 outcomes in the US. Methods In this umbrella review, we searched four databases (Pubmed, Embase, the Cochrane Database of Systematic Reviews, and Epistemonikos) from database inception to April 2022. The methodological quality of each meta-analysis was assessed using the Assessment of Multiple Systematic Reviews, version 2 (AMSTAR-2). The strength of evidence of the associations between race and ethnicity with outcomes was ranked according to established criteria as convincing, highly suggestive, suggestive, weak, or non-significant. The study protocol was registered with PROSPERO, CRD42022336805. Results Of 880 records screened, we selected seven meta-analyses for evidence synthesis, with 42 associations examined. Overall, 10 of 42 associations were statistically significant (p ≤ 0.05). Two associations were highly suggestive, two were suggestive, and two were weak, whereas the remaining 32 associations were non-significant. The risk of COVID-19 infection was higher in Black individuals compared to White individuals (risk ratio, 2.08, 95% Confidence Interval (CI), 1.60-2.71), which was supported by highly suggestive evidence; with the conservative estimates from the sensitivity analyses, this association remained suggestive. Among those infected with COVID-19, Hispanic individuals had a higher risk of COVID-19 hospitalization than non-Hispanic White individuals (odds ratio, 2.08, 95% CI, 1.60-2.70) with highly suggestive evidence which remained after sensitivity analyses. Conclusion Individuals of Black and Hispanic groups had a higher risk of COVID-19 infection and hospitalization compared to their White counterparts. These associations of race and ethnicity and COVID-19 outcomes existed more obviously in the pre-hospitalization stage. More consideration should be given in this stage for addressing health inequity.
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Affiliation(s)
- Khanh N. C. Duong
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, United States
| | - Lan M. Le
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, United States
| | - Sajesh K. Veettil
- International Medical University, School of Pharmacy, Department of Pharmacy Practice, Kuala Lumpur, Malaysia
| | - Pantakarn Saidoung
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, United States
| | | | - Richard E. Nelson
- Division of Epidemiology, School of Medicine, University of Utah, Salt Lake City, UT, United States
- IDEAS Center, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT, United States
| | - Mike Friedrichs
- Utah Department of Health, Salt Lake City, UT, United States
| | - Barbara E. Jones
- IDEAS Center, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT, United States
- Division of Pulmonary & Critical Care, University of Utah, Salt Lake City, UT, United States
| | - Andrew T. Pavia
- Division of Pediatric Infectious Diseases, University of Utah, Salt Lake City, UT, United States
| | - Makoto M. Jones
- Division of Epidemiology, School of Medicine, University of Utah, Salt Lake City, UT, United States
- IDEAS Center, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT, United States
| | - Matthew H. Samore
- Division of Epidemiology, School of Medicine, University of Utah, Salt Lake City, UT, United States
- IDEAS Center, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT, United States
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, United States
- IDEAS Center, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT, United States
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27
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Yang DH, Justen M, Lee D, Kim H, Boatright D, Desai M, Tiyyagura G. Experiences with Racism Among Asian American Medical Students. JAMA Netw Open 2023; 6:e2333067. [PMID: 37695582 PMCID: PMC10495868 DOI: 10.1001/jamanetworkopen.2023.33067] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/27/2023] [Indexed: 09/12/2023] Open
Abstract
Importance Asian American physicians have experienced a dual pandemic of racism and COVID-19 since 2020; understanding how racism has affected the learning environment of Asian American medical students is necessary to inform strategies to promoting a more inclusive medical school environment and a diverse and inclusive workforce. While prior research has explored the influence of anti-Asian racism on the experiences of Asian American health care workers, to our knowledge there are no studies investigating how racism has impacted the training experiences of Asian American medical students. Objective To characterize how Asian American medical students have experienced anti-Asian racism in a medical school learning environment. Design, Setting, and Participants This qualitative study included online video interviews of Asian American medical students performed between July 29, 2021, and August 22, 2022. Eligible participants were recruited through the Asian Pacific American Medical Students Association and snowball sampling, and the sample represented a disaggregated population of Asian Americans and all 4 medical school years. Main Outcomes and Measures The medical school experiences of Asian American medical students. Results Among 25 participants, Asian ethnicities included 8 Chinese American (32%), 5 Korean American (20%), 5 Indian American (20%), 3 Vietnamese American (12%), 2 Filipino American (8%), and 1 (4%) each Nepalese, Pakistani, and Desi American; 16 (64%) were female. Participants described 5 major themes concerning their experience with discrimination: (1) invisibility as racial aggression (eg, "It took them the whole first year to be able to tell me apart from the other Asian guy"); (2) visibility and racial aggression ("It transitioned from these series of microaggressions that every Asian person felt to actual aggression"); (3) absence of the Asian American experience in medical school ("They're not going to mention Asian Americans at all"); (4) ignored while seeking support ("I don't know what it means to have this part of my identity supported"); and (5) envisioning the future. Conclusions and Relevance In this qualitative study, Asian American medical students reported feeling invisible within medical school while a target of anti-Asian racism. Addressing these unique challenges related to anti-Asian racism is necessary to promote a more inclusive medical school learning environment.
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Affiliation(s)
- David H. Yang
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Marissa Justen
- Yale University School of Medicine, Hew Haven, Connecticut
| | - Dana Lee
- Yale University School of Medicine, Hew Haven, Connecticut
| | - Heeryoung Kim
- Department of Psychiatry, Middlesex Hospital, Middletown, Connecticut
| | - Dowin Boatright
- Department of Emergency Medicine, New York University School of Medicine, New York
| | - Miraj Desai
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Gunjan Tiyyagura
- Department of Pediatrics and Emergency Medicine, Yale School of Medicine, New Haven, Connecticut
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Metheny N, Scott D, Buch J, Fallon S, Chavez J. Trusted Sources of Information and COVID-19 Vaccine Uptake in a Sample of Latinx Sexual and Gender Minorities in South Florida. J Public Health Manag Pract 2023; 29:729-734. [PMID: 37104063 PMCID: PMC10524457 DOI: 10.1097/phh.0000000000001757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
OBJECTIVE To examine factors associated with COVID-19 vaccine uptake in a sample of Latino/a/x sexual and/or gender minority (SGM) individuals in South Florida. DESIGN Data were collected via an online survey from March 2021 to August 2022, as part of the Community Engagement Alliance Against COVID-19 Disparities. A multivariate regression analysis was fit using completion of a COVID-19 vaccine regimen as the outcome. Key covariates included trusted sources of information (eg, doctor, media), COVID-19-related challenges (eg, accessing medication, transportation), and dominant wave of SARS-CoV-2 at the time of data collection. SETTING Miami-Dade and Broward counties, Florida. RESULTS White Latino/a/x, bachelor's educated respondents, and those with high levels of trust in community organizations had significantly greater odds of vaccination. CONCLUSION Community organizations may be key to improving vaccine uptake among marginalized Latino/a/x SGM for COVID-19 and other emerging communicable diseases, such as meningitis and Mpox (monkeypox). The results of this study suggest that tailored public health messaging and additional funding for vaccine distribution are needed to better equip community organizations with the resources they need to serve this population.
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Affiliation(s)
- Nicholas Metheny
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida (Dr Metheny and Mr Scott); Latinos Salud, Miami, Florida (Mr Buch and Dr Fallon); and Miller School of Medicine, University of Miami, Miami, Florida (Ms Chavez)
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Nguemeni Tiako MJ, Browne A. How race, sex and age interact in association with COVID-19 outcomes over time: An analysis of Michigan data. PLoS One 2023; 18:e0288383. [PMID: 37651422 PMCID: PMC10470902 DOI: 10.1371/journal.pone.0288383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 06/26/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND COVID-19 has had a disproportionate impact on racial and ethnic minorities compared to White people. Studies have not sufficiently examined how sex and age interact with race/ethnicity, and potentially shape COVID-19 outcomes. We sought to examine disparities in COVID-19 outcomes by race, sex and age over time, leveraging data from Michigan, the only state whose Department of Health and Human Services (DHSS) publishes cross-sectional race, sex and age data on COVID-19. METHODS This is an observational study using publicly available COVID-19 data (weekly cases, deaths, and vaccinations) from August 31 2020 to June 9 2021. Outcomes for descriptive analysis were age-standardized COVID-19 incidence and mortality rates, case-fatality rates by race, sex, and age, and within-gender and within-race incidence rate ratios and mortality rate ratios. We used descriptive statistics and linear regressions with age, race, and sex as independent variables. RESULTS The within-sex Black-White racial gap in COVID-19 incidence and mortality decreased at a similar rate among men and women but the remained wider among men. As of June 2021, compared to White people, incidence was lower among Asian American and Pacific Islander people by 2644 cases per 100,000 people and higher among Black people by 1464 cases per 100,000 people. Mortality was higher among those aged 60 or greater by 743.6 deaths per 100,000 people vs those 0-39. The interaction between race and age was significant between Black race and age 60 or greater, with an additional 708.5 deaths per 100,000 people vs White people aged 60 or greater. Black people had a higher case fatality rate than White people. CONCLUSION COVID-19 incidence, mortality and vaccination patterns varied over time by race, age and sex. Black-White disparities decreased over time, with a larger effect on Black men, and Older Black people were particularly more vulnerable to COVID-19 in terms of mortality. Considering different individual characteristics such as age may further help elucidate the mechanisms behind racial and gender health disparities.
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Affiliation(s)
- Max Jordan Nguemeni Tiako
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA, United States of America
- Harvard Medical School, Boston, MA, United States of America
| | - Alyssa Browne
- Department of Sociology, UNC Chapel Hill, Chapel Hill, NC, United States of America
- Carolina Population Center, UNC Chapel Hill, Chapel Hill, NC, United States of America
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30
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Travaini G, Flutti E, Blandi L, Sala R, Songhorian S, Caruso P, Mugellini G. Compliance with recommended preventive behaviours and restrictions for Covid-19: an exploratory analysis of Italians' attitudes. Acta Biomed 2023; 94:e2023182. [PMID: 37695183 DOI: 10.23750/abm.v94is3.14431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/12/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND AND AIM as a reaction to the COVID-19 pandemic, countries all over the world have undertaken wide-scale measures to prevent and limit the spread of the virus. Suggested preventative measures mainly included "lockdown", social distancing, wearing facemasks, and vaccinations. The success of these measures was widely dependent on the cooperation of citizens. However, people reacted differently to the several types of restrictions and recommendations. Even if the majority followed the rules, others ignored them. This study aims to investigate the reasons for the compliance or violation of the rules developed to fight against the COVID-19 pandemic in Italy. METHODS to answer the research question, the analysis of two different surveys conducted on a representative sample of Italians (N=2000) were conducted and analysed through descriptive statistics. RESULTS the data collection agreed with published literature. Compliance with rules during emergencies followed diligence and altruistic patterns. Fear of sanctions did not seem to work in relation to rules compliance during emergency situations. The lack of clarity of regulations in terms of complexity or constant changes led to non-compliance even intervening as a neutralization technique. CONCLUSIONS government's fear-based interventions did not seem to work since Italians tended to adhere to the rules primarily out of respect for legitimate authority. Future research should focus more on the topic of trust in institutions in emergency situations with the aim of highlighting the key points for successful governance, also in terms of rules compliance.
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Affiliation(s)
- Guido Travaini
- Department of Medicine, University of Vita-Salute San Raffaele, Milano, Italy.
| | - Emma Flutti
- Department of Medicine, University of Vita-Salute San Raffaele, Milano, Italy; Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.
| | - Lorenzo Blandi
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
| | - Roberta Sala
- Department of Philosophy, University of Vita-Salute San Raffaele, Milano, Italy.
| | - Sarah Songhorian
- Department of Philosophy, University of Vita-Salute San Raffaele, Milano, Italy.
| | - Palmina Caruso
- Department of Medicine, University of Milano, Milano, Italy.
| | - Giulia Mugellini
- Department of Communication Sciences, University of Italian Switzerland (USI), Lugano, Switzerland.
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Entrup P, Brodsky L, Trimble C, Garcia S, Mohamed N, Deaner M, Martell JP, Teater J, Jordan A, Tetrault JM, Hall OT. Years of life lost due to deaths of despair and COVID-19 in the United States in 2020: patterns of excess mortality by gender, race and ethnicity. Int J Equity Health 2023; 22:161. [PMID: 37612748 PMCID: PMC10464324 DOI: 10.1186/s12939-023-01949-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/02/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND In 2020 COVID-19 was the third leading cause of death in the United States. Increases in suicides, overdoses, and alcohol related deaths were seen-which make up deaths of despair. How deaths of despair compare to COVID-19 across racial, ethnic, and gender subpopulations is relatively unknown. Preliminary studies showed inequalities in COVID-19 mortality for Black and Hispanic Americans in the pandemic's onset. This study analyzes the racial, ethnic and gender disparities in years of life lost due to COVID-19 and deaths of despair (suicide, overdose, and alcohol deaths) in 2020. METHODS This cross-sectional study calculated and compared years of life lost (YLL) due to Deaths of Despair and COVID-19 by gender, race, and ethnicity. YLL was calculated using the CDC WONDER database to pull death records based on ICD-10 codes and the Social Security Administration Period Life Table was used to get estimated life expectancy for each subpopulation. RESULTS In 2020, COVID-19 caused 350,831 deaths and 4,405,699 YLL. By contrast, deaths of despair contributed to 178,598 deaths and 6,045,819 YLL. Men had more deaths and YLL than women due to COVID-19 and deaths of despair. Among White Americans and more than one race identification both had greater burden of deaths of despair YLL than COVID-19 YLL. However, for all other racial categories (Native American/Alaskan Native, Asian, Black/African American, Native Hawaiian/Pacific Islander) COVID-19 caused more YLL than deaths of despair. Also, Hispanic or Latino persons had disproportionately higher mortality across all causes: COVID-19 and all deaths of despair causes. CONCLUSIONS This study found greater deaths of despair mortality burden and differences in burden across gender, race, and ethnicity in 2020. The results indicate the need to bolster behavioral health research, support mental health workforce development and education, increase access to evidence-based substance use treatment, and address systemic inequities and social determinants of deaths of despair and COVID-19.
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Affiliation(s)
- Parker Entrup
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, 181 Taylor Ave., Columbus, OH, 43203, USA.
| | - Leon Brodsky
- College of Medicine, the Ohio State University, Columbus, OH, USA
| | - Candice Trimble
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, 181 Taylor Ave., Columbus, OH, 43203, USA
| | | | - Nasra Mohamed
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, 181 Taylor Ave., Columbus, OH, 43203, USA
| | - Megan Deaner
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, 181 Taylor Ave., Columbus, OH, 43203, USA
| | - J P Martell
- Department of Psychiatry and Behavioral Sciences, University of Kansas Health System, Kansas City, KS, USA
| | - Julie Teater
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, 181 Taylor Ave., Columbus, OH, 43203, USA
| | - Ayana Jordan
- Department of Population Health NYU Grossman School of Medicine, New York City, NY, USA
| | - Jeanette M Tetrault
- Department of Internal Medicine, Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA
| | - O Trent Hall
- Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center Talbot Hall, 181 Taylor Ave., Columbus, OH, 43203, USA
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Liu T, Phan L, Chen-Sankey J, Ajith A, Hacker K, Jewett B, Choi K. Race, Concern About COVID-19 Discrimination, and Cigarette Smoking Behavior: Comparison Between US Asian and White Adults Who Use Commercial Tobacco. J Racial Ethn Health Disparities 2023; 10:1955-1961. [PMID: 35994174 PMCID: PMC9395842 DOI: 10.1007/s40615-022-01377-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/16/2022] [Accepted: 07/19/2022] [Indexed: 11/25/2022]
Abstract
Anti-Asian discrimination incidents in the USA have resurged during the COVID-19 pandemic. It is unclear how concern about being discriminatorily treated due to the COVID-19 pandemic varies between Asian and Asian American (A&AsA) and White adults. We examined A&AsA vs. White differences in concern about COVID-19 discrimination and associations of this concern with changes in cigarette smoking behaviors before and during the pandemic. Data were from a US representative sample of A&AsA and White adults (≥ 21 years) who currently and formerly used commercial tobacco (n = 1052), collected through an online panel oversampling A&AsA adults in January-February 2021. Participants reported their concern, worry, and stress about COVID-19 discrimination and past-30-day cigarette consumption before and during the pandemic. We examined the association between race and overall concern about COVID-19 discrimination, and this concern's associations with changes in past-30-day cigarette smoking consumption, smoking continuation, and return to smoking using weighted multivariable logistic and linear regression models. Overall concern about COVID-19 discrimination was higher (adjusted mean = 1.7, standard error = 0.16) among A&AsA adults who currently and formerly used commercial tobacco than their White counterparts (adjusted mean = 0.60, standard error = 0.04; p < 0.01). Overall concern about COVID-19 discrimination was associated with increased past-30-day cigarette consumption by 26.5 cigarettes (95% confidence interval [CI] = 1.2-51.9) and 4.4 times (95% CI = 2.3-8.5) greater odds of return to smoking among adults who smoke cigarettes. A&AsA adults who currently and formerly used commercial tobacco disproportionately bore higher concern about COVID-19 discrimination, and in turn could lead to increased smoking behavior and related morbidity and mortality among A&AsA adults.
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Affiliation(s)
- Tina Liu
- Department of Stem Cell and Regenerative Biology, Harvard College, Cambridge, MA, USA
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, MD, 20892, Bethesda, USA
| | - Lilianna Phan
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, MD, 20892, Bethesda, USA.
| | - Julia Chen-Sankey
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, Newark, NJ, USA
- School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Aniruddh Ajith
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kiana Hacker
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, MD, 20892, Bethesda, USA
| | - Bambi Jewett
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, MD, 20892, Bethesda, USA
| | - Kelvin Choi
- National Institute on Minority Health and Health Disparities Division of Intramural Research, 9000 Rockville Pike, MD, 20892, Bethesda, USA
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Fabusoro OK, Singleton CR, Teran-Garcia M, Lara-Cinisomo S. Predictors of Food and Water Stockpiling During the COVID-19 Pandemic Among Latinos and Non-Latino Black People. Disaster Med Public Health Prep 2023; 17:e447. [PMID: 37519243 DOI: 10.1017/dmp.2023.74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
OBJECTIVE The study examined factors associated with food and water stockpiling (FWS) during the COVID-19 pandemic. METHODS A secondary analysis of online survey data collected in two waves: April 2020 (wave 1) and June/July 2020 (wave 2), was conducted through REDCap web application. A total of 2,271 Non-Latino Black and Latino adults (mean age: 36.8 years (SD = 16.0); 64.3% female) living in Illinois were recruited. Participants self-reported if they stockpiled food and/or water (FWS) seven days prior to survey completion because of the pandemic. Logistic regression was used to determine if each variable was associated with the odds of reporting FWS. RESULTS Nearly a quarter (23.3%) of participants reported FWS. The adjusted model revealed that odds of FWS increase as the number of household members increased (OR: 1.21; 95% CI: 1.05-1.41). Odds of FWS were lower among participants who were not self-quarantining compared to those self-quarantining all the time (OR: 0.32; 95% CI: 0.17 - 0.62). Furthermore, individuals with lower levels of concern about COVID-19 had lower odds of FWS than those extremely concerned. CONCLUSIONS Household size, self-quarantine status, and concern about COVID-19 were significantly associated with FWS. These findings highlight the need to address the concerns of marginalized individuals to promote healthy behaviors.
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Affiliation(s)
| | - Chelsea R Singleton
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, USA
| | - Margarita Teran-Garcia
- Division of Nutritional Sciences, University of Illinois Urbana-Champaign, Illinois, USA
- Illinois Extension, College of Agricultural, Consumer and Environmental Sciences, University of Illinois Urbana-Champaign, Illinois, USA
| | - Sandraluz Lara-Cinisomo
- Division of Nutritional Sciences, University of Illinois Urbana-Champaign, Illinois, USA
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Illinois, USA
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Salgin L, Ayers LO, Burola ML, Engler AM, Osuna A, Gay L, Cain K, Stadnick N, Rabin B, Zaslavsky I, Laurent LC, Tukey R, Seifert M. Perceived COVID-19 risk and testing experiences in the San Ysidro U.S./Mexico border region. Transl Behav Med 2023; 13:432-441. [PMID: 36999822 PMCID: PMC10314726 DOI: 10.1093/tbm/ibac120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023] Open
Abstract
Racial and ethnic disparities in COVID-19 incidence are pronounced in underserved U.S./Mexico border communities. Working and living environments in these communities can lead to increased risk of COVID-19 infection and transmission, and this increased risk is exacerbated by lack of access to testing. As part of designing a community and culturally tailored COVID-19 testing program, we surveyed community members in the San Ysidro border region. The purpose of our study was to characterize knowledge, attitudes, and beliefs of prenatal patients, prenatal caregivers, and pediatric caregivers at a Federally Qualified Health Center (FHQC) in the San Ysidro region regarding perceived risk of COVID-19 infection and access to testing. A cross-sectional survey was used to collect information on experiences accessing COVID-19 testing and perceived risk of COVID-19 infection within San Ysidro between December 29, 2020 and April 2, 2021. A total of 179 surveys were analyzed. Most participants identified as female (85%) and as Mexican/Mexican American (75%). Over half (56%) were between the age of 25 and 34 years old. Perceived Risk: 37% reported moderate to high risk of COVID-19 infection, whereas 50% reported their risk low to none. Testing Experience: Approximately 68% reported previously being tested for COVID-19. Among those tested, 97% reported having very easy or easy access to testing. Reasons for not testing included limited appointment availability, cost, not feeling sick, and concern about risk of infection while at a testing facility. This study is an important first step to understand the COVID-19 risk perceptions and testing access among patients and community members living near the U.S./Mexico border in San Ysidro, California.
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Affiliation(s)
- Linda Salgin
- San Ysidro Health, San Diego, CA, USA
- San Diego State University/University of California San Diego Joint Doctoral Program in Public Health, San Diego, CA, USA
| | - Lawrence O Ayers
- University of California, San Diego Department of Obstetrics, Gynecology, and Reproductive Sciences, San Diego, CA, USA
| | - Maria-Linda Burola
- University of California, San Diego Department of Obstetrics, Gynecology, and Reproductive Sciences, San Diego, CA, USA
| | - Anne-Marie Engler
- University of California, San Diego Department of Obstetrics, Gynecology, and Reproductive Sciences, San Diego, CA, USA
| | | | - Luis Gay
- San Ysidro Health, San Diego, CA, USA
| | - Kelli Cain
- University of California, San Diego, Herbert Wertheim School of Public Health and Human Longevity Science, San Diego, CA, USA
| | - Nicole Stadnick
- University of California San Diego, Department of Psychiatry, San Diego, CA, USA
- University of California, San Diego Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center, San Diego, CA, USA
- Child and Adolescent Services Research Center, San Diego, CA, USA
| | - Borsika Rabin
- University of California, San Diego, Herbert Wertheim School of Public Health and Human Longevity Science, San Diego, CA, USA
- University of California, San Diego Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center, San Diego, CA, USA
| | - Ilya Zaslavsky
- University of California San Diego, Spatial Information Systems Lab, San Diego Supercomputer Center, San Diego, CA, USA
| | - Louise C Laurent
- University of California, San Diego Department of Obstetrics, Gynecology, and Reproductive Sciences, San Diego, CA, USA
| | - Robert Tukey
- University of California San Diego, Department of Chemistry and Biochemistry, San Diego, CA, USA
| | - Marva Seifert
- University of California San Diego, Division of Pulmonary and Critical Care Medicine, San Diego, CA, USA
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Diaz AA, Thakur N, Celedón JC. Lessons Learned from Health Disparities in Coronavirus Disease-2019 in the United States. Clin Chest Med 2023; 44:425-434. [PMID: 37085230 PMCID: PMC9678822 DOI: 10.1016/j.ccm.2022.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In the United States, the coronavirus disease-2019 (COVID-19) pandemic has disproportionally affected Black, Latinx, and Indigenous populations, immigrants, and economically disadvantaged individuals. Such historically marginalized groups are more often employed in low-wage jobs without health insurance and have higher rates of infection, hospitalization, and death from COVID-19 than non-Latinx White individuals. Mistrust in the health care system, language barriers, and limited health literacy have hindered vaccination rates in minorities, further exacerbating health disparities rooted in structural, institutional, and socioeconomic inequities. In this article, we discuss the lessons learned over the last 2 years and how to mitigate health disparities moving forward.
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Affiliation(s)
- Alejandro A Diaz
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
| | - Neeta Thakur
- Department of Medicine, University of California at San Francisco, 505 Parnassus Avenue, Box 0841, San Francisco, CA 94143, USA
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, Suite 9130, Rangos Building, 4401 Penn Avenue, Pittsburgh, PA 15224, USA
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Lundberg DJ, Wrigley-Field E, Cho A, Raquib R, Nsoesie EO, Paglino E, Chen R, Kiang MV, Riley AR, Chen YH, Charpignon ML, Hempstead K, Preston SH, Elo IT, Glymour MM, Stokes AC. COVID-19 Mortality by Race and Ethnicity in US Metropolitan and Nonmetropolitan Areas, March 2020 to February 2022. JAMA Netw Open 2023; 6:e2311098. [PMID: 37129894 PMCID: PMC10155069 DOI: 10.1001/jamanetworkopen.2023.11098] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/10/2023] [Indexed: 05/03/2023] Open
Abstract
Importance Prior research has established that Hispanic and non-Hispanic Black residents in the US experienced substantially higher COVID-19 mortality rates in 2020 than non-Hispanic White residents owing to structural racism. In 2021, these disparities decreased. Objective To assess to what extent national decreases in racial and ethnic disparities in COVID-19 mortality between the initial pandemic wave and subsequent Omicron wave reflect reductions in mortality vs other factors, such as the pandemic's changing geography. Design, Setting, and Participants This cross-sectional study was conducted using data from the US Centers for Disease Control and Prevention for COVID-19 deaths from March 1, 2020, through February 28, 2022, among adults aged 25 years and older residing in the US. Deaths were examined by race and ethnicity across metropolitan and nonmetropolitan areas, and the national decrease in racial and ethnic disparities between initial and Omicron waves was decomposed. Data were analyzed from June 2021 through March 2023. Exposures Metropolitan vs nonmetropolitan areas and race and ethnicity. Main Outcomes and Measures Age-standardized death rates. Results There were death certificates for 977 018 US adults aged 25 years and older (mean [SD] age, 73.6 [14.6] years; 435 943 female [44.6%]; 156 948 Hispanic [16.1%], 140 513 non-Hispanic Black [14.4%], and 629 578 non-Hispanic White [64.4%]) that included a mention of COVID-19. The proportion of COVID-19 deaths among adults residing in nonmetropolitan areas increased from 5944 of 110 526 deaths (5.4%) during the initial wave to a peak of 40 360 of 172 515 deaths (23.4%) during the Delta wave; the proportion was 45 183 of 210 554 deaths (21.5%) during the Omicron wave. The national disparity in age-standardized COVID-19 death rates per 100 000 person-years for non-Hispanic Black compared with non-Hispanic White adults decreased from 339 to 45 deaths from the initial to Omicron wave, or by 293 deaths. After standardizing for age and racial and ethnic differences by metropolitan vs nonmetropolitan residence, increases in death rates among non-Hispanic White adults explained 120 deaths/100 000 person-years of the decrease (40.7%); 58 deaths/100 000 person-years in the decrease (19.6%) were explained by shifts in mortality to nonmetropolitan areas, where a disproportionate share of non-Hispanic White adults reside. The remaining 116 deaths/100 000 person-years in the decrease (39.6%) were explained by decreases in death rates in non-Hispanic Black adults. Conclusions and Relevance This study found that most of the national decrease in racial and ethnic disparities in COVID-19 mortality between the initial and Omicron waves was explained by increased mortality among non-Hispanic White adults and changes in the geographic spread of the pandemic. These findings suggest that despite media reports of a decline in disparities, there is a continued need to prioritize racial health equity in the pandemic response.
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Affiliation(s)
- Dielle J. Lundberg
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle
| | - Elizabeth Wrigley-Field
- Department of Sociology, University of Minnesota, Minneapolis
- Minnesota Population Center, University of Minnesota, Minneapolis
| | - Ahyoung Cho
- Center for Antiracist Research, Boston University, Boston, Massachusetts
- Department of Political Science, Boston University, Boston, Massachusetts
| | - Rafeya Raquib
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
| | - Elaine O. Nsoesie
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
- Center for Antiracist Research, Boston University, Boston, Massachusetts
| | - Eugenio Paglino
- Department of Sociology, University of Pennsylvania, Philadelphia
- Population Studies Center, University of Pennsylvania, Philadelphia
| | - Ruijia Chen
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Mathew V. Kiang
- Department of Epidemiology and Population Health, Stanford University, Stanford, California
| | - Alicia R. Riley
- Department of Sociology, University of California, Santa Cruz
| | - Yea-Hung Chen
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Marie-Laure Charpignon
- Institute for Data, Systems, and Society, Massachusetts Institute of Technology, Cambridge
| | | | - Samuel H. Preston
- Department of Sociology, University of Pennsylvania, Philadelphia
- Population Studies Center, University of Pennsylvania, Philadelphia
| | - Irma T. Elo
- Department of Sociology, University of Pennsylvania, Philadelphia
- Population Studies Center, University of Pennsylvania, Philadelphia
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Andrew C. Stokes
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
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Zerden LDS, Ross AM, Cederbaum J, Guan T, Zelnick J, Ruth BJ. Race and COVID-19 among Social Workers in Health Settings: Physical, Mental Health, Personal Protective Equipment, and Financial Stressors. Health Soc Work 2023; 48:91-104. [PMID: 36869753 DOI: 10.1093/hsw/hlad002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/13/2021] [Accepted: 12/22/2021] [Indexed: 06/18/2023]
Abstract
Social work is an essential workforce integral to the United States' public health infrastructure and response to COVID-19. To understand stressors among frontline social workers during COVID-19, a cross-sectional study of U.S-based social workers (N = 1,407) in health settings was collected (in June through August 2020). Differences in outcome domains (health, mental health, personal protective equipment [PPE] access, financial stress) were examined by workers' demographics and setting. Ordinal logistic, multinomial, and linear regressions were conducted. Participants reported moderate or severe physical (57.3 percent) and mental (58.3 percent) health concerns; 39.3 percent expressed PPE access concerns. Social workers of color were more likely to report significantly higher levels of concern across all domains. Those identifying as Black, American Indian/Alaska Native (AIAN), Asian American/Pacific Islander (AAPI), multiracial, or Hispanic/Latinx were over 50 percent more likely to experience either moderate or severe physical health concerns, 60 percent more likely to report severe mental health concerns, and over 30 percent more likely to report moderate PPE access concerns. The linear regression model was significantly associated with higher levels of financial stress for social workers of color. COVID-19 has exposed racial and social injustices that that hold true for social workers in health settings. Improved social systems are critical not just for those impacted by COVID-19, but also for the protection and sustainability of the current and future workforce responding to COVID-19.
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Affiliation(s)
- Lisa de Saxe Zerden
- PhD, MSW, is associate professor, School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB 3550, Chapel Hill, NC 27599-3550, USA
| | - Abigail M Ross
- PhD, is assistant professor, Graduate School of Social Service, Fordham University, New York, NY USA
| | - Julie Cederbaum
- PhD, is associate professor, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Ting Guan
- MS, is an assistant professor, Syracuse University, Syracuse, NY, USA
| | - Jennifer Zelnick
- ScD, is social welfare policy chair and professor, Graduate School of Social Work, Touro College, New York, NY, USA
| | - Betty J Ruth
- MSW, is a retired clinical professor, School of Social Work, Boston University, Boston, MA, USA
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Bornstein ER, Miller AD, Zambrano LD, Yousaf AR, Apostolou A, Weiser T, Campbell AP. Multisystem Inflammatory Syndrome in American Indian/Alaska Native Children, March 2020-May 2022. Pediatr Infect Dis J 2023; 42:e105-e108. [PMID: 36728676 PMCID: PMC9990482 DOI: 10.1097/inf.0000000000003822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2022] [Indexed: 02/03/2023]
Abstract
We describe characteristics, clinical features and outcomes of multisystem inflammatory syndrome in children among American Indian and Alaska Native (AI/AN) persons compared with non-Hispanic white persons. AI/AN patients with multisystem inflammatory syndrome in children were younger, more often obese, and from areas of higher social vulnerability. A greater proportion of AI/AN patients had severe respiratory involvement and shock.
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Affiliation(s)
- Ethan R. Bornstein
- From the CDC COVID-19 Response Team
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
- Northwest Portland Area Indian Health Board, Portland, Oregon
| | | | | | | | | | - Thomas Weiser
- Northwest Portland Area Indian Health Board, Portland, Oregon
- Portland Area Indian Health Service, Portland, Oregon
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McCullen JR, Counts CJ, John-Henderson NA. Childhood adversity and emotion regulation strategies as predictors of psychological stress and mental health in American Indian adults during the COVID-19 pandemic. Emotion 2023; 23:805-813. [PMID: 35951388 PMCID: PMC9918611 DOI: 10.1037/emo0001106] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Life events, such as the Coronavirus disease 2019 (COVID-19) pandemic, elicit increases in psychological stress and symptoms of anxiety and depression. In turn, these outcomes have negative implications for mental health. Emotion regulation strategies and prior adversity may moderate the degree to which life events affect outcomes that are linked to mental health. The purpose of the current study was to evaluate whether childhood adversity and emotion regulation strategy use interactively informed changes in outcomes linked to mental health following the onset of the pandemic in American Indian (AI) adults. AI adults (N = 210) reported levels of childhood adversity, emotion regulation strategy use, symptoms of anxiety and depression, and psychological stress 1 month prior to the onset of the COVID-19 pandemic. One month following the declaration of the pandemic, they reported on their stress, symptoms of anxiety and depression once again. The interaction between expressive suppression and childhood adversity predicted changes in psychological stress and symptoms of depression (B = .26, t(198) = 4.43 p < .001, R² change = .06) and (B = .23 t(199) = 4.14, p < .001, R² change = .05) respectively. The findings indicate that expressive suppression may be a maladaptive emotion regulation strategy for AI adults who experienced high levels of childhood adversity. This work represents a first step in understanding the role of emotion regulation strategy use in predicting mental health-relevant outcomes in the context of a life event, in a community that is disproportionately affected by chronic mental health conditions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Edmiston JB, Cohn EG, Teruya SL, Sabogal N, Massillon D, Muralidhar V, Rodriguez C, Helmke S, Fine D, Winburn M, Chiuzan C, Hod EA, Raiszadeh F, Kurian D, Maurer MS, Ruberg FL. Clinical and social determinants of health features of SARS-CoV-2 infection among Black and Caribbean Hispanic patients with heart failure: The SCAN-MP Study. PLoS One 2023; 18:e0283730. [PMID: 36996149 PMCID: PMC10062570 DOI: 10.1371/journal.pone.0283730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 03/15/2023] [Indexed: 03/31/2023] Open
Abstract
Patients with heart failure (HF) often have multiple chronic conditions and are at increased risk for severe disease and mortality when infected by SARS-CoV-2, the virus that causes COVID-19. Furthermore, disparities in outcomes with COVID-19 have been associated with both racial/ethnic identity but also social determinants of health. Among older, urban-dwelling, minority patients with HF, we sought to characterize medical and non-medical factors associated with SARS-CoV-2 infection. Patients with HF living in Boston and New York City over 60 years of age participating in the Screening for Cardiac Amyloidosis with Nuclear Imaging (SCAN-MP) study between 12/1/2019 and 10/15/2021 (n = 180) were tested for nucleocapsid antibodies to SARS-CoV-2 and queried for symptomatic infection with PCR verification. Baseline testing included the Kansas City Cardiomyopathy Questionnaire (KCCQ), assessment of health literacy, biochemical, functional capacity, echocardiography, and a novel survey tool that determined living conditions, perceived risk of infection, and attitudes towards COVID-19 mitigation. The association of infection with prevalent socio-economic conditions was assessed by the area deprivation index (ADI). There were 50 overall cases of SARS-CoV-2 infection (28%) including 40 demonstrating antibodies to SARS-CoV-2 (indicative of prior infection) and 10 positive PCR tests. There was no overlap between these groups. The first documented case from New York City indicated infection prior to January 17, 2020. Among active smokers, none tested positive for prior SARS-CoV-2 infection (0 (0%) vs. 20 (15%), p = 0.004) vs. non-smokers. Cases were more likely to be taking ACE-inhibitors/ARBs compared to non-cases (78% vs 62%, p = 0.04). Over a mean follow-up of 9.6 months, there were 6 total deaths (3.3%) all unrelated to COVID-19. Death and hospitalizations (n = 84) were not associated with incident (PCR tested) or prior (antibody) SARS-CoV-2 infection. There was no difference in age, co-morbidities, living conditions, attitudes toward mitigation, health literacy, or ADI between those with and without infection. SARS-CoV-2 infection was common among older, minority patients with HF living in New York City and Boston, with evidence of infection documented in early January 2020. Health literacy and ADI were not associated with infection, and there was no increased mortality or hospitalizations among those infected with SARS-CoV-2.
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Affiliation(s)
- Jonathan B. Edmiston
- Section of Cardiovascular Medicine, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Elizabeth G. Cohn
- Hunter College, City University of New York, New York, New York, United States of America
| | - Sergio L. Teruya
- Seymour, Paul, and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Natalia Sabogal
- Section of Cardiovascular Medicine, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Daniel Massillon
- Section of Cardiovascular Medicine, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Varsha Muralidhar
- Section of Cardiovascular Medicine, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Carlos Rodriguez
- Seymour, Paul, and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Stephen Helmke
- Seymour, Paul, and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Denise Fine
- Section of Cardiovascular Medicine, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Morgan Winburn
- Section of Cardiovascular Medicine, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Codruta Chiuzan
- Feinstein Institute for Medical Research, Northwell Health, New York, New York, United States of America
| | - Eldad A. Hod
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, New York, United States of America
| | - Farbod Raiszadeh
- Division of Cardiology, Harlem Hospital Center, New York City Health and Hospital Corporation, New York, New York, United States of America
| | - Damien Kurian
- Division of Cardiology, Harlem Hospital Center, New York City Health and Hospital Corporation, New York, New York, United States of America
| | - Mathew S. Maurer
- Seymour, Paul, and Gloria Milstein Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Frederick L. Ruberg
- Section of Cardiovascular Medicine, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, United States of America
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Yu Q, Cao W, Hamer D, Urbanek N, Straif-Bourgeois S, Cormier SA, Ferguson T, Richmond-Bryant J. Associations of COVID-19 Hospitalizations, ICU Admissions, and Mortality with Black and White Race and Their Mediation by Air Pollution and Other Risk Factors in the Louisiana Industrial Corridor, March 2020-August 2021. Int J Environ Res Public Health 2023; 20:4611. [PMID: 36901619 PMCID: PMC10001987 DOI: 10.3390/ijerph20054611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
Louisiana ranks among the bottom five states for air pollution and mortality. Our objective was to investigate associations between race and Coronavirus Disease 2019 (COVID-19) hospitalizations, intensive care unit (ICU) admissions, and mortality over time and determine which air pollutants and other characteristics may mediate COVID-19-associated outcomes. In our cross-sectional study, we analyzed hospitalizations, ICU admissions, and mortality among positive SARS-CoV-2 cases within a healthcare system around the Louisiana Industrial Corridor over four waves of the pandemic from 1 March 2020 to 31 August 2021. Associations between race and each outcome were tested, and multiple mediation analysis was performed to test if other demographic, socioeconomic, or air pollution variables mediate the race-outcome relationships after adjusting for all available confounders. Race was associated with each outcome over the study duration and during most waves. Early in the pandemic, hospitalization, ICU admission, and mortality rates were greater among Black patients, but as the pandemic progressed, these rates became greater in White patients. However, Black patients were disproportionately represented in these measures. Our findings imply that air pollution might contribute to the disproportionate share of COVID-19 hospitalizations and mortality among Black residents in Louisiana.
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Affiliation(s)
- Qingzhao Yu
- Biostatistics Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Wentao Cao
- Biostatistics Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Diana Hamer
- Division of Academic Affairs, Our Lady of the Lake Regional Medical Center, Baton Rouge, LA 70808, USA
| | - Norman Urbanek
- Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, NC 27695, USA
| | - Susanne Straif-Bourgeois
- Epidemiology Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Stephania A. Cormier
- Department of Biological Sciences, Louisiana State University, Baton Rouge, LA 70803, USA
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Tekeda Ferguson
- Epidemiology Program, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Jennifer Richmond-Bryant
- Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, NC 27695, USA
- Center for Geospatial Analytics, North Carolina State University, Raleigh, NC 27695, USA
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Khunti K, Feldman EL, Laiteerapong N, Parker W, Routen A, Peek M. The Impact of the COVID-19 Pandemic on Ethnic Minority Groups With Diabetes. Diabetes Care 2023; 46:228-236. [PMID: 35944272 PMCID: PMC10090266 DOI: 10.2337/dc21-2495] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 05/10/2022] [Indexed: 02/03/2023]
Abstract
Major ethnic disparities in diabetes care, especially for intermediate outcomes and diabetes complications, were evident prior to the coronavirus disease 2019 (COVID-19) pandemic. Diabetes is a risk factor for severe COVID-19, and the combination of these ethnic disparities in diabetes care and outcomes may have contributed to the inequity in COVID-19 outcomes for people with diabetes. Overall, ethnic minority populations have suffered disproportionate rates of COVID-19 hospitalization and mortality. Results from the limited number of studies of COVID-19 in ethnic minority populations with diabetes are mixed, but there is some suggestion that rates of hospitalization and mortality are higher than those of White populations. Reasons for the higher incidence and severity of COVID-19-related outcomes in minority ethnic groups are complex and have been shown to be due to differences in comorbid conditions (e.g., diabetes), exposure risk (e.g., overcrowded living conditions or essential worker jobs), and access to treatment (e.g., health insurance status and access to tertiary care medical centers), which all relate to long-standing structural inequities that vary by ethnicity. While guidelines and approaches for diabetes self-management and outpatient and inpatient care during the pandemic have been published, few have recommended addressing wider structural issues. As we now plan for the recovery and improved surveillance and risk factor management, it is imperative that primary and specialist care services urgently address the disproportionate impact the pandemic has had on ethnic minority groups. This should include a focus on the larger structural barriers in society that put ethnic minorities with diabetes at potentially greater risk for poor COVID-19 outcomes.
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Affiliation(s)
- Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, U.K
| | - Eva L. Feldman
- Department of Neurology, School of Medicine, University of Michigan, Ann Arbor, MI
| | | | - William Parker
- Department of Pulmonary and Critical Care, University of Chicago, Chicago, IL
| | - Ash Routen
- Diabetes Research Centre, University of Leicester, Leicester, U.K
| | - Monica Peek
- Department of Medicine, University of Chicago, Chicago, IL
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Medeiros M, Edwards HA, Baquet CR. Research in the USA on COVID-19's long-term effects: measures needed to ensure black, indigenous and Latinx communities are not left behind. J Med Ethics 2023; 49:87-91. [PMID: 35365568 PMCID: PMC8983399 DOI: 10.1136/medethics-2021-107436] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 03/13/2022] [Indexed: 06/14/2023]
Abstract
The SARS-CoV-2 (COVID-19) pandemic continues to expose underlying inequities in healthcare for black, indigenous and Latinx communities in the USA. The gaps in equitable care for communities of colour transcend the diagnosis, treatment and vaccinations related to COVID-19. We are experiencing a continued gap across racial and socioeconomic lines for those who suffer prolonged effects of COVID-19, also known as 'Long COVID-19'. What we know about the treatment for Long COVID-19 so far is that it is complex, requires a multidisciplinary approach and there is still much research needed to fully understand the effects. In this paper, we discuss pragmatic considerations for including affected communities, relevant stakeholders, and leaders from communities of colour in the planning and implementation of Long COVID-19 research.
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Affiliation(s)
- Michelle Medeiros
- Pharmaceutical Health Services Research, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Hillary Anne Edwards
- Pharmaceutical Health Services Research, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Claudia Rose Baquet
- Pharmaceutical Health Services Research, University of Maryland Baltimore, Baltimore, Maryland, USA
- HOPE Institute, LLC, Columbia, Maryland, USA
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Harris CM, Wright SM. Inpatient outcomes comparing White and Black patients with obesity hospitalized for COVID-19 infection. J Natl Med Assoc 2023; 115:157-163. [PMID: 36682964 PMCID: PMC9859723 DOI: 10.1016/j.jnma.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 01/09/2023] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Comparisons between Black and White patients with obesity hospitalized with COVID-19 have not been fully studied. We sought to determine outcomes differences between these two groups. METHODS National Inpatient Sample database year 2020 was studied using multivariable regression to compare Black and White patients with obesity and COVID-19 infection. Outcomes were in-hospital mortality, length of stay, and hospital charges. RESULTS 205,365 Black and White patients with obesity were hospitalized for COVID-19. 141,010 (68.6%) were White and 64,355 (31.3%) were Black. Black patients were younger (mean age [± standard error] 55.5 ± 0.14 vs. 62.1± 0.11; p < 0.01), more likely female (63.2% vs 50.9%; p < 0.01), and had lower mean comorbidity (Elixhauser score means [± standard error] 4.4 ± 0.02 vs. 4.6 ± 0.01; p < 0.01) than White patients. Black patients had lower odds of in-hospital mortality (adjusted Odds Ratio {aOR}=0.86 CI [0.77-0.97]; p = 0.01), longer hospital stays (adjusted Mean Difference {aMD}=0.32 days CI [0.14-0.51]; p < 0.01) and incurred higher, though non-significant hospital charges (aMD = $2,144 CI [-2270-+6560]; p = 0.34) than White patients. CONCLUSION During the first year of the pandemic, Black patients with obesity and COVID-19 were less likely to die during the incident hospitalization but used greater hospital resources compared to White patients.
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Affiliation(s)
- Ché Matthew Harris
- Department of Medicine, Johns Hopkins School of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Baltimore, MD 21224, United States.
| | - Scott Mitchell Wright
- Department of Medicine, Johns Hopkins School of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Baltimore, MD 21224, United States
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García DT, Ruiz SY, Siles K, Akinkugbe AA. Teledentistry Acceptability Among Latina/o/x Adults in Rural Southwest Virginia. J Health Care Poor Underserved 2023; 34:1353-1365. [PMID: 38661760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Inequitable access to dental care remains a barrier to optimal health for rural populations. With the COVID-19 pandemic, teledentistry to improve the delivery of oral health care has been emphasized. Few previous investigations of teledentistry acceptability have included Latina/o/x populations in rural areas of the United States. We recruited Latina/o/x adults (N=91) in rural southwest Virginia to participate in a survey to assess correlates related to teledentistry acceptability. More than half of participants (57%) reported no interest in using teledentistry if it were available. Having a yearly household income above $24,000 and not having dental insurance were positively associated with telehealth acceptability (p=.04 and p=.01, respectively). Inequitable access to dental care may persist even with broad availability of teledentistry services unless there is explicit integration of health equity.
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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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Porter A, Brown CC, Rodriguez A, Zohoori N, Wells S, Crump A, Romero J, Tilford JM. Variation in Time Between Testing Positive for COVID-19 and Hospital Admission by Race/Ethnicity and Insurance Status. J Health Care Poor Underserved 2023; 34:1290-1304. [PMID: 38661756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Understanding the extent to which demographic and socioeconomic factors play a role in the disparities associated with duration between testing positive for COVID-19 and hospital admission will help in achieving equitable health outcomes. This project linked the statewide COVID-19 registry to administrative datasets to examine the variation in times between testing positive for COVID-19 and hospital admission by race/ethnicity and insurance. In 2020, there were 11,314 patients admitted for COVID-19 in Arkansas. Approximately 42.2% tested positive for COVID-19 on the same day as hospital admission. Black patients had 38% higher odds of hospitalization on the day of testing compared with White patients (p<.001). Medicaid and uninsured patients had 51% and 50% higher odds of admission on the day of testing compared with privately insured patients (both p<.001), respectively. This study highlights the implications of reduced access to testing with respect to equitable health outcomes.
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48
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Rao V, Chandra N. In-silico study of influence of HLA heterogeneity on CTL responses across ethnicities to SARS-CoV-2. Hum Immunol 2022; 83:797-802. [PMID: 36229378 PMCID: PMC9550298 DOI: 10.1016/j.humimm.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/12/2022] [Accepted: 09/29/2022] [Indexed: 11/04/2022]
Abstract
Differences in outcome to COVID-19 infection in different individuals is largely attributed to genetic heterogeneity leading to differential immune responses across individuals and populations. HLA is one such genetic factor that varies across individuals leading to differences in how T-cell responses are triggered against SARS-CoV-2, directly influencing disease susceptibility. HLA alleles that influence COVID-19 outcome, by virtue of epitope binding and presentation, have been identified in cohorts worldwide. However, the heterogeneity in HLA distribution across ethnic groups limits the generality of such association. In this study, we address this limitation by comparing the recognition of CTL epitopes across HLA genotypes and ethnic groups. Using HLA allele frequency data for ethnic groups from Allele Frequency Net Database (AFND), we construct synthetic populations for each ethnic group and show that CTL epitope strength varies across HLA genotypes and populations. We also observe that HLA genotypes, in certain cases, can have high CTL epitope strengths in the absence of top-responsive HLA alleles. Finally, we show that the theoretical estimate of responsiveness and hence protection offered by a HLA allele is bound to vary across ethnic groups, due to the influence of other HLA alleles within the HLA genotype on CTL epitope recognition. This emphasizes the need for studying HLA-disease associations at the genotype level rather than at a single allele level.
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Affiliation(s)
- Vishal Rao
- Department of Biochemistry, Indian Institute of Science, Bangalore, India
| | - Nagasuma Chandra
- Department of Biochemistry, Indian Institute of Science, Bangalore, India; Center for BioSystems Science and Engineering (BSSE), Indian Institute of Science, Bangalore, India.
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Sadarangani TR, Gaugler JE, Dabelko-Schoeny H, Marx KA. Adult Day Services, Health Equity for Older Adults With Complex Needs, and the COVID-19 Pandemic. Am J Public Health 2022; 112:1421-1428. [PMID: 36103694 PMCID: PMC9480461 DOI: 10.2105/ajph.2022.306968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/04/2022]
Abstract
Morbidity and mortality from COVID-19 have unduly affected older adults from racial and ethnic minority groups. In this article, we highlight the experiences and vulnerabilities of diverse older adults with complex health and social needs when their access to vital, but overlooked, community-based adult day service centers (ADSCs) was abruptly cut off during a pandemic. Pandemic-related ADSC closures left vulnerable older adults and their care partners without essential daily support and services, such as health monitoring and socialization. However, the magnitude of the impact of ADSC closures on well-being, particularly among members of racial/ethnic minority groups, has yet to be measured with any form of "big data" because large-scale, nationally representative data sets consisting of participant-level information and outcomes associated with ADSC participation do not yet exist. Unmet needs of older adults resulting from pandemic-related ADSC closures are underrecognized because of a lack of systematic data collection, undermining efforts to achieve health equity. We call on ADSCs to link rigorous collection of racial and ethnic data to quality measures of access to equitable "age-friendly" care as a means of better supporting diverse community-dwelling older adults beyond the COVID-19 pandemic. (Am J Public Health. 2022;112(10):1421-1428. https://doi.org/10.2105/AJPH.2022.306968).
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Affiliation(s)
- Tina R Sadarangani
- Tina R. Sadarangani is with the Rory Meyers College of Nursing, New York University, New York. Joseph E. Gaugler is with the School of Public Health, Division of Health Policy and Management, University of Minnesota, Minneapolis. Holly Dabelko-Schoeny is with the College of Social Work, Age-Friendly Innovation Center, Ohio State University, Columbus. Katherine A. Marx is with the School of Nursing, Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD
| | - Joseph E Gaugler
- Tina R. Sadarangani is with the Rory Meyers College of Nursing, New York University, New York. Joseph E. Gaugler is with the School of Public Health, Division of Health Policy and Management, University of Minnesota, Minneapolis. Holly Dabelko-Schoeny is with the College of Social Work, Age-Friendly Innovation Center, Ohio State University, Columbus. Katherine A. Marx is with the School of Nursing, Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD
| | - Holly Dabelko-Schoeny
- Tina R. Sadarangani is with the Rory Meyers College of Nursing, New York University, New York. Joseph E. Gaugler is with the School of Public Health, Division of Health Policy and Management, University of Minnesota, Minneapolis. Holly Dabelko-Schoeny is with the College of Social Work, Age-Friendly Innovation Center, Ohio State University, Columbus. Katherine A. Marx is with the School of Nursing, Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD
| | - Katherine A Marx
- Tina R. Sadarangani is with the Rory Meyers College of Nursing, New York University, New York. Joseph E. Gaugler is with the School of Public Health, Division of Health Policy and Management, University of Minnesota, Minneapolis. Holly Dabelko-Schoeny is with the College of Social Work, Age-Friendly Innovation Center, Ohio State University, Columbus. Katherine A. Marx is with the School of Nursing, Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD
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Aburto JM, Tilstra AM, Floridi G, Dowd JB. Significant impacts of the COVID-19 pandemic on race/ethnic differences in US mortality. Proc Natl Acad Sci U S A 2022; 119:e2205813119. [PMID: 35998219 PMCID: PMC9436308 DOI: 10.1073/pnas.2205813119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/20/2022] [Indexed: 11/28/2022] Open
Abstract
The coronavirus 2019 (COVID-19) pandemic triggered global declines in life expectancy. The United States was hit particularly hard among high-income countries. Early data from the United States showed that these losses varied greatly by race/ethnicity in 2020, with Hispanic and Black Americans suffering much larger losses in life expectancy compared with White people. We add to this research by examining trends in lifespan inequality, average years of life lost, and the contribution of specific causes of death and ages to race/ethnic life-expectancy disparities in the United States from 2010 to 2020. We find that life expectancy in 2020 fell more for Hispanic and Black males (4.5 and 3.6 y, respectively) compared with White males (1.5 y). These drops nearly eliminated the previous life-expectancy advantage for the Hispanic compared with the White population, while dramatically increasing the already large gap in life expectancy between Black and White people. While the drops in life expectancy for the Hispanic population were largely attributable to official COVID-19 deaths, Black Americans saw increases in cardiovascular diseases and "deaths of despair" over this period. In 2020, lifespan inequality increased slightly for Hispanic and White populations but decreased for Black people, reflecting the younger age pattern of COVID-19 deaths for Hispanic people. Overall, the mortality burden of the COVID-19 pandemic hit race/ethnic minorities particularly hard in the United States, underscoring the importance of the social determinants of health during a public health crisis.
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Affiliation(s)
- José Manuel Aburto
- Leverhulme Centre for Demographic Science, Department of Sociology, and Nuffield College, University of Oxford, Oxford, OX1 1JD, United Kingdom
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, United Kingdom
- Interdisciplinary Centre on Population Dynamics, University of Southern Denmark; Odense 5000, Denmark
| | - Andrea M. Tilstra
- Leverhulme Centre for Demographic Science, Department of Sociology, and Nuffield College, University of Oxford, Oxford, OX1 1JD, United Kingdom
- University of Colorado Population Center, Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO 80302
| | - Ginevra Floridi
- Leverhulme Centre for Demographic Science, Department of Sociology, and Nuffield College, University of Oxford, Oxford, OX1 1JD, United Kingdom
| | - Jennifer Beam Dowd
- Leverhulme Centre for Demographic Science, Department of Sociology, and Nuffield College, University of Oxford, Oxford, OX1 1JD, United Kingdom
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