COVID-19 mortality and deprivation: pandemic, syndemic, and endemic health inequalities

The Lancet Public Health, Год журнала: 2022, Номер 7(11), С. e966 - e975

Опубликована: Ноя. 1, 2022

Язык: Английский

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County-Level Social Vulnerability and Breast, Cervical, and Colorectal Cancer Screening Rates in the US, 2018

JAMA Network Open, Год журнала: 2022, Номер 5(9), С. e2233429 - e2233429

Опубликована: Сен. 27, 2022

Importance Area-level factors have been identified as important social determinants of health (SDoH) that impact many health-related outcomes. Less is known about how the vulnerability index (SVI), a scalable composite score, can multidimensionally explain population-based cancer screening program uptake at county level. Objective To examine geographic variation US Preventive Services Task Force (USPSTF)–recommended breast, cervical, and colorectal rates association between county-level SVI 3 rates. Design, Setting, Participants This cross-sectional study used information from Centers for Disease Control Prevention’s PLACES data sets 2018 3141 counties. Analyses were conducted October 2021 to February 2022. Exposures Social score categorized in quintiles. Main Outcomes Measures The main outcome was USPSTF guideline-concordant, up-to-date screenings. Odds ratios calculated each by quintile unadjusted (only accounting eligible population per county) or adjusted urban-rural status, percentage uninsured adults, primary care physician rate 100 000 residents. Results Across counties, showed regional disparities ranging 54.0% 81.8% breast screening, 69.9% 89.7% cervical 39.8% 74.4% screening. multivariable regression model higher significantly associated with lower odds lowest highest quintile. When comparing (SVI-Q5) (SVI-Q1), ratio 0.86 (95% posterior credible interval [CrI], 0.84-0.87) 0.80 CrI, 0.79-0.81) 0.72 0.71-0.73) fully adjusted, 0.92 0.90-0.93) 0.87 0.86-0.88) 0.85-0.88) showing slightly attenuated associations. Conclusions Relevance In this study, found Quantifying associates could provide insight into design focus future interventions targeting prevention disparities.

Язык: Английский

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Social Determinants and Indicators of COVID-19 Among Marginalized Communities: A Scientific Review and Call to Action for Pandemic Response and Recovery

Disaster Medicine and Public Health Preparedness, Год журнала: 2022, Номер 17

Опубликована: Май 2, 2022

Abstract Coronavirus disease 2019 (COVID-19) has placed massive socio-psychological, health, and economic burdens including deaths on countless lives; however, it disproportionally impacted certain populations. Co-occurring Social Determinants of Health (SDoH) disparities other underlying determinants have exacerbated the COVID-19 pandemic. This literature review sought to (1) examine focused SDoH outcomes ie, infectivity, hospitalization, death rates among marginalized communities; (2) identify associated with outcomes. We searched electronic databases for studies published from October 2021. Studies that were selected those intersecting indicators conducted in United States. Our underscored disproportionate vulnerabilities adverse racial/ethnic minority communities disadvantaged groups (ie, senior citizens, displaced/homeless individuals). indicators, race/ethnicity, poverty, median income level, housing density, insecurity, health-care access, occupation, transportation/commuting patterns, education, air quality, food old age, etc. concluded recommendations a call action integrate along relevant health data when implementing intelligent solutions intervention strategies pandemic response/recovery vulnerable

Язык: Английский

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Temporal trends in the association of social vulnerability and race/ethnicity with county-level COVID-19 incidence and outcomes in the USA: an ecological analysis

BMJ Open, Год журнала: 2021, Номер 11(7), С. e048086 - e048086

Опубликована: Июль 1, 2021

The COVID-19 pandemic adversely affected the socially vulnerable and minority communities in USA initially, but temporal trends during year-long remain unknown.

Язык: Английский

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Estimated SARS-CoV-2 antibody seroprevalence trends and relationship to reported case prevalence from a repeated, cross-sectional study in the 50 states and the District of Columbia, United States—October 25, 2020–February 26, 2022

The Lancet Regional Health - Americas, Год журнала: 2022, Номер 18, С. 100403 - 100403

Опубликована: Дек. 2, 2022

Sero-surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can reveal trends and differences in subgroups capture undetected or unreported infections that are not included case-based surveillance systems. Cross-sectional, convenience samples remnant sera from clinical laboratories 51 U.S. jurisdictions were assayed for infection-induced SARS-CoV-2 antibodies biweekly October 25, 2020, to July 11, 2021, monthly September 6, February 26, 2022. Test results analyzed infection-induced, nucleocapsid-protein seroprevalence using mixed effects models adjusted demographic variables assay type. Analyses 1,469,792 serum specimens revealed increased 8.0% (95% confidence interval (CI): 7.9%–8.1%) November 2020 58.2% (CI: 57.4%–58.9%) The ratio the change estimated reported case prevalence was 2.8 2.8–2.9) during winter 2020–2021, 2.3 2.0–2.5) summer 3.1 3.0–3.3) 2021–2022. Change ratios ranged 2.6 2.3–2.8) 3.5 3.3–3.7) by region Ratios suggest a high proportion detected periods transmission. largest increases coincided with spread B.1.1.529 (Omicron) variant accessibility home testing. varied season highest midwestern southern United States Our demonstrate counts did fully differing underlying infection rates value sero-surveillance understanding full burden infection. Levels antibody seroprevalence, particularly spikes transmission, important contextualize vaccine effectiveness data as susceptibility population changes. This work supported Centers Disease Control Prevention, Atlanta, Georgia.

Язык: Английский

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Social vulnerability and county stay-at-home behavior during COVID-19 stay-at-home orders, United States, April 7–April 20, 2020

Annals of Epidemiology, Год журнала: 2021, Номер 64, С. 76 - 82

Опубликована: Сен. 6, 2021

Early COVID-19 mitigation relied on people staying home except for essential trips. The ability to stay may differ by sociodemographic factors. We analyzed how factors related social vulnerability impact a community's during stay-at-home order.Using generalized, linear mixed models stratified order (mandatory or not mandatory), we county-level behavior (inferred from mobile devices) period when majority of United States counties had orders (April 7-April 20, 2020) with the Centers Disease Control and Prevention Social Vulnerability Index (CDC SVI).Counties higher percentages single-parent households, homes, persons lower educational attainment were associated compared respective percentages. Counties unemployment, limited-English-language speakers, more multi-unit housing increases in Stronger effects found mandatory orders.Sociodemographic orders. Communities have workers without work-from-home options fewer resources extended periods, which increase risk COVID-19. Results are useful tailoring messaging, vaccine delivery, public health responses future outbreaks.

Язык: Английский

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Association Between Medicaid Expansion Under the Affordable Care Act and Survival Among Newly Diagnosed Cancer Patients

JNCI Journal of the National Cancer Institute, Год журнала: 2022, Номер 114(8), С. 1176 - 1185

Опубликована: Апрель 14, 2022

Medicaid expansion under the Affordable Care Act (ACA) is associated with increased insurance coverage among patients cancer. Whether these gains translate to improved survival largely unknown. This study examines changes in 2-year newly diagnosed cancer following ACA expansion.Patients aged 18-62 years from 42 states' population-based registries pre (2010-2012) and post (2014-2016) were followed through September 30, 2013, December 31, 2017, respectively. Difference-in-differences (DD) analysis of overall was stratified by sex, race ethnicity, census tract-level poverty, rurality.A total 2 555 302 included (n = 1 523 585) nonexpansion 031 717) states. The 80.58% pre-ACA 82.23% post-ACA states 78.71% 80.04% states, resulting a net increase 0.44 percentage points (ppt) (95% confidence interval [CI] 0.24ppt 0.64ppt) after adjusting for sociodemographic factors. By site, greater colorectal (DD 0.90ppt, 95% CI 0.19ppt 1.60ppt), lung 1.29ppt, 0.50ppt 2.08ppt), non-Hodgkin lymphoma 1.07ppt, 0.14ppt 1.99ppt), pancreatic 1.80ppt, 0.40ppt 3.21ppt), liver 2.57ppt, 1.00ppt 4.15ppt). improvement larger non-Hispanic Black 0.72ppt, 0.12ppt 1.31ppt) residing rural areas 1.48ppt, CI= -0.26ppt 3.23ppt), leading narrowing disparities rurality.Medicaid survival, prominent Blacks areas, highlighting role reducing health disparities. Future studies should monitor longer-term outcomes ACA.

Язык: Английский

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Social vulnerability indicators in pandemics focusing on COVID‐19: A systematic literature review

Public Health Nursing, Год журнала: 2022, Номер 39(5), С. 1142 - 1155

Опубликована: Апрель 7, 2022

Social factors can affect the vulnerability of disaster-prone communities. This review aimed to identify and categorize social indicators in COVID-19 pandemic.

Язык: Английский

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Temporal Dynamics of Socioeconomic Inequalities in COVID-19 Outcomes Over the Course of the Pandemic—A Scoping Review

International Journal of Public Health, Год журнала: 2022, Номер 67

Опубликована: Авг. 29, 2022

Objectives: International evidence of socioeconomic inequalities in COVID-19 outcomes is extensive and growing, but less known about the temporal dynamics these over course pandemic. Methods: We systematically searched Embase Scopus databases. Additionally, several relevant journals reference lists all included articles were hand-searched. This study follows PRISMA guidelines for scoping reviews. Results: Forty-six studies included. Of analyses, 91.4% showed stable or increasing pandemic, with socioeconomically disadvantaged populations being most affected. Furthermore, results COVID-19, frequently initiated through higher incidence mortality rates better-off subsequent crossover to (41.9% analyses). Conclusion: The identified have public health implications. Socioeconomic should be monitored time enable adaption prevention interventions according social particularities specific pandemic phases.

Язык: Английский

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The Geographical Distribution and Influencing Factors of COVID-19 in China

Tropical Medicine and Infectious Disease, Год журнала: 2022, Номер 7(3), С. 45 - 45

Опубликована: Март 6, 2022

The study of the spatial differentiation COVID-19 in cities and its driving mechanism is helpful to reveal distribution pattern, transmission diffusion model, evolution epidemic can lay foundation for constructing dynamics model provide theoretical basis policy design, planning implementation prevention control social governance. Geodetector (Origin version, Beijing, China) a great tool analysis influencing factors, it provides decision support differentiated design executing city-specific policies. Using factor detection interaction Geodetector, 15 indicators economic, social, ecological, environmental dimensions were integrated, 143 selected empirical research China. shows that, first all, risks both infection death show positive autocorrelation, but geographical local autocorrelation differs significantly between two. Secondly, inequalities urban residential environments interact with heterogeneity, stronger explanatory power especially when multidimensional are superimposed. Thirdly, spread highly spatially heterogeneous correlated due complex influence multiple factors such as Area Urban Construction Land, GDP, Industrial Smoke Dust Emission, Expenditure having strongest influence, Green, Number Hospital Beds Parks, NOx Emissions unignorable while Free Parks Enterprises, Per-GDP, Population Density play an indirect role mainly by means interaction. Fourthly, effect from infected person's perspective nonlinear enhancement effect, that is, joint two greater than sum their direct influences; dead, two-factor maximum influences less sum. Fifthly, some suggestions put forward perspectives building healthy, resilient, safe, smart city, providing valuable reference city governments carry out design.

Язык: Английский

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