Prevalence of COVID-19 in Louisiana and Its Association With Race, Concentrated Disadvantage, Chronic Disease Prevalence and Other Social Determinants of Health

Abstract Background Multisector collaboration between state health departments (SHDs) and diverse community partners is increasingly recognized as important for promoting positive public health outcomes, addressing social determinants of health, and reducing health inequalities. This study investigates collaborations between SHDs and different types of organizations addressing chronic disease in and outside of the health sector. Methods SHD employees were randomly selected from the National Association of Chronic Disease Directors membership list for participation in an online survey. Participants were asked about their primary chronic disease work unit (cancer, obesity, tobacco, diabetes, cardiovascular disease, and others), as well as their work unit collaborations (exchange of information/cooperation in activities) with organizations in health and non-health sectors. As a measure of the different organizations SHDs collaborated with in health and non-health sectors, a collaboration heterogeneity score for each program area was calculated. One-way ANOVA with Tukey’s post hoc tests were used to assess differences in collaborator heterogeneity between program areas. Results A total of 574 participants were surveyed. Results indicated the cancer program area, along with diabetes and cardiovascular disease, had significantly less collaboration heterogeneity with organizations outside of the health sector compared to the obesity and tobacco program areas. Conclusions Evidence suggests that to address social determinants of health and promote health equity, increased public health collaborations with diverse non-health sector community-based settings is critical.

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Impact of Social Determinants of Health and Demographics on Refill Requests by Medicare Patients Using a Conversational Artificial Intelligence Text Messaging Solution: Cross-Sectional Study

JMIR mhealth and uhealth ◽

10.2196/15771 ◽

2019 ◽

Vol 7 (11) ◽

pp. e15771 ◽

Cited By ~ 1

Author(s):

Rena Brar Prayaga ◽

Ridhika Agrawal ◽

Benjamin Nguyen ◽

Erwin W Jeong ◽

Harmony K Noble ◽

...

Keyword(s):

Artificial Intelligence ◽

Chronic Disease ◽

Social Determinants Of Health ◽

Social Determinants ◽

Patient Population ◽

Text Messaging ◽

Determinants Of Health ◽

English Speakers ◽

Kaiser Permanente ◽

Race Ethnicity

Background Nonadherence among patients with chronic disease continues to be a significant concern, and the use of text message refill reminders has been effective in improving adherence. However, questions remain about how differences in patient characteristics and demographics might influence the likelihood of refill using this channel. Objective The aim of this study was to evaluate the efficacy of an SMS-based refill reminder solution using conversational artificial intelligence (AI; an automated system that mimics human conversations) with a large Medicare patient population and to explore the association and impact of patient demographics (age, gender, race/ethnicity, language) and social determinants of health on successful engagement with the solution to improve refill adherence. Methods The study targeted 99,217 patients with chronic disease, median age of 71 years, for medication refill using the mPulse Mobile interactive SMS text messaging solution from December 2016 to February 2019. All patients were partially adherent or nonadherent Medicare Part D members of Kaiser Permanente, Southern California, a large integrated health plan. Patients received SMS reminders in English or Spanish and used simple numeric or text responses to validate their identity, view their medication, and complete a refill request. The refill requests were processed by Kaiser Permanente pharmacists and support staff, and refills were picked up at the pharmacy or mailed to patients. Descriptive statistics and predictive analytics were used to examine the patient population and their refill behavior. Qualitative text analysis was used to evaluate quality of conversational AI. Results Over the course of the study, 273,356 refill reminders requests were sent to 99,217 patients, resulting in 47,552 refill requests (17.40%). This was consistent with earlier pilot study findings. Of those who requested a refill, 54.81% (26,062/47,552) did so within 2 hours of the reminder. There was a strong inverse relationship (r10=−0.93) between social determinants of health and refill requests. Spanish speakers (5149/48,156, 10.69%) had significantly lower refill request rates compared with English speakers (42,389/225,060, 18.83%; X21 [n=273,216]=1829.2; P<.001). There were also significantly different rates of refill requests by age band (X26 [n=268,793]=1460.3; P<.001), with younger patients requesting refills at a higher rate. Finally, the vast majority (284,598/307,484, 92.23%) of patient responses were handled using conversational AI. Conclusions Multiple factors impacted refill request rates, including a strong association between social determinants of health and refill rates. The findings suggest that higher refill requests are linked to language, race/ethnicity, age, and social determinants of health, and that English speakers, whites, those younger than 75 years, and those with lower social determinants of health barriers are significantly more likely to request a refill via SMS. A neural network–based predictive model with an accuracy level of 78% was used to identify patients who might benefit from additional outreach to narrow identified gaps based on demographic and socioeconomic factors.

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4405 Chronic Disease in Indiana – Using a Community Health Matrix to Determine Health Factors for Indiana Counties

Journal of Clinical and Translational Science ◽

10.1017/cts.2020.263 ◽

2020 ◽

Vol 4 (s1) ◽

pp. 82-83

Author(s):

Sarah Wiehe ◽

Aaron Zych ◽

Karen Hinshaw ◽

Ann Alley ◽

Gina Claxton ◽

...

Keyword(s):

Lung Cancer ◽

Cardiovascular Disease ◽

Chronic Disease ◽

Health Outcomes ◽

Social Determinants Of Health ◽

Social Determinants ◽

Determinants Of Health ◽

Health Priorities ◽

Evidence Based ◽

Evidence Based Programs

OBJECTIVES/GOALS: The goal of this project was to inform four chronic disease initiatives, working together on the team Connections IN Health, and counties in Indiana on certain areas of need to assist them in collaborative planning. The chronic diseases focused on include diabetes, cardiovascular disease, stroke, asthma, lung cancer and obesity. METHODS/STUDY POPULATION: Chronic disease health outcomes and social determinants of health indicators were identified in all 92 Indiana counties. Counties were compared by composite z scores in a matrix to determine the 23 counties with the poorest health statistics for diabetes, cardiovascular disease, stroke, asthma, lung cancer, obesity and life expectancy. Qualitative data were used to identify local health coalitions that have the capacity and desire to work with Connections IN Health to improve these health outcomes. With input from partners, the counties were narrowed to 10 that were identified as those with the most need in the specific areas of chronic disease that the initiatives focus on. The team will begin listening sessions with two of these counties to identify strategic partnerships, funding sources, and evidence-based programs to address community-identified health priorities. RESULTS/ANTICIPATED RESULTS: The 23 counties with the poorest health outcomes related to chronic disease and factors were Blackford, Clark, Clay, Fayette, Fulton, Grant, Greene, Howard, Jay, Jennings, Knox, Lake, LaPorte, Madison, Marion, Pike, Scott, Starke, Sullivan, Vanderburgh, Vermillion, Vigo, and Washington. There was significant overlap in low z score rankings for individual health and social determinants of health measures among these 23 counties. The following 10 counties were selected for focus in the next five years based on partner input: Blackford, Clay, Grant, Jennings, Lake, Madison, Marion, Starke, Vermillion, and Washington. The Connections IN Health team has initiated listening sessions in Grant and Vermillion Counties (with data for presentation at the ACTS meeting). DISCUSSION/SIGNIFICANCE OF IMPACT: This mixed methods approach using existing data and partner input on county capacity/readiness directed Connections IN Health to counties with the most need for coalition efforts. Engagement within each county will inform next steps (e.g., capacity building, partnership development, applications for funding, implementation of evidence-based programs) and specific health focus area(s).

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Exploring civil society leadership to advance action on the social determinants of health

PsycEXTRA Dataset ◽

10.1037/e515722013-001 ◽

2008 ◽

Author(s):

Susan McCunn

Keyword(s):

Civil Society ◽

Social Determinants Of Health ◽

Social Determinants ◽

Determinants Of Health ◽

The Social

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Invited presentation; Psychological and social determinants of health among Mexican immigrants in the U.S.

PsycEXTRA Dataset ◽

10.1037/e566792012-012 ◽

2010 ◽

Author(s):

V. Nelly Salgado de Snyder ◽

Gabriela Martorell

Keyword(s):

Social Determinants Of Health ◽

Social Determinants ◽

Mexican Immigrants ◽

Determinants Of Health ◽

The U.S

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Uncovering the social determinants of health

PsycEXTRA Dataset ◽

10.1037/e673532010-001 ◽

2010 ◽

Author(s):

Lydia Buki

Keyword(s):

Social Determinants Of Health ◽

Social Determinants ◽

Determinants Of Health ◽

The Social

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Addressing the Social Determinants of Health

Southern California Quarterly ◽

10.1525/scq.2019.101.4.357 ◽

2019 ◽

Vol 101 (4) ◽

pp. 357-395 ◽

Cited By ~ 1

Author(s):

Saty Satya-Murti ◽

Jennifer Gutierrez

Keyword(s):

Twentieth Century ◽

Los Angeles ◽

Social Determinants Of Health ◽

Social Determinants ◽

Social Activism ◽

Determinants Of Health ◽

Medical Attention ◽

Community Center ◽

Early Twentieth Century ◽

The Social

The Los Angeles Plaza Community Center (PCC), an early twentieth-century Los Angeles community center and clinic, published El Mexicano, a quarterly newsletter, from 1913 to 1925. The newsletter’s reports reveal how the PCC combined walk-in medical visits with broader efforts to address the overall wellness of its attendees. Available records, some with occasional clinical details, reveal the general spectrum of illnesses treated over a twelve-year span. Placed in today’s context, the medical care given at this center was simple and minimal. The social support it provided, however, was multifaceted. The center’s caring extended beyond providing medical attention to helping with education, nutrition, employment, transportation, and moral support. Thus, the social determinants of health (SDH), a prominent concern of present-day public health, was a concept already realized and practiced by these early twentieth-century Los Angeles Plaza community leaders. Such practices, although not yet nominally identified as SDH, had their beginnings in the late nineteenth- and early twentieth-century social activism movement aiming to mitigate the social ills and inequities of emerging industrial nations. The PCC was one of the pioneers in this effort. Its concerns and successes in this area were sophisticated enough to be comparable to our current intentions and aspirations.

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