Socioeconomic Status and Race Outperform Concussion History and Sport Participation in Predicting Collegiate Athlete Baseline Neurocognitive Scores

2017 ◽  
Vol 24 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Zac Houck ◽  
Breton Asken ◽  
James Clugston ◽  
William Perlstein ◽  
Russell Bauer
Keyword(s):  
Socioeconomic Status ◽  
African American ◽  
Collegiate Athletes ◽  
Older Age ◽  
Football Players ◽  
Black African ◽  
Speed Performance ◽  
History Of ◽  
Concussion History ◽  
African American Race

AbstractObjectives: The purpose of this study was to assess the contribution of socioeconomic status (SES) and other multivariate predictors to baseline neurocognitive functioning in collegiate athletes. Methods: Data were obtained from the Concussion Assessment, Research and Education (CARE) Consortium. Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) baseline assessments for 403 University of Florida student-athletes (202 males; age range: 18–23) from the 2014–2015 and 2015–2016 seasons were analyzed. ImPACT composite scores were consolidated into one memory and one speed composite score. Hierarchical linear regressions were used for analyses. Results: In the overall sample, history of learning disability (β=−0.164; p=.001) and attention deficit–hyperactivity disorder (β=−0.102; p=.038) significantly predicted worse memory and speed performance, respectively. Older age predicted better speed performance (β=.176; p<.001). Black/African American race predicted worse memory (β=−0.113; p=.026) and speed performance (β=−.242; p<.001). In football players, higher maternal SES predicted better memory performance (β=0.308; p=.007); older age predicted better speed performance (β=0.346; p=.001); while Black/African American race predicted worse speed performance (β=−0.397; p<.001). Conclusions: Baseline memory and speed scores are significantly influenced by history of neurodevelopmental disorder, age, and race. In football players, specifically, maternal SES independently predicted baseline memory scores, but concussion history and years exposed to sport were not predictive. SES, race, and medical history beyond exposure to brain injury or subclinical brain trauma are important factors when interpreting variability in cognitive scores among collegiate athletes. Additionally, sport-specific differences in the proportional representation of various demographic variables (e.g., SES and race) may also be an important consideration within the broader biopsychosocial attributional model. (JINS, 2018, 24, 1–10)

Multivariate Base Rates of Low Scores and Reliable Decline on ImPACT in Healthy Collegiate Athletes Using CARE Consortium Norms

2019 ◽  
Vol 25 (09) ◽  
pp. 961-971 ◽  
Author(s):  
Zac M. Houck ◽  
Breton M. Asken ◽  
Russell M. Bauer ◽  
Anthony P. Kontos ◽  
Michael A. McCrea ◽  
...  
Keyword(s):  
Collegiate Athletes ◽  
Cognitive Testing ◽  
Chi Square ◽  
Reliable Change ◽  
Black African ◽  
Hyperactivity Disorder ◽  
Base Rates ◽  
African American Athletes ◽  
Concussion History ◽  
Composite Scores

AbstractObjectives: To describe multivariate base rates (MBRs) of low scores and reliable change (decline) scores on Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) in college athletes at baseline, as well as to assess MBR differences among demographic and medical history subpopulations. Methods: Data were reported on 15,909 participants (46.5% female) from the NCAA/DoD CARE Consortium. MBRs of ImPACT composite scores were derived using published CARE normative data and reliability metrics. MBRs of sex-corrected low scores were reported at &lt;25th percentile (Low Average), &lt;10th percentile (Borderline), and ≤2nd percentile (Impaired). MBRs of reliable decline scores were reported at the 75%, 90%, 95%, and 99% confidence intervals. We analyzed subgroups by sex, race, attention-deficit/hyperactivity disorder and/or learning disability (ADHD/LD), anxiety/depression, and concussion history using chi-square analyses. Results: Base rates of low scores and reliable decline scores on individual composites approximated the normative distribution. Athletes obtained ≥1 low score with frequencies of 63.4% (Low Average), 32.0% (Borderline), and 9.1% (Impaired). Athletes obtained ≥1 reliable decline score with frequencies of 66.8%, 32.2%, 18%, and 3.8%, respectively. Comparatively few athletes had low scores or reliable decline on ≥2 composite scores. Black/African American athletes and athletes with ADHD/LD had higher rates of low scores, while greater concussion history was associated with lower MBRs (p &lt; .01). MBRs of reliable decline were not associated with demographic or medical factors. Conclusions: Clinical interpretation of low scores and reliable decline on ImPACT depends on the strictness of the low score cutoff, the reliable change criterion, and the number of scores exceeding these cutoffs. Race and ADHD influence the frequency of low scores at all cutoffs cross-sectionally.

scholarly journals Re-operation within 30 days of radical cystectomy: Identifying high-risk patients and complications using ACS-NSQIP database

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Rashid K. Sayyid ◽  
Diana Magee ◽  
Amanda E. Hird ◽  
Benjamin T. Harper ◽  
Eric Webb ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bladder Cancer ◽  
African American ◽  
High Risk ◽  
Radical Cystectomy ◽  
High Risk Patients ◽  
Metastatic Bladder Cancer ◽  
Risk Patients ◽  
History Of ◽  
African American Race

Introduction: Radical cystectomy (RC) is a highly morbid procedure, with 30-day complication rates approaching 31%. Our objective was to determine risk factors for re-operation within 30 days following a RC for non-metastatic bladder cancer. Methods: We included all patients who underwent a RC for non-metastatic bladder cancer using The American College of Surgeons National Surgical Quality Improvement Program database between January 1, 2007 and December 31, 2014. Logistic regression analyses were used to evaluate predictors of re-operation. Results: A total of 2608 patients were included; 5.8% of patients underwent re-operation within 30 days. On multivariable analysis, increasing body mass index (BMI) (odds ratio [OR] 1.04; 95% confidence interval [CI] 1.01–1.07), African-American race (vs. Caucasian OR 2.29; 95% CI 1.21–4.34), and history of chronic obstructive pulmonary disease (COPD) (OR 2.33; 95% CI 1.45–3.74) were significant predictors of re-operation within 30 days of RC. Urinary diversion type (ileal conduit vs. continent) and history of chemotherapy or radiotherapy within 30 days prior to RC were not. Patients who underwent re-operation within this timeframe had a significantly higher mortality rate (4.0% vs. 1.6%) and were more likely to experience cardiac (7.2% vs. 1.9%), pulmonary (23.0% vs. 3.0%), neurological (2.0% vs. 0.49%), and venous thromboembolic events (10.5% vs. 5.4%), as well as infectious complications (64.5% vs. 24.1%) with a significantly longer hospital length of stay (16.5 vs. 7.0 days). Conclusions: Recognizing increasing BMI, COPD, and African-American race as risk factors for re-operation within 30 days of RC will allow urologists to preoperatively identify such high-risk patients and prompt them to adopt more aggressive approaches to minimize postoperative surgical complications.

scholarly journals The Impact of Diabetes and African American Race in COVID-19 Severity

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A350-A351
Author(s):  
Marilyn A Arosemena ◽  
Athalia Pyzer ◽  
Jovian Yu ◽  
Blake Flood ◽  
Sherin Rouhani ◽  
...  
Keyword(s):  
African American ◽  
Pearson Correlation ◽  
Severity Index ◽  
Older Age ◽  
Moderate Severity ◽  
High Severity ◽  
Significant Difference ◽  
The Impact ◽  
The Relationship ◽  
African American Race

Abstract Introduction: COVID-19, an illness caused by the novel coronavirus usually presents as a mild to moderate flu like illness, but can lead to pneumonia, acute respiratory distress syndrome and death in some patients. Since the onset of the COVID-19 pandemic there has been special attention towards patients with diabetes. Not only is diabetes highly prevalent in patients with COVID-19, but diabetes has been reported as a significant predictor of morbidity and mortality. Furthermore, race seems to be a predictor of severity with black people dying at 2.3 times the rate of white people. Methods: Here we performed a retrospective study of 524 cases of COVID-19 at an academic center in Chicago between March 2020 until August 2020. Data were obtained from patients that consented to the study to examine the relationship between diabetes, BMI, age, and race with degree of COVID-19 severity. Not all patients had all clinical and demographic data available. COVID-19 severity was determined using a severity index obtained from the measured SpO2 divided by the FiO2/fraction of inspired oxygen times 100. Numbers ≥ 315 mmHg were defined as low severity with patients generally requiring outpatient care, while 235–314 mm Hg were classified as moderate severity generally requiring inpatient care and≤ 234 mm Hg indicated high severity generally requiring intubation/ICU care. The Pearson correlation coefficient was used for linear correlation analyses. Proportion for categorical values were compared using the Chi squared test, the means for continuous variables were compared using two-tailed t tests or one way ANOVA (with Tukey post-test) for comparisons involving more than two conditions. A multiple linear regression model was used to assess the contribution of different variables. Differences were considered statistically significant at p&lt;0.05 Results: Among 120 patients with an A1c, 55 (46%) patients had diabetes and 65 (54%) did not have diabetes. More patients with a high severity index were seen in the cohort with diabetes compared to those without diabetes (72% compared to 28% p=0.004). Univariate analyses revealed statistically significant positive correlations with higher COVID-19 severity and older age, BMI, and African American race. ANOVA analysis revealed a statistically significant difference between increasing BMI and worse severity category with a BMI mean of 29.3 kg/m2 in the low severity category compared to 34.9 kg/m2 in the moderate severity category (p=0.006). A multi-variate analysis adjusting for all variables revealed that A1c, older age and race were positively associated with higher COVID-19 severity. Conclusion: Increased A1c, older age and race are positively and independently associated with a higher COVID-19 severity index. Further research regarding the relationship between COVID-19 and these associations is urgently needed.

scholarly journals Prenatal Hemoglobinopathy Screening Practices: Areas for Improvement

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 2298-2298
Author(s):  
Scott Moerdler ◽  
Ellen Fraint ◽  
Ellen Silver ◽  
Siobhan M Dolan ◽  
Kafui A Demasio ◽  
...  
Keyword(s):  
African American ◽  
Family History ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Prenatal Screening ◽  
Sickle Cell Trait ◽  
Cell Disease ◽  
Black African ◽  
Screening Practices ◽  
History Of

Background: Sickle cell disease is one of the most common inherited red blood cell disorders, yet many are not aware of their carrier status (Treadwell, J Nat Med Assoc, 2006), which can lead to confusion around pregnancy and newborn diagnosis. Furthermore, data is emerging about the severe and life-threatening risks of sickle cell trait (Kark, NEJM, 1987 and Olaniran, Am J Nephro, 2019). The American College of Obstetricians and Gynecologists' guidelines recommend that pregnant women of African, Mediterranean and Southeast Asian descent be screened for hemoglobinopathies with a complete blood count (CBC) and hemoglobin electrophoresis (ACOG, Opinion #691, 2017). However, adherence to this practice and frequency of improper screening with Sickledex is unknown. Proper screening and counseling can impact families' knowledge and allow them to establish relationships with hematology providers earlier. Objectives: We sought to assess prenatal hemoglobinopathy screening practice patterns and methods of Obstetrics & Gynecology (OBGYN) and Family Medicine (FM) providers in the Tri-State regional area. Methods: A cross-sectional electronic survey was administered to OBGYN and FM practitioners from six tri-state area institutions using publicly available information and contacts at each institution. Questions focused on prenatal hemoglobinopathy screening practices using case scenarios with variations on parental trait status and ethnicities. Chi-square analyses were used to compare the two provider groups on categorical variables. Results: There were 167 total responses; 120 surveys were complete, of which 87 were OBGYN and 33 FM providers. Respondents were mainly faculty (69/120, 58%) and from academic medical centers (n=107). 42% of providers reported that they ask "76-100%" of their patients about a personal history of sickle cell disease or trait. When asked about the proportion of pregnant patients with a positive family history of a hemoglobinopathy, there was a significant difference between OBGYN and FM providers, with 95% of OBGYN providers responding that they screen "76-100%" of those patients as opposed to only 75% of FM providers screening with the same frequency (p=0.0034). When asked about screening practices for patients without a personal/family history of a hemoglobinopathy, OBGYN providers consistently screen more frequently (Figure 1). When analyzed by ethnic background, screening practices were significantly different only between the subspecialty providers who "always" or "often" screened for hemoglobinopathies in mothers of Asian descent (p=0.03). Over 73% of providers report that they "always" screen patients of Mediterranean, Asian, and Middle Eastern descent and 84% always screen patients of Black descent. Over 30% of all respondents said they would use Sickledex for screening in case scenarios for a Black/African American mother, even when it was already known that she is a sickle cell carrier. In cases where the mother's hemoglobinopathy status was unknown, over 80% of providers responded that they would "always" evaluate with a hemoglobin electrophoresis regardless of Black/African American or Mediterranean descent. In terms of referrals to Hematology, in a case where both parents have sickle cell trait 46% of providers would "never" refer that family to Hematology. Conclusion: This pilot survey highlights differences in the methods and likelihood of prenatal hemoglobinopathy screening based on the type of prenatal care provider. Screening differences can lead to variations in prenatal guidance, diagnostic procedures, informed decision-making and knowledge of families referred to pediatric hematology clinics. This is the first study analyzing prenatal screening for hemoglobinopathies in OBGYN and FM. This study demonstrates that not all prenatal providers adhere to existing ACOG recommendations regarding which patients to screen for hemoglobinopathies and suggests an actionable area in which to enhance education for prenatal providers. Specifically, providers need to be educated that the use of Sickledex is an inappropriate laboratory screening test, since it will not detect other hemoglobinopathies. Improving prenatal screening practices by collaborating with hematologists may increase adherence to guidelines and allow for earlier relationship building with hematology. Figure 1 Disclosures Manwani: GBT: Consultancy, Research Funding; Novartis: Consultancy; Pfizer: Consultancy.

Health disparity in Central Valley of California: Higher incidence of breast cancer in Asian population.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19029-e19029
Author(s):  
Soujanya Sodavarapu ◽  
Kate Hatter ◽  
Megha Goyal ◽  
Prakash Ramdass ◽  
Majed Sayedi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Socioeconomic Status ◽  
African American ◽  
Ductal Carcinoma ◽  
Central Valley ◽  
Asian Population ◽  
Foreign Born ◽  
Recurrence Rates ◽  
History Of ◽  
The Impact

e19029 Background: California has the most immigrants of any state in the U.S., with approximately a quarter of the residents being foreign-born. The impact of migration on breast cancer incidences over time has not yet been characterized in the Northern Central Valley. This provides a unique opportunity to study the influence of migration, socioeconomic gradient, and racial identity on the incidence of breast cancer in San Joaquin County. Methods: This study was a retrospective, single-institution study that compared the socio-demographic variables and clinical characteristics of the patients who had a history of breast cancer in a teaching central valley hospital. We reviewed all charts with a breast cancer diagnosis from 2014-2019. We compared age, demographics, socioeconomic status comorbidities, pathology, treatment, and outcomes. Appropriate statistics have been used to analyze the data. Results: A retrospective chart review of all patients with a diagnosis of breast cancer from 2014-2019 at a central valley teaching hospital. 33.5% were white, 17.2% African American, 26.6% Hispanic, and 22.6% were Asian. Migrated Asian women are having three times increased incidence in central California compared to their peers in Asian. Additionally, those of lower socioeconomic status were more often affected (61.9% vs. 30.4% of middle-class status) in our population. Demographics and comorbidities were studied. Smoking was seen in 23.2% of patients, alcohol in 16.3%, hypertension in 43.6%, Diabetes in 18.9%, lung disease in 11.7%, and Kidney disease in 6.9%. 23.8% of the patients had a family history of cancer. Screening was only done in 41% of patients, and the distribution of race was as follows: white 10.6%, African American 7.7%, Hispanic 8.9%, Asian 8.9%. It was found that infiltrating ductal carcinoma was seen in 54.8% of patients, of which 16.1% were white, 10% African American, 15.5% Hispanic, and 13.2% were Asian. Triple-negative breast cancer was seen in 14.9% in our patient population. We further reviewed treatment methods, including chemotherapy, radiation, and surgery, as well as recurrence rates. Conclusions: We suggest that screening has to be more concentrated in all communities. The fact that the Asian population in the Central Valley shows higher rates of breast cancer could be due to epigenetic, western lifestyle, and environmental factors. Higher awareness and willingness as a subgroup may be contributing as well or there may be an actual increase; this requires further investigation, and we will present further subgroup analysis at presentation.

Disparities in Telemedicine Access: A Cross-Sectional Study of a Newly Established Infrastructure during the COVID-19 Pandemic

2021 ◽  
Vol 12 (03) ◽  
pp. 445-458
Author(s):  
Vivian Hsiao ◽  
Thevaa Chandereng ◽  
Robin L. Lankton ◽  
Jeffrey A. Huebner ◽  
Jeffrey J. Baltus ◽  
...  
Keyword(s):  
African American ◽  
Health Care Access ◽  
Digital Literacy ◽  
Geographic Region ◽  
Secondary Outcome ◽  
Primary Study ◽  
Patient Portal ◽  
Cross Sectional ◽  
Black African ◽  
African American Race

Abstract Background The COVID-19 pandemic led to dramatic increases in telemedicine use to provide outpatient care without in-person contact risks. Telemedicine increases options for health care access, but a “digital divide” of disparate access may prevent certain populations from realizing the benefits of telemedicine. Objectives The study aimed to understand telemedicine utilization patterns after a widespread deployment to identify potential disparities exacerbated by expanded telemedicine usage. Methods We performed a cross-sectional retrospective analysis of adults who scheduled outpatient visits between June 1, 2020 and August 31, 2020 at a single-integrated academic health system encompassing a broad range of subspecialties and a large geographic region in the Upper Midwest, during a period of time after the initial surge of COVID-19 when most standard clinical services had resumed. At the beginning of this study period, approximately 72% of provider visits were telemedicine visits. The primary study outcome was whether a patient had one or more video-based visits, compared with audio-only (telephone) visits or in-person visits only. The secondary outcome was whether a patient had any telemedicine visits (video-based or audio-only), compared with in-person visits only. Results A total of 197,076 individuals were eligible (average age = 46 years, 56% females). Increasing age, rural status, Asian or Black/African American race, Hispanic ethnicity, and self-pay/uninsured status were significantly negatively associated with having a video visit. Digital literacy, measured by patient portal activation status, was significantly positively associated with having a video visit, as were Medicaid or Medicare as payer and American Indian/Alaskan Native race. Conclusion Our findings reinforce previous evidence that older age, rural status, lower socioeconomic status, Asian race, Black/African American race, and Hispanic/Latino ethnicity are associated with lower rates of video-based telemedicine use. Health systems and policies should seek to mitigate such barriers to telemedicine when possible, with efforts such as digital literacy outreach and equitable distribution of telemedicine infrastructure.

scholarly journals Examining the Role of Family History of US Enslavement in Health Care System Distrust Today

2021 ◽  
Vol 31 (3) ◽  
pp. 417-424
Author(s):  
Lorraine T. Dean ◽  
Genee S. Smith
Keyword(s):  
Health Care ◽  
African American ◽  
Family History ◽  
African Americans ◽  
Health Care System ◽  
The United States ◽  
Black African ◽  
The Us ◽  
History Of ◽  
Care System

Objective: Black/African American people have long reported high, albeit warranted, distrust of the US health care system (HCS); however, Blacks/African Americans are not a homogenous racial/ethnic group. Little in­formation is available on how the subgroup of Black Americans whose families suffered under US chattel slavery, here called De­scendants of Africans Enslaved in the United States (DAEUS), view health care institu­tions. We compared knowledge of unethical treatment and HCS distrust among DAEUS and non-DAEUS.Design and Setting: A cross-sectional random-digit dialing survey was adminis­tered in 2005 to Blacks/African Americans, aged 21-75 years, from the University of Pennsylvania Clinical Practices in Philadel­phia, Penn.Participants: Blacks/African Americans self-reported a family history of persons enslaved in the US (DAEUS) or no family history of persons enslaved in the US (non- DAEUS).Main Outcome Measures: HCS distrust was measured by a validated scale assessing perceptions of unethical experimentation and active or passive discrimination.Methods: We compared responses to the HCS distrust scale using Fisher’s exact and t-tests.Results: Of 89 respondents, 57% self-re­ported being DAEUS. A greater percentage of DAEUS reported knowledge of unethical treatment than non-DAEUS (56% vs 21%; P<.001), were significantly more likely to express distrust, and to endorse the pres­ence of covert (eg, insurance-based) than overt forms (eg, race-based) of discrimina­tion by the HCS.Conclusions: DAEUS express greater HCS distrust than non-DAEUS, patterned by awareness of unethical treatment and passive discrimination. Understanding how long-term exposure to US institutions influ­ences health is critical to resolving dispari­ties for all Black/African American groups. Rectifying past injustices through repara­tive institutional measures may improve DAEUS’ trust and engagement with the US HCS.Ethn Dis. 2021:31(3):417-424; doi:10.18865/ed.31.3.417

scholarly journals Concussion History and Postconcussion Neurocognitive Performance and Symptoms in Collegiate Athletes

2008 ◽  
Vol 43 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Tracey Covassin ◽  
David Stearne ◽  
Robert Elbin
Keyword(s):  
Reaction Time ◽  
Processing Speed ◽  
Verbal Memory ◽  
Visual Memory ◽  
Collegiate Athletes ◽  
Neurocognitive Performance ◽  
Significant Group ◽  
Repeated Measures Design ◽  
History Of ◽  
Concussion History

Abstract Context: Athletes are at an inherent risk for sustaining concussions. Research examining the long-term consequences of sport-related concussion has been inconsistent in demonstrating lingering neurocognitive decrements that may be associated with a previous history of concussion. Objective: To determine the relationship between concussion history and postconcussion neurocognitive performance and symptoms in collegiate athletes. Design: Repeated-measures design. Setting: Multi-center analysis of collegiate athletes. Patients or Other Participants: Fifty-seven concussed collegiate athletes (36 without concussion history, 21 with a history of 2 or more concussions). Intervention(s): All subjects were administered an Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) neurocognitive test battery, which measures verbal memory, visual memory, reaction time, and visual processing speed and 22 concussion symptoms. Main Outcome Measure(s): Subjects who sustained a concussion were administered 2 follow-up tests at days 1 and 5 postinjury. Independent variables were history of concussion (no history of concussion, 2 or more concussions) and time (baseline, day 1 postconcussion, or day 5 postconcussion). Results: A within-subjects effect (time) on ImPACT performance (P &lt; .001), a between-subjects multivariate effect of group (P &lt; .001), and a group-by-time interaction (P  =  .034) were noted. Athletes with a concussion history performed significantly worse on verbal memory (P  =  .01) and reaction time (P  =  .023) at day 5 postconcussion compared with athletes who did not report a previous concussion. No significant group differences were seen at day 5 postinjury on visual memory (P  =  .167), processing speed (P  =  .179), or total concussion symptoms (P  =  .87). Conclusions: Concussed collegiate athletes with a history of 2 or more concussions took longer to recover verbal memory and reaction time than athletes without a history of concussion.

scholarly journals Who’s Vaccinated? A Closer Look at Healthcare Workers’ COVID-19 Vaccine Hesitancy and Demographics

2021 ◽  
pp. 1-7
Author(s):  
Mary Fossen ◽  
Margaret Bethany ◽  
Sanjay Modak ◽  
Sally Parris ◽  
Rohit Modak
Keyword(s):  
African American ◽  
Odds Ratio ◽  
Vaccination Rate ◽  
Vaccine Hesitancy ◽  
Black African ◽  
Demographic Groups ◽  
Vaccination Rates ◽  
Hospital Employees ◽  
American Employees ◽  
African American Race

Abstract Objective: To compare COVID-19 vaccine hesitancy among hospital employees by demographics. Methods: Our institution has offered an mRNA COVID-19 vaccine to all employees since January 2021. We collected data on vaccination rates among hospital employees and looked for differences in demographic groups to determine in which groups vaccine hesitancy is the highest. Those who received at least one dose of vaccine were considered “vaccinated” for this study. Results: There was a 71% vaccination rate among all hospital employees as of March 10, 2021. Age over 50 (odds ratio 1.85, 95% CI 1.53 to 2.24, p<0.01), working in a clinical department (odds ratio 1.19, 95% CI 1.01 to 1.42, p = 0.02), and white race compared to black/African American race (odds ratio 4.55, 95% CI 3.74 to 5.52, p<0.01) were all significant factors for receiving vaccination. Gender (odds ratio 1.12, 95% CI 0.94 to 1.35, p=0.10) was not significant. Conclusions: In a population with equal access to the COVID-19 vaccine, there were significant differences in vaccination rates among different demographic groups. Employees under 50 years of age, non-clinical employees, and black/African American employees were less likely to be vaccinated. This suggests that attitudes towards vaccination, and not simply access to the vaccine, are factors in vaccination rates.

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