A national evaluation of geographic accessibility and provider availability of obesity medicine diplomates in the United States between 2011 and 2019

AbstractImportanceAccess to testing is key to a successful response to the COVID-19 pandemic.ObjectiveTo determine the geographic accessibility to SARS-CoV-2 testing sites in the United States, as quantified by travel time.DesignCross-sectional analysis of SARS-CoV-2 testing sites as of April 7, 2020 in relation to travel time.SettingUnited States COVID-19 pandemic.ParticipantsThe United States, including the 48 contiguous states and the District of Columbia.ExposuresPopulation density, percent minority, percent uninsured, and median income by county from the 2018 American Community Survey demographic data.Main OutcomeSARS-CoV-2 testing sites identified in two national databases (Carbon Health and CodersAgainstCovid), geocoded by address. Median county 1 km2 gridded friction surface of travel times, as a measure of geographic accessibility to SARS-CoV-2 testing sites.Results6,236 unique SARS-CoV-2 testing sites in 3,108 United States counties were identified. Thirty percent of the U.S. population live in a county (N = 1,920) with a median travel time over 20 minutes. This was geographically heterogeneous; 86% of the Mountain division population versus 5% of the Middle Atlantic population lived in counties with median travel times over 20 min. Generalized Linear Models showed population density, percent minority, percent uninsured and median income were predictors of median travel time to testing sites. For example, higher percent uninsured was associated with longer travel time (β = 0.41 min/percent, 95% confidence interval 0.3-0.53, p = 1.2×10−12), adjusting for population density.Conclusions and RelevanceGeographic accessibility to SARS-Cov-2 testing sites is reduced in counties with lower population density and higher percent of minority and uninsured, which are also risk factors for worse healthcare access and outcomes. Geographic barriers to SARS-Cov-2 testing may exacerbate health inequalities and bias county-specific transmission estimates. Geographic accessibility should be considered when planning the location of future testing sites and interpreting epidemiological data.Key PointsSARS-CoV-2 testing sites are distributed unevenly in the US geography and population.Median county-level travel time to SARS-CoV-2 testing sites is longer in less densely populated areas, and in areas with a higher percentage of minority or uninsured populations.Improved geographic accessibility to testing sites is imperative to manage the COVID-19 pandemic in the United States.

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Geographic Accessibility to Clinical Trials for Advanced Cancer in the United States

JAMA Internal Medicine ◽

10.1001/jamainternmed.2014.6300 ◽

2015 ◽

Vol 175 (2) ◽

pp. 293 ◽

Cited By ~ 11

Author(s):

Matthew D. Galsky ◽

Kristian D. Stensland ◽

Russell B. McBride ◽

Asma Latif ◽

Erin Moshier ◽

...

Keyword(s):

United States ◽

Clinical Trials ◽

Advanced Cancer ◽

The United States ◽

Geographic Accessibility

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Party Strength in the United States: Some Corrections

The Journal of Politics ◽

10.1017/s0022381600041591 ◽

1975 ◽

Vol 37 (2) ◽

pp. 641-642 ◽

Cited By ~ 1

Author(s):

Paul T. David

Keyword(s):

United States ◽

The United States ◽

Party Strength

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Correlative microscopy in distrubuted (client/server) computing environments: tools for catalyzing the rapid dissemination of information about the cell biology of the human prostate

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100139780 ◽

1995 ◽

Vol 53 ◽

pp. 682-683

Author(s):

A. Hakam ◽

J.T. Gau ◽

M.L. Grove ◽

B.A. Evans ◽

M. Shuman ◽

...

Keyword(s):

United States ◽

Cell Biology ◽

Tissue Bank ◽

The United States ◽

Prostate Adenocarcinoma ◽

Correlative Microscopy ◽

Client Server ◽

Critical Elements ◽

Transplant Organ

Prostate adenocarcinoma is the most common malignant tumor of men in the United States and is the third leading cause of death in men. Despite attempts at early detection, there will be 244,000 new cases and 44,000 deaths from the disease in the United States in 1995. Therapeutic progress against this disease is hindered by an incomplete understanding of prostate epithelial cell biology, the availability of human tissues for in vitro experimentation, slow dissemination of information between prostate cancer research teams and the increasing pressure to “ stretch” research dollars at the same time staff reductions are occurring.To meet these challenges, we have used the correlative microscopy (CM) and client/server (C/S) computing to increase productivity while decreasing costs. Critical elements of our program are as follows:1) Establishing the Western Pennsylvania Genitourinary (GU) Tissue Bank which includes >100 prostates from patients with prostate adenocarcinoma as well as >20 normal prostates from transplant organ donors.

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Digital image acquisition, processing, and analysis in a polymer microscopy laboratory

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100170001 ◽

1994 ◽

Vol 52 ◽

pp. 454-455

Author(s):

Vinod K. Berry ◽

Xiao Zhang

Keyword(s):

United States ◽

Image Analysis ◽

Digital Image ◽

Image Acquisition ◽

Image Transmission ◽

The United States ◽

Quantitative Image Analysis ◽

Quantitative Image

In recent years it became apparent that we needed to improve productivity and efficiency in the Microscopy Laboratories in GE Plastics. It was realized that digital image acquisition, archiving, processing, analysis, and transmission over a network would be the best way to achieve this goal. Also, the capabilities of quantitative image analysis, image transmission etc. available with this approach would help us to increase our efficiency. Although the advantages of digital image acquisition, processing, archiving, etc. have been described and are being practiced in many SEM, laboratories, they have not been generally applied in microscopy laboratories (TEM, Optical, SEM and others) and impact on increased productivity has not been yet exploited as well.In order to attain our objective we have acquired a SEMICAPS imaging workstation for each of the GE Plastic sites in the United States. We have integrated the workstation with the microscopes and their peripherals as shown in Figure 1.

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Silence of the Land: On the Historical Irrelevance of Territory to Congressional Districting and Political Representation in the United States

Studies in American Political Development ◽

10.1017/s0898588x01010045 ◽

2001 ◽

Vol 15 (01) ◽

pp. 53-87 ◽

Cited By ~ 2

Author(s):

Andrew Rehfeld

Keyword(s):

United States ◽

House Of Representatives ◽

Political Representation ◽

The United States ◽

Representative Government ◽

Congressional District ◽

Congressional Districts ◽

Communities Of Interest

Every ten years, the United States “constructs” itself politically. On a decennial basis, U.S. Congressional districts are quite literally drawn, physically constructing political representation in the House of Representatives on the basis of where one lives. Why does the United States do it this way? What justifies domicile as the sole criteria of constituency construction? These are the questions raised in this article. Contrary to many contemporary understandings of representation at the founding, I argue that there were no principled reasons for using domicile as the method of organizing for political representation. Even in 1787, the Congressional district was expected to be far too large to map onto existing communities of interest. Instead, territory should be understood as forming a habit of mind for the founders, even while it was necessary to achieve other democratic aims of representative government.

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