scholarly journals 448. Disproportionate Burden of COVID-19 on Latinx Residents among Hospitalized Patients at San Francisco’s Public Health Hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S292-S292
Author(s):  
Vivek Jain ◽  
Lillian B Brown ◽  
Carina Marquez ◽  
Luis Rubio ◽  
Natasha Spottiswoode ◽  
...  
Keyword(s):  
Public Health ◽  
African American ◽  
San Francisco ◽  
Ethnic Disparities ◽  
Food Service ◽  
Lengths Of Stay ◽  
Hospital Deaths ◽  
Health Hospital ◽  
Disproportionate Burden ◽  
Overall Mortality

Abstract Background San Francisco implemented one of the earliest shelter-in-place public health mandates in the U.S., with flattened curves of diagnoses and deaths. We describe demographics, clinical features and outcomes of COVID-19 patients admitted to a public health hospital in a high population-density city with an early containment response. Methods We analyzed inpatients with COVID-19 admitted to San Francisco General Hospital (SFGH) from 3/5/2020–5/11/2020. SFGH serves a network of >63,000 patients (32% Latinx/24% Asian/19% African American/19% Caucasian). Demographic and clinical data through 5/18/2020 were abstracted from hospital records, along with ICU and ventilator utilization, lengths of stay, and in-hospital deaths. Results Of 157 admitted patients, 105/157 (67%) were male, median age was 49 (range 19-96y), and 127/157 (81%) of patients with COVID-19 were Latinx. Crowded living conditions were common: 60/157 (38%) lived in multi-family shared housing, 12/1578 (8%) with multigenerational families, and 8/157 (5%) were homeless living in shelters. Of 102 patients with ascertained occupations, most had frontline essential jobs: 23% food service, 14% construction/home maintenance, and 10% cleaning. Overall, 86/157 (55%) of patients lived in neighborhoods home to majority Latinx and African-American populations. Overall, 45/157 (29%) of patients needed ICU care, and 26/157 (17%) required mechanical ventilation; 20/26 (77%) of ventilated patients were successfully extubated, and 137/157 (87%) were discharged home. Median hospitalization duration was 4 days (IQR, 2–10), and only 6/157 (4%) patients died in hospital. Conclusion In San Francisco, where early COVID-19 mitigation was enacted, we report a stark, disproportionate COVID-19 burden on Latinx patients, who accounted for 81% of hospitalizations despite making up only 32% of the patient base and 15% of San Francisco’s total population. Latinx inpatients frequently lived in high-density settings, increasing household risk, and frequently worked essential jobs, potentially limiting the opportunity to effectively distance from others. We also report here favorable clinical outcomes and low overall mortality. However, an effective COVID-19 response must urgently address racial and ethnic disparities. Disclosures All Authors: No reported disclosures

scholarly journals Demographics and Incident Location of Gunshot Wounds at a Single Level I Trauma Center

2021 ◽  
Vol 14 ◽  
Author(s):  
Blair Benton ◽  
David Watson ◽  
Elizabeth Ablah ◽  
Kelly Lightwine ◽  
Ronda Lusk ◽  
...  
Keyword(s):  
African American ◽  
Racial Differences ◽  
Low Income ◽  
Trauma Center ◽  
Ethnic Disparities ◽  
Gunshot Wounds ◽  
Lengths Of Stay ◽  
Level I ◽  
Geographical Maps ◽  
National Trends

Introduction:  Little is known surrounding the demographic and geospatial factors of firearm-related traumas in the Midwest Region.  The purpose of this study was to describe the overall incidence of firearm-related traumas and examine any racial/ethnic disparities that may exist. Methods:  A retrospective review was conducted of all patients 14 years or older who were admitted with a gunshot wound (GSW) to a Level I trauma center between 2016 and 2017.  Results:  Forty-nine percent of patients were Caucasian, 26.5% African American, and 19.6% Hispanic/Latino.  Hispanic/Latino patients were the youngest (25.8 ± 8.8) and Caucasians were the oldest (34.3 ± 14.1, P = 0.002).  Compared to Caucasian patients, African American (42.0%) and Hispanic/Latino (54.1%) patients were more likely to be admitted to the intensive care unit (ICU) (P = 0.034) and experienced longer ICU lengths of stay (2.5 ± 6.3 and 2.4 ± 4.7, P = 0.031, respectively).  African American patients (96.0%) experienced more assaults while Caucasians were more likely to receive gunshot wounds accidentally (26.9%, P = 0.001).  More African American (86.0%) and Hispanic/Latino (89.2%) patients were injured with a handgun and Caucasians sustained the highest number of shotgun/rifle related injuries (16.1%, P = 0.012).  Most GSWs occurred in zip codes 67202, 67203, 67213, 67211, and 67214.  Geographical maps indicated that GSWs were concentrated in low-income areas and areas with high minority populations.                                                                                                                                                                                              Conclusions:  Racial differences were noted, however, unlike national trends, most of our patients were older Caucasian males.

Complaint-Oriented “Services”: Shelters as Tools for Criminalizing Homelessness

2021 ◽  
Vol 693 (1) ◽  
pp. 264-283
Author(s):  
Chris Herring
Keyword(s):  
Public Health ◽  
San Francisco ◽  
Homeless People ◽  
Public Spaces ◽  
Health Initiatives ◽  
Public Health Initiatives

This article argues that the expansion of shelter and welfare provisions for the homeless can lead to increased criminalization of homeless people in public spaces. First, I document how repression of people experiencing homelessness by the police in San Francisco neighborhoods increased immediately after the opening of new shelters. Second, I reveal how shelter beds are used as a privileged tool of the police to arrest, cite, and confiscate property of the unhoused, albeit in the guise of sanitary and public health initiatives. I conclude by considering how shelters increasingly function as complaint-oriented “services,” aimed at addressing the interests of residents, businesses, and politicians, rather than the needs of those unhoused.

scholarly journals A Geography of Risk: Structural Racism and COVID-19 Mortality in the United States

2021 ◽  
Author(s):  
Lauren C Zalla ◽  
Chantel L Martin ◽  
Jessie K Edwards ◽  
Danielle R Gartner ◽  
Grace A Noppert
Keyword(s):  
Minority Groups ◽  
Ethnic Disparities ◽  
The United States ◽  
Structural Racism ◽  
Public Health Response ◽  
Health Response ◽  
The Us ◽  
Racialized Minority ◽  
Racial And Ethnic Minority ◽  
Disproportionate Burden

Abstract Coronavirus disease 2019 (COVID-19) is disproportionately burdening racial and ethnic minority groups in the US. Higher risks of infection and mortality among racialized minorities are a consequence of structural racism, reflected in specific policies that date back centuries and persist today. Yet, our surveillance activities do not reflect what we know about how racism structures risk. When measuring racial and ethnic disparities in deaths due to COVID-19, the CDC statistically accounts for the geographic distribution of deaths throughout the US to reflect the fact that deaths are concentrated in areas with different racial and ethnic distributions than that of the larger US. In this commentary, we argue that such an approach misses an important driver of disparities in COVID-19 mortality, namely the historical forces that determine where individuals live, work, and play, and consequently determine their risk of dying from COVID-19. We explain why controlling for geography downplays the disproportionate burden of COVID-19 on racialized minority groups in the US. Finally, we offer recommendations for the analysis of surveillance data to estimate racial disparities, including shifting from distribution-based to risk-based measures, to help inform a more effective and equitable public health response to the pandemic.

Consequences of a match made in hell: the harm caused by menthol smoking to the African American population over 1980–2018

2021 ◽  
pp. tobaccocontrol-2021-056748 ◽  
Author(s):  
David Mendez ◽  
Thuy T T Le
Keyword(s):  
Public Health ◽  
African American ◽  
African Americans ◽  
Smoking Initiation ◽  
African American Community ◽  
American Population ◽  
The Public ◽  
African American Population ◽  
Menthol Cigarettes ◽  
Life Years

BackgroundFor many years, national surveys have shown a consistently disproportionately high prevalence of menthol smokers among African Americans compared with the general population. However, to our knowledge, no prior study has quantified the harm that menthol smoking has caused on that population. In this work, we estimate the public health harm that menthol cigarettes have caused to the African American community over the last four decades.MethodsUsing National Health Interview Survey data, we employed a well-established simulation model to reproduce the observed smoking trajectory over 1980–2018 in the African American population. Then, we repeat the experiment, removing the effects of menthol on the smoking initiation and cessation rates over that period, obtaining a new hypothetical smoking trajectory. Finally, we compared both scenarios to calculate the public health harm attributable to menthol cigarettes over 1980–2018.ResultsOur results show that menthol cigarettes were responsible for 1.5 million new smokers, 157 000 smoking-related premature deaths and 1.5 million life-years lost among African Americans over 1980–2018. While African Americans constitute 12% of the total US population, these figures represent, respectively, a staggering 15%, 41% and 50% of the total menthol-related harm.DiscussionOur results show that menthol cigarettes disproportionally harmed African Americans significantly over the last 38 years and are responsible for exacerbating health disparities among that population. Removing menthol cigarettes from the market would benefit the overall US population but, particularly, the African American community.

scholarly journals Do Black Lives Matter in the American Public’s Mitigation Responses to the Covid-19 Pandemic? A Cross-Sectional Analysis of Mask Wearing and Racial/ethnic Disparities in Deaths from COVID-19 in the United States

2021 ◽  
Author(s):  
Berkeley Franz ◽  
Adrienne Milner ◽  
Jomills H. Braddock
Keyword(s):  
Public Health ◽  
Residential Segregation ◽  
Ethnic Disparities ◽  
The United States ◽  
Ethnic Composition ◽  
Cross Sectional ◽  
Public Health Challenges ◽  
History Of ◽  
Sectional Analysis ◽  
Racial Ethnic

Abstract Background: Anti-black and anti-Hispanic attitudes in the U.S. must be included in efforts to understand resistance to public health measures, such as mask wearing, during the COVID-19 pandemic. Focusing on the structural and individual context of racism will enable us to improve public health and better prepare for future public health challenges. The purpose of this study was to determine the relationship between mask usage, racial segregation, and racial disparities in COVID-19 deaths.Methods: We used linear regression to assess whether the racial/ethnic composition of deaths and residential segregation predicted Americans’ decisions to wear masks in July 2020. Results: After controlling for mask mandates, mask usage increased when the White death rates relative to Black and Hispanic rates increased. Conclusions: Mask wearing may be shaped by an insensitivity to Black and Hispanic deaths and a corresponding unwillingness to engage in health protective behaviors. The broader history of systemic racism and residential segregation may also explain why white Americans do not wear masks or perceive themselves to be at risk when communities of color are disproportionately affected by COVID-19.

scholarly journals Tuberculosis with malaria or HIV co-infection in a large hospital in Luanda, Angola

2013 ◽  
Vol 7 (03) ◽  
pp. 269-272 ◽  
Author(s):  
Emília Valadas ◽  
Augusto Gomes ◽  
Ana Sutre ◽  
Sara Brilha ◽  
Afonso Wete ◽  
...  
Keyword(s):  
Public Health ◽  
Plasmodium Falciparum ◽  
Hospital Stay ◽  
Infection Rate ◽  
Current Data ◽  
Infection Rates ◽  
Large Hospital ◽  
Predominant Species ◽  
Integrated Approaches ◽  
Overall Mortality

Introduction: Three major public health problems, tuberculosis, malaria and HIV/AIDS, are widespread in Angola, often as co-infections in the same individual. In 2009, it was assumed that 44,151 new cases of TB occurred in Angola. Interestingly, interventions such as treatment/prevention of malaria appear to reduce mortality in HIV-infected and possibly TB co-infected patients. However, despite the seriousness of the situation, current data on TB and co-infection rates are scarce. This study aimed to characterize all TB cases seen at the Hospital Sanatório de Luanda, and to determine the co-infection rate with HIV and/or malaria. Methodology: This retrospective study collected demographic, diagnostic and clinical data from all patients admitted during 2007. Results: A total of 4,666 patients were admitted, of whom 1,906 (40.8%) were diagnosed with TB. Overall, 1,111 patients (58.3%) were male and most patients (n=1302, 68.3%) were adults (≥14 years). The rate of HIV co-infection was 37.4% (n=712).  Malaria was diagnosed during admission and hospital stay in 714 patients (37.5%), with Plasmodium falciparum the predominant species. Overall mortality was 15.2% (n=290). Conclusions: Because Luanda does not have the infrastructure to perform culture-based diagnosis of TB, confirmation of TB is problematic. The HIV-co-infection rate is high, with 37.4% of patients requiring integrated approaches to address this problem. With more than 1/3 of the TB patients co-infected with malaria, even during the hospital stay, the prevention of malaria in TB patients appears to be an effective way to reduce overall mortality.

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