scholarly journals The Effect of Area Deprivation on COVID-19 Risk in Louisiana

2020 ◽  
Author(s):  
Madhav KC ◽  
Evrim Oral ◽  
Susanne Straif-Bourgeois ◽  
Ariane L Rung ◽  
Edward S Peters
Keyword(s):  
Census Tract ◽  
The United States ◽  
Neighborhood Environment ◽  
Deprivation Index ◽  
Area Deprivation ◽  
Neighborhood Deprivation ◽  
Department Of Health ◽  
High Deprivation ◽  
Case Count ◽  
Deprived Neighborhoods

Purpose: Louisiana currently has the highest per capita case count for COVID-19 in the United States and disproportionately affects the Black or African American population. Neighborhood deprivation has been observed to be associated with poorer health outcomes. The purpose of this study was to examine the relationship between neighborhood deprivation and COVID-19 in Louisiana. Methods: The Area Deprivation Index (ADI) was calculated and used to classify neighborhood deprivation at the census tract level. A total of 17 US census variables were used to calculate the ADI for each of the 1148 census tracts in Louisiana. The data were extracted from the American Community Survey (ACS) 2018. The neighborhoods were categorized into quintiles as well as low and high deprivation. The publicly available COVID-19 cumulative case counts by census tract was obtained from the Louisiana Department of Health website on July 31, 2020. Descriptive and Poisson regression analyses were performed. Results: Neighborhoods in Louisiana were substantially different with respect to deprivation. The ADI ranged from 136.00 for the most deprived neighborhood and -33.87 in the least deprived neighborhood. We observed that individuals residing in the most deprived neighborhoods had a 45% higher risk of COVID-19 disease compared to those residing in the least deprived neighborhoods. Conclusion: While the majority of previous studies were focused on very limited socio-environmental factors such as crowding and income, this study used a composite area-based deprivation index to examine the role of neighborhood environment on COVID-19. We observed a positive relationship between neighborhood deprivation and COVID-19 risk in Louisiana. The study findings can be utilized to promote public health preventions measures besides social distancing, wearing a mask while in public and frequent handwashing in vulnerable neighborhoods with greater deprivation.

scholarly journals The effect of area deprivation on COVID-19 risk in Louisiana

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243028
Author(s):  
Madhav K. C. ◽  
Evrim Oral ◽  
Susanne Straif-Bourgeois ◽  
Ariane L. Rung ◽  
Edward S. Peters
Keyword(s):  
Census Tract ◽  
The United States ◽  
Neighborhood Environment ◽  
Deprivation Index ◽  
Area Deprivation ◽  
Neighborhood Deprivation ◽  
Department Of Health ◽  
High Deprivation ◽  
Case Count ◽  
Deprived Neighborhoods

Background Louisiana in the summer of 2020 had the highest per capita case count for COVID-19 in the United States and COVID-19 deaths disproportionately affects the African American population. Neighborhood deprivation has been observed to be associated with poorer health outcomes. The purpose of this study was to examine the relationship between neighborhood deprivation and COVID-19 in Louisiana. Methods The Area Deprivation Index (ADI) was calculated and used to classify neighborhood deprivation at the census tract level. A total of 17 US census variables were used to calculate the ADI for each of the 1148 census tracts in Louisiana. The data were extracted from the American Community Survey (ACS) 2018. The neighborhoods were categorized into quintiles as well as low and high deprivation. The publicly available COVID-19 cumulative case counts by census tract were obtained from the Louisiana Department of Health website on July 31, 2020. Descriptive and Poisson regression analyses were performed. Results Neighborhoods in Louisiana were substantially different with respect to deprivation. The ADI ranged from 136.00 for the most deprived neighborhood and –33.87 in the least deprived neighborhood. We observed that individuals residing in the most deprived neighborhoods had almost a 40% higher risk of COVID-19 compared to those residing in the least deprived neighborhoods. Conclusion While the majority of previous studies were focused on very limited socio-environmental factors such as crowding and income, this study used a composite area-based deprivation index to examine the role of neighborhood environment on COVID-19. We observed a positive relationship between neighborhood deprivation and COVID-19 risk in Louisiana. The study findings can be utilized to promote public health preventions measures besides social distancing, wearing a mask while in public and frequent handwashing in vulnerable neighborhoods with greater deprivation.

scholarly journals Excess 30-Day Heart Failure Readmissions and Mortality in Black Patients Increases With Neighborhood Deprivation

2020 ◽  
Vol 13 (12) ◽  
Author(s):  
Shivani A. Patel ◽  
Maya Krasnow ◽  
Kaitlyn Long ◽  
Theresa Shirey ◽  
Neal Dickert ◽  
...  
Keyword(s):  
United States ◽  
Heart Failure ◽  
Social Deprivation ◽  
The United States ◽  
Neighborhood Environment ◽  
Deprivation Index ◽  
Neighborhood Deprivation ◽  
Black And White ◽  
Black Patients ◽  
White Patients

Background: Longstanding racial disparities in heart failure (HF) outcomes exist in the United States, in part, due to social determinants of health. We examined whether neighborhood environment modifies the disparity in 30-day HF readmissions and mortality between Black and White patients in the Southeastern United States. Methods: We created a geocoded retrospective cohort of patients hospitalized for acute HF within Emory Healthcare from 2010 to 2018. Quartiles of the Social Deprivation Index characterized neighborhood deprivation at the census tract level. We estimated the relative risk of 30-day readmission and 30-day mortality following an index hospitalization for acute HF. Excess readmissions and mortality were estimated as the absolute risk difference between Black and White patients within each Social Deprivation Index quartile, adjusted for geographic clustering, demographic, clinical, and hospital characteristics. Results: The cohort included 30 630 patients, mean age 66 years, 48% female, 53% Black. Compared with White patients, Black patients were more likely to reside in deprived census tracts and have higher comorbidity scores. From 2010 to 2018, 29.4% of Black and 23.0% of White patients experienced either a 30-day HF readmission or 30-day death ( P <0.001). Excess in composite 30-day HF readmissions and mortality for Black patients ranged from 3.9% (95% CI, 1.5%–6.3%; P =0.0002) to 6.8% (95% CI, 4.1%–9.5%; P <0.0001) across Social Deprivation Index quartiles. Accounting for traditional risk factors did not eliminate the Black excess in combined 30-day HF readmissions or mortality in any of the neighborhood quartiles. Conclusions: Excess 30-day HF readmissions and mortality are present among Black patients in every neighborhood strata and increase with progressive neighborhood socioeconomic deprivation.

scholarly journals Geospatial analysis of neighborhood deprivation index (NDI) for the United States by county

2020 ◽  
Vol 16 (1) ◽  
pp. 101-112 ◽  
Author(s):  
Marcus R. Andrews ◽  
Kosuke Tamura ◽  
Sophie E. Claudel ◽  
Samantha Xu ◽  
Joniqua N. Ceasar ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Geospatial Analysis ◽  
Deprivation Index ◽  
Neighborhood Deprivation

scholarly journals Associations between Neighborhood Deprivation Index, Parent Perceptions and Preschooler Lifestyle Behaviors

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 959
Author(s):  
Carolina Bassul ◽  
Clare A. Corish ◽  
John M. Kearney
Keyword(s):  
Physical Activity ◽  
Dietary Intake ◽  
Heavy Traffic ◽  
Parental Perceptions ◽  
Neighborhood Environment ◽  
Deprivation Index ◽  
Age Group ◽  
Lifestyle Behaviors ◽  
Cross Sectional ◽  
Neighborhood Deprivation

Parental perceptions and use of neighborhood facilities are important factors that are related to children’s dietary intake and physical activity. The aim of this study was to examine the association between neighborhood deprivation index, parents’ perceptions of their neighborhood environment, and healthy/unhealthy markers of child dietary intake, physical activity, and TV screen time. This cross-sectional study was conducted in Dublin, Ireland. The lifestyle behaviors among children and parental perceptions of their neighborhood environment were reported by the parents of 276 children aged 3–5 years by using parent-completed questionnaires. Deprivation index was assessed using the geographic information system (GIS). Data were analyzed using binary logistic regression, adjusting for socio-demographic confounders. In adjusted models, high deprivation index was associated with parental perception of the neighborhood as unsafe for walking and cycling due to crime (OR 1.59, 95% CI 1.04–2.43, p = 0.031) and children’s low engagement in structured physical activity (OR 0.35, 95% CI 0.17–0.72, p = 0.004). Parental perceptions of an unsafe neighborhood due to heavy traffic were negatively correlated with children’s active play (OR 0.73, 95% CI 0.55–0.95, p = 0.022). Children whose parents reported high satisfaction with the number of local sit-in and takeaway restaurants were 41% more likely to consume confectionary/sugar sweetened beverages (SSBs) weekly. In this age group, parents play an important role in children’s lifestyle behaviors; therefore, a better understanding of parents’ perceptions and their use of neighborhood facilities could contribute to creating a healthy environment for this age group.

scholarly journals Relationship of Neighborhood Deprivation and Outcomes of a Comprehensive ST Elevation Myocardial Infarction Protocol

2021 ◽  
Author(s):  
Chetan P. Huded ◽  
Jarrod E. Dalton ◽  
Anirudh Kumar ◽  
Nikolas I. Krieger ◽  
Nicholas Kassis ◽  
...  
Keyword(s):  
Coronary Intervention ◽  
Area Deprivation ◽  
Neighborhood Deprivation ◽  
High Deprivation ◽  
Percutaneous Coronary ◽  
Hospital Patients ◽  
Observational Cohort ◽  
St Elevation ◽  
Door To Balloon ◽  
Relationship Of

ABSTRACT Background We evaluated whether a comprehensive STEMI protocol (CSP) focusing on guideline‐directed medical therapy, trans‐radial percutaneous coronary intervention (PCI), and rapid door to balloon time (D2BT) improves process and outcome metrics in patients with moderate or high socioeconomic deprivation. Methods and Results A total of 1761 patients with STEMI treated with PCI at a single hospital before (1/1/2011‐7/14/2014) and after (7/15/2014‐7/15/2019) CSP implementation were included in an observational cohort study. Neighborhood deprivation was assessed by the Area Deprivation Index and was categorized as low (≤ 50 th percentile; 29.0%), moderate (51‐90 th percentile; 40.8%), and high (>90 th percentile; 30.2%). The primary process outcome was D2BT. Achievement of guideline‐recommend D2BT goals improved in all deprivation groups pre‐ vs. post‐CSP (low: 67.8% vs. 88.5%; moderate: 50.7% vs. 77.6%; high: 65.5% vs. 85.6%; all p<0.001). Median D2BT among ED/in‐hospital patients was significantly non‐inferior in higher vs. lower deprivation groups post‐CSP (non‐inferiority limit = 5 minutes, p non‐inferiority high vs. moderate 0.002, high vs. low <0.001, moderate vs. low 0.02). In‐hospital mortality, the primary clinical outcome, was significantly lower post‐CSP in patients with moderate / high deprivation in unadjusted (pre‐CSP 7.0% vs. post‐CSP 3.1%, OR 0.42 [95% CI 0.25, 0.72], p=0.002) and risk‐adjusted (OR 0.42 [0.23, 0.77], p=0.005) models. Conclusions A CSP was associated with improved STEMI care across all deprivation groups and reduced mortality in those with moderate or high deprivation. Standardized initiatives to reduce care variability may mitigate social determinants of health in time‐sensitive conditions such as STEMI.

scholarly journals Built Environment and Preterm Birth

2014 ◽  
Vol 7 (3) ◽  
pp. 77-87
Author(s):  
Nikki Keene Woods ◽  
Linda Watson ◽  
An-Diep T Nguyen
Keyword(s):  
United States ◽  
Preterm Birth ◽  
Systems Approach ◽  
Health Resources ◽  
Preterm Births ◽  
The United States ◽  
Neighborhood Environment ◽  
Neighborhood Deprivation ◽  
Infant Deaths ◽  
Group Density

Background. Preterm birth affects approximately 500,000 babies a year in the United States. One out of nine babies born in the United States deliver before 37 weeks gestation. Preterm birth can cause lifelong neurological problems, cerebral palsy, vision and hearing impairments, and developmental delay. The estimated $26 billion a year in preterm birth related costs are staggering to the health care system. Preterm-related causes of death in 2008 together accounted for 35% of all infant deaths. Methods. This paper is a review of the literature published (2006-2012) on the relationship between neighborhood environment and preterm birth. Results. Neighborhood deprivation and the neighborhood environment were associated with low-birth weight and preterm birth. Examples of neighborhood deprivation include economic deprivation, social disorder, and lack of health resources. Neighborhood environment can be described as neighborhood physical deterioration, violent crime, and group density. Conclusions. A significant association exists between the neighborhood environment and birth outcomes. More research is needed to explore interventions with a systems approach to promote healthy maternal behavior, reduce stress, and improve care for expecting mothers living in stressful neighborhood environments in order to reduce preterm births.

scholarly journals Socioeconomic Position and the Incidence, Severity, and Clinical Outcomes of Hospitalized Patients With Community-Acquired Pneumonia

2020 ◽  
Vol 135 (3) ◽  
pp. 364-371 ◽  
Author(s):  
Timothy L. Wiemken ◽  
Ruth M. Carrico ◽  
Stephen P. Furmanek ◽  
Brian E. Guinn ◽  
William A. Mattingly ◽  
...  
Keyword(s):  
Socioeconomic Position ◽  
Population Based ◽  
Community Acquired Pneumonia ◽  
Community Level ◽  
Deprivation Index ◽  
Area Deprivation ◽  
High Deprivation ◽  
The Relationship ◽  
Long Term Mortality

Objectives The influence of socioeconomic disparities on adults with pneumonia is not well understood. The objective of our study was to evaluate the relationship between community-level socioeconomic position, as measured by an area deprivation index, and the incidence, severity, and outcomes among adults with community-acquired pneumonia (CAP). Methods This was an ancillary study of a population-based, prospective cohort study of patients hospitalized with CAP in Louisville, Kentucky, from June 1, 2013, through May 31, 2015. We used a race-specific, block group–level area deprivation index as a proxy for community-level socioeconomic position and evaluated it as a predictor of CAP incidence, CAP severity, early clinical improvement, 30-day mortality, and 1-year mortality. Results The cohort comprised 6349 unique adults hospitalized with CAP. CAP incidence per 100 000 population increased significantly with increasing levels of area deprivation, from 303 in tertile 1 (low deprivation), to 467 in tertile 2 (medium deprivation), and 553 in tertile 3 (high deprivation) ( P < .001). Adults in medium- and high-deprivation areas had significantly higher odds of severe CAP (tertile 2 odds ratio [OR] = 1.2 [95% confidence interval (CI), 1.06-1.39]; tertile 3 OR = 1.4 [95% CI, 1.18-1.64] and 1-year mortality (tertile 2 OR = 1.3 [95% CI, 1.11-1.54], tertile 3 OR = 1.3 [95% CI, 1.10-1.64]) than adults in low-deprivation areas. Conclusions Compared with adults residing in low-deprivation areas, adults residing in high-deprivation areas had an increased incidence of CAP, and they were more likely to have severe CAP. Beyond 30 days of care, we identified an increased long-term mortality for persons in high-deprivation areas. Community-level socioeconomic position should be considered an important factor for research in CAP and policy decisions.

scholarly journals Neighborhood Disadvantage, Cognition, and Health Self-Efficacy of Older Adults in a Clinical Population

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 483-484
Author(s):  
Kristen Berg ◽  
Nikolas I Krieger ◽  
Douglas Einstadter ◽  
Lorella Shamakian ◽  
Jarrod Dalton ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Functioning ◽  
Health Risks ◽  
Self Efficacy ◽  
The United States ◽  
Neighborhood Environment ◽  
Clinical Population ◽  
Area Deprivation ◽  
Cognitive Screening ◽  
Disadvantaged Neighborhoods

Abstract The Medicare Annual Wellness Visit (MWV) includes an assessment of health risks for older adults in the United States. Research suggests that neighborhood-level social inequality influences multiple health outcomes. We sought to examine the association between neighborhood socioeconomic position and older adults’ cognition, health management self-efficacy, and other health risks. We identified a cohort of 12,434 adults aged 65 and over from the NEOCARE Learning Health Registry who attended a routine MWV between 2011 and 2019. NEOCARE includes electronic health record and neighborhood data from 1999-2017 on over 3 million unique Northeast Ohio individuals. The study population was 60% White, 32% Black or African American, 64% female, and 90% non-Hispanic. Over 60% were ages 65-74, 29% 75-84, and 10% 85 years or older (range from 65 to 101). We used ANOVA and chi square tests to examine variation in health risks by quintile of census tract area deprivation index. Cognitive functioning differed across quintiles of area deprivation and Bonferroni-corrected tests indicated that adults in the most socioeconomically disadvantaged neighborhoods had lower average cognitive screening scores as compared to older adults in less disadvantaged areas (F=53.50, df=4, n=12,204, p&lt;.001). The proportion of adults feeling efficacious in managing their health differed according to area deprivation, with adults in more disadvantaged neighborhoods having slightly lower self-efficacy, (x2=11.01, df=8, n=11,937, p&lt;.001). Better understanding of the relationship between cognitive functioning and health self-efficacy and neighborhood environment is critical for designing programmatic and policy interventions aimed at supporting proactive aging in older adulthood.

1673-P: The Neighborhood Deprivation Index and Provider Geocoding Identify Critical Catchment Areas for Diabetes Outreach Programs

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1673-P
Author(s):  
ASHBY F. WALKER ◽  
HUI HU ◽  
NICOLAS CUTTRISS ◽  
MICHAEL J. HALLER ◽  
C. JASON WANG ◽  
...  
Keyword(s):  
Deprivation Index ◽  
Neighborhood Deprivation ◽  
Outreach Programs ◽  
Catchment Areas

Restoring Damaged Relationships Through the Art of Invitation: Application with Addicted Incarcerated Women

2019 ◽  
Vol 46 (3) ◽  
Author(s):  
Katti J. Sneed ◽  
Debbie Teike
Keyword(s):  
Human Services ◽  
Addiction Treatment ◽  
The United States ◽  
Incarcerated Women ◽  
Relationship Building ◽  
Health And Human Services ◽  
Guiding Principle ◽  
Faith Based ◽  
Department Of Health ◽  
Complementary Approach

This article presents a description of Art of Invitation as a complementary approach to traditional addiction treatment through the alignment of Art of Invitation (AOI) with Substance Abuse and Mental Health Services Administration (SAMHSA) Ten Guiding Principles for Recovery.  AOI is a faith based relationship building approach that combines key Judeo/Christian teachings with relationship building tools, skills, and concepts for those seeking to build and restore relationships.  SAMHSA, as the leading agency within the U.S. Department of Health and Human Services, spearheads public health efforts to advance behavioral health within the United States.  Each Guiding Principle is presented along with a description of how AOI is shared with incarcerated women, an often neglected population, participating in an inpatient treatment program housed in a community corrections facility.

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