scholarly journals COVID-19 risk perceptions of social interaction and essential activities and inequity in the United States: Results from a nationally representative survey

Author(s):  
Daniel J. Erchick ◽  
Alexander J. Zapf ◽  
Prativa Baral ◽  
Jeffrey Edwards ◽  
Shruti H. Mehta ◽  
...  

ABSTRACTIntroductionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) related diagnoses, hospitalizations, and deaths have disproportionately affected disadvantaged communities across the United States. Few studies have sought to understand how risk perceptions related to social interaction and essential activities during the COVID-19 pandemic vary by sociodemographic factors, information that could inform targeted interventions to reduce inequities in access to care and information.MethodsWe conducted a nationally representative online survey of 1,592 adults in the United States to understand risk perceptions related to transmission of COVID-19 for various social and essential activities. We assessed relationships for each activity, after weighting to adjust for the survey design, using bivariate comparisons and multivariable logistic regression modeling, between responses of safe and unsafe, and participant characteristics, including age, gender, race, education, income, and political affiliation.ResultsHalf of participants were younger than 45 years (n=844, 53.0%), female (n=800, 50.3%), and White/Caucasian (n=685, 43.0%), Black/African American (n=410, 25.8%), or Hispanic/Latino (n=382, 24.0%). Risk perceptions of unsafe for 13 activities ranged from 29.2% to 73.5%. Large gatherings, indoor dining, and visits with elderly relatives had the highest proportion of unsafe responses (>58%) while activities outdoor, visiting the doctor or dentist, and going to the grocery store had the lowest (<36%). Older respondents were more likely to view social gatherings and indoor activities as unsafe, yet more likely to view activities such as going to the grocery store, participating in outdoor activities, visiting elderly relatives, and visiting the doctor or emergency room as safe. Compared to White/Caucasian respondents, Black/African American and Hispanic/Latino respondents were more likely to view activities such as dining and visiting friends outdoor as unsafe. Generally, men vs. women, Republicans vs. Democrats and independents, and individuals with higher vs. lower income were more likely to view activities as safe.ConclusionsThese findings suggest the importance of sociodemographic differences in risk perception, health behaviors, and access to information and health care when implementing efforts to control the COVID-19 pandemic. Further research should address how evidence-based interventions can be tailored considering these differences with a goal of increased health equity in the pandemic response.

2020 ◽  
pp. 002242942098252
Author(s):  
Justin J. West

The purpose of this study was to evaluate music teacher professional development (PD) practice and policy in the United States between 1993 and 2012. Using data from the nationally representative Schools and Staffing Survey (SASS) spanning these 20 years, I examined music teacher PD participation by topic, intensity, relevance, and format; music teachers’ top PD priorities; and the reach of certain PD-supportive policies. I assessed these descriptive results against a set of broadly agreed-on criteria for “effective” PD: content specificity, relevance, voluntariness/autonomy, social interaction, and sustained duration. Findings revealed a mixed record. Commendable improvements in content-specific PD access were undercut by deficiencies in social interaction, voluntariness/autonomy, sustained duration, and relevance. School policy, as reported by teachers, was grossly inadequate, with only one of the nine PD-supportive measures appearing on SASS reaching a majority of teachers in any given survey year. Implications for policy, practice, and scholarship are presented.


Author(s):  
Raghav Tripathi ◽  
Konrad D Knusel ◽  
Harib H Ezaldein ◽  
Jeremy S Bordeaux ◽  
Jeffrey F Scott

Abstract Background Limited information exists regarding the burden of emergency department (ED) visits due to scabies in the United States. The goal of this study was to provide population-level estimates regarding scabies visits to American EDs. Methods This study was a retrospective analysis of the nationally representative National Emergency Department Sample from 2013 to 2015. Outcomes included adjusted odds for scabies ED visits, adjusted odds for inpatient admission due to scabies in the ED scabies population, predictors for cost of care, and seasonal/regional variation in cost and prevalence of scabies ED visits. Results Our patient population included 416 017 218 ED visits from 2013 to 2015, of which 356 267 were due to scabies (prevalence = 85.7 per 100 000 ED visits). The average annual expenditure for scabies ED visits was $67 125 780.36. The average cost of care for a scabies ED visit was $750.91 (±17.41). Patients visiting the ED for scabies were most likely to be male children from lower income quartiles and were most likely to present to the ED on weekdays in the fall, controlling for all other factors. Scabies ED patients that were male, older, insured by Medicare, from the highest income quartile, and from the Midwest/West were most likely to be admitted as inpatients. Older, higher income, Medicare patients in large Northeastern metropolitan cities had the greatest cost of care. Conclusion This study provides comprehensive nationally representative estimates of the burden of scabies ED visits on the American healthcare system. These findings are important for developing targeted interventions to decrease the incidence and burden of scabies in American EDs.


2021 ◽  
pp. 003335492110094
Author(s):  
Jacqueline M. Ferguson ◽  
Hoda S. Abdel Magid ◽  
Amanda L. Purnell ◽  
Mathew V. Kiang ◽  
Thomas F. Osborne

Objective COVID-19 disproportionately affects racial/ethnic minority groups in the United States. We evaluated characteristics associated with obtaining a COVID-19 test from the Veterans Health Administration (VHA) and receiving a positive test result for COVID-19. Methods We conducted a retrospective cohort analysis of 6 292 800 veterans in VHA care at 130 VHA medical facilities. We assessed the number of tests for SARS-CoV-2 administered by the VHA (n = 822 934) and the number of positive test results (n = 82 094) from February 8 through December 28, 2020. We evaluated associations of COVID-19 testing and test positivity with demographic characteristics of veterans, adjusting for facility characteristics, comorbidities, and county-level area-based socioeconomic measures using nested generalized linear models. Results In fully adjusted models, veterans who were female, Black/African American, Hispanic/Latino, urban, and low income and had a disability had an increased likelihood of obtaining a COVID-19 test, and veterans who were Asian had a decreased likelihood of obtaining a COVID-19 test. Compared with veterans who were White, veterans who were Black/African American (risk ratio [RR] = 1.23; 95% CI, 1.19-1.27) and Native Hawaiian/Other Pacific Islander (RR = 1.13; 95% CI, 1.05-1.21) had an increased likelihood of receiving a positive test result. Hispanic/Latino veterans had a 43% higher likelihood of receiving a positive test result than non-Hispanic/Latino veterans did. Conclusions Although veterans have access to subsidized health care at the VHA, the increased risk of receiving a positive test result for COVID-19 among Black and Hispanic/Latino veterans, despite receiving more tests than White and non-Hispanic/Latino veterans, suggests that other factors (eg, social inequities) are driving disparities in COVID-19 prevalence.


2021 ◽  
Author(s):  
Dustin Gibson ◽  
Smisha Agarwal ◽  
Ankita Meghani ◽  
Rupali J. Limaye ◽  
Alain Labrique

AbstractBackgroundAt the time of this survey, September 1st, there were roughly 6 million COVID-19 cases and 176,771 deaths in the United States and no federally approved vaccine. The objective of this study was to explore the willingness to accept a COVID-19 vaccine in the United States and describe variability in this acceptability by key racial, ethnic and socio-demographic characteristics.MethodsThis was a cross-sectional digital survey that sampled participants from a nationally-representative panel maintained by a third party, Dynata. Dynata randomly sampled their database and emailed web-based surveys to United States residents ensuring the sample was matched to US Census estimates for age, race, gender, income, and Census region. Participants were asked how willing or unwilling they would be to: 1) receive a COVID-19 vaccine as soon as it was made publicly available, and 2) receive the influenza vaccine for the upcoming influenza season. Participants could respond with extremely willing, willing, unwilling, or extremely unwilling. For those who reported being unwilling to receive a COVID-19 vaccine, reasons for this hesitancy were captured. All participants were asked about where they obtain vaccine-related information, and which sources they trust most. Univariable and multivariable logistic regressions were conducted to examine the association of all demographic characteristics with willingness to receive COVID-19 vaccine.FindingsFrom September 1st to September 7, 2020, 1592 respondents completed the online survey. Overall, weighted analyses found that only 58.9% of the sample population were either willing or extremely willing to receive a COVID-19 vaccine as soon as it was made publicly available. In comparison, 67.7% of the respondents were willing or extremely willing to take the influenza vaccine. By gender, 66.1% of males and 51.5% of females were willing to receive a COVID-19 vaccine. Males were significantly more willing to receive a COVID-19 vaccine (adjusted odds ratio (OR)=1.98, 95% CI: 1.56, 2.53; p<0.001) than females. Blacks were the least willing racial/ethnic group (48.8%) Blacks, (aOR=0.59, 95%CI: 0.43, 0.80; p<0.001) were significantly less willing, than whites, to receive a COVID-19 vaccine. There were numerous reasons provided for being unwilling to receive a COVID-19 vaccine. The most common reason was concern about the vaccine’s safety (36.9%), followed by concerns over its efficacy (19.1%).InterpretationIn conclusion, we found that a substantial proportion (41%) of United States residents are unwilling to receive a COVID-19 vaccine as soon as one is made publicly available. We found that vaccine acceptance differs by sub-populations. In addition to sub-group differences in willingness to receive the vaccine, respondents provided a variety of reasons for being unwilling to receive the vaccine, driven by various sources of vaccine information (and misinformation). This compounds the challenge of delivering a safe and efficacious COVID-19 vaccine at a population level to achieve herd immunity. A multi-pronged and targeted communications and outreach effort is likely needed to achieve a high level of immunization coverage.


2005 ◽  
Vol 36 (2) ◽  
pp. 4-11 ◽  
Author(s):  
Keith B. Wilson

Vocational Rehabilitation (VR) research focusing on race, ethnicity and other demographic variables has continued to gain needed attention in the VR literature over the past ten years. In the study described here, the Chi-squared Automatic Interaction Detector (CHAID), an exploratory multivariate statistical tool from Answer Tree (SPSS, 2001), was used to investigate closure codes (statuses) with Race, Ethnicity, Age, and Gender. The test statistic revealed a statistically significant difference with the Hispanic ethnicity, age, and types of closures with the race (i.e., African American and White American) of customers in the United States VR system. Particularly, customers who are non-Hispanic (African Americans) between the ages of 51-60 are more likely not to be accepted for VR services (Status 08 from 02) and once accepted for VR services, close not rehabilitated (Statuses 28,30, & closed from pre-service, Status 38 from Status 04). Results further indicated that Black (African American) and White (European American) Hispanics in the United States VR system tend to have different experiences. Suggestions for VR counselors are discussed.


2020 ◽  
Vol 36 (9) ◽  
pp. 689-702
Author(s):  
Jennifer D Roberts ◽  
Katherine L Dickinson ◽  
Elizabeth Koebele ◽  
Lindsay Neuberger ◽  
Natalie Banacos ◽  
...  

In Spring/Summer 2020, most individuals living in the United States experienced several months of social distancing and stay-at-home orders because of the coronavirus (COVID-19) pandemic. Clinicians, restaurant cooks, cashiers, transit operators, and other essential workers (EWs), however, continued to work outside the home during this time in order to keep others alive and maintain a functioning society. In the United States, EWs are often low-income persons of color who are more likely to face socioeconomic vulnerabilities, systemic racism, and health inequities. To assess the various impacts of COVID-19 on EWs, an online survey was distributed to a representative sample of individuals residing in six states during May/June 2020. The sample included 990 individuals who identified as EWs and 736 nonessential workers (NWs). We assessed differences between EW and NW respondents according to three categories related to health equity and social determinants of health: (1) demographics (e.g. race/ethnicity); (2) COVID-19 exposure risk pathways (e.g. ability to social distance); and (3) COVID-19 risk perceptions (e.g. perceived risk of contracting COVID-19). EWs were more likely to be Black or Hispanic than NWs and also had lower incomes and education levels on average. Unsurprisingly, EWs were substantially more likely to report working outside the home and less likely to report social distancing and wearing masks indoors as compared to NWs. EWs also perceived a slightly greater risk of contracting COVID-19. These findings, which we discuss in the context of persistent structural inequalities, systemic racism, and health inequities within the United States, highlight ways in which COVID-19 exacerbates existing socioeconomic vulnerabilities faced by EWs.


2019 ◽  
Vol 46 (6) ◽  
pp. 1035-1044 ◽  
Author(s):  
Ann Oyare Amuta-Jimenez ◽  
Nafissatou Cisse-Egbounye ◽  
Wura Jacobs ◽  
Gabrielle P. A. Smith

Introduction. Most studies lump Black immigrants (BIs) and African Americans (AAs) as “Black/African American” during investigation. Such categorization assumes that the sociocultural determinants that influence BIs are the same as for AAs. This study attempts to disentangle the AA and BI subgroups to recognize the differences in cancer-related psychosocial characteristics and health behaviors. Methods. Merged data from the Health Information National Survey (2011–2017) were used. Two groups were created: those who identified as AA and those who identified as AA but were born outside the United States (BI). Between-group differences were assessed with Mann–Whitney U and chi-square tests. Results. Positive communication patterns with health care providers were significantly higher among AAs ( M [mean] = 3.41, SD [standard deviation] = 0.68) compared with BIs ( M = 3.28, SD = 0.71) ( p = .004). A greater proportion of BIs indicated that their health was excellent (14.2%), compared with AAs (7.9%). AAs reported higher cancer family history (75.1%) than BIs (46.5%). More AAs had smoked at least 100 cigarettes in their lifetime (41.5%) than BIs (16.7%). BIs consumed significantly more fruits each day ( M = 2.77, SD = 1.43) than AAs ( M = 2.40, SD = 1.44) ( p < .001). BIs also reported more physical activity ( M = 2.62, SD = 2.15) than AAs ( M = 2.37, SD = 2.18) ( p = .030). AA women were more likely to have had a pap smear test ( M = 2.07, SD = 1.44) compared with BI women ( M = 1.73, SD = 1.21) ( p = .002). Discussion. Evidence suggests the need to disentangle the “Black/African American” ethnic grouping. Lumping the BI populations together with the AAs, who have been in the United States for generations, may limit the ability to uncover and consequently address culturally driven disease prevention efforts and promote understanding of the biological, environmental, and psychosocial risk factors within Black heterogeneous populations.


2019 ◽  
Vol 22 (3) ◽  
pp. 307-316 ◽  
Author(s):  
Philip H Smith ◽  
Biruktawit Assefa ◽  
Simranpreet Kainth ◽  
Kaliris Y Salas-Ramirez ◽  
Sherry A McKee ◽  
...  

Abstract Introduction Previous qualitative reviews have summarized evidence of an association between menthol cigarette use and likelihood of smoking cessation. The objective of this meta-analysis was to provide a quantitative summary of effect sizes, their variability, and factors related to the variability in effect size for the association between menthol use and likelihood of smoking cessation. Methods We systematically searched Medline, PsycINFO, and Embase for prospective and cross-sectional studies of the association between menthol use and smoking cessation. We analyzed data with random effects meta-analyses and meta-regression. Results Our review identified 22 reports from 19 studies of the association between menthol use and cessation. All identified study samples included only US smokers, with one exception that included both Canadian and US smokers. Our overall model did not demonstrate a significant association between menthol use and cessation; however, menthol users were significantly less likely to quit among blacks/African American smokers (odds ratio = 0.88). Conclusions Among blacks/African Americans predominantly in the US menthol users have approximately 12% lower odds of smoking cessation compared to non-menthol users. This difference is likely the result of the tobacco industry’s ongoing marketing influence on the black/African American Community, suggesting that a menthol ban may have a unique public health benefit for black/African American smokers by encouraging quitting behavior. Implications This study adds a quantitative summary of the association between menthol cigarette use and smoking cessation in the United States. Findings of an association with lower likelihood of cessation among black/African American smokers, likely resulting from the tobacco industry’s marketing influence, support the ban of menthol flavoring as part of a comprehensive tobacco control effort to increase cessation among black/African American smokers.


2020 ◽  
Vol 37 (2) ◽  
pp. 169-192
Author(s):  
Dwight A. Radcliff

Abstract Using the idiomatic expression found in the United States, this essay contends that the current field of missiology is black-ish. The expression is used to describe something purports to be Black (African American), but upon close inspection may not be authentic to the culture. This essay seeks to examine the dearth of specifically African American contributions to missiology. Citing issues of internal structuring and epistemology, an argument is made that African American voices and culture are often lost in this maze constituted by a lack of uniformity within mission studies. Additionally, there is an existing catalogue of Black scholarship that deals, directly and indirectly, with mission but is often not given the same latitude of inclusion and review that White scholarship is afforded in the United States.


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