Geographically-targeted COVID-19 vaccination is more equitable than age-based thresholds alone

AbstractCOVID-19 mortality increases dramatically with age and is also substantially higher among Black, Indigenous, and People of Color (BIPOC) populations in the United States. These two facts introduce tradeoffs because BIPOC populations are younger than white populations. In analyses of California and Minnesota--demographically divergent states--we show that COVID vaccination schedules based solely on age benefit the older white populations at the expense of younger BIPOC populations with higher risk of death from COVID-19. We find that strategies that prioritize high-risk geographic areas for vaccination at all ages better target mortality risk than age-based strategies alone, although they do not always perform as well as direct prioritization of high-risk racial/ethnic groups.One-sentence summaryAge-based COVID-19 vaccination prioritizes white people above higher-risk others; geographic prioritization improves equity.

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PM2.5 polluters disproportionately and systemically affect people of color in the United States

Science Advances ◽

10.1126/sciadv.abf4491 ◽

2021 ◽

Vol 7 (18) ◽

pp. eabf4491

Author(s):

Christopher W. Tessum ◽

David A. Paolella ◽

Sarah E. Chambliss ◽

Joshua S. Apte ◽

Jason D. Hill ◽

...

Keyword(s):

United States ◽

Rural Areas ◽

The United States ◽

People Of Color ◽

Emission Sources ◽

Particulate Air Pollution ◽

Fine Particulate ◽

Exposure Levels ◽

Urban And Rural Areas ◽

Racial Ethnic

Racial-ethnic minorities in the United States are exposed to disproportionately high levels of ambient fine particulate air pollution (PM2.5), the largest environmental cause of human mortality. However, it is unknown which emission sources drive this disparity and whether differences exist by emission sector, geography, or demographics. Quantifying the PM2.5 exposure caused by each emitter type, we show that nearly all major emission categories—consistently across states, urban and rural areas, income levels, and exposure levels—contribute to the systemic PM2.5 exposure disparity experienced by people of color. We identify the most inequitable emission source types by state and city, thereby highlighting potential opportunities for addressing this persistent environmental inequity.

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Association of 152 Biomarker Reference Intervals with All-Cause Mortality in Participants of a General United States Survey from 1999 to 2010

Clinical Chemistry ◽

10.1093/clinchem/hvaa271 ◽

2020 ◽

Author(s):

Nam Pho ◽

Arjun K Manrai ◽

John T Leppert ◽

Glenn M Chertow ◽

John P A Ioannidis ◽

...

Keyword(s):

United States ◽

Mortality Risk ◽

Diagnostic Tests ◽

Serum Alkaline Phosphatase ◽

The United States ◽

Reference Intervals ◽

Mortality Data ◽

Distribution Width ◽

Risk Of Death ◽

All Cause Mortality

Abstract Background Physicians sometimes consider whether or not to perform diagnostic testing in healthy people, but it is unknown whether nonextreme values of diagnostic tests typically encountered in such populations have any predictive ability, in particular for risk of death. The goal of this study was to quantify the associations among population reference intervals of 152 common biomarkers with all-cause mortality in a representative, nondiseased sample of adults in the United States. Methods The study used an observational cohort derived from the National Health and Nutrition Examination Survey (NHANES), a representative sample of the United States population consisting of 6 survey waves from 1999 to 2010 with linked mortality data (unweighted N = 30 651) and a median followup of 6.1 years. We deployed an X-wide association study (XWAS) approach to systematically perform association testing of 152 diagnostic tests with all-cause mortality. Results After controlling for multiple hypotheses, we found that the values within reference intervals (10–90th percentiles) of 20 common biomarkers used as diagnostic tests or clinical measures were associated with all-cause mortality, including serum albumin, red cell distribution width, serum alkaline phosphatase, and others after adjusting for age (linear and quadratic terms), sex, race, income, chronic illness, and prior-year healthcare utilization. All biomarkers combined, however, explained only an additional 0.8% of the variance of mortality risk. We found modest year-to-year changes, or changes in association from survey wave to survey wave from 1999 to 2010 in the association sizes of biomarkers. Conclusions Reference and nonoutlying variation in common biomarkers are consistently associated with mortality risk in the US population, but their additive contribution in explaining mortality risk is minor.

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Early Mortality in Patients With Muscle-Invasive Bladder Cancer Undergoing Cystectomy in the United States

JNCI Cancer Spectrum ◽

10.1093/jncics/pky075 ◽

2018 ◽

Vol 2 (4) ◽

Cited By ~ 5

Author(s):

Kathryn E Marqueen ◽

Nikhil Waingankar ◽

John P Sfakianos ◽

Reza Mehrazin ◽

Scot A Niglio ◽

...

Keyword(s):

United States ◽

Bladder Cancer ◽

High Risk ◽

Mortality Risk ◽

Cross Validation ◽

The United States ◽

Early Mortality ◽

Muscle Invasive Bladder Cancer ◽

Muscle Invasive ◽

Quality Adjusted Life

Abstract Background Although radical cystectomy (RC) is a standard treatment for muscle-invasive bladder cancer (MIBC), for many patients the risks versus benefits of RC may favor other approaches. We sought to define the landscape of early postcystectomy mortality in the United States and identify patients at high risk using pretreatment variables. Methods We identified patients with MIBC (cT2-T4aN0M0) who underwent RC without perioperative chemotherapy within the National Cancer Database (2003–2012). Using multistate multivariable modeling, we calculated time spent in three health states: hospitalized, discharged, and death more than 90 days postcystectomy. Cross-validation was performed by geographic region. Time spent in each state was weighted by utility to determine 90-day quality-adjusted life days (QALDs). Results Among 7922 patients, 90-day mortality was 7.6% (8.0% for lower and 6.7% for higher volume hospitals). Increasing age, clinical T stage, Charlson Comorbidity Index, and lower volume were associated with higher 90-day mortality and were included in the model. Cross-validation revealed appropriate performance (C-statistics of 0.53–0.74; calibration slopes of 0.50–1.67). The model predicted 25% of patients had a 90-day mortality risk higher than 10%, and observed 90-day mortality in this group was 14.0% (95% CI = 12.5% to 15.6%). Mean quality-adjusted life days (QALDs) was 63 (range = 44–68). Conclusions RC is associated with relatively high early mortality risk. Pretreatment variables may identify patients at particularly high risk, which may inform clinical trial design, facilitate shared decision making, and enhance quality improvement initiatives.

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How USA-Centric Is Psychology? An Archival Study of Implicit Assumptions of Generalizability of Findings to Human Nature Based on Origins of Study Samples

Social Psychological and Personality Science ◽

10.1177/1948550620927269 ◽

2020 ◽

Vol 11 (7) ◽

pp. 928-937 ◽

Cited By ~ 1

Author(s):

Bobby K. Cheon ◽

Irene Melani ◽

Ying-yi Hong

Keyword(s):

United States ◽

Sampling Bias ◽

The United States ◽

American Population ◽

White People ◽

White American ◽

Cultural Minorities ◽

Research Findings ◽

Racial Ethnic ◽

Archival Study

Conclusions about human behavior are primarily based upon observations from western, educated, industrialized, rich, and democratic (WEIRD) samples, especially from the United States. One consequence may be the promotion of assumptions that research findings from these populations are more generalizable to humankind than findings from non-WEIRD populations. We tested this with an archival study comparing the extent to which titles of over 5,000 published psychology articles specify samples’ racial/ethnic/national/cultural characteristics—a practice that implies constraints to generalizability. We observed that samples from the United States were less frequently specified in titles compared to both other WEIRD and non-WEIRD regions. Yet, samples from the United States (compared to other regions) were more frequently specified in titles if they referred to racial/ethnic/cultural minorities who may be perceived as exceptions to assumed generalizability of the White American population. These findings suggest that one consequence of a USA-centric sampling bias in psychology may be biased assumptions of (White) people from the United States as especially reflective of humankind.

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Responding to the introduction of high-risk exotic pests in the United States — the supporting role of New Pest Response Guidelines

10.1603/ice.2016.111163 ◽

2016 ◽

Author(s):

Godshen Robert Pallipparambil

Keyword(s):

United States ◽

High Risk ◽

The United States ◽

Exotic Pests ◽

New Pest

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1488-P: Closing the Racial/Ethnic Disparity Gap in Kidney Failure from Diabetes in the United States, 2000-2016

Diabetes ◽

10.2337/db20-1488-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 1488-P

Author(s):

NILKA RIOS BURROWS ◽

YAN ZHANG ◽

ISRAEL A. HORA ◽

MEDA E. PAVKOV ◽

GIUSEPPINA IMPERATORE

Keyword(s):

United States ◽

Kidney Failure ◽

The United States ◽

Ethnic Disparity ◽

Racial Ethnic

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Faculty Opinions recommendation of Outcomes and temporal trends among high-risk patients after lung transplantation in the United States.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718000892.793475030 ◽

2013 ◽

Author(s):

Keith Meyer

Keyword(s):

United States ◽

High Risk ◽

Lung Transplantation ◽

Temporal Trends ◽

The United States ◽

High Risk Patients ◽

Risk Patients

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The Politics of US Latino Literature and American Realism

The Oxford Handbook of American Literary Realism ◽

10.1093/oxfordhb/9780190642891.013.14 ◽

2019 ◽

pp. 231-248

Author(s):

Ramón J. Guerra

Keyword(s):

United States ◽

Social Justice ◽

Mexican Revolution ◽

The United States ◽

Spanish American ◽

Spanish American War ◽

Men And Women ◽

Latino Literature ◽

The Common ◽

Racial Ethnic

This chapter examines the development of Latino literature in the United States during the time when realism emerged as a dominant aesthetic representation. Beginning with the Treaty of Guadalupe Hidalgo (1848) and including the migrations resulting from the Spanish-American War (1898) and the Mexican Revolution (1910), Latinos in the United States began to realistically craft an identity served by a sense of displacement. Latinos living in the United States as a result of migration or exile were concerned with similar issues, including but not limited to their predominant status as working-class, loss of homeland and culture, social justice, and racial/ethnic profiling or discrimination. The literature produced during the latter part of the nineteenth century by some Latinos began to merge the influence of romantic style with a more socially conscious manner to reproduce the lives of ordinary men and women, draw out the specifics of their existence, characterize their dialects, and connect larger issues to the concerns of the common man, among other realist techniques.

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Racial and Sex Disparities in Trauma Outcomes Based on Geographical Region

The American Surgeon ◽

10.1177/0003134820960063 ◽

2020 ◽

pp. 000313482096006

Author(s):

William Q. Duong ◽

Areg Grigorian ◽

Cyrus Farzaneh ◽

Jeffry Nahmias ◽

Theresa Chin ◽

...

Keyword(s):

United States ◽

The United States ◽

Trauma Patients ◽

Improvement Program ◽

Trauma Outcomes ◽

Risk Of Death ◽

Hospital Access ◽

Risk Of Mortality ◽

Sex Disparities ◽

Male Patients

Objectives Disparities in outcomes among trauma patients have been shown to be associated with race and sex. The purpose of this study was to analyze racial and sex mortality disparities in different regions of the United States, hypothesizing that the risk of mortality among black and Asian trauma patients, compared to white trauma patients, will be similar within all regions in the United States. Methods The Trauma Quality Improvement Program (2010-2016) was queried for adult trauma patients, separating by U.S. Census regions. Multivariable logistic regression analyses were performed for each region, controlling for known predictors of morbidity and mortality in trauma. Results Most trauma patients were treated in the South (n = 522 388, 40.7%). After risk adjustment, black trauma patients had a higher associated risk of death in all regions, except the Northeast, compared to white trauma patients. The highest associated risk of death for blacks (vs. whites) was in the Midwest (odds ratio [OR] 1.30, P < .001). Asian trauma patients only had a higher associated risk of death in the West (OR 1.39, P < .001). Male trauma patients, compared to women, had an increased associated risk of mortality in all four regions. Discussion This study found major differences in outcomes among different races within different regions of the United States. There was also both an increased rate and associated risk of mortality for male patients in all regions. Future prospective studies are needed to identify what regional differences in trauma systems including population density, transport times, hospital access, and other trauma resources explain these findings.

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