scholarly journals Standardized incidence ratio of the COVID-19 pandemic: a case study in a Midwestern state

2021 ◽  
Author(s):  
Emma Spors ◽  
Semhar Michael
Keyword(s):  
Major Change ◽  
Reference Population ◽  
The State ◽  
Mitigation Strategies ◽  
High Association ◽  
Death Rates ◽  
Indian Reservations ◽  
State Rate ◽  
Adjusted Rate ◽  
American Indian Reservations

ABSTRACTMotivationThe Coronavirus disease 2019 (COVID-19) has made a dramatic impact around the world, with some communities facing harsher outcomes than others. We sought to understand how counties in the state of South Dakota (SD) fared compared to expected based on a reference population and what factors contributed to negative outcomes from the pandemic in SD.MethodsThe Standardized Incidence Ratios (SIR) of all counties, using age-adjusted and crude adjusted hospitalization and death rates were computed using the SD age-adjusted rate as a reference population. In addition, a penalized generalized linear regression model was used to identify factors that are associated with COVID-19 hospitalization and death rates. This model was then used to compute a new SIR after controlling for other socio-demographic and -economic factors.ResultsWe identified counties that had more or less severe outcomes than what would be expected based on the rate of SD after age adjustment. Additionally, race, education, and testing rate were some of the significant factors associated with the outcome. The SIR values after controlling for these additional factors showed change in magnitude from the range of 4 times more severe to 1.5 times more severe out-come than what is expected. Interestingly the lower end of this interval did not have a major change.ConclusionThe age adjusted SIR model used in this study allowed for the identification of counties with more or less severe than what is expected based on the state rate. These counties tended to be those with high nonwhite percentage, which mostly included counties with American Indian reservations. Although several predictors are associated with hospitalization and deaths, the penalized model confirmed what is already reported in literature that race and education level have a very high association with the outcome variables. As can be expected the further adjusted SIR mostly changed in those counties with higher than expected outcomes. We believe that these results may provide useful information to improve the implementation of mitigation strategies to curb the damage of this or future pandemics by providing a way for data-driven resource allocation.

Indigenous Self-Governance and Development on American Indian Reservations

2021 ◽  
Vol 111 ◽  
pp. 233-237
Author(s):  
Dustin Frye ◽  
Dominic P. Parker
Keyword(s):  
American Indian ◽  
Indigenous People ◽  
Income Growth ◽  
Indian Reservations ◽  
Indian Reorganization Act ◽  
Trade Offs ◽  
Long Run ◽  
Per Capita ◽  
Will Self ◽  
American Indian Reservations

The UN Declaration on the Rights of Indigenous People promotes self-governance as a matter of justice rather than economics. How will self-governance affect the incomes of indigenous people? To gain insight, we compare long-run income growth on American Indian reservations with and without federal oversight through the 1934 Indian Reorganization Act. Reservations with more autonomy had 12-15 percent higher income per capita in 2016, even conditional on 1930s income. However, these more autonomous reservations also experienced wider income variance with more downside risk. The findings are consistent with theory emphasizing the development trade-offs between local and centralized governance.

scholarly journals Food Environments around American Indian Reservations: A Mixed Methods Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (8) ◽  
pp. e0161132 ◽  
Author(s):  
Gwen M. Chodur ◽  
Ye Shen ◽  
Stephen Kodish ◽  
Vanessa M. Oddo ◽  
Daniel A. Antiporta ◽  
...  
Keyword(s):  
Mixed Methods ◽  
American Indian ◽  
Mixed Methods Study ◽  
Food Environments ◽  
Indian Reservations ◽  
American Indian Reservations

scholarly journals Double Fortified Salt (DFS) Program in Uttar Pradesh, India: Lessons from the Implementation of a Salt Fortification Intervention in a Nutritionally Insecure Region (P10-098-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Shruthi Cyriac ◽  
Mduduzi Mbuya ◽  
Kriti Khurana ◽  
Reynaldo Martorell ◽  
Lynnette Neufeld
Keyword(s):  
Iron Deficiency ◽  
Population Distribution ◽  
Health Workers ◽  
Uttar Pradesh ◽  
The State ◽  
Mitigation Strategies ◽  
Communication Strategy ◽  
Deficiency Anemia ◽  
Full Potential ◽  
Depth Interviews

Abstract Objectives Iron deficiency prevalence is high in the state of Uttar Pradesh (UP), India. With an aim to reduce iron deficiency anemia, the state introduced double fortified salt (DFS) – salt fortified with iodine and iron – through its widespread network of fair price shops (FPS). FPS sell subsidized food grains among other goods to eligible households, and DFS was added to this package in 10 districts. In this study, we examined the coverage of the DFS program in UP and assessed the drivers/barriers to DFS utilization at the household level. Methods A midline coverage survey was conducted ∼8 months after program roll-out, in which data was collected from 1200 FPS cardholder households on their purchase and consumption of DFS. Additionally, in-depth interviews were administered to 10 household caregivers – to assess DFS consumption – as well as 20 FPS owners, 5 health workers, and 5 program staff – to examine the fidelity of DFS program implementation and identify programmatic bottlenecks. Results 82% of the households had heard of DFS and 70% had purchased it at least once. However, knowledge about DFS was sub-optimal - 81% of households had no knowledge of DFS benefits. High DFS purchase rates were not driven by higher consumption but by bundled FPS sales, where each item was sold only as part of a package and not individually. 37% of households typically used DFS in their cooking, and only 24% used DFS exclusively (no other salt present in the house). Several issues arising from poor DFS awareness were identified in the in-depth interviews – few understood why DFS turned their food darker; respondents said they could see ‘tiny stones in the salt’ (referring to the iron in the fortification premix). However, some households, especially in rural areas, adopted mitigation strategies to overcome DFS issues, like using it only for darker colored dishes. Conclusions DFS consumption was low among the population. Distribution through FPS, with state subsidies, made DFS available and affordable to households, but its benefits remain unknown and its potential unexplored. A strong communication strategy is missing in the program; habitual food practices and poor awareness levels are key barriers to regular DFS use. Limited implementation of awareness and behavior change campaigns related to DFS hampered the strategy from achieving its full potential. Funding Sources Bill and Melinda Gates Foundation.

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