scholarly journals A tiger in the Upper Midwest: Surveillance and genetic data support the introduction and establishment of Aedes albopictus in Iowa, USA

2021 ◽  
Author(s):  
David R. Hall ◽  
Ryan E. Tokarz ◽  
Eleanor N. Field ◽  
Ryan C Smith
Keyword(s):  
Aedes Albopictus ◽  
Rural Areas ◽  
Ecological Factors ◽  
The United States ◽  
Upper Midwest ◽  
Potential Barriers ◽  
Data Support ◽  
Winter Temperatures ◽  
The Us ◽  
Vector Borne

Aedes albopictus is a competent vector of several arboviruses that has spread throughout the United States over the last three decades after it was initially detected in Texas in 1985. With the emergence of Zika virus in the Americas in 2015-2016 and an increased need to better understand the current distributions of Ae. albopictus in the US, we initiated surveillance efforts to determine the abundance of invasive Aedes species in Iowa. Here, we describe the resulting surveillance efforts from 2016-2020 in which we detect stable and persistent populations of Aedes albopictus in three Iowa counties. Based on temporal patterns in abundance and genetic analysis of mitochondrial DNA haplotypes between years, our data support that populations of Ae. albopictus are overwintering and have likely become established in the state. In addition, the localization of Ae. albopictus predominantly in areas of urbanization and noticeable absence in rural areas suggests that these ecological factors may represent potential barriers to their further spread and contribute to overwintering success. Together, these data document the establishment of Ae. albopictus in Iowa and their expansion into the Upper Midwest, where freezing winter temperatures were previously believed to limit their spread. With increasing globalization, urbanization, and rising temperatures associated with global warming, the range of invasive arthropod vectors, such as Ae. albopictus, is expected to only further expand, creating increased risks for vector-borne disease.

scholarly journals Rural-Urban Disparities in Place of Death in Hematologic Malignancies in the US from 2003 to 2019

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4137-4137
Author(s):  
Syed M. Qasim Hussaini ◽  
Arjun Gupta
Keyword(s):  
United States ◽  
Metropolitan Area ◽  
Rural Areas ◽  
Hospice Care ◽  
Metropolitan Areas ◽  
Hematologic Malignancies ◽  
The United States ◽  
Medical Facility ◽  
Nursing Facility ◽  
The Us

Abstract Background: more than 60,000 people die annually from hematologic malignancies in the united states (us). Patients with hematologic malignancies more frequently receive aggressive care toward the end-of-life and are more likely to die in a hospital compared to those with a solid tumor. Appropriate care of such patients is very dependent on an existing healthcare infrastructure. There are notable challenges to rural healthcare in the united states which contains less than 1/5th of all hospices in the us. In this study, we sought to investigate rural-urban disparities in place of death the us in individuals that died from hematologic malignancies. Methods: we utilized the us centers for disease control and prevention wide-ranging online data for epidemiologic research database to analyze all deaths from hematologic malignancies in the us from 2003 to 2019. A population classification utilizing the 2013 us census was made using the national center for health statistics urban-rural classification scheme. These classifications included: large metropolitan area (1 million), small- or medium-sized metropolitan area (50 000-999 999), and rural area (<50 000). We estimated deaths in a medical facility, hospice, home, or nursing care facility. We stratified the results by age, sex, and race/ethnicity. The annual percentage change (apc) in deaths was estimated. All data was publicly available and de-identified. Findings: from 2003-2019, there were a total 1,088,589 deaths form hematologic malignancies in the united states, predominantly in large metropolitan areas (50.2%), followed by small or medium sized metropolitan areas (31.7%) and rural areas (18.2%). All regions noted decreases in medical facility and nursing facility related deaths, and increase in hospice and home deaths. While rural areas demonstrated the quickest uptake of hospice care (apc 61.5), they had the lowest overall presence of hospice care (8.3% of all rural deaths in 2019 vs. 14.9% for small or medium metropolitan vs. 12% for large metropolitan) and larger share of nursing facility related deaths (15.8% of all rural deaths in 2019 vs 12.3% for small or medium metropolitan vs 10.6% for large metropolitan). Discussion: we demonstrate end-of-life disparities in hematologic malignancies based on where an individual resides in the us with rural areas having notably lower share of deaths in hospice facilities. Older infrastructure, inadequate access to care, and financial barriers add to the medical complexity of care for all patients, and especially hematologic patients with high needs and complex treatment planning. These have been aggravated by rural hospital closures in the previous 18 months. The us senate is currently debating a bipartisan infrastructure that may add billions in building rural healthcare infrastructure to state budgets. Our findings are timely in helping inform congressional policy. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

scholarly journals Anticipating emerging arboviruses: What comes after Zika?

2017 ◽  
Author(s):  
Michelle V. Evans ◽  
Courtney C. Murdock ◽  
John M. Drake
Keyword(s):  
Public Health ◽  
The United States ◽  
Statistical Techniques ◽  
Public Health Community ◽  
Vector Borne Diseases ◽  
The Public ◽  
Health Community ◽  
Partially Observed ◽  
The Us ◽  
Vector Borne

AbstractNew vector-borne diseases have emerged on multiple occasions over the last several decades, raising fears that they may become established within the United States. Here, we provide a watchlist of flaviviruses with high potential to emerge in the US, identified using new statistical techniques for mining the associations in partially observed data, to allow the public health community to better target surveillance.

scholarly journals The COVID States Project #26: Trajectory of COVID-19-related behaviors

2021 ◽  
Author(s):  
David Lazer ◽  
Mauricio Santillana ◽  
Roy H. Perlis ◽  
Alexi Quintana ◽  
Katherine Ognyanova ◽  
...  
Keyword(s):  
State Level ◽  
The United States ◽  
Contact Tracing ◽  
Upper Midwest ◽  
Social Distancing ◽  
Current State ◽  
Change Behavior ◽  
Current Prevalence ◽  
The Us ◽  
National Trends

The current state of the COVID-19 pandemic in the United States is dire, with circumstances in the Upper Midwest particularly grim. In contrast, multiple countries around the world have shown that temporary changes in human behavior and consistent precautions, such as effective testing, contact tracing, and isolation, can slow transmission of COVID-19, allowing local economies to remain open and societal activities to approach normalcy as of today. These include island countries such as New Zealand, Taiwan, Iceland and Australia, and continental countries such as Norway, Uruguay, Thailand, Finland, and South Korea. These successes demonstrate that coordinated action to change behavior can control the pandemic. In this report, we evaluate how the human behaviors that have been shown to inhibit the spread of COVID-19 have evolved across the US since April, 2020.Our report is based on surveys that the COVID States Project has been conducting approximately every month since April in all 50 US states plus the District of Columbia. We address four primary questions:1) What are the national trends in social distancing behaviors and mask wearing since April?2) What are the trends among particular population subsets?3) What are the trends across individual states plus DC?4) What is the relationship, at the state level, between social distancing behaviors and mask wearing with the current prevalence of COVID-19?

scholarly journals Rurality and Origin–Destination Trajectories of Medical School Application and Matriculation in the United States

2021 ◽  
Vol 10 (6) ◽  
pp. 417
Author(s):  
Lan Mu ◽  
Yusi Liu ◽  
Donglan Zhang ◽  
Yong Gao ◽  
Michelle Nuss ◽  
...  
Keyword(s):  
Medical School ◽  
Rural Areas ◽  
Urban Areas ◽  
The United States ◽  
Application Rate ◽  
School Students ◽  
Rural Counties ◽  
Physician Shortages ◽  
The Us ◽  
Using Data

Physician shortages are more pronounced in rural than in urban areas. The geography of medical school application and matriculation could provide insights into geographic differences in physician availability. Using data from the Association of American Medical Colleges (AAMC), we conducted geospatial analyses, and developed origin–destination (O–D) trajectories and conceptual graphs to understand the root cause of rural physician shortages. Geographic disparities exist at a significant level in medical school applications in the US. The total number of medical school applications increased by 38% from 2001 to 2015, but the number had decreased by 2% in completely rural counties. Most counties with no medical school applicants were in rural areas (88%). Rurality had a significant negative association with the application rate and explained 15.3% of the variation at the county level. The number of medical school applications in a county was disproportional to the population by rurality. Applicants from completely rural counties (2% of the US population) represented less than 1% of the total medical school applications. Our results can inform recruitment strategies for new medical school students, elucidate location decisions of new medical schools, provide recommendations to close the rural–urban gap in medical school applications, and reduce physician shortages in rural areas.

scholarly journals Socio-economic disparities and COVID-19 in the USA

2020 ◽  
Author(s):  
Ayan Paul ◽  
Philipp Englert ◽  
Melinda Varga
Keyword(s):  
Rural Areas ◽  
Death Rate ◽  
Large Fraction ◽  
Local Population ◽  
The United States ◽  
Census Bureau ◽  
The Us ◽  
The Usa ◽  
Urban And Rural Areas ◽  
Us Census

COVID-19 is not a universal killer. We study the spread of COVID-19 at the county level for the United States up until the 15th of August, 2020. We show that the prevalence of the disease and the death rate are correlated with the local socio-economic conditions often going beyond local population density distributions, especially in rural areas. We correlate the COVID-19 prevalence and death rate with data from the US Census Bureau and point out how the spreading patterns of the disease show asymmetries in urban and rural areas separately and is preferentially affecting the counties where a large fraction of the population is non-white. Our findings can be used for more targeted policy building and deployment of resources for future occurrence of a pandemic due to SARS-CoV-2. Our methodology, based on interpretable machine learning and game theory, can be extended to study the spread of other diseases.

Using a cultural and social identity lens to understand pandemic responses in the US and India

2021 ◽  
pp. 147059582110573
Author(s):  
Nisha Nair ◽  
Patturaja Selvaraj
Keyword(s):  
Social Identity ◽  
Rural Areas ◽  
Behavioral Responses ◽  
The United States ◽  
Cross Cultural ◽  
Cultural Dimensions ◽  
Migrant Labor ◽  
Cultural Norms ◽  
Cross Cultural Differences ◽  
The Us

The world over, countries have been racing to control the spread of the Covid-19 pandemic. Central to the mitigation of the virus spread is the ability of nations to ensure behavior of its people adheres to the constraints imposed in the wake of the pandemic. However, there has been much variation in how individuals and collectives have responded in conformance to expected behavioral changes necessitated by the pandemic. The paper offers a cross-cultural and social identity perspective based on group categorizations to understand the variation in pandemic responses in the context of two different countries, that of India and the United States. Relevant cultural dimensions of difference shaping behavior such as individualism-collectivism, power distance, and other cultural norms shaping divergent behavioral responses in the US and India are examined. Differing group categorizations relevant for each country are also explored to understand the dynamics of behavioral response, be it adherence to mask wearing and following norms of social distancing, or the migrant labor exodus in India from urban to rural areas amidst the first wave of the pandemic. Implications for managing behavioral responses considering cross-cultural differences and group categorization processes are also discussed.

Deplorable or Disposable? The Carceral State and ‘Breaking Bad’ in Rural America

2021 ◽  
pp. 94-132
Author(s):  
Marie Gottschalk
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Mass Incarceration ◽  
War On Drugs ◽  
The United States ◽  
Carceral State ◽  
Breaking Bad ◽  
The Us ◽  
Urban And Rural Areas ◽  
Racial Ethnic

This chapter examines the limitations of viewing the US carceral state primarily through a racial disparities lens centred on differences in incarceration rates between whites and blacks. It surveys important shifts since the 1970s in who is being incarcerated in the United States, including racial, ethnic, gender, and geographic shifts, most notably between urban and rural areas. It deploys three common frameworks used to help explain the rise of mass incarceration and the hyper-incarceration of African Americans—the culture of control, the culture of poverty, and the war on drugs—to analyse the deepening penetration of the carceral state outside of major urban areas and to examine the opioid crisis.

China agreement will not help US manufacturers

2019 ◽  
Keyword(s):  
United States ◽  
The United States ◽  
Trade Negotiations ◽  
Upper Midwest ◽  
Donald Trump ◽  
Content Type ◽  
China Trade ◽  
The Us ◽  
The Impact ◽  
Trade Wars

Subject The impact of the US-China trade wars on US manufacturers. Significance The United States and China reached a tentative agreement in trade negotiations on October 11 that President Donald Trump described as "a substantial phase one deal". The deal, which is yet to be finalised, centres on China's agreement to purchase some 40-50 billion dollars' worth of additional US agricultural goods annually, and Trump's agreement to suspend a planned increase in tariffs on 250 billion dollars' worth of Chinese goods, from 25% to 30%, that was due to take effect tomorrow. However, existing tariffs on both sides remain in place. Impacts A manufacturing recession could lead to greater upper Midwest voters’ discontent. Midwestern voter discontent could help a Democrat win the presidency in 2020, and a populist win the party’s nomination. US-based manufacturers could benefit from new contracts as supply lines are revised, but costs would rise. A second Trump tax cut in 2020 could temporarily help US-based firms avoid competitiveness gaps.

scholarly journals Role of Pharmacists in Hormonal Contraceptive Access: A Survey of North Carolina Pharmacists

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 191
Author(s):  
Gwen J Seamon ◽  
Allison Burke ◽  
Casey R Tak ◽  
Amy Lenell ◽  
Macary Weck Marciniak ◽  
...  
Keyword(s):  
North Carolina ◽  
Rural Areas ◽  
Hormonal Contraception ◽  
Community Pharmacists ◽  
The United States ◽  
The State ◽  
Public Health Issue ◽  
Future Research ◽  
Potential Barriers

The role of pharmacy in healthcare continues to evolve as pharmacists gain increased clinical responsibilities in the United States, such as the opportunity to prescribe hormonal contraception. Currently, North Carolina (NC) pharmacists do not have this ability. While previous research focused on the perceptions of community pharmacists surrounding this practice, no previous research surveyed all pharmacists in a state. This cross-sectional, web-based survey was distributed to all actively licensed pharmacists residing in the state of NC in November 2018. The primary objective was to determine the likelihood of NC community pharmacists to prescribe hormonal contraception. Secondary outcomes included: evaluation of all respondent support and perceptions of this practice as advocacy occurs on the state organization level and unified support is critical; opinions regarding over-the-counter (OTC) status of contraception; and potential barriers to prescribing. Overall, 83% of community pharmacists were likely to prescribe hormonal contraception. No differences in likelihood to prescribe were detected between geographic settings. Community pharmacists reported that the most common barriers to impact prescribing were added responsibility and liability (69.8%) and time constraints (67.2%). Fewer than 10% of respondents felt that hormonal contraception should be classified as OTC (7.9%). Noncommunity pharmacists were significantly more likely to agree that prescribing hormonal contraception allows pharmacists to practice at a higher level, that increased access to hormonal contraception is an important public health issue, and that rural areas would benefit from pharmacist-prescribed hormonal contraception. Overall, this study found a willingness to prescribe and support from the majority of both community and noncommunity pharmacists. Limitations of the study included a low response rate and potential nonresponse bias. Future research is needed to address solutions to potential barriers and uptake of this practice, if implemented.

scholarly journals RACIAL DISPARITIES IN RURAL-URBAN MORTALITY GAP IN THE UNITED STATES: A 24-YEAR LONGITUDINAL STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S733-S733
Author(s):  
Nasim Ferdows ◽  
Soroosh Baghban Ferdows ◽  
Amit Kumar
Keyword(s):  
Mortality Rate ◽  
Rural Areas ◽  
Urban Areas ◽  
Fixed Effects ◽  
The United States ◽  
Mortality Rates ◽  
Race And Gender ◽  
Racial Gap ◽  
The Us ◽  
And Gender

Abstract Although overall life expectancy in the US has improved rapidly over the course of the 20th century and the racial gap in all-cause mortality has declined in recent decades, geographical disparities in mortality have increased in the last three decades. This research aims to study racial and geographical disparities by comparing the race and sex-specific mortality trends of the US rural and urban populations. We created a longitudinal county level analytic file of the US population 65 years and older, over the period of 1968 to 2015 obtained from CDC-WONDER and Area Health Resources Files. First, we used an OLS regression of age-adjusted mortality rate onto year indicators interaction with race and gender to depict the race and sex-specific trend in age-adjusted mortality rates. We also estimated the change in in mortality rate over time, for each race and gender, relative to values in 1968. Finally, we estimated race and sex specific trend in rural-urban mortality gap using state fixed effects regression. Our results indicate that racial gap in mortality rates has only declined in urban areas. Mortality rates of the whites in rural areas declined more rapidly than their Black counterparts, resulting in a gap that has been widening in the last three decades. The racial gap has increased considerably for males residing in rural counties not adjacent to an urban county. Thus, racial disparity in mortality has increased in rural areas, with a considerable widening between white and black male population living in the more remote rural areas.

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