scholarly journals US-county level variation in intersecting individual, household and community characteristics relevant to COVID-19 and planning an equitable response: a cross-sectional analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e039886 ◽  
Author(s):  
Taylor Chin ◽  
Rebecca Kahn ◽  
Ruoran Li ◽  
Jarvis T Chen ◽  
Nancy Krieger ◽  
...  
Keyword(s):  
Severe Disease ◽  
Health Resources ◽  
County Level ◽  
Community Characteristics ◽  
Cross Sectional ◽  
Online Tool ◽  
Community Factors ◽  
Individual Household ◽  
Us Counties ◽  
The Impact

ObjectivesTo illustrate the intersections of, and intercounty variation in, individual, household and community factors that influence the impact of COVID-19 on US counties and their ability to respond.DesignWe identified key individual, household and community characteristics influencing COVID-19 risks of infection and survival, guided by international experiences and consideration of epidemiological parameters of importance. Using publicly available data, we developed an open-access online tool that allows county-specific querying and mapping of risk factors. As an illustrative example, we assess the pairwise intersections of age (individual level), poverty (household level) and prevalence of group homes (community-level) in US counties. We also examine how these factors intersect with the proportion of the population that is people of colour (ie, not non-Hispanic white), a metric that reflects histories of US race relations. We defined ‘high’ risk counties as those above the 75th percentile. This threshold can be changed using the online tool.SettingUS counties.ParticipantsAnalyses are based on publicly available county-level data from the Area Health Resources Files, American Community Survey, Centers for Disease Control and Prevention Atlas file, National Center for Health Statistic and RWJF Community Health Rankings.ResultsOur findings demonstrate significant intercounty variation in the distribution of individual, household and community characteristics that affect risks of infection, severe disease or mortality from COVID-19. About 9% of counties, affecting 10 million residents, are in higher risk categories for both age and group quarters. About 14% of counties, affecting 31 million residents, have both high levels of poverty and a high proportion of people of colour.ConclusionFederal and state governments will benefit from recognising high intrastate, intercounty variation in population risks and response capacity. Equitable responses to the pandemic require strategies to protect those in counties at highest risk of adverse COVID-19 outcomes and their social and economic impacts.

scholarly journals The impact of disease severity and duration on cost, early retirement and ability to work in rheumatoid arthritis in Europe: an economic modelling study

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
James Galloway ◽  
Jean-Philippe Capron ◽  
Francesco De Leonardis ◽  
Walid Fakhouri ◽  
Alison Rose ◽  
...  
Keyword(s):  
Disease Activity ◽  
Early Retirement ◽  
Disease Duration ◽  
Severe Disease ◽  
Economic Modelling ◽  
Ability To Work ◽  
Activity Impairment ◽  
Cross Sectional ◽  
Work Impairment ◽  
The Impact

Abstract Objective RA is a progressive, chronic autoimmune disease. We summarize the impact of disease activity as measured by the DAS in 28 joints (DAS28-CRP scores) and pain on productivity and ability to work using the Work Productivity and Activity Impairment questionnaire (WPAI) scores, in addition to the impact of disease duration on the ability to work. Methods Data were drawn from the Burden of RA across Europe: a Socioeconomic Survey (BRASS), a European cross-sectional study in RA. Analyses explored associations between DAS28-CRP score and disease duration with stopping work because of RA, and regression analyses assessed impacts of pain and DAS28-CRP on early retirement and WPAI. Results Four hundred and seventy-six RA specialist clinicians provided information on 4079 adults with RA, of whom 2087 completed the patient survey. Severe disease activity was associated with higher rates of stopping work or early retirement attributable to RA (21%) vs moderate/mild disease (7%) or remission (8%). Work impairment was higher in severe (67%) or moderate RA (45%) compared with low disease activity [LDA (37%)] or remission (28%). Moreover, patients with severe (60%) or moderate pain (48%) experienced increased work impairment [mild (34%) or no pain (19%)]. Moderate to severe pain is significant in patients with LDA (35%) or remission (22%). A statistically significant association was found between severity, duration and pain vs work impairment, and between disease duration vs early retirement. Conclusion Results demonstrate the high burden of RA. Furthermore, subjective domains, such as pain, could be as important as objective measures of RA activity in affecting the ability to work.

scholarly journals Identifying and Understanding Communities Using Twitter to Connect About Depression: Cross-Sectional Study

2018 ◽  
Vol 5 (4) ◽  
pp. e61 ◽  
Author(s):  
Amber D DeJohn ◽  
Emily English Schulz ◽  
Amber L Pearson ◽  
E Megan Lachmar ◽  
Andrea K Wittenborn
Keyword(s):  
Pearson Correlation ◽  
Future Research ◽  
Multilevel Regression ◽  
Community Characteristics ◽  
Cross Sectional ◽  
Web Based ◽  
Study Region ◽  
Community Factors ◽  
Single Person ◽  
Twitter Users

Background Depression is the leading cause of diseases globally and is often characterized by a lack of social connection. With the rise of social media, it is seen that Twitter users are seeking Web-based connections for depression. Objective This study aimed to identify communities where Twitter users tweeted using the hashtag #MyDepressionLooksLike to connect about depression. Once identified, we wanted to understand which community characteristics correlated to Twitter users turning to a Web-based community to connect about depression. Methods Tweets were collected using NCapture software from May 25 to June 1, 2016 during the Mental Health Month (n=104) in the northeastern United States and Washington DC. After mapping tweets, we used a Poisson multilevel regression model to predict tweets per community (county) offset by the population and adjusted for percent female, percent population aged 15-44 years, percent white, percent below poverty, and percent single-person households. We then compared predicted versus observed counts and calculated tweeting index values (TIVs) to represent undertweeting and overtweeting. Last, we examined trends in community characteristics by TIV using Pearson correlation. Results We found significant associations between tweet counts and area-level proportions of females, single-person households, and population aged 15-44 years. TIVs were lower than expected (TIV 1) in eastern, seaboard areas of the study region. There were communities tweeting as expected in the western, inland areas (TIV 2). Counties tweeting more than expected were generally scattered throughout the study region with a small cluster at the base of Maine. When examining community characteristics and overtweeting and undertweeting by county, we observed a clear upward gradient in several types of nonprofits and TIV values. However, we also observed U-shaped relationships for many community factors, suggesting that the same characteristics were correlated with both overtweeting and undertweeting. Conclusions Our findings suggest that Web-based communities, rather than replacing physical connection, may complement or serve as proxies for offline social communities, as seen through the consistent correlations between higher levels of tweeting and abundant nonprofits. Future research could expand the spatiotemporal scope to confirm these findings.

scholarly journals Identifying and Understanding Communities Using Twitter to Connect About Depression: Cross-Sectional Study (Preprint)

2017 ◽  
Author(s):  
Amber D. DeJohn ◽  
Emily English Schulz ◽  
Amber L Pearson ◽  
E Megan Lachmar ◽  
Andrea K Wittenborn
Keyword(s):  
Pearson Correlation ◽  
Future Research ◽  
Multilevel Regression ◽  
Community Characteristics ◽  
Cross Sectional ◽  
Web Based ◽  
Study Region ◽  
Community Factors ◽  
Single Person ◽  
Twitter Users

BACKGROUND Depression is the leading cause of diseases globally and is often characterized by a lack of social connection. With the rise of social media, it is seen that Twitter users are seeking Web-based connections for depression. OBJECTIVE This study aimed to identify communities where Twitter users tweeted using the hashtag #MyDepressionLooksLike to connect about depression. Once identified, we wanted to understand which community characteristics correlated to Twitter users turning to a Web-based community to connect about depression. METHODS Tweets were collected using NCapture software from May 25 to June 1, 2016 during the Mental Health Month (n=104) in the northeastern United States and Washington DC. After mapping tweets, we used a Poisson multilevel regression model to predict tweets per community (county) offset by the population and adjusted for percent female, percent population aged 15-44 years, percent white, percent below poverty, and percent single-person households. We then compared predicted versus observed counts and calculated tweeting index values (TIVs) to represent undertweeting and overtweeting. Last, we examined trends in community characteristics by TIV using Pearson correlation. RESULTS We found significant associations between tweet counts and area-level proportions of females, single-person households, and population aged 15-44 years. TIVs were lower than expected (TIV 1) in eastern, seaboard areas of the study region. There were communities tweeting as expected in the western, inland areas (TIV 2). Counties tweeting more than expected were generally scattered throughout the study region with a small cluster at the base of Maine. When examining community characteristics and overtweeting and undertweeting by county, we observed a clear upward gradient in several types of nonprofits and TIV values. However, we also observed U-shaped relationships for many community factors, suggesting that the same characteristics were correlated with both overtweeting and undertweeting. CONCLUSIONS Our findings suggest that Web-based communities, rather than replacing physical connection, may complement or serve as proxies for offline social communities, as seen through the consistent correlations between higher levels of tweeting and abundant nonprofits. Future research could expand the spatiotemporal scope to confirm these findings.

Factors Associated with Nonattendance to a Geriatric Clinic among Mexican Older Adults

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Juan Pablo Negrete-Najar ◽  
Yoselin Juárez-Carrillo ◽  
Jimena Gómez-Camacho ◽  
Nancy R. Mejía-Domínguez ◽  
Enrique Soto-Perez-de-Celis ◽  
...  
Keyword(s):  
Older Adults ◽  
Geriatric Medicine ◽  
Health Resources ◽  
Public Health Problem ◽  
Time Frame ◽  
Cross Sectional Study ◽  
Multinomial Regression ◽  
Cross Sectional ◽  
History Of ◽  
The Impact

<b><i>Introduction:</i></b> Outpatient appointment nonattendance (NA) represents a public health problem, increasing the risk of unfavorable health-related outcomes. Although NA is significant among older adults, little is known regarding its correlates. This study aimed to identify the correlates (including several domains from the geriatric assessment) of single and repeated NA episodes in a geriatric medicine outpatient clinic, in general and in the context of specific comorbidities. <b><i>Methods:</i></b> This is a cross-sectional study including data from 3,034 older adults aged ≥60 years with ≥1 scheduled appointments between January 1, 2016, and December 31, 2016. Appointment characteristics as well as sociodemographic, geographical, and environmental information were obtained. Univariate and multivariate multinomial regression analyses were carried out. <b><i>Results:</i></b> The mean age was 81.8 years (SD 7.19). Over a third (37.4%) of participants missed one scheduled appointment, and 14.4% missed ≥2. Participants with a history of stroke (OR 1.336, <i>p</i> = 0.041) and those with a greater number of scheduled appointments during the study time frame (OR 1.182, <i>p</i> &#x3c; 0.001) were more likely to miss one appointment, while those with Parkinson’s disease (OR 0.346, <i>p</i> &#x3c; 0.001), other pulmonary diseases (OR 0.686, <i>p</i> = 0.008), and better functioning for activities of daily living (ADL) (OR 0.883, <i>p</i> &#x3c; 0.001) were less likely to do so. High socioeconomic level (OR 2.235, <i>p</i> &#x3c; 0.001), not having a partner (OR 1.410, <i>p</i> = 0.006), a history of fractures (OR 1.492, <i>p</i> = 0.031), and a greater number of scheduled appointments (OR 1.668, <i>p</i> &#x3c; 0.001) increased the risk of repeated NA, while osteoarthritis (OR 0.599, <i>p</i> = 0.001) and hypertension (OR 0.680, <i>p</i> = 0.002) decreased it. In specific comorbidity populations (hypertension, type 2 diabetes mellitus, and cancer), better ADL functioning protected from a single NA, while better mobility functioning protected from repeated NA in older patients with hypertension and cancer. <b><i>Discussion/Conclusion:</i></b> Identifying geriatric factors linked to an increased probability of NA may allow one to anticipate its likelihood and lead to the design and implementation of preventive strategies and to an optimization of the use of available health resources. The impact of these factors on adherence to clinical visits requires further investigation.

scholarly journals Differential Privacy and the Accuracy of County-Level Net Migration Estimates

2021 ◽  
Author(s):  
Richelle L. Winkler ◽  
Jaclyn L. Butler ◽  
Katherine J. Curtis ◽  
David Egan-Robertson
Keyword(s):  
Census Data ◽  
Differential Privacy ◽  
Age Groups ◽  
Level Of Detail ◽  
County Level ◽  
High Quality ◽  
Net Migration ◽  
The Past ◽  
Us Counties ◽  
The Impact

AbstractEach decade since the 1950s, demographers have generated high-quality net migration estimates by age, sex, and race for US counties using decennial census data as starting and ending populations. The estimates have been downloaded tens of thousands of times and widely used for planning, diverse applications, and research. Census 2020 should allow the series to extend through the 2010–2020 decade. The accuracy of new estimates, however, could be challenged by differentially private (DP) disclosure avoidance techniques in Census 2020 data products. This research brief estimates the impact of DP implementation on the accuracy of county-level net migration estimates. Using differentially private Census 2010 demonstration data, we construct a hypothetical set of DP migration estimates for 2000–2010 and compare them to published estimates, using common accuracy metrics and spatial analysis. Findings show that based on demonstration data released in 2020, net migration estimates by five-year age groups would only be accurate enough for use in about half of counties. Inaccuracies are larger in counties with populations less than 50,000, among age groups 65 and over, and among Hispanics. These problems are not fully resolved by grouping into broader age groups. Moreover, errors tend to cluster spatially in some regions of the country. Ultimately, the ability to generate accurate net migration estimates at the same level of detail as in the past will depend on the Census Bureau’s allocation of the privacy loss budget.

scholarly journals A multidimensional study of public satisfaction with the healthcare system: a mixed-method inquiry in Ghana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Padmore Adusei Amoah ◽  
Kingsley Atta Nyamekye ◽  
Ebenezer Owusu-Addo
Keyword(s):  
Healthcare System ◽  
Mixed Method ◽  
Rural Areas ◽  
Social Insurance ◽  
Well Being ◽  
Political Orientation ◽  
Sub Saharan Africa ◽  
Cross Sectional ◽  
Community Factors ◽  
The Impact

Abstract Background Many governments in sub-Saharan Africa have recently sought to improve their health systems by increasing investment in healthcare facilities and introducing social insurance programmes. However, little is known about the impact of these intended improvements on public perceptions about the healthcare systems. This article examines whether and why people of different socioeconomic and ideological backgrounds are satisfied (or not) with the current healthcare system in Ghana from a social ecological perspective. Method Data were elicited from a cross-sectional mixed-method study conducted in four regions in Ghana in 2018. We used ordinal logistic regression and thematic analysis techniques to analyse the data. Results Satisfaction with the healthcare system was generally low. From our quantitative study, intrapersonal factors (e.g., being older and having good health and well-being status); interpersonal factors (e.g., linking social capital); community factors (e.g., living in rural areas); and organisational and public policy factors (e.g., trust in the health system, favouring welfare policies, and being interested in politics) were positively associated with satisfaction with the healthcare system. These were corroborated by the qualitative study, which showed that poor attitudes of health personnel, financial constraints, perceived poor health facilities, and perceived inefficacy of services contribute to dissatisfaction with the healthcare system. Conclusion Strategies to improve satisfaction with the healthcare system in Ghana should incorporate ecological perspectives by considering factors such as demographic profile, health needs, political orientation, issues of trust in the healthcare system, and the dynamics and impact of social relationships of populations concerned.

scholarly journals Unravelling adolescent girls’ aspirations in Nepal: Status and associations with individual-, household-, and community-level characteristics

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0258416
Author(s):  
Dónya S. Madjdian ◽  
Kenda Cunningham ◽  
Hilde Bras ◽  
Maria Koelen ◽  
Lenneke Vaandrager ◽  
...  
Keyword(s):  
Adolescent Girls ◽  
Low Income ◽  
School Attendance ◽  
Well Being ◽  
Household Wealth ◽  
Ecological Zone ◽  
Community Characteristics ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
Individual Household

Background Adolescents’ aspirations have potential to influence their present and future well-being. Limited knowledge exists on adolescent girls’ aspirations and their determinants, particularly in low-income contexts. Methods and findings Using cross-sectional data, collected in 2018 in Nepal, within the Suaahara II Adolescent Panel Survey, (n = 840), adolescent girls’ aspirations in several domains—education, occupation, marriage, fertility, health, and nutrition–were described. Regression models were estimated to explore associations between individual, household and community characteristics and these aspirations for all adolescents and separately for younger (10–14 years) and older (15–19 years) girls. Age, school attendance, and self-efficacy, as well as household wealth, caste/ethnicity, size, and agro-ecological zone of residence were significantly associated with aspirations, although effect sizes and significance varied by aspiration domain and age group. Conclusions Findings underscore the curtailing effect of poverty on aspirations and the dynamic nature of aspirations. Initiatives to foster girls’ aspirations must address both individual and contextual factors.

scholarly journals Clinical and Radiological Outcomes of Recovered COVID-19 Patients- An Observational Study during the Early Phase of Pandemic

2021 ◽  
Author(s):  
Disha Atul Padalkar ◽  
Medha Bargaje ◽  
Purwa Prakash Doke ◽  
Sarosh Gilani ◽  
Varad Nadkarni ◽  
...  
Keyword(s):  
Observational Study ◽  
Pulmonary Rehabilitation ◽  
Severe Disease ◽  
Multivariate Logistic Regression Analysis ◽  
Medical Attention ◽  
Post Discharge ◽  
Cross Sectional ◽  
Health Crisis ◽  
Persistent Symptoms ◽  
The Impact

Introduction: The pandemic caused by the Coronavirus Disease 2019 (COVID-19) has caused huge economic and health crisis. It is reported to have pulmonary sequelae which can overburden the healthcare systems. Survivors needing medical attention in the form of pulmonary rehabilitation should be prioritised. Aim: To study the impact of COVID-19 infection in terms of the pulmonary and extrapulmonary sequelae. Materials and Methods: This cross-sectional observational study was carried out at a tertiary hospital in India. Recovered COVID-19 patients who were admitted from April to July 2020 were enrolled. Participants with radiological evidence of pneumonia during hospitalisation were assessed two months post-discharge. They were evaluated for persistent symptomatology, chest radiography, Six-Minute Walk Test (6MWT). The relationship between the outcome parameters with the baseline epidemiology, laboratory and radiology were evaluated by using student t-test, Mann- Whitney U test and multivariate logistic regression analysis. Results: Thirty participants were recruited. Their mean age was 47.93 years. Males were more than females. Persistent symptoms were reported by 17 (56.66%) and 4 (13.33%) developed pulmonary fibrosis on Chest X-Ray (CXR). Prolonged hospitalisation (mean >20 days) strongly correlated to the fibrosis (p=0.022). A fall in the finger oxygen saturation after the 6MWT was significant (p≤0.001). Higher serum levels of lactate dehydrogenase and D-dimer were associated with a more severe disease (p=0.02 and p≤0.001, respectively). Conclusion: Convalescent phase of COVID-19 is characterised by persistent symptomatology in half of the recovered patients. Simple and inexpensive CXRs and the 6MWT can be used as the primary investigation to identify post COVID-19 patients requiring pulmonary rehabilitation in resource limited settings.

scholarly journals P112 Impact of the SARS-COV2 pandemic on patients with inflammatory bowel disease - Preliminary results of a prospective, single-center study

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S204-S205
Author(s):  
L Martins Figueiredo ◽  
F Correia ◽  
M A Rafael ◽  
L Lourenço ◽  
A M Oliveira ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Incidence Rate ◽  
Bowel Disease ◽  
Risk Group ◽  
Severe Disease ◽  
Outpatient Basis ◽  
Cross Sectional ◽  
Preliminary Results ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Background The real impact of COVID-19 infection on patients with Inflammatory Bowel Disease (IBD) is unknown. It was speculated that this population could be a risk group. The aim of this study is to evaluate the incidence of SARS-CoV2 infection, the impact of initiation/change of IBD therapy and its morbidity and mortality, during the COVID-19 pandemic in Portugal. Methods Prospective cross-sectional study. Patients with IBD followed at a Gastroenterology Department in an area with a high incidence rate of SARS-CoV2 were included, from 01/03/2020 to 31/08/2020. Data was obtained through telephonic appointments, hospital inpatients admissions, Emergency Department Service and Day Hospital episodes. Results 335 patients were included, 194 female, with a mean age of 47.4 years (18–88). 200 had Crohn’s disease (CD), 132 Ulcerative Colitis, 3 unclassified colitis. 320 were on therapy (95.5%): salicylates n=230 (71.9%), systemic corticosteroids n=34 (10.6%) (18 started during the pandemic), thiopurines/methotrexate n=117 (36.6%) (8 started in this period), biological n=148 (46.3%) (14 started in this period). 7 patients (2.2%) triple immunosuppressed. 75 patients had disease in remission, 232 mild/moderate, 28 severe disease (requiring hospitalization). SARS-CoV2 infection was observed in 3 patients (incidence rate: 0.89%), treated as an outpatient basis. 2 male, mean age 58 years, 2 with CD. Comorbidities: 0: n = 1; 2: n = 1; 4: n = 1. 2 patients were on salicylates and one on adalimumab (monotherapy, before the pandemic). There were no deaths. Conclusion All patients started or maintained their IBD therapy according to current international guidelines. A significantly higher incidence of COVID-19 infection than that of the local and Portuguese population in general has not been documented. According to our preliminary results, the population with IBD does not appear to be a risk group for acquiring infection or having a severe course of the disease.

scholarly journals County-Level Proportions of Black and Hispanic populations, and Socioeconomic Characteristics in Association with Confirmed COVID-19 Cases and Deaths in the United States

2020 ◽  
Author(s):  
Ahmad Khanijahani
Keyword(s):  
Health Resources ◽  
Population Group ◽  
Population Data ◽  
The United States ◽  
Housing Cost ◽  
County Level ◽  
Negative Consequences ◽  
Population Groups ◽  
Study Results ◽  
Us Counties

Objectives. The objective of this study was to investigate potential county-level disparities among racial/ethnic and economic groups in COVID-19 burden which was measured using confirmed cases and deaths in 100,000 population. Design. Secondary data analysis Using county-level data for 3,142 US counties was conducted in 2020. Hierarchical linear regression and concentration curve analyses were performed. The combined association of COVID-19 cases and deaths was examined separately by sociodemographic and economic characteristics of the county population. Data from the American Community Survey (ACS) 5-year estimates (2014-2018), Area Health Resources File (AHRF) 2018-2019, and 2020 COVID-19 data from Johns Hopkins University were used in this study. Results. After adjusting for covariates, US counties with a higher proportion of the black population, and a higher proportion of adults with less than high school diploma had disproportionately higher COVID-19 cases and deaths (β>0, p<0.05). A higher proportion of the Hispanic population was associated with higher confirmed cases (β= 1.03, 95% CI= 0.57-1.5), and higher housing cost to household income ratio was associated with higher deaths (β= 3.74, 95% CI= 2.14-5.37). This can potentially aggravate the existing health disparities among these population groups. Conclusions. Identification of disproportionately impacted population groups can pave the way towards narrowing the disparity gaps and guide policymakers and stakeholders in designing and implementing population group-specific interventions to mitigate the negative consequences of COVID-19 pandemic.

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