scholarly journals Clinicians, cooks, and cashiers: Examining health equity and the COVID-19 risks to essential workers

2020 ◽  
Vol 36 (9) ◽  
pp. 689-702
Author(s):  
Jennifer D Roberts ◽  
Katherine L Dickinson ◽  
Elizabeth Koebele ◽  
Lindsay Neuberger ◽  
Natalie Banacos ◽  
...  
Keyword(s):  
United States ◽  
Health Equity ◽  
Low Income ◽  
Perceived Risk ◽  
Risk Perceptions ◽  
Online Survey ◽  
Health Inequities ◽  
The United States ◽  
Systemic Racism ◽  
Social Distancing

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.

Impacts of Social Distancing on Pedestrian Behavior and Risk Perception

2021 ◽  
Vol 65 (1) ◽  
pp. 1302-1306
Author(s):  
Kyra B. Phillips ◽  
Kelly N. Byrne ◽  
Branden S. Kolarik ◽  
Audra K. Krake ◽  
Young C. Bui ◽  
...  
Keyword(s):  
United States ◽  
Risk Perception ◽  
Perceived Risk ◽  
Close Contact ◽  
The United States ◽  
Survey Study ◽  
Pedestrian Behavior ◽  
Social Distancing ◽  
Global Pandemic ◽  
Over Time

Since COVID-19 transmission accelerated in the United States in March 2020, guidelines have recommended that individuals wear masks and limit close contact by remaining at least six feet away from others, even while outdoors. Such behavior is important to help slow the spread of the global pandemic; however, it may require pedestrians to make critical decisions about entering a roadway in order to avoid others, potentially creating hazardous situations for both themselves and for drivers. In this survey study, we found that while overall patterns of self-reported pedestrian activity remained largely consistent over time, participants indicated increased willingness to enter active roadways when encountering unmasked pedestrians since the COVID-19 pandemic began. Participants also rated the risks of encountering unmasked pedestrians as greater than those associated with entering a street, though the perceived risk of passing an unmasked pedestrian on the sidewalk decreased over time.

scholarly journals Perceived Risk of Mosquito-Borne Arboviruses in the Continental United States

Pathogens ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1562
Author(s):  
Saul Lozano ◽  
Jonathan Day ◽  
Lilyana Ortega ◽  
Maggie Silver ◽  
Roxanne Connelly
Keyword(s):  
United States ◽  
Risk Perception ◽  
Vector Control ◽  
News Media ◽  
Perceived Risk ◽  
Risk Perceptions ◽  
The United States ◽  
Transmission Risk ◽  
Accurate Information ◽  
Use Of Resources

The United States experienced local transmission of West Nile Virus (WNV) for the first time in 1999, and Zika Virus (ZIKV) in 2016. These introductions captured the public’s attention in varying degrees. The research presented here analyzes the disproportional perception of ZIKV risk compared to WNV transmission risk, by the public and vector control personnel. The risk perception of vector control was measured through purposive sampled interviews (24 interviews in 13 states; May 2020–June 2021), while the public’s perception was estimated from news publications (January 2000–December 2020), and Google searches (January 2004–December 2020). Over time, we observed a decrease in the frequency of press reporting and Google searches of both viruses with decreasing annual peaks in the summer. The highest peak of ZIKV news, and searches, surpassed that of WNV. We observed clear differences in the contents of the headlines for both viruses. We propose that the main reason in risk perception differences between the viruses were psychological. Zika infections (mosquito-borne and sexually transmitted) can result in devastating symptoms in fetuses and newborns, observations that frequently appeared in ZIKV-related headlines. Our results highlight the likely influence the news media has on risk perception and the need for public health agencies to play active roles in the conversation, helping disseminate timely and accurate information. Understanding the factors that shape risk perceptions of vector-borne diseases will hopefully lead to better use of resources by providing better guidance.

scholarly journals Using implementation science to mitigate worsening health inequities in the United States during the COVID-19 pandemic

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Tyler A. Jacobson ◽  
Lauren E. Smith ◽  
Lisa R. Hirschhorn ◽  
Mark D. Huffman
Keyword(s):  
United States ◽  
Community Engagement ◽  
Implementation Research ◽  
Policy Design ◽  
Contextual Factors ◽  
Health Inequities ◽  
The United States ◽  
Audit And Feedback ◽  
Evidence Based ◽  
Social Distancing

Abstract With the threat of coronavirus disease 2019 (Covid-19) enduring in the United States, effectively and equitably implementing testing, tracing, and self-isolation as key prevention and detection strategies remain critical to safely re-opening communities. As testing and tracing capacities increase, frameworks are needed to inform design and delivery to ensure their effective implementation and equitable distribution, and to strengthen community engagement in slowing and eventually stopping Covid-19 transmission. In this commentary, we highlight opportunities for integrating implementation research into planned and employed strategies in the United States to accelerate reach and effectiveness of interventions to more safely relax social distancing policies and open economies, schools, and other institutions. Implementation strategies, such as adapting evidence-based interventions based on contextual factors, promoting community engagement, and providing data audit and feedback on implementation outcomes, can support the translation of policies on testing, tracing, social distancing, and public mask use into reality. These data can demonstrate how interventions are put into practice and where adaptation in policy or practice is needed to respond to the needs of specific communities and socially vulnerable populations. Incorporating implementation research into Covid-19 policy design and translation into practice is urgently needed to mitigate the worsening health inequities in the pandemic toll and response. Applying rigorous implementation research frameworks and evaluation systems to the implementation of evidence-based interventions which are adapted to contextual factors can promote effective and equitable pandemic response and accelerate learning both among local stakeholders as well as between states to further inform their varied experiences and responses to the pandemic.

scholarly journals Food insecurity among households with children during the COVID-19 pandemic: results from a study among social media users across the United States

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Niyati Parekh ◽  
Shahmir H. Ali ◽  
Joyce O’Connor ◽  
Yesim Tozan ◽  
Abbey M. Jones ◽  
...  
Keyword(s):  
United States ◽  
Social Media ◽  
Food Security ◽  
Food Insecurity ◽  
Low Income ◽  
Online Survey ◽  
The United States ◽  
Household Food Security ◽  
United States Department ◽  
Households With Children

Abstract Background In the United States, approximately 11% of households were food insecure prior to the COVID-19 pandemic. The present study aims to describe the prevalence of food insecurity among adults and households with children living in the United States during the pandemic. Methods This study utilized social media as a recruitment platform to administer an original online survey on demographics and COVID-related food insecurity. The survey was disseminated through an advertisement campaign on Facebook and affiliated platforms. Food insecurity was assessed with a validated six-item United States Department of Agriculture (USDA) Household Food Security Survey Module, which was used to create a six-point numerical food security score, where a higher score indicates lower food security. Individual-level participant demographic information was also collected. Logistic regressions (low/very-low compared with high/marginal food security) were performed to generate adjusted odds ratios (AOR) and 95%CIs for food insecurity and select demographic characteristics. Results Advertisements reached 250,701 individuals and resulted in 5,606 complete surveys. Overall, 14.7% of participants self-identified as having low or very low food security in their households, with higher prevalence (17.5%) among households with children. Unemployment (AOR:1.76, 95%CI:1.09–2.80), high school or lower education (AOR:2.25, 95%CI:1.29–3.90), and low income (AOR[$30,000-$50,000]:5.87, 95%CI:3.35–10.37; AOR[< $30,000]:10.61, 95%CI:5.50–20.80) were associated with higher odds of food insecurity in multivariable models among households with children (and the whole sample). Conclusions These data indicate exacerbation of food insecurity during the pandemic. The study will be instrumental in guiding additional research and time-sensitive interventions targeted towards vulnerable food insecure subgroups.

scholarly journals Time Spent at Home and Alone in the United States, 2019

2021 ◽  
Author(s):  
Kelsey Jeanne Drotning
Keyword(s):  
United States ◽  
Time Use ◽  
Low Income ◽  
Black People ◽  
The United States ◽  
Foreign Born ◽  
Social Distancing ◽  
American Time Use Survey ◽  
Time Use Survey ◽  
At Home

Social distancing conditions implemented in response to the Covid-19 pandemic significantly altered where and with whom people were able to spend their time. By examining data from the 2019 American Time Use Survey, this study provides a baseline of how much time people spent at home, alone, and alone at home prior to the onset of the pandemic. Men, Black people, older adults, low-income households, foreign-born adults, people who live alone, and people who are unemployed spend more time alone than other groups. These findings highlight which groups in the United States already spent more time at home and more time alone pre-pandemic, forecasting how other groups time use may shift in response to Covid-19 pandemic social distancing regulations.

scholarly journals Compliance with COVID-19 Mitigation Measures in the United States

2020 ◽  
Author(s):  
Benjamin van Rooij ◽  
Anne Leonore de Bruijn ◽  
Christopher Reinders Folmer ◽  
Emmeke Barbara Kooistra ◽  
Malouke Esra Kuiper ◽  
...  
Keyword(s):  
United States ◽  
Social Norms ◽  
Human Behavior ◽  
Online Survey ◽  
The United States ◽  
Self Control ◽  
Mitigation Measures ◽  
Social Distancing ◽  
Intrinsic Motivations ◽  
Fundamental Shift

The COVID-19 mitigation measures require a fundamental shift in human behavior. The present study assesses what factors influence Americans to comply with the stay at home and social distancing measures. It analyzes data from an online survey, conducted on April 3, 2020, of 570 participants from 35 states that have adopted such measures. The results show that while perceptual deterrence was not associated with compliance, people actually comply less when they fear the authorities. Further, two broad processes promote compliance. First, compliance depended on people’s capacity to obey the rules, opportunity to break the rules, and self-control. As such, compliance results from their own personal abilities and the context in which they live. Second, compliance depended on people’s intrinsic motivations, including substantive moral support and social norms. This paper discusses the implications of these findings for ensuring compliance to effectively mitigate the virus.

scholarly journals The Role of Perceived Susceptibility and Collectivist Values in Support for Using Social Distancing to Prevent COVID-19 in the United States

2021 ◽  
pp. 263207702110154
Author(s):  
Xiao Wang
Keyword(s):  
United States ◽  
Cultural Values ◽  
Risk Perceptions ◽  
Behavioral Control ◽  
The United States ◽  
Amazon Mechanical Turk ◽  
Perceived Behavioral Control ◽  
Perceived Susceptibility ◽  
Social Distancing

The present investigation examined the factors that were related to U.S. residents’ support for social distancing measures (i.e., stay-at-home) that can help prevent COVID-19 infections and save lives. Relying on a survey of 387 U.S.-based participants from Amazon Mechanical Turk (MTurk), conducted in May 2020, the results revealed that perceived susceptibility and collectivist cultural values predicted their support for social distancing, both directly and indirectly. The total effect sizes were moderate and strong, respectively. In addition, instrumental attitudes were a stronger predictor of the participants’ support for social distancing than experiential attitudes and perceived behavioral control. The results contribute to the understanding of how risk perceptions, collectivist values, and various attitudes are related to an important preventive behavior (i.e., social distancing) during a pandemic. It should be acknowledged that the concept of social distancing evolved throughout the pandemic in the United States.

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

2021 ◽  
Author(s):  
Daniel J. Erchick ◽  
Alexander J. Zapf ◽  
Prativa Baral ◽  
Jeffrey Edwards ◽  
Shruti H. Mehta ◽  
...  
Keyword(s):  
United States ◽  
African American ◽  
Social Interaction ◽  
Risk Perceptions ◽  
Online Survey ◽  
The United States ◽  
Grocery Store ◽  
Black African ◽  
Targeted Interventions ◽  
Nationally Representative

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.

scholarly journals The Future of Health Equity in America: Addressing the Multiple, Intersecting Determinants of Health

2019 ◽  
Vol 29 (Supp2) ◽  
pp. 343-344 ◽  
Author(s):  
Daniel E. Dawes
Keyword(s):  
United States ◽  
Health Policy ◽  
Health Equity ◽  
Policy Research ◽  
Health Inequities ◽  
The United States ◽  
Determinants Of Health ◽  
Policy Issues ◽  
The Past ◽  
The Future

 Even though health equity is a key compo­nent of the transforming journey of health that our nation is embarking on, little has been done to trans-disciplinarily coordinate health policy research and collaboratively address issues driving health inequities. This article examines the past and present health policy issues affecting health equity in the United States and discusses the need to ad­dress the multiple, intersecting determinants of health in order to fully realize health equity and eliminate health disparities in the future. Ethn Dis. 2019;29(Suppl 2): 343- 344; doi:10.18865/ed.29.S2.343.

Predicting intentions to practice COVID-19 preventative behaviors in the United States: A test of the risk perception attitude framework and the theory of normative social behavior

2021 ◽  
pp. 135910532110573
Author(s):  
Ying Cheng ◽  
Rain Wuyu Liu ◽  
Taylor Ann Foerster
Keyword(s):  
United States ◽  
Social Factors ◽  
Risk Perceptions ◽  
Online Survey ◽  
Face Mask ◽  
The United States ◽  
Efficacy Beliefs ◽  
Descriptive Norm ◽  
Injunctive Norms ◽  
Risk Perception Attitude Framework

This study examined risk perceptions, efficacy beliefs, social norms, and their interactions as predictors of people’s intention to practice four COVID-19 preventative behaviors among a U.S. sample with quotas on age, sex, ethnicity, and region ( N = 336). This online survey found that perceived injunctive norms predicted intentions to clean and disinfect (β = 0.20), practice social distancing (β = 0.14), and wear a face mask (β = 0.24). Additionally, efficacy beliefs were found to attenuate the association between descriptive norm perceptions and intention to wash hands ( B = −0.15) and wear a face mask( B = −0.12). The results revealed the importance of considering both psychological and social factors to promote COVID-19 preventative behaviors.

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