scholarly journals Do racial and ethnic disparities in following stay-at-home orders influence COVID-19 health outcomes? A mediation analysis approach

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259803
Author(s):  
Songhua Hu ◽  
Weiyu Luo ◽  
Aref Darzi ◽  
Yixuan Pan ◽  
Guangchen Zhao ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Infection Rate ◽  
Ethnic Differences ◽  
Human Mobility ◽  
Ethnic Disparities ◽  
Case Fatality ◽  
Equation Modeling ◽  
Case Fatality Ratio ◽  
Racial Ethnic ◽  
At Home

Racial/ethnic disparities are among the top-selective underlying determinants associated with the disproportional impact of the COVID-19 pandemic on human mobility and health outcomes. This study jointly examined county-level racial/ethnic differences in compliance with stay-at-home orders and COVID-19 health outcomes during 2020, leveraging two-year geo-tracking data of mobile devices across ~4.4 million point-of-interests (POIs) in the contiguous United States. Through a set of structural equation modeling, this study quantified how racial/ethnic differences in following stay-at-home orders could mediate COVID-19 health outcomes, controlling for state effects, socioeconomics, demographics, occupation, and partisanship. Results showed that counties with higher Asian populations decreased most in their travel, both in terms of reducing their overall POIs’ visiting and increasing their staying home percentage. Moreover, counties with higher White populations experienced the lowest infection rate, while counties with higher African American populations presented the highest case-fatality ratio. Additionally, control variables, particularly partisanship, median household income, percentage of elders, and urbanization, significantly accounted for the county differences in human mobility and COVID-19 health outcomes. Mediation analyses further revealed that human mobility only statistically influenced infection rate but not case-fatality ratio, and such mediation effects varied substantially among racial/ethnic compositions. Last, robustness check of racial gradient at census block group level documented consistent associations but greater magnitude. Taken together, these findings suggest that US residents’ responses to COVID-19 are subject to an entrenched and consequential racial/ethnic divide.

scholarly journals Geographic Regional Variation in Patterns of Racial and Ethnic Disparities in Late-Life Depression

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 168-168
Author(s):  
Chirag Vyas ◽  
Charles Reynolds ◽  
David Mischoulon ◽  
Grace Chang ◽  
Olivia Okereke
Keyword(s):  
Native American ◽  
Ethnic Differences ◽  
Ethnic Disparities ◽  
Late Life ◽  
Geographic Region ◽  
Omega 3 ◽  
Late Life Depression ◽  
Item Level ◽  
Racial Ethnic ◽  
Hispanic White

Abstract There is evidence of racial/ethnic disparities in late-life depression (LLD) burden and treatment in the US. Geographic region may be a novel social determinant; yet, limited data exist regarding the interplay of geographic region with racial/ethnic differences in LLD severity, item-level symptom burden and treatment. We conducted a cross-sectional study among 25,503 men aged 50+ years and women aged 55+ years in VITAL-DEP (VITamin D and OmegA-3 TriaL-Depression Endpoint Prevention), an ancillary study to the VITAL trial. Racial/ethnic groups included Non-Hispanic White, Black, Hispanic, Asian, and other groups (Native American/Alaskan Native and other/multiple/unspecified-race/ethnicity). We assessed depression status using: the Patient Health Questionnaire-8 (PHQ-8); self-reported clinician/physician diagnosis of depression; medication and/or counseling treatment for depression. In the full sample, Midwest region was significantly associated with 12% lower severity of LLD, compared to Northeast region (rate ratio (RR) (95% confidence interval (CI)): 0.88 (0.83-0.93)). However, racial/ethnic differences in LLD varied by region. For example, in the Midwest, Blacks and Hispanics had significantly higher depression severity compared to non-Hispanic Whites (RR (95% CI): for Black, 1.16 (1.02-1.31); for Hispanic, 2.03 (1.38-3.00)). Furthermore, in multivariable-adjusted logistic regression models, minority vs. non-Hispanic White adults had 2- to 3-fold significantly higher odds of several item-level symptoms across all regions, especially in the Midwest and Southwest. Finally, among those endorsing PHQ-8≥10, Blacks had 60-80% significantly lower odds of depression treatment, compared to non-Hispanic Whites, in all regions. In summary, we observed significant geographic variation in patterns of racial/ethnic disparities in LLD outcomes. This requires further longitudinal investigation.

scholarly journals Physical Activity as a Mediator in the Relationship Between Race or Ethnicity and Changes in Multimorbidity

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 342-342
Author(s):  
Jason Newsom ◽  
Emily Denning ◽  
Ana Quinones ◽  
Miriam Elman ◽  
Anda Botoseneanu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sex Education ◽  
Chronic Conditions ◽  
Structural Equation ◽  
Insurance Coverage ◽  
Ethnic Disparities ◽  
Later Life ◽  
Equation Modeling ◽  
The Relationship ◽  
Racial Ethnic

Abstract Racial/ethnic disparities in multimorbidity (≥2 chronic conditions) and their rate of accumulation over time have been established. Studies report differences in physical activity across racial/ethnic groups. We investigated whether racial/ethnic differences in accumulation of multimorbidity over a 10-year period (2004-2014) were mediated by physical activity using data from the Health and Retirement Study (N = 10,724, mean age = 63.5 years). Structural equation modeling was used to estimate a latent growth curve model of changes in the number of self-reported chronic conditions (of nine) and investigate whether the relationship of race/ethnicity (non-Hispanic Black, Hispanic, non-Hispanic White) to change in the number of chronic conditions was mediated by physical activity after controlling for age, sex, education, marital status, personal wealth, and insurance coverage. Results indicated that Blacks engaged in significantly lower levels of physical activity than Whites (b = -.171, □ = -.153, p < .001), but there were no differences between Hispanics and Whites (b = -.010, □ = -.008, ns). Physical activity also significantly predicted both lower initial levels of multimorbidity (b = -1.437, □ = -.420, p < .001) and greater decline in multimorbidity (b = -.039, □ = -.075, p < .001). The indirect (mediational) effect for the Black vs. White comparison was significant (b = .007, □ = .011, 95% CI [.004,.010]). These results provide important new information for understanding how modifiable lifestyle factors may help explain disparities in multimorbidity in middle and later life, suggesting greater need to reduce sedentary behavior and increase activity.

scholarly journals Measuring the missing: greater racial and ethnic disparities in COVID-19 burden after accounting for missing race/ethnicity data

2020 ◽  
Author(s):  
Katie Labgold ◽  
Sarah Hamid ◽  
Sarita Shah ◽  
Neel R. Gandhi ◽  
Allison Chamberlain ◽  
...  
Keyword(s):  
Ethnic Disparities ◽  
Case Fatality ◽  
The United States ◽  
Infection Rates ◽  
Bias Adjustment ◽  
Social Inequities ◽  
Increased Risk ◽  
Race Ethnicity ◽  
The Difference ◽  
Racial Ethnic

AbstractBlack, Hispanic, and Indigenous persons in the United States have an increased risk of SARS-CoV-2 infection and death from COVID-19, due to persistent social inequities. The magnitude of the disparity is unclear, however, because race/ethnicity information is often missing in surveillance data. In this study, we quantified the burden of SARS-CoV-2 infection, hospitalization, and case fatality rates in an urban county by racial/ethnic group using combined race/ethnicity imputation and quantitative bias-adjustment for misclassification. After bias-adjustment, the magnitude of the absolute racial/ethnic disparity, measured as the difference in infection rates between classified Black and Hispanic persons compared to classified White persons, increased 1.3-fold and 1.6-fold respectively. These results highlight that complete case analyses may underestimate absolute disparities in infection rates. Collecting race/ethnicity information at time of testing is optimal. However, when data are missing, combined imputation and bias-adjustment improves estimates of the racial/ethnic disparities in the COVID-19 burden.

scholarly journals The major genetic risk factor for severe COVID-19 among Europeans does not show any association among Indian populations

2021 ◽  
Author(s):  
Prajjval Pratap Singh ◽  
Anshika Shrivastava ◽  
Gazi Nurun Nahar Sultana ◽  
Nargis Khanam ◽  
Abhishek Pathak ◽  
...  
Keyword(s):  
Infection Rate ◽  
South Asian ◽  
Case Fatality ◽  
Infection Rates ◽  
Genetic Loci ◽  
Asian Origin ◽  
Case Fatality Ratio ◽  
South Asian Origin ◽  
Asian Populations ◽  
Introgressed Segment

Abstract With the growing evidence on the variable human susceptibility against COVID-19, it is clear that there are some genetic loci modulating the severity. Recent studies have identified several loci associated with the higher severity. More recently, a study has identified 50kb segment introgressed from Neanderthal adding risk for COVID-19, and is present among 16% and 50% people of European and South Asian origin respectively. Contrary to that, our studies on ACE2 identified a haplotype present among 20% and 60% of European and South Asian populations respectively, was probably responsible for the low case fatality ratio among South Asian populations. This result was also consistent with the realtime infection rate and case fatality ratio among various states of India. We readdressed this issue using both of the contrasting datasets and compared them with the realtime infection rates and case fatality ratio in India. We found out that that the polymorphism present in 50kb introgressed segment (rs10490770) did not show any significant correlation with the realtime infection and case fatality ratio in India.With the growing evidence on the variable human susceptibility against COVID-19, it is clear that there are some genetic loci modulating the severity. Recent studies have identified several loci associated with the higher severity. More recently, a study has identified 50kb segment introgressed from Neanderthal adding risk for COVID-19, and is present among 16% and 50% people of European and South Asian origin respectively. Contrary to that, our studies on ACE2 identified a haplotype present among 20% and 60% of European and South Asian populations respectively, was probably responsible for the low case fatality ratio among South Asian populations. This result was also consistent with the realtime infection rate and case fatality ratio among various states of India. We readdressed this issue using both of the contrasting datasets and compared them with the realtime infection rates and case fatality ratio in India. We found out that that the polymorphism present in 50kb introgressed segment (rs10490770) did not show any significant correlation with the realtime infection and case fatality ratio in India.

scholarly journals Temporal Trends in Racial and Ethnic Disparities in Sleep Duration in the United States: A National Health Interview Survey Analysis from 2004 to 2018

2021 ◽  
Author(s):  
César Caraballo ◽  
Shiwani Mahajan ◽  
Javier Valero-Elizondo ◽  
Daisy Massey ◽  
Yuan Lu ◽  
...  
Keyword(s):  
Sleep Duration ◽  
Ethnic Differences ◽  
Household Income ◽  
National Health Interview Survey ◽  
Temporal Trends ◽  
Ethnic Disparities ◽  
Short Sleep ◽  
Long Sleep ◽  
Interview Survey ◽  
Racial Ethnic

Importance: Minoritized racial and ethnic groups are generally more likely to experience sleep deficiencies. It is unclear how these sleep duration disparities have changed over recent years. Objective: To determine 15–year trends in the racial and ethnic differences in self–reported sleep duration among adults in the US. Design: Serial cross–sectional study. Setting: National Health Interview Survey from years 2004–2018. Participants: 429,195 non–institutionalized adults. Exposures: Self–reported race, ethnicity, household income, and sex/gender. Main Outcomes: Temporal trends and racial/ethnic differences in short– and long–sleep duration (≤6 and ≥10 hours in a 24–hour period, respectively) and racial/ethnic differences in the relationship between sleep duration and age. Results: The study sample consisted of 429,195 individuals (mean age 46.5 [SE, 0.08] years; 51.7% female) of which 5.1% identified as Asian, 11.8% as Black, 14.7% as Latino/Hispanic, and 68.5% as White. In 2004, the adjusted estimated prevalence of short–sleep duration and long–sleep duration, respectively, were 31.3% and 2.5% among Asian individuals, 35.3% and 6.4% among Black individuals, 27.0% and 4.6% among Latino/Hispanic individuals, and 27.8% and 3.5% among White individuals. Over the study period, there was a significant increase in the short sleep prevalence among Black, Latino/Hispanic, and White individuals (P≤0.02 for each), whereas prevalence of long sleep changed significantly only among Latino/Hispanic individuals (–1.4 points, P=0.01). In 2018, compared with White individuals, short sleep prevalence among Black and Latino/Hispanic individuals was higher by 10.7 points and 2.6 points, respectively (P≤0.02 each), and long sleep prevalence among Black people was significantly higher by 1.4 points (P=0.01). These racial/ethnic disparities were the greatest among women and among those with middle/high household income. Over the study period, Black individuals younger than 60 years old had the highest prevalence of short sleep compared with those of the same age; and Black individuals had a higher long–sleep duration prevalence than White individuals across all age groups. Conclusions: From 2004 to 2018, the prevalence of unrecommended sleep duration was persistently higher among Black individuals. The Black–White disparities were highest among women, individuals who had middle or high income, and among young or middle–aged adults.

scholarly journals RACE/ETHNICITY AND U.S. ADULT MORTALITY

2011 ◽  
Vol 8 (1) ◽  
pp. 5-24 ◽  
Author(s):  
Robert A. Hummer ◽  
Juanita J. Chinn
Keyword(s):  
Ethnic Differences ◽  
Mexican Americans ◽  
Mexican Immigrants ◽  
Ethnic Disparities ◽  
Adult Mortality ◽  
Social Resources ◽  
Socioeconomic Resources ◽  
Race Ethnicity ◽  
Racial Ethnic ◽  
Lower Mortality Risk

AbstractAlthough there have been significant decreases in U.S. mortality rates, racial/ethnic disparities persist. The goals of this study are to: (1) elucidate a conceptual framework for the study of racial/ethnic differences in U.S. adult mortality, (2) estimate current racial/ethnic differences in adult mortality, (3) examine empirically the extent to which measures of socioeconomic status and other risk factors impact the mortality differences across groups, and (4) utilize findings to inform the policy community with regard to eliminating racial/ethnic disparities in mortality. Relative Black-White differences are modestly narrower when compared to a decade or so ago, but remain very wide. The majority of the Black-White adult mortality gap can be accounted for by measures of socioeconomic resources that reflect the historical and continuing significance of racial socioeconomic stratification. Further, when controlling for socioeconomic resources, Mexican Americans and Mexican immigrants exhibit significantly lower mortality risk than non-Hispanic Whites. Without aggressive efforts to create equality in socioeconomic and social resources, Black-White disparities in mortality will remain wide, and mortality among the Mexican-origin population will remain higher than what would be the case if that population achieved socioeconomic equality with Whites.

scholarly journals Racial/ethnic differences in HIV testing: An application of the health services utilization model

2018 ◽  
Vol 6 ◽  
pp. 205031211878341 ◽  
Author(s):  
Celia C Lo ◽  
Ratonia C Runnels ◽  
Tyrone C Cheng
Keyword(s):  
Health Services ◽  
Hiv Testing ◽  
Ethnic Groups ◽  
Ethnic Differences ◽  
Health Services Utilization ◽  
Ethnic Disparities ◽  
Hiv Treatment ◽  
Statistical Testing ◽  
Services Utilization ◽  
Racial Ethnic

This study applying the health services utilization model examined the importance of predisposing, enabling, and need variables to the social mechanisms explaining lifetime HIV testing across racial/ethnic groups. Data for the study were derived from the National Health Interview Survey (collected 2013–2014), our final sample numbering 18,574 adults. Four subsamples reflected race/ethnicity: 13,347 Whites, 2267 Blacks, 2074 Hispanics, and 886 Asians. Logistic regression established respondent odds of ever having received HIV testing. Further statistical testing evaluated race/ethnicity’s potential moderating role in HIV testing. The findings generally support a role for Aday’s predisposing, enabling, and need factors in explaining HIV testing. Across the four subsamples, female gender, older age, and sexual minority status consistently increased lifetime HIV testing. However, we found racial/ethnic differences in HIV testing’s associations with these factors and others. Our study made a beginning in the effort to specify mechanisms leading to HIV testing—and reliable diagnosis—among four racial/ethnic groups. Understanding these mechanisms might multiply opportunities to raise testing rates for all, in turn reducing racial/ethnic disparities in HIV treatment.

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