scholarly journals Who has nature during the pandemic? COVID-19 cases track widespread inequity in nature access across the United States

2021 ◽  
Author(s):  
Erica Spotswood ◽  
Matthew Benjamin ◽  
Lauren Stoneburner ◽  
Megan Wheeler ◽  
Erin Beller ◽  
...  
Keyword(s):  
Low Income ◽  
Vegetation Index ◽  
Normalized Difference Vegetation Index ◽  
The United States ◽  
Incidence Rates ◽  
Demographic Variables ◽  
Urban Nature ◽  
Communities Of Color ◽  
The Us ◽  
Block Groups

Abstract Urban nature can alleviate distress and provide space for safe recreation during the COVID-19 pandemic. However, nature is often less available in low-income and communities of color—the same communities hardest hit by COVID-19. We quantified nature inequality across all urbanized areas in the US and linked nature access to COVID-19 case rates for ZIP Codes in 17 states. Areas with majority persons of color had both higher case rates and less greenness. Furthermore, when controlling for socio-demographic variables, an increase of 0.1 in Normalized Difference Vegetation Index (NDVI) was associated with a 4.1% decrease in COVID-19 incidence rates (95% confidence interval: 0.9-6.8%). Across the US, block groups with lower-income and majority persons of color are less green and have fewer parks. Thus, communities most impacted by COVID-19 also have the least nature nearby. Given urban nature is associated with both human health and biodiversity, these results have far-reaching implications both during and beyond the pandemic.

scholarly journals Nature inequity and higher COVID-19 case rates in less-green neighbourhoods in the United States

2021 ◽  
Author(s):  
Erica N. Spotswood ◽  
Matthew Benjamin ◽  
Lauren Stoneburner ◽  
Megan M. Wheeler ◽  
Erin E. Beller ◽  
...  
Keyword(s):  
United States ◽  
Low Income ◽  
Vegetation Index ◽  
Normalized Difference Vegetation Index ◽  
The United States ◽  
Incidence Rates ◽  
Lower Income ◽  
Urban Nature ◽  
Urbanized Areas ◽  
Block Groups

AbstractUrban nature—such as greenness and parks—can alleviate distress and provide space for safe recreation during the COVID-19 pandemic. However, nature is often less available in low-income populations and communities of colour—the same communities hardest hit by COVID-19. In analyses of two datasets, we quantified inequity in greenness and park proximity across all urbanized areas in the United States and linked greenness and park access to COVID-19 case rates for ZIP codes in 17 states. Areas with majority persons of colour had both higher case rates and less greenness. Furthermore, when controlling for sociodemographic variables, an increase of 0.1 in the Normalized Difference Vegetation Index was associated with a 4.1% decrease in COVID-19 incidence rates (95% confidence interval: 0.9–6.8%). Across the United States, block groups with lower income and majority persons of colour are less green and have fewer parks. Our results demonstrate that the communities most impacted by COVID-19 also have the least nature nearby. Given that urban nature is associated with both human health and biodiversity, these results have far-reaching implications both during and beyond the pandemic.

scholarly journals Remote sensing vegetation index methods to evaluate changes in greenness and evapotranspiration in riparian vegetation in response to the Minute 319 environmental pulse flow to Mexico

2018 ◽  
Vol 380 ◽  
pp. 45-54 ◽  
Author(s):  
Pamela L. Nagler ◽  
Christopher J. Jarchow ◽  
Edward P. Glenn
Keyword(s):  
Remote Sensing ◽  
Gulf Of California ◽  
Vegetation Index ◽  
Normalized Difference Vegetation Index ◽  
Colorado River ◽  
Environmental Flows ◽  
The United States ◽  
Landsat 8 ◽  
Pulse Flow ◽  
The Us

Abstract. During the spring of 2014, 130 million m3 of water were released from the United States' Morelos Dam on the lower Colorado River to Mexico, allowing water to reach the Gulf of California for the first time in 13 years. Our study assessed the effects of water transfer or ecological environmental flows from one nation to another, using remote sensing. Spatial applications for water resource evaluation are important for binational, integrated water resources management and planning for the Colorado River, which includes seven basin states in the US plus two states in Mexico. Our study examined the effects of the historic binational experiment (the Minute 319 agreement) on vegetative response along the riparian corridor. We used 250 m Moderate Resolution Imaging Spectroradiometer (MODIS), Enhanced Vegetation Index (EVI) and 30 m Landsat 8 satellite imagery to track evapotranspiration (ET) and the normalized difference vegetation index (NDVI). Our analysis showed an overall increase in NDVI and evapotranspiration (ET) in the year following the 2014 pulse, which reversed a decline in those metrics since the last major flood in 2000. NDVI and ET levels decreased in 2015, but were still significantly higher (P < 0.001) than pre-pulse (2013) levels. Preliminary findings show that the decline in 2015 persisted into 2016 and 2017. We continue to analyse results for 2018 in comparison to short-term (2013–2018) and long-term (2000–2018) trends. Our results support the conclusion that these environmental flows from the US to Mexico via the Minute 319 “pulse” had a positive, but short-lived (1 year), impact on vegetation growth in the delta.

scholarly journals The convergence of racial and income disparities in health insurance coverage in the United States

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
De-Chih Lee ◽  
Hailun Liang ◽  
Leiyu Shi
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Combined Effect ◽  
Medical Expenditure ◽  
The Us ◽  
Race Ethnicity ◽  
Vulnerability Measure

Abstract Objective This study applied the vulnerability framework and examined the combined effect of race and income on health insurance coverage in the US. Data source The household component of the US Medical Expenditure Panel Survey (MEPS-HC) of 2017 was used for the study. Study design Logistic regression models were used to estimate the associations between insurance coverage status and vulnerability measure, comparing insured with uninsured or insured for part of the year, insured for part of the year only, and uninsured only, respectively. Data collection/extraction methods We constructed a vulnerability measure that reflects the convergence of predisposing (race/ethnicity), enabling (income), and need (self-perceived health status) attributes of risk. Principal findings While income was a significant predictor of health insurance coverage (a difference of 6.1–7.2% between high- and low-income Americans), race/ethnicity was independently associated with lack of insurance. The combined effect of income and race on insurance coverage was devastating as low-income minorities with bad health had 68% less odds of being insured than high-income Whites with good health. Conclusion Results of the study could assist policymakers in targeting limited resources on subpopulations likely most in need of assistance for insurance coverage. Policymakers should target insurance coverage for the most vulnerable subpopulation, i.e., those who have low income and poor health as well as are racial/ethnic minorities.

scholarly journals Trends in Opioid Prescribing Among Hemodialysis Patients, 2007–2014

2018 ◽  
Vol 49 (1) ◽  
pp. 20-31 ◽  
Author(s):  
Matthew Daubresse ◽  
G. Caleb Alexander ◽  
Deidra C. Crews ◽  
Dorry L. Segev ◽  
Mara A. McAdams-DeMarco
Keyword(s):  
Low Income ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
The United States ◽  
Incidence Rates ◽  
Opioid Prescription ◽  
Opioid Prescribing ◽  
Hispanic Patients ◽  
Estimate Annual Incidence ◽  
National Trends

Background: Hemodialysis (HD) patients frequently experience pain. Previous studies of HD patients suggest increased opioid prescribing through 2010. It remains unclear if this trend continued after 2010 or declined with national trends. Methods: Longitudinal cohort study of 484,745 HD patients in the United States Renal Data System/Medicare data. We used Poisson/negative binomial regression to estimate annual incidence rates of opioid prescribing between 2007 and 2014. We compared prescribing rates with the general US population using IQVIA’s National Prescription Audit data. Outcomes included the following: percent of HD patients receiving an opioid prescription, rate of opioid prescriptions, quantity, days supply, morphine milligram equivalents (MME) dispensed per 100 person-days, and prescriptions per person. Results: In 2007, 62.4% of HD patients received an opioid prescription. This increased to 63.2% in 2010 then declined to 53.7% by 2014. Opioid quantity peaked in 2011 at 73.5 pills per 100 person-days and declined to 62.6 pills per 100 person-days in 2014. MME peaked between 2010 and 2012 then declined through 2014. In 2014, MME rates were 1.8-fold higher among non-Hispanic patients and 1.6-fold higher among low-income patients. HD patients received 3.2-fold more opioid prescriptions per person compared to the general US population and were primarily prescribed oxycodone and hydrocodone. Between 2012 and 2014, HD patients experienced greater declines in opioid prescriptions per person (18.2%) compared to the general US population (7.1%). Conclusion: Opioid prescribing among HD patients declined between 2012 and 2014. However, HD patients continue receiving substantially more opioids than the general US population.

scholarly journals Major disparities in COVID-19 test positivity for patients with non-English preferred language even after accounting for race and social factors in the United States in 2020

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hannah Cohen-Cline ◽  
Hsin-Fang Li ◽  
Monique Gill ◽  
Fatima Rodriguez ◽  
Tina Hernandez-Boussard ◽  
...  
Keyword(s):  
Low Income ◽  
Social Factors ◽  
The United States ◽  
Healthcare Systems ◽  
English Speakers ◽  
Health Records ◽  
Communities Of Color ◽  
Multi Level ◽  
Race Ethnicity ◽  
Barriers To Health

Abstract Background The COVID-19 pandemic has further exposed inequities in our society, demonstrated by disproportionate COVID-19 infection rate and mortality in communities of color and low-income communities. One key area of inequity that has yet to be explored is disparities based on preferred language. Methods We conducted a retrospective cohort study of 164,368 adults tested for COVID-19 in a large healthcare system across Washington, Oregon, and California from March – July 2020. Using electronic health records, we constructed multi-level models that estimated the odds of testing positive for COVID-19 by preferred language, adjusting for age, race/ethnicity, and social factors. We further investigated interaction between preferred language and both race/ethnicity and state. Analysis was performed from October–December 2020. Results Those whose preferred language was not English had higher odds of having a COVID-19 positive test (OR 3.07, p < 0.001); this association remained significant after adjusting for age, race/ethnicity, and social factors. We found significant interaction between language and race/ethnicity and language and state, but the odds of COVID-19 test positivity remained greater for those whose preferred language was not English compared to those whose preferred language was English within each race/ethnicity and state. Conclusions People whose preferred language is not English are at greater risk of testing positive for COVID-19 regardless of age, race/ethnicity, geography, or social factors – demonstrating a significant inequity. Research demonstrates that our public health and healthcare systems are centered on English speakers, creating structural and systemic barriers to health. Addressing these barriers are long overdue and urgent for COVID-19 prevention.

Politics, Power, and Money

2021 ◽  
pp. 98-118
Author(s):  
Sandro Galea
Keyword(s):  
Low Income ◽  
The United States ◽  
Political Leaders ◽  
The Public ◽  
Political Dynamics ◽  
Public Health Infrastructure ◽  
The Us ◽  
Data Informed ◽  
Disproportionate Burden ◽  
Trump Administration

This chapter investigates how politics and power shape health outcomes, with special emphasis on how these forces intersect with economic inequality and the disproportionate burden of sickness experienced by low-income populations. During the spread of COVID-19, American political leadership faced a test of its ability to respond to sudden crisis. Rising to such a difficult occasion requires detailed plans for what to do in such a scenario, robust public health infrastructure, and leadership which takes decisive, data-informed action, listening to experts and communicating clearly and consistently with the public. Tragically, COVID-19 found the United States lacking in all these areas. Political leaders are in a position to mold public opinion, nudging the public mind towards new ways of thinking. The precise term for this is “shifting the Overton window.” By helping to mainstream a cavalier attitude towards COVID-19, the Trump administration shifted the Overton window towards greater acceptance of behaviors which create poorer health. The chapter then looks at the failure to adequately address race in the US. Among the factors that shape health, the area of race is particularly sensitive to political dynamics.

scholarly journals Efficient Child Care Subsidies

2020 ◽  
Vol 110 (1) ◽  
pp. 162-199 ◽  
Author(s):  
Christine Ho ◽  
Nicola Pavoni
Keyword(s):  
Child Care ◽  
Low Income ◽  
The United States ◽  
Tax Rates ◽  
Child Care Subsidies ◽  
Optimal Program ◽  
The Us ◽  
Marginal Tax Rates ◽  
Welfare Problem ◽  
Care Costs

We study the design of child care subsidies in an optimal welfare problem with heterogeneous private market productivities. The optimal subsidy schedule is qualitatively similar to the existing US scheme. Efficiency mandates a subsidy on formal child care costs, with higher subsidies paid to lower income earners and a kink as a function of child care expenditure. Marginal labor income tax rates are set lower than the labor wedges, with the potential to generate negative marginal tax rates. We calibrate our simple model to features of the US labor market and focus on single mothers with children aged below 6. The optimal program provides stronger participation but milder intensive margin incentives for low-income earners with subsidy rates starting very high and decreasing with income more steeply than those in the United States. (JEL D82, H21, H24, J13, J16, J32)

Impact of Ethnicity On Incidence and Survival Among Adults with Acute Lymphoblastic Leukemia in the United States; Insights From 2005 SEER Data.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3069-3069
Author(s):  
Casey L O'Connell ◽  
Pedram Razavi ◽  
Roberta McKean-Cowdin ◽  
Malcolm C. Pike
Keyword(s):  
T Cell ◽  
B Cell ◽  
Ethnic Groups ◽  
Lymphoblastic Leukemia ◽  
The United States ◽  
Incidence Rates ◽  
The Us ◽  
Race Ethnicity ◽  
The Impact ◽  
Racial Ethnic

Abstract Abstract 3069 Poster Board III-6 Background Acute lymphoblastic leukemia (ALL) is an aggressive malignancy whose incidence declines through adolescence and then increases steadily with age. Prognosis appears to be inversely related to age among adults. We sought to explore the impact of race/ethnicity on incidence and survival among adults with ALL in the United States (US). Methods We examined trends in incidence and survival among adults with ALL in the US using the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program which includes data from 17 SEER registries. We calculated the incidence rates for the most recent time period (2001-2005) because the classification for ALL subtypes was more complete during this time. For the survival analysis we used the data collected between 1975 and 2005. We categorized race/ethnicity into 5 mutually exclusive categories: non-Hispanic whites (NHW), Hispanic whites (HW), African Americans (AA), Asian/Pacific Islanders (API) and American Indians/Native Alaskans (AI/NA). Hispanic ethnicity was defined using SEER's Hispanic-origin variable which is based on the NAACCR Hispanic Identification Algorithm (NHIA); 11 patients dually coded as black and Hispanic were included in the AA group for our analyses. Few ALL cases were identified among AI/NA, so that group is not represented in the final analyses. We included ALL cases coded in the SEER registry using the International Classification of Disease for Oncology (ICD-0-3) as 9827-9829 and 9835-9837. We excluded cases of Burkitt's leukemia (n=228), cases that were not confirmed by microscopic or cytologic tests (n=132), cases that were reported only based on autopsy data (n=3) and cases whose race/ethnicity were unknown (n=20). The average annual incidence rates per 100,000 for 2001-2005, age-adjusted to the 2000 US standard population were calculated using SEER*Stat Version 6.4.4 statistical software. We used multivariate Cox hazard models stratified by SEER registry and age category to estimate the hazard ratios (HR) and 95% confidence intervals (95% CI) for relative survival of adult ALL cases across race/ethnicity, sex and cell of origin (B- or T-cell). All models were adjusted for the diagnosis era, and use of non-CNS radiation. The model also included an interaction term for age and diagnosis era. We performed a separate stratified analysis of the impact of race/ethnicity on survival within age subgroups (20-29, 30-39, 40-59, 60-69, 70+). Results The highest incidence rate (IR) of ALL was observed for HW (IR: 1.60; 95% CI: 1.43-1.79). HW had a significantly higher IR across all age categories as compared to the other racial/ethnic groups, while AA had the lowest IR. In particular, the observed rate of B-cell ALL among HW (IR 0.77; 95% CI 0.69-0.87) was more than twice that of NHW (IR: 0.29; 95% CI: 0.27-0.32) and more than three times the rate observed among AA (IR: 0.20; 95% CI: 0.15-0.26). In contrast, we did not observe statistically significant variability in the rates of T-cell ALL across race/ethnic groups (overall IR: 0.12; 95% CI: 0.11-0.14). Survival was significantly poorer among AA (HR: 1.26; 95% CI: 1.09-1.46), HW (HR: 1.21; 95% CI: 1.09-1.46), and API (HR: 1.18; 95% CI: 1.06-1.32) compared to NHW with all subtypes of ALL. Among adults younger than 40 with B-cell ALL, survival was significantly poorer among AA (HR: 1.60; 95% CI:1.021-2.429) and HW (HR: 1.53; 95% CI:1.204-1.943) with a non-signficant trend among API (HR: 1.22; 95% 0.834-1.755) compared to NHW. Survival differences between the different racial/ethnic groups were no longer statistically significant among adults with B-cell ALL over the age of 40. For T-cell ALL, survival was significantly poorer among AA (HR: 1.61; 95% CI: 1.22-2.10), HW (HR: 1.49; 95% CI: 1.14-1.93) and API (HR: 1.57; 95% CI: 1.13-2.13), as compared to NHW. A similar survival pattern by age (adults above and below age 40 years) was observed for T-cell as described for B-cell, with AA under 40 having a particularly dismal prognosis (HR: 2.89; 95% CI 1.96-4.17) compared to NHW. Conclusions The incidence rate of B-cell ALL among adults in the US is higher among HW than other ethnic groups. Survival is significantly poorer among AA and HW than among NHW under the age of 40 with B-cell ALL. Survival is also significantly poorer among AA, HW and API than among NHW with T-cell ALL in adults under 40. Survival trends appear to converge after the age of 40 among all racial/ethnic groups. Disclosures No relevant conflicts of interest to declare.

Decision-making preferences of advanced cancer Hispanic patients from the United States and Latin America.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9063-9063
Author(s):  
Henrique Afonseca Parsons ◽  
Sriram Yennurajalingam ◽  
Eva Rosina Duarte ◽  
Alejandra Palma ◽  
Sofia Bunge ◽  
...  
Keyword(s):  
Decision Making ◽  
Latin America ◽  
Advanced Cancer ◽  
Family Involvement ◽  
Assessment Tool ◽  
The United States ◽  
Demographic Variables ◽  
The Family ◽  
The Us ◽  
Hispanic Patients

9063 Background: To determine whether preferences in frequency of passive decision making differ between Hispanic patients from Latin America (HLA) and Hispanic-American (HA) patients. Methods: We conducted a survey of advanced cancer Hispanic patients referred to outpatient palliative care clinics in the U.S, Chile, Argentina, and Guatemala. Information on demographic variables, PS,andMarin Acculturation Assessment Tool (only U.S. patients) was collected. Decision-making preference was evaluated by the decision-making assessment tool. Results: A total of 387 patients with advanced cancer were surveyed: 91 (24%) in the US, 100 (26%) in Chile, 94 (25%) in Guatemala, and 99 (26%) in Argentina. Median age was 59 years, and 61% were female. HLA preferred passive decision-making strategies significantly more frequently with regard to involvement of the family (24% versus 10%, p=0.009) or the physician (35% versus 26%, p<0.001), even after controlling for age and education (OR 3.8, p<0.001 for physician and 2.4, p=0.03 for family) (Table 1). 76/91 HA (83.5%), and 242/293 HLA (82%) preferred family involvement in decision-making (p=NS). No differences were found in decision-making preferences between low- and highly acculturated U.S. Hispanics. Conclusions: HA prefer more active decision-making as compared to HLA. Among HA, acculturation did not seem to play a role in decision-making preference determination. Our findings in this study confirm the importance of family participation in decision making in both HA and HLA. However, HA patients were much less likely to want family members or physicians to make decisions on their behalf. [Table: see text] [Table: see text]

Incidence of testicular cancer in the United States from 1992 to 2009.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 339-339 ◽  
Author(s):  
Manas Nigam ◽  
Brisa Aschebrook-Kilfoy ◽  
Sergey Shikanov ◽  
Scott E. Eggener
Keyword(s):  
United States ◽  
Testicular Cancer ◽  
White Men ◽  
The United States ◽  
Incidence Rates ◽  
The Us ◽  
Hispanic Men ◽  
Tumor Characteristic ◽  
Race Ethnicity ◽  
Hispanic White

339 Background: The incidence of testicular cancer (TC) increased in the US through 2003. However, little is known about these trends after 2003. We sought to determine trends in TC incidence based on race, ethnicity and tumor characteristics. Methods: TC incidence and tumor characteristic data from 1992-2009 were extracted from the Surveillance, Epidemiology, and End Results-13 (SEER) registry. Trends were determined using JoinPoint. Results: TC incidence in the US increased from 1992 (5.7/100,000) to 2009 (6.8/100,000) with annual percentage change (APC) of 1.1% (p < 0.001). TC rates were highest in non-Hispanic white men (1992: 7.5/100,000; 2009: 8.6/1000) followed by Hispanic men (1992: 4.0/100,000; 2009: 6.3/100,000) and lowest among non-Hispanic black men (1992: 0.7/100,000; 2009: 1.7/100,000). Significantly increasing incidence rates were observed in non-Hispanic white men (1.2%, p < 0.001) but most prominently among Hispanics, especially from 2002-2009 (5.6%, p < 0.01). A significant increase was observed for localized TC (1.21%, p < 0.001) and metastatic TC (1.43%, p < 0.01). Increased incidence occurred in localized tumors for non-Hispanic white men (1.56%, p <0.001), while Hispanic men experienced an increase in localized (2.6%, p < 0.001), regionalized (16.5% from 2002-09, p < 0.01), and distant (2.6%, p < 0.01) disease. Conclusions: Through 2009, testicular cancer incidence continues to increase in the United States, most notably among Hispanic men. [Table: see text]

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