scholarly journals Social Determinants Predict Outcomes in Data From a Multi-Ethnic Cohort of 20,899 Patients Investigated for COVID-19

2020 ◽  
Vol 8 ◽  
Author(s):  
Dara J. Lundon ◽  
Nihal Mohamed ◽  
Anna Lantz ◽  
Heather H. Goltz ◽  
Brian D. Kelly ◽  
...  
Keyword(s):  
At Risk ◽  
New York ◽  
Social Determinants ◽  
Disease Burden ◽  
Close Contact ◽  
Cross Sectional ◽  
History Of ◽  
Race Ethnicity ◽  
Sectional Analysis ◽  
Zip Code

Importance: The COVID-19 pandemic exploits existing inequalities in social determinants of health (SDOH) in disease burden and access to healthcare. Few studies have examined these emerging disparities using indicators of SDOH.Objective: To evaluate predictors of COVID-19 test positivity, morbidity, and mortality and their implications for inequalities in SDOH and for future policies and health care improvements.Design, Setting, and Participants: A cross sectional analysis was performed on all patients tested for COVID-19 on the basis of symptoms with either a history of travel to at risk regions or close contact with a confirmed case, across the Mount Sinai Health System (MSHS) up until April 26th 2020.Main Outcomes and Measures: Primary outcome was death from COVID-19 and secondary outcomes were test positivity, and morbidity (e.g., hospitalization and intubation caused by COVID-19).Results: Of 20,899 tested patients, 8,928 tested positive, 1,701 were hospitalized, 684 were intubated, and 1,179 died from COVID-19. Age, sex, race/ethnicity, New York City borough (derived from first 3 digits of zip-code), and English as preferred language were significant predictors of test positivity, hospitalization, intubation and COVID-19 mortality following multivariable logistic regression analyses.Conclusions and Relevance: People residing in poorer boroughs were more likely to be burdened by and die from COVID-19. Our results highlight the importance of integrating comprehensive SDOH data into healthcare efforts with at-risk patient populations.

scholarly journals Reported neighborhood traffic and the odds of asthma/asthma like symptoms: a cross-sectional analysis of a multi-racial cohort of children

2020 ◽  
Author(s):  
Sarah Commodore ◽  
Pamela Ferguson ◽  
Brian Neelon ◽  
Roger Newman ◽  
William Grobman ◽  
...  
Keyword(s):  
Air Pollution ◽  
Family History ◽  
Home Environment ◽  
Cross Sectional ◽  
History Of ◽  
Male Sex ◽  
Race Ethnicity ◽  
Environmental Air ◽  
Sectional Analysis ◽  
Environmental Air Pollution

Abstract Background: Respiratory symptoms and asthma in children pose a significant clinical and public health burden. Our aim was to examine exposures to environmental air pollution in relation to asthma and related symptoms in a multi-racial cohort of children. Methods: We conducted a cross-sectional analysis evaluating the association between reported neighborhood traffic (a proxy for traffic-related air pollution) and asthma among 855 children aged 4 to 8 years old who participated in the Environmental Influences on Child Health Outcomes (ECHO) cohort. The primary outcome, asthma/asthma like symptoms (defined as current and/or past physician diagnosed asthma, past wheezing, or nighttime cough or wheezing in the past 12 months), was assessed by parental report via questionnaire. The relationship between the primary exposure and asthma/asthma like symptoms was examined using logistic regression. Results: The prevalence of asthma/asthma like symptoms was 23%. Fifteen percent of parents responded “Agree” or “Strongly Agree” to the question, “There is so much traffic along the streets that it makes it difficult or dangerous to walk with my child in my neighborhood” (n=129/855). Children whose parents had affirmed significant neighborhood traffic had a higher odds of having asthma/asthma like symptoms than children without significant neighborhood traffic [adjusted OR=1.78 (95% CI: 1.10, 2.88)] after controlling for child’s race-ethnicity, age, sex, maternal education level, family history of asthma, presence of play equipment in the home environment, public parks in the neighborhood and obesity. Other factors significantly associated with asthma/asthma like symptoms were: non-Hispanic Black and Hispanic race/ethnicity [OR=2.53 (95% CI: 1.43, 4.50)] and [OR=2.25 (95% CI: 1.28, 3.94), respectively, vs. non-Hispanic White referent], play equipment in the home environment or backyard [OR=1.60 (95% CI: 1.09, 2.35)], obese status [OR=2.54 (95% CI: 1.55, 4.17)], male sex [OR=1.53 (1.06, 2.22)] and family history of asthma [OR=3.19 (2.20, 4.64)]. Conclusions: Reported neighborhood traffic, non-Hispanic Black and Hispanic race/ethnicity, male sex, play equipment within the home environment, obesity, and family history of asthma were associated with greater odds for asthma/asthma like symptoms. Further characterization of neighborhood traffic patterns is needed, since many children live near this source of environmental air pollution and significant racial/ethnic disparities exist.

Evaluation of the prevalence and nutritional and social determinants of overweight in a population of schoolchildren: a cross-sectional analysis of 5,037 children

2012 ◽  
Vol 58 (4) ◽  
pp. 472-476 ◽  
Author(s):  
Caroline Filla Rosaneli ◽  
Flavia Auler ◽  
Carla Barreto Manfrinato ◽  
Claudine Filla Rosaneli ◽  
Caroline Sganzerla ◽  
...  
Keyword(s):  
Social Determinants ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis

Comparison of Non-radiographic Axial Spondyloarthritis and Ankylosing Spondyltis from a Single Rheumatology Hospital in Morocco

2020 ◽  
Vol 16 (3) ◽  
pp. 240-244 ◽  
Author(s):  
Nessrine Akasbi ◽  
Siar Nihad ◽  
Zoukal Sofia ◽  
El Kohen Khadija ◽  
Harzy Taoufik
Keyword(s):  
Disease Burden ◽  
Axial Spondyloarthritis ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Low Back ◽  
New Classification ◽  
Cross Sectional ◽  
Asas Criteria ◽  
History Of ◽  
High Level

Background: According to the new classification criteria developed by The Assessment of SpondyloArthritis International Society, patients with axial spondyloarthritis (axSpA) can be classified in 2 subgroups: Patients with radiographic axial spondyloarthritis: ankylosing spondylitis patients (AS) and those with non-radiographic axial spondyloarthritis (nr-axSpA). Objective: The aim of the present study is to describe and discuss the differences and similarities between the two subgroups. Patients and Methods: A cross-sectional study was conducted in a single rheumatology hospital in Morocco. These included patients diagnosed as having axial spondyloarthritis according to ASAS criteria 2010, during a period of 6 years. The AS and the nr-axSpA subgroups were compared for the various axSpA-related variables. Results: Of the 277 patients with a diagnosis of axial SpA who were included in this study, 160 had AS and 117 had nr-axSpA. AS and nr-ax-SpA shared a similar age at diagnosis, similar prevalence of low back pain, lumbar stiffness, extra-articular manifestations, BASDAI and BASFI. In the multivariate analysis, AS patients were mainly male with cervical stiffness, enthesitis, coxitis and high level of ESR (erythrocyte sedimentation rate). The females generally had a family history of SpA and arthritis and were associated to the nr-axSpA form in the univariate analysis. Conclusion: This was the first study to characterise patients with AS and nr-axSpA in Morocco. Consistent with other studies published, this study showed that patients with nr-axSpA and patients with AS shared a comparable degree of disease burden.

scholarly journals Healthcare provider counselling for weight management behaviours among adults with overweight or obesity: a cross-sectional analysis of National Health and Nutrition Examination Survey, 2011–2018

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039295
Author(s):  
Mary L. Greaney ◽  
Steven A. Cohen ◽  
Furong Xu ◽  
Christie L Ward-Ritacco ◽  
Deborah Riebe
Keyword(s):  
Older Adults ◽  
National Health ◽  
Weight Status ◽  
Calorie Intake ◽  
Nutrition Examination Survey ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
Race Ethnicity ◽  
Sectional Analysis ◽  
Overweight Or Obesity

ObjectivesTo determine if adults with overweight or obesity received counselling from their healthcare providers (HCPs) to lose weight and/or adopt healthful behaviours associated with weight loss, and whether they took action on their HCPs’ recommendations.DesignCross-sectional analysis of 2011–2018 National Health and Nutrition Examination Survey (NHANES) data.SampleNHANES respondents aged 18+ who were overweight/obese and had seen an HCP in the previous 12 months (n=13 158).MethodsRespondents reported if their HCPs recommended they control/lose weight, increase exercise/physical activity (PA) and/or reduce fat/calorie intake, and if they adopted the offered recommendation(s). Weighted logistic regression models examined receipt of HCP counselling by sex, age, race/ethnicity, and weight status accounting for demographic characteristics and complex sampling. Similar analyses examined reported adoption of HCPs’ recommendations.ResultsThe sample was 53.1% women, 45.0% were overweight and 55.0% had obesity. In total, 40.4% received counselling to control/lose weight, 49.5% to increase exercise/PA and 38.9% to reduce fat/calorie intake. The following groups were less likely (p<0.001) to receive counselling: men; younger adults (aged 18–39) versus middle-aged (aged 40–64) and older adults (aged 65+); White versus Black and Hispanic respondents; overweight respondents versus respondents with obesity. Approximately half of those advised to make changes reported doing so (53.6% controlled/lost weight, 57.3% increased exercise/PA, 51.8% reduced fat/calorie intake). Differences in the adoption of recommendations were identified by sex, age group, race/ethnicity and weight status (all p<0.05); women, middle-aged and older adults, Black and Hispanic respondents and individuals with obesity were more likely to adopt one or more recommendations.ConclusionMost respondents did not receive HCP counselling, and approximately half of those who received counselling reported taking action. HCPs may need training to provide counselling and to offer recommendations tailored to the social contexts of populations less likely to adopt weight control related recommendations.

scholarly journals Reported Neighborhood Traffic and the Odds of Asthma/Asthma-Like Symptoms: A Cross-Sectional Analysis of a Multi-Racial Cohort of Children

2020 ◽  
Vol 18 (1) ◽  
pp. 243
Author(s):  
Sarah Commodore ◽  
Pamela L. Ferguson ◽  
Brian Neelon ◽  
Roger Newman ◽  
William Grobman ◽  
...  
Keyword(s):  
Maternal Education ◽  
Ethnic Disparities ◽  
Traffic Density ◽  
Public Parks ◽  
Cross Sectional ◽  
Public Health Burden ◽  
Child Health Outcomes ◽  
History Of ◽  
Study Participants ◽  
Sectional Analysis

Asthma in children poses a significant clinical and public health burden. We examined the association between reported neighborhood traffic (a proxy for traffic-related air pollution) and asthma among 855 multi-racial children aged 4–8 years old who participated in the Environmental Influences on Child Health Outcomes (ECHO) cohort. We hypothesized that high neighborhood traffic density would be associated with the prevalence of asthma. Asthma/asthma-like symptoms (defined as current and/or past physician diagnosed asthma, past wheezing, or nighttime cough or wheezing in the past 12 months) was assessed by parental report. The relationship between neighborhood traffic and asthma/asthma-like symptoms was assessed using logistic regression. The prevalence of asthma/asthma-like symptoms among study participants was 23%, and 15% had high neighborhood traffic. Children with significant neighborhood traffic had a higher odds of having asthma/asthma-like symptoms than children without neighborhood traffic [adjusted OR = 2.01 (95% CI: 1.12, 3.62)] after controlling for child’s race-ethnicity, age, sex, maternal education, family history of asthma, play equipment in the home environment, public parks, obesity and prescribed asthma medication. Further characterization of neighborhood traffic is needed since many children live near high traffic zones and significant racial/ethnic disparities exist.

scholarly journals Natural history of fibrodysplasia ossificans progressiva: cross-sectional analysis of annotated baseline phenotypes

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Robert J. Pignolo ◽  
Geneviève Baujat ◽  
Matthew A. Brown ◽  
Carmen De Cunto ◽  
Maja Di Rocco ◽  
...  
Keyword(s):  
Natural History ◽  
Fibrodysplasia Ossificans Progressiva ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
History Of ◽  
Sectional Analysis

Epidemiological Characteristics of Sport-Related Concussion in Athletes of Brazilian Jiu-Jitsu and Muay Thai

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S23.1-S23
Author(s):  
Carlos Pinheiro ◽  
Francisca Taciane Nascimento Sousa
Keyword(s):  
Close Contact ◽  
Cross Sectional Study ◽  
Self Report ◽  
Combat Sports ◽  
Cross Sectional ◽  
Brazilian Sample ◽  
Individual Interviews ◽  
History Of ◽  
The Moment ◽  
Epidemiological Characteristics

ObjectiveTo evaluate the self-reported history of concussion in athletes of both Brazilian Jiu-Jitsu (BJJ) and Muay Thai.BackgroundCombat sports are widely practiced around the world. They include modalities that involves punches or kicks directed at the opponent's head (Striking sports) or that consists of grabbing an opponent and taking him to the ground (Grappling sports). Due to the objectives and close contact in combat sports, the risk of concussion is significant.Design/MethodsThis was a cross-sectional study involving a Brazilian sample of BJJ athletes (n-18) and Muay Thai athletes (n-22). The sample was consisted of both professional and amateur athletes (Women constituted 20% of sample). Through individual interviews with a researcher the following data were collected: self-report of concussion and the moment of the injury (whether in practice or in the fight). The Post-Concussion Symptoms Scale (PCSS) was also applied. In the present study, a concussion was considered as a direct impact on the head followed by symptoms. This study was approved by a local Ethics Committee.ResultsAmong BJJ athletes, 61% reported a history of concussion, while among Muay Thai athletes the percentage was more higher (86%). The main mechanisms of head impact were the throw/takedown and elbow-hits to the head in BJJ and punches and knee-hits to the head in Muay Thai. There was no difference in the symptom score between BJJ and Muay Thai concussed athletes (average of 11 vs 10.7, respectively). The most common symptoms were dizziness, headache and nausea in BJJ athletes, and headache, nausea, drowsiness and brain fogginess in Muay Thai ones.ConclusionsThe results presented herein suggest that concussions in Muay Thai and BJJ occur through different mechanisms. The clinical profile of post-concussion symptoms appears to be different between BJJ and Muay Thai athletes.

scholarly journals Do Black Lives Matter in the American Public’s Mitigation Responses to the Covid-19 Pandemic? A Cross-Sectional Analysis of Mask Wearing and Racial/ethnic Disparities in Deaths from COVID-19 in the United States

2021 ◽  
Author(s):  
Berkeley Franz ◽  
Adrienne Milner ◽  
Jomills H. Braddock
Keyword(s):  
Public Health ◽  
Residential Segregation ◽  
Ethnic Disparities ◽  
The United States ◽  
Ethnic Composition ◽  
Cross Sectional ◽  
Public Health Challenges ◽  
History Of ◽  
Sectional Analysis ◽  
Racial Ethnic

Abstract Background: Anti-black and anti-Hispanic attitudes in the U.S. must be included in efforts to understand resistance to public health measures, such as mask wearing, during the COVID-19 pandemic. Focusing on the structural and individual context of racism will enable us to improve public health and better prepare for future public health challenges. The purpose of this study was to determine the relationship between mask usage, racial segregation, and racial disparities in COVID-19 deaths.Methods: We used linear regression to assess whether the racial/ethnic composition of deaths and residential segregation predicted Americans’ decisions to wear masks in July 2020. Results: After controlling for mask mandates, mask usage increased when the White death rates relative to Black and Hispanic rates increased. Conclusions: Mask wearing may be shaped by an insensitivity to Black and Hispanic deaths and a corresponding unwillingness to engage in health protective behaviors. The broader history of systemic racism and residential segregation may also explain why white Americans do not wear masks or perceive themselves to be at risk when communities of color are disproportionately affected by COVID-19.

scholarly journals Stillbirth and infant death: mental health among low-income mothers in Mumbai

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lisa Roberts ◽  
Solomon J. Renati ◽  
Shreeletha Solomon ◽  
Susanne Montgomery
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Low Income ◽  
Infant Death ◽  
Postnatal Depression ◽  
Perinatal Loss ◽  
Reproductive Age ◽  
Cross Sectional ◽  
History Of ◽  
Perinatal Grief

Abstract Background India has the highest number of stillbirths and the highest neonatal death rate in the world. In the context of its pronatalist society, women who experience perinatal loss often encounter significant social repercussions on top of grief. Furthermore, even when pregnancy outcomes were favorable, adverse life circumstances put some women at risk for postnatal depression. Therefore, perinatal loss and postnatal depression take a heavy toll on women’s mental health. The purpose of this study is to assess mental health among a sample of Mumbai slum-dwelling women with a history of recent childbirth, stillbirth, or infant death, who are at risk for perinatal grief, postnatal depression, or mental health sequelae. Methods We conducted a mixed method, cross-sectional study. A focus group discussion informed the development of a comprehensive survey using mainly internationally validated scales. After rigorous forward and back-translation, surveys were administered as face-to-face structured interviews due to low literacy and research naiveté among our respondents. Interviews were conducted by culturally, linguistically, gender-matched, trained research assistants. Results Of our reproductive age (N = 260) participants, 105 had experienced stillbirth, 69 had a history of infant death, and 25 had experienced both types of loss. Nearly half of the sample met criteria for postnatal depression, and 20% of these women also met criteria for perinatal grief. Anxiety and depression varied by subgroup, and was highest among women desiring an intervention. Conclusions Understanding factors contributing to women’s suffering related to reproductive challenges in this pronatalist context is critically important for women’s wellbeing.

scholarly journals Eating alone at each meal and associated health status by cohabitation situation among Japanese community-dwelling elderly: a cross-sectional analysis of the KAGUYA study

2020 ◽  
Author(s):  
Osamu Kushida ◽  
Jong-Seong Moon ◽  
Daisuke Matsumoto ◽  
Naomi Yamasaki ◽  
Katsuhiko Takatori
Keyword(s):  
Health Status ◽  
Functional Capacity ◽  
Health Status Indicators ◽  
Subjective Health ◽  
Community Dwelling ◽  
Care Needs ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
History Of ◽  
Sectional Analysis

Abstract Background: This study investigated the association between eating alone at each meal and health status including functional capacity according to cohabitation situation among Japanese community-dwelling elderly.Methods: This was a cross-sectional analysis of baseline data from the Keeping Active across Generations Uniting the Youth and the Aged (KAGUYA) study in Japan. A self-administered questionnaire was mailed to all 8004 residents aged 65 or older residing in the same Japanese town the participants in March 2016. Eating alone was assessed by first asking whether participants ate three separate meals each day (i.e., breakfast, lunch, and dinner), and those who answered affirmatively were then asked how many people were usually present at each meal. Health status was assessed in terms of subjective health, medical history, care needs, body mass index, depression, and functional capacity.Results: Data from 3057 respondents were analyzed. Among those living with others, those who reported not being in good subjective health and a history of hypertension were significantly more likely to eat alone at breakfast (odds ratio 1.27; 95% confidence interval 1.01–1.61, and 1.26; 1.06–1.49). Depressive symptoms and many subscales of functional capacity were also significantly associated with eating alone at breakfast, lunch, and dinner (P < 0.05). Among those living alone, those eating alone at breakfast had lower scores for indicators of functional capacity including information practice (P = 0.010) and total scores (P = 0.049).Conclusions: For both cohabitation situations, many health status indicators were related to eating alone at each meal, especially breakfast.

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