Racial and Ethnic Disparities in COVID-19 Outcomes: Social Determination of Health

As of 18 October 2020, over 39.5 million cases of coronavirus disease 2019 (COVID-19) and 1.1 million associated deaths have been reported worldwide. It is crucial to understand the effect of social determination of health on novel COVID-19 outcomes in order to establish health justice. There is an imperative need, for policy makers at all levels, to consider socioeconomic and racial and ethnic disparities in pandemic planning. Cross-sectional analysis from COVID Boston University’s Center for Antiracist Research COVID Racial Data Tracker was performed to evaluate the racial and ethnic distribution of COVID-19 outcomes relative to representation in the United States. Representation quotients (RQs) were calculated to assess for disparity using state-level data from the American Community Survey (ACS). We found that on a national level, Hispanic/Latinx, American Indian/Alaskan Native, Native Hawaiian/Pacific Islanders, and Black people had RQs > 1, indicating that these groups are over-represented in COVID-19 incidence. Dramatic racial and ethnic variances in state-level incidence and mortality RQs were also observed. This study investigates pandemic disparities and examines some factors which inform the social determination of health. These findings are key for developing effective public policy and allocating resources to effectively decrease health disparities. Protective standards, stay-at-home orders, and essential worker guidelines must be tailored to address the social determination of health in order to mitigate health injustices, as identified by COVID-19 incidence and mortality RQs.

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Improved measurement of racial/ethnic disparities in COVID-19 mortality in the United States

10.1101/2020.05.21.20109116 ◽

2020 ◽

Cited By ~ 8

Author(s):

Joshua R. Goldstein ◽

Serge Atherwood

Keyword(s):

United States ◽

New York ◽

National Level ◽

Ethnic Disparities ◽

State Level ◽

The United States ◽

Estimation Methods ◽

Death Rates ◽

Population Distributions ◽

Racial Ethnic

AbstractDifferent estimation methods produce diverging accounts of racial/ethnic disparities in COVID-19 mortality in the United States. The CDC’s decision to present the racial/ethnic distribution of COVID-19 deaths at the state level alongside re-weighted racial/ethnic population distributions—in effect, a geographic adjustment—makes it seem that Whites have the highest death rates. Age adjustment procedures used by others, including the New York City Department of Health and Mental Hygiene, lead to the opposite conclusion that Blacks and Hispanics are dying from COVID-19 at higher rates than Whites. In this paper, we use indirect standardization methods to adjust per-capita death rates for both age and geography simultaneously, avoiding the one-sided adjustment procedures currently in use. Using CDC data, we find age-and-place-adjusted COVID-19 death rates are 80% higher for Blacks and more than 50% higher for Hispanics, relative to Whites, on a national level, while there is almost no disparity for Asians. State-specific estimates show wide variation in mortality disparities. Comparison with non-epidemic mortality reveals potential roles for pre-existing health disparities and differential rates of infection and care.

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Applicability of management guidelines for surfing resources in California

Shore & Beach ◽

10.34237/1008835 ◽

2020 ◽

pp. 53-64

Author(s):

Edward Atkin ◽

Dan Reineman ◽

Jesse Reiblich ◽

David Revell

Keyword(s):

New Zealand ◽

National Level ◽

State Level ◽

The United States ◽

Management Guidelines ◽

For Profit ◽

Aotearoa New Zealand ◽

Coastal Marine ◽

Management Measures ◽

Legal Frameworks

Surf breaks are finite, valuable, and vulnerable natural resources, that not only influence community and cultural identities, but are a source of revenue and provide a range of health benefits. Despite these values, surf breaks largely lack recognition as coastal resources and therefore the associated management measures required to maintain them. Some countries, especially those endowed with high-quality surf breaks and where the sport of surfing is accepted as mainstream, have recognized the value of surfing resources and have specific policies for their conservation. In Aotearoa New Zealand surf breaks are included within national environmental policy. Aotearoa New Zealand has recently produced Management Guidelines for Surfing Resources (MGSR), which were developed in conjunction with universities, regional authorities, not-for-profit entities, and government agencies. The MGSR provide recommendations for both consenting authorities and those wishing to undertake activities in the coastal marine area, as well as tools and techniques to aid in the management of surfing resources. While the MGSR are firmly aligned with Aotearoa New Zealand’s cultural and legal frameworks, much of their content is applicable to surf breaks worldwide. In the United States, there are several national-level and state-level statutes that are generally relevant to various aspects of surfing resources, but there is no law or policy that directly addresses them. This paper describes the MGSR, considers California’s existing governance frameworks, and examines the potential benefits of adapting and expanding the MGSR in this state.

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259 RACIAL AND ETHNIC DISPARITIES IN INCIDENCE AND MORTALITY FOR FIVE GASTROINTESTINAL CANCERS: RESULTS FROM THE SURVEILLANCE, EPIDEMIOLOGY, AND END RESULTS CANCER REGISTRY

Gastroenterology ◽

10.1016/s0016-5085(21)00887-8 ◽

2021 ◽

Vol 160 (6) ◽

pp. S-60

Author(s):

Aileen Bui ◽

Liu Yang ◽

Camille Soroudi ◽

Folasade (Fola) P. May

Keyword(s):

Cancer Registry ◽

Ethnic Disparities ◽

Racial And Ethnic Disparities ◽

Gastrointestinal Cancers ◽

Incidence And Mortality ◽

End Results

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Shooting from the ‘Scrip: Scope of Practice Laws and Access to Immunizations in the Pharmacy Setting

Vaccines ◽

10.3390/vaccines9050444 ◽

2021 ◽

Vol 9 (5) ◽

pp. 444

Author(s):

Charles Stoecker

Keyword(s):

Positive Impact ◽

National Level ◽

State Level ◽

The United States ◽

Scope Of Practice ◽

Patient Specific ◽

Behavioral Risk ◽

Influenza Immunization ◽

Immunization Rates ◽

The Impact

In the past two decades, most states in the United States have added authorization for pharmacists to administer some vaccinations. Expansions of this authority have also come with prescription requirements or other regulatory burdens. The objective of this study was to evaluate the impact of these expansions on influenza immunization rates in adults age 65 and over. A panel data, differences-in-differences regression framework to control for state-level unobserved confounders and shocks at the national level was used on a combination of a dataset of state-level statute and regulatory changes and influenza immunization data from the Behavioral Risk Factor Surveillance System. Giving pharmacists permission to vaccinate had a positive impact on adult influenza immunization rates of 1.4 percentage points for adults age 65 and over. This effect was diminished by the presence of laws requiring pharmacists to obtain patient-specific prescriptions. There was no evidence that allowing pharmacists to administer vaccinations led patients to have fewer annual check-ups with physicians or not have a usual source of health care. Expanding pharmacists’ scope of practice laws to include administering the influenza vaccine had a positive impact on influenza shot uptake. This may have implications for relaxing restrictions on other forms of care that could be provided by pharmacists.

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