scholarly journals Racial Disparities-Associated COVID-19 Mortality among Minority Populations in the US

2020 ◽  
Vol 9 (8) ◽  
pp. 2442 ◽  
Author(s):  
Donald J. Alcendor
Keyword(s):  
Social Services ◽  
Underserved Populations ◽  
The United States ◽  
Cultural Barriers ◽  
Systems Science ◽  
Minority Populations ◽  
Populations At Risk ◽  
Increased Risk ◽  
The Us ◽  
Novel Coronavirus

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a betacoronavirus that causes the novel coronavirus disease 2019 (COVID-19), is highly transmissible and pathogenic for humans and may cause life-threatening disease and mortality, especially in individuals with underlying comorbidities. First identified in an outbreak in Wuhan, China, COVID-19 is affecting more than 185 countries and territories around the world, with more than 15,754,651 confirmed cases and more than 640,029 deaths. Since December 2019, SARS-CoV-2 transmission has become a global threat, which includes confirmed cases in all 50 states within the United States (US). As of 25 July 2020, the Johns Hopkins Whiting School of Engineering Center for Systems Science and Engineering reports more than 4,112,651 cases and 145,546 deaths. To date, health disparities are associated with COVID-19 mortality among underserved populations. Here, the author explores potential underlying reasons for reported disproportionate, increased risks of mortality among African Americans and Hispanics/Latinos with COVID-19 compared with non-Hispanic Whites. The author examines the underlying clinical implications that may predispose minority populations and the adverse clinical outcomes that may contribute to increased risk of mortality. Government and community-based strategies to safeguard minority populations at risk for increased morbidity and mortality are essential. Underserved populations living in poverty with limited access to social services across the US are more likely to have underlying medical conditions and are among the most vulnerable. Societal and cultural barriers for ethnic minorities to achieve health equity are systemic issues that may be addressed only through shifts in governmental policies, producing long-overdue, substantive changes to end health care inequities.

scholarly journals Epidemiology of Reopening in the COVID-19 Pandemic in the United States, Europe and Asia

2020 ◽  
Author(s):  
Weiqi Zhang ◽  
Alina Oltean ◽  
Scott Nichols ◽  
Fuad Odeh ◽  
Fei Zhong
Keyword(s):  
United States ◽  
Age Groups ◽  
Interrupted Time Series ◽  
The United States ◽  
Interrupted Time Series Analysis ◽  
Us States ◽  
Younger Age ◽  
Increased Risk ◽  
The Us ◽  
Novel Coronavirus

Since the discovery of the novel coronavirus (SARS-CoV-2), COVID-19 has become a global healthcare and economic crisis. The United States (US) and Europe exhibited wide impacts from the virus with more than six million cases by the time of our analysis. To inhibit spread, stay-at-home orders and other non-pharmaceutical interventions (NPIs) were instituted. Beginning late April 2020, some US states, European, and Asian countries lifted restrictions and started the reopening phases. In this study, the changes of confirmed cases, hospitalizations, and deaths were analyzed after reopening for 11 countries and 40 US states using an interrupted time series analysis. Additionally, the distribution of these categories was further analyzed by age due to the known increased risk in elderly patients. Reopening had varied effects on COVID-19 cases depending on the region. Recent increases in cases did not fully translate into increased deaths. Eight countries had increased cases after reopening while only two countries showed the same trend in deaths. In the US, 30 states had observed increases in cases while only seven observed increased deaths. In addition, we found that states with later reopening dates were more likely to have significant decreases in cases, hospitalizations, and deaths. Furthermore, age distributions through time were analyzed in relation to COVID-19 in the US. Younger age groups typically had an increased share of cases after reopening.

scholarly journals Long-Term Physical Health Outcomes of Resettled Refugee Populations in the United States: A Scoping Review

2021 ◽  
Author(s):  
Gayathri S. Kumar ◽  
Jenna A. Beeler ◽  
Emma E. Seagle ◽  
Emily S. Jentes
Keyword(s):  
Health Outcomes ◽  
Physical Health ◽  
Public Health Practice ◽  
The United States ◽  
Inclusion Criteria ◽  
Physical Health Outcomes ◽  
Increased Risk ◽  
The Us ◽  
Bhutanese Refugee

AbstractSeveral studies describe the health of recently resettled refugee populations in the US beyond the first 8 months after arrival. This review summarizes the results of these studies. Scientific articles from five databases published from January 2008 to March 2019 were reviewed. Articles were included if study subjects included any of the top five US resettlement populations during 2008–2018 and if data described long-term physical health outcomes beyond the first 8 months after arrival in the US. Thirty-three studies met the inclusion criteria (1.5%). Refugee adults had higher odds of having a chronic disease compared with non-refugee immigrant adults, and an increased risk for diabetes compared with US-born controls. The most commonly reported chronic diseases among Iraqi, Somali, and Bhutanese refugee adults included diabetes and hypertension. Clinicians should consider screening and evaluating for chronic conditions in the early resettlement period. Further evaluations can build a more comprehensive, long-term health profile of resettled refugees to inform public health practice.

scholarly journals COVID-19 positivity associated with traumatic stress response to childbirth and no visitors and infant separation in the hospital

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gus A. Mayopoulos ◽  
Tsachi Ein-Dor ◽  
Kevin G. Li ◽  
Sabrina J. Chan ◽  
Sharon Dekel
Keyword(s):  
Traumatic Stress ◽  
Neonatal Intensive Care ◽  
Acute Stress ◽  
Psychiatric Morbidity ◽  
Neonatal Intensive Care Units ◽  
Stress Symptoms ◽  
Increased Risk ◽  
The Us ◽  
Control Survey ◽  
Novel Coronavirus

AbstractAs the novel coronavirus (COVID-19) has spread globally, a significant portion of pregnant and delivering women were infected with COVID-19. While emerging studies examined birth outcomes in COVID-19 positive women, knowledge of the psychological experience of childbirth and maternal wellness remains lacking. This matched-control survey-based study included a sample of women recruited during the first wave of the pandemic in the US who gave birth in the previous six months. Women reporting confirmed/suspected COVID-19 (n = 68) during pregnancy or childbirth were matched on background factors with women reporting COVID-19 negativity (n = 2,276). We found nearly 50% of COVID positive women endorsed acute traumatic stress symptoms at a clinical level in response to childbirth. This group was more than twice as likely to endorse acute stress and to have no visitors during maternity hospitalization than COVID negative women; they were also less likely to room-in with newborns. The COVID positive group reported higher levels of pain in delivery, lower newborn weights, and more infant admission to neonatal intensive care units. Our findings suggest COVID-19 affected populations are at increased risk for traumatic childbirth and associated risk for psychiatric morbidity. Attention to delivering women’s wellbeing is warranted during the pandemic.

scholarly journals Negative health outcomes associated with food insecurity status in the United States of America: A systematic review of peer-reviewed studies

2018 ◽  
Author(s):  
Daniel Jose Arenas ◽  
Sara Zhou ◽  
Arthur Thomas ◽  
Jici Wang ◽  
Gilberto Vila Arroyo ◽  
...  
Keyword(s):  
United States ◽  
Systematic Review ◽  
Health Outcomes ◽  
Food Insecurity ◽  
United States Of America ◽  
Underserved Populations ◽  
The United States ◽  
Health Providers ◽  
Populations At Risk ◽  
Negative Health Outcomes

Introduction: Social determinants of health, such as food security, are an important target for health providers, particularly in the care of patients from underserved populations, including the uninsured and socially marginalized. Preliminary research has shown that food insecurity status (FIS) is associated with negative health outcomes.Objective: We aim to present a concise, yet comprehensive resource that lists the health outcomes associated with FIS. This guide is meant to provide innovative health providers with the tools needed to justify the importance of using FIS screening and treatment as a preventive medicine intervention.Methods: We conducted a systematic review of peer-reviewed manuscripts that studied FIS in the United States of America (USA) and at least one health outcome. We searched PubMed, Embase, Web of Science, and Scopus and had multiple reviewers examine each abstract and manuscript. We only retained peer-reviewed studies that contained USA data, directly measured FIS, and directly compared FIS to a health outcome.Results: The initial search yielded 1,817 manuscripts. After screening abstracts for duplicates and inclusion criteria, a total of 117 manuscripts were retained and fully examined. Several manuscripts showed significant association between FIS and neurologic, cardiac, endocrine, and pulmonary health outcomes. Studies in the USA population show robust associations between FIS and poor mental health (including depression, anxiety, sleep disorders, impaired cognitive functioning, and epilepsy), metabolic syndrome, hyperlipidemia, greater risk for bone fracture in children, higher risk of end-stage renal disease in patients with chronic kidney disease, self-reported poor health, and higher mortality in patients with the human immunodeficiency virus. Though other literature reviews show positive associations between FIS and health outcomes such as diabetes, body mass index, and hypertension, our systematic review showed mixed results.Conclusions: FIS leaves underserved populations at risk for negative health outcomes. More research should be done to examine the effects of FIS alleviation as a preventative medicine intervention.

scholarly journals Neurocognitive Impairment in Spanish-Speaking Latinos Living with Human Immunodeficiency Virus in the United States: Validation of Neuropsychological Tests Norms

2019 ◽  
Vol 34 (7) ◽  
pp. 1259-1259
Author(s):  
L Kamalyan ◽  
M A Hussain ◽  
M M Diaz ◽  
A Umlauf ◽  
D R Franklin ◽  
...  
Keyword(s):  
Neuropsychological Test ◽  
The United States ◽  
Neurocognitive Impairment ◽  
Spanish Speakers ◽  
Border Region ◽  
Spanish Speaking ◽  
Speed Of Information Processing ◽  
Increased Risk ◽  
The Us ◽  
Mexico Border

Abstract Objective Latinos in the US are at increased risk for HIV-associated neurocognitive impairment (NCI). Yet, most studies in this group have included English-speakers only. We investigated the rate and pattern of HIV-associated NCI in Spanish-speaking Latinos from the US-Mexico border region by utilizing newly developed norms for this group, and compared it to previously published norms for English-speaking non-Latino Whites and Blacks/African Americans. Participants and Method Participants included 153 HIV+ Spanish-speaking Latinos (Age: M = 38.2, SD = 9.7; Education: M = 10.9, SD = 3.6; 27% female; 56% AIDS) living in the greater San Diego area. Participants completed comprehensive neuropsychological, neuromedical and psychiatric assessments in Spanish. The neuropsychological test battery employed in this study - and used extensively in prior studies of HIV- assesses seven ability domains. Raw test scores were converted to demographically-adjusted T-scores using regional norms for Spanish-speakers, and for non-Latino Whites and Blacks. NCI was defined per established criteria. Results Rate of global NCI was 39% using norms for Spanish-speaking Latinos, compared to 64% with White norms and 18% with Black norms. Using norms for Spanish speakers, domain specific NCI among those impaired was highest in executive function (68%), speed of information processing (65%), learning (51%), and working memory (50%). The pattern of HIV associated NCI varied when norms developed for non-Latino Whites and Blacks were used. Conclusions HIV+ Spanish speakers showed similar rates of global NCI to those in other HIV+ populations, when norms developed for this group were used. In contrast, use of non-Latino White and Black norms resulted in misclassification of impairment. The pattern of NCI differed based on the norms used. Present findings highlight the importance of utilizing norms developed for Spanish-speakers in the US in order to obtain more precise and valid depictions of cognition in this population.

scholarly journals Novel Coronavirus, Old Partisanship: COVID-19 Attitudes and Behaviours in the United States and Canada

2020 ◽  
Vol 53 (2) ◽  
pp. 357-364 ◽  
Author(s):  
Mark Pickup ◽  
Dominik Stecula ◽  
Clifton van der Linden
Keyword(s):  
United States ◽  
Early Response ◽  
The United States ◽  
Political Elites ◽  
The Novel ◽  
The Us ◽  
Media Reports ◽  
American Case ◽  
Conservative Media ◽  
Novel Coronavirus

The novel coronavirus reached the United States and Canada almost at the same time. The first reported American case was January 20, 2020, and in Canada it was January 15, 2020 (Canada, 2020; Holshue et al., 2020). Yet, the response to this crisis has been different in the two countries. In the US, President Donald Trump, prominent Republicans, and conservative media initially dismissed the dangers of COVID-19 (Stecula, 2020). The pandemic became politicized from the early days, and even though Trump and Republicans have walked back many of their initial claims, there continue to be media reports of partisan differences in public opinion shaped by that early response. At the same time, the response in Canada has been mostly characterized by across-the-board partisan consensus among political elites (Merkley et al., 2020).

scholarly journals Food Insecurity Is Associated With Cardiovascular and All‐Cause Mortality Among Adults in the United States

2020 ◽  
Vol 9 (19) ◽  
Author(s):  
Yangbo Sun ◽  
Buyun Liu ◽  
Shuang Rong ◽  
Yang Du ◽  
Guifeng Xu ◽  
...  
Keyword(s):  
United States ◽  
Cardiovascular Disease ◽  
Food Security ◽  
Food Insecurity ◽  
The United States ◽  
Sampling Weights ◽  
Cardiovascular Disease Mortality ◽  
Disease Mortality ◽  
Increased Risk ◽  
The Us

Background Food insecurity is a global leading public health challenge that affects not only developing countries but also developed countries, including the United States. About 50 million Americans are food insecure. In this study we examined the associations of the adult food insecurity with all‐cause and cardiovascular disease mortality in a nationally representative sample of US adults. Methods and Results We included 27 188 US adults (age ≥40 years of age) who participated in the US National Health and Nutrition Examination Survey from 1999 to 2014. Food insecurity status was assessed using the Food Security Survey Module developed by the US Department of Agriculture. Mortality from all causes and cardovascular disease was ascertained through data linkage to the National Death Index through December 31, 2015. We used multivariable Cox proportional hazards regression with sampling weights to estimate hazard ratios ( HR s) and 95% CIs of all‐cause and cardiovascular disease mortality, according to food security status. During 205 389 person‐years of the period, 5039 deaths occurred, including 1084 cardiovascular disease deaths. After adjustment for age, sex, race/ethnicity, education, income, and dietary and lifestyle factors, participants with very low food security had higher risk of all‐cause and cardiovascular disease mortality, with multivariable‐adjusted HR s of 1.32 (95% CI , 1.07–1.62), and 1.53 (95% CI, 1.04–2.26), respectively, compared with those with high food security. Conclusions Food insecurity is significantly associated with increased risk of excess death from cardiovascular disease and all causes in US adults.

Intergenerational Transfers and Public Expenditure on the Elderly in Modern Britain

1988 ◽  
Vol 8 (2) ◽  
pp. 129-146 ◽  
Author(s):  
Paul Johnson ◽  
Jane Falkingham
Keyword(s):  
Social Services ◽  
Elderly Population ◽  
Public Expenditure ◽  
Age Groups ◽  
The Elderly ◽  
The United States ◽  
Generational Conflict ◽  
The Us ◽  
Families With Children ◽  
Poor Children

ABSTRACTIn the United States, much attention has recently been directed to the issue of whether the welfare system has become over-generous to the retired population, at the expense of families with children. The proportion of the US elderly population living in poverty has fallen significantly in the last fifteen years while the number of poor children has increased rapidly, and it has been suggested that this lack of investment in the next generation of workers may have disastrous longterm consequences for the U.S. economy. This paper considers whether similar trends are evident in Britain. It reviews data on the poverty and income of the elderly population, and finds little unequivocal evidence of relative economic gain over the last two decades, although it is clear that many children have suffered from the recent rise in unemployment-induced poverty. It also looks at direct public expenditure on the elderly through both the pension and the health and personal social services systems, and finds no evidence of a transfer of public resources away from children and towards the elderly population. The paper concludes that the British welfare state has been remarkably neutral in its allocation of resources between generations, and that, in the British context, any discussion of inter-generational conflict for welfare resources establishes a false dichotomy, because economic inequality within broad age groups is much greater than inequality between age groups.

scholarly journals Discrepancies in Written Versus Calculated Durations in Opioid Prescriptions: Pre-Post Study (Preprint)

2019 ◽  
Author(s):  
Benjamin H Slovis ◽  
John Kairys ◽  
Bracken Babula ◽  
Melanie Girondo ◽  
Cara Martino ◽  
...  
Keyword(s):  
The United States ◽  
Opioid Use ◽  
Duration Of Treatment ◽  
Record System ◽  
Opioid Prescription ◽  
Increased Risk ◽  
The Us ◽  
Control And Prevention ◽  
Opioid Medications

BACKGROUND The United States is in the midst of an opioid epidemic. Long-term use of opioid medications is associated with an increased risk of dependence. The US Centers for Disease Control and Prevention makes specific recommendations regarding opioid prescribing, including that prescription quantities should not exceed the intended duration of treatment. OBJECTIVE The purpose of this study was to determine if opioid prescription quantities written at our institution exceed intended duration of treatment and whether enhancements to our electronic health record system improved any discrepancies. METHODS We examined the opioid prescriptions written at our institution for a 22-month period. We examined the duration of treatment documented in the prescription itself and calculated a duration based on the quantity of tablets and doses per day. We determined whether requiring documentation of the prescription duration affected these outcomes. RESULTS We reviewed 72,314 opioid prescriptions, of which 16.96% had a calculated duration that was greater than what was documented in the prescription. Making the duration a required field significantly reduced this discrepancy (17.95% vs 16.21%, <i>P</i>&lt;.001) but did not eliminate it. CONCLUSIONS Health information technology vendors should develop tools that, by default, accurately represent prescription durations and/or modify doses and quantities dispensed based on provider-entered durations. This would potentially reduce unintended prolonged opioid use and reduce the potential for long-term dependence.

scholarly journals Risk factors for increased COVID-19 case-fatality in the United States: A county-level analysis during the first wave

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258308
Author(s):  
Jess A. Millar ◽  
Hanh Dung N. Dao ◽  
Marianne E. Stefopulos ◽  
Camila G. Estevam ◽  
Katharine Fagan-Garcia ◽  
...  
Keyword(s):  
Generalized Linear Model ◽  
Ecological Study ◽  
Negative Binomial ◽  
Case Fatality ◽  
The United States ◽  
Asthma Prevalence ◽  
County Level ◽  
Increased Risk ◽  
The Us ◽  
Level Analysis

The ongoing COVID-19 pandemic is causing significant morbidity and mortality across the US. In this ecological study, we identified county-level variables associated with the COVID-19 case-fatality rate (CFR) using publicly available datasets and a negative binomial generalized linear model. Variables associated with decreased CFR included a greater number of hospitals per 10,000 people, banning religious gatherings, a higher percentage of people living in mobile homes, and a higher percentage of uninsured people. Variables associated with increased CFR included a higher percentage of the population over age 65, a higher percentage of Black or African Americans, a higher asthma prevalence, and a greater number of hospitals in a county. By identifying factors that are associated with COVID-19 CFR in US counties, we hope to help officials target public health interventions and healthcare resources to locations that are at increased risk of COVID-19 fatalities.

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