Small-Area Estimation for the USDA Forest Service, National Woodland Owner Survey: Creating a Fine-Scale Land Cover and Ownership Layer to Support County-Level Population Estimates

Small area estimation is a powerful modeling technique in which ancillary data can be utilized to “borrow” additional information, effectively increasing sample sizes in small spatial, temporal, or categorical domains. Though more commonly applied to biophysical variables within the study of forest inventory analyses, small area estimation can also be implemented in the context of understanding social values, behaviors, and trends among types of forest landowners within small domains. Here, we demonstrate a method for deriving a continuous fine-scale land cover and ownership layer for the state of Delaware, United States, and an application of that ancillary layer to facilitate small-area estimation of several variables from the USDA Forest Service’s National Woodland Owner Survey. Utilizing a proprietary parcel layer alongside the National Land Cover Database, we constructed a continuous layer with 10-meter resolution depicting land cover and land ownership classes. We found that the National Woodland Owner Survey state-level estimations of total acreage and total ownerships by ownership class were generally within one standard error of the population values calculated from the raster layer, which supported the direct calculation of several population-level summary variables at the county levels. Subsequently, we compare design-based and model-based methods of predicting commercial harvesting by family forest ownerships in Delaware in which forest ownership acreage, taken from the parcel map, was utilized to inform the model-based approach. Results show general agreement between the two modes, indicating that a small area estimation approach can be utilized successfully in this context and shows promise for other variables, especially if additional variables, e.g., United States Census Bureau data, are also incorporated.

What a difference a year makes: A snapshot of the trends in vaccinations, hospitalizations, and mortality rates for SARS- CoV-2 across the state of Indiana

Background: Many efforts both scientifically and politically helped reduced the spread of SARS-CoV-2. In December of 2020, vaccinations were authorized for distribution. It is important to understand demographical correlations to COVID-19 acute illness rates and whether COVID-19 vaccinations significantly reduced these rates. Project Methods: This study focused on data from seventeen counties in Indiana. This information was used to determine if there were correlations between demographics and COVID-19 illness rates. County demographics were obtained from the United States Census Bureau. COVID-19 hospitalization and mortality were collected from the Regenstrief Institute and the Indiana State Department of Health respectively. Linear regression analyses were performed to determine if there were significant correlations between demographics and rates COVID-19 illness. T-test analyses assuming unequal variances were performed in order to determine if there has been a significant reduction in COVID-19 illness. Results: The results of this study revealed that the percentage of the population over the age of 65, with a bachelor’s degree, disabled under age 65, and the median income (r values: 0.729, 0.701, 0.661, and 0.533 respectively) are significantly correlated to the mortality rate. The percentage of the population over the age of 65 and with a bachelor’s degree (r values: 0.565 and 0.524 respectively) are significantly correlated to the hospitalization rate. When comparing the COVID-19 acute illness rates for each county from 07/27/20 until 02/01/21 to the rates after 02/01/21 until late- June of 2021, each county had significant decrease in the hospitalization and mortality rate after February 1, 2021. Potential Impact: The result of this study suggests that vaccinating residents was a significant factor in the 50% or higher reduction in COVID-19 hospitalization and mortality rates. These findings emphasize the importance of COVID-19 vaccinations to protect Americans from COVID-19 severe illness.

Telehealth Use By Persons with Disabilities During the COVID-19 Pandemic

Telehealth use rapidly expanded during the COVID-19 pandemic. Understanding if, and how, people from disabilities used telehealth during the pandemic is vital to assuring this evolving and increasingly common form of health care is equitably developed and delivered to avoid reproducing the health disparities people with disabilities already face. Our aim was to explore the use of telehealth among people with disabilities during the pandemic. We conducted a weighted secondary analysis of United States Census Bureau data (April-July 2021) from 38,512 (unweighted) people with disabilities. Our findings revealed 39.8% of people with disabilities used telehealth during the second year of the pandemic, ranging from 34.5% of people with hearing disabilities to 43.3% of people with mobility disabilities. There were also differences in telehealth use based on sociodemographics. Telehealth promises to open doors to more equitable health care access for many people with disabilities, but only if access barriers are removed.

Alzheimer’s Disease Among American Minority Populations: An Ecological Exploratory Study

A significant public health concern with regards to increasing rates of Alzheimer’s is that it disproportionately affects minority groups in the United States. The present ecological exploratory study uses secondary aggregate data from the fifty United States in the year of 2019. The purpose of this study was to address the disparities in Alzheimer’s in minority populations in the US and explore associated factors. The “minority” populations considered were African American and Latino populations, and the “majority” population was referred to as “white”. The data was extracted from the United States Census Bureau, the CDC National Center for Health Statistics, and the Behavioral Risk Factor Surveillance System (BRFSS) Dataset. The prevalence rates of Alzheimer’s disease are greatest in both older Latinos (12.2%) and African Americans (13.8%), compared to older whites (10.3%) in the investigated time period. Our results showed that being over 65 years old (p=.009), with a below-average ($62,843) median household income (p=.024), history of stroke (p=.029), and being a part of the Latino population (p=.036), were significantly associated with Alzheimer’s mortality rates in the United States. By identifying disparities in access to Alzheimer’s healthcare and at-risk communities, more comprehensive intervention strategies can be developed to promote change and advocate for more Alzheimer’s education and resource allocation for minority populations.

Post-pandemic consumer behavior towards e-commerce and retail stores in United States

COVID-19 profoundly impacted consumer behavior and psychology; this impact is perceived in social habits and shopping changes. Online stores have successfully boosted their sales, to the detriment of retail stores. This article aims to provide statistical analysis and evaluate consumers’ buying behavior by age groups toward retail and online stores for showing recommendations at online store entrepreneurs and retail store owners; thus, optimize costs and have higher sales projections. The methodology used is based on statistical data from various sources and databases such as Statista, United States Census Bureau, and international organizations, contrasted with the information obtained from 314 surveys conducted with consumers in different cities of the United States. In this study, statistical data and surveys upon groups of people were between twenty-two (22) to eighty (80) years old were analyzed. As a result, an increase in online shopping preferences was obtained, where the youngest population group leads the consumption in virtual platforms due to their familiarity with technology. In conclusion, there is a significant increase in online shopping, which is exacerbated by the pandemic.

Incidence Rates of Pediatric Central Nervous Tumors Display No Geographical Variation

Background: Central nervous system (CNS) tumors affect over 4,600 children throughout the United States each year. Despite recent trends of increasing incidence of pediatric CNS tumors, the understanding of variations in their incidence between different geographical regions remains incomplete. Methods: Data used in this study was obtained from the Surveillance, Epidemiology, and End Results (SEER) Program. The SEER database and its built-in operation software was used to generate state-specific incidence data for newly diagnosed CNS tumor diagnoses in children ages 0-19 for the years 2001-2014. Results were organized by tumor type and individual states were clustered into nine geographical regions as defined by the United States Census Bureau. Results: Statistically significant differences were found in the regional incidence of astrocytoma, primitive neuroectodermal tumor (PNET), and the category of unspecified intracranial and intraspinal neoplasms. However, the magnitude of the difference in incidence (ΔI) between specific regions was small, on the order of 0.1 to 0.6 per 100,000 population, representing a nominal 0.05-fold to 0.79-fold change in incidence (ΔI/incidence for comparator region) for astrocytoma and for the category of unspecified intracranial and intraspinal neoplasms, and a larger 3.25-fold to 3.75-fold change in incidence for PNET. Conclusions: Differences in incidence between geographical regions for certain CNS tumor types met the bar for statistical significance. However, these differences are unlikely to be clinically meaningful due to the small effect size.

Complications Leading to Keratoplasty among Contact Lens Users and LASIK Patients: A 10-Year Cross-Sectional Analysis

Purpose. To determine the incidence and outcomes in patients who underwent penetrating keratoplasty (PK) resulting from complications related to contact lens (CL) use and laser in situ keratomileusis (LASIK) in a metropolitan area of the United States. Methods. Population data was obtained from the United States Census Bureau and the Centers for Disease Control. A retrospective, cross-sectional chart review was performed on all patients who underwent keratoplasty in a specific metropolitan geographic area over a ten-year period. The main outcome was best-corrected visual acuity (BCVA) at 2 years in patients who underwent PK secondary to complications related to CL use and LASIK. The secondary outcome was the relative risk of undergoing PK secondary to a complication related to CL use versus LASIK. Results. The study’s geographic area had 46,545 CL users in one or both eyes during any given year and 10,285 patients who underwent LASIK in one or both eyes during the study interval. There were 24 CL users (0.52 per 1,000) and 3 post-LASIK patients (0.29 per 1,000) who underwent PK secondary to complications during the study interval (OR 1.77 [0.53–5.87, 95% CI]; p = 0.35 ). BCVA at 2 years was 1.45 [1.0–1.90] logMAR (20/564 Snellen) in the CL using cohort and 0.07 [−1.19–1.33] logMAR (20/23 Snellen) in post-LASIK cohort following PK ( p = 0.04 ). Conclusions. Patients who underwent PK secondary to complications related to CL use had worse visual outcomes at 2 years compared to those related to LASIK. Complications leading to PK were rare in both cohorts, but the incidence of undergoing PK secondary to CL use trended higher than LASIK.

Economic Competition and Racial/Ethnic Disparities in Sentencing: A Test of Economic Threat Perspective

Economic threat arguments within the broader racial/ethnic threat theory suggest that economic competition between minorities and Whites encourages the majority group to apply formal social controls on minorities to maintain their advantaged positions. Prior sentencing research has given limited attention to economic threat and has only done so using cross-sectional measures, which does not capture changing economic circumstances (a key element of racial/ethnic threat). The goal of this study is to provide a test of economic threat—and racial/ethnic threat more broadly—utilizing time variant measures. To achieve this goal, we use case-level data from the Minnesota Sentencing Guidelines Commission (N = 122,666) and county-level data from the United States Census Bureau. Multilevel regression models reveal partial but limited support for economic threat. Specifically, counties with a growing portion of minorities living above the poverty line between 2000 and 2010 had larger minority disadvantages (in comparison to Whites) at incarceration. However, economic threat measures do not significantly contextualize minority–White sentence length differences, while the broader racial/ethnic threat measures do not significantly influence minority–White outcomes at the incarceration or sentencing length decision. The results suggest that economic threat may explain a small but limited portion of the racial disparities identified.

#41: Examining the Role of Rurality on the Incidence of Acute Respiratory Illnesses, Overall Antibiotic Use and Inappropriate Antibiotic Use Among Young Children in Tennessee

Background The Centers for Disease Control and Prevention (CDC) defines inappropriate antibiotic use as prescribing antibiotics not in accordance with national and local evidence-based guidelines, wrong selection of antibiotics, wrong dosing of antibiotics, or wrong duration of antibiotic use. Inappropriate antibiotic use has been associated with the development and transmission of antibiotic-resistant organisms. Acute respiratory illnesses (ARI) are the leading causes of antibiotic use among children with rates of antibiotic use in Tennessee children among the highest in the United States. The reasons for this have not been adequately assessed, particularly in children enrolled in the Tennessee Medicaid (TennCare) program, who tend to live in low-income households and rural locales and are disproportionately underrepresented in database studies conducted in large managed care organizations. We sought to examine whether the rates of ARI-related overall antibiotic use and inappropriate antibiotic use among young children enrolled in TennCare vary by the rurality of their county of residence. Methods This was a retrospective cohort study of children aged 2 months–5 years enrolled in TennCare from July 1, 2007, to June 30, 2017. We used pharmacy and healthcare claims data to calculate the incidence of ARI and ARI-related antibiotic use. Each eligible child entered into the cohort at the earliest time when selection criteria were met, and follow-up continued from cohort entry until the earliest of loss of enrollment, death, end of study, or meeting exclusion criteria. ARI was identified using International Classification of Diseases, Ninth and Tenth Revisions (ICD-9 and ICD-10) and ARI-related antibiotic use was defined as an antibiotic prescription filled within 72 hours of an ARI. ARI-related antibiotic use was classified as potentially appropriate or inappropriate using a previously published CDC classification system. The rurality of children’s county of residence was defined as either mostly urban, mostly rural, or completely rural based upon the United States Census Bureau definitions. We calculated incidence rates for ARI, ARI-related antibiotic use, and ARI-related inappropriate antibiotic use. To assess the effect of rurality of residence on these outcomes, we used multivariable mixed-effects Poisson regression. These analyses accounted for other factors including child age, gender, race, underlying comorbidities, calendar year and month, and history of antibiotic exposure. Results In total, 813,432 children met enrollment criteria and contributed a total of 2,057,272 person-years for the cohort. Overall, the rate of ARIs, antibiotic use associated with ARIs, and inappropriate antibiotic use associated with ARIs has trended down over time (Figure 1A). There were higher rates of these three outcomes in children who live in mostly rural and completely rural counties compared with those who live in mostly urban counties (Figure 1B–D). Conclusions Children who live in rural counties in Tennessee are disproportionately affected by higher rates of ARIs, antibiotic use, and inappropriate antibiotic use compared with those who live in urban counties. These findings can inform targeted stewardship interventions to reduce inappropriate antibiotic prescribing and to decrease the rates of antibiotic-resistant infections.

The relationship between seasonality, latitude and tuberculosis notifications in Pakistan

Background Pakistan ranks amongst the top 20 highest burden tuberculosis (TB) countries in the world. Approximately 369,548 cases of TB (all forms) were notified in 2018, with an estimated incidence of 265 per 100,000 people per year. In other settings, TB has been shown to demonstrate seasonal variation, with higher incidence in the spring/summer months and lower incidence in the autumn/winter; the amplitude of seasonal variation has also been reported to be higher with increasing distance from the equator. Methods Notifications of newly-diagnosed pulmonary and extrapulmonary TB cases were obtained for 139 districts in Pakistan from 2011 to 2017. Data were provided by the Pakistan National TB Control Programme, Islamabad, Pakistan. Statistical analyses were performed to determine whether there was seasonal variation in TB notifications in Pakistan; whether the amplitude of seasonal variation in TB notifications varied according to latitude; whether the amplitude of seasonal variation of TB in Pakistan differed between extrapulmonary TB vs. pulmonary TB. To assess the quarterly seasonality of TB, we used the X-13-ARIMA-SEATS seasonal adjustment programme from the United States Census Bureau. The mean difference and corresponding 95% confidence intervals of seasonal amplitudes between different latitudes and clinical phenotype of TB were estimated using linear regression. Results TB notifications were highest in quarter 2, and lowest in quarter 4. The mean amplitude of seasonal variation was 25.5% (95% CI 25.0 to 25.9%). The mean seasonal amplitude of TB notifications from latitude 24.5°N- < 26.5°N was 29.5% (95% CI 29.3 to 29.7%) whilst the mean seasonal amplitude of TB notifications from latitude 34.5°N - < 36.5°N was 21.7% (95% CI 19.6 to 23.9%). The mean seasonal amplitude of TB notifications across Pakistan between latitudes 24.5°N to 36.5°N reached statistically significant difference (p < 0.001). The amplitude of seasonal variation was greater for extrapulmonary TB (mean seasonal amplitude: 32.6, 95% CI 21.4 to 21.8%) vs. smear positive pulmonary TB mean seasonal amplitude: 21.6, 95% CI 32.1 to 33.1%), p < 0.001. Conclusion TB notifications in Pakistan exhibit seasonal variation with a peak in quarter 2 (April–June) and trough in quarter 4 (October–December). The amplitude of seasonality decreases with increasing latitude, and is more pronounced for extrapulmonary than for pulmonary TB.