Differential Effects of Race/Ethnicity and Social Vulnerability on COVID-19 Positivity, Hospitalization, and Death in the San Francisco Bay Area

BACKGROUND: Higher COVID-19 incidence and morbidity have been amply documented for US Black and Hispanic populations but not as clearly for other racial and ethnic groups. Efforts to elucidate the mechanisms underlying racial health disparities can be confounded by the relationship between race/ethnicity and socioeconomic status. OBJECTIVE: Examine race/ethnicity and social vulnerability effects on COVID-19 outcomes in the San Francisco Bay Area, an ethnically and socioeconomically diverse region. DESIGN: Retrospective cohort study. SETTING: Geocoded patient records from the University of California, San Francisco Health system between January 1, 2020 to December 31, 2020. PATIENTS: Patients who underwent polymerase chain reaction testing for COVID-19. EXPOSURES: Race/ethnicity and Social Vulnerability Index (SVI). MAIN MEASURES: COVID-19 test frequency, positivity, hospitalization rates, and mortality. KEY RESULTS: Higher social vulnerability, but not race/ethnicity, was associated with less frequent testing yet a higher likelihood of testing positive. Asian hospitalization rates (11.5\%) were double that of White patients (5.4\%) and exceeded the rates for Black (9.3\%) and Hispanic (6.9\%) groups. A modest relationship between higher hospitalization rates and increasing social vulnerability was evident only for White individuals. The Hispanic group had the lowest mean age at death and thus highest years of expected life lost due to COVID-19. CONCLUSIONS: COVID-19 outcomes were not consistently explained by greater socioeconomic vulnerability. Asian individuals showed disproportionately high rates of hospitalization regardless of socioeconomic status. Study of the San Francisco Bay Area population not only provides valuable insights into the differential contributions of race/ethnicity and social determinants of health to COVID-19 outcomes but also emphasizes that all racial groups have experienced the toll of the pandemic, albeit in different ways and to varying degrees.

Vulnerability of Human Populations to Climate Change

Moroccan ecosystems are considered endangered due to climate change that affects directly or indirectly different key features (biodiversity, snow cover, run-off processes, and water availability). The chapter describes the strategy for achieving collaboration between natural and social scientists, stakeholders, decision makers, and other societal groups in order to carry out an integrated assessment of climate change in the 12 Moroccan regions, with an emphasis on vulnerability and adaptation, and evaluate the vulnerability of human population to climate change applying the socioeconomic vulnerability index (SeVI) that measures socioeconomic vulnerability by regions. Result suggest that three southern and one north region are relatively more vulnerable, which are the most exposed to natural hazard. Furthermore, significant adaptive capacity scores are recorded in in the remaining regions, and average sensitivity for all. Therefore, societies and economies at all levels and on every region have to prepare for and adapt to impacts of climate change.

County-level Analysis of Perinatal Health Indicators Within a Single Health System Catchment

Background: Adverse perinatal health outcomes are disproportionally impacted in rural communities. Social determinants of health (SDoH) defined by nonclinical social, behavioral, and economic factors may impact up to 90% of health outcomes in rural communities. Objective: To evaluate county-level perinatal patterns in health outcomes, health behaviors, socioeconomic vulnerability, and healthcare providers across rural and non-rural Florida counties within a single health system catchment. Methods: Socioeconomic vulnerability metrics, digital connectivity, licensed provider metrics, and behavioral data and were obtained from Floridahealthcharts.com and the County Health Rankings. County-level birth and perinatal health outcome data were obtained from the Florida Department of Health. The University of Florida Health Perinatal Catchment Area (UFHPCA) was defined as all Florida counties where ≥5% of all infants were delivered at Shands Hospital in Alachua county between June 2011 and April 2017. County-level rurality was determined by Florida Statutes 288.0656 rurality designations. Results: The UFHPCA included three non-rural and ten rural counties that represented more than 64,000 deliveries over a 5-year 9-month period. We found that nearly 1 in 3 infants resided in a rural county (n=20,899), and 7 out of 13 counties did not have a licensed obstetrician gynecologist. Nine counties reported maternal death rates that were between 1 and 4-fold higher than the statewide rate, and rural counties generally reported neonatal mortality and preterm birth rates that were higher than the statewide averages. We found maternal smoking rates (range 6.8% – 24.8%) were above the statewide rate (6.2%) for all counties in the catchment. Except for Alachua county, breastfeeding initiation rates (range 54.9% - 81.4%) and access to household computing devices (range 72.8% - 86.4%) were below the statewide rate (82.9% and 87.9%, respectively). Finally, we found that childhood poverty rates (range 16.3% - 36.9%) in our catchment was above the statewide rate (18.5%), except for Suwanee and Columbia counties.Conclusions: The health burden of the UFHPCA is characterized by both rural and non-rural counties with increased maternal and neonatal death and preterm birth, as well as adverse health behaviors that include smoking during pregnancy and lower levels of breastfeeding.

Kerentanan Sosial Ekonomi dan Resiliensi Keluarga Petani Miskin Selama Pandemi COVID-19: Kasus Dari Madura

The Covid-19 pandemic, in addition its health impacts, also has a serious impact to people's socioeconomic vulnerabilities. Socio-economic vulnerabilities due to the Covid-19 pandemic forced people to adapt, one of which was a poor peasant family in rural Madura. This article presents the results of research focusing on the socio-economic vulnerability of poor peasant family as well as various efforts in dealing with the Covid-19 pandemic. Using descriptive qualitative approach and data collection method through participation observation, interviews, airy records, and documentation, this study revealed that the socioeconomic vulnerability of poor peasant family in Ponteh Village resulted from social restrictions so that the household income sector decreased. Though they have to adaptation meet the cost of household consumption, health threats in the Covid-19 pandemic. Adaptation strategy carried out by poor peasant family in rural areas is, first, building group solidarity according to values and norms that are strong, for example, mutual help in the form of basic needs. Second, every poor peasant family makes use of very strong family ties. Parental assistance as a source of supporting living is now a basic source used to make ends meet during pandemics. Third, poor peasant family in rural areas minimize household in spending and utilizing-social networks for business development. The contribution of this article is to provide views, efforts, accompanied by resilience in keeping the public from the threat of future pandemics.

Socioeconomic Vulnerability Index and Obesity among Korean Adults

Examining the socioeconomic vulnerability–obesity relationship is a different approach than comparing obesity rates according to the socioeconomic level. This study explored the socioeconomic vulnerability–obesity relationship among Korean adults. This secondary analysis used data from the Korea National Health and Nutrition Examination Survey, which were collected nationwide from participants aged 30–64 years. Seven socioeconomic indicators (education level, residential area, personal income level, household income level, food insecurity, house ownership, and national basic livelihood security beneficiary status) were used to create the socioeconomic vulnerability index. The prevalence of obesity was higher in the lowest socioeconomic vulnerability index quartile than in the highest socioeconomic vulnerability index quartile (odds ratio = 1.31; 95% confidence interval = 1.13–1.52) after adjusting for gender. When developing future interventions for the prevention and management of obesity, health care providers and researchers need to consider the differences in socioeconomic vulnerability index in adults.

Identification of the urban heat islands phenomenon in a small city: the study case of Três Rios/RJ, Brazil

The phenomenon of urban heat islands (UHI) is caused by the increase in temperatures of an urban area as a result of the development of human activities within that area, this phenomenon is usually studied in medium and large cities. This study aims to verify if the phenomenon of UHI occurs in the municipality of Três Rios – RJ, a small sized city. This study included the use of mobile transect, through pre-established data collection points/stations. Five data collection points were selected, from which one was included in a rural area, one in the Parque Natural Municipal (Urban Park, within the city), and three points within the urbanized area. The equipment used was the Brunton® / ADC PRO handheld weather station. The data collection period ranged from September 2018 until July 2019, which included the four seasons. Measurements were taken at 6:00, 12:00, 15:00, 18:00, and 21:00h, in alternate days during the study period. Considering the temperature measurements, two different indicators of thermal variability were used. Strong magnitude heat islands were detected, taking into consideration the relevant variation of maximum temperatures observed in the urban area when compared to the rural area. The results indicate the most affected populations to be the ones located within urban areas, mostly individuals under socioeconomic vulnerability. The results obtained can be used as support for the development of strategies to minimize the thermal discomfort to populations exposed to the influence of higher magnitude urban heat islands.

Leveraging Hazard, Exposure, and Social Vulnerability Data to Assess Flood Risk to Indigenous Communities in Canada

This study integrates novel data on 100-year flood hazard extents, exposure of residential properties, and place-based social vulnerability to comprehensively assess and compare flood risk between Indigenous communities living on 985 reserve lands and other Canadian communities across 3701 census subdivisions. National-scale exposure of residential properties to fluvial, pluvial, and coastal flooding was estimated at the 100-year return period. A social vulnerability index (SVI) was developed and included 49 variables from the national census that represent demographic, social, economic, cultural, and infrastructure/community indicators of vulnerability. Geographic information system-based bivariate choropleth mapping of the composite SVI scores and of flood exposure of residential properties and population was completed to assess the spatial variation of flood risk. We found that about 81% of the 985 Indigenous land reserves had some flood exposure that impacted either population or residential properties. Our analysis indicates that residential property-level flood exposure is similar between non-Indigenous and Indigenous communities, but socioeconomic vulnerability is higher on reserve lands, which confirms that the overall risk of Indigenous communities is higher. Findings suggest the need for more local verification of flood risk in Indigenous communities to address uncertainty in national scale analysis.

Mortality and case fatality rates of covid-19 in the state of goiás, brazil

Introduction: the initial spread of the pandemic in Brazil was mainly affected by patterns of socioeconomic vulnerability. It should be noted that the Central-West region of Brazil is one of the regions with the lowest number of cases, but the states of this region together have the highest mortality rate of COVID-19 in the country. Goiás was the most affected state of this region, with the highest number of deaths in the area. Objective: to assess the incidence of mortality and lethality caused by COVID-19 from March 2020 to June 2021 in the State of Goiás, Brazil. Methods: an ecological study, using a series of time series of public and official data of the Department of Health of the State of Goiás, Brazil. Information was collected on cases and deaths from COVID-19 from March 2020 to June 2021. Mortality, case fatality, and incidence rates were calculated. The Prais-Wisten regression model was used to build time series. The daily percent change (DPC) and the effective reproductive number (Rt) were estimated. Results: Goiás had a predominance of a greater viral spread during the first and the beginning of the second wave, with Rt higher than 1. The second wave from December 2020 to June 2021 was more lethal and had higher mortality rates than the first wave. It was observed, higher scores of case fatality and mortality belonged to males and the elderly. Conclusion: an analysis of mortality and case fatality rates helps understand the COVID-19 pandemic behavior in Goiás. It is essential to monitor epidemiological indicators and strengthen intervention strategies to contain the pandemic in this state.