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2021 ◽  
pp. 147797142110492
Author(s):  
Wonmai Punksungka ◽  
Takashi Yamashita ◽  
Abigail Helsinger ◽  
Rita Karam ◽  
Phyllis Cummins ◽  
...  

This study examined the associations between adult education and training (AET) participation, educational attainment, literacy skills, gender, and race/ethnicity among the U.S. adult population aged 25 to 65 years old (n = 5,450). Given the socioeconomic advancements of women and racial/ethnic minorities in the last few decades, including higher educational attainment, increased labor force participation, and greater income, and as new data becomes available, it is important to re-examine AET participation by gender and race/ethnicity in the U.S while controlling for educational attainment and literacy skills. This study employed the 2012/2014 Program for International Assessment of Adult Competencies (PIAAC) public-use file (PUF). Binary logistic regression was used to examine (1) any AET, (2) formal AET, and (3) non-formal AET across all variables of interest. Indeed, educational attainment and literacy skills are associated with greater AET participation. Further analyses showed that more women than men participated in all forms of AET, and there were some variations in AET participation by racial/ethnic minorities. More Black, Hispanic, and other racial/ethnic minority adults participated in formal AET, and more Black adults participated in all forms of AET, compared to their White counterparts. This study also provides within-race/ethnicity group variations.


2021 ◽  
Author(s):  
Elizabeth B Pathak ◽  
Janelle M Menard ◽  
Rebecca B Garcia ◽  
Jason L Salemi

Importance: Substantial racial/ethnic disparities in COVID-19 mortality have been documented. Social class is a likely explanation of mortality disparities across and within racial/ethnic groups. This is the first U.S. study of social class and COVID-19 mortality in working age adults. Objectives: To determine the joint effects of social class, race/ethnicity, and gender on the burden of COVID-19 mortality. A secondary objective was to determine whether differences in opportunities for remote work were correlated with COVID-19 death rates for sociodemographic groups. Design: Annual mortality study which used a special government tabulation of 2020 COVID-19 related deaths stratified by decedent social class (educational attainment) and race/ethnicity. Setting: United States in 2020. Participants: COVID-19 decedents aged 25 to 64 years old (n=69,001). Exposures: Social class (working class, some college, college graduate), race/ethnicity (Hispanic, Black, Asian, Indigenous, multiracial, and non-Hispanic white), and gender (women, men). Detailed census data on occupations held by adults in 2020 in each of the 36 sociodemographic groups studied were used to quantify the possibility of remote work for each group. Main Outcomes and Measures: Age-adjusted COVID-19 death rates for 36 sociodemographic groups defined by social class, race/ethnicity, and gender. Disparities were quantified by relative risks and 95% confidence intervals. College graduates were the (low risk) referent group for all relative risk calculations. Results: A higher proportion of Hispanics, Blacks, and Indigenous people were working class in 2020. COVID-19 mortality was five times higher in the working class vs. college graduates (72.2 vs. 14.6 deaths per 100,000, RR=4.94, 95% CI 4.82-5.05). The joint detriments of lower socioeconomic position, Hispanic ethnicity, and male gender resulted in a COVID-19 death rate which was over 27 times higher (178.0 vs. 6.5 deaths/100,000, RR=27.4, 95%CI 25.9-28.9) for working class Hispanic men vs. college graduate white women. In regression modeling, percent employed in never remote jobs explained 72% of the variance in COVID-19 death rates. Conclusions and Relevance: SARS-CoV-2 infection control efforts should prioritize the working class (i.e. those with no college education), particularly those employed in never remote jobs with inflexible and unsafe working conditions (i.e. blue collar, service, and retail sales workers).


2021 ◽  
pp. 105477382110612
Author(s):  
Chiyoung Lee ◽  
Eleanor Schildwachter McConnell ◽  
Sijia Wei ◽  
Tingzhong (Michelle) Xue ◽  
Hideyo Tsumura ◽  
...  

This retrospective cohort study used electronic health records to explore the effect of race/ethnicity, insurance status, and area deprivation on post-discharge outcomes in older patients undergoing hip fracture surgery between 2015 and 2018 ( N = 1,150). Inverse probability of treatment weight-adjusted regression analysis was used to identify the effects of the predictors on outcomes. White patients had higher 90- and 365-day readmission risks than Black patients and higher all-period readmissions than the Other racial/ethnic (Hispanic, Asian, American Indian, and Multicultural) group ( p < .000). Black patients had a higher risk of 30- and 90-day readmission than the Other racial/ethnic group ( p < .000). Readmission risk across 1-year follow-up was generally higher among patients from less deprived areas than more deprived areas ( p < .05). The 90- and 365-day mortality risk was lower for patients from less deprived areas (vs. more deprived areas) and patients with Medicare Advantage (vs. Medicare), respectively ( p < .05). Our findings can guide efforts to identify patients for additional post-discharge support. Nevertheless, the findings regarding readmission risks contrast with previous knowledge and thus require more validation studies.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Martha J. Decker ◽  
Tara V. Atyam ◽  
Catherine Gilmore Zárate ◽  
Angela M. Bayer ◽  
Consuelo Bautista ◽  
...  

Abstract Background Adolescents may forego needed sexual and reproductive health (SRH) services due to a variety of concerns and barriers. The purpose of this study is to compare adolescents’ perceptions of these barriers by participant characteristics including race/ethnicity, gender, sexual orientation, housing situation, and sexual experience. Methods Adolescents in a California-wide sexual health education program completed an anonymous survey at baseline (N = 10,015) about perceived barriers to using SRH services. Logistic regression analyses that accounted for the clustered data structure assessed differences by gender, age, sexual orientation, race/ethnicity, living situation, and sexual experience. Results The majority of participants were Hispanic/Latino (76.4%) with an average age of 14.9 years, and 28.8% had sexual experience. Half of the youth reported concerns about test results (52.7%), cost of services (52.0%), and confidentiality of services (49.8%). When controlling for other characteristics, youth identifying as transgender/non-binary/multiple genders had the highest odds of perceiving cost (odds ratio (OR) 1.89) and confidentiality (OR 1.51) as barriers. Increasing age was associated with decreasing odds of all barriers. Sexual orientation was a consistent predictor, with LGBQ+ youth having higher odds of perceiving test results (OR 1.21), cost (OR 1.36), and confidentiality (OR 1.24) as barriers. Asian or Pacific Islander/Native Hawaiian youth had higher odds of perceiving test results (OR 1.68) and cost (OR 1.37) as barriers. In contrast, Black youth had lower odds of reporting cost (OR 0.65) and confidentiality (OR 0.77) as barriers. Younger respondents and youth who identified as female, transgender/non-binary/multiple genders, LGBQ+, and Asian or Pacific Islander/Native Hawaiian had higher odds of reporting five or more barriers compared to reference groups. Conclusions The majority of adolescents face barriers to accessing appropriate SRH services, with females, gender-minority youth, younger adolescents, LGBQ+ youth, and Asian and Pacific Islander/Native Hawaiian youth more likely than others to report barriers. Access to SRH services can be improved through strengthening linkages between clinics and SRH education programs, providing youth-friendly clinical services, and ensuring youth have sufficient information, skills, and support to access care. Trial registration Approved by California Health and Human Services Agency’s Committee for the Protection of Human Subjects [12-08-0658, 11/30/2017].


2021 ◽  
Author(s):  
Elizabeth Wrigley-Field ◽  
Kaitlyn M. Berry ◽  
Govind Persad

We provide the first age-standardized race/ethnicity-specific, state-specific vaccination rates for the United States, encompassing all states reporting race/ethnicity-specific vaccinations. The data reflect vaccinations through mid-October 2021. We use indirect age standardization to compare racial/ethnic state vaccination rates to national age-specific vaccination patterns. Results show that white and Black state median vaccination rates are, respectively, 89% and 76% of what would be predicted based on age; Hispanic and Native rates are almost identical to what would be predicted; and Asian-American/Pacific Islander rates are 110% of what would be predicted. We also find that racial/ethnic group vaccination rates are associated with state politics, as proxied by 2020 Trump vote share: for each percentage point increase in 2020 Trump vote share, vaccination rates decline by 1.08 percent of what would be predicted based on age. This decline is sharpest for Native American populations, although Native vaccinations are reported for relatively few states.


Author(s):  
Alissa C. Kress ◽  
Asia Asberry ◽  
Julio Dicent Taillepierre ◽  
Michelle M. Johns ◽  
Pattie Tucker ◽  
...  

We aimed to assess Centers for Disease Control and Prevention (CDC) data systems on the extent of data collection on sex, sexual orientation, and gender identity as well as on age and race/ethnicity. Between March and September 2019, we searched 11 federal websites to identify CDC-supported or -led U.S. data systems active between 2015 and 2018. We searched the systems’ website, documentation, and publications for evidence of data collection on sex, sexual orientation, gender identity, age, and race/ethnicity. We categorized each system by type (disease notification, periodic prevalence survey, registry/vital record, or multiple sources). We provide descriptive statistics of characteristics of the identified systems. Most (94.1%) systems we assessed collected data on sex. All systems collected data on age, and approximately 80% collected data on race/ethnicity. Only 17.7% collected data on sexual orientation and 5.9% on gender identity. Periodic prevalence surveys were the most common system type for collecting all the variables we assessed. While most U.S. public health data and monitoring systems collect data disaggregated by sex, age, and race/ethnicity, far fewer do so for sexual orientation or gender identity. Standards and examples exist to aid efforts to collect and report these vitally important data. Additionally important is increasing accessibility and appropriately tailored dissemination of reports of these data to public health professionals and other collaborators.


Author(s):  
Patricia I. Jewett ◽  
Rachel I. Vogel ◽  
Rahel Ghebre ◽  
Jane Y. C. Hui ◽  
Helen M. Parsons ◽  
...  

2021 ◽  
pp. 088626052110501
Author(s):  
Annelise Mennicke ◽  
Constance Austin Coates ◽  
Bridget Jules ◽  
Jennifer Langhinrichsen-Rohling

Disclosure of interpersonal violence (i.e., sexual violence, sexual harassment, dating violence, and stalking) is often the first step toward receiving social and systemic support. Research demonstrates that sexual assault and dating violence survivors on college campuses are more likely to disclosure to informal sources (i.e., friends and family) than formal sources (e.g., police, Title IX, counseling centers). However, there is limited research examining disclosure rates after other forms of violence (i.e., stalking, sexual harassment), and little is known about the impact of the survivors' identities on disclosure. Utilizing four academic years (2016-2019) of aggregated campus climate data from a large Southeastern university, the current study examined rates of disclosure across experiences of sexual violence, sexual harassment, dating violence, and stalking while identifying whether the prevalence and type of disclosure (formal versus informal-only) differed by gender, sexual orientation, and/or race/ethnicity. Of 8,017 participants, 4.6% reported sexual violence, 18.9% reported sexual harassment, 12.3% reported dating violence, and 11.3% reported stalking in the past academic year. Results of multinomial logistic regression indicated that, across all four types of violence, men (as compared to women) had lower odds of disclosing both informally-only and formally. Bisexual as compared to heterosexual students had higher odds of formal disclosure of sexual harassment and stalking while gay/lesbian students had higher odds of formally disclosing sexual harassment. Individuals of another race/ethnicity (compared to White students) had lower odds of informal-only disclosure of dating violence. Findings underscore the need to implement programs to improve the social reactions of friends and family members receiving disclosures, and to increase culturally-tailored service provision.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hannah Cohen-Cline ◽  
Hsin-Fang Li ◽  
Monique Gill ◽  
Fatima Rodriguez ◽  
Tina Hernandez-Boussard ◽  
...  

Abstract Background The COVID-19 pandemic has further exposed inequities in our society, demonstrated by disproportionate COVID-19 infection rate and mortality in communities of color and low-income communities. One key area of inequity that has yet to be explored is disparities based on preferred language. Methods We conducted a retrospective cohort study of 164,368 adults tested for COVID-19 in a large healthcare system across Washington, Oregon, and California from March – July 2020. Using electronic health records, we constructed multi-level models that estimated the odds of testing positive for COVID-19 by preferred language, adjusting for age, race/ethnicity, and social factors. We further investigated interaction between preferred language and both race/ethnicity and state. Analysis was performed from October–December 2020. Results Those whose preferred language was not English had higher odds of having a COVID-19 positive test (OR 3.07, p < 0.001); this association remained significant after adjusting for age, race/ethnicity, and social factors. We found significant interaction between language and race/ethnicity and language and state, but the odds of COVID-19 test positivity remained greater for those whose preferred language was not English compared to those whose preferred language was English within each race/ethnicity and state. Conclusions People whose preferred language is not English are at greater risk of testing positive for COVID-19 regardless of age, race/ethnicity, geography, or social factors – demonstrating a significant inequity. Research demonstrates that our public health and healthcare systems are centered on English speakers, creating structural and systemic barriers to health. Addressing these barriers are long overdue and urgent for COVID-19 prevention.


2021 ◽  
Author(s):  
Jiawen Liu ◽  
Lara P. Clark ◽  
Matthew Bechle ◽  
Anjum Hajat ◽  
Sun-Young Kim ◽  
...  

All data used are publicly available. Demographic data are available via IPUMS National Historic Geographic Information Systems [<a href="http://www.nhgis.org/" target="_blank">www.nhgis.org</a>]; air pollution estimates are available via the EPA CACES project [<a href="http://www.caces.us/" target="_blank">www.caces.us</a>]).


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