Gender Composition in Biomedical Research Grant Submissions and Grant Review Panels Before Versus During the COVID-19 Pandemic.

Purpose: This study examined the gender composition of career development award applicants and grant review panels during the pandemic compared with that beforehand. Methods: Data were collected from 14 Health Research Alliance (HRA) organizations, which fund biomedical research and training. HRA members provided the gender of grant applicants and grant reviewers during the pandemic (April 1, 2020, to February 28, 2021) and prepandemic (April 1, 2019, to February 29, 2020). The signed-rank test compared medians and the chi square test compared the overall gender distribution. Results: The total number of applicants was similar during the pandemic (N = 3,724) and prepandemic (N = 3,882) periods, as was the percentage of women applicants (45.2% pandemic vs. 44.9% prepandemic, p = 0.78). The total number of men and women grant reviewers declined during the pandemic (N = 856) compared with that pre-pandemic (N = 1,689); this decrease was driven by a change for the largest funder. Also driven by changes for this one funder, the percentage of total grant reviewers who were women increased significantly during the pandemic (45.9%) compared with that during prepandemic (38.8%; p = 0.001), but the median percentage of women grant reviewers across organizations remained similar during the pandemic (43.6%) and prepandemic periods (38.2%; p = 0.53). Conclusions: In a sample of research organizations, the gender composition of grant applicants and grant review panels remained similar, except for the review panel composition for one large funder. Given evidence from other studies that have revealed gender differences in other career and life experiences of scientists during the pandemic, ongoing evaluation of women's representation in grant submission and review mechanisms is essential.

Occupation and Educational Attainment Characteristics Associated With COVID-19 Mortality by Race and Ethnicity in California.

Importance: Racial and ethnic inequities in COVID-19 mortality may be driven by occupation and education, but limited evidence has assessed these mechanisms. Objective: To estimate whether occupational characteristics or educational attainment explained the associations between race and ethnicity and COVID-19 mortality. Design, Setting, and Participants: This population-based retrospective cohort study of Californians aged 18 to 65 years linked COVID-19 deaths to population estimates within strata defined by race and ethnicity, gender, age, nativity in the US, region of residence, education, and occupation. Analysis was conducted from September 2020 to February 2022. Exposures: Education and occupational characteristics associated with COVID-19 exposure (essential sector, telework option, wages). Main Outcomes and Measures: All confirmed COVID-19 deaths in California through February 12, 2021. The study estimated what COVID-19 mortality would have been if each racial and ethnic group had (1) the COVID-19 mortality risk associated with the education and occupation distribution of White people and (2) the COVID-19 mortality risk associated with the lowest-risk educational and occupational positions. Results: Of 25 235 092 participants (mean [SD] age, 40 [14] years; 12 730 395 [50%] men), 14 783 died of COVID-19, 8 125 565 (32%) had a Bachelor's degree or higher, 13 345 829 (53%) worked in essential sectors, 11 783 017 (47%) could not telework, and 12 812 095 (51%) had annual wages under $51 700. COVID-19 mortality ranged from 15 deaths per 100 000 for White women and Asian women to 139 deaths per 100 000 for Latinx men. Accounting for differences in age, nativity, and region of residence, if all races and ethnicities had the COVID-19 mortality associated with the occupational characteristics of White people (sector, telework, wages), COVID-19 mortality would be reduced by 10% (95% CI, 6% to 14%) for Latinx men, but increased by 5% (95% CI, -8% to 17%) for Black men. If all working-age Californians had the COVID-19 mortality associated with the lowest-risk educational and occupational position (Bachelor's degree, nonessential, telework, and highest wage quintile), there would have been 43% fewer COVID-19 deaths among working-age adults (8441 fewer deaths; 95% CI, 32%-54%), with the largest absolute risk reductions for Latinx men (3755 deaths averted; 95% CI, 3304-4255 deaths) and Latinx women (2329 deaths averted; 95% CI, 2038-2621 deaths). Conclusions and Relevance: In this population-based cohort study of working-age California adults, occupational disadvantage was associated with excess COVID-19 mortality for Latinx men. For all racial and ethnic groups, excess risk associated with low-education, essential, on-site, and low-wage jobs accounted for a substantial fraction of COVID-19 mortality.

Hepatitis C Screening Among Medicaid Patients With Schizophrenia, 2002-2012.

OBJECTIVE: Although people with schizophrenia are disproportionately affected by Hepatitis C virus (HCV) compared to the general population, HCV screening among US Medicaid recipients with schizophrenia has not been characterized. Following 1998 CDC recommendations for screening in high-risk populations, we estimated the proportion of Medicaid recipients with and without schizophrenia screened for HCV across states and over time. Examining patterns of screening will inform the current public health imperative to test all adults for HCV now that safer and more effective treatments are available. METHODS: Data are drawn from 1 353 424 Medicaid recipients aged 15-64 years with schizophrenia and frequency-matched controls from 2002 to 2012. Participants with known HCV infection one year prior and those dual-eligible for Medicare were excluded. Multivariable logistic regression estimated associations between predictor variables and HCV screening. RESULTS: HCV screening was low (<4%) but increased over time. Individuals with schizophrenia consistently showed higher screening compared to controls across years and states. Several demographic and clinical characteristics predicted higher screening, especially comorbid HIV (OR = 6.5; 95% CI = 6.0-7.0). Outpatient medical care utilization increased screening by nearly double in 2002 (OR = 1.8; CI = 1.7-1.9) and almost triple in 2012 (OR = 2.7; CI = 2.6-2.9). CONCLUSIONS: Low screening was a missed opportunity to improve HCV prevention efforts and reduce liver-related mortality among people with schizophrenia. Greater COVID-19 disease severity in HCV patients and the availability of effective HCV treatments increase the urgency to improve HCV screening. Eliminating Medicaid restrictions and expanding statewide HIV policies to include HCV would have multiple public health benefits, particularly for people with schizophrenia.

A descriptive analysis of 2020 California Occupational Safety and Health Administration covid-19-related complaints.

COVID-19 mortality has disproportionately affected specific occupations and industries. The Occupational Safety and Health Administration (OSHA) protects the health and safety of workers by setting and enforcing standards for working conditions. Workers may file OSHA complaints about unsafe conditions. Complaints may indicate poor workplace safety during the pandemic. We evaluated COVID-19-related complaints filed with California (Cal)/OSHA between January 1, 2020 and December 14, 2020 across seven industries. To assess whether workers in occupations with high COVID-19-related mortality were also most likely to file Cal/OSHA complaints, we compared industry-specific per-capita COVID-19 confirmed deaths from the California Department of Public Health with COVID-19-related complaints. Although 7820 COVID-19-related complaints were deemed valid by Cal/OSHA, only 627 onsite inspections occurred, and 32 citations were issued. Agricultural workers had the highest per-capita COVID-19 death rates (402 per 100,000 workers) but were least represented among workplace complaints (44 per 100,000 workers). Health Care workers had the highest complaint rates (81 per 100,000 workers) but the second lowest COVID-19 death rate (81 per 100,000 workers). Industries with the highest inspection rates also had high COVID-19 mortality. Our findings suggest complaints are not proportional to COVID-19 risk. Instead, higher complaint rates may reflect worker groups with greater empowerment, resources, or capacity to advocate for better protections. This capacity to advocate for safe workplaces may account for relatively low mortality rates in potentially high-risk occupations. Future research should examine factors determining worker complaints and complaint systems to promote participation of those with the greatest need of protection.

Whites' County-Level Racial Bias, COVID-19 Rates, and Racial Inequities in the United States.

Mounting evidence reveals considerable racial inequities in coronavirus disease 2019 (COVID-19) outcomes in the United States (US). Area-level racial bias has been associated with multiple adverse health outcomes, but its association with COVID-19 is yet unexplored. Combining county-level data from Project Implicit on implicit and explicit anti-Black bias among non-Hispanic Whites, Johns Hopkins Coronavirus Resource Center, and The New York Times, we used adjusted linear regressions to estimate overall COVID-19 incidence and mortality rates through 01 July 2020, Black and White incidence rates through 28 May 2020, and Black-White incidence rate gaps on average area-level implicit and explicit racial bias. Across 2994 counties, the average COVID-19 mortality rate (standard deviation) was 1.7/10,000 people (3.3) and average cumulative COVID-19 incidence rate was 52.1/10,000 (77.2). Higher racial bias was associated with higher overall mortality rates (per 1 standard deviation higher implicit bias b = 0.65/10,000 (95% confidence interval: 0.39, 0.91); explicit bias b = 0.49/10,000 (0.27, 0.70)) and higher overall incidence (implicit bias b = 8.42/10,000 (4.64, 12.20); explicit bias b = 8.83/10,000 (5.32, 12.35)). In 957 counties with race-specific data, higher racial bias predicted higher White and Black incidence rates, and larger Black-White incidence rate gaps. Anti-Black bias among Whites predicts worse COVID-19 outcomes and greater inequities. Area-level interventions may ameliorate health inequities.

After "The China Virus" Went Viral: Racially Charged Coronavirus Coverage and Trends in Bias Against Asian Americans.

On March 8, 2020, there was a 650% increase in Twitter retweets using the term "Chinese virus" and related terms. On March 9, there was an 800% increase in the use of these terms in conservative news media articles. Using data from non-Asian respondents of the Project Implicit "Asian Implicit Association Test" from 2007-2020 (n = 339,063), we sought to ascertain if this change in media tone increased bias against Asian Americans. Local polynomial regression and interrupted time-series analyses revealed that Implicit Americanness Bias-or the subconscious belief that European American individuals are more "American" than Asian American individuals-declined steadily from 2007 through early 2020 but reversed trend and began to increase on March 8, following the increase in stigmatizing language in conservative media outlets. The trend reversal in bias was more pronounced among conservative individuals. This research provides evidence that the use of stigmatizing language increased subconscious beliefs that Asian Americans are "perpetual foreigners." Given research that perpetual foreigner bias can beget discriminatory behavior and that experiencing discrimination is associated with adverse mental and physical health outcomes, this research sounds an alarm about the effects of stigmatizing media on the health and welfare of Asian Americans.