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1.
Soc Sci Med ; 311: 115319, 2022 Sep 05.
Article in English | MEDLINE | ID: covidwho-2008124

ABSTRACT

One of the most consistent and worrying features of the COVID-19 pandemic globally has been the disproportionate burden of the epidemic in the most deprived areas. Most of the literature so far though has focused on estimating the extent of these inequalities. There has been much less attention paid to exploring the main pathways underpinning them. In this study, we employ the syndemic pandemic theoretical framework and apply novel decomposition methods to investigate the proportion of the COVID-19 mortality gap by area-level deprivation in England during the first wave of the pandemic (January to July 2020) was accounted for by pre-existing inequalities in the compositional and contextual characteristics of place. We use a decomposition approach to explicitly quantify the independent contribution of four inequalities pathways (vulnerability, susceptibility, exposure and transmission) in explaining the more severe COVID-19 outcomes in the most deprived local authorities compared to the rest. We find that inequalities in transmission (73%) and in vulnerability (49%) factors explained the highest proportion of mortality by deprivation. Our results suggest that public health agencies need to develop short- and long-term strategies to alleviate these underlying inequalities in order to alleviate the more severe impacts on the most vulnerable communities.

2.
BMJ Open ; 12(4): e061340, 2022 04 08.
Article in English | MEDLINE | ID: covidwho-1784842

ABSTRACT

INTRODUCTION: The UK social security system is being transformed by the implementation of Universal Credit (UC), which combines six existing benefits and tax credits into a single payment for low-income households. Despite extensive reports of hardship associated with the introduction of UC, no previous studies have comprehensively evaluated its impact on mental health. Because payments are targeted at low-income households, impacts on mental health will have important consequences for health inequalities. METHODS AND ANALYSIS: We will conduct a mixed methods study. Work package (WP) 1 will compare health outcomes for new recipients of UC with outcomes for legacy benefit recipients in two large population surveys, using the phased rollout of UC as a natural experiment. We will also analyse the relationship between the proportion of UC claimants in small areas and a composite measure of mental health. WP2 will use data collected by Citizen's Advice to explore the sociodemographic and health characteristics of people who seek advice when claiming UC and identify features of the claim process that prompt advice-seeking. WP3 will conduct longitudinal in-depth interviews with up to 80 UC claimants in England and Scotland to explore reasons for claiming and experiences of the claim process. Up to 30 staff supporting claimants will also be interviewed. WP4 will use a dynamic microsimulation model to simulate the long-term health impacts of different implementation scenarios. WP5 will undertake cost-consequence analysis of the potential costs and outcomes of introducing UC and cost-benefit analyses of mitigating actions. ETHICS AND DISSEMINATION: We obtained ethical approval for the primary data gathering from the University of Glasgow, College of Social Sciences Research Ethics Committee, application number 400200244. We will use our networks to actively disseminate findings to UC claimants, the public, practitioners and policy-makers, using a range of methods and formats. TRIAL REGISTRATION NUMBER: The study is registered with the Research Registry: researchregistry6697.


Subject(s)
Mental Health , Cost-Benefit Analysis , England , Humans , Scotland , Surveys and Questionnaires
3.
BMC Public Health ; 22(1): 590, 2022 03 26.
Article in English | MEDLINE | ID: covidwho-1765444

ABSTRACT

BACKGROUND: We estimated socioeconomic factors associated with food insecurity during the first year of the Covid pandemic in the UK and explored potential mechanisms explaining these associations. METHODS: Data were from the April, July, and September 2020 waves of the UK Understanding Society Covid Survey. Food insecurity was measured as 'not having access to healthy and nutritious food' and 'reporting being hungry but not eating'. Logistic regression estimated the relationship between socioeconomic factors and food insecurity. A decomposition approach explored if financial vulnerability and having Covid-19 explained associations between socioeconomics factors and food insecurity. RESULTS: Single parents and young people aged 16-30 years had a higher odds of reporting both measures of food insecurity. Financial insecurity explained 5% to 25% of the likelihood of reporting being food insecure for young people and single parents depending on the food insecurity measure used. Experiencing Covid-19 symptoms explained less than 5% of the likelihood of being food insecure for single parents but approximately 30% of not having access to healthy and nutritious food for young people. CONCLUSION: Policies providing additional financial support may help to reduce the impact of Covid-19 on food insecurity in the UK.


Subject(s)
COVID-19 , Pandemics , Adolescent , Adult , COVID-19/epidemiology , Food Insecurity , Food Supply , Humans , Socioeconomic Factors , United Kingdom/epidemiology , Young Adult
4.
J Nurses Prof Dev ; 2022 Mar 14.
Article in English | MEDLINE | ID: covidwho-1746174

ABSTRACT

This article will inform the reader about challenges of onboarding new graduate nurses during COVID-19 and discuss how to combat those challenges. New graduate nurses attended a skills day and completed pre- and postsurveys, rating their level of confidence in the same identified skills. Each participant showed improved confidence (p < .001). Offering skills days to bridge the gap to clinical practice is shown to be beneficial.

5.
The Lancet ; 398, 2021.
Article in English | ProQuest Central | ID: covidwho-1537163

ABSTRACT

Background The COVID-19 pandemic and associated UK containment measures implemented to reduce viral spread are likely to influence the prevalence of food insecurity. Food insecurity is associated with wide-ranging negative effects on health and wellbeing. Specific containment measures such as closure of schools and hospitality venues might be expected to disproportionately affect some vulnerable groups, including single parents and young people. We aimed to identify sociodemographic and economic factors that increase the likelihood of reporting food insecurity during the COVID-19 pandemic, and to explore the extent to which financial vulnerability and experiencing COVID-19 symptoms explain the likelihood of becoming food insecure. Methods This analysis used cross-sectional cohort data from April, July, and September, 2020, of the UK Understanding Society COVID-19 Survey, which involved approximately 17 000 households. Food insecurity was defined as reporting positively to either or both of: “being hungry and not able to eat” or “inability to access sufficient and nutritious food because of lack of money or other resources”. Logistic regression was used to identify sociodemographic and economic factors associated with increased risk of food insecurity during the COVID-19 pandemic. A decomposition approach was used to explore the extent to which these associations were explained by financial vulnerability, or experiencing COVID-19 symptoms. Ethics approval for the study was not required. Findings Single parents and young people aged 16–30 years were at highest risk of reporting either or both measures of food insecurity. For single parents, financial vulnerability explained 5–20% of the likelihood of being food insecure, and experiencing COVID-19 symptoms explained less than 5%. For young people, financial vulnerability explained 5–25% of the likelihood of being food insecure, and experiencing COVID-19 symptoms explained 5–30%. Interpretation Single parents and young people may be especially at risk of food insecurity in the context of COVID-19. The wide explanatory ranges identified could be attributable to heterogeneity within groups and differing eligibility for financial support. Targeted funding, including for those self-isolating, could be an effective strategy to avoid or mitigate food insecurity among such vulnerable groups in the UK during the COVID-19 pandemic and other future pandemics. Funding None.

6.
Journal of Epidemiology and Community Health ; 75(Suppl 1):A51-A52, 2021.
Article in English | ProQuest Central | ID: covidwho-1394160

ABSTRACT

BackgroundIn light of the Covid-19 pandemic, the government has prioritised reducing obesity rates. Many local authorities have employed planning guidance to manage the local food environment and promote a healthy environment. There is a lack of evidence on the effectiveness of this type of guidance on the food environment and subsequently health outcomes in particular inequalities. The primary aim of this paper is to examine the impact of planning guidance on the number and type of food outlets, health outcomes in particular obesity rates for children, and inequalities in these outcomes in a local authority in the North East of England. Gateshead implemented a blanket ban on all new takeaways in 2015.MethodsThe datasets consist of yearly number and type of food outlets in Gateshead from the Food Standards Agency Food Hygiene Rating System, Index of Multiple Deprivation 2015/2019, population density from the Office for National Statistics, childhood obesity data from the National Child Measurement Programme, and type 2 diabetes and hypertension data from Public Health England. The data is merged and analysed at lower layer super output area level across 8 years from 2012–2019. We use fixed effects and difference in difference models to investigate the impact of planning guidance on the food environment in Gateshead. The control groups are the neighbouring local authorities where did not implement the guidance. A fixed effects model will be employed to test the relationship between the density of food establishments and incidence of the relevant health conditions such as childhood obesity.ResultsOur preliminary results show the planning guidance significantly reduced the proportion of takeaways compared to all other types of food outlets (p-value: 0.000). However, there was no statistically significant reduction in takeaways.ConclusionThis study provides preliminary evidence on the effectiveness of policy to manage the food environment. Our next step will be to explore how changes to the food environment impact on health outcomes and inequalities.

7.
Int J Environ Res Public Health ; 18(14)2021 Jul 06.
Article in English | MEDLINE | ID: covidwho-1295854

ABSTRACT

In March 2020, a national UK lockdown was implemented in response to rapidly rising COVID-19 infections. Those experiencing the most severe public health restrictions were 'shielding' groups as well as those over 70 years of age. Older age adults, many of whom were active, independent, and socially connected were immediately instructed to stay at home, to limit all external social contact and consider contingency for maintaining personal food security and social contact. The purpose of this qualitative study was to explore the experiences of older adults during the first UK lockdown (March-June 2020), specifically how our sample reacted to public health messaging, staying food secure and drawing on available social capital within their community. Semi-structured telephone interviews were conducted with eight participants. In addition, twenty-five participants completed a qualitative 'open-ended' survey. The data was collated and analysed, adopting a Thematic Analysis informed approach. Three themes were identified: (1) Too Much Information, (2) The Importance of Neighbours and Connections and (3) Not Wishing to be a Burden. These findings offer a rich insight into how early lockdown measures, never witnessed since World War 2, exposed existing pre-pandemic inequalities and concerns relating to loneliness, isolation and wellbeing. The findings are of relevance to researchers, older adult advocate groups and policy makers to inform post COVID-recovery within communities to ensure healthy ageing.


Subject(s)
COVID-19 , Social Capital , Aged , Aged, 80 and over , Communicable Disease Control , Food Security , Humans , SARS-CoV-2 , Social Isolation , United Kingdom
8.
Brock Education: A Journal of Educational Research and Practice ; 30(1):74-94, 2021.
Article in English | ProQuest Central | ID: covidwho-1229731

ABSTRACT

Technology continues to form an important part of the educational landscape, although the value of portable devices as learning tools is still being explored and debated. In light of the technology-based teaching methods suddenly brought into effect in response to the COVID-19 pandemic, the deliberate use of technology for learning is increasingly significant. The purpose of this article is to highlight student perspectives of learning with portable devices to inform the use of portable technology in the Canadian school system going forward. To gather student perceptions, the research team surveyed 704 students in Grades 6 to 9 about their use of iPads in the classroom during a 1:1 technology initiative. While students were enthusiastic about the presence of portable technology, they also shared mixed feelings about the use of such technology as a learning tool. Key themes fell into three categories--engagement, inclusivity, and learning--as students shared their insight into the academic, social, and physical barriers that exist as a result of the technology. In the discussion, we identify lessons learned, especially in the area of self-regulation, and make recommendations on how to harness the power of this multi-faceted learning tool and minimize the chaos it can create when not utilized deliberately and carefully.

9.
BMJ Open ; 11(3): e042753, 2021 03 15.
Article in English | MEDLINE | ID: covidwho-1136082

ABSTRACT

OBJECTIVE: There has been an unprecedented rise in infant mortality associated with deprivation in recent years in the United Kingdom (UK) and Republic of Ireland. A healthy pregnancy can have significant impacts on the life chances of children. The objective of this review was to understand the association between individual-level and household-level measures of socioeconomic status and adverse pregnancy outcomes. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Nine databases were searched (Medline, Embase, Scopus, ASSIA, CINAHL, PsycINFO, BNI, MIDRIS and Google Scholar) for articles published between 1999 and August 2019. Grey literature searches were also assessed. STUDY SELECTION CRITERIA: Studies reporting associations between individual-level or household socioeconomic factors on pregnancy outcomes in the UK or Ireland. RESULTS: Among the 82 353 search results, 53 821 titles were identified and 35 unique studies met the eligibility criteria. Outcomes reported were neonatal, perinatal and maternal mortality, preterm birth, birth weight and mode of delivery. Pooled effect sizes were calculated using random-effects meta-analysis. There were significantly increased odds of women from lower levels of occupation/social classes compared with the highest level having stillbirth (OR 1.40, 95% CI 1.23 to 1.59, I2 98.62%), neonatal mortality (OR 1.39, 95% CI 1.22 to 1.57, I2 97.09%), perinatal mortality (OR 1.39, 95% CI 1.23 to 1.57, I2 98.69%), preterm birth (OR 1.41, 95% CI 1.33 to 1.50, I2 70.97%) and low birth weight (OR 1.40, 95% CI 1.19 to 1.61, I2 99.85%). Limitations relate to available data, unmeasured confounders and the small number of studies for some outcomes. CONCLUSIONS: This review identified consistent evidence that lower occupational status, especially manual occupations and unemployment, were significantly associated with increased risk of multiple adverse pregnancy outcomes. Strategies to improve pregnancy outcomes should incorporate approaches that address wider determinants of health to provide women and families with the best chances of having a healthy pregnancy and baby and to decrease pregnancy-related health inequalities in the general population. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019140893.


Subject(s)
Pregnancy Outcome , Premature Birth , Child , Female , Humans , Infant , Infant, Newborn , Ireland/epidemiology , Pregnancy , Pregnancy Outcome/epidemiology , Premature Birth/epidemiology , Socioeconomic Factors , United Kingdom/epidemiology
10.
J Emerg Nurs ; 47(2): 321-325, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1002747

ABSTRACT

The coronavirus 2019 pandemic has affected almost every aspect of health care delivery in the United States, and the emergency medicine system has been hit particularly hard while dealing with this public health crisis. In an unprecedented time in our history, medical systems and clinicians have been asked to be creative, flexible, and innovative, all while continuing to uphold the important standards in the US health care system. To continue providing quality services to patients during this extraordinary time, care providers, organizations, administrators, and insurers have needed to alter longstanding models and procedures to respond to the dynamics of a pandemic. The Emergency Medicine Treatment and Active Labor Act of 1986, or EMTALA, is 1 example of where these alterations have allowed health care facilities and clinicians to continue their work of caring for patients while protecting both the patients and the clinicians themselves from infectious exposures at the same time.


Subject(s)
COVID-19/therapy , Delivery of Health Care/methods , Emergency Medical Services/legislation & jurisprudence , Emergency Medical Services/methods , Humans , Pandemics , SARS-CoV-2 , Telemedicine/methods , United States
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