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Syst Rev ; 10(1): 196, 2021 07 02.
Article in English | MEDLINE | ID: covidwho-1295482


BACKGROUND: The COVID-19 pandemic caused by SARS-CoV-2 has highlighted consistent inequities in incidence, disease severity, and mortality across racial and ethnic minority populations in the United States (US) and beyond. While similar patterns have been observed with previous viral respiratory pathogens, to date, no systematic review has comprehensively documented these disparities or potential contributing factors. In response, this review aims to synthesize data on racial and ethnic disparities in morbidity and mortality due to viral acute respiratory infections (ARI) other than SARS-CoV-2. This review will focus on understanding structural health and social factors to contextualize race and ethnicity driving these disparities in the US. METHODS: We will conduct a systematic review of studies published from January 1, 2002, onward. Our search will include PubMed/MEDLINE, EBSCO Host-CINAHL Plus, PsycInfo, EMBASE, and Cochrane Library databases to identify relevant articles. We will include studies of any design that describe racial/ethnic disparities associated with viral ARI conducted in the US. Primary outcomes include incidence, disease severity or complication, hospitalization, or death attributed to ARI. Secondary outcomes include uptake of preventive interventions including vaccination, handwashing, social distancing, and wearing masks. Two reviewers will independently screen all citations, full-text articles, and abstract relevant data. Data characterizing individual-, community-, and structural-level factors associated with these disparities will be abstracted to better understand the underlying structural inequities contributing to racial disparities in ARI. We will assess the methodological quality of all studies and will conduct meta-analyses using random effects models if appropriate. DISCUSSION: Findings from this systematic review will shed light on patterns of racial and ethnic disparities in viral ARI in the United States to support mathematical modeling of epidemic trajectories, intervention impact, and structural drivers of transmission, including structural racism. Moreover, data emerging from this review may reignite pandemic preparedness focused on communities with specific vulnerabilities related to living and working conditions given prevailing structural inequities, thus facilitating improved future pandemic responses to novel or endemic viral respiratory pathogens. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020219771.

COVID-19 , Respiratory Tract Infections , Humans , Minority Groups , Pandemics , SARS-CoV-2 , Systematic Reviews as Topic , United States/epidemiology
Popul Health Manag ; 24(6): 657-663, 2021 12.
Article in English | MEDLINE | ID: covidwho-1242093


The objective was to summarize data on coronavirus disease 2019 (COVID-19) testing uptake, social determinants of health, and patient satisfaction with mobile health clinic services within underserved minority and low-income communities. This COVID-19 pilot project was conducted during June and July 2020 in low-income residential neighborhoods in West Baltimore, Maryland. Quantitative data were collected and assessed cross-sectionally. Demographically, 85% of the patients identified as Black or African American (n = 265) and 58.2% as female (n = 184). The COVID-19 test was administered by the registered nurse to 78.2% (n = 288) of the patients. More than 90% of patients confirmed high levels of satisfaction with the services they received from the community mobile health clinic. Social determinants were assessed and females reported significantly worse health literacy than their male counterparts (P < 0.05). Study findings suggest that the community mobile health clinic model was effective in attracting hard-to-reach and marginalized individuals, who otherwise may have gone untested or undiagnosed. This care delivery model can be one solution to disparities by improving access to COVID-19 testing and primary care for communities with higher vulnerability to COVID-19 complications.

COVID-19 , Telemedicine , Baltimore , COVID-19 Testing , Female , Humans , Male , Pilot Projects , SARS-CoV-2 , Social Determinants of Health
Journal of Health Care for the Poor and Underserved ; 32(2 Supplement):189-197, 2021.
Article in English | ProQuest Central | ID: covidwho-1208107


This report from the field describes the uptake of a telemedicine outreach model among residents in under-resourced urban settings as a proactive response to the COVID-19 pandemic. We describe the methods and uptake of our telehealth virtual hospital program and implications for practice.