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1.
Ind Health ; 2022 May 16.
Article in English | MEDLINE | ID: covidwho-1847112

ABSTRACT

TheCOVID-19 pandemic has precipitated broad and extensive changes in the waypeople live and work. While the general subject of working from home hasrecently drawn increased attention, few studies have assessed genderdifferences in vulnerability to the potential mental health effects of workingfrom home. Using data from 1,585workers who participated in the Health, Ethnicity, and Pandemic (HEAP) study, anational survey conducted in the U.S. during the COVID-19 pandemic in October2020, associations of working from home with psychological distress wereexamined with weighted logistic regression among 1,585 workers and stratified bygender. It was found that workers who worked from home had higher odds ofpsychological distress (aOR and 95% CI = 2.62 [1.46, 4.70]) compared to workerswho did not work from home, adjusting for demographic factors, socioeconomicstatus, and health behaviors. In gender-stratified analyses, this positiveassociation between working from home and psychological distress was significantin women (aOR and 95% CI = 3.68 [1.68, 8.09]) but not in men. These resultshave implications for female workers' mental health in the transition towardsworking from home in the COVID-19 pandemic era.

2.
J Gen Intern Med ; 2022 Apr 11.
Article in English | MEDLINE | ID: covidwho-1782935

ABSTRACT

BACKGROUND: While hate crimes rose during the COVID-19 pandemic, few studies examined whether this pandemic-time racial discrimination has led to negative health consequences at the population level. OBJECTIVE: We examined whether experienced and perceived racial discrimination were associated with mental or behavioral health outcomes during the pandemic. DESIGN: In October 2020, we conducted a national survey with minorities oversampled that covered respondents' sociodemographic background and health-related information. PARTICIPANTS: A total of 2709 participants responded to the survey (response rate: 4.2%). MAIN MEASURES: The exposure variables included (1) experienced and encountered racial discrimination, (2) experienced racial and ethnic cyberbullying, and (3) perceived racial bias. Mental health outcomes were measured by psychological distress and self-rated happiness. Measures for behavioral health included sleep quality, change in cigarette smoking, and change in alcohol consumption. Weighted logistic regressions were performed to estimate the associations between the exposure variables and the outcomes, controlling for age, gender, race and ethnicity, educational attainment, household income, eligibility to vote, political party, COVID-19 infection, and geographic region. Separate regressions were performed in the six racial and ethnic subgroups: non-Hispanic White, non-Hispanic Black, Hispanic, East Asian, South Asian, and Southeast Asian respondents. KEY RESULTS: Experienced racial discrimination was associated with higher likelihood of psychological distress (adjusted odds ratio [AOR] = 2.18, 95% confidence interval [95% CI]: 1.34-3.55). Experienced racial discrimination (AOR = 2.31, 95% CI: 1.34-3.99) and perceived racial bias (AOR = 1.05, 95% CI: 1.00-1.09) were both associated with increased cigarette smoking. The associations between racial discrimination and mental distress and substance use were most salient among Black, East Asian, South Asian, and Hispanic respondents. CONCLUSIONS: Racial discrimination may be associated with higher likelihood of distress, and cigarette smoking among racial and ethnic minorities. Addressing racial discrimination is important for mitigating negative mental and behavioral health ramifications of the pandemic.

3.
Popul Health Manag ; 25(3): 317-322, 2022 06.
Article in English | MEDLINE | ID: covidwho-1577496

ABSTRACT

A healthy diet is an important protective factor to prevent cardiometabolic disease. Traditional face-to-face dietary interventions are often episodic, expensive, and may have limited effectiveness, particularly among older adults and people living in rural areas. Telehealth-delivered dietary interventions have proven to be a low-cost and effective alternative approach to improve dietary behaviors among adults with chronic health conditions. In this study, we developed a validated agent-based model of cardiometabolic health conditions to project the impact of expanding telehealth-delivered dietary interventions among older adults in the state of Georgia, a state with a large rural population. We projected the incidence of major cardiometabolic health conditions (type 2 diabetes, hypertension, and high cholesterol) with the implementation of telehealth-delivered dietary interventions versus no intervention among all older adults and 3 subpopulations (older adults with diabetes, hypertension, and high cholesterol, separately). The results showed that expanding telehealth-delivered dietary interventions could avert 22,774 (95% confidence interval [CI]: 22,091-23,457) cases of type 2 diabetes, 19,732 (19,145-20,329) cases of hypertension, and 18,219 (17,672-18,766) cases of high cholesterol for 5 years among older adults in Georgia. The intervention would have a similar effect in preventing cardiometabolic health conditions among the 3 selected subpopulations. Therefore, expanding telehealth-delivered dietary interventions could substantially reduce the burden of cardiometabolic health conditions in the long term among older adults and those with chronic health conditions.


Subject(s)
Diabetes Mellitus, Type 2 , Hypertension , Telemedicine , Aged , Cholesterol , Chronic Disease , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/prevention & control , Diet, Healthy , Humans , Hypertension/epidemiology , Hypertension/prevention & control , Telemedicine/methods
4.
J Occup Environ Med ; 63(11): 931-937, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1504374

ABSTRACT

OBJECTIVE: We examined associations of negative employment changes during the COVID-19 pandemic with mental health in a national sample of U.S. workers, and whether the associations differed by race. METHODS: Data were from the Health, Ethnicity, and Pandemic Study, a cross-sectional survey. The effects of negative employment changes on psychological distress in 1510 workers were examined via linear regression, and stratified analyses were conducted across racial subgroups. RESULTS: After adjustment for covariates, compared to workers with no change in employment, those who experienced permanent job loss had the highest psychological distress (ß and 95% CI = 3.27 [1.89, 4.65]). Permanent job loss had the greatest effect on psychological distress in Blacks and Asians. CONCLUSION: Negative employment changes related to the pandemic may have deleterious impacts on workers' mental health, with disproportionate effects on racial minorities.


Subject(s)
COVID-19 , Psychological Distress , Cross-Sectional Studies , Employment , Humans , Pandemics , SARS-CoV-2
5.
J Telemed Telecare ; : 1357633X211051677, 2021 Oct 11.
Article in English | MEDLINE | ID: covidwho-1463096

ABSTRACT

Telehealth is an important source of health care during the COVID-19 pandemic. Evidence is scarce regarding disparities in telehealth utilization in the United States. We aimed to investigate the prevalence and factors associated with telehealth utilization among US adults. Our data came from the Health, Ethnicity, and Pandemic Study, a nationally representative survey conducted in October 2020, with 2554 adults ≥ 18 and an oversample of racial/ethnic minorities. Telehealth utilization was measured as self-reported teleconsultation with providers via email, text message, phone, video, and remote patient monitoring during the pandemic. Logistic regressions were performed to examine the association between telehealth use and factors at the individual, household, and community levels. Overall, 43% of the sample reported having used telehealth, representing 114.5 million adults in the nation. East and Southeast Asians used telehealth less than non-Hispanic Whites (OR = 0.5, 95% CI: 0.3-0.8). Being uninsured (compared with private insurance: OR = 0.4, 95% CI: 0.2-0.8), and those with limited broadband coverage in the community (OR = 0.5, 95% CI: 0.3-0.8) were less likely to use telehealth. There is a need to develop and implement more equitable policies and interventions at both the individual and community levels to improve access to telehealth services and reduce related disparities.

6.
Nutrients ; 13(10)2021 Sep 25.
Article in English | MEDLINE | ID: covidwho-1438685

ABSTRACT

OBJECTIVE: To investigate the impact of the COVID-19 pandemic on multiple lifestyle changes among adults in the United States (USA). METHODS: We conducted a survey, the Health, Ethnicity, and Pandemic (HEAP) Study, in October 2020 among USA adults. Participants were selected from the United States using 48 sampling strata, including age, race, ethnicity, education, and gender, and were asked to report five lifestyle behaviors (i.e., exercise time, screen time, fast-food meal consumption, alcohol drinking, and cigarette smoking) before and during the COVID-19 pandemic. The associations of sociodemographic factors with each lifestyle change were estimated using weighted multivariable logistic regression models. RESULTS: All 2709 HEAP participants were included in this study. Compared to pre-pandemic, the time spent on exercise decreased (32.06 vs. 38.65 min/day; p < 0.001) and screen time increased (6.79 vs. 5.06 h/day; p < 0.001) during the pandemic. The percentage of individuals who reported consuming fast-food meals ≥3 times/week decreased from 37.7% before the pandemic to 33.3% during the pandemic. The percentage of heavy drinkers (≥5 times/week) increased from 20.9% before the pandemic to 25.7% during the pandemic. Among smokers, heavy smoking (≥11 cigarettes/day) increased from 5.8% before the pandemic to 7.9% during the pandemic. We also identified subgroups who were more vulnerable to adverse influences from the pandemic, including racial/ethnic minority groups and young adults. CONCLUSIONS: The COVID-19 pandemic had negative impacts on multiple lifestyle behaviors among Americans. Mitigating such negative impacts of COVID-19 requires effective interventions, particularly for some vulnerable subgroups.


Subject(s)
Alcohol Drinking/epidemiology , COVID-19/psychology , Cigarette Smoking/epidemiology , Exercise/psychology , Fast Foods/statistics & numerical data , Screen Time , Adolescent , Adult , Age Factors , Alcohol Drinking/psychology , Cigarette Smoking/psychology , Cross-Sectional Studies , /statistics & numerical data , Female , Health Behavior , Humans , Male , Middle Aged , Pandemics , /statistics & numerical data , SARS-CoV-2 , Socioeconomic Factors , United States/epidemiology , Young Adult
7.
J Occup Environ Med ; 63(11): 931-937, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1315712

ABSTRACT

OBJECTIVE: We examined associations of negative employment changes during the COVID-19 pandemic with mental health in a national sample of U.S. workers, and whether the associations differed by race. METHODS: Data were from the Health, Ethnicity, and Pandemic Study, a cross-sectional survey. The effects of negative employment changes on psychological distress in 1510 workers were examined via linear regression, and stratified analyses were conducted across racial subgroups. RESULTS: After adjustment for covariates, compared to workers with no change in employment, those who experienced permanent job loss had the highest psychological distress (ß and 95% CI = 3.27 [1.89, 4.65]). Permanent job loss had the greatest effect on psychological distress in Blacks and Asians. CONCLUSION: Negative employment changes related to the pandemic may have deleterious impacts on workers' mental health, with disproportionate effects on racial minorities.


Subject(s)
COVID-19 , Psychological Distress , Cross-Sectional Studies , Employment , Humans , Pandemics , SARS-CoV-2
8.
JMIR Public Health Surveill ; 7(5): e26372, 2021 05 26.
Article in English | MEDLINE | ID: covidwho-1290683

ABSTRACT

BACKGROUND: The COVID-19 epidemic and the related containment strategies may affect parental and pediatric health behaviors. OBJECTIVE: The goal of this study was to assess the change in children's and adolescents' prevention and vaccination behaviors amid China's COVID-19 epidemic. METHODS: We conducted a cross-sectional online survey in mid-March 2020 using proportional quota sampling in Wuhan (the epidemic epicenter) and Shanghai (a nonepicenter). Data were collected from 1655 parents with children aged 3 to 17 years. Children's and adolescents' prevention behaviors and regular vaccination behaviors before and during the epidemic were assessed. Descriptive analyses were used to investigate respondents' characteristics, public health prevention behaviors, unproven protection behaviors, and vaccination behaviors before and during the COVID-19 epidemic. Univariate analyses were performed to compare differences in outcome measures between cities and family characteristics, using chi-square tests or Fisher exact tests (if expected frequency was <5) and analyses of variance. Multivariate logistic regressions were used to identify the factors and disparities associated with prevention and vaccination behaviors. RESULTS: Parent-reported prevention behaviors increased among children and adolescents during the COVID-19 epidemic compared with those before the epidemic. During the epidemic, 82.2% (638/776) of children or adolescents always wore masks when going out compared with 31.5% (521/1655) before the epidemic; in addition, 25.0% (414/1655) and 79.8% (1321/1655) had increased their frequency and duration of handwashing, respectively, although only 46.9% (776/1655) went out during the epidemic. Meanwhile, 56.1% (928/1655) of the families took unproven remedies against COVID-19. Parent-reported vaccination behaviors showed mixed results, with 74.8% (468/626) delaying scheduled vaccinations and 80.9% (1339/1655) planning to have their children get the influenza vaccination after the epidemic. Regarding socioeconomic status, children and adolescents from larger families and whose parents had lower education levels were less likely to improve prevention behaviors but more likely to take unproven remedies. Girls were less likely than boys to always wear a mask when going out and wash their hands. CONCLUSIONS: Prevention behaviors and attitudes toward influenza vaccination have improved during the COVID-19 epidemic. Public health prevention measures should be continuously promoted, particularly among girls, parents with lower education levels, and larger families. Meanwhile, misinformation about COVID-19 remains a serious challenge and needs to be addressed by public health stakeholders.


Subject(s)
Adolescent Behavior , COVID-19/prevention & control , Child Behavior , Hand Disinfection , Masks , Pandemics , Vaccination , Adolescent , Adult , Child , Child, Preschool , China , Cross-Sectional Studies , Epidemics , Female , Health Behavior , Humans , Male , Parents , Patient Acceptance of Health Care , SARS-CoV-2 , Social Class , Surveys and Questionnaires
10.
JMIR Public Health Surveill ; 7(5): e26372, 2021 05 26.
Article in English | MEDLINE | ID: covidwho-1197475

ABSTRACT

BACKGROUND: The COVID-19 epidemic and the related containment strategies may affect parental and pediatric health behaviors. OBJECTIVE: The goal of this study was to assess the change in children's and adolescents' prevention and vaccination behaviors amid China's COVID-19 epidemic. METHODS: We conducted a cross-sectional online survey in mid-March 2020 using proportional quota sampling in Wuhan (the epidemic epicenter) and Shanghai (a nonepicenter). Data were collected from 1655 parents with children aged 3 to 17 years. Children's and adolescents' prevention behaviors and regular vaccination behaviors before and during the epidemic were assessed. Descriptive analyses were used to investigate respondents' characteristics, public health prevention behaviors, unproven protection behaviors, and vaccination behaviors before and during the COVID-19 epidemic. Univariate analyses were performed to compare differences in outcome measures between cities and family characteristics, using chi-square tests or Fisher exact tests (if expected frequency was <5) and analyses of variance. Multivariate logistic regressions were used to identify the factors and disparities associated with prevention and vaccination behaviors. RESULTS: Parent-reported prevention behaviors increased among children and adolescents during the COVID-19 epidemic compared with those before the epidemic. During the epidemic, 82.2% (638/776) of children or adolescents always wore masks when going out compared with 31.5% (521/1655) before the epidemic; in addition, 25.0% (414/1655) and 79.8% (1321/1655) had increased their frequency and duration of handwashing, respectively, although only 46.9% (776/1655) went out during the epidemic. Meanwhile, 56.1% (928/1655) of the families took unproven remedies against COVID-19. Parent-reported vaccination behaviors showed mixed results, with 74.8% (468/626) delaying scheduled vaccinations and 80.9% (1339/1655) planning to have their children get the influenza vaccination after the epidemic. Regarding socioeconomic status, children and adolescents from larger families and whose parents had lower education levels were less likely to improve prevention behaviors but more likely to take unproven remedies. Girls were less likely than boys to always wear a mask when going out and wash their hands. CONCLUSIONS: Prevention behaviors and attitudes toward influenza vaccination have improved during the COVID-19 epidemic. Public health prevention measures should be continuously promoted, particularly among girls, parents with lower education levels, and larger families. Meanwhile, misinformation about COVID-19 remains a serious challenge and needs to be addressed by public health stakeholders.


Subject(s)
Adolescent Behavior , COVID-19/prevention & control , Child Behavior , Hand Disinfection , Masks , Pandemics , Vaccination , Adolescent , Adult , Child , Child, Preschool , China , Cross-Sectional Studies , Epidemics , Female , Health Behavior , Humans , Male , Parents , Patient Acceptance of Health Care , SARS-CoV-2 , Social Class , Surveys and Questionnaires
11.
Value Health ; 24(5): 615-624, 2021 05.
Article in English | MEDLINE | ID: covidwho-1091712

ABSTRACT

OBJECTIVES: Movement restriction policies (MRPs) are effective in preventing/delaying COVID-19 transmission but are associated with high societal cost. This study aims to estimate the health burden of the first wave of COVID-19 in China and the cost-effectiveness of early versus late implementation of MRPs to inform preparation for future waves. METHODS: The SEIR (susceptible, exposed, infectious, and recovered) modeling framework was adapted to simulate the health and cost outcomes of initiating MRPs at different times: rapid implementation (January 23, the real-world scenario), delayed by 1 week, delayed by 2 weeks, and delayed by 4 weeks. The end point was set as the day when newly confirmed cases reached zero. Two costing perspectives were adopted: healthcare and societal. Input data were obtained from official statistics and published literature. The primary outcomes were disability-adjusted life-years, cost, and net monetary benefit. Costs were reported in both Chinese renminbi (RMB) and US dollars (USD) at 2019 values. RESULTS: The first wave of COVID-19 in China resulted in 38 348 disability adjusted life-years lost (95% CI 19 417-64 130) and 2639 billion RMB losses (95% CI 1347-4688). The rapid implementation strategy dominated all other delayed strategies. This conclusion was robust to all scenarios tested. At a willingness-to-pay threshold of 70 892 RMB (the national annual GDP per capita) per disability-adjusted life-year saved, the probability for the rapid implementation to be the optimal strategy was 96%. CONCLUSIONS: Early implementation of MRPs in response to COVID-19 reduced both the health burden and societal cost and thus should be used for future waves of COVID-19.


Subject(s)
COVID-19/complications , Cost of Illness , Physical Distancing , Time Factors , COVID-19/economics , COVID-19/epidemiology , China , Cost-Benefit Analysis , Humans , Public Health/methods , Public Health/standards , Public Health/statistics & numerical data
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