Predictors of Alcohol Use Among Latinx Men in South Florida: Machismo as a Correlate of Alcohol Use Frequency and Quantity.

Previous studies have found Latinx cultural values to be positively associated with healthy behaviors. This study aims to examine socioeconomic and cultural correlates of alcohol use among Latinx adult men living in Miami-Dade County, Florida. The study sample included 122 Latinx adult men (mean age = 44, SD = 10), predominantly of South and Central American origin. Data was collected using REDCap. Interviews included the Timeline Follow-Back scale for alcohol use. Results indicate that Caribbean participants were significantly less likely to report drinking in the past 90 days (aOR = 0.08, p = 0.042) compared to their Venezuelan counterparts. Higher machismo scores were associated with low drinking frequency (aRR = 0.67, p = 0.043), while no significant associations were found between machismo and other drinking outcomes. Drinking quantity and frequency are significantly associated with higher income and authorized immigration status in the US among Latinx men in South Florida. Higher machismo scores were associated with low drinking frequency.

Internet addiction and mental health disorders in high school students in a Peruvian region: a cross-sectional study.

OBJECTIVES: To determine the association between internet addiction disorder (IAD) and anxiety and depressive symptomatology in high school students in two private schools in Chiclayo, Peru, during the COVID-19 pandemic. MATERIALS AND METHODS: Analytical cross-sectional investigation of 505 adolescents from two private schools. The dependent variables were anxiety and depressive symptomatology, measured with the Beck Adapted Depression Questionnaire (BDI-IIA) and the Beck Anxiety Inventory (BAI), respectively. The main independent variable was IAD, measured with the Internet Addiction Test instrument(IATI). Prevalence ratios (PR) and 95% confidence intervals (95%CI) were estimated. RESULTS: The average age was 14.16 years and 54.9% were women. 22.2% and 3.2% presented mild and moderate IAD; respectively. 9.3% presented severe anxiety and 34.3% severe depressive symptomatology. In the simple regression, adolescents with mild, moderate and severe IAD presented 19% (PR = 1.19; 95%CI: 1.05-1.35), 25% (PR = 1.25; 95%CI: 1.02-1.53) and 53% (PR = 1.47; 95% CI: 1.47-1.60) higher prevalence of depressive symptomatology; however, this association was not maintained in the multiple model. Anxiety increased 196% in adolescents with severe IAD (PR = 2.96; 95%CI: 1.86-4.71). CONCLUSION: We found that 2, 1, and 3 out of 10 students presented IAD, depressive symptomatology, and anxiety, respectively. We did not find an association between IAD and depressive symptomatology, but we did find an association with anxiety. Among the factors associated with the development of depressive symptomatology were the male sex, the presence of eating disorders, subclinical insomnia, using devices for more than 2 h, and using the Internet for academic activities. About anxiety, the associated factors are the female sex, the presence of eating disorders, subclinical insomnia, and the use of the Internet as social interaction. We recommend implementing counseling programs in view of the imminent introduction of the Internet as a pillar in education.

Poverty and Suicidal Ideation Among Hispanic Mental Health Care Patients Leading up to the COVID-19 Pandemic.

Introduction: Suicide rates have risen in Hispanic communities since 2015, and poverty rates among Hispanics often exceed the national average. Suicidality is a complex phenomenon. Mental illness may not alone explain whether suicidal thoughts or behaviors will occur; it remains uncertain how poverty affects suicidality among Hispanic persons with known mental health conditions. Our objective was to examine whether poverty was associated with suicidal ideation among Hispanic mental healthcare patients from 2016 to 2019. Methods: We used de-identified electronic health record (EHR) data from Holmusk, captured using the MindLinc EHR system. Our analytic sample included 4,718 Hispanic patient-year observations from 13 states. Holmusk uses deep-learning natural language processing (NLP) algorithms to quantify free-text patient assessment data and poverty for mental health patients. We conducted a pooled cross-sectional analysis and estimated logistic regression models. Results: Hispanic mental health patients who experienced poverty had 1.55 greater odds of having suicidal thoughts in a given year than patients who did not experience poverty. Conclusion: Poverty may put Hispanic patients at greater risk for suicidal thoughts even when they are already receiving treatment for psychiatric conditions. NLP appears to be a promising approach for categorizing free-text information on social circumstances affecting suicidality in clinical settings.

Unequal outcomes: The effects of the COVID-19 pandemic on mental health and wellbeing among Hispanic/Latinos with varying degrees of 'Belonging'.

BACKGROUND: The COVID-19 pandemic has brought disparities in mental and physical health faced by ethnic minorities to the forefront. In the U.S., Hispanic/Latino communities are plagued by elevated rates of psychiatric conditions and trauma. Exacerbating this burden, common discourse often implicates Hispanic/Latino ethnicity as a causal factor, despite clear evidence of systemic causes, including lack of access to resources, and discrimination. AIMS: To parse apart Hispanic/Latino ethnicity from determinants of wellbeing (such as trauma, financial status, and loneliness), we examined mental and physical health during COVID-19 via an online, anonymous survey available in both English and Spanish. METHODS: We examined wellbeing across three participant groups, including two groups of Hispanic/Latino adults with varying degrees of 'belonging' to the dominant culture in their country of residence: Hispanic/Latino individuals living in Spanish-speaking and/or Central or Latin American countries (Group 1), Hispanic/Latino individuals living in the U.S. (Group 2), and non-Hispanic/Latino individuals living in the U.S. (Group 3). RESULTS: Results demonstrated there were significant differences between groups in specific aspects of wellbeing. Most importantly, results showed Hispanic/Latino ethnicity does not significantly predict psychosocial wellbeing or psychosis risk, and identified several predictors of these outcomes, including U.S. residence, trauma, loneliness, and age. CONCLUSION: Our results demonstrate that Hispanic/Latino ethnicity itself is not a causal factor of poor psychosocial wellbeing or elevated psychosis risk and instead identify several social and systemic causal factors commonly faced by Hispanic/Latino Americans. We suggest that language reporting on minority mental health acknowledge systemic factors as contributing to poor outcome rather than referring to ethnicity as if it were a causal factor.

Unexpected, but consistent and pre-registered: Experimental evidence on interview language and Latino views of COVID-19

Much uncertainty remains about effective messaging to boost public support for COVID-19 mitigation efforts, especially among people of color. We investigate the relationship between interview language and expressed support for COVID-19 public health protocols among Latinos: America's largest ethnic group. Prior work establishes that interview language shapes opinions by cognitively structuring which considerations people use to express attitudes. Yet other work suggests interview language shapes opinions by activating specific cultural norms associated with a tongue. We predicted that interviewing in Spanish (versus English) would boost support for COVID-19 protocols by activating pro-social norms known to be strongly associated with that language. We uncover null support for this prediction in a pre-registered experiment on bilingual Latino adults (N = 1645). Instead, we find that Latinos assigned to interview in Spanish report weaker support for COVID-19 protocols, regardless of which cultural norms are primed. We discuss implications for COVID-19 attitudes in linguistically diverse polities.

Latino Mortality Paradox Found (Again): COVID-19 Mortality a Tale of Two Years.

OBJECTIVES: This study examines the resiliency of the Latino Mortality paradox during the COVID-19 pandemic. METHODS: Data from the Centers for Disease Control and Prevention are used to compute the ratio of Latino-to-white all-causes death rates for adults aged 45 and older, nationally and among 13 U.S. states with Latino populations greater than one million. RESULTS: Nationally, the Latino mortality paradox persisted in 2020 and 2021. However, there was significant variation across states. We document three distinct patterns of COVID-19 mortality across 13 U.S. states: 1) the disappearance of the Latino mortality paradox, 2) the persistence of the Latino mortality paradox, and 3) the disappearance in 2020 and reemergence in 2021 of the Latino mortality paradox. DISCUSSION: COVID-19 Mortality has disproportionately affected mid- and late-life Latinos, although the disparities relative to whites have narrowed. We discuss the dynamics influencing the waning and waxing of the Latino mortality paradox.

The Impact of the COVID-19 Pandemic on Older Latino Immigrants

This article examines the impact of the COVID-19 pandemic on Latino immigrants age sixty and older from Cuba, Dominican Republic, El Salvador, Mexico, Puerto Rico, and Venezuela. Based on 178 interviews with immigrants in Florida and Massachusetts, this study identifies the financial and health hardships they endured, the kinds of government and nonprofit aid they accessed, the factors keeping many from accessing aid, and the coping strategies they adopted. Respondents faced unemployment, hunger, and loss of income. Unauthorized immigrants and people in mixed-status families were deliberately excluded from federal aid. Many other immigrants who qualified were reluctant or refused it. Immigrants without legal status and those who had more recently arrived were the most severely affected. Individuals and families responded to these challenges by doubling up, going without food and medicine, and working while sick. Greater outreach and more humane public policies could have prevented much of this suffering.

Mitigating childhood food insecurity during COVID-19: a qualitative study of how school districts in California's San Joaquin Valley responded to growing needs.

OBJECTIVES: To explore best practices and challenges in providing school meals during COVID-19 in a low-income, predominantly Latino, urban-rural region. DESIGN: Semi-structured interviews with school district stakeholders and focus groups with parents were conducted to explore school meal provision during COVID-19 from June to August 2020. Data were coded and themes were identified to guide analysis. Community organisations were involved in all aspects of study design, recruitment, data collection and analysis. SETTING: Six school districts in California's San Joaquin Valley. PARTICIPANTS: School district stakeholders (n 11) included food service directors, school superintendents and community partners (e.g. funders, food cooperative). Focus groups (n 6) were comprised of parents (n 29) of children participating in school meal programmes. RESULTS: COVID-19-related challenges for districts included developing safe meal distribution systems, boosting low participation, covering COVID-19-related costs and staying informed of policy changes. Barriers for families included transportation difficulties, safety concerns and a lack of fresh foods. Innovative strategies to address obstacles included pandemic-electronic benefits transfer (EBT), bus-stop delivery, community pick-up locations, batched meals and leveraging partner resources. CONCLUSIONS: A focus on fresher, more appealing meals and greater communication between school officials and parents could boost participation. Districts that leveraged external partnerships were better equipped to provide meals during pandemic conditions. In addition, policies increasing access to fresh foods and capitalising on United States Department of Agriculture waivers could boost school meal participation. Finally, partnering with community organisations and acting upon parent feedback could improve school meal systems, and in combination with pandemic-EBT, address childhood food insecurity.

Navigating health and well-being during the COVID-19 pandemic: Experiences of Latina immigrant mothers in rural Midwestern communities

Objective: In this study, we sought to gain insight into the challenges Latina immigrant mothers in rural Midwest communities encountered during the pandemic, strategies they employed to avoid infection of the virus, and impacts of the pandemic on family health and well-being. Background: In rural Midwestern communities, the pandemic disproportionately affected immigrants, many of whom are Latino and worked in meatpacking and food processing plants. Latina mothers are commonly viewed as caretakers of the family. This prescribed role placed mothers at the center of safeguarding their families' health during the pandemic. Method: In this descriptive study, we conducted individual interviews with 124 Latina immigrant mothers across six rural Midwestern communities who participated in one of two previous studies in the communities. Thematic analyses was used to identify themes that aligned with three areas of interest: challenges experienced, strategies employed to avoid virus infection, and impacts of the pandemic on family health and well-being. Results: Mothers enacted behaviors (e.g., sanitation practices, wore masks, stayed home) to lessen negative impacts of the pandemic on family health and well-being. Factors beyond their control (e.g., public policies, work policies and practices) placed families at greater risk for poor health and well-being. Eleven themes were identified that aligned with the three areas of interest. Conclusion: Findings build upon and extend prior research that reexposed unjust employment conditions, inadequate health-care systems, and an anti-immigrant context during the pandemic that perpetuated health disparities among Latino immigrants and other minoritized populations. Implications: Ethnographic and longitudinal studies that give voice to populations underrepresented in COVID-19 research and at high risk for poor health are warranted to inform policies and practices to protect health during public health crises. © 2023 The Authors. Family Relations published by Wiley Periodicals LLC on behalf of National Council on Family Relations.

Latino-Targeted Misinformation and the Power of Factual Corrections

Do individual, interpersonal, or institutional factors condition the effects of misinformation on beliefs? Can interventions such as fact checks stem the tide of the "infodemic” within marginalized communities? We explore the sudden flood of misinformation and disinformation targeting Latinos during the 2020 election and global COVID-19 pandemic to answer these questions. In a preregistered experiment, we find that exposure to misinformation can decrease factual accuracy, and neither trust in nor consumption of media, including ethnic media, serves as a buffer against these misinformation effects. However, fact checks eliminate the effects of misinformation on false beliefs without "backfiring” and reducing accuracy. Fact checks improve factual accuracy among subgroups varying in levels of political knowledge, trust, and acculturation. These findings provide crucial support for recent investments into fact checking by Latino-oriented media outlets and address gaps within the literature over whether such interventions are also effective within marginalized groups.

COVID-19 Vaccine Uptake and Hesitancy in a Latino Agricultural Community.

Amid the COVID-19 pandemic, vaccine hesitancy is believed to be among the top global health threats. U.S. Latinos have disproportionately been affected by the pandemic and have higher COVID-19 vaccine hesitancy. This study applied the Vaccine Hesitancy Determinants Matrix to understand COVID-19 vaccine hesitancy in a Latino agricultural community. Surveys were conducted with 180 adults from a Migrant Community Health Center to measure pandemic experiences and hesitancy factors across three categories: individual and group factors, vaccine/vaccination-specific factors, and contextual factors. Approximately 16% of participants reported having tested positive for COVID-19, 90% endorsed loss of income, and 47% reported their mental health was affected. Only 46% received a COVID-19 vaccine. Common individual vaccine hesitancy factors included worry about side effects, worry that vaccines cause infection, and concern that side effects would be worse than the virus. Vaccine/vaccination-specific factors included concern about how quickly COVID-19 vaccines were developed and concern about there being insufficient research on their effectiveness, potential risks, and side effects. Common contextual factors included religious beliefs and political mistrust. Logistic regression results indicated that subjects who tested positive for COVID-19, or had a coworker who tested positive were more likely to get vaccinated. The odds ratio of being vaccinated increased with age. Subjects who endorsed concern that vaccine side effects were worse than the virus were less likely to be vaccinated. Results highlight that there are health literacy gaps among Latino communities such as interpretation of vaccine efficacy and safety to gain a more accurate understanding of side effects.

Evolving Science on Cardiovascular Disease Among Hispanic/Latino Adults: JACC International.

The landmark, multicenter HCHS/SOL (Hispanic Community Health Study/Study of Latinos) is the largest, most comprehensive, longitudinal community-based cohort study to date of diverse Hispanic/Latino persons in the United States. The HCHS/SOL aimed to address the dearth of comprehensive data on risk factors for cardiovascular disease (CVD) and other chronic diseases in this population and has expanded considerably in scope since its inception. This paper describes the aims/objectives and data collection of the HCHS/SOL and its ancillary studies to date and highlights the critical and sizable contributions made by the study to understanding the prevalence of and changes in CVD risk/protective factors and the burden of CVD and related chronic conditions among adults of diverse Hispanic/Latino backgrounds. The continued follow-up of this cohort will allow in-depth investigations on cardiovascular and pulmonary outcomes in this population, and data from the ongoing ancillary studies will facilitate generation of new hypotheses and study questions.

Advocating for individuals and communities

The role of advocating for individuals and communities not only includes advocating for the basic needs and resources of communities and entails conducting policy advocacy. This chapter provides two accounts of how CHWs provide advocacy and advocate for their profession. CHWs in Arizona advocated for their communities and their workforce on the state, local, and federal level to address the social determinants of health and structural issues such as poverty, unemployment, the built environment, and discrimination. The first team explores stories of CHWs who have advocated on multiple levels, including organizational and policy levels, and discusses the factors that support and hinder CHW advocacy efforts. The team describes how local and grassroots advocacy efforts ultimately helped to create a CHW workforce sustainability movement and support the statewide CHW professional association, Arizona Community Health Workers Association (AzCHOW), in advocating for voluntary certification on the state level. The second team provides timely information on how CHWs with Enlace Chicago advocated for their communities during COVID-19 to address social determinants of health, including poverty, unemployment, discrimination, and exploitation of worker rights, and provide basic needs. The CHW stories describe how advocacy efforts were instrumental in directing community members to food banks, personal protection equipment, sources of employment and workers' rights, and emergency rental assistance programs. These stories underscore how CHWs were often the only links connecting their community members to what they needed while facilitating the community's understanding to public health guidelines during COVID-19 and addressing mental health needs. © Springer Nature Switzerland AG 2021.

The psychological influence of family on college adjustment during COVID-19: A mixed method study with latine undergraduate students

Research conducted by the National Student Clearinghouse Research Center found that amid the pandemic undergraduate enrollment fell by 6.6% from Fall 2019 to Fall 2021, representing just over a million students (Conley & Massa, 2022). The literature points to college adjustment as vital to individuals' retention and completion of college (Baker & Siryk, 1984;Gerdes & Mallinckrodt, 1994). As declines occur due to the impact of a global pandemic it is critical to understand how to support students in their adjustment and persistence through college. A mixed methods approach was used to gain a better understanding of the role that family plays for Latine undergraduate students' adjustment to college during the COVID-19 pandemic. In the qualitative component, participants described their unique experience navigating changes during unprecedented times, which resulted in four emergent themes: Psychological Impacts of COVID-19, Transitions Amid the Pandemic, Perceived Support, and Adjustment Mechanisms. Quantitative data suggests there is a predictive relationship between specific family variables and adjustment to college, such that low stress, high perceived family support, high levels of familismo, and low levels of family achievement guilt significantly predict college adjustment. This dissertation contributes to the literature on the psychological experiences and college adjustment of Latine undergraduate students under additional stressful circumstances caused by the pandemic. Findings have implications for practitioners, higher education administrators, and policy makers working to support retention efforts among Latine college students. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

COVID, climate change, and carework: Mesoamerican diasporic indigenous and Latino communities in the Willamette Valley

Community-based agriculture is not only concerned with the cultivation of food, but also with the cultivation of connection, care, and exchange. This dissertation is based on fieldwork with a non-profit organization that operates seven community garden sites in Lane County, Oregon. Most of my research activity occurred at the largest garden site which happens to also be the oldest garden site, with some families having the same garden plot for two decades. I also travelled to all seven sites to either volunteer or attend workshops. In addition, I draw on my participation as an analyst and interviewer in the COVID-19 Farmworker Study (COFS) of Oregon, a collaborative research project involving twelve community-based organizations that serve farmworkers in Oregon. My research examines the experiences of multigenerational immigrant families in Oregon engaged in preserving traditional foodways and collective care through community gardening. The primary goals are to investigate the historical relationships between foodways and emotional carework within Latino and Mesoamerican Indigenous communities in diaspora. It examines how foodways shape community well-being despite the many challenges and traumas of migration. Participation in community gardening can serve as a social, emotional, and health resource for immigrant Latino families, functioning as a nexus of care and source of hope. This research is urgent since disproportionate food insecurities have only been exaggerated by the global COVID-19 pandemic. Using ethnographic methods such as participant observation, formal interviewing, and informal conversational interviewing, I document some of the integrated physical, emotional, mental health, and social impacts of the pandemic. These impacts include getting infected with COVID-19, losing loved ones, living in uncertainty, and experiencing significant loss of income that affected people's ability to pay rent, utilities, food, and other expenses, producing what I call stress proliferation. Being exposed to the virus or having the virus forced people into two-week quarantines or even longer periods of recovery when many could not work, and if sick were physically debilitated. The precarity of Latino workers' economic situations and the stress that comes from that precarity was inflated during the pandemic and left many struggling to catch up even after recovery and quarantine. Because the research has taken place both before and during the pandemic, I demonstrate how the caregiving practices forged through community gardening may continue to benefit families and communities after the pandemic through ideas such as curar y pertencer, caring and belonging, identified by my study participants. I also demonstrate how care practices might have shifted from pre-pandemic times to pandemic times. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Team Science: Advancing Women and Black, Indigenous, and other People of Color on the Pathway of Conducting Clinical Research.

Introduction: Innovative discovery begins with diverse perspectives; research teams should harness this model. Black, Indigenous, and other People of Color (BIPOC) and women are underrepresented as researchers. Team science leverages collaborative and cross-disciplinary approaches to diversify the research workforce, and introduces academic (and non-academic) faculty with limited research exposure/experience to clinical research. Methods: In 2020, two Black women academic physicians implemented an academic collaborative - COVID-19 Characteristics, Readmissions, Outcomes, and Social Determinants of Health (CROSS) - to investigate COVID-19 health inequities, with intentional recruitment of BIPOC and women. The 37 CROSS team members were of diverse races, ethnicities, sex, specialties, and disciplines, and represented eight hospitals. Team members were electronically surveyed to determine their interest, desired activities, and level of participation in research activities; concurrently, self-identified demographics (including race, ethnicity, sex, and language(s) spoken) were obtained. Results: All team members completed the survey: 78.4% (n = 29) were BIPOC and 78.4% (n = 29) were women. Team members spoke 18 languages (including English). Academic medical ranks included Assistant Professor (32.4%; n = 12), Associate Professor (16.2%; n = 6), and Full Professor (2.7%; n = 1). Each member identified desired activities (data collection, data analytics, manuscript development, abstract development/poster presentation, serving as a consultant) and the percentage of time they intended to allocate to each. Between June 2020 and February 2023, the team produced five original peer-reviewed manuscripts (including this article); five members served as first or senior authors. Twenty-one abstracts were presented at local conferences, and 10 at national and regional conferences. Five members achieved academic promotion, and team members were awarded three intramural grants resulting directly from team collaborations. Conclusion: Intentional recruitment and assessment of team members' desired levels of participation in an integrated clinical research team is an effective strategy to engage BIPOC and women. The CROSS Collaborative is a model for diversity and inclusion in team science and clinical research.

Economic and Psychosocial Impact of COVID-19 in the Hispanic Community Health Study/Study of Latinos.

Objectives: To examine the prevalence and correlates of economic hardship and psychosocial distress experienced during the initial phase of the coronavirus disease 2019 (COVID-19) pandemic in a large cohort of Hispanic/Latino adults. Methods: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL), an ongoing multicenter study of Hispanic/Latino adults, collected information about COVID-19 illness and psychosocial and economic distress that occurred during the pandemic (N=11,283). We estimated the prevalence of these experiences during the initial phase of the pandemic (May 2020 to May 2021) and examined the prepandemic factors associated with pandemic-related economic hardship and emotional distress using multivariable log linear models with binomial distributions to estimate prevalence ratios. Results: Almost half of the households reported job losses and a third reported economic hardship during the first year of the pandemic. Pandemic-related household job losses and economic hardship were more pronounced among noncitizens who are likely to be undocumented. Pandemic-related economic hardship and psychosocial distress varied by age group and sex. Contrary to the economic hardship findings, noncitizens were less likely to report pandemic-related psychosocial distress. Prepandemic social resources were inversely related to psychosocial distress. Conclusions: The study findings underscore the economic vulnerability that the pandemic has brought to ethnic minoritized and immigrant populations in the United States, in particular noncitizens. The study also highlights the need to incorporate documentation status as a social determinant of health. Characterizing the initial economic and mental health impact of the pandemic is important for understanding the pandemic consequences on future health. Clinical Trial Registration Number: NCT02060344.

A characterization of pre- to post-immigration alcohol use among recent Latino immigrants to the United States before and during the COVID-19 pandemic.

BACKGROUND: Although Latino immigrants to the United States tend to display a gradual increase in alcohol use after immigration, such escalation may not generalize to all Latino/a groups. This study examines patterns of alcohol use shown by recent Latino immigrants (RLIs) to Miami/Dade County (MDC), Florida covering a period from pre-immigration to the first two years after immigration. Differences in alcohol use prior to and during the COVID-19 pandemic were also assessed. METHODS: Data came from an on-going longitudinal study of 540 young adult (50% female) RLIs. Inclusion criteria were age 18 to 34, residing in MDC and having immigrated from a Latin American country within the past year. Respondent-driven sampling was the primary recruitment strategy. RESULTS: Recent Latino immigrants reported a decline in alcohol use from before immigration (18.3 drinks per month, d/m) to the first (13.9 d/m), and second years (10.4 d/m before and 12.9 d/m during the pandemic lockdown) in MDC. The decline, which was moderated by RLIs' sex and legal residency status, was halted by the pandemic lockdown. While "to celebrate" was the most often cited reason for drinking, "to forget" was often cited during the lockdown. CONCLUSIONS: The noted decrease in alcohol use since immigration may reflect the unique array of support and resources available to RLIs in MDC. Nevertheless, some RLIs increased their alcohol use over time, particularly during the COVID-19 pandemic. This disparate impact of the pandemic on alcohol use calls attention to the need to identify the most vulnerable RLIs to MDC and develop targeted interventions for them.

Lessons Learned from Health Disparities in Coronavirus Disease-2019 in the United States.

In the United States, the coronavirus disease-2019 (COVID-19) pandemic has disproportionally affected Black, Latinx, and Indigenous populations, immigrants, and economically disadvantaged individuals. Such historically marginalized groups are more often employed in low-wage jobs without health insurance and have higher rates of infection, hospitalization, and death from COVID-19 than non-Latinx White individuals. Mistrust in the health care system, language barriers, and limited health literacy have hindered vaccination rates in minorities, further exacerbating health disparities rooted in structural, institutional, and socioeconomic inequities. In this article, we discuss the lessons learned over the last 2 years and how to mitigate health disparities moving forward.

Epidemiologic trends of multiple sclerosis in Puerto Rico (2013-2020).

BACKGROUND: Previous studies have demonstrated higher multiple sclerosis (MS) incidence and prevalence in Puerto Rico (PR) than in other Caribbean and Latin American countries. Our objectives are to update the epidemiologic trends in MS incidence and prevalence rates for PR from 2017 through 2020 and compare them to prior rate data from 2013 to 2016. METHODS: We used the Puerto Rico MS Foundation's registry (PRMS Registry) data to identify all newly diagnosed MS cases between January 2017 and December 2020. The study population included 568 MS patients, 406 women and 162 men living in PR. All individuals were 18 years and older and met the 2017 revised McDonald criteria for MS diagnosis. In addition, age- and sex-standardized incidence rates were estimated. RESULTS: A total of 568 new MS cases were diagnosed in Puerto Rico between 2017 and 2020. The 2020 MS cumulative prevalence for Puerto Rico was 95.3/100,000 (95% CI: 91.6, 99.1), higher than previously reported. The age- and sex-standardized MS incidence rate for Puerto Rico decreased from 6.5/100,000 (2017) to 6.3/100,000 (2020). The annual age-standardized MS incidence rates declined for females: from 9.5/100,000 (2017) to 8.2/100,000 (2020) but increased for males from 3.6/100,000 to 4.6/100,000 during the same period. CONCLUSION: These incidence and prevalence rates are among the highest reported among Caribbean and Latin American countries. A peak in the age- and sex-standardized MS incidence rate was observed after hurricane María (2018) and a decline during the first year of the COVID-19 pandemic (2020). Further investigation is needed to determine whether there was a causal relationship between the fluctuations observed and those natural events.