Who do we trust? Differences in types of trust and beliefs in conspiracy theories between vaccinated and unvaccinated Europeans across 17 European countries

A plethora of research has highlighted that trust in science, political trust, and conspiracy theories are all important contributors to vaccine uptake behavior. In the current investigation, relying on data from 17 countries (N = 30,096) from the European Social Survey we examined how those who received (and wanted to receive the COVID-19 vaccine) compared to those who did not differ in their trust in: science, politicians and political parties, international organizations and towards people in general. We also examined whether they differed in how much they believed in conspiracy theories. Those who received (or wanted to receive) the COVID vaccine scored significantly higher in all forms of trust, and lower in conspiracy theory beliefs. A logistic regression suggested that trust in science, politicians, international organizations, as well as belief in conspiracy theories were significant predictors, even after accounting for key demographic characteristics.

Tracking the Transit Divide: A Multilevel Modelling Approach of Urban Inequalities and Train Ridership Disparities in Chicago

Using a multilevel modelling approach, this study investigates the impact of urban inequalities on changes to rail ridership across Chicago's "L” stations during the pandemic, the mass vaccination rollout, and the full reopening of the city. Initially believed to have an equal impact, COVID-19 disproportionally impacted the ability of lower socioeconomic status (SES) neighbourhoods' to adhere to non-pharmaceutical interventions: working-from-home and social distancing. We find that "L” stations in predominately Black or African American and Hispanic or Latino neighbourhoods with high industrial land-use recorded the smallest behavioural change. The maintenance of higher public transport use at these stations is likely to have exacerbated existing health inequalities, worsening disparities in users' risk of exposure, infection rates, and mortality rates. This study also finds that the vaccination rollout and city reopening did not significantly increase the number of users at stations in higher vaccinated, higher private vehicle ownership neighbourhoods, even after a year into the pandemic. A better understanding of the spatial and socioeconomic determinants of changes in ridership behaviour is crucial for policymakers in adjusting service routes and frequencies that will sustain reliant neighbourhoods' access to essential services, and to encourage trips at stations which are the most impacted to revert the trend of declining public transport use.

The selective effect of lockdown experience on citizens' perspectives: A multilevel, multiple informant approach to personal and community resilience during COVID-19 pandemic.

In the face of the first wave of COVID-19 contagion, citizens all over the world experienced concerns for their safety and health, as well as prolonged lockdowns - which brought about limitations but also unforeseen opportunities for personal growth. Broad variability in these psychological responses to such unprecedented experiences emerged. This study addresses this variability by investigating the role of personal and community resilience. Personal resilience, collective resilience, community disaster management ability, provided information by local authorities, and citizens' focus on COVID-19-related personal concerns and lockdown-related opportunities for personal growth were detected through an online questionnaire. Multilevel modelling was run with data from 3,745 Italian citizens. The potential of personal resilience as a driver for individuals to overcome adverse situations with positive outcomes was confirmed. Differently, the components of community resilience showed more complex paths, highlighting the need to pay more attention to its role in the face of far-reaching adverse events which hardly test individuals' as well as communities' adaptability and agency skills. The complexities linked to the multi-component and system-specific nature of resilience, as well as potential paths towards making the most out of citizens' and communities' ones, emerge. The theoretical and practical implications are discussed.

Megaregions and COVID-19: a call for an innovative governing structure in the United States

In the United States, megaregions, which are networks of urban centres and their hinterlands, have a greater prevalence of COVID-19, but have been overlooked as a geographical unit for multi-jurisdictional governance for pandemic response. Existing multi-metropolitan planning organization (MPO) collaborations and state-level COVID-19 coalitions in the United States demonstrate the utility of the megaregion as an effective framework for regional collaboration and operations. Using multilevel modelling, we explore the significance of megaregions in explaining disease occurrence. The results suggest that the megaregion can be an appropriate geographical scale for multi-jurisdictional operations, governance and pandemic response. © 2023 Regional Studies Association.

Exploring the spatiotemporal factors affecting bicycle-sharing demand during the COVID-19 pandemic.

This study investigates the roles of the socio-economic, land use, built environment, and weather factors in shaping up the demand for bicycle-sharing trips during the COVID-19 pandemic in Toronto. It uses "Bike Share Toronto" ridership data of 2019 and 2020 and a two-stage methodology. First, multilevel modelling is used to analyze how the factors affect monthly station-level trip generation during the pandemic compared to pre-pandemic period. Then, a geographically weighted regression analysis is performed to better understand how the relationships vary by communities and regions. The study results indicate that the demand of the service for commuting decreased, and the demand for recreational and maintenance trips increased significantly during the pandemic. In addition, higher-income neighborhoods are found to generate fewer weekday trips, whereas neighbourhoods with more immigrants experienced an increase in bike-share ridership during the pandemic. Moreover, the pandemic trip generation rates are more sensitive to the availability of bicycle facilities within station buffers than pre-pandemic rates. The results also suggest significant spatial heterogeneity in terms of the level of influence of the explanatory factors on the demand for bicycle-sharing during the pandemic. Based on the findings, some neighbourhood-specific policy recommendations are made, which inform decisions regarding the locations and capacity of new stations and the management of existing stations so that equity concerns about the usage of the system are adequately accounted for.

Alcohol and marijuana use predicting next-day absenteeism and engagement at school and work: A daily study of young adults.

This study examined effects of alcohol and marijuana use on next-day absenteeism and engagement at work and school among young adults (18-25 years old) who reported past-month alcohol use and simultaneous alcohol and marijuana use. Participants completed twice daily surveys for five, 14-day bursts. The analytic sample was 409 [64 % were enrolled in university (N = 263) and 95 % were employed (N = 387) in at least one burst]. Daily measures included: any alcohol or marijuana use, quantity of alcohol or marijuana use (i.e., number of drinks, number of hours high), attendance at work or school, and engagement (i.e., attentiveness, productivity) at school or work. Multilevel models examined between- and within-person associations between alcohol and marijuana use and next-day absenteeism and engagement at school or work. Between-persons, the proportion of days of alcohol use days was positively associated with next-day absence from school, consuming more drinks was positively associated with next-day absence from work, and the proportion of days of marijuana use was positively associated with next-day engagement at work. At the daily-level, when individuals consumed any alcohol and when they consumed more drinks than average, they reported lower next-day engagement during school and work. When individuals used marijuana and when they were high for more hours than average, they reported lower next-day engagement during school. Findings suggest alcohol and marijuana use consequences include next-day absence and decrements in next-day engagement at school and work, which could be included in interventions aimed at ameliorating harmful impacts of substance use among young adults.

Catastrophe bond pricing in the primary market: The issuer effect and pricing factors

COVID pandemic has highlighted the importance of hedging against catastrophic events, for which the catastrophe bond market plays a critical role. Our paper develops a two-level modelling and uses a unique, hand-collected dataset, which is one of the largest and most detailed datasets to date containing: 101 different issuers, 794 different bonds, spanning 1997–2020. We identify issuer effects robustly, isolating them from bond specific pricing effects, therefore providing more credible pricing factor results. We find that bond pricing and volatility are heavily impacted by the issuer, causing 26% of total price variation. We also identify specific issuer characteristics that significantly impact bond pricing and volatility, such as the issuer's line of business accounting for up to 36% of total price variation. We further find that issuer effects are significant over different market cycles and time periods, causing substantial price variation. The size and content of our data also enables us to identify the counter-intuitive relation between bond premiums and maturity, and bond premiums and hybrid bond triggers. © 2022 Elsevier Inc.

Improvements in Compassion and Fears of Compassion throughout the COVID-19 Pandemic: A Multinational Study.

During large-scale disasters, social support, caring behaviours, and compassion are shown to protect against poor mental health outcomes. This multi-national study aimed to assess the fluctuations in compassion over time during the COVID-19 pandemic. Respondents (Time 1 n = 4156, Time 2 n = 980, Time 3 n = 825) from 23 countries completed online self-report questionnaires measuring the flows of compassion (i.e., Compassionate Engagement and Action Scales) and fears of compassion toward self and others and from others (i.e., Fears of Compassion Scales) and mental health at three time-points during a 10-month period. The results for the flows of compassion showed that self-compassion increased at Time 3. Compassion for others increased at Time 2 and 3 for the general population, but in contrast, it decreased in health professionals, possibly linked to burnout. Compassion from others did not change in Time 2, but it did increase significantly in Time 3. For fears of compassion, fears of self-compassion reduced over time, fears of compassion for others showed more variation, reducing for the general public but increasing for health professionals, whilst fears of compassion from others did not change over time. Health professionals, those with compassion training, older adults, and women showed greater flows of compassion and lower fears of compassion compared with the general population, those without compassion training, younger adults, and men. These findings highlight that, in a period of shared suffering, people from multiple countries and nationalities show a cumulative improvement in compassion and reduction in fears of compassion, suggesting that, when there is intense suffering, people become more compassionate to self and others and less afraid of, and resistant to, compassion.

Telephone treatments in Improving Access to Psychological Therapies services: an analysis of use and impact on treatment uptake.

BACKGROUND: There is debate about how best to increase access to psychological therapy and deliver mental healthcare effectively and efficiently at a national level. One trend is the increased use of the telephone to deliver therapy. However, there is the potential to disadvantage certain patient groups and/or impact on uptake of help. This study aims to answer three questions: (i) Which factors are associated with being offered an assessment by telephone? (ii) Which factors are associated with attendance at assessment? and (iii) What is the impact of an assessment by telephone on subsequent treatment appointment? METHODS: Routine outcome data was provided by seven UK Improving Access to Psychological Therapy services. The analysis sample comprised 49,923 patients who referred to 615 general practices in 2017. Multilevel modelling, including service and GP practice as random factors, was used to answer the three research questions. RESULTS: The offer of an initial assessment by telephone was strongly associated with local service configuration. Patient self-referral, a shorter wait, greater age and lower deprivation were associated with attendance at assessment and subsequent treatment session. Telephone mode assessment had no impact on the uptake of the assessment but may influence the uptake of further treatment if this was also by telephone. The practitioner carrying out the assessment had a significant effect on subsequent treatment uptake. CONCLUSION: Offering telephone assessments does not have a negative impact on uptake of assessment and services may benefit by facilitating and integrating telephone assessments into their systems. The COVID-19 pandemic has accelerated the use of telephone and other remote means of delivery, and results from this study can inform services to consider how best to re-configure post-pandemic.

A quantitative approach to the intersectional study of mental health inequalities during the COVID-19 pandemic in UK young adults.

PURPOSE: Mental health inequalities across social identities/positions during the COVID-19 pandemic have been mostly reported independently from each other or in a limited way (e.g., at the intersection between age and sex or gender). We aim to provide an inclusive socio-demographic mapping of different mental health measures in the population using quantitative methods that are consistent with an intersectional perspective. METHODS: Data included 8,588 participants from two British cohorts (born in 1990 and 2000-2002, respectively), collected in February/March 2021 (during the third UK nationwide lockdown). Measures of anxiety and depressive symptomatology, loneliness, and life satisfaction were analysed using Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) models. RESULTS: We found evidence of large mental health inequalities across intersectional strata. Large proportions of those inequalities were accounted for by the additive effects of the variables used to define the intersections, with some of the largest gaps associated with sexual orientation (with sexual minority groups showing substantially worse outcomes). Additional inequalities were found by cohort/generation, birth sex, racial/ethnic groups, and socioeconomic position. Intersectional effects were observed mostly in intersections defined by combinations of privileged and marginalised social identities/positions (e.g., lower-than-expected life satisfaction in South Asian men in their thirties from a sexual minority and a disadvantaged childhood social class). CONCLUSION: We found substantial inequalities largely cutting across intersectional strata defined by multiple co-constituting social identities/positions. The large gaps found by sexual orientation extend the existing evidence that sexual minority groups were disproportionately affected by the pandemic. Study implications and limitations are discussed.

Catastrophe bond pricing in the primary market: The issuer effect and pricing factors

COVID pandemic has highlighted the importance of hedging against catastrophic events, for which the catastrophe bond market plays a critical role. Our paper develops a two-level modelling and uses a unique, hand-collected dataset, which is one of the largest and most detailed datasets to date containing: 101 different issuers, 794 different bonds, spanning 1997–2020. We identify issuer effects robustly, isolating them from bond specific pricing effects, therefore providing more credible pricing factor results. We find that bond pricing and volatility are heavily impacted by the issuer, causing 26% of total price variation. We also identify specific issuer characteristics that significantly impact bond pricing and volatility, such as the issuer’s line of business accounting for upto 36% of total price variation. We further find that issuer effects are significant over different market cycles and time periods, causing substantial price variation. The size and content of our data also enables us to identify the counter-intuitive relation between bond premiums and maturity, and bond premiums and hybrid bond triggers.

Poverty, parental work intensity and child emotional and conduct problems.

Poverty is known to be associated with poorer child mental wellbeing. Relatedly, the security and quality of employment are reported to affect adult wellbeing. Less is known about how both poverty and parental employment affect children's mental wellbeing. This paper uses nine waves (2005/06-2017/18) of the Growing Up in Scotland (GUS) study to examine how the longitudinal trajectories of poverty and work intensity are associated with the longitudinal trajectories of mental wellbeing in a nationally representative sample of 3994 children (ages 0 to 12). This analysis was conducted via a bivariate multilevel non-linear growth curve model for the widely used Strengths and Difficulties Questionnaire (SDQ) subscales of conduct problems and emotional symptoms. Results show that unstable work intensity and poverty trajectories arising from the 2008 financial crisis are associated with substantial changes in the trajectories of conduct and emotional problems, but with key differences between the individual outcomes: increasing work intensity is associated with around a fifth of a standard deviation increase in conduct problems; decreasing work intensity over time is associated with around a fifth of a standard deviation increase in emotional problems; material deprivation is associated with an increase in both conduct and emotional problems, at around a tenth of a standard deviation; and longitudinal income poverty trajectories are associated with up to around a fifth of a standard deviation increase in conduct problems, but not emotional symptoms. These findings are discussed with the purpose of informing policies to tackle the effects of unstable and/or changing socioeconomic circumstances on children's mental health wellbeing in the context of an economic crisis, as well as its implications for the contemporary socioeconomic landscape and the devastating effects expected of the COVID-19 crisis.

Multilevel evidence on how policymakers may reduce avoidable deaths due to COVID-19: the case of Brazil

We propose a hierarchical linear method to investigate the effectiveness of social distancing measures. By considering the COVID-19 data as a two-level structure, we are able to demonstrate a significant reduction of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases as a direct consequence of lockdown measures adopted by some states in Brazil. The multilevel modelling is the most appropriate method for the case of Brazil due to the fact that political battles between federal and State government leaders have led to the adoption of lockdown measures with distinct levels of flexibility adopted by each of its 27 states. During the outbreak of such a novel and highly contagious disease, decisions made by policymakers either prevent or increase the number of avoidable deaths. Thus, our results are also potentially useful to convince policymakers to adopt reasonable policy measures to shorten the COVID-19 pandemic in the biggest Latin American country. Copyright © 2022 Inderscience Enterprises Ltd.

How do policy levers shape the quality of a national health system?

Poor quality of care may have a detrimental effect on access and take-up and can become a serious barrier to the universality of health services. This consideration is of particular interest in view of the fact that health systems in many countries must address a growing public-sector deficit and respond to increasing pressures due to COVID-19 and aging population, among other factors. In line with a rapidly emerging literature, we focus on patient satisfaction as a proxy for quality of health care. Drawing on rich longitudinal and cross-sectional data for Spain and multilevel estimation techniques, we show that in addition to individual level differences, policy levers (such as public health spending and the patient-doctor ratio, in particular) exert a considerable influence on the quality of a health care system. Our results suggest that policymakers seeking to enhance the quality of care should be cautious when compromising the level of health resources, and in particular, health personnel, as a response to economic downturns in a sector that traditionally had insufficient human resources in many countries, which have become even more evident in the light of the current health crisis. Additionally, we provide evidence that the increasing reliance on the private health sector may be indicative of inefficiencies in the public system and/or the existence of features of private insurance which are deemed important by patients.

Variation in colon cancer survival for patients living and receiving care in London, 2006-2013: does where you live matter?

BACKGROUND: Marked geographical disparities in survival from colon cancer have been consistently described in England. Similar patterns have been observed within London, almost mimicking a microcosm of the country's survival patterns. This evidence has suggested that the area of residence plays an important role in the survival from cancer. METHODS: We analysed the survival from colon cancer of patients diagnosed in 2006-2013, in a pre-pandemic period, living in London at their diagnosis and received care in a London hospital. We examined the patterns of patient pathways between the area of residence and the hospital of care using flow maps, and we investigated whether geographical variations in survival from colon cancer are associated with the hospital of care. To estimate survival, we applied a Bayesian excess hazard model which accounts for the hierarchical structure of the data. RESULTS: Geographical disparities in colon cancer survival disappeared once controlled for hospitals, and the disparities seemed to be augmented between hospitals. However, close examination of patient pathways revealed that the poorer survival observed in some hospitals was mostly associated with higher proportions of emergency diagnosis, while their performance was generally as expected for patients diagnosed through non-emergency routes. DISCUSSION: This study highlights the need to better coordinate primary and secondary care sectors in some areas of London to improve timely access to specialised clinicians and diagnostic tests. This challenge remains crucially relevant after the recent successive regroupings of Clinical Commissioning Groups (which grouped struggling areas together) and the observed exacerbation of disparities during the COVID-19 pandemic.

Work-related and personal predictors of COVID-19 transmission: evidence from the UK and USA.

OBJECTIVE: To develop evidence of work-related and personal predictors of COVID-19 transmission. SETTING AND RESPONDENTS: Data are drawn from a population survey of individuals in the USA and UK conducted in June 2020. BACKGROUND METHODS: Regression models are estimated for 1467 individuals in which reported evidence of infection depends on work-related factors as well as a variety of personal controls. RESULTS: The following themes emerge from the analysis. First, a range of work-related factors are significant sources of variation in COVID-19 infection as indicated by self-reports of medical diagnosis or symptoms. This includes evidence about workplace types, consultation about safety and union membership. The partial effect of transport-related employment in regression models makes the chance of infection over three times more likely while in univariate analyses, transport-related work increases the risk of infection by over 40 times in the USA. Second, there is evidence that some home-related factors are significant predictors of infection, most notably the sharing of accommodation or a kitchen. Third, there is some evidence that behavioural factors and personal traits (including risk preference, extraversion and height) are also important. CONCLUSIONS: The paper concludes that predictors of transmission relate to work, transport, home and personal factors. Transport-related work settings are by far the greatest source of risk and so should be a focus of prevention policies. In addition, surveys of the sort developed in this paper are an important source of information on transmission pathways within the community.

COVID-19 distribution in Bogotá, Colombia: effect of poverty during the first 2 months of pandemic.

BACKGROUND: The current SARS-CoV-2 pandemic has especially affected individuals living in conglomerate settings having poverty as common characteristic. However, evidence of the association between COVID-19 severity and social determinants is still scarce, particularly, for Latin American countries. The objective was to assess the effect of socioeconomic deprivation in the clinical severity of COVID-19 infection among different localities of Bogotá, Colombia. METHODS: Secondary analyses using data of SARS-CoV-2 infected cases in Bogotá from 6 March 2020 to 19 April 2020 were carried out. Direct and indirect indicators of deprivation at area level and individual demographic characteristics (age, sex and type of case) were included in the analyses. FINDINGS: 1684 COVID-19 cases were included in the study. There were 217 (12.9%; 95% CI 11.3 to 14.5) serious cases, of which 32.6% (95% CI 26.4 to 38.8) cases were deceased. In the multilevel logistic regression, age, sex (female), type of case (different of imported case), number of serious cases recorded the previous day and multidimensional poverty were associated with serious cases (median OR: 1.72, 95% CI 1.56 to 1.87). INTERPRETATION: This paper explored the association between COVID-19 severity and social determinants. Expressions of poverty were associated with more severe cases during first 2 months of pandemic. It is a clear syndemic for the joint presentation of COVID-19 and other comorbidities among more serious cases.

Job loss and lower healthcare utilisation due to COVID-19 among older adults across 27 European countries.

BACKGROUND: Older adults are at greater risk for becoming severely ill from COVID-19; however, the impact of the pandemic on their economic activity and non-COVID-19-related healthcare utilisation is not well understood. The aim of this study was to examine the prevalence and predictors of COVID-19-related unemployment and healthcare utilisation in a sample of older adults across 27 European countries. METHODS: We used data from the Survey of Health, Ageing and Retirement in Europe COVID-19 Survey, collected between June and August 2020. Participants (n=52 061) reported whether they lost a job, forwent medical treatment and whether their appointment was postponed due to COVID-19. Three-level models were estimated for each outcome to test the effects of individual, household and country-level characteristics. RESULTS: The mean prevalence of reported job loss, and forgone and postponed medical care was 19%, 12% and 26%, respectively. Job loss was associated with female sex, lower education and household income, and older age in women. For example, the OR of job loss, comparing primary versus tertiary (college) education, was 1.89 (95% CI 1.59 to 2.26). Forgone and postponed medical care was associated with older age in men, female sex and higher education. At the country level, postponed medical care was associated with more stringent governmental anti-COVID measures. CONCLUSION: Job loss and lower healthcare utilisation for non-COVID-19-related reasons were common among older adults and were associated with several sociodemographic characteristics. Job loss appeared to disproportionally affect already economically vulnerable individuals, raising concerns about the exacerbation of social inequalities.