social welfare advice and health among young people: a scoping review

Social determinants of mental and physical health that influence young peoples' trajectories into adulthood are often remediable through law. To address inequalities, including those exacerbated since the COVID-19 pandemic, there is a need to better understand young people's need for and uptake of advice for social welfare legal problems. This scoping review aimed to review available evidence and identify gaps to inform further research. To identify studies relevant to social welfare legal advice among young adults we conducted searches of eight bibliographic databases (compiled between January 1998 and June 2020), hand searches of included article reference lists and targeted grey literature searches. 35 peer reviewed and grey literature studies were selected based on inclusion and exclusion criteria including evaluations of interventions to promote access to advice, general population surveys, observational studies, and audits of charity data or targeted surveys. Evidence suggests considerable and inequitable need for social welfare legal advice among young adults with adverse consequences for health and wellbeing. Needs among higher risk groups are likely underestimated. Evidence for interventions to enhance access/uptake of advice is limited and methodologically weak. We identify several gaps in the literature to inform research and to enable systematic reviews around more specific questions to inform practice.

Differences in Disease Burden and Treatment Utilization By Socioeconomic Status Among a Large Cohort of Patients with COVID-19 Diagnosis in the United States

Objectives: Social determinants of health (SDoH) including income, education, employment, and housing are known to affect health outcomes;while use in real-world database studies are limited. This study assessed socioeconomic differences in burden of disease and utilization of COVID-19 specific medications in a large cohort of patients in the US. Method(s): A total of 17,682,111 patients having a COVID-19 diagnosis between 4/1/2020 and 4/30/2022 were identified in the IQVIA longitudinal medical and pharmacy claims databases of >277 million patients. For SDoH, a 3-digit zip code median Area Deprivation Index (ADI) (v2.0 University of Wisconsin School of Medicine and Public Health 2015) was calculated for each patient, maintaining patient privacy. The ADI is a validated tool ranking neighborhoods by socioeconomic disadvantage. Medical and pharmacy utilization was assessed and stratified by ADI pentiles, where 0-20 was the least disadvantaged, and 81-100 was the most disadvantaged. Result(s): The proportion of patients having a claim with COVID-19 diagnosis was higher in the most disadvantaged (7.75%) compared to the least disadvantaged group (5.94%) (US overall: 6.37%). Medical claims prior to COVID-19 diagnosis were highest in the least disadvantaged, while prior pharmacy utilization was highest in the most-disadvantaged group. There was sparse use of COVID-19 medications overall;the least disadvantaged patients had the lowest use of COVID-19 specific medications. Casirivimab/imdevimab use was highest in the 61-80 (2.01%) and 81-100 (1.79%) ADI groups, and remdesivir use was highest in the moderately disadvantaged (ADI 41-60 and 61-80) groups (both 2.33%). Utilization of hydroxychloroquine (unapproved for COVID-19) increased from 0.91% in the least to 2.13% in the most disadvantaged groups. Conclusion(s): This study shows unequal burden of COVID-19 prevalence by SDoH, with the most disadvantaged having a higher disease burden and utilization of certain approved and unapproved COVID-19 medications, highlighting the need for further study of the reasons for these disparities.Copyright © 2023

Innovative Methods for Integrating Social Determinants of Health Data with Administrative Claims to Facilitate Health Equity Research

Objectives: The Covid-19 pandemic highlighted the importance of considering Social Determinants of Health (SDoH) in healthcare research. Administrative claims databases are widely used for research, but often lack SDoH data or sufficient transparency in how these data were obtained. This study describes innovative methods for integrating SDoH data with administrative claims to facilitate health equity research. Method(s): The HealthCore Integrated Research Database (HIRD) contains medical and pharmacy claims from a large, national US payer starting in 2006 and includes commercial (Comm), Medicare Advantage (MCare), and Medicaid (MCaid) populations. The HIRD includes individually identifiable information, which was used for linking with SDoH data from the following sources: national neighborhood-level data from the American Community Survey, the Food Access Research Atlas, and the National Center for Health Statistics' urbanicity classification;and member-level data on race/ethnicity from enrollment files, medical records, self-attestation, and imputation algorithms. We examined SDoH metrics for members enrolled as of 05-July-2022 and compared them to the respective US national data using descriptive statistics. We also examined telehealth utilization in 2022. Result(s): SDoH data were available for ~95% of currently active members in the HIRD (Comm/MCare/MCaid 12.5m/1m/7.6m). Socioeconomic characteristics at the neighborhood-level differed by membership type and vs. national data: % of members with at least a high-school education (90/88/84 vs. 87);median family income ($98k/$76k/$70k vs. $82k);% of members living in low-income low-food-access tracts (9/14/18 vs. 13);urban (57/52/47 vs. 61). At the member-level, the % of White Non-Hispanics, Black Non-Hispanics, Asian Non-Hispanics, and Hispanics were 61/6/5/6 (Comm), 76/12/2/2 (MCare), and 45/26/5/19 (MCaid). Imputation contributed 15-60% of race/ethnicity values across membership types. Telehealth utilization increased with socioeconomic status. Conclusion(s): We successfully integrated SDoH data from a variety of sources with administrative claims. SDoH characteristics differed by type of insurance coverage and were associated with differences in telehealth utilization.Copyright © 2023

Impact of the COVID-19 Pandemic on Cervical Cancer Screening Rates in Colombia: An Interrupted Time Series Analysis, Stratified By Region

Objectives: The objective of this study is to measure the national impact of COVID-19 on cervical cancer screening rates in Colombia in five of its geographic regions to inform future health policy decision making. Method(s): This study utilized a quasi-experimental interrupted time-series design to examine changes in trends for the number of cervical cancer screenings performed in five geographic regions of Colombia. Result(s): In the rural region of Vichada, we found the lowest incidence of cervical cancer screenings, totaling at 3,771 screenings. In Cundinamarca, the region which hosts the capital city, a total of 1,213,048 cervical cancer screenings were performed. The researcher measured the impact on cervical cancer screenings in December 2021 against the counterfactual. This impact was ~269 cases that were not performed in December 2021 as a result of the COVID-19 pandemic compared to the counterfactual. In Cundinamarca, unlike other regions, we observed a stagnant pre-pandemic trend, a sharp drop in screenings in March 2020, and an immediate upward trend starting in April 2020. In the month of April 2020, compared to the counterfactual, there were 27,359 screenings missed, and by the month of December 2021, there were only 5,633 cervical cancer screenings missed. Conclusion(s): The region of Cundinamarca's sharp climb back to pre-pandemic screening levels could signal the relatively stronger communication system in the region, and especially in the capital district of Bogota, in re-activating the economy. This can serve as an example of what should be implemented in other regions to improve cervical cancer screening rates. Areas for further research include the examination of social determinants of health, such as the breakdown of the type of insurance screened patients hold (public versus private), zone (urban versus rural), insurance providers of those screened, ethnicities of the patients screened, and percentage of screenings that resulted in early detection of cervical cancer.Copyright © 2023

Lessons for the Age of Consequences: COVID-19 and the Macroeconomy

Comparative empirical evidence for 22 OECD countries shows that country differences in cumulative mortality impacts of SARS-CoV-2 are caused by weaknesses in public health competences, pre-existing variances in structural socio-economic and public health vulnerabilities, and the presence of fiscal constraints. Remarkably, the (fiscally non-constrained) U.S. and the U.K. stand out, as they experience mortality outcomes similar to those of fiscally-constrained countries. High COVID19 mortality in the U.S. and the U.K. is due to pre-existing socio-economic and public health vulnerabilities, created by the following macroeconomic policy errors: (a) a deadly emphasis on fiscal austerity (which diminished public health capacities, damaged public health and deepened inequalities);(b) an obsessive belief in a trade-off between ‘efficiency' and ‘equity', which is mostly used to justify extreme inequality;(c) a complicit endorsement by mainstream macro of the unchecked power over monetary and fiscal policy-making of global finance and the rentier class;and (d) an unhealthy aversion to raising taxes, which deceives the public about the necessity to raise taxes to counter the excessive liquidity preference of the rentiers and to realign the interests of finance and of the real economy. The paper concludes by outlining a few lessons for a saner macroeconomics.

The Relationship between Marine Sports Tourist Destinations, Social Responsibility, and Environmentally Responsible Behavior

This study investigated the structural relationship between tourist destination identification and environmental responsibility practices based on the social responsibility activities for visitors of marine sports tourist destinations where domestic travel has been active since COVID-19. Furthermore, we aimed to provide academic and practical implications by investigating the relationship between DSR, a major variable in sustainable marine sports tourism, and ERB. Data from a survey of tourists who participated in marine sports (n = 392) were analyzed using structural equation modeling and Hayes PROCESS macro with bootstrapping procedures. According to the analysis results, it was found that marine sports tourist DSR positively affected destination identification and ERB, and that tourist destination identification positively influenced ERB. Second, it was shown that the effect of the social responsibility of a marine sports tourist destination on ERB is mediated via the influence of tourist destination identification.

Social Cognition Approaches to Understanding and Changing COVID-19 Preventive Behaviors

Until pharmacological measures are rolled out on a global scale, reducing the transmission of COVID-19 and preventing future outbreaks require the continued promotion of behaviors known to effectively limit the spread of infections (e.g., physical distancing, hand hygiene practices). The success of such behavioral measures, however, relies on widespread compliance, highlighting the importance of theory-and evidence-based behavior change interventions targeting COVID-19 preventive behaviors. Theories of social cognition have recently been applied to COVID-19 preventive behaviors to identify the key modifiable determinants of behavior that can be targeted by strategies or techniques in interventions. The identification of key modifiable determinants of COVID-19 preventive behaviors permits the matching of evidence-based behavior change strategies or techniques proposed to affect change in the targeted determinants. The goal of this chapter is to provide an overview of the social cognition literature and interventions targeting key psychological constructs as means to adopt and maintain COVID-19 preventive behaviors. The chapter also provides example materials used in behavior change interventions based on social cognition theory, which may have application across a broad range of COVID-19 preventive behaviors. First, the chapter provides an overview of social cognition theories that have been used to explain and predict health and social behavior and how behavior change occurs. Next, the emerging research evidence of potentially modifiable social cognition determinants of COVID-19 preventive behaviors are reviewed. Finally, a step-by-step example of how interventionists might develop a theory-based intervention targeting change in an important COVID-19 preventive behavior is provided. The chapter concludes with a summary of some key challenges and future directions in moving forward behavior change research in this area. Overall, this chapter provides information useful to the design and development of effective behavior change interventions targeting the adoption and maintenance of COVID-19 preventive behaviors which are relevant to current and future pandemic contexts. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Determinant factors of the improvement of nutritional status (based on height-for-age index category) in children during the COVID-19 pandemic: a cohort study of children's growth and development in Bogor

The COVID-19 pandemic is predicted to trigger a global economic and food supply crisis, which further affects children's nutritional status as a vulnerable group. This study aimed to observe alterations in nutritional status before and during the COVID-19 pandemic (during 2019-2021) and determinant factors involved in the improvement of nutritional status (based on the height-for-age Z-score (HAZ) index category) during the COVID-19 pandemic. The findings were intended as evidence-based suggestions for policy formulation concerning the improvement of child nutritional status and stunting reductions. This study was part of a cohort study of children's growth and development conducted by National Institute of Health Research and Development (NIHRD) in Bogor city-Indonesia. The analysis was conducted on 565 children under five in 2019 with height measurement data in 2019 and 2021, environmental conditions, parental education, consumption habits, and social assistance. Children were classified as having an improved nutritional status if the HAZ category increased in 2021 compared to 2019. In addition, multiple logistic regression analyses were performed to predict determinant factors involved in improving the child's nutritional status. In this study, 17.5% of children had improved nutritional status, and 79.3% had a steady nutritional status. However, there were 3.2% of children with decreased nutritional status. Model factors determinant related to improved nutritional status includes consumption more than once per week of red meat (adjusted odds ratio (aOR) = 2.15;95% confidence interval (CI): 1.06-4.35, p=0.034), milk consumption more than once per week (aOR = 1.56;95% CI: 0.89-2.74, p=0.119), and age under 5 years old (aOR = 1.86;95% CI: 1.14-3.15, p=0.016). Children under five years old, the consumption of red meat and milk more than once a week have the opportunity to improve nutritional status (by height-for-age index) in children.

COVID-19 and its consequences on the physical, psychological and social health of obstetricians

Introduction: The COVID-19 pandemic has had effects on the health of health workers, including obstetricians, but the consequences in this occupational group are unknown. Objective: Determine the consequences of COVID-19 on the physical, psychological and social health of obstetricians in Peru. Methods: Observational, descriptive, cross-sectional study, carried out on 511 attending obstetricians, in the first line of care. An online questionnaire, previously validated and reliable, was applied to measure the variables: general characteristics and exposure to COVID-19, physical health, psychological health, and social health. Data were analyzed using descriptive statistics. Results: 468 (91.6%) obstetricians are women, 287 (56.2%) aged 40-59 years, 213 (41.7%) married, 292 (57.1%) working at the first level of care;216 (42.3%) were infected with COVID-19, 165 (32.3%) had headache, 127 (24.9%) sore throat and 121 (23.7%) fatigue;167 (77.3%) required outpatient treatment and 3 (1.3%) intensive care. Obesity reported by 102 (20.0%) obstetricians was the main comorbidity, followed by hypertension with 38 (7.4%) and diabetes with 14 (2.7%);263 (51.5%) reported depressive symptoms and 464 (90.8%) stress;238 (46.6%) felt discrimination and 118 (23.1%) carried the workload of the home alone. Conclusions: The physical, psychological and social health of obstetricians is affected by the pandemic;generates disorders of overweight/obesity, depression, stress;as well as discrimination and work overload at home. © 2023, Editorial Ciencias Medicas. All rights reserved.

Do free-floated shares and board characteristics influence corporate risk disclosure? An empirical analysis on conventional banks in a developing country

PurposeThis study aims to explore the status and drivers (including free-floated shares, board size, rule duality and board independence) of corporate risk disclosure (CRD) for the conventional listed banks in the Egyptian stock market from 2010 to 2021, which include the country's major political upheavals and the COVID-19 pandemic. Design/methodology/approachThis study based on a sample of 117 annual reports of sampled banks from 2010 to 2021. RD index of Al-Maghzom (2016) was developed and adopted to quantify CRD using an unweighted scoring system. The multiple linear regression model was used to validate the hypotheses. FindingsThe analysis shows that the COVID-19 pandemic increased insignificantly disclosure of all risks except for segment risks. In addition, findings reveal that all sampled banks adhere highly to the requirements of mandatory RD, with a low level of adherence to voluntary RD. Moreover, the analysis concluded that the board size and free-floating shares positively affect the disclosure of financial, operational, general information. Research limitations/implicationsThe study's limitations include the content analysis methodology, reliance on annual reports, emphasis on financial and non-financial risks, focus on listed conventional banks in Egypt. Practical implicationsCurrent study's findings are more likely to be useful for many parties. It informs investors about the characteristics of the boards' directors of Egyptian listed banks that disclosed risk information. Banks should disclose more comprehensive risk information. For academics, the current study's limitations can be considered in their future research. Originality/valueThis work fills a new research area in which there is relatively little research in emerging financial markets that adds new evidence to the relationship between RD and both free-floating shares and board characteristics, particularly in Egypt.

The Determinants of Positive Food Procurement Practices in COVID-19 Affected Communities: A Cross-Sectional Study Conducted in Chiredzi Zimbabwe

The coronavirus pandemic has led to diminished income, which threatens nutrition security. Cash transfer programs increase the resilience of poor and vulnerable households by giving them an improved ability to obtain food and healthcare, which lead to nutrition security. However, the provision of cash does not necessarily translate to ideal behaviours, such as procuring nutritious foods. This study investigated the determinants of procurement of legumes and animal source foods amongst potential beneficiaries of a cash transfer project. We conducted a barrier analysis study in Chiredzi, Zimbabwe. Structured interviews were administered to 90 purposively sampled respondents (45 doers and 45 non-doers). The study investigated the four most common behavioural determinants, perceived self-efficacy, perceived social norms, perceived positive consequences and perceived negative consequences. Non-doers were 1.89 times more likely to state that receiving social assistance would make it easier to procure legumes and animal source foods for household consumption. Non-doers were 2.05 times more likely to state that the ability to barter their own possessions for legumes and animal source foods would make it easier to purchase the items for household consumption. Doers were 4.5 times more likely to report that relish comprising of animal source foods or legumes and pulses was tastier than other relishes. Doers were 12 times more likely to report that most people approve of purchasing animal source foods and legumes for household consumption. Doers were 3.23 times more likely to identify friends and relatives as the members of the community that approved of this behaviour. We identified three determinants of the procurement of legumes and animal-source foods, namely, perceived self-efficacy, social norms and perceived positive consequences. Cash transfer projects provide a first step to achieving nutrition security in the new normal but must be delivered with a context-specific behaviour change intervention. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.

Abstract: Cultural responses to the first wave of COVID-19 pandemic in different parts of the world

The article reports on different cultural understandings of the first wave of COVID-19 pandemic and various coping mechanisms in India, Bangladesh, Japan, Syria, New Zealand, South Africa, Kenya, Tunisia, El Salvador, the USA, Italy and Belgium. Culture influences how an epidemic affects society, in terms of its origin, mode of spread and treatment, as well as responses to distress and health practices. Cultural responses to the pandemic contribute to control or accelerate its spread, and even unite or divide certain sectors of society. Culture also influences the perception of medical interventions and thus the demand or not for help from health services. The varied cultural responses show the importance of culture in public health, especially in a crisis, and of understanding it to implement health measures. Finally, in the depths of the first pandemic wave, the collaborative experience of gathering expressions of cultural influence in the pandemic created a sense of connection within the human system of a generation of early career psychiatrists across the globe, which helped cope with the traumatic potential of the pandemic as a factor of isolation and withdrawal, through challenges of respective professional contexts. © 2023 Boeck Universite. All rights reserved.

Combatting Food Insecurity Through Implementing Food Pantry Amenities in Clinical Settings

INTRODUCTION: The SARS-CoV-2 pandemic has brought renewed public attention to food insecurity and other social determinants of health. According to the United States Department of Agriculture (USDA), food insecurity affects 10.5% of households nationwide. Our study sought to determine the prevalence of food insecurity at the University of Louisville and the effect that implementing food pantry amenities within the clinic has on pregnancy outcomes. METHODS: Institutional review board approval was obtained. We screened pregnant women presenting to our outpatient clinic for prenatal care each trimester. Food security was determined using a modified version of the USDA Adult Food Security Survey over the past 12 months. Women that were determined to be food insecure were provided access to food pantry amenities at each prenatal visit. Screening data were entered in REDCap, then exported into Stata for statistical analysis. RESULTS: Survey data demonstrated that 38% of our patients screened positive for food insecurity. As a result, a total of 5,829 lb of food have been distributed. Secondary outcomes including prenatal care adherence rates, weight gain during pregnancy, pregnancy complications, and birth outcomes will be displayed graphically. CONCLUSION: Rates of food insecurity in our clinic population were three times higher compared to the national average. Formal screening allows providers to better identify families experiencing food insecurity and connect them to food pantry amenities. Importantly, our initiative can serve as a guide for other institutions considering food security interventions. Implementing food pantries in academic institutions nationwide will enhance and inform these innovations to target at-risk populations and provide health equity. [ FROM AUTHOR] Copyright of Obstetrics & Gynecology is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Social determinants in association with postpartum blues during the transition period of COVID-19 pandemic

Background:The COVID-19 pandemic has considerably impacted individuals' lives, extensively from mental and socioeconomic aspects, that requires someone to adapt. For postpartum mothers who also need to go through the maternal psychological adaptation phase, the pandemic could impose overwhelming emotional tension on them, increasing the risk of experiencing postpartum blues. This study aims to analyze the relationship between social factors that are affected during a pandemic with the incidence of postpartum blues on screening test results during the transition period of the COVID-19 pandemic in Banyumanik, Semarang. Subjects and Method: This was a cross-sectional study conducted in Banyumanik, Semarang, from November to December 2022.39 subjects were selected using a consecutive sampling technique. The dependent variable is postpartum blues. The independent variables include marital status, employment status of the mother, employment status of the spouse, and family income level. The study instrument was EPDS questionnaire. The data were analyzed used Chi-square. Results: Out of 39 subjects, 13 (33.3%) were experiencing postpartum blues, and 26 (66.7%) were not experiencing it. Mother's employment status associated with postpartum blues. Mothers who unemployed have a risk of experiencing postpartum blues 1.65 times compared to employed, but these were not statistically significant (OR= 1.65;95% CI= 0.40 to 6.77;p= 0.727). Family income level associated with postpartum blues. Mothers with low to moderate family income reduced postpartum blues by 0.73 times compared to mothers with high income levels, but these were not statistically significant (OR= 0.73;95%CI= 0.19 to 2.80;p= 0.908). Meanwhile, marital status and spouse employment status were not related to the incidence of postpartum blues. Conclusion: Mother's employment status and family income status associated with postpartum blues. Meanwhile, marital status and spouse employment status were not related to the incidence of postpartum blues.

The Influence of Intellectual and Innovative Determinants on the Development of Regions in the Conditions of COVID-19 and Global Digitalization

The social challenges of modern globalization caused by the COVID-19 pandemic have led to significant changes in the development of economic systems at various levels. Social development in the direction of a post-industrial society activates the introduction of digital technologies in all areas of life, which requires paying attention not only to the innovative component of its development, but also to the intellectual one, since the digital transformation requires a constant updating of knowledge;this determines the purpose of this scientific study. The article aims to highlight the influence of intellectual and innovative determinants in the development of regions under current conditions, which are outlined by the manifestations of the COVID-19 pandemic and global digitalization in the development of economic systems. The foundation of the system approach methodology made it possible to distinguish the development trends of the regions in the conditions of the COVID-19 pandemic and global digitalization. It is proposed to create guidelines for the intellectual and innovative promotion, determinants of the development of the regions in the conditions of the COVID-19 pandemic and global digitalization, according to the socioeconomic, scientific-technological, organizational and legal components. The main guidelines of efforts to increase the role of intellectual and innovative determinants in the development of regional systems in the conditions of the COVID-19 pandemic and global digitalization have been tested, taking into account the principles of complexity, integrity, flexibility, efficiency and long term.

The significance of educational level in acquiring good literacy of COVID-19: a case study in Indonesia

Background. Surveys on Public Knowledge, Attitude, and Practice (PKAP) have been conducted in various countries with respondents from the public as well as health workers. Measuring the knowledge of the public about COVID-19 is very important to determine the knowledge gap among the public and also as an evaluation of the preventive efforts for COVID-19. Objective. The purpose of this research was to determine whether education level is a factor that affects one's literacy about COVID-19. Materials and Methods. This is cross-sectional research with online-based data collection using the Kobo toolbox application. The data collection was carried out from the 19th of April until the 2nd of May 2020. The number of people under study is 792. The level of knowledge was measured using 12 research questions with true or false question types. the multivariable logistic regression was carried out. Results. Most of the respondents (52.5%) were in the young age group (15-35 years old), were male (57.3%), and had a bache-lor or diploma education level (62.1%). Furthermore, most of the respondents had good knowledge (65.4%). The higher the respon-dents' educational level means, the better knowledge they had concerning COVID-19 (P=0.013). Conclusions. Public knowledge about COVID-19 is affected by their level of education. A good level of knowledge about COVID-19 was found among respondents with master's and doctoral degrees. This finding can contribute to the prevention of COVID-19, in which the priority of educating communities about COVID-19 should be given to those having an educational level below a master's degree.Copyright © the Author(s), 2023.

Social Determinants of Health and Their Impact on Families of Children with Sickle Cell Disease during Covid-19 Pandemic

Background: According to national prevalence data, SCD has an estimated economic burden of $2.98 billion per year in the United States and caring for a child with sickle cell disease (SCD) carries its own financial burden, resulting in higher healthcare costs and unintended days lost from employment. Social experiences are known to impact health outcomes in the general pediatric population. These experiences can be examined through the construct of social determinants of health (SDOH), the "condition in which people are born, grow, work, live and age" that impact their health. Since the WHO has designated COVID-19 a pandemic in January 2020, many families in the US have suffered financially, and during the shutdowns, there was a record number of jobs lost. The objective of this study was to determine the impact of the COVID-19 pandemic on financial and employment status of SCD Families Methods: This study was part of the larger CNH Sickle Cell Disease Social Determinants of Health study that was IRB approved. Caregivers of children with SCD completed a 30-question survey reporting their experiences with SDOH that included Demographics, USDA Food Security Scale, the We Care housing screening tool, and the validated COVID-19 Employment Status/COVID-19 related household finances survey in RedCap during clinic visits and hospitalizations Results: 99 caregivers of SCD patients responded to our survey (82.5% Female, 17.5% Male) (N=97). 93.9% identified as African-American, 3% identified as Hispanic or Latinx, 1% identified as "other". Of respondents, 66% were insured through on Medicaid and 33% had private insurance. Twenty-six percent endorsed food insecurity and 2724% relied on low-cost food. Thirty-one percent lived in an apartment, 67.768% lived in a home, 1% lived in shelter or transitional housing. Sixteen percent lived in subsidized or public housing. Thirty-seven (36.8%) percent reported at least once they were being unable to pay the mortgage or rent on time at least once, 9% (8.5%) reported living with other people because of financial difficulties, 55.2% reported their home not being heated, 7.2% reported being evicted from their home and 3.1% lived in an emergency shelter or transitional housing. 6.1% had an educational level of high school graduation or less, 42.2% were college graduates or completed additional post-graduate education (N=98). Two weeks prior to the pandemic, 61.5% worked full time, 13.5% worked part time, 6.3% were unemployed with only 2.1% working from home of the 96 caregivers who responded to this question. 15.5% (N=12 of 77) reported losing their job or were furloughed during the pandemic;34.4% (N=33 of 96) reporting at least one household member losing a job or a significant amount of income. Twenty-five percent (N=21 of 83) reported it was difficult to get work/school done because of the home environment. 36.4 % (N=35 of 96) reported household income was significantly less since February 2020. 53% (N=52 of 97) worried their household income has been or will be negatively impacted by the COVID-19 pandemic. Additionally, 48.9% (N=47 of 96) worried the value of their assets (housing, savings, other financial assets) has been or will be negatively impacted by COVID-19 and its effects. Since February 2020, 9.8% (N= 9 of 97) received unemployment insurance, 30.9% (N=29 of 94) received SNAP or food stamps, 16.5% (N= 15 of 91) received from the food pantry, 6.6% (N=6 of 90) applied for temp ass.

The pandemic within systemic injustice: Intersectional cultural dimensions of women's aging, health, and case stories of COVID-19

This book chapter delves into the intersectional cultural dimensions of COVID-19 and explores how pandemics expose and amplify past and current health inequities and disparities for minoritized women. In this chapter, the authors question how gender reflects and intersects with health determinants of oppressed and privileged identities to produce disparate health outcomes, affecting discourse, ideologies, and women's activity as they age. Additionally, issues of racism, classism, ageism, and other "isms" are examined to understand the challenges faced by aging women as they strive to stay healthy. The chapter concludes with case story narratives of women diagnosed with COVID-19, showing the virus' effect on marginalized women aging within a stratified society. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023. All rights reserved.

Creation and implementation of the SIENMECRO chronic patient drug delivery system: qualitative study

Introduction: Faced with the pandemic produced by SARS-CoV-2, the Peruvian government implemented several measures such as the temporary closure of primary care facilities and the health system implemented various policies and strategies;one of them was to create and implement the Drug Delivery System for Chronic Patients (SIENMECRO) project. Background: To describe the creation and implementation process of SIENMECRO project. Methods: Qualitative case study that involved reviewing existing documentation such as texts and videos and conducting in-depth interviews with officials and collaborators involved since the preparation of SIENMECRO proposal. Results: SIENMECRO project emerges as a positive initiative with the aspiration of promoting an integrated health system that addresses the health reality from the social determinants of health, due to patients' difficulties to go to their controls and to receive their treatment. Although there was no comprehensive plan for the implementation and control of the project, it was essential to cover the need for health care for a vulnerable segment of the population, avoiding their transfer and preserving the health of the people most likely to suffer complications from COVID-19 infection. Conclusions: It is an initiative where the health system takes a more proactive role for the benefit of the population, implementing the use of technology of the information and communication in health care, articulating with the various providers and bringing services closer to the most vulnerable citizens.

Evaluating Business Performance and the Impact of Funding Diversity during Covid-19: Kosovo Evidence

This paper aims to examine the barriers and challenges faced by busi-nesses in Kosovo in terms of access to SMEs funding sources during the pandemic, as well as their impact on the business evaluation of SMEs. Given that more than 99 percent of businesses in Kosovo are SMEs, which are considered essential for economic development, they also contribute to job creation. This study employs a quantitative approach, with reported data provided directly by SMEs via questionnaires. The empirical approach used in the study is ordered logit regression to measure the effect of credit lending, business plan, own investment, donations, and borrowings from family or friends on business evaluation during the Covid-19 pandemic. Empirical re-sults show that credit lending and business plans have a signiAcant positive impact on business evaluation, whereas borrowings from family or friends and donations have a signiAcant negative impact. Despite the study's limi-tations, we are convinced that it should spark a debate between research-ers, academics, and policymakers. The study contains the original value and contribution in the empirical aspect, which is designed on the data provided for Kosovo to evaluate the association between SMEs and the use of funding sources during the Covid-19 pandemic.