Age, race/Hispanic origin, and COVID-19 mortality among sickle cell disease patients in the United States

The COVID-19 pandemic remains a global health challenge, with 6.7 million deaths worldwide as of January 2023. It has illuminated the health iniquities in underserved communities and populations like those with sickle cell disease (SCD). Researchers have associated the COVID-19 outcome among SCD patients in other regions of the globe. The purpose of this retrospective cross-sectional observational study was to investigate the relationship between age, race/Hispanic origin, and COVID-19 mortality among persons with SCD in the United States from January 2020 to March 2021. The Krieger ecosocial theory of disease distribution framed the study. Data were drawn from an existing Centers for Disease Control and Prevention provisional SCD death data set (N = 140). The binary logistic regression analysis result showed a statistically significant relationship between age and race/Hispanic origin and COVID-19 mortality. The variability between ages was 42.9%;race/Hispanic origin was 29.9%;and age and race/Hispanic origin were the highest, with 62.4% dying from COVID-19. Non-Hispanic Black patients were 9.6 times more likely to die overall but those aged 60+ were 17.5 times more likely to die from COVID-19 than the reference groups (0-19-year-old and other race). This study can benefit the research community, public health workers, medical professionals, and policymakers to understand better and influence policy on developing and prioritizing age- and race-tailored preventive protocols and medical care. They may minimize pain and suffering while mitigating mortality from COVID-19 and other unforeseen future pandemics within the SCD community at home and abroad and positively effect social change. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Clinical and laboratory markers of severity of the new coronavirus infection (COVID-19).

The aim of the research. To study clinical and laboratory features of the new coronavirus infection (COVID-19) in order to develop a model that would allow, taking the publicly available research methods into account, to carry out early diagnosis of severe community-acquired pneumonia against the background of the new coronavirus infection. Material and methods. A total of 82 COVID-19 patients who complied with inclusion and exclusion criteria were enrolled. Depending on the clinical severity, three study groups were formed: group 1 included 13 patients with uncomplicated COVID-19, group 2 consisted of 39 patients with non-severe forms of pneumonia that developed against COVID-19 and group 3 was comprised of 30 patients with COVID-19 complicated by severe pneumonia. The groups were comparable in age and gender. All patients underwent general clinical examination, laboratory tests, including general and biochemical blood analysis, as well as chest computed tomography. Results. The clinical picture in COVID-19 patients differed depending on the disease severity. Coughing and shortness of breath were more often observed in patients with severe pneumonia;sore throat, on the contrary, was more often noted in patients with uncomplicated COVID-19. On admission to the inpatient facility, patients with severe pneumonia had higher body temperature and respiratory rate, with simultaneous decrease in blood oxygen saturation. One half of the patients with severe pneumonia had hypertensive disease in medical history, and one third had ischaemic heart disease. As a rule, uncomplicated COVID-19 patients did not have ischaemic heart disease. It was found through laboratory analysis of blood that groups of patients significantly differed in the levels of neutrophils, lymphocytes, monocytes, basophils and eosinophils. Conclusion. The use of such clinical and laboratory data as acute respiratory failure, fever, the levels of neutrophils, monocytes, lymphocytes, eosinophils and basophils makes it possible to identify patients with more severe pneumonia against the background of COVID-19 even before chest computed tomography. Key words:.Copyright © 2022, Krasnoyarsk State Medical University. All rights reserved.

Comparative analysis of factors associated with the severe course of COVID-19 in the age groups under 60 and over 60 years of age

Introduction: Coronavirus infection is a disease that causes respiratory failure and complications in certain groups of people, leading to death. The factors associated with the severe course of COVID-19 have been fairly well studied by now;at the present stage, it is necessary to search for and study them in separate groups of people that differ in age, gender, ethnicity, the presence of background diseases, etc. to develop more personalized approaches to severe disease prevention. Background: To conduct a comparative analysis of the factors associated with the severe course of COVID-19 in people under and over 60 years of age and evaluate their prognostic significance in combination of factors. Materials and methods: A retrospective analysis of the clinical and laboratory parameters of 812 COVID-19 patients was carried out. Multiple logistic regression analysis was used to identify factors associated with the development of severe COVID-19. ROC analysis was performed to assess the prognostic significance of the set of identified statistically significant factors in the development of a severe course of COVID-19. Results: Multivariate logistic regression analysis showed that patients under 60 diabetes mellitus (OR=2,561, p=0,048), lymphopenia (OR=2,133, p=0,030), and pneumonia at admission (OR=2,556, p=0,011), rapid breathing (OR=3,497, p=0,001), low saturation (OR=4,076, p=0,006) were significantly associated with the development of severe COVID-19. At the same time, in patients older than 60 years, the presence of diabetes mellitus (OR=1,899, p=0,029), rapid breathing (OR=2,338, p=0,007) and low saturation (OR=4,248, p < 0,0001) were significantly associated with the development of a severe course of COVID-19. In groups under 60 and over 60 years of age, the prognostic value of the combination of all statistically significant factors corresponding to the groups was equal to the average level (AUC=0,760 and AUC=0,709, respectively) Conclusion: Factors associated with the development of a severe course of COVID-19 in elderly and middle-aged people have some differences related to the pathogenesis of the disease. For individuals under 60 years of age, factors associated with severe COVID-19 are diabetes mellitus, the presence of pneumonia on admission, dyspnea, low oxygen saturation, and lymphopenia. For individuals over 60 years of age, factors associated with severe COVID-19 are the presence of diabetes mellitus, shortness of breath, and low saturation. The combination of all the studied factors significantly increases the risk of developing a severe course of COVID-19 in both age groups.

The COVID-19 pandemic and temporal change in metabolic risk factors for cardiovascular disease: A natural experiment within the HELIUS study.

The coronavirus disease 2019 (COVID-19) pandemic, including the restrictive measures taken to reduce the spread of the virus, negatively affected people's health behavior. We explored whether the pandemic also had an effect on metabolic risk factors for cardiovascular disease (CVD) in women and men. We conducted a natural experiment, using data from 6962 participants without CVD at baseline (2011-2015) of six ethnic groups of the HELIUS study in Amsterdam, the Netherlands. We studied whether participants whose follow-up measurements were taken within the 11 months before the pandemic (control group) differed from those whose measurements were taken taken within 6 months after the first lockdown (exposed group). Using sex-stratified linear regressions with inverse probability weighting, we compared changes in baseline- and follow-up data between the control and exposed group in six metabolic risk factors: systolic and diastolic blood pressure (SBP, DBP), total cholesterol (TC), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), and estimated glomerular filtration rate (eGFR). Next, we explored the mediating effect of changes in body-mass index (BMI), alcohol, smoking, depressive symptoms and negative life events at follow-up. We observed less favorable changes in SBP (+1.12mmHg for women, +1.38mmHg for men), DBP (+0.85mmHg, +0.80mmHg) and FPG (only in women, +0.12 mmol/L) over time in the exposed group relative to the control group. Conversely, changes in HbA1c (-0.65 mmol/mol, -0.84 mmol/mol) and eGFR (+1.06 mL/min, +1.04 mL/min) were more favorable in the exposed compared to the control group, respectively. Changes in SBP, DBP, and FPG were partially mediated by changes in behavioral factors, in particular BMI and alcohol consumption. Concluding, the COVID-19 pandemic, in particular behavioral changes associated with restrictive lockdown measures, may have negatively affected several CVD risk factors, in both women and men.

Racial and ethnic disparities in excess mortality among U.S. veterans during the COVID-19 pandemic.

OBJECTIVE: The COVID-19 pandemic disproportionately affected racial and ethnic minorities among the general population in the United States; however, little is known regarding its impact on U.S. military Veterans. In this study, our objectives were to identify the extent to which Veterans experienced increased all-cause mortality during the COVID-19 pandemic, stratified by race and ethnicity. DATA SOURCES: Administrative data from the Veterans Health Administration's Corporate Data Warehouse. STUDY DESIGN: We use pre-pandemic data to estimate mortality risk models using five-fold cross-validation and quasi-Poisson regression. Models were stratified by a combined race-ethnicity variable and included controls for major comorbidities, demographic characteristics, and county fixed effects. DATA COLLECTION: We queried data for all Veterans residing in the 50 states plus Washington D.C. during 2016-2020. Veterans were excluded from analyses if they were missing county of residence or race-ethnicity data. Data were then aggregated to the county-year level and stratified by race-ethnicity. PRINCIPAL FINDINGS: Overall, Veterans' mortality rates were 16% above normal during March-December 2020 which equates to 42,348 excess deaths. However, there was substantial variation by racial and ethnic group. Non-Hispanic White Veterans experienced the smallest relative increase in mortality (17%, 95% CI 11%-24%), while Native American Veterans had the highest increase (40%, 95% CI 17%-73%). Black Veterans (32%, 95% CI 27%-39%) and Hispanic Veterans (26%, 95% CI 17%-36%) had somewhat lower excess mortality, although these changes were significantly higher compared to White Veterans. Disparities were smaller than in the general population. CONCLUSIONS: Minoritized Veterans experienced higher rates excess of mortality during the COVID-19 pandemic compared to White Veterans, though with smaller differences than the general population. This is likely due in part to the long-standing history of structural racism in the United States that has negatively affected the health of minoritized communities via several pathways including health care access, economic, and occupational inequities.

Racial Disparities and Common Respiratory Infectious Diseases in Children of the United States: A Systematic Review and Meta-Analysis.

Due to the lack of sufficient data on the relationship between racial disparities and the occurrence of infectious respiratory diseases in children, the aim of this systematic review and meta-analysis is to evaluate the presence of racial gaps in the occurrence of respiratory infectious diseases in children. This study follows the PRISMA flow guidelines for systematic reviews and the standards of meta-analysis for 20 quantitative studies conducted from 2016 to 2022 including 2,184,407 participants. As evidenced from the review, in the U.S., racial disparities are present among children, with Hispanic and Black children carrying the burden of infectious respiratory disease occurrence. Several factors are contributory to these outcomes among Hispanic and Black children, including higher rates of poverty; higher rates of chronic conditions, such as asthma and obesity; and seeking care outside of the home. However, vaccinations can be used to reduce the risk of infection among Black and Hispanic children. Whether a child is very young or a teen, racial disparities are present in occurrence rates of infectious respiratory diseases, with the burden resting among minorities. Therefore, it is important for parents to be aware of the risk of infectious diseases and to be aware of resources, such as vaccines.

Polymorphisms of leukocyte genes human and congenital antigen immunity associated with different the severity of the course of the new coronavirus infections

The most significant single nucleotide human leukocyte antigen genes polymorphisms and innate immunity genes associated with varying degrees of acute respiratory infection severity are considered-COVID-19 caused by the SARS-CoV-2 coronavirus. As data accumulated, it became clear that the SARS-CoV-2 virus exhibits significant regional, ethnic, and individual specificity. This is due to the population groups' genetic characteristics. This is necessary to reliably know the human genotype relationship with the COVID-19 course severity (asymptomatic, mild, moderate, severe, and extremely severe up to fatal outcomes) for more successful therapy and vaccination. At the same time, it was also known that the innate immunity system is on the first line of defense against the pathogenic penetration into the body, and the human leukocyte antigen system encodes molecules of the same name on the surface of cells that present various antigens, including viral infection pathogens, and determine the severity of the course of many diseases;therefore, these systems' genes. This approach makes it possible to assess the likelihood of a severe and extremely severe disease course in healthy and infected people, which in turn contributes to the correct therapy strategy, pharmacotherapy, and vaccination, as well as to create new antiviral therapeutic and preventive medicines. The genetically determined immune response heterogeneity to SARS-CoV-2 infection requires further study, since there is no unambiguous opinion about the leading mechanism that determines disease severity.

Socio-economic and ethnic health inequalities in COVID-19 outcomes across OECD countries

The COVID 19 pandemic has disproportionately hit some vulnerable population groups. Those living in deprived areas, migrant population, and ethnic minorities are at higher risk of catching and dying from the virus than other groups, and they also face significant indirect health impacts of the COVID-19 pandemic - both mental health impacts and disruption of routine care. The working paper gathers evidence on the direct and indirect health impacts of the COVID-19 on the poor population and the ethnic minorities. It reviews factors underlying these inequalities, and maps policy interventions adopted by OECD countries to help address the disproportionate impacts of the COVID-19 pandemic on vulnerable population groups.

A study of rural domestic helpers knowledge, attitude, and practice of COVID-19 in Mizoram, India

Background: In times of an epidemic such as coronavirus disease 2019 (COVID-19), the public's knowledge and attitude toward the disease affects the ability to abide to different preventive measures. Aims and Objectives: (1) to assess the knowledge and awareness of the domestic helpers in a tribal population, (2) whether the domestic helpers practice appropriate preventative measures that are recommended by WHO. Materials and Methods: This cross-sectional study was designed and carried out using questionnaire among rural domestic workers in Mizoram, above 14 years of age belonging to both Mizo and Non-Mizo ethnicity. Data were collected from 105 participants and analyzed through t-test, one-way analysis of variance and Pearson correlation analysis. Results: Majority of the respondents had higher secondary level of education (78.1%) and 95.2% could identify COVID-19 as a communicable disease. Almost all the participants (97.1%) were afraid of infection and the majority (92.4%) had fear of dying with the disease. Three-fourth of the participants were working during the pandemic of which 44.8% had volunteered. Media (68.6%) was the most common source of information about the disease. The education level was significantly associated with knowledge and attitude scores whereas there were no significant differences with respect to the practice (P > 0.05). Conclusion: Our findings indicate an overall good KAP of the rural domestic workers. Since these workers move from house to house and also take care of the vulnerable, and that they themselves and the families, they work for may be at an increased risk of infection with COVID-19, these findings are important from a health campaign perspective.

Genetic risk factors associated with SARS-CoV-2 susceptibility in multiethnic populations

Susceptibility to infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes the disease COVID-19, may be understood more clearly by looking at genetic variants and their associations to susceptibility phenotype. I conducted a genome-wide association study of SARS-CoV-2 susceptibility in a multiethnic set of three populations (European, African, and South Asian) from a UK BioBank clinical and genomic dataset. I estimated associations between susceptibility phenotype and genotyped or imputed SNPs, adjusting for age at enrollment, sex, and the ten top principal components of ancestry. Three genome-wide significant loci and their top associated SNPs were discovered in the European ancestry population: SLC6A20 in the chr3p21.31 locus (rs73062389-A;P=2.315 x 10-12), ABO on chromosome 9 (rs9411378-A;P=2.436 x 10-11) and LZTFL1 on chromosome 3 (rs73062394;P=4.4 x 10-11);these SNPs were not found to be significant in the African and South Asian populations. A multiethnic GWAS may help elucidate further insights into SARS-CoV-2 susceptibility.

COVID-19 exposes weaknesses in public health in the Peruvian Amazon and highlights opportunities for a one health approach

The Amazon is home to important wildlife and a biodiversity hotspot of global importance. The ancestral knowledge kept by Indigenous communities about its fauna and flora contributes further to its irreplaceable value. The Peruvian Amazon was heavily struck by the COVID-19 epidemic with a cumulative incidence of 725, a mortality rate of 34 per 100,000 inhabitants, and a case fatality rate of 4.6% by the end of July 2020. In this work, we review scientific literature and media to trace the events that happened at the beginning of the COVID-19 epidemic in the Peruvian Amazon. Results are synthesized in three observations: (1) the evolution of the COVID-19 epidemic within the Peruvian Amazon and the response of the Peruvian health care system, (2) Confusing information about Ivermectin use for COVID-19 treatment and prevalent self-medication (3) The response of the traditional Indigenous health care system to the COVID-19 epidemic. These three observations are interdependent. There is an unexploited potential for integrative approaches linking traditional medical practices (TMP) and biomedical approaches and they may benefit from the interactions that occur between them. Synergies can also be explored between the human and animal health care sector, especially in terms of the use and stewardship of medicines. We conclude that there is a benefit of the One Health approach in the region, which can go through the common ambition to improve the integrated health of people, animals and ecosystems, facilitate the enhancement of equity and inclusion while improving access to health services and conserving biodiversity.

Racial Ethnic Differences in Advance Directive Completion Among Middle-Aged and Older US Adults (Sch455)

1. Understand demographic factors associated with advance directive (AD) completion. 2. Identify racial/ethnic groups with lower AD completion rates. Previous research has found lower AD completion by Black and Latinx adults. However, most studies were conducted prior to COVID-19 and included patients with different types of insurance coverage. To identify racial/ethnic differences in percentages of middle-aged and older adults in a large US health plan who report having an AD. We analyzed self-reported data for 6,719 adults aged 45 to 90 years who completed the self-administered 2020 Kaiser Permanente Northern California (KPNC) Member Health Survey, which included a question about having an AD. Using data weighted to the 2019 KPNC membership, we estimated AD prevalence for white, Black, Latinx, and Asian American/Pacific Islander (AAPI) adults aged 45 to 64 years, 65 to 74 years, and 75 to 90 years. We used modified log Poisson regression to produce AD prevalence ratios (aPR) comparing Black, Latinx, and AAPI to white adults within ages 45 to 64 years and 65to 90 years adjusted for age, sex, education, relationship status, and overall health rating. Overall, white adults (56.1%) were significantly more likely to report having an AD than AAPI (35.3%), Black (34.4%), and Latinx (29.0%) adults. Compared to white adults, AD prevalence was lower among AAPI (aPR 0.69, CI 0.58-0.82), Black (aPR 0.71, CI 0.52-0.97), and Latinx (aPR 0.56, CI 0.42-0.73) adults ages 45 to 64 years and among AAPI (aPR 0.75, CI 0.69-0.81), Black (aPR 0.82, CI 0.73-0.92), and Latinx (aPR 0.82, CI 0.74-0.92) adults ages 65 to 90 years. Within both age groups, AD prevalence was higher among adults with a college degree and in a committed relationship, after controlling for age, sex, race/ethnicity, and overall health rating. Despite increased public awareness and life-care planning programs, racial/ethnic disparities persist in AD completion. The largest racial/ethnic gaps are seen in middle-aged adults. Further research is needed to develop effective, culturally humble approaches to increasing AD completion across all racial/ethnic groups. [ FROM AUTHOR] Copyright of Journal of Pain & Symptom Management is the property of Elsevier B.V. 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.)

Patterns of Earnings and Employment by Worker Sex, Race, and Ethnicity Using State Administrative Data: Results from a Sample of Workers Connected to Public Assistance Programs

During the strong economic conditions that predated the COVID-19 pandemic, many US workers, especially females and individuals of color, suffered from economic vulnerability. Despite growing research attention, we lack an understanding of how the prevalence and patterns of earnings and job instability vary with worker characteristics, particularly at the intersections between sex and race/ethnicity. This study uses longitudinal administrative data from a large, diverse state from 2015 through 2018 to document changes in earnings and jobs. We then examine variation in the size, frequency, and direction of these changes by worker sex and race/ethnicity among a subsample of workers who are connected to the public welfare system. Results indicate that, as expected, workers who are connected to the public welfare system experienced higher levels of economic vulnerability, but with substantial racial/ethnic and sex differences. As a consequence, a large number of workers—disproportionately those of color—were experiencing high levels of economic instability during a period of strong economic growth. Our findings have implications for policy and practice strategies.

Vaccine success and challenges in northern Australia. (Special Issue: Infectious diseases in northern Australia.)

Aboriginal and Torres Strait Islander people living in rural and remote Australia have lower vaccine coverage rates and experience higher rates of notification and hospitalisations for vaccine preventable diseases than non-Aboriginal people. This paper explores important public health and research activities being undertaken in the Northern Territory to reduce this disparity in vaccine program performance, with a particular focus on rotavirus, meningococcal, human papilloma virus and COVID-19 vaccines.

Digital mental health interventions for college students of color: Understanding uptake and enhancing engagement

College students of color have significant mental health needs, but they are less likely to receive treatment than their white counterparts (Lin et al., 2022). Given students of color are a high need, understudied, and underserved group, increased attention to their mental health and strategies targeting mental health equity are imperative. Digital mental health interventions (DMHI) have been proposed as mechanisms for disparity reduction, and research indicates DMHI are effective in college student populations (Lattie et al., 2019). However, less is known about DMHI preferences, needs, and usage among students of color. Addressing pertinent questions about DMHI reach and uptake for this population can support efforts to advance health equity. This dissertation comprised two studies that explored the following research questions: Can DMHI enhance racial/ethnic equity in college student mental health treatment receipt? (Study 1) What are key barriers to DMHI uptake for college students of color and what strategies might enhance DMHI uptake in this population? (Study 2). Study 1 evaluated racial/ethnic differences in mental health problems and treatment enrollment within a largescale screening and treatment research initiative on a diverse college campus. Results illustrated racial/ethnic differences in student depression, anxiety, and suicidality. Students of color were less likely to have received prior mental health treatment compared to white students but were no less likely to initiate digital and face-to-face treatment through the research initiative. DMHI uptake rates were comparable to prior studies, with just 8.7% of those eligible initiating use of the DMHI. Given these findings, Study 2 employed a modified Delphi design to generate expert consensus on barriers to DMHI uptake and strategies to improve uptake among college students of color. Cross-disciplinary experts (n=35) participated in a three-round survey. Results revealed important barriers to uptake, including factors associated with the user, program, technology, and environment. Strategies were coded within four implementation levels, including DMHI design, marketing and outreach, orientation and onboarding, and campus/community-level efforts. Analyses yielded a subset of promising strategies rated highly important and feasible. These findings provide guidance for future efforts focused on tailoring and implementing DMHI uptake strategies through co-creation with students of color. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Navigating parental involvement: Restoring bridges and inspiring change

It appears that the predominantly European centered educational system has failed Black students. There is a disparity in academic success for Black students in comparison to White students. In 2013, it was reported that 34% of Black students and 9% of White students scored below basic on the National Assessment of Educational Progress (National Education Policy and Practice and Priority Schools Department, 2015). In a study conducted by Stanford professor Reardon, average test scores of Black students were two grade levels lower than White students (Rabinovitz, 2016). Black students at the national level scored 30 points lower than their White peers in 2011, according to the National Center for Educational Statistics (Bohrnstedt et al., 2015). Nonacademic factors such as student motivational levels, work ethic, and family/parent support have emerged as possible causes (Ratcliff et al., 2016). Research by LaRocque et al. (2011) supports the need for collaboration of parents and teachers to increase student learning. The need to build relationships with Black families is especially crucial to improving the academic experiences of Black students. Epstein's Framework for Parental Involvement should also be held under the careful lens of Critical Race Theory (CRT) when used in school districts that serve predominately Black students. In this qualitative case study, I describe the process and challenges of initiating and maintaining parent/ teacher relationships in urban, middle schools to improve Black students' academic performance. Data was obtained from interviews with 6 Black and 5 White middle school educators. The data gathered was coded and analyzed to draw out the perceptions teachers have about parental involvement and student achievement. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Factors associated with COVID-19 vaccine acceptance worldwide: a rapid review

Background: While vaccines are acknowledged as one of the most successful public health measures, an increasing number of people doubt the safety or necessity of vaccines. We aimed to assess and identify the factors associated with COVID-19 vaccination acceptance worldwide. Materials and Methods: In this review, a systemic search of online databases (Medline, EMBASE, Scopus, Web of Science, Cochrane Library, CIVILICA, and Google Scholar search engine) was conducted for related studies with no time limit up to December 2021. Results: The percentage of individuals willing to receive a COVID-19 vaccine across worldwide studies ranged from 23.1% to 92%. Willingness to vaccinate was dependent on factors such as male gender, older age groups (aged 65 or older), race (Asian race), higher income, ethnicity (Hispanic ethnicity), specialists' recommendations, access barriers (location of vaccine delivery, relative cost, time and distance to access vaccine), and a higher level of education. Hesitancy was mostly driven by vaccine safety concerns, perceived effectiveness, distrust in health officials or public health experts to ensure vaccine safety, lack of vaccine offer or lack of communication from trusted providers and community, vaccine characteristics (i.e., ways the vaccine will be administered and where the vaccine is made), and speed of vaccine development and was associated with fear of known or unknown long-term side effects. Conclusion: The top three reasons people agree to vaccinate were "to protect themselves and others", "belief in vaccination and science", and "to help stop the virus spread". Willingness to vaccinate differed by age, gender, race, income status, ethnicity, specialists' recommendations, access barriers (including the location of vaccine delivery, relative cost, time, and distance to access a vaccine), and education.

Personal and professional reflections: Shame and race

In this chapter, I will discuss my understanding of shame and race having been born, and having lived and worked in racialised societies. I decided to write from my personal and professional experiences of seeing people who expressed their feelings of being made to feel ashamed and what actions they took to be relieved of these feelings. On refection, during this year of the enforced "lock down" caused by the pandemic of COVID-19, I have had more time to observe people whilst standing at the stipulated distance of two metres. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Integrated Health Care during the COVID-19 Pandemic: A Social Justice View from the Perspectives of Social Workers

COVID-19 has laid bare the enormous health disparities that still exist in the United States due to racial injustice. Due to these disparities, nondominant racial and ethnic groups have experienced disproportionate rates of infection and death from COVID-19. Social justice is a cardinal value of the social work profession. In response to the COVID-19 pandemic, social workers need to play a role in addressing the health disparities that exist in the United States. This qualitative study examined the perspectives of forty social workers who worked as individuals in integrated healthcare settings during the COVID-19 pandemic. Participants indicated that structural racism was a primary factor that contributed to health disparities during the COVID-19 pandemic.

Disparities in COVID-19 case counts and incidence in Florida by race and ethnicity at the county and state level

Background: In 2020, as COVID-19 spread across the United States, reports of disparities in COVID-19 incidence and mortality by race and ethnicity soon followed. This study assessed COVID-19 case counts and incidence by race and ethnicity at county and state levels focusing on Florida. Methods: Counts of COVID-19 were collected from June through December 2020. Chi square analyses assessed disparities in case distribution and linear regressions assessed disparities in incidence and potential interaction between predictors. Results: Race and ethnicity were significant predictors of COVID-19 incidence. Mean incidence was 4.9, 6.6, and 14.3 per 1,000 people among White, Black, and Other populations and 10.9 and 5.0 per 1,000 people among Hispanic and non-Hispanic populations. Incidence was greatest among the Other population (P=0.3825), and greater among Hispanic than non-Hispanic populations (P=0.0057). Conclusion: This study illustrates the disproportionate impact of COVID-19 upon racial and ethnic minorities and highlights the need to improve race and ethnicity data collection in disease reporting.