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.

COVID-19 VACCINE PERCEPTION AND HESITANCY AMONG PATIENTS WITH AUTOIMMUNE RHEUMATIC DISEASE (AIRD) IN MALAYSIA

BackgroundPatients with autoimmune rheumatic disease (AIRD) are at risk of severe COVID-19 infection and vaccine has been demonstrated to be able to reduce the severity of infection. Malaysia has a low flu vaccination coverage rate (approximately 3%) and hence it is important to assess the perception and hesitancy of COVID-19 vaccine especially among the vulnerable group.ObjectivesTo study the perception of COVID-19 vaccine and to determine the prevalence of vaccine hesitancy among AIRD patients in Malaysia.MethodsThis was a cross-sectional survey using online Google Forms® that was conducted among adult AIRD patients (18 years and older) from August 2021 until February 2022. Patients were recruited from the outpatient clinics as well as distribution of the survey through social medias. The survey was in English and Malay language. The survey collected data on the socio-demographic background, prior history of other vaccination after the age of 18 and COVID-19 vaccination with reasons of hesitancy, defined as being unsure or unwilling to be vaccinated. The survey also assessed the patients' perception by specifying the level of agreement to COVID-19 vaccine statements using the Likert response scale: 1-Strongly disagree;2- Disagree;3-Neither agree nor disagree;4-Agree;5-Strongly agree.ResultsA total of 162 patients participated in the survey and majority of them were females (87.7%). Our multi-racial cohort consisted of Malay (n=103, 63.5%), followed by Chinese (n=38, 23.5%), Sabahan Bumiputra (n=12, 7.4%) and Indian (n=7, 4.3%). More than half (n=107,66.6%) have not had any history of other vaccination after the age of 18. Only 16.7% (n=27) agreed/strongly agreed that COVID-19 vaccine can be given to patients with co-morbidities and 24.1 (n=39) agreed/strongly agreed that COVID-19 vaccine can be given to patients who have history of allergy to other drugs or food. At the time of the survey, vast majority of the respondents have received at least the 1st dose of Covid-19 vaccine (n=148, 91.4%). A total of 9 (5.6%) patients were hesitant to be vaccinated (6 were unsure and 3 patients were not willing to be vaccinated). The commonest reasons of being unsure or not willing to be vaccinated was worried of the vaccine's adverse effects (66.7%), worried of the blood clot complication (33,3%), worried of disease flare post-vaccine (33,3%), worried of allergic reaction (22.2%), lack of information on the safety of the vaccine in patients with AIRD from government and media (22.2%), face mask and social distancing measures were adequate (22.2%). Statistical analysis revealed that more patients who had vaccine hesitancy were from the lower socioeconomic status (income <1066 Euro/month), 88.9% vs 11.1%, p=0.03 but no association with ethnicity, education status, marital status or place of residence (urban vs rural).ConclusionCOVID-19 vaccine hesitancy is low in Malaysian patients with AIRD but patients with a low socioeconomic status are prone to have vaccine hesitancy. More education on the vaccine's efficacy and safety especially among patients with co-morbidities are warranted.Reference[1]Knowledge, acceptance and perception on COVID-19 vaccine among Malaysians: A web-based survey. Mohamed NA, Solehan HM, Mohd Rani MD, Ithnin M, Che Isahak CI (2021) Knowledge, acceptance and perception on COVID-19 vaccine among Malaysians: A web-based survey. PLOS ONE 16(8): e0256110.Acknowledgements:NIL.Disclosure of InterestsSyahrul Sazliyana Shaharir Speakers bureau: Pfizer,Novartis, Lydia Kamaruzaman: None declared, Theepa Nesam Mariamutu: None declared, Mohd Shahrir Mohamed Said: None declared, Azmawati Mohammed Nawi: None declared, Wan Syamimee Wan Ghazali: None declared, Malehah Mohd Noh: None declared.

Prevalence of Post-traumatic Stress Disorder in People With a History of Hospitalization With COVID-19 and Its Relationship With Socio-economic Status

Background: COVID-19 has had many negative consequences in all aspects of human life, especially physical and mental health. This study aims to determine the prevalence of post-traumatic stress disorder (PTSD) in people with a history of hospitalization with COVID-19 and its relationship with socio-economic status (SES). Materials and Methods: The present study was a cross-sectional descriptive study and the statistical population of the study included all people with a history of being infected with COVID-19 and subsequent hospitalization in Shohada Hospital of Sarpol-e Zahab, Kermanshah Province, Iran. The sample members were randomly selected from the list of hospitalized patients. A total of 479 people were evaluated face to face using the PTSD Checklist Scale (PCL-S) questionnaire to examine PTSD, as well as the Ghodrat Nama et al.'s SES questionnaire to determine the SES. The data were analyzed using SPSS software, version 21 and by Chi-square test, one-way ANOVA, and Pearson correlation coefficient (P≤0.05). Results: The prevalence of PTSD was 31.10%. No significant relationship was observed between socioeconomic status and the prevalence of PTSD (P=0.97). Among the demographic variables, only gender had a significant relationship with the prevalence of this disorder (P=0.00) and the prevalence was higher in women than in men. Conclusion: The prevalence of PTSD is high in people with a history of hospitalization with COVID-19. Getting infected with COVID-19 and subsequent hospitalization hurts people's mental health. Maintaining the mental health of this group of people should be considered. © 2023, Negah Institute for Scientific Communication. All rights reserved.

Converging Crises and the Cost of Exclusion: Unveiling the Invisible Women of Sri Lanka's Economy

In Sri Lanka, womens labor force participation has never exceeded 35% in over three decades. As of 2022, the country was ranked 110 out of 146 countries in the World Economic Forums Gender Gap Index. The gaps in womens participation in the formal economy alongside womens limited political empowerment are two leading causes for the country to be lagging in such global gender equality indicators. At a large cost to the economy, the existence of archaic gender norms that promulgate womens unpaid care work often exclude women from the formal labor force. This paper dissects the socio-economic and socio-political factors that lead to the invisibility of women in Sri Lankas economy, while seeking to understand how such underlying causes have been aggravated within the precarity of the post-pandemic context. It is important, now more than ever, to recognize the invisibility of women in Sri Lankas formal economy, while bringing about a transformative vision with a multi-pronged approach to address existing gaps and challenges. With reference to key principles of feminist economics, including the theoretical foundations of Claudia Goldin, Nancy Folbre, and Diane Elson, among others, the paper will make a case for inclusivity and intersectionality in policy recommendations aimed at encouraging womens entry, active engagement, contribution, and retention in Sri Lankas economy. The paper reaches a conclusion that when women lead, participate, and benefit equally in all aspects of life, societies and economies will thrive, thereby contributing to sustainable development and inclusive economic growth.

Building a Framework for a More Inclusive Healthcare System

Objective: With the explosion in the use of telehealth technologies, it is essential to address the challenges in global telehealth inequity in order to create a path to healthcare equality. To this end, this research paper focuses on investigating telehealth as it relates to the COVID-19 pandemic and its impact on healthcare inequality, telehealth inequity, and the continued vulnerabilities with increased demand in implementation. Study Design: A set of voluntary questions were e-mailed to active members of the IEEE-SA (Institute of Electrical and Electronics Engineers Standards Association) Transforming the Telehealth Paradigm: Sustainable Connectivity, Accessibility, Privacy, and Security for all. The interview answers were analyzed via deductive thematic analysis organized into higher themes and theme-specific codes. Setting: The country of residence varied among individuals who are the IEEE-SA Telehealth program members. These continents included: North America, South America, Africa, Asia, and Europe. Participants: Global healthcare leaders who are active members of the IEEE-SA Transforming the Telehealth Paradigm: Sustainable Connectivity, Accessibility, Privacy, and Security for all participated. The occupations of these individuals ranged from a variety of areas within the healthcare domain, such as physicians, scientists, and public health experts. Main outcome measure: Qualitative data obtained voluntarily from global healthcare leaders participating in the IEEE-SA Transforming the Telehealth Paradigm: Sustainable Connectivity, Accessibility, Privacy, and Security for all. Results: The major themes that emerged from the participants' responses included: telehealth infrastructure and access, digital literacy and user interface, government regulations, and telehealth legislation. Conclusions: Telehealth has the power to decrease healthcare disparities, thus getting closer to achieving health equity. However, there are three significant common global barriers to the implementation of telehealth: infrastructure, digital literacy, and government regulations. Because the results were based on interviewer responses, the conclusions acknowledged how the background of respondents, including career and education, influenced their experiences and, thus, the responses. Suggestions for change in reducing barriers to telehealth accessibility are detailed in this research. These suggestions were derived from respondents and focused on the global barriers to implementation. To reduce these barriers, changes in political health policy, patient health education, health provider telemedicine support, and in regulation for telemedicine are suggested. Limitations in our research project included a small sample size and the ensuing lack of representation from more geographical regions.

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.

Confinement with No Rights. Perceptions of Inmates' Relatives Regarding Measures for COVID-19 Control Implemented in Mexican Prisons

Based on a participatory study design, this article describes how a group of family members of people deprived of liberty (PDL) experienced the COVID-19 control measures implemented in Mexico's prisons. We conducted 28 in-depth interviews and analyzed them using ATLAS.ti. We found that the measures implemented in Mexican prisons to avoid the spread of COVID-19 focused mainly on suspension of visitation and PDL confinement. The isolation imposed on PDL impacted their living conditions, making them more vulnerable to contracting COVID-19 due to lack of access to essential services, food, and hygiene supplies. Visit restrictions and PDL isolation also impacted PDL relatives' health and socioeconomic conditions. Our findings indicate that the consequences of COVID-19 control actions in Mexican prisons differ according to the gender and jurisdiction of PDL. Women in federal prisons were more isolated, while those in local ones were more deprived of basic supplies. Imprisoned women's isolation has especially severe effects on the mental and physical health of their elderly parents and children. The results show how the measures adopted to control COVID-19 outbreaks in Mexican prisons have exacerbated the preexisting systemic violence experienced by PDL and their families and how they have failed to prevent the spread of COVID-19 in these settings. These findings provide support for the health-informed penal reform of Mexican prisons.

A study on mental distress among the undergraduate students of medical college, Kolkata

The World Health Organization defines Mental Health as "a state of well-being in which every individual realizes (their) own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to (their) community." [8,9] According to a study conducted by National Council for Mental Health in India, at least 6.5% of the nation's population are suffering from some form of mental disorder, with no detectable urbanrural differences. Overall mental distress of medical students is significantly higher than that of general population and it may impact their academic performance/14,15 In a study titled "Stress, anxiety, and depression among medical undergraduate students and their socio-demographic correlates" published in Indian journal of medical research, VoL 141, March, 2015, more than 50% of the respondents, who were the MBBS students from Institute of Medical Sciences at Bhubaneswar, Odisha, India, were affected by depression (51.3%), anxiety (66.9%) and stress (53%). With this background, we undertook this study among the undergraduate students of Medical College, Kolkata with the objectives of finding out socio-demographic, behavioral and academic profile of the undergraduate medical students of Medical College, Kolkata, to estimate the proportion of different types of mental distress among them, and to examine relationship of mental distress with sociodemographic, behavioral, and academic profile.

Medical Dental Integration in Wisconsin: Integrating dental hygienists into pediatric well child visits and prenatal care

Disparities exist in access to early oral health care, disproportionately impacting minority ethnic groups and populations with low socioeconomic status. Medical dental integration provides an opportunity to create a new dental access point for early prevention and intervention as well as care coordination. The Wisconsin Medical Dental Integration (WI-MDI) model expanded early access to preventive oral health services by integrating dental hygienists (DHs) into pediatric primary care and prenatal care teams to address oral health inequities with the goal of reducing dental disease. This case study will describe how DHs were incorporated into the medical care teams in Wisconsin and how legislation expanding scope of practice made this possible. Since 2019, five federally qualified health systems, one non-profit clinic, and two large health systems have enrolled in the WI-MDI project. Thirteen DHs have worked across nine clinics in the WI-MDI project and over 15,000 patient visits to a medical provider included oral health services provided by DHs from 2019 to 2023. Dental hygienists working in alternative practice models such as those demonstrated in the innovative WI-MDI approach are positioned to reduce oral health disparities through the provision of early and frequent dental prevention, intervention, and care coordination.

PREDICTION OF MORTALITY USING CLUSTERS BASED ON CLINICAL AND LAB PARAMETERS: DATA FROM 2072 PATIENTS FROM INSPIRE COHORT

BackgroundLupus is a heterogenous diseases which results in significant premature mortality. Most studies have evaluated risk factors for lupus mortality using regression models which considers the phenotype in isolation. Identifying clusters of patients on the other hand may help overcome the limitations of such analyses.ObjectivesThe objectives of this study were to describe the causes of mortality and to analyze survival across clusters based on clinical phenotype and autoantibodies in patients of the Indian SLE Inception cohort for Research (INSPIRE)MethodsOut of all patients, enrolled in the INSPIRE database till March 3st 2022, those who had <10% missing variables in the clustering variables were included in the study. The cause of mortality and duration between the recruitment into the cohort and mortality was calculated. Agglomerative unsupervised hierarchical cluster analysis was performed using 25 variables that define SLE phenotype in clinical practice. The number of clusters were fixed using the elbow and silhouette methods. Survival rates were examined using Cox proportional hazards models: unadjusted, adjusted for age at disease onset, socio-economic status, steroid pulse, CYC, MMF usage and cluster of the patients.ResultsIndian patients with lupus have significant early mortality and the majority of deaths occurs outside the hospital setting.Out of 2211 patients in the cohort, 2072 were included into the analysis. The median (IQR) age of the patients was 26 (20-33) years and 91.7% were females. There were 288 (13.1%) patients with juvenile onset lupus. The median (range) duration of follow up of the patients was 37 (6-42) months. There were 170 deaths, with only 77 deaths occurring in a health care setting. Death within 6 months of enrollment occured in in 80 (47.1%) patients. Majority (n=87) succumbed to disease activity, 23 to infections, 24 to coexisting disease activity and infection and 21 to other causes. Pneumonia was the leading cause of death (n=24). Pneumococcal infection led to death in 11 patients and SARS-COV2 infection in 7 patients. The hierarchical clustering resulted in 4 clusters and the characteristics of these clusters are represented in a heatmap (Figure-1A,B). The mean (95% confidence interval [95% CI] survival was 39.17 (38.45-39.90), 39.52 (38.71-40.34), 37.73 (36.77-38.70) and 35.80 (34.10-37.49) months (p<0.001) in clusters 1, 2, 3 and 4, respectively with an HR (95% CI) of 2.34 (1.56, 3.49) for cluster 4 with cluster 1 as reference(Figure 1C). The adjusted model showed an HR (95%CI) for cluster 4 of 2.22 (1.48, 3.22) with an HR(95%CI) of 1.78 (1.29, 2.45) for low socioeconomic status as opposed to a high socioeconomic status (Table 1).ConclusionIndian patients with lupus have significant early mortality and the majority of deaths occurs outside the hospital setting. Disease activity as determined by the traditional activity measures may not be sufficient to understand the true magnitude of organ involvement resulting in mortality. Clinically relevant clusters can help clinicians identify those at high risk for mortality with greater accuracy.Table 1.Univariate and multivariate Cox regression models predicting mortalityUnivariateMultivariateVariablesHazard ratio (95% Confidence interval)P valueHazard ratio (95% Confidence interval)P valueCluster1Reference-Reference-20.87 (0.57, 1.34)0.5320.89 (0.57, 1.38)0.59831.22 (0.81, 1.84)0.3371.15 (0.76, 1.73)0.51342.34 (1.56, 3.49)<0.0012.22(1.48, 3.22)<0.001Socioeconomic statusLower1.78 (1.29, 2.45)<0.001Pulse steroidYes1.6 (0.99, 2.58)0.051MMFYes0.71 (0.48, 1.05)0.083CYCYes1.42 (0.99, 2.02)0.052Proliferative LNYes0.99 (0.62, 1.56)0.952Date of birth age0.99 (0.98, 1.01)0.657CYC- cyclophosphamide, MMF- Mycophenolate mofetilFigure 1.A. Agglomerative clustering dendrogram depicting the formation of four clusters. B.Heatmap depicting distribution of variables used in clustering C. Kaplan-Meier curve showing the survival function across the 4 clusters[Figure omitted. See PDF]REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone eclared.

GIS-Based Analysis of the Spatial Distribution and Influencing Factors of Traditional Villages in Hebei Province, China

Traditional villages are a valuable cultural asset that occupy an important position in Chinese traditional culture. This study focuses on 206 traditional villages in Hebei Province and aims to explore their spatial distribution characteristics and influencing factors using ArcGIS spatial analysis. The analysis shows that traditional villages in Hebei Province were distributed in clusters during different historical periods, and eventually formed three core clusters in Shijiazhuang, Zhangjiakou and Xingtai-Handan after different historical periods. Moreover, the overall distribution of traditional villages in Hebei Province is very uneven, with clear regional differences, and most of them are concentrated in the eastern foothills of the Taihang Mountains. To identify the factors influencing traditional villages, natural environmental factors, socio-economic factors, and historical and cultural factors are considered. The study finds that socio-economic and natural environmental factors alternate in the spatial distribution of traditional villages in Hebei Province. The influence of the interaction of these factors increases significantly, and socio-economic factors have a stronger influence on the spatial distribution. Specifically, the spatial distribution of traditional villages in Hebei Province is influenced by natural environmental factors, while socio-economic factors act as drivers of spatial distribution. Historical and cultural factors act as catalysts of spatial distribution, and policy directions are external forces of spatial distribution. Overall, this study provides valuable insights into the spatial distribution characteristics and influencing factors of traditional villages in Hebei Province, which can be used to develop effective strategies for rural revitalisation in China.

Housing inequalities and resilience: the lived experience of COVID-19

COVID-19 policy responses have intensified the use of housing as a spatial and material defence against community spread of infection. In so doing, they have focussed attention upon pre-existing inequalities and the effects of socio-economic management of COVID-19. This paper draws upon individual households' accounts to explore these effects on housing inequalities, and then adapts a critical resilience framework from disaster response in order to examine the implications for policymaking. The empirical work centres upon a case study of lived experiences of COVID-19-constrained conditions, based on a longitudinal-style study combining semi-structured interviews with 40 households, photographs and household tours at two datapoints (before/during COVID-19) in Victoria, Australia. The study reveals how these households were impacted across four domains: (1) employment, finances, services, and mobilities;(2) homemaking including comfort and energy bills, food and provisioning, and home-schooling/working from home;(3) relationships, care and privacy, and;(4) social, physical and mental health. The interviews also indicate how households coped and experienced relief payments and other related support policies during COVID-19. Drawing upon literature on disaster response, we highlight the centrality of vulnerability and resilience in recognising household exposure and sensitivity to COVID-19, and capabilities in coping. From this analysis, gaps in COVID-19 housing and welfare policy are exposed and guide a discussion for future housing policy interventions and pandemic planning.

Savings groups and the COVID-19 pandemic in Zimbabwe: Critical assessment of the informal social protection scheme

The COVID-19 pandemic has ravaged nations and people's lives throughout the globe across multiple dimensions. Measures to curtail the spread of the disease in Zimbabwe have stifled the capacity of the majority of the population, relegated to the informal sector, to source a living. In the absence of robust social protection interventions from the state, these measures pose a more immediate threat to the lives of marginalised and vulnerable communities than the pandemic itself. Savings groups (SGs), which have providedfinancial relief andprotection from economic shocks and stressors to such population groups, have been entrapped by the preventive and containment measures employed by the Zimbabwean authorities. It is unclear how and to what degree such conditions leave underserved populations exposed to socioeconomic shocks as such vital informal social protection alternatives have been rendered ineffectual. Using documentary review, this study examines the fate of SGs in such socially restricted and economically debilitating circumstances. In addition, the authors discuss strategies for improving the sustainability of such grassroots micro-finance initiatives under COVID-19 induced contraptions. Programmatic andpolicy measures necessary for retaining and protecting the viability of (SGs) as alternatives for informal social protection for marginalised and vulnerable groups under COVID-19 are advanced.

Do socioeconomic inequalities increase the spread of COVID-19 in Turkey?

This paper clarifies the medical and socio-economic factors affecting the prevalence of COVID-19 by using clinical and survey data in a binary probit model. Socio-economic factors are associated with risk of infection and can increase exposure to and mortality from COVID-19. Inequalities in socio-economic variables affect the prevalence to different degrees. Disparities in education and poverty are more important than being employed or being a smoker for the spread of COVID-19, we find evidence that confirms the hypothesis.

The Impact of Fast-Food Density on Obesity during the COVID-19 Lockdown in the UK: A Multi-Timepoint Study on British Cohort Data

Poor food environments are considered to trigger obesity and related health complications by restricting the local food options to predominantly low quality, energy-dense foods. This study investigated the impact of the food environment on obesity with a focus on any changes that might have occurred around the COVID lockdown period in the UK when majority of the population relied on food delivery and the local food environments. The proportion of fast-food retailers in the area and the Retail Food Environment Index (RFEI) were calculated for participants of the 1970 British Cohort Study (BCS70) at three timepoints: pre-COVID (2016), the first UK nation-wide lockdown (April–May 2020) and post lockdown (September–October 2020). The association of the food environment and the odds of obesity was estimated through multivariable logistic regression, with adjustments being made for selected socioeconomic variables. A model using the fast-food proportion as the sole predictor estimated that higher fast-food proportion increased the odds of obesity by 2.41 in 2016, 2.89 during the lockdown and 1.34 post lockdown, compared with 1.87, 2.23, and 0.73, respectively, for the same three periods with adjustments being made for select socioeconomic variables. On the other hand, RFEI increased the odds of obesity only slightly at 1.01, 1.02 and 1.03, respectively, with the model with adjustments yielding respective similar values. The fast-food proportion model indicates that proximity to a poor food environment is linked to obesity, especially during the COVID lockdown period, but the impact of a poor-food environment is limited if the RFEI is used as its indicator. The findings will add much needed insights on the UK data and will inform public health planning and policy.

Risk of partial school closure for COVID-19 by socio-economic level in the period 2020-22.

BACKGROUND: The objective was to analyse the risk of partial school closure by economic level in Barcelona city. METHODS: In this ecological study, the risk of partial school closure for the academic years 2020-21 and 2021-22 was estimated by dividing the total number of days that each child was in quarantine or isolation by the total number of days that each child was at risk to be in quarantine or isolation in the academic year. The association between partial school closure risk and mean income by district was estimated with the Spearman rho. RESULTS: The lower the mean income, the higher the risk of partial closure (Spearman rho = 0.83; P-value = 0.003) during the academic year 2020-21. Specifically, the children from the district with the lowest income had a six times greater risk of partial school closure compared with those from the highest-income district. This risk did not show a significant socioeconomic gradient in the academic year 2021-22. CONCLUSIONS: The risk of partial school closure presented an inverse socioeconomic gradient in the city of Barcelona according to average income by district in the academic year 2020-21. This distribution was not observed in the academic year 2021-22.

Socioeconomic disparities and concentration of the spread of the COVID-19 pandemic in the province of Quebec, Canada.

BACKGROUND: Recent studies suggest that the risk of SARS-CoV-2 infection may be greater in more densely populated areas and in cities with a higher proportion of persons who are poor, immigrant, or essential workers. This study examines spatial inequalities in SARS-CoV-2 exposure in a health region of the province of Quebec in Canada. METHODS: The study was conducted on the 1206 Canadian census dissemination areas in the Capitale-Nationale region of the province of Quebec. The observation period was 21 months (March 2020 to November 2021). The number of cases reported daily in each dissemination area was identified from available administrative databases. The magnitude of inequalities was estimated using Gini and Foster-Greer-Thorbecke (FGT) indices. The association between transmission and socioeconomic deprivation was identified based on the concentration of transmission in socially disadvantaged areas and on nonparametric regressions relating the cumulative incidence rate by area to ecological indicators of spatial disadvantage. Quantification of the association between median family income and degree of exposure of dissemination areas was supplemented by an ordered probit multiple regression model. RESULTS: Spatial disparities were elevated (Gini = 0.265; 95% CI [0.251, 0.279]). The spread was more limited in the less densely populated areas of the Quebec City agglomeration and outlying municipalities. The mean cumulative incidence in the subsample made up of the areas most exposed to the pandemic was 0.093. The spread of the epidemic was concentrated in the most disadvantaged areas, especially in the densely populated areas. Socioeconomic inequality appeared early and increased with each successive pandemic wave. The models showed that areas with economically disadvantaged populations were three times more likely to be among the areas at highest risk for COVID-19 (RR = 3.55; 95% CI [2.02, 5.08]). In contrast, areas with a higher income population (fifth quintile) were two times less likely to be among the most exposed areas (RR = 0.52; 95% CI [0.32, 0.72]). CONCLUSION: As with the H1N1 pandemics of 1918 and 2009, the SARS-CoV-2 pandemic revealed social vulnerabilities. Further research is needed to explore the various manifestations of social inequality in relation to the pandemic.

The role of digital transformation in the socio-economic recovery post COVID-19

Several measures have been taken to reduce the impact of COVID-19 pandemic. One of these measures is the broad digital transformation that has rapidly and unexpectedly forced the deployment of digital technologies into corporations' business models and organizational structures. This digital transformation has affected all the socio-economic aspects. In response to the COVID-19 global pandemic, this paper explores the impact of the implementation of digital transformation on the socio-economic recovery by employing cross-sectional regression analysis on 99 countries in year 2020. The paper analyzes the impact of digital transformation on each of economic growth, health care, and income inequality. The results reveal that the digital transformation has a positive and significant impact on the GDP per capita in which a 1% increase in digital transformation results in 1.52% increase in GDP per capita, a positive and significant impact on income equality in which a 1% increase in digital transformation leads to 0.05% increase in income equality, and a negative and significant impact on infant mortality rate, in which a 1% increase in digital transformation results in 0.85% decrease in infant mortality rate which reflects its positive impact on the health care. Hence, the digital transformation has a positive and significant effects on different socio-economic aspects.

Racism in pediatric health

SPECIAL REPORT Since the inception of the United States, social, economic, political, and scientific institutions have been built on a foundation emphasizing the inferiority of individuals related to phenotypic differences.1 This hierarchy ensconced white individuals as superior to all other groups with Native Americans and Blacks on the bottom. Some fifty years after the discovery of the genetic code, at a White House ceremony in 2000 to announce the discovery, Craig Venter, a pioneer of DNA sequencing, observed, "The concept of race has no genetic or scientific basis. With structural or institutional racism, there is decreased access to health care and resources for education, leading to lower health literacy and fewer health care providers of color.12'13 Over time, this has led to a distrust of the health care system as a whole by POC due to widely publicized historical events such as the Tuskegee Syphilis Study and the Marion tuberculosis outbreak. [...]non-Hispanic Blacks have a higher prevalence of recurrent asthma exacerbations and hospitalizations than Whites after adjusting for demographic and socioeconomic factors.16 One study revealed that with non-Black children, poor children were 45% more likely than children who were not poor to have asthma.

A final review: How are our children doing right now?

In caring for our pediatric patients, we will continue to live with the fact that the disruptions have not been uniformly felt, with increased impact on Black and Brown children and those living in poverty;additionally, levels of access to routine pediatric health services have varied throughout the pandemic.1 For all children, though, we have to make up much lost time when it comes to physical, mental, and academic concerns, as well as socialization issues. Because schools provide another resource for identifying and addressing mental health concerns, the complete or partial shift to virtual learning likely compounded the mental health crisis. According to one study, "the prevalence of depression and anxiety symptoms during the COVID-19 pandemic has doubled, compared with prepan-demic estimates. Early childhood: A profound degree of development takes place from birth to 5 years of life. Because of the pandemic, children 5 years and younger have spent all or a significant portion of their lives in social isolation alongside parents or caregivers.