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1.
Am J Mens Health ; 16(2): 15579883221082427, 2022.
Article in English | MEDLINE | ID: covidwho-1731484

ABSTRACT

This study investigated associations among economic status deterioration, mental health, and gender during the COVID-19 pandemic. A total of 1,807 participants completed an online questionnaire that included demographic variables and questions measuring three mental health variables: psychological distress (as measured by symptoms of depression, anxiety, and stress), adjustment disorder, and emotional eating. Results indicated that women reported higher mental health impairment than men. Men and women whose economic status significantly deteriorated because of the COVID-19 pandemic reported greater mental health impairment than those whose economic status did not significantly deteriorate. However, men whose economic status significantly deteriorated reported high mental health impairment (emotional eating and adjustment difficulties) similar to women in the same situation. This change in men's reporting pattern suggests that the economic impact of COVID-19 severely impacted their mental health and affected how they view their masculinity, which, in turn, further impaired their mental health. As the COVID-19 outbreak has had a significant impact on mental health worldwide, it is important to identify individuals and groups who are at high risk of mental health impairment. The current study demonstrates that men's distress, which is frequently complex to identify, can be detected using standardized measures and analyzing these according to changes in reporting patterns as opposed to simply examining means and frequencies. The results suggest that the COVID-19 crisis may provide an opportunity to understand more about mental health, in particular, that of men.


Subject(s)
COVID-19 , Depression/epidemiology , Depression/psychology , Economic Status , Female , Humans , Male , Masculinity , Men's Health , Mental Health , Pandemics , SARS-CoV-2
2.
BMC Public Health ; 22(1): 160, 2022 01 24.
Article in English | MEDLINE | ID: covidwho-1650542

ABSTRACT

BACKGROUND: This study aimed to examine whether the extended use of a variety of digital screen devices was associated with lower economic status and other environmental factors among Korean elementary school children and their caregivers during school closures precipitated by the coronavirus disease 2019 (COVID-19) pandemic. METHODS: A total of 217 caregivers of children 7-12 years of age from Suwon, Korea, were recruited and asked to respond to a self-administered questionnaire in June 2020. The questionnaire addressed demographic information and children's use of digital media, in addition to their caregivers. The t-test was used for continuous variables, and the Kruskal-Wallis test was used for variables measured on an interval scale. A multiple regression analyses were performed to examine the effects of significant correlative factors on screen time in children as predictors. RESULTS: Children with lower household incomes demonstrated a higher frequency and longer duration of smartphone and tablet personal computer use compared to those from higher income households. Children of households in which incomes decreased after COVID-19 used smartphones and tablet PCs more often and for longer durations. Children from households that experienced decreased income(s) after COVID-19 used personal computers more often and for a longer duration, and children from low-income families engaged in longer screen time on smartphones. A change in primary caregiver(s) may have increased children's screen time on smartphones. CONCLUSION: Lower household income was associated with longer screen time among children, and poor mental health among caregivers during school closures precipitated the COVID-19 pandemic.


Subject(s)
COVID-19 , Child , Economic Status , Humans , Internet , Pandemics , SARS-CoV-2 , Schools , Screen Time
3.
Int J Environ Res Public Health ; 19(2)2022 01 13.
Article in English | MEDLINE | ID: covidwho-1625711

ABSTRACT

Research has shown that the confinement measures implemented to curb the spread of COVID-19 can have negative effects on people's lives at multiple levels. The objective of this cross-sectional study was to better understand the mental, physical, and socio-economic status of adults living in Spain during the late stages of the state of emergency caused by COVID-19. Five hundred and forty-four individuals responded to an online survey between 3 June and 30 July 2020. They were asked to report data about their mental and physical health, financial situation, and satisfaction with the information received about the pandemic. Means, percentages, t-test, ANOVAs, and logistic regressions were computed. A third of the participants reported symptoms of anxiety, depression, and stress, and worries about their health and the future. Participants also described mild levels of fatigue and pain during lockdown (66%), and a reduction in household income (39%). Respondents that were female, younger, single, and with lower levels of education reported experiencing a greater impact of the COVID-19 pandemic. The data showed that the negative effects of lockdown were present in the late stages of the state of emergency. The findings can be used to contribute to the development of programs to prevent or mitigate the negative impact of confinement measures.


Subject(s)
COVID-19 , Communicable Disease Control , Cross-Sectional Studies , Depression , Economic Status , Female , Humans , Pandemics , SARS-CoV-2 , Spain/epidemiology
4.
PLoS One ; 17(1): e0262301, 2022.
Article in English | MEDLINE | ID: covidwho-1622357

ABSTRACT

In May 2020, Westat, in partnership with Stanford University School of Medicine, conducted a nationally-representative household survey of American attitudes and behaviors regarding COVID-19. In this article, we examine what the Coronavirus Attitudes and Behaviors Survey tells us about the impact of COVID-19 on financial status and how this impact varies by demographic characteristics, the presence of health risk factors, and financial status (including employment factors). The survey reveals significant inequality in financial impact, as those who were most financially vulnerable prior to the pandemic found themselves under greater financial strain, while those who were more financially secure have experienced a neutral or even positive impact of the pandemic on household finances. These findings have important implications for public policy as policymakers seek to target aid to those who need it most.


Subject(s)
COVID-19 , Employment , Adult , Aged , COVID-19/epidemiology , Economic Status , Family Characteristics , Female , Humans , Income , Male , Middle Aged , Pandemics , Surveys and Questionnaires , United States , Young Adult
6.
BMC Pregnancy Childbirth ; 21(1): 755, 2021 Nov 08.
Article in English | MEDLINE | ID: covidwho-1506167

ABSTRACT

BACKGROUND: The COVID-19 pandemic has exacerbated the financial insecurity of women and their families globally. Some studies have explored the impact of financial strain among pregnant women, in particular, during the pandemic. However, less is known about the factors associated with pregnant women's experiences of material hardship. METHODS: This cross-sectional study used a non-probability sample to examine the factors associated with pregnant women's experiences of material hardship during the COVID-19 pandemic. In January 2021, 183 pregnant women living in the United States participated in an online Qualtrics panel survey. In addition to socio-demographic characteristics, individuals were asked about their finances and predictors of financial well-being, mental health symptoms, and intimate partner violence (IPV) experiences. Chi-square analysis and one-way ANOVA were used to examine whether women's experiences with material hardship and associated factors differed by income level (i.e., less than $20,000; $20,000 to $60,000; more than $60,000). Ordinary least squares regression was used to calculate unadjusted and adjusted estimates. RESULTS: Study findings showed that the majority of women in the sample experienced at least one form of material hardship in the past year. Individuals with an annual household income less than $20,000 reported the highest average number of material hardships experienced (M = 3.7, SD = 2.8). Compared to women with household incomes less than $20,000, women with incomes of more than $60,000 reported significantly fewer material hardships, less financial strain, and higher levels of financial support, economic self-efficacy, and economic-self-sufficiency. Women with incomes of $60,000 or more also reported significantly lower levels of psychological abuse, and a smaller percentage met the cut-off for anxiety. Economic self-sufficiency, financial strain, posttraumatic stress disorder, and economic abuse were all significantly associated with material hardship. CONCLUSIONS: A contribution of this study is that it highlights the significant, positive association between economic abuse, a unique form of IPV, and material hardship among pregnant women during the pandemic. These findings suggest the need for policy and practice interventions that help to ameliorate the financial insecurity experienced by some pregnant women, as well as respond to associated bidirectional vulnerabilities (e.g., mental health symptoms, experiences of IPV).


Subject(s)
COVID-19/economics , Economic Status , Income/classification , Pregnant Women/psychology , Adult , Anxiety/epidemiology , COVID-19/epidemiology , COVID-19/psychology , Cross-Sectional Studies , Depression/epidemiology , Female , Humans , Income/statistics & numerical data , Intimate Partner Violence/psychology , Intimate Partner Violence/statistics & numerical data , Pandemics , Pregnancy , SARS-CoV-2 , Stress Disorders, Post-Traumatic , Surveys and Questionnaires , United States/epidemiology
7.
Nihon Koshu Eisei Zasshi ; 69(1): 3-16, 2022 Jan 28.
Article in Japanese | MEDLINE | ID: covidwho-1497890

ABSTRACT

Objective This study aimed to assess the household income changes during COVID-19 pandemic among Japanese adults, and to evaluate how this was related to changes in dietary behaviors and food-related accessibility issues and information needs during the emergency period.Method We conducted an online cross-sectional survey in July, 2020 among residents (aged 20-69 years) of the 13 prefectures under special confinement during the COVID-19 pandemic. Participants were asked about their dietary behaviors before the pandemic (before February 2020) and during the confinement period (April-May 2020), as well as about their food-related accessibility issues and information needs during the confinement period. Data from 2,225 residents were analyzed. Participants were divided into three groups (decreased, unchanged, and increased) based on the household income changes due to COVID-19. Demographics, dietary behaviors, and food-related accessibility issues and information needs were then compared among these three groups. Multiple logistic regression analyses were performed to examine the effect of household income changes on dietary behavior changes, food-related accessibility issues, and food-related information needs, while adjusting for sociodemographic factors. Furthermore, the effect of household income changes and subjective economic status were also analyzed using multiple logistic regression analyses.Result The participant distribution in each group were as follows: decreased (34.6%), unchanged (63.9%), and increased (1.6%). Higher proportion of those who were employed part-time, self-employed, or unemployed during the confinement period were found among the decreased group. The odds ratios (OR) of the decreased group were significantly higher than the unchanged group for lower frequency of eating out, and for higher frequency of home-cooking, consuming ready-to-eat convenience meals, and eating with children during the confinement period. Furthermore, regardless of the subjective economic status, the decreased group experienced difficulties in accessing required foods because of shortages and congestion in grocery stores, as well as increased prices. Additionally, food-related information needs regarding reduction of food expenses were also high among the decreased group.Conclusion Participants with a decreased household income were more likely to experience difficulties with food accessibility and desire information about lowering food-related expenses. Furthermore, they reported lower frequency of eating out, and higher frequency of home-cooking and consuming ready-to-eat convenience meals during the confinement period than before the pandemic. Future studies should evaluate the direction (positive or negative) of these changed food consumption patterns.


Subject(s)
COVID-19 , Pandemics , Adult , Child , Cross-Sectional Studies , Diet , Economic Status , Feeding Behavior , Humans , SARS-CoV-2
10.
Acta Oncol ; 60(8): 1019-1024, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1337164

ABSTRACT

BACKGROUND: The COVID-19 pandemic has caused excess deaths (all causes) and has disproportionately affected the elderly with certain characteristics. OBJECTIVES: To study how COVID-19 affected cancer deaths regarding age, sex, socio-economic status, comorbidities, and access to palliative care. An additional objective was to study changes in place of care and death. MATERIAL AND METHODS: A descriptive, retrospective study of all cancer patients who died during March-May 2020 in the Stockholm region, n = 1467 of which 278 died with a COVID-19 diagnosis, compared with deaths in 2016-2019. The Stockholm Regional Council's central data warehouse was used. T-tests, 95% CI, Wilcoxon and chi-squared tests were used for comparisons. RESULTS: There were excess cancer deaths compared with 2016-2019 (p < 0.001) and patients dying with a COVID-19 diagnosis were older (79.7 vs. 75.9 years, p < 0.0001), more often male (67% vs. 55%, p < 0.0001), and had more comorbidities (Charlson Comorbidity Index 1.6 vs. 1.1, p < 0.0001). Patients with COVID-19 more seldom had access to palliative care (34% vs. 59%, p = 0.008), had more changes in place of care during the last two weeks of life (p < 0.0001) and died more often in acute hospitals (34% vs. 14%, p < 0.0001). For the subgroup with access to palliative care, the hospital deaths for individuals with and without a COVID-19 diagnosis were 11% and 4%, respectively (p = 0.008). CONCLUSION: Cancer patients dying with a COVID-19 diagnosis were older, more often male, and had more comorbidities. A COVID-19 diagnosis negatively affected the probability of being admitted to specialized palliative care and increased the likelihood of dying in an acute hospital.


Subject(s)
COVID-19 , Neoplasms , Aged , COVID-19 Testing , Comorbidity , Economic Status , Humans , Neoplasms/epidemiology , Pandemics , Retrospective Studies , SARS-CoV-2
12.
BMC Pregnancy Childbirth ; 21(1): 477, 2021 Jul 02.
Article in English | MEDLINE | ID: covidwho-1295449

ABSTRACT

BACKGROUND: During public health emergencies, including the COVID-19 pandemic, access to adequate healthcare is crucial for providing for the health and wellbeing of families. Pregnant and postpartum people are a particularly vulnerable subgroup to consider when studying healthcare access. Not only are perinatal people likely at higher risk for illness, mortality, and morbidity from COVID-19 infection, they are also at higher risk for negative outcomes due to delayed or inadequate access to routine care. METHODS: We surveyed 820 pregnant people in California over two waves of the COVID-19 pandemic: (1) a 'non-surge' wave (June 2020, n = 433), and (2) during a 'surge' in cases (December 2020, n = 387) to describe current access to perinatal healthcare, as well as concerns and decision-making regarding childbirth, over time. We also examined whether existing structural vulnerabilities - including acute financial insecurity and racial/ethnic minoritization - are associated with access, concerns, and decision-making over these two waves. RESULTS: Pregnant Californians generally enjoyed more access to, and fewer concerns about, perinatal healthcare during the winter of 2020-2021, despite surging COVID-19 cases and hospitalizations, as compared to those surveyed during the COVID-19 'lull' in the summer of 2020. However, across 'surge' and 'non-surge' pandemic circumstances, marginalized pregnant people continued to fare worse - especially those facing acute financial difficulty, and racially minoritized individuals identifying as Black or Indigenous. CONCLUSIONS: It is important for clinicians, researchers, and policymakers to understand whether and how shifting community transmission and infection rates may impact access to perinatal healthcare. Targeting minoritized and financially insecure communities for increased upstream perinatal healthcare supports are promising avenues to blunt the negative impacts of the COVID-19 pandemic on pregnant people in California.


Subject(s)
COVID-19 , Decision Making , Economic Status , Health Services Accessibility , Perinatal Care , Adolescent , Adult , Birth Setting , COVID-19/epidemiology , California/epidemiology , Female , Humans , Minority Groups , Parturition , Pregnancy , Prenatal Care , SARS-CoV-2 , Surveys and Questionnaires , Young Adult
13.
Sci Rep ; 11(1): 13069, 2021 06 22.
Article in English | MEDLINE | ID: covidwho-1279895

ABSTRACT

Mobility restrictions have been identified as key non-pharmaceutical interventions to limit the spread of the SARS-COV-2 epidemics. However, these interventions present significant drawbacks to the social fabric and negative outcomes for the real economy. In this paper we propose a real-time monitoring framework for tracking the economic consequences of various forms of mobility reductions involving European countries. We adopt a granular representation of mobility patterns during both the first and second waves of SARS-COV-2 in Italy, Germany, France and Spain to provide an analytical characterization of the rate of losses of industrial production by means of a nowcasting methodology. Our approach exploits the information encoded in massive datasets of human mobility provided by Facebook and Google, which are published at higher frequencies than the target economic variables, in order to obtain an early estimate before the official data becomes available. Our results show, in first place, the ability of mobility-related policies to induce a contraction of mobility patterns across jurisdictions. Besides this contraction, we observe a substitution effect which increases mobility within jurisdictions. Secondly, we show how industrial production strictly follows the dynamics of population commuting patterns and of human mobility trends, which thus provide information on the day-by-day variations in countries' economic activities. Our work, besides shedding light on how policy interventions targeted to induce a mobility contraction impact the real economy, constitutes a practical toolbox for helping governments to design appropriate and balanced policy actions aimed at containing the SARS-COV-2 spread, while mitigating the detrimental effect on the economy. Our study reveals how complex mobility patterns can have unequal consequences to economic losses across countries and call for a more tailored implementation of restrictions to balance the containment of contagion with the need to sustain economic activities.


Subject(s)
COVID-19/epidemiology , Economic Status , Travel , COVID-19/pathology , COVID-19/virology , Europe/epidemiology , Humans , Pandemics , Quarantine , SARS-CoV-2/isolation & purification , Social Media
14.
Euro Surveill ; 26(20)2021 05.
Article in English | MEDLINE | ID: covidwho-1273317

ABSTRACT

BackgroundPopulation-based studies characterising outcomes of COVID-19 in European settings are limited, and effects of socio-economic status (SES) on outcomes have not been widely investigated. AimWe describe the epidemiological characteristics of COVID-19 cases, highlighting incidence and mortality rate differences across SES during the first wave in Barcelona, Catalonia, Spain.MethodsThis population-based study reports individual-level data of laboratory-confirmed COVID-19 cases diagnosed from 24 February to 4 May 2020, notified to the Public Health Agency of Barcelona and followed until 15 June 2020. We analysed end-of-study vital status and the effects of chronic conditions on mortality using logistic regression. Geocoded addresses were linked to basic health area SES data, estimated using the composed socio-economic index. We estimated age-standardised incidence, hospitalisation, and mortality rates by SES.ResultsOf 15,554 COVID-19-confirmed cases, the majority were women (n = 9,028; 58%), median age was 63 years (interquartile range: 46-83), 8,046 (54%) required hospitalisation, and 2,287 (15%) cases died. Prevalence of chronic conditions varied across SES, and multiple chronic conditions increased risk of death (≥ 3, adjusted odds ratio: 2.3). Age-standardised rates (incidence, hospitalisation, mortality) were highest in the most deprived SES quartile (incidence: 1,011 (95% confidence interval (CI): 975-1,047); hospitalisation: 619 (95% CI: 591-648); mortality: 150 (95% CI: 136-165)) and lowest in the most affluent (incidence: 784 (95% CI: 759-809); hospitalisation: 400 (95% CI: 382-418); mortality: 121 (95% CI: 112-131)).ConclusionsCOVID-19 outcomes varied markedly across SES, underscoring the need to implement effective preventive strategies for vulnerable populations.


Subject(s)
COVID-19 , Economic Status , Female , Humans , Incidence , Male , Middle Aged , SARS-CoV-2 , Socioeconomic Factors , Spain/epidemiology
15.
West J Emerg Med ; 22(3): 552-560, 2021 Apr 28.
Article in English | MEDLINE | ID: covidwho-1266882

ABSTRACT

INTRODUCTION: In March 2020, shelter-in-place orders were enacted to attenuate the spread of coronavirus 2019 (COVID-19). Emergency departments (EDs) experienced unexpected and dramatic decreases in patient volume, raising concerns about exacerbating health disparities. METHODS: We queried our electronic health record to describe the overall change in visits to a two-ED healthcare system in Northern California from March-June 2020 compared to 2019. We compared weekly absolute numbers and proportional change in visits focusing on race/ethnicity, insurance, household income, and acuity. We calculated the z-score to identify whether there was a statistically significant difference in proportions between 2020 and 2019. RESULTS: Overall ED volume declined 28% during the study period. The nadir of volume was 52% of 2019 levels and occurred five weeks after a shelter-in-place order was enacted. Patient demographics also shifted. By week 4 (April 5), the proportion of Hispanic patients decreased by 3.3 percentage points (pp) (P = 0.0053) compared to a 6.2 pp increase in White patients (P = 0.000005). The proportion of patients with commercial insurance increased by 11.6 pp, while Medicaid visits decreased by 9.5 pp (P < 0.00001) at the initiation of shelter-in-place orders. For patients from neighborhoods <300% federal poverty levels (FPL), visits were -3.8 pp (P = 0.000046) of baseline compared to +2.9 pp (P = 0.0044) for patients from ZIP codes at >400% FPL the week of the shelter-in-place order. Overall, 2020 evidenced a consistently elevated proportion of high-acuity Emergency Severity Index (ESI) level 1 patients compared to 2019. Increased acuity was also demonstrated by an increase in the admission rate, with a 10.8 pp increase from 2019. Although there was an increased proportion of high-acuity patients, the overall census was decreased. CONCLUSION: Our results demonstrate changing ED utilization patterns circa the shelter-in-place orders. Those from historically vulnerable populations such as Hispanics, those from lower socioeconomic areas, and Medicaid users presented at disproportionately lower rates and numbers than other groups. As the pandemic continues, hospitals should use operations data to monitor utilization patterns by demographic, in addition to clinical indicators. Messaging about availability of emergency care and other services should include vulnerable populations to avoid exacerbating healthcare disparities.


Subject(s)
COVID-19/ethnology , Emergency Service, Hospital/statistics & numerical data , Healthcare Disparities/statistics & numerical data , Adolescent , Adult , Aged , Child , Child, Preschool , Economic Status/statistics & numerical data , Humans , Infant , Infant, Newborn , Insurance, Health/statistics & numerical data , Male , Medicaid/statistics & numerical data , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index , United States/epidemiology , Young Adult
16.
J Empir Res Hum Res Ethics ; 16(3): 179-187, 2021 07.
Article in English | MEDLINE | ID: covidwho-1247550

ABSTRACT

Individuals throughout the world are being recruited into studies to examine the social impacts of coronavirus disease 2019 (COVID-19). While previous literature has illustrated how research participation can impact distress and wellbeing, to the authors' best knowledge no study has examined this in the COVID-19 context. Using an innovative approach, this study analyses the impacts of participation in a COVID-19 survey in Australia on subjective wellbeing through a survey experiment. At a population level, we find no evidence that participation impacts subjective wellbeing. However, this may not hold for those with mental health concerns and those living in financial insecurity. These findings provide the research community with a deeper understanding of the potential wellbeing impacts from COVID-19-related research participation.


Subject(s)
COVID-19 , Personal Satisfaction , Surveys and Questionnaires , Adolescent , Adult , Australia/epidemiology , COVID-19/epidemiology , Economic Status , Female , Happiness , Humans , Male , Mental Health/statistics & numerical data , Young Adult
17.
PLoS One ; 16(5): e0250940, 2021.
Article in English | MEDLINE | ID: covidwho-1216958

ABSTRACT

BACKGROUND: The emergence of a pandemic presents challenges and opportunities for healthcare, health promotion interventions, and overall improvement in healthcare seeking behaviour. This study explored the impact of COVID-19 on health knowledge, lifestyle, and healthcare seeking behaviour among residents of a resource-limited setting in Ghana. METHODS: This qualitative study adopted an exploratory design to collect data from 20 adult residents in the Cape Coast Metropolis using face-to-face in-depth interviews. Data collected were analysed thematically and statements from participants presented verbatim to illustrate the themes realised. RESULTS: Health knowledge has improved due to COVID-19 in terms of access to health information and increased understanding of health issues. There were reductions in risky health-related lifestyles (alcohol intake, sharing of personal items, and consumption of junk foods) while improvements were observed in healthy lifestyles such as regular physical exercise and increased consumption of fruits and vegetables. COVID-19 also positively impacted health seeking behaviour through increased health consciousness and regular check-ups. However, reduced healthcare utilization was prevalent. CONCLUSION: The COVID-19 pandemic has presented a positive cue to action and helped improved health knowledge, lifestyle, and care seeking behaviour although existing health system constrains and low economic status reduced healthcare utilization. To improve health systems, health-related lifestyles and healthcare seeking behaviour as well as overall health outcomes even after the pandemic wades off, COVID-19 associated conscious and unconscious reforms should be systematically harnessed.


Subject(s)
COVID-19/pathology , Health Behavior , Knowledge , Adult , COVID-19/epidemiology , COVID-19/virology , Economic Status , Female , Ghana/epidemiology , Humans , Interviews as Topic , Life Style , Male , Middle Aged , Pandemics , SARS-CoV-2/isolation & purification , Surveys and Questionnaires
18.
PLoS One ; 16(4): e0249270, 2021.
Article in English | MEDLINE | ID: covidwho-1207628

ABSTRACT

This paper investigates economic impacts of COVID-19 on households based on differences in the socio-economic status (SES). We determine the household-level effects of the COVID-19 shock using income sources, types of industries, communities' resilience, household susceptibility, and relevant policy measures. For this purpose, we used primary data of 555 households collected through snowball sampling technique using an online survey questionnaire from different villages mostly located in Sichuan Province, China. Using step-wise binary logistic regression analysis, we estimated and validated the model. Results suggest the use of SES as a better measure for understanding the impacts of COVID-19 on different households. We find that households with low SES tend to depend more on farmland income and transfer payments from the government. Contrarily, high SES households focus more on business and local employment as sources of income generation. Poor households were less resilient and more likely to fall back into poverty due to COVID-19, while the opposite stands true for non-poor households with high SES. Based on the estimations, policies encouraging employment and businesses complemented with loans on lower interest rates are recommended, which may increase the SES, thus minimizing vulnerability and enhancing the households' resilience towards poverty alleviation and economic shocks.


Subject(s)
COVID-19 , Employment , Poverty , COVID-19/epidemiology , China/epidemiology , Economic Status , Family Characteristics , Humans , SARS-CoV-2/isolation & purification , Social Class , Socioeconomic Factors
19.
BMJ Open ; 11(3): e047310, 2021 03 31.
Article in English | MEDLINE | ID: covidwho-1166513

ABSTRACT

OBJECTIVE: We assessed the impact of key population variables (age, gender, income and education) on perceptions of governmental effectiveness in communicating about COVID-19, helping meet needs for food and shelter, providing physical and mental healthcare services, and allocating dedicated resources to vulnerable populations. DESIGN: Cross-sectional study carried out in June 2020. PARTICIPANTS AND SETTING: 13 426 individuals from 19 countries. RESULTS: More than 60% of all respondents felt their government had communicated adequately during the pandemic. National variances ranged from 83.4% in China down to 37.2% in Brazil, but overall, males and those with a higher income were more likely to rate government communications highly. Almost half (48.8%) of the respondents felt their government had ensured adequate access to physical health services (ranging from 89.3% for Singapore to 27.2% for Poland), with higher ratings reported by younger and higher-income respondents. Ratings of mental health support were lower overall (32.9%, ranging from 74.8% in China to around 15% in Brazil and Sweden), but highest among younger respondents. Providing support for basic necessities of food and housing was rated highest overall in China (79%) and lowest in Ecuador (14.6%), with higher ratings reported by younger, higher-income and better-educated respondents across all countries. The same three demographic groups tended to rate their country's support to vulnerable groups more highly than other respondents, with national scores ranging from around 75% (Singapore and China) to 19.5% (Sweden). Subgroup findings are mostly independent of intercountry variations with 15% of variation being due to intercountry differences. CONCLUSIONS: The tendency of younger, better-paid and better-educated respondents to rate their country's response to the pandemic more highly, suggests that government responses must be nuanced and pay greater attention to the needs of less-advantaged citizens as they continue to address this pandemic.


Subject(s)
COVID-19/prevention & control , Government Programs , Pandemics/legislation & jurisprudence , Age Factors , COVID-19/epidemiology , Cross-Sectional Studies , Economic Status , Government , Humans , Male , SARS-CoV-2 , Sex Factors , Socioeconomic Factors
20.
Milbank Q ; 99(2): 503-518, 2021 06.
Article in English | MEDLINE | ID: covidwho-1158075

ABSTRACT

Policy Points  The United States finds itself in the middle of an unprecedented combination of crises: a global pandemic, economic crisis, and unprecedented civic responses to structural racism.  While public sector responses to these crises have faced much justified criticism, the commercial determinants of these crises have not been sufficiently examined.  In this commentary we examine the nature of the contributions of such actors to the conditions that underpin these crises in the United States through their market and nonmarket activities.  On the basis of this analysis, we make recommendations on the role of governance and civil society in relation to such commercial actors in a post-COVID-19 world.


Subject(s)
COVID-19/epidemiology , Economic Status , Racism , Social Determinants of Health , Health Status Disparities , Humans , Industry/ethics , Industry/trends , Pandemics , Population Health , SARS-CoV-2 , United States
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