Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 14 de 14
Filter
1.
Pediatr Clin North Am ; 68(6): 1157-1169, 2021 12.
Article in English | MEDLINE | ID: covidwho-1504878

ABSTRACT

Pediatric gastroenterologists took on a variety of challenges during the coronavirus disease 2019 pandemic, including learning about a new disease and how to recognize and manage it, prevent its spread among their patients and health professions colleagues, and make decisions about managing patients with chronic gastrointestinal and liver problems in light of the threat. They adapted their practice to accommodate drastically decreased numbers of in-person visits, adopting telehealth technologies, and instituting new protocols to perform endoscopies safely. The workforce pipeline was also affected by the impact of the pandemic on trainee education, clinical experience, research, and job searches.


Subject(s)
COVID-19/epidemiology , Child Welfare/statistics & numerical data , Gastroenterology/organization & administration , Health Equity/statistics & numerical data , Healthcare Disparities/statistics & numerical data , Social Determinants of Health , Child , Health Services Accessibility/organization & administration , Health Status Disparities , Humans , Socioeconomic Factors , United States
4.
J Prev Med Public Health ; 54(1): 1-7, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1314808

ABSTRACT

The Korean government's strategy to combat coronavirus disease 2019 (COVID-19) has focused on non-pharmaceutical interventions, such as social distancing and wearing masks, along with testing, tracing, and treatment; overall, its performance has been relatively good compared to that of many other countries heavily affected by COVID-19. However, little attention has been paid to health equity in measures to control the COVID-19 pandemic. The study aimed to examine the unequal impacts of COVID-19 across socioeconomic groups and to suggest potential solutions to tackle these inequalities. The pathways linking social determinants and health could be entry points to tackle the unequal consequences of this public health emergency. It is crucial for infectious disease policy to consider social determinants of health including poor housing, precarious working conditions, disrupted healthcare services, and suspension of social services. Moreover, the high levels of uncertainty and complexity inherent in this public health emergency, as well as the health and socioeconomic inequalities caused by the pandemic, underscore the need for good governance other than top-down measures by the government. We emphasize that a people-centered perspective is a key approach during the pandemic era. Mutual trust between the state and civil society, strong accountability of the government, and civic participation are essential components of cooperative disaster governance.


Subject(s)
COVID-19/prevention & control , Health Equity/standards , Health Policy , Infectious Disease Medicine/legislation & jurisprudence , COVID-19/physiopathology , Government Programs/legislation & jurisprudence , Government Programs/methods , Health Equity/statistics & numerical data , Humans , Infectious Disease Medicine/methods , Infectious Disease Medicine/trends , Pandemics/prevention & control , Pandemics/statistics & numerical data , Public Health/legislation & jurisprudence , Public Health/methods , Public Health/trends , Republic of Korea
6.
Am Soc Clin Oncol Educ Book ; 41: e13-e19, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1249567

ABSTRACT

The COVID-19 pandemic and the simultaneous increased focus on structural racism and racial/ethnic disparities across the United States have shed light on glaring inequities in U.S. health care, both in oncology and more generally. In this article, we describe how, through the lens of fundamental ethical principles, an ethical imperative exists for the oncology community to overcome these inequities in cancer care, research, and the oncology workforce. We first explain why this is an ethical imperative, centering the discussion on lessons learned during 2020. We continue by describing ongoing equity-focused efforts by ASCO and other related professional medical organizations. We end with a call to action-all members of the oncology community have an ethical responsibility to take steps to address inequities in their clinical and academic work-and with guidance to practicing oncologists looking to optimize equity in their research and clinical practice.


Subject(s)
Health Equity/statistics & numerical data , Health Status Disparities , Healthcare Disparities/statistics & numerical data , Medical Oncology/methods , Neoplasms/therapy , Racism/prevention & control , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/virology , Health Equity/ethics , Healthcare Disparities/ethics , Humans , Medical Oncology/ethics , Medical Oncology/organization & administration , Neoplasms/diagnosis , Pandemics , Public Health/ethics , Public Health/methods , Public Health/statistics & numerical data , Racism/ethics , SARS-CoV-2/isolation & purification , SARS-CoV-2/physiology , United States
7.
J Community Psychol ; 49(6): 1718-1731, 2021 08.
Article in English | MEDLINE | ID: covidwho-1231854

ABSTRACT

Large amounts of text-based data, like study abstracts, often go unanalyzed because the task is laborious. Natural language processing (NLP) uses computer-based algorithms not traditionally implemented in community psychology to effectively and efficiently process text. These methods include examining the frequency of words and phrases, the clustering of topics, and the interrelationships of words. This article applied NLP to explore the concept of equity in community psychology. The COVID-19 crisis has made pre-existing health equity gaps even more salient. Community psychology has a specific interest in working with organizations, systems, and communities to address social determinants that perpetuate inequities by refocusing interventions around achieving health and wellness for all. This article examines how community psychology has discussed equity thus far to identify strengths and gaps for future research and practice. The results showed the prominence of community-based participatory research and the diversity of settings researchers work in. However, the total number of abstracts with equity concepts was lower than expected, which suggests there is a need for a continued focus on equity.


Subject(s)
Community Psychiatry/methods , Community-Based Participatory Research/methods , Health Equity/statistics & numerical data , Knowledge Discovery/methods , Natural Language Processing , Social Determinants of Health/statistics & numerical data , Humans , Periodicals as Topic
9.
Emerg Med J ; 38(6): 474-476, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1120760

ABSTRACT

The use of telemedicine has grown immensely during the COVID-19 pandemic. Telemedicine provides a means to deliver clinical care while limiting patient and provider exposure to the COVID-19. As such, telemedicine is finding applications in a variety of clinical environments including primary care and the acute care setting and the array of patient populations who use telemedicine continues to grow. Yet as telehealth becomes ubiquitous, it is critical to consider its potential to exacerbate disparities in care. Challenges accessing technology and digital literacy, for example, disproportionately impact older patients and those living in poverty. When implemented with the consideration of health disparities, telemedicine provides an opportunity to address these inequities. This manuscript explores potential mechanisms by which telemedicine may play a role in exacerbating or ameliorating disparities in care. We further describe a framework and suggested strategies with which to implement telemedicine systems to improve health equity.


Subject(s)
Digital Divide , Health Equity/organization & administration , Telemedicine/organization & administration , COVID-19/epidemiology , COVID-19/therapy , Health Equity/statistics & numerical data , Healthcare Disparities/organization & administration , Healthcare Disparities/statistics & numerical data , Humans , Telemedicine/statistics & numerical data
10.
Acad Med ; 96(6): 795-797, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1006108

ABSTRACT

Global health and its predecessors, tropical medicine and international health, have historically been driven by the agendas of institutions in high-income countries (HICs), with power dynamics that have disadvantaged partner institutions in low- and middle-income countries (LMICs). Since the 2000s, however, the academic global health community has been moving toward a focus on health equity and reexamining the dynamics of global health education (GHE) partnerships. Whereas GHE partnerships have largely focused on providing opportunities for learners from HIC institutions, LMIC institutions are now seeking more equitable experiences for their trainees. Additionally, lessons from the COVID-19 pandemic underscore already important lessons about the value of bidirectional educational exchange, as regions gain new insights from one another regarding strategies to impact health outcomes. Interruptions in experiential GHE programs due to COVID-19-related travel restrictions provide an opportunity to reflect on existing GHE systems, to consider the opportunities and dynamics of these partnerships, and to redesign these systems for the equitable benefit of the various partners. In this commentary, the authors offer recommendations for beginning this process of change, with an emphasis on restructuring GHE relationships and addressing supremacist attitudes at both the systemic and individual levels.


Subject(s)
Developing Countries/economics , Global Health/education , Health Equity/statistics & numerical data , Training Support/methods , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Developing Countries/statistics & numerical data , Health Education/statistics & numerical data , Health Equity/trends , Humans , Interdisciplinary Communication , International Cooperation , Leadership , SARS-CoV-2/isolation & purification
11.
J Urban Health ; 97(6): 759-775, 2020 12.
Article in English | MEDLINE | ID: covidwho-778022

ABSTRACT

Reduced access to school meals during public health emergencies can accelerate food insecurity and nutritional status, particularly for low-income children in urban areas. To prevent the exacerbation of health disparities, there is a need to understand the implementation of meal distribution among large urban school districts during emergencies and to what degree these strategies provide equitable meal access. Our case study of four large urban school districts during the COVID-19 pandemic aims to address these knowledge gaps. Guided by the Getting to Equity (GTE) framework, we conducted a mixed-methods study evaluating emergency meal distribution and strategy implementation in four large urban school districts (Chicago Public Schools, Houston Independent School District, Los Angeles Unified School District, and New York City Department of Education). We gathered data from school district websites on (1) meal service and delivery sites and (2) district documents, policies, communication, and resources. Using qualitative coding approaches, we identified unique and shared district strategies to address meal distribution and communications during the pandemic according to the four components of the GTE framework: increase healthy options, reduce deterrents, build on community capacity, and increase social and economic resources. We matched district census tract boundaries to demographic data from the 2018 American Community Survey and United States Department of Agriculture food desert data, and used geographic information systems (GIS) software to identify meal site locations relative to student population, areas of high poverty and high minority populations, and food deserts. We found that all districts developed strategies to optimize meal provision, which varied across case site. Strategies to increase healthy options included serving adults and other members of the general public, providing timely information on meal site locations, and promoting consumption of a balanced diet. The quantity and frequency of meals served varied, and the degree to which districts promoted high-quality nutrition was limited. Reducing deterrents related to using inclusive language and images and providing safety information on social distancing practices in multiple languages. Districts built community capacity through partnering with first responder, relief, and other community organizations. Increased social and economic resources were illustrated by providing technology assistance to families, childcare referrals for essential workers, and other wellness resources. Geospatial analysis suggests that service locations across cities varied to some degree by demographics and food environment, with potential gaps in reach. This study identifies strategies that have the potential to increase equitable access to nutrition assistance programs. Our findings can support (1) ongoing efforts to address child food insecurity during the pandemic and (2) future meal provision through programs like the Summer Food Service Program and Seamless Summer Option. Future research should further examine the rationale behind meal site placement and how site availability changed over time.


Subject(s)
COVID-19/epidemiology , Food Assistance/organization & administration , Food Insecurity , Food Services/organization & administration , Health Equity/statistics & numerical data , Schools/organization & administration , Child , Female , Food Assistance/statistics & numerical data , Food Services/statistics & numerical data , Humans , Male , Meals , Pandemics , Poverty , SARS-CoV-2 , Schools/statistics & numerical data , Socioeconomic Factors , United States , United States Department of Agriculture , Urban Population
13.
J Clin Epidemiol ; 128: 35-48, 2020 12.
Article in English | MEDLINE | ID: covidwho-591727

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a global pandemic. Governments have implemented combinations of "lockdown" measures of various stringencies, including school and workplace closures, cancellations of public events, and restrictions on internal and external movements. These policy interventions are an attempt to shield high-risk individuals and to prevent overwhelming countries' healthcare systems, or, colloquially, "flatten the curve." However, these policy interventions may come with physical and psychological health harms, group and social harms, and opportunity costs. These policies may particularly affect vulnerable populations and not only exacerbate pre-existing inequities but also generate new ones. METHODS: We developed a conceptual framework to identify and categorize adverse effects of COVID-19 lockdown measures. We based our framework on Lorenc and Oliver's framework for the adverse effects of public health interventions and the PROGRESS-Plus equity framework. To test its application, we purposively sampled COVID-19 policy examples from around the world and evaluated them for the potential physical, psychological, and social harms, as well as opportunity costs, in each of the PROGRESS-Plus equity domains: Place of residence, Race/ethnicity, Occupation, Gender/sex, Religion, Education, Socioeconomic status, Social capital, Plus (age, and disability). RESULTS: We found examples of inequitably distributed adverse effects for each COVID-19 lockdown policy example, stratified by a low- or middle-income country and high-income country, in every PROGRESS-Plus equity domain. We identified the known policy interventions intended to mitigate some of these adverse effects. The same harms (anxiety, depression, food insecurity, loneliness, stigma, violence) appear to be repeated across many groups and are exacerbated by several COVID-19 policy interventions. CONCLUSION: Our conceptual framework highlights the fact that COVID-19 policy interventions can generate or exacerbate interactive and multiplicative equity harms. Applying this framework can help in three ways: (1) identifying the areas where a policy intervention may generate inequitable adverse effects; (2) mitigating the policy and practice interventions by facilitating the systematic examination of relevant evidence; and (3) planning for lifting COVID-19 lockdowns and policy interventions around the world.


Subject(s)
COVID-19/epidemiology , COVID-19/therapy , Health Equity/statistics & numerical data , Health Policy , Health Status Disparities , Public Health/standards , Quarantine/standards , Humans , Pandemics , Vulnerable Populations
SELECTION OF CITATIONS
SEARCH DETAIL
...