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3.
JAMA ; 327(6): 588-589, 2022 02 08.
Article in English | MEDLINE | ID: covidwho-2172107
4.
J Health Soc Behav ; 63(4): 471, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2153296
5.
Lancet Public Health ; 7(11): e966-e975, 2022 11.
Article in English | MEDLINE | ID: covidwho-2150892

ABSTRACT

COVID-19 has exacerbated endemic health inequalities resulting in a syndemic pandemic of higher mortality and morbidity rates among the most socially disadvantaged. We did a scoping review to identify and synthesise published evidence on geographical inequalities in COVID-19 mortality rates globally. We included peer-reviewed studies, from any country, written in English that showed any area-level (eg, neighbourhood, town, city, municipality, or region) inequalities in mortality by socioeconomic deprivation (ie, measured via indices of multiple deprivation: the percentage of people living in poverty or proxy factors including the Gini coefficient, employment rates, or housing tenure). 95 papers from five WHO global regions were included in the final synthesis. A large majority of the studies (n=86) found that COVID-19 mortality rates were higher in areas of socioeconomic disadvantage than in affluent areas. The subsequent discussion reflects on how the unequal nature of the pandemic has resulted from a syndemic of COVID-19 and endemic inequalities in chronic disease burden.


Subject(s)
COVID-19 , Pandemics , Humans , Syndemic , Health Status Disparities , Residence Characteristics
6.
BMC Public Health ; 22(1): 2131, 2022 11 19.
Article in English | MEDLINE | ID: covidwho-2139231

ABSTRACT

BACKGROUND: Vaccination reduces the overall burden of COVID-19, while its allocation procedure may introduce additional health inequality, since populations characterized with certain social vulnerabilities have received less vaccination and been affected more by COVID-19. We used structural equation modeling to quantitatively evaluate the extent to which vaccination disparity would amplify health inequality, where it functioned as a mediator in the effect pathways from social vulnerabilities to COVID-19 mortality. METHODS: We used USA nationwide county (n = 3112, 99% of the total) level data during 2021 in an ecological study design. Theme-specific rankings of social vulnerability index published by CDC (latest data of 2018, including socioeconomic status, household composition & disability, minority status & language, and housing type & transportation) were the exposure variables. Vaccination coverage rate (VCR) during 2021 published by CDC was the mediator variable, while COVID-19 case fatality rate (CFR) during 2021 published by John Hopkinson University, the outcome variable. RESULTS: Greater vulnerabilities in socioeconomic status, household composition & disability, and minority status & language were inversely associated with VCR, together explaining 11.3% of the variance of VCR. Greater vulnerabilities in socioeconomic status and household composition & disability were positively associated with CFR, while VCR was inversely associated with CFR, together explaining 10.4% of the variance of CFR. Our mediation analysis, based on the mid-year data (30th June 2021), found that 37.6% (mediation/total effect, 0.0014/0.0037), 10% (0.0003/0.0030) and 100% (0.0005/0.0005) of the effects in the pathways involving socioeconomic status, household composition & disability and minority status & language, respectively, were mediated by VCR. As a whole, the mediation effect significantly counted for 30.6% of COVID-19 CFR disparity. Such a mediation effect was seen throughout 2021, with proportions ranging from 12 to 32%. CONCLUSIONS: Allocation of COVID-19 vaccination in the USA during 2021 led to additional inequality with respect to COVID-19 mortality. Viable public health interventions should be taken to guarantee an equitable deployment of healthcare recourses across different population groups.


Subject(s)
COVID-19 , Health Status Disparities , Humans , United States/epidemiology , COVID-19/prevention & control , Socioeconomic Factors , COVID-19 Vaccines , Social Vulnerability , Vaccination
9.
Int J Environ Res Public Health ; 19(22)2022 Nov 12.
Article in English | MEDLINE | ID: covidwho-2110103

ABSTRACT

Nature-based solutions (NbS), including green social prescribing (GSP), are sustainable ways to address health and wellbeing, especially since the COVID-19 pandemic exacerbated the strain on healthcare. NbS require national and local cross-sector coordination across complex, interrelated systems, but little is known about the specific challenges this poses for community-led NbS. We carried out a traditional literature review to establish the context and knowledge base for this study and interviewed 26 stakeholders. These came from environment, health and social care sectors at national and local levels, with local-level stakeholders from Bradford and Walsall: English cities significantly affected by the pandemic, with high levels of deprivation and health inequality. The interviews explored experiences of implementing NbS, both pre- and post-pandemic and the resulting renewed interest in the salutogenic effects of engaging with natural environments. We coded the interview transcriptions using NVivo to identify the challenges existing in the systems within which these stakeholders operate to create and manage NbS. By synthesizing what is known about the challenges from existing literature with findings from the interviews, we developed eight categories of challenges (perception and knowledge, political, financial, access to natural spaces, engagement, institutional and organisational, coordination, GSP referral and services) faced by multiple sectors in implementing community-led NbS in England. Furthermore, this study highlights the new challenges related to the pandemic. Identifying these challenges helps stakeholders in existing complex systems recognise what is needed to support and mainstream NbS in England.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Negotiating , Pandemics/prevention & control , Health Status Disparities , Cities
10.
Lancet Respir Med ; 10(11): 1009, 2022 11.
Article in English | MEDLINE | ID: covidwho-2106216
13.
Int J Environ Res Public Health ; 19(21)2022 Oct 27.
Article in English | MEDLINE | ID: covidwho-2090150

ABSTRACT

The SARS-CoV-2 virus responsible for the COVID-19 pandemic continues to spread worldwide, with over half a billion cases linked to over 6 million deaths globally. COVID-19 has impacted populations unequally based on income, age, race, sex, and geographical location. This study aimed to characterize COVID-19 incidence and death rate trends in six states of the southern region of the USA and to understand the demographic and racial differences in its incidence and death rates. Data for the study were collected from the COVID-19 Data tracker of the Centers for Disease Control and Prevention for the following southern states: Alabama (AL), Florida (FL), Georgia (GA), Louisiana (LA), Mississippi (MS), and Tennessee (TN). The results showed a significant geographical variation in the COVID-19 cases and related deaths. Significant variations in COVID-19 cases and death rates were observed among different races and ethnic groups. The highest number of COVID-19 cases were observed among the Hispanic and Black populations, and the highest death rates were found among non-Hispanic Blacks and Whites. The southern states included in this paper showed a high number of COVID-19 cases and high death rates during the study period. These increased rates may result from the low socioeconomic status and large minority populations.


Subject(s)
COVID-19 , United States/epidemiology , Humans , COVID-19/epidemiology , Ethnicity , SARS-CoV-2 , Pandemics , Incidence , Health Status Disparities
15.
BMJ ; 378: o2369, 2022 09 30.
Article in English | MEDLINE | ID: covidwho-2064121
16.
17.
Sociol Health Illn ; 44(8): 1211-1213, 2022 09.
Article in English | MEDLINE | ID: covidwho-2052134
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