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1.
J Cyst Fibros ; 20 Suppl 3: 49-54, 2021 12.
Article in English | MEDLINE | ID: covidwho-1587337

ABSTRACT

BACKGROUND: Due to the COVID-19 pandemic, there was an uptake of telehealth in cystic fibrosis care. Previous studies show disparities in telehealth use based on socioeconomic status (SES). We aimed to: (1) understand telehealth use and perceptions and (2) identify the facilitators and barriers to telehealth use among people with CF and their families (PwCF) from diverse racial/ethnic and socioeconomic backgrounds. METHODS: We conducted an analysis of the 2020 Cystic Fibrosis State of Care surveys completed by PwCF (PFSoC), CF Care Programs (SoC1) and the CF Foundation Patient Registry (CFFPR). RESULTS: A total of 424 PwCF and 286 programs responded to the PFSoC and SoC1. Among PwCF, 90% self-identified as White, 6% as Hispanic/Latino, and 2% as Black. Racial/ethnic minorities were less likely to have had a telehealth visit (p=.015). This difference was pronounced among the Hispanic/Latino population (p<.01). Telehealth use did not differ by health insurance and was similarly offered independent of financial status. Compared to PwCF who denied financial constraints, those who reported financial difficulties found telehealth more difficult to use (p=.018) and were less likely to think that their concerns (p=.010) or issues that mattered most to them (p=.020) were addressed during telehealth. Programs perceived lack of technology, language barriers, and home conditions as barriers to telehealth in vulnerable populations. CONCLUSION: PFSoC and SoC1 identified differences in telehealth use and care perceptions by ethnicity, race, and socioeconomic characteristics. Further studies are needed to understand how telehealth can change access to CF care in diverse subpopulations.


Subject(s)
COVID-19 , Communication Barriers , Cystic Fibrosis , Minority Health , Telemedicine , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control/methods , Cystic Fibrosis/economics , Cystic Fibrosis/ethnology , Cystic Fibrosis/psychology , Cystic Fibrosis/therapy , Financial Stress/ethnology , Health Services Accessibility/organization & administration , Health Services Accessibility/trends , Healthcare Disparities/ethnology , Healthcare Disparities/standards , Humans , Minority Health/ethnology , Minority Health/standards , Minority Health/statistics & numerical data , Needs Assessment , Organizational Innovation , SARS-CoV-2 , Socioeconomic Factors , Telemedicine/organization & administration , Telemedicine/standards , United States/epidemiology , Vulnerable Populations/statistics & numerical data
2.
Sci Rep ; 11(1): 18117, 2021 09 13.
Article in English | MEDLINE | ID: covidwho-1406408

ABSTRACT

COVID-19 vaccination is being rapidly rolled out in the US and many other countries, and it is crucial to provide fast and accurate assessment of vaccination coverage and vaccination gaps to make strategic adjustments promoting vaccine coverage. We reported the effective use of real-time geospatial analysis to identify barriers and gaps in COVID-19 vaccination in a minority population living in South Texas on the US-Mexico Border, to inform vaccination campaign strategies. We developed 4 rank-based approaches to evaluate the vaccination gap at the census tract level, which considered both population vulnerability and vaccination priority and eligibility. We identified areas with the highest vaccination gaps using different assessment approaches. Real-time geospatial analysis to identify vaccination gaps is critical to rapidly increase vaccination uptake, and to reach herd immunity in the vulnerable and the vaccine hesitant groups. Our results assisted the City of Brownsville Public Health Department in adjusting real-time targeting of vaccination, gathering coverage assessment, and deploying services to areas identified as high vaccination gap. The analyses and responses can be adopted in other locations.


Subject(s)
COVID-19 Vaccines/immunology , COVID-19/immunology , Immunization Programs/statistics & numerical data , SARS-CoV-2/immunology , Vaccination Coverage/statistics & numerical data , Vaccination/statistics & numerical data , COVID-19/prevention & control , COVID-19/virology , COVID-19 Vaccines/administration & dosage , Geography , Humans , Immunization Programs/methods , Mexico/ethnology , Minority Groups/statistics & numerical data , Minority Health/statistics & numerical data , SARS-CoV-2/physiology , Socioeconomic Factors , Texas/ethnology , Vaccination/methods , Vaccination Coverage/methods , Vulnerable Populations/ethnology , Vulnerable Populations/statistics & numerical data
4.
Ann Glob Health ; 87(1): 34, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1173034

ABSTRACT

Background: Incidence and mortality from COVID-19 are starkly elevated in poor, minority and marginalized communities. These differences reflect longstanding disparities in income, housing, air quality, preexisting health status, legal protections, and access to health care. The COVID-19 pandemic and its economic consequences have made these ancient disparities plainly visible. Methodology: As scholars in Catholic research universities committed to advancing both scientific knowledge and social justice, we examined these disparities through the lenses of both epidemiology and ethics. Findings: We see these widening disparities as not only as threats to human health, societal stability, and planetary health, but also as moral wrongs - outward manifestations of unrecognized privilege and greed. They are the concrete consequences of policies that promote structural violence and institutionalize racism. Recommendations: We encourage governments to take the following three scientific and ethical justified actions to reduce disparities, prevent future pandemics, and advance the common good: (1) Invest in public health systems; (2) Reduce economic inequities by making health care affordable to all; providing education, including early education, to all children; strengthening environmental and occupational safeguards; and creating more just tax structures; and (3) Preserve our Common Home, the small blue planet on which we all live.


Subject(s)
COVID-19 , Health Status Disparities , Healthcare Disparities , Minority Health , Quality of Life , Social Justice/standards , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Global Health , Healthcare Disparities/ethics , Healthcare Disparities/standards , Healthcare Disparities/statistics & numerical data , Humans , Minority Health/ethics , Minority Health/standards , Minority Health/statistics & numerical data , Quality Improvement , Social Determinants of Health
5.
Emerg Infect Dis ; 27(4): 1032-1038, 2021 04.
Article in English | MEDLINE | ID: covidwho-1085129

ABSTRACT

The coronavirus disease (COVID-19) pandemic has severely impacted the meat processing industry in the United States. We sought to detail demographics and outcomes of severe acute respiratory syndrome coronavirus 2 infections among workers in Nebraska meat processing facilities and determine the effects of initiating universal mask policies and installing physical barriers at 13 meat processing facilities. During April 1-July 31, 2020, COVID-19 was diagnosed in 5,002 Nebraska meat processing workers (attack rate 19%). After initiating both universal masking and physical barrier interventions, 8/13 facilities showed a statistically significant reduction in COVID-19 incidence in <10 days. Characteristics and incidence of confirmed cases aligned with many nationwide trends becoming apparent during this pandemic: specifically, high attack rates among meat processing industry workers, disproportionately high risk of adverse outcomes among ethnic and racial minority groups and men, and effectiveness of using multiple prevention and control interventions to reduce disease transmission.


Subject(s)
COVID-19 , Disease Transmission, Infectious/prevention & control , Food-Processing Industry , Infection Control , Meat-Packing Industry , Adult , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Female , Food-Processing Industry/methods , Food-Processing Industry/organization & administration , Food-Processing Industry/trends , Humans , Incidence , Infection Control/instrumentation , Infection Control/methods , Infection Control/organization & administration , Male , Meat-Packing Industry/methods , Meat-Packing Industry/organization & administration , Meat-Packing Industry/trends , Minority Health/statistics & numerical data , Nebraska/epidemiology , Occupational Health/standards , Outcome Assessment, Health Care , Personal Protective Equipment/standards , Risk Assessment , SARS-CoV-2/isolation & purification , Workplace/standards
6.
Br J Gen Pract ; 70(699): e696-e704, 2020 10.
Article in English | MEDLINE | ID: covidwho-749112

ABSTRACT

BACKGROUND: The first wave of the London COVID-19 epidemic peaked in April 2020. Attention initially focused on severe presentations, intensive care capacity, and the timely supply of equipment. While general practice has seen a rapid uptake of technology to allow for virtual consultations, little is known about the pattern of suspected COVID-19 presentations in primary care. AIM: To quantify the prevalence and time course of clinically suspected COVID-19 presenting to general practices, to report the risk of suspected COVID-19 by ethnic group, and to identify whether differences by ethnicity can be explained by clinical data in the GP record. DESIGN AND SETTING: Cross-sectional study using anonymised data from the primary care records of approximately 1.2 million adults registered with 157 practices in four adjacent east London clinical commissioning groups. The study population includes 55% of people from ethnic minorities and is in the top decile of social deprivation in England. METHOD: Suspected COVID-19 cases were identified clinically and recorded using SNOMED codes. Explanatory variables included age, sex, self-reported ethnicity, and measures of social deprivation. Clinical factors included data on 16 long-term conditions, body mass index, and smoking status. RESULTS: GPs recorded 8985 suspected COVID-19 cases between 10 February and 30 April 2020.Univariate analysis showed a two-fold increase in the odds of suspected COVID-19 for South Asian and black adults compared with white adults. In a fully adjusted analysis that included clinical factors, South Asian patients had nearly twice the odds of suspected infection (odds ratio [OR] = 1.93, 95% confidence interval [CI] = 1.83 to 2.04). The OR for black patients was 1.47 (95% CI = 1.38 to 1.57). CONCLUSION: Using data from GP records, black and South Asian ethnicity remain as predictors of suspected COVID-19, with levels of risk similar to hospital admission reports. Further understanding of these differences requires social and occupational data.


Subject(s)
Coronavirus Infections , General Practice/methods , Pandemics , Pneumonia, Viral , Primary Health Care/statistics & numerical data , Betacoronavirus , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/ethnology , Diagnosis, Differential , Female , Health Status Disparities , Humans , London/epidemiology , Male , Medical Records, Problem-Oriented/statistics & numerical data , Middle Aged , Minority Health/statistics & numerical data , Multiple Chronic Conditions/epidemiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/ethnology , Prevalence , Risk Factors , SARS-CoV-2
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