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1.
Sex Transm Dis ; 49(12): 844-850, 2022 Dec 01.
Article in English | MEDLINE | ID: covidwho-2117649

ABSTRACT

BACKGROUND: The purpose was to assess COVID-19 beliefs and attitudes and examine COVID-19-related changes in sexual behavior of men who have sex with men during 3 time periods: April-July 2020 (T1), August-December 2020 (T2), January-May 2021 (T3). METHODS: Data were analyzed from 157 men who have sex with men in Ohio recruited to participate in a longitudinal multisite network study of syphilis epidemiology in 3 US cities: Columbus, Ohio; Baltimore, Maryland; and Chicago, Illinois. In April 2020, a COVID-19 module was appended to existing baseline and follow-up surveys to assess beliefs, attitudes, and changes in sexual behavior. Sample characteristics were summarized. Correlations between demographic variables (age, racial identity) and COVID-19 outcomes were examined. RESULTS: In response to COVID-19 social distancing restrictions and self-reported anxiety, some men limited sexual activity at T1, but the majority (n = 105 [67%]) continued to engage in sex. The number of men engaging in sex increased over time (T2: n = 124 [79%]; T3: n = 121 [77%]). At T1, men not in a relationship more frequently reported having less sex compared with prepandemic (n = 39 [57%]). By T3, men in a relationship more frequently reported less sex (n = 32 [54%]). Increased anxiety about sex and condom use was positively correlated with identifying as a man of color (P < 0.001). Most of the sample reported either starting or increasing online sexual activity during each time period. CONCLUSIONS: Future efforts to target sexual health during a pandemic or other health emergencies should prioritize men of color and address the unique perspective of both single and partnered men.


Subject(s)
COVID-19 , Sexual Behavior , Sexual and Gender Minorities , Humans , Male , COVID-19/epidemiology , Homosexuality, Male , Ohio/epidemiology , Pandemics
3.
J Public Health Manag Pract ; 28(6): 739-748, 2022.
Article in English | MEDLINE | ID: covidwho-1992425

ABSTRACT

CONTEXT: Data sharing between local health departments and health care systems is challenging during public health crises. In early 2021, the supply of COVID-19 vaccine was limited, vaccine appointments were difficult to schedule, and state health departments were using a phased approach to determine who was eligible to get the vaccine. PROGRAM: Multiple local health departments and health care systems with the capacity for mobile and pop-up vaccine clinics came together in Columbus and Franklin County, Ohio, with a common objective to coordinate where, when, and how to set up mobile/pop-up COVID-19 vaccine clinics. To support this objective, the Equity Mapping Tool, which is a set of integrated tools, workflows, and processes, was developed, implemented, and deployed in partnership with an academic institution. IMPLEMENTATION: The Equity Mapping Tool was designed after a rapid community engagement phase. Our analytical approaches were informed by community engagement activities, and we translated the Equity Mapping Tool for stakeholders, who typically do not share timely and granular data, to build capacity for data-enabled decision making. DISCUSSION: We discuss our observations related to the sustainability of the Equity Mapping Tool, lessons learned for public health scientists/practitioners, and future directions for extending the Equity Mapping Tool to other jurisdictions and public health crises.


Subject(s)
COVID-19 , Health Equity , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Delivery of Health Care , Goals , Humans , Ohio , Public Health , Vaccination
4.
Int J Environ Res Public Health ; 19(10)2022 05 14.
Article in English | MEDLINE | ID: covidwho-1855625

ABSTRACT

The COVID-19-related lockdowns led to school closures across the United States, cutting off critical resources for nutritious food. Foodservice employees emerged as frontline workers; understanding their experiences is critical to generate innovations for program operations and viability. The purpose of this cross-sectional study was to characterize COVID-19-related foodservice adaptations for summer and school year meal provision. Public school district foodservice administrators across Ohio were surveyed in December 2020. Questions related to meal provision before, during, and after COVID-19-related school closures. Results indicate the majority of districts continued providing meals upon their closure in Spring 2020 (n = 182, 87.1%); fewer did so in Summer (n = 88, 42.1%) and Fall (n = 32, 15.3%). In Spring and Summer, most districts that offered meals functioned as 'open sites' (67.0% and 87.5%, respectively), not limiting food receipt to district-affiliated students. Most districts employed a pick-up system for food distribution (76-84% across seasons), though some used a combination of approaches or changed their approach within-season. Qualitatively, districts reported both "successes" (e.g., supporting students) and "challenges" (e.g., supply chain). Despite being ill-prepared, districts responded quickly and flexibly to demands of the pandemic. This analysis provides insight for future practice (e.g., establishing community partnerships) and policy (e.g., bolstering local food systems).


Subject(s)
COVID-19 , COVID-19/epidemiology , Communicable Disease Control , Cross-Sectional Studies , Humans , Meals , Ohio/epidemiology , Schools , United States
5.
BMC Public Health ; 22(1): 226, 2022 02 04.
Article in English | MEDLINE | ID: covidwho-1736397

ABSTRACT

BACKGROUND: Recent studies in the United States have shown that between 56 to 74% are willing to receive the COVID-19 vaccine. A significant portion of the population should be vaccinated to avoid severe illness and prevent unnecessary deaths. We examined correlates of COVID-19 vaccine acceptance among a representative sample of adults residing in Ohio. METHODS: We conducted a cross-sectional study using an online platform (n = 2358). Descriptive statistics, chi-square test and multivariable regression analysis were performed. RESULTS: Overall, 59.1% of the participants indicated COVID-19 vaccine acceptance to be vaccinated. In the multivariable model, the likelihood of COVID-19 vaccine acceptance was lower for younger individuals compared to those 55 years and older. The odds of COVID-19 vaccine acceptance were lower for: females compared to males (OR 0.58, 95% CI: 0.47-0.71; P = 0.001), non-Hispanic blacks compared to non-Hispanic whites (OR: 0.49 95% CI: 0.35-0.70; P = 0.001), previously married (OR 0.64 95% CI: 0.49-0.84; P = 0.002) and never been married (OR 0.75 95% CI: 0.59-0.96; P = 0.023) compared to married people, individuals with less than high school (OR 0.21 95% CI: 0.08-0.60; P = 0.003) and high school education (OR: 0.45 95% CI: 0.36-0.55; P < 0.001) compared to those with education beyond high school, and for individuals who had no confidence in the abilities of the state government (OR 0.69 95% CI: 0.53-0.89; P = 0.005) and other world governments to combat COVID-19 (OR 0.67 95% CI: 0.50-0.91; P = 0.009). A one unit increase in knowledge about COVID-19 (OR 1.19, 95% CI: 1.13-1.26; P < 0.001), behavioral adherence (OR 1.25, 95% CI: 1.15-1.37; P < 0.001), perceived susceptibility (OR 1.10, 95% CI: 1.03-1.17; P = 0.004), perceived severity (OR 1.09, 95% CI: 1.03-1.16; P = 0.003), and trust in COVID-19 messages from the government scores (OR 1.08, 95% CI: 1.06-1.10; P < 0.001) were associated with an increase in the likelihood of COVID-19 vaccine acceptance. CONCLUSIONS: COVID-19 vaccine acceptance differed by sociodemographic and other modifiable factors. Findings can inform local public health authorities in the development of effective, context-specific communication strategies to improve vaccination uptake.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adult , Cross-Sectional Studies , Female , Humans , Male , Ohio , SARS-CoV-2 , United States , Vaccination
6.
Gerontologist ; 62(3): 452-463, 2022 Mar 28.
Article in English | MEDLINE | ID: covidwho-1650059

ABSTRACT

BACKGROUND AND OBJECTIVES: Low access to food can have an adverse impact on health yet there is limited research on how it is related to coronavirus disease 2019 (COVID-19). The objective of this study was to (a) better understand how inadequate food access was associated with older adult mortality from COVID-19 and (b) determine the spatial distribution of mortality from low food access utilizing a socio-ecological framework. RESEARCH DESIGN AND METHODS: This study area was the larger Midwest, a region of the United States, which included the following states: Minnesota, Wisconsin, Iowa, Illinois, Indiana, Michigan, Ohio, and Pennsylvania. Data were aggregated from multiple sources at the county-level. Because the spatial data used in this study violated several assumptions of the global regression framework, geographically weighted regression (GWR) was employed. RESULTS: Results from GWR revealed low access to food was positively associated with mortality from COVID-19 for older adults but the association varied in (a) magnitude and (b) significance across the larger Midwest. More specifically, the socio-ecological framework suggested low access to food, female-headed households, and percentage Hispanic played a meaningful role in explaining older adult mortality for the western region of the larger Midwest. This was not as evident for the eastern portion. DISCUSSION AND IMPLICATIONS: Such a finding calls attention to the importance of capturing the local context when devising policies to reduce mortality for older adults from COVID-19. Regional policymakers can collaborate with public health professionals when applying these results to formulate local action plans that recognize variations across geographic space.


Subject(s)
COVID-19 , Aged , Female , Humans , Michigan , Minnesota , Ohio , Pennsylvania , United States/epidemiology
7.
BMJ Open ; 12(1): e055490, 2022 01 07.
Article in English | MEDLINE | ID: covidwho-1613008

ABSTRACT

PURPOSE: Obesity prevention is increasingly focused on early childhood, but toddlers have not been well-studied, and children born preterm are frequently excluded. The Play & Grow Cohort was established to investigate child growth in relation to parent-child interactions in mealtime and non-mealtime settings. PARTICIPANTS: Between December 2017 and May 2019, 300 toddlers and primary caregivers were recruited from records of a large paediatric care provider in Columbus, Ohio, USA. This report describes recruitment of the cohort and outlines the data collection protocols for two toddler and two preschool-age visits. The first study visit coincided with enrolment and occurred when children (57% boys) were a mean (SD) calendar age of 18.2 (0.7) months. FINDINGS TO DATE: Children in the cohort are diverse relative to gestational age at birth (16%, 28-31 completed weeks' gestation; 21%, 32-36 weeks' gestation; 63%, ≥37 weeks' gestation) and race/ethnicity (8%, Hispanic; 35%, non-Hispanic black; 46%, non-Hispanic white). Caregivers enrolled in the cohort are primarily the child's biological mother (93%) and are diverse in age (range 18-54 years), education (23%, high school or less; 20% graduate degree) and annual household income (27%,

Subject(s)
COVID-19 , Adolescent , Adult , Child , Child, Preschool , Cohort Studies , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Obesity , Ohio , SARS-CoV-2 , Young Adult
8.
BMC Cardiovasc Disord ; 21(1): 626, 2021 12 31.
Article in English | MEDLINE | ID: covidwho-1592243

ABSTRACT

INTRODUCTION: The majority of studies evaluating the effect of myocardial injury on the survival of COVID-19 patients have been performed outside of the United States (U.S.). These studies have often utilized definitions of myocardial injury that are not guideline-based and thus, not applicable to the U.S. METHODS: The current study is a two-part investigation of the effect of myocardial injury on the clinical outcome of patients hospitalized with COVID-19. The first part is a retrospective analysis of 268 patients admitted to our healthcare system in Toledo, Ohio, U.S.; the second part is a systematic review and meta-analysis of all similar studies performed within the U.S. RESULTS: In our retrospective analysis, patients with myocardial injury were older (mean age 73 vs. 59 years, P 0.001), more likely to have hypertension (86% vs. 67%, P 0.005), underlying cardiovascular disease (57% vs. 24%, P 0.001), and chronic kidney disease (26% vs. 10%, P 0.004). Myocardial injury was also associated with a lower likelihood of discharge to home (35% vs. 69%, P 0.001), and a higher likelihood of death (33% vs. 10%, P 0.001), acute kidney injury (74% vs. 30%, P 0.001), and circulatory shock (33% vs. 12%, P 0.001). Our meta-analysis included 12,577 patients from 8 U.S. states and 55 hospitals who were hospitalized with COVID-19, with the finding that myocardial injury was significantly associated with increased mortality (HR 2.43, CI 2.28-3.6, P 0.0005). The prevalence of myocardial injury ranged from 9.2 to 51%, with a mean prevalence of 27.2%. CONCLUSION: Hospitalized COVID-19 patients in the U.S. have a high prevalence of myocardial injury, which was associated with poorer survival and outcomes.


Subject(s)
COVID-19/complications , Myocardial Infarction/etiology , Aged , Cardiovascular Diseases/complications , Female , Hospitalization , Humans , Male , Middle Aged , Myocardial Infarction/diagnosis , Ohio , Prognosis , Renal Insufficiency, Chronic/complications , Retrospective Studies , SARS-CoV-2 , Troponin I/blood
9.
Nature ; 602(7897): 481-486, 2022 02.
Article in English | MEDLINE | ID: covidwho-1585829

ABSTRACT

Humans have infected a wide range of animals with SARS-CoV-21-5, but the establishment of a new natural animal reservoir has not been observed. Here we document that free-ranging white-tailed deer (Odocoileus virginianus) are highly susceptible to infection with SARS-CoV-2, are exposed to multiple SARS-CoV-2 variants from humans and are capable of sustaining transmission in nature. Using real-time PCR with reverse transcription, we detected SARS-CoV-2 in more than one-third (129 out of 360, 35.8%) of nasal swabs obtained from O. virginianus in northeast Ohio in the USA during January to March 2021. Deer in six locations were infected with three SARS-CoV-2 lineages (B.1.2, B.1.582 and B.1.596). The B.1.2 viruses, dominant in humans in Ohio at the time, infected deer in four locations. We detected probable deer-to-deer transmission of B.1.2, B.1.582 and B.1.596 viruses, enabling the virus to acquire amino acid substitutions in the spike protein (including the receptor-binding domain) and ORF1 that are observed infrequently in humans. No spillback to humans was observed, but these findings demonstrate that SARS-CoV-2 viruses have been transmitted in wildlife in the USA, potentially opening new pathways for evolution. There is an urgent need to establish comprehensive 'One Health' programmes to monitor the environment, deer and other wildlife hosts globally.


Subject(s)
Animals, Wild/virology , COVID-19/veterinary , Deer/virology , Phylogeny , SARS-CoV-2/isolation & purification , Viral Zoonoses/transmission , Viral Zoonoses/virology , Amino Acid Sequence , Amino Acid Substitution , Animals , COVID-19/epidemiology , COVID-19/transmission , Evolution, Molecular , Humans , Male , Ohio/epidemiology , One Health/trends , SARS-CoV-2/chemistry , SARS-CoV-2/classification , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/chemistry , Spike Glycoprotein, Coronavirus/genetics , Viral Zoonoses/epidemiology
10.
Ann Epidemiol ; 67: 50-60, 2022 03.
Article in English | MEDLINE | ID: covidwho-1568496

ABSTRACT

Purpose To estimate the prevalence of current and past COVID-19 in Ohio adults. Methods We used stratified, probability-proportionate-to-size cluster sampling. During July 2020, we enrolled 727 randomly-sampled adult English- and Spanish-speaking participants through a household survey. Participants provided nasopharyngeal swabs and blood samples to detect current and past COVID-19. We used Bayesian latent class models with multilevel regression and poststratification to calculate the adjusted prevalence of current and past COVID-19. We accounted for the potential effects of non-ignorable non-response bias. Results The estimated statewide prevalence of current COVID-19 was 0.9% (95% credible interval: 0.1%-2.0%), corresponding to ∼85,000 prevalent infections (95% credible interval: 6,300-177,000) in Ohio adults during the study period. The estimated statewide prevalence of past COVID-19 was 1.3% (95% credible interval: 0.2%-2.7%), corresponding to ∼118,000 Ohio adults (95% credible interval: 22,000-240,000). Estimates did not change meaningfully due to non-response bias. Conclusions Total COVID-19 cases in Ohio in July 2020 were approximately 3.5 times as high as diagnosed cases. The lack of broad COVID-19 screening in the United States early in the pandemic resulted in a paucity of population-representative prevalence data, limiting the ability to measure the effects of statewide control efforts.


Subject(s)
COVID-19 , Adult , Bayes Theorem , COVID-19/epidemiology , Humans , Ohio/epidemiology , Prevalence , SARS-CoV-2 , United States
13.
J Dev Behav Pediatr ; 42(8): 672-676, 2021.
Article in English | MEDLINE | ID: covidwho-1517916

ABSTRACT

OBJECTIVE: This study examines the media use of children from low-income homes during school closings during the COVID-19 pandemic. METHODS: Caregivers of 151 kindergarteners from low-income homes completed questionnaires as part of a larger study. Caregivers reported how much time children spent watching television/videos and using apps on the most recent weekday and weekend days. Caregivers also reported how their child's current use of media for several different purposes compared with how much the child usually uses media for that purpose. RESULTS: Weekly average media use was 46.3 hours or 6.6 hours per day. Counter to previous research, weekday media use was higher than weekend media use, suggesting that media was likely used as a replacement for time usually spent in school. Caregivers reported increased child media use for positive purposes, such as education and maintaining relationships with family and friends outside of the home, and potentially useful but less socially valued purposes, such as occupying the child's time while caregivers were completing other tasks. Having more children in the household was related to higher media use, and girls used media for maintaining remote relationships more than boys. CONCLUSION: These findings provide reason for both concern and optimism for the impacts of pandemic closures on low-income children. High levels of media use seem to be prevalent in this population. However, the diverse purposes for media use suggest that caregivers relied on media to supplement children's academic and social growth at a time when school and socializing were not safe in their typical forms.


Subject(s)
COVID-19 , Poverty , Television , Caregivers , Child, Preschool , Family Characteristics , Female , Humans , Male , Ohio , Pandemics , Television/statistics & numerical data
14.
JAMA Netw Open ; 4(11): e2134241, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1508587

ABSTRACT

Importance: The influence of sleep-disordered breathing (SDB) and sleep-related hypoxemia in SARS-CoV-2 viral infection and COVID-19 outcomes remains unknown. Controversy exists regarding whether to continue treatment for SDB with positive airway pressure given concern for aerosolization with limited data to inform professional society recommendations. Objective: To investigate the association of SDB (identified via polysomnogram) and sleep-related hypoxia with (1) SARS-CoV-2 positivity and (2) World Health Organization (WHO)-designated COVID-19 clinical outcomes while accounting for confounding including obesity, underlying cardiopulmonary disease, cancer, and smoking history. Design, Setting, and Participants: This case-control study was conducted within the Cleveland Clinic Health System (Ohio and Florida) and included all patients who were tested for COVID-19 between March 8 and November 30, 2020, and who had an available sleep study record. Sleep indices and SARS-CoV-2 positivity were assessed with overlap propensity score weighting, and COVID-19 clinical outcomes were assessed using the institutional registry. Exposures: Sleep study-identified SDB (defined by frequency of apneas and hypopneas using the Apnea-Hypopnea Index [AHI]) and sleep-related hypoxemia (percentage of total sleep time at <90% oxygen saturation [TST <90]). Main Outcomes and Measures: Outcomes were SARS-CoV-2 infection and WHO-designated COVID-19 clinical outcomes (hospitalization, use of supplemental oxygen, noninvasive ventilation, mechanical ventilation or extracorporeal membrane oxygenation, and death). Results: Of 350 710 individuals tested for SARS-CoV-2, 5402 (mean [SD] age, 56.4 [14.5] years; 3005 women [55.6%]) had a prior sleep study, of whom 1935 (35.8%) tested positive for SARS-CoV-2. Of the 5402 participants, 1696 were Black (31.4%), 3259 were White (60.3%), and 822 were of other race or ethnicity (15.2%). Patients who were positive vs negative for SARS-CoV-2 had a higher AHI score (median, 16.2 events/h [IQR, 6.1-39.5 events/h] vs 13.6 events/h [IQR, 5.5-33.6 events/h]; P < .001) and increased TST <90 (median, 1.8% sleep time [IQR, 0.10%-12.8% sleep time] vs 1.4% sleep time [IQR, 0.10%-10.8% sleep time]; P = .02). After overlap propensity score-weighted logistic regression, no SDB measures were associated with SARS-CoV-2 positivity. Median TST <90 was associated with the WHO-designated COVID-19 ordinal clinical outcome scale (adjusted odds ratio, 1.39; 95% CI, 1.10-1.74; P = .005). Time-to-event analyses showed sleep-related hypoxia associated with a 31% higher rate of hospitalization and mortality (adjusted hazard ratio, 1.31; 95% CI, 1.08-1.57; P = .005). Conclusions and Relevance: In this case-control study, SDB and sleep-related hypoxia were not associated with increased SARS-CoV-2 positivity; however, once patients were infected with SARS-CoV-2, sleep-related hypoxia was an associated risk factor for detrimental COVID-19 outcomes.


Subject(s)
COVID-19 , Cause of Death , Hospitalization , Severity of Illness Index , Sleep Apnea Syndromes/complications , Aged , COVID-19/complications , COVID-19/mortality , COVID-19/therapy , Case-Control Studies , Continuous Positive Airway Pressure , Delivery of Health Care, Integrated , Extracorporeal Membrane Oxygenation , Female , Florida , Hospital Mortality , Humans , Hypoxia , Logistic Models , Male , Middle Aged , Odds Ratio , Ohio , Respiration, Artificial , Risk Factors , SARS-CoV-2 , Sleep , Sleep Apnea Syndromes/pathology , Sleep Apnea Syndromes/therapy
15.
J Public Health Manag Pract ; 27(5): 492-500, 2021.
Article in English | MEDLINE | ID: covidwho-1501235

ABSTRACT

OBJECTIVES: To examine levels of expenditure and needed investment in public health at the local level in the state of Ohio pre-COVID-19. DESIGN: Using detailed financial reporting from fiscal year (FY) 2018 from Ohio's local health departments (LHDs), we characterize spending by Foundational Public Health Services (FPHS). We also constructed estimates of the gap in public health spending in the state using self-reported gaps in service provision and a microsimulation approach. Data were collected between January and June 2019 and analyzed between June and September 2019. PARTICIPANTS: Eighty-four of the 113 LHDs in the state of Ohio covering a population of almost 9 million Ohioans. RESULTS: In FY2018, Ohio LHDs spent an average of $37 per capita on protecting and promoting the public's health. Approximately one-third of this investment supported the Foundational Areas (communicable disease control; chronic disease and injury prevention; environmental public health; maternal, child, and family health; and access to and linkages with health care). Another third supported the Foundational Capabilities, that is, the crosscutting skills and capacities needed to support all LHD activities. The remaining third supported programs and activities that are responsive to local needs and vary from community to community. To fully meet identified LHD needs in the state pre-COVID-19, Ohio would require an additional annual investment of $20 per capita on top of the current $37 spent per capita, or approximately $240 million for the state. CONCLUSIONS: A better understanding of the cost and value of public health services can educate policy makers so that they can make informed trade-offs when balancing health care, public health, and social services investments. The current environment of COVID-19 may dramatically increase need, making understanding and growing public health investment critical.


Subject(s)
Health Care Costs/statistics & numerical data , Health Services Needs and Demand/economics , Public Health Practice/economics , Public Health/economics , COVID-19/economics , Financing, Government/economics , Humans , Local Government , Ohio
16.
Am Surg ; 88(3): 404-408, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1467789

ABSTRACT

INTRODUCTION: There is a growing concern that certain public health restrictions imposed to prevent the spread of coronavirus disease 2019 (COVID-19) could result in more violence against women (VAW). We sought to determine if the rates and types of VAW changed during the COVID-19 pandemic at our level 1 trauma center (L1TC). METHODS: We performed a retrospective review of female patients who presented to our L1TC because of violence from 2019 through 2020. Patients were grouped into a pre-COVID or COVID period. The primary aim of this study was to compare rates of VAW between groups. Secondary aims sought to evaluate for any difference in traumatic mechanism between periods and to determine if a temporal relationship existed between COVID-19 and VAW rates. RESULTS: There was no difference in rates of VAW between the pre-COVID and COVID period (3.1% vs 3.6%, P = .6); however, rates of penetrating trauma were greater during the COVID period (38.2% vs 10.3%, P = .01). After controlling for patient age and race, the odds of penetrating trauma increased during the pandemic (OR 5.8, 95% CI 1.6-28.5, P < .01). From February 2020 through October 2020, there was a direct relationship between rates of COVID-19 and VAW (r2 .78, P < .01). CONCLUSION: Rates of VAW were unchanged between the pre-COVID and COVID periods, yet the odds of penetrating VAW were 5 times greater during the pandemic. Moving forward, trauma surgeons must remain vigilant for signs of violence and ensure that support services are available during future crises.


Subject(s)
COVID-19/epidemiology , Gender-Based Violence/statistics & numerical data , Pandemics , Trauma Centers/statistics & numerical data , Wounds, Nonpenetrating/epidemiology , Wounds, Penetrating/epidemiology , Adult , COVID-19/prevention & control , Female , Gender-Based Violence/ethnology , Humans , Injury Severity Score , Intimate Partner Violence/ethnology , Intimate Partner Violence/statistics & numerical data , Linear Models , Ohio/epidemiology , Retrospective Studies , Wounds, Nonpenetrating/ethnology , Wounds, Penetrating/ethnology , Young Adult
17.
Front Health Serv Manage ; 38(1): 4-13, 2021 Oct 01.
Article in English | MEDLINE | ID: covidwho-1455389

ABSTRACT

SUMMARY: Across the healthcare landscape, the COVID-19 pandemic has been incredibly challenging. It also has been a catalyst for change. It has ignited a redesign of the US health system and presented opportunities in areas such as caregiver and patient communication, digital practice, telehealth and virtual care, and more. Notably, the pandemic also has shined a new light on caregiver well-being. As executive leaders of Cleveland Clinic's Caregiver Office, our top priority throughout the pandemic has been to support our caregivers professionally and personally-to help them be their best for themselves and for their fellow caregivers, our patients, our organization, and our communities. Today, Cleveland Clinic is realizing the profound impact of many of the strategies put in place during the pandemic and seeing how COVID-19 accelerated our organization's unified vision for caregiver well-being. This article offers insight into Cleveland Clinic's commitment to caregiver well-being, highlights actions we undertook during the pandemic, shares the resulting lessons we learned, and showcases how those lessons are shaping our future caregiver well-being strategy.


Subject(s)
Ambulatory Care Facilities/organization & administration , COVID-19 , Caregivers/standards , Delivery of Health Care/organization & administration , Health Personnel/standards , Holistic Health , Practice Guidelines as Topic , Adult , Female , Humans , Male , Middle Aged , Ohio , Organizational Culture , Organizational Objectives , Pandemics , SARS-CoV-2
18.
Nurs Res ; 70(5S Suppl 1): S3-S12, 2021.
Article in English | MEDLINE | ID: covidwho-1429365

ABSTRACT

BACKGROUND: Black/African American women in the United States are more likely to live in neighborhoods with higher social vulnerability than other racial/ethnic groups, even when adjusting for personal income. Social vulnerability, defined as the degree to which the social conditions of a community affect its ability to prevent loss and suffering in the event of disaster, has been used in research as an objective measure of neighborhood social vulnerability. Black/African American women also have the highest rates of hypertension and obesity in the United States. OBJECTIVES: The purpose of this study was to examine the relationship between neighborhood social vulnerability and cardiovascular risk (hypertension and obesity) among Black/African American women. METHODS: We conducted a secondary analysis of data from the InterGEN Study that enrolled Black/African American women in the Northeast United States. Participants' addresses were geocoded to ascertain neighborhood vulnerability using the Centers for Disease Control and Prevention's Social Vulnerability Index at the census tract level. We used multivariable regression models to examine associations between objective measures of neighborhood quality and indicators of structural racism and systolic and diastolic blood pressure and obesity (body mass index > 24.9) and to test psychological stress, coping, and depression as potential moderators of these relationships. RESULTS: Seventy-four percent of participating Black/African American women lived in neighborhoods in the top quartile for social vulnerability nationally. Women living in the top 10% of most socially vulnerable neighborhoods in our sample had more than a threefold greater likelihood of hypertension when compared to those living in less vulnerable neighborhoods. Objective neighborhood measures of structural racism (percentage of poverty, percentage of unemployment, percentage of residents >25 years old without a high school diploma, and percentage of residents without access to a vehicle) were significantly associated with elevated diastolic blood pressure and obesity in adjusted models. Psychological stress had a significant moderating effect on the associations between neighborhood vulnerability and cardiovascular risk. DISCUSSION: We identified important associations between structural racism, the neighborhood environment, and cardiovascular health among Black/African American women. These findings add to a critical body of evidence documenting the role of structural racism in perpetuating health inequities and highlight the need for a multifaceted approach to policy, research, and interventions to address racial health inequities.


Subject(s)
Blacks/ethnology , Heart Disease Risk Factors , Social Segregation/psychology , Adult , Blacks/psychology , Blacks/statistics & numerical data , COVID-19/prevention & control , COVID-19/psychology , Female , Humans , Middle Aged , Ohio , Socioeconomic Factors
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