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1.
Front Public Health ; 10: 853292, 2022.
Article in English | MEDLINE | ID: covidwho-1776074

ABSTRACT

There is still a scarcity of literature on the specific mechanisms of the linkage between the built environment and obesity. As a result, this study investigated whether and how physical activities mediate the associations between the objective built environment and the BMI of elderly people. To investigate the effect of the duration and intensity of physical activity on the effect of the built environment, the study made use of the bootstrap method. In general, we discovered that physical activity duration has a huge mediating effect on the elderly people in Shanghai, especially with respect to the density and accessibility of facilities (gyms, parks, fast-food restaurants) that can greatly stimulate physical activity in elderly people to reduce their BMI. There were both direct and indirect effects on their BMI, which means that the health benefits of green spaces for older people may be more complicated than first thought.


Subject(s)
Built Environment , Exercise , Obesity , Residence Characteristics , Aged , Body Mass Index , China/epidemiology , Humans , Obesity/epidemiology
2.
Front Public Health ; 9: 706151, 2021.
Article in English | MEDLINE | ID: covidwho-1775820

ABSTRACT

Introduction: Neighborhood environment factors are relevant for dietary behaviors, but associations between home neighborhood context and disease prevention behaviors vary depending on the definition of neighborhood. The present study uses a publicly available dataset to examine whether associations between neighborhood socioeconomic status (NSES) and fruit/vegetable (FV) consumption vary when NSES is defined by different neighborhood sizes and shapes. Methods: We analyzed data from 1,736 adults with data in GeoFLASHE, a geospatial extension of the National Cancer Institute's Family Life, Activity, Sun, Health, and Eating Study (FLASHE). We examined correlations of NSES values across neighborhood buffer shapes (circular or street network) and sizes (ranging from 400 to 1,200 m) and ran weighted simple and multivariable regressions modeling frequency of FV consumption by NSES for each neighborhood definition. Regressions were also stratified by gender. Results: NSES measures were highly correlated across various neighborhood buffer definitions. In models adjusted for socio-demographics, circular buffers of all sizes and street buffers 750 m and larger were significantly associated with FV consumption frequency for women only. Conclusion: NSES may be particularly relevant for women's FV consumption, and further research can examine whether these associations are explained by access to food stores, food shopping behavior, and/or psychosocial variables. Although different NSES buffers are highly correlated, researchers should conceptually determine spatial areas a priori.


Subject(s)
Feeding Behavior , Residence Characteristics , Adult , Female , Fruit , Humans , Social Class , Vegetables
3.
BMC Public Health ; 22(1): 627, 2022 Mar 31.
Article in English | MEDLINE | ID: covidwho-1770515

ABSTRACT

BACKGROUND: The interconnectedness of physical inactivity and sedentarism, obesity, non-communicable disease (NCD) prevalence, and socio-economic costs, are well known. There is also strong research evidence regarding the mutuality between well-being outcomes and the neighbourhood environment. However, much of this evidence relates to urban contexts and there is a paucity of evidence in relation to regional communities. A better understanding of available physical activity (PA) infrastructure, its usage, and community perceptions regarding neighbourhood surroundings, could be very important in determining requirements for health improvement in regional communities. The aims of this research were to 1. Explore and evaluate the public's perception of the PA environment; and 2. Evaluate the quantity, variety, and quality of existing PA infrastructure in regional Northwest (NW) Tasmania. METHODS: A mixed methods approach guided data collection, analysis, and presentation. Quality of PA infrastructure was assessed using the Physical Activity Resource Assessment (PARA) instrument and public perception about PA environment was evaluated using the International Physical Activity Questionnaire - Environmental (IPAQ-E) module. Quantitative data were analysed using descriptive summative methods and a team-based researcher triangulation approach was utilised for qualitative data. RESULTS: Overall, a wide array of high-quality PA infrastructure (with minimal incivilities such as auditory annoyance, litter, graffiti, dog refuse, and vandalism etc.) was available. Survey respondents rated neighbourhoods positively. The overall quality of PA infrastructure, rated on a scale from 0 to 3, was assessed as high (all rated between 2 to 3) with minimal incivilities (rated between 0 and 1.5). Of note, survey respondents confirmed the availability of numerous free-to-access recreational tracks and natural amenities across the 3 local government areas (LGAs) studied. Importantly, most respondents reported minimal disruption to their routine PA practices due to the COVID-19 pandemic. CONCLUSION: This exploratory research confirmed the availability of a wide range of high-quality PA infrastructure across all three LGAs and there was an overwhelming public appreciation of this infrastructure. The challenge remains to implement place-based PA interventions that address extant barriers and further increase public awareness and utilisation of high-quality PA infrastructure.


Subject(s)
COVID-19 , Exercise , Pandemics , Animals , Humans , Residence Characteristics , Surveys and Questionnaires , Tasmania/epidemiology
4.
Front Public Health ; 9: 660624, 2021.
Article in English | MEDLINE | ID: covidwho-1771097

ABSTRACT

Physical activity decreases the risk of long-term health consequences including cardiac diseases. According to the American Health Association (AHA), adults should perform at least 75 min of vigorous physical activity (PA) or 150 min of moderate PA per week to impact long-term health. Results of previous studies are varied and have yet to integrate perceived access to facilities with AHA PA guidelines. We investigated whether access to free or low-cost recreational facilities was associated with meeting the AHA PA guidelines. Methodology: This cross-sectional study utilized data extracted from the Family Life, Activity, Sun, Health, and Eating (FLASHE) database collected in 2017 (n = 1,750). The main exposure variable was access to free or low-cost recreational facilities. The main outcome variable was meeting the AHA guidelines of 150 min moderate PA or 75 min vigorous PA per week. Covariates included age, sex, level of education, overall health, BMI, ethnicity, hours of work per week, income, and time living at current address. Unadjusted and adjusted logistic regression analysis were used to calculate measures of odds ratio (OR) and corresponding 95% confidence interval (CI). Results: Of the 1,750 included participants, 61.7% (n = 1,079) reported to have access to recreational facilities. Of those with access to facilities, 69.9% met AHA PA guidelines while 30.4% did not. After adjusting for covariates, participants who reported access to recreational facilities were 42% more likely to meet AHA PA guidelines compared with participants who did not (adjusted OR 1.42; 95% CI 1.14-1.76). Secondary results suggest that healthier individuals were more likely to have met AHA PA guidelines. Conclusions: Having access to free or low-cost recreational facilities such as parks, walking trails, bike paths and courts was associated with meeting the AHA PA guidelines. Increasing prevalence and awareness of neighborhood recreational facilities could assist in access to these facilities and increase the ability of individuals to meet AHA PA guidelines. Future research should determine which types of recreational facilities impact physical activity strongest and discover methods of increasing their awareness.


Subject(s)
Exercise , Guideline Adherence , Sports and Recreational Facilities , Adult , American Heart Association , Cross-Sectional Studies , Guideline Adherence/statistics & numerical data , Humans , Residence Characteristics , Sports and Recreational Facilities/statistics & numerical data , United States
5.
Front Public Health ; 9: 669022, 2021.
Article in English | MEDLINE | ID: covidwho-1771102

ABSTRACT

Chronic biological stress may adversely affect adolescents' physical and mental health, but insight in the personal and environmental factors that determine chronic stress is limited. We measured 3-month cumulative hair cortisol concentration (HCC) in 419 adolescents, participating in the Flemish Environment and Health Study. Adolescents' health and lifestyle characteristics, household and neighborhood socio-economic status as well as neighborhood urbanicity were assessed as potential determinants of HCC, using multiple linear regression models. We additionally explored heterogeneity of our results by sex. HCC were significantly higher in boys from densely populated neighborhoods, the association was not significant in girls. Accordingly, boys living outside cities had significantly lower HCC than boys, living in cities. HCC was significantly lower in adolescents with an optimal vitality, a measure of a positive mental health status. In adolescent girls, menarcheal status (pre-/postmenarche) was a significant determinant of HCC. Our findings are the first to suggest that residential urbanicity may have an impact on chronic biological stress in a general population of adolescent boys.


Subject(s)
Hydrocortisone , Adolescent , Female , Hair , Humans , Male , Residence Characteristics , Stress, Physiological
6.
BMC Infect Dis ; 22(1): 274, 2022 Mar 21.
Article in English | MEDLINE | ID: covidwho-1753108

ABSTRACT

BACKGROUND: Motivated by the need for precise epidemic control and epidemic-resilient urban design, this study aims to reveal the joint and interactive associations between urban socioeconomic, density, connectivity, and functionality characteristics and the COVID-19 spread within a high-density city. Many studies have been made on the associations between urban characteristics and the COVID-19 spread, but there is a scarcity of such studies in the intra-city scale and as regards complex joint and interactive associations by using advanced machine learning approaches. METHODS: Differential-evolution-based association rule mining was used to investigate the joint and interactive associations between the urban characteristics and the spatiotemporal distribution of COVID-19 confirmed cases, at the neighborhood scale in Hong Kong. The associations were comparatively studied for the distribution of the cases in four waves of COVID-19 transmission: before Jun 2020 (wave 1 and 2), Jul-Oct 2020 (wave 3), and Nov 2020-Feb 2021 (wave 4), and for local and imported confirmed cases. RESULTS: The first two waves of COVID-19 were found mainly characterized by higher-socioeconomic-status (SES) imported cases. The third-wave outbreak concentrated in densely populated and usually lower-SES neighborhoods, showing a high risk of within-neighborhood virus transmissions jointly contributed by high density and unfavorable SES. Starting with a super-spread which considerably involved high-SES population, the fourth-wave outbreak showed a stronger link to cross-neighborhood transmissions driven by urban functionality. Then the outbreak diffused to lower-SES neighborhoods and interactively aggravated the within-neighborhood pandemic transmissions. Association was also found between a higher SES and a slightly longer waiting period (i.e., the period from symptom onset to diagnosis of symptomatic cases), which further indicated the potential contribution of higher-SES population to the pandemic transmission. CONCLUSIONS: The results of this study may provide references to developing precise anti-pandemic measures for specific neighborhoods and virus transmission routes. The study also highlights the essentiality of reliving co-locating overcrowdedness and unfavorable SES for developing epidemic-resilient compact cities, and the higher obligation of higher-SES population to conform anti-pandemic policies.


Subject(s)
COVID-19 , COVID-19/epidemiology , Cities/epidemiology , Cross-Sectional Studies , Humans , Residence Characteristics , Social Class
7.
Sleep ; 45(3)2022 03 14.
Article in English | MEDLINE | ID: covidwho-1741017

ABSTRACT

STUDY OBJECTIVES: African Americans have faced disproportionate socioeconomic and health consequences associated with the COVID-19 pandemic. The current study examines employment and its association with sleep quality during the initial months of the pandemic in a low-income, predominantly African American adult sample. METHODS: In the early months of COVID-19 (March to May 2020), we administered a survey to an ongoing, longitudinal cohort of older adults to assess the impact of COVID-related changes in employment on self-reported sleep quality (N = 460; 93.9% African American). Participants had prior sleep quality assessed in 2018 and a subset also had sleep quality assessed in 2013 and 2016. Primary analyses focused on the prevalence of poor sleep quality and changes in sleep quality between 2018 and 2020, according to employment status. Financial strain and prior income were assessed as moderators of the association between employment status and sleep quality. We plotted trend lines showing sleep quality from 2013 to 2020 in a subset (n = 339) with all four waves of sleep data available. RESULTS: All participants experienced increases in poor sleep quality between 2018 and 2020, with no statistical differences between the employment groups. However, we found some evidence of moderation by financial strain and income. The trend analysis demonstrated increases in poor sleep quality primarily between 2018 and 2020. CONCLUSIONS: Sleep quality worsened during the pandemic among low-income African American adults. Policies to support the financially vulnerable and marginalized populations could benefit sleep quality.


Subject(s)
COVID-19 , Aged , COVID-19/epidemiology , Employment , Humans , Pandemics , Residence Characteristics
8.
JAMA Netw Open ; 5(3): e221744, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1739100

ABSTRACT

Importance: Crisis standards of care (CSOC) scores designed to allocate scarce resources during the COVID-19 pandemic could exacerbate racial disparities in health care. Objective: To analyze the association of a CSOC scoring system with resource prioritization and estimated excess mortality by race, ethnicity, and residence in a socially vulnerable area. Design, Setting, and Participants: This retrospective cohort analysis included adult patients in the intensive care unit during a regional COVID-19 surge from April 13 to May 22, 2020, at 6 hospitals in a health care network in greater Boston, Massachusetts. Participants were scored by acute severity of illness using the Sequential Organ Failure Assessment score and chronic severity of illness using comorbidity and life expectancy scores, and only participants with complete scores were included. The score was ordinal, with cutoff points suggested by the Massachusetts guidelines. Exposures: Race, ethnicity, Social Vulnerability Index. Main Outcomes and Measures: The primary outcome was proportion of patients in the lowest priority score category stratified by self-reported race. Secondary outcomes were discrimination and calibration of the score overall and by race, ethnicity, and neighborhood Social Vulnerability Index. Projected excess deaths were modeled by race, using the priority scoring system and a random lottery. Results: Of 608 patients in the intensive care unit during the study period, 498 had complete data and were included in the analysis; this population had a median (IQR) age of 67 (56-75) years, 191 (38.4%) female participants, 79 (15.9%) Black participants, and 225 patients (45.7%) with COVID-19. The area under the receiver operating characteristic curve for the priority score was 0.79 and was similar across racial groups. Black patients were more likely than others to be in the lowest priority group (12 [15.2%] vs 34 [8.1%]; P = .046). In an exploratory simulation model using the score for ventilator allocation, with only those in the highest priority group receiving ventilators, there were 43.9% excess deaths among Black patients (18 of 41 patients) and 28.6% (58 of 203 patients among all others (P = .05); when the highest and intermediate priority groups received ventilators, there were 4.9% (2 of 41 patients) excess deaths among Black patients and 3.0% (6 of 203) among all others (P = .53). A random lottery resulted in more excess deaths than the score. Conclusions and Relevance: In this study, a CSOC priority score resulted in lower prioritization of Black patients to receive scarce resources. A model using a random lottery resulted in more estimated excess deaths overall without improving equity by race. CSOC policies must be evaluated for their potential association with racial disparities in health care.


Subject(s)
COVID-19/mortality , Health Care Rationing/statistics & numerical data , Residence Characteristics/statistics & numerical data , Standard of Care , Aged , Boston , COVID-19/diagnosis , COVID-19/therapy , Critical Care , Female , Health Priorities , Healthcare Disparities , Hospitalization , Humans , Male , Middle Aged , Organ Dysfunction Scores , Retrospective Studies , Severity of Illness Index , Vulnerable Populations/statistics & numerical data
9.
Geospat Health ; 17(s1)2022 01 14.
Article in English | MEDLINE | ID: covidwho-1726244

ABSTRACT

With people restricted to their residences, neighbourhood characteristics may affect behaviour and risk of coronavirus disease 2019 (COVID-19) infection. We aimed to analyse whether neighbourhoods with higher walkability, public transit, biking services and higher socio-economic status were associated with lower COVID-19 infection during the peak of the COVID-19 pandemic in Massachusetts. We used Walk Score®, Bike Score®, and Transit Score® indices to assess the walkability and transportation of 72 cities in Massachusetts, USA based on availability of data and collected the total COVID-19 case numbers of each city up to 10 April 2021. We used univariate and multivariate linear models to analyse the effects of these scores on COVID-19 cases per 100,000 in each city, adjusting for demographic covariates and all covariates, respectively. In the 72 cities studied, the average Walk Score, Transit Score and Bike Score was 48.7, 36.5 and 44.1, respectively, with a total of 426,182 COVID-19 cases. Higher Walk Score, Transit Score, and Bike Score rankings were negatively associated with COVID-19 cases per 100,000 persons (<0.05). Cities with a higher proportion of Hispanic population and a lower median household income were associated with more COVID-19 cases per 100,000 (P<0.05). Higher Walk Score, Transit Score and Bike Score were shown to be protective against COVID-19 transmission, while socio-demographic factors were associated with COVID-19 infection. Understanding the complex relationship of how the structure of the urban environment may constrain commuting patterns for residents and essential workers during COVID-19 would offer potential insights on future pandemic preparedness and response.


Subject(s)
COVID-19 , Environment Design , Residence Characteristics , Bicycling , Cities , Humans , Massachusetts , Pandemics , SARS-CoV-2 , Social Class , Socioeconomic Factors , Transportation , Walking
10.
Int J Equity Health ; 20(1): 258, 2021 12 18.
Article in English | MEDLINE | ID: covidwho-1724494

ABSTRACT

BACKGROUND: Belgium was one of the countries that was struck hard by COVID-19. Initially, the belief was that we were 'all in it together'. Emerging evidence showed however that deprived socioeconomic groups suffered disproportionally. Yet, few studies are available for Belgium. The main question addressed in this paper is whether excess mortality during the first COVID-19 wave followed a social gradient and whether the classic mortality gradient was reproduced. METHODS: We used nationwide individually linked data from the Belgian National Register and the Census 2011. Age-standardized all-cause mortality rates were calculated during the first COVID-19 wave in weeks 11-20 in 2020 and compared with the rates during weeks 11-20 in 2015-2019 to calculate absolute and relative excess mortality by socioeconomic and -demographic characteristics. For both periods, relative inequalities in total mortality between socioeconomic and -demographic groups were calculated using Poisson regression. Analyses were stratified by age, gender and care home residence. RESULTS: Excess mortality during the first COVID-19 wave was high in collective households, with care homes hit extremely hard by the pandemic. The social patterning of excess mortality was rather inconsistent and deviated from the usual gradient, mainly through higher mortality excesses among higher socioeconomic groups classes in specific age-sex groups. Overall, the first COVID-19 wave did not change the social patterning of mortality, however. Differences in relative inequalities between both periods were generally small and insignificant, except by household living arrangement. CONCLUSION: The social patterning during the first COVID-19 wave was exceptional as excess mortality did not follow the classic lines of higher mortality in lower classes and patterns were not always consistent. Relative mortality inequalities did not change substantially during the first COVID-19 wave compared to the reference period.


Subject(s)
COVID-19 , Belgium/epidemiology , Humans , Infant , Mortality , Pandemics , Residence Characteristics , SARS-CoV-2 , Socioeconomic Factors
11.
Int J Environ Res Public Health ; 19(5)2022 02 27.
Article in English | MEDLINE | ID: covidwho-1715358

ABSTRACT

Neighborhoods play a central role in health and mental health, particularly during disasters and crises such as the COVID-19 pandemic. We examined changes in psychological distress following the pandemic, and the potential role of neighborhood conditions among 244 residents of New Orleans, Louisiana. Using modified linear regression models, we assessed associations between neighborhood characteristics and change in psychological distress from before to during the pandemic, testing effect modification by sex and social support. While higher density of offsite alcohol outlets (ß = 0.89; 95% CI: 0.52, 1.23), assault rate (ß = 0.14; 95% CI: 0.03, 0.24), and walkable streets (ß = 0.05; 95% CI: 0.02, 0.07) in neighborhoods were associated with an increase in distress, access to neighborhood parks (ß = -0.03; 95% CI: -0.05, -0.01), collective efficacy (ß = -0.23; 95% CI: -0.35, -0.09), and homicide rate (ß = -1.2; 95% CI: -1.8, -0.6) were associated with reduced distress related to the pandemic. These relationships were modified by sex and social support. Findings revealed the important but complicated relationship between psychological distress and neighborhood characteristics. While a deeper understanding of the neighborhoods' role in distress is needed, interventions that target neighborhood environments to ameliorate or prevent the residents' distress may be important not only during crisis situations.


Subject(s)
COVID-19 , Pandemics , COVID-19/epidemiology , Humans , Residence Characteristics , SARS-CoV-2 , Social Support
12.
Am J Public Health ; 112(3): 518-526, 2022 03.
Article in English | MEDLINE | ID: covidwho-1709096

ABSTRACT

Objectives. To quantify the relationship between the segregation of Black, Indigenous, and Latinx communities and COVID-19 testing sites in populous US cities. Methods. We mapped testing sites as of June 2020 in New York City; Chicago, Illinois; Los Angeles, California; and Houston, Texas; we applied Bayesian methods to estimate the association between testing site location and the proportion of the population that is Black, Latinx, or Indigenous per block group, the smallest unit for which the US Census collects sociodemographic data. Results. In New York City, Chicago, and Houston, the expected number of testing sites decreased by 1.29%, 3.05%, and 1.06%, respectively, for each percentage point increase in the Black population. In Chicago, Houston, and Los Angeles, testing sites decreased by 5.64%, 1.95%, and 1.69%, respectively, for each percentage point increase in the Latinx population. Conclusions. In the largest highly segregated US cities, neighborhoods with more Black and Latinx residents had fewer COVID-19 testing sites, likely limiting these communities' participation in the early response to COVID-19. Public Health Implications. In light of conversations on the ethics of racial vaccine prioritization, authorities should consider structural barriers to COVID-19 control efforts. (Am J Public Health. 2022;112(3):518-526. https://doi.org/10.2105/AJPH.2021.306558).


Subject(s)
COVID-19 Testing/statistics & numerical data , COVID-19/diagnosis , Health Services Accessibility/statistics & numerical data , Residence Characteristics/statistics & numerical data , Social Segregation , Bayes Theorem , Cities , Humans , United States
13.
Am J Public Health ; 112(3): 408-416, 2022 03.
Article in English | MEDLINE | ID: covidwho-1706319

ABSTRACT

Objectives. To evaluate the occurrence of HIV and COVID-19 infections in Philadelphia, Pennsylvania, through July 2020 and identify ecological correlates driving racial disparities in infection incidence. Methods. For each zip code tabulation area, we created citywide comparison Z-score measures of COVID-19 cases, new cases of HIV, and the difference between the scores. Choropleth maps were used to identify areas that were similar or dissimilar in terms of disease patterning, and weighted linear regression models helped identify independent ecological predictors of these patterns. Results. Relative to COVID-19, HIV represented a greater burden in Center City Philadelphia, whereas COVID-19 was more apparent in Northeast Philadelphia. Areas with a greater proportion of Black or African American residents were overrepresented in terms of both diseases. Conclusions. Although race is a shared nominal upstream factor that conveys increased risk for both infections, an understanding of separate structural, demographic, and economic risk factors that drive the overrepresentation of COVID-19 cases in racial/ethnic communities across Philadelphia is critical. Public Health Implications. Difference-based measures are useful in identifying areas that are underrepresented or overrepresented with respect to disease occurrence and may be able to elucidate effective or ineffective mitigation strategies. (Am J Public Health. 2022;112(3):408-416. https://doi.org/10.2105/AJPH.2021.306538).


Subject(s)
COVID-19/epidemiology , HIV Infections/epidemiology , Adolescent , Adult , African Americans/statistics & numerical data , Aged , COVID-19/ethnology , Child , Cross-Sectional Studies , Female , HIV Infections/ethnology , Humans , Incidence , Male , Middle Aged , Philadelphia/epidemiology , Residence Characteristics , SARS-CoV-2 , Spatial Analysis , Young Adult
14.
PLoS One ; 17(2): e0263777, 2022.
Article in English | MEDLINE | ID: covidwho-1705282

ABSTRACT

This study examines changes in gun violence at the census tract level in Philadelphia, PA before and after the onset of the COVID-19 pandemic. Piecewise generalized linear mixed effects models are used to test the relative impacts of social-structural and demographic factors, police activity, the presence of and proximity to drug markets, and physical incivilities on shooting changes between 2017 and June, 2021. Model results revealed that neighborhood structural characteristics like concentrated disadvantage and racial makeup, as well as proximity to drug markets and police activity were associated with higher shooting rates. Neighborhood drug market activity and police activity significantly predicted changes in shooting rates over time after the onset of COVID-19. This work demonstrates the importance of understanding whether there are unique factors that impact the susceptibility to exogenous shocks like the COVID-19 pandemic. The increasing risk of being in a neighborhood with an active drug market during the pandemic suggests efforts related to disrupting drug organizations, or otherwise curbing violence stemming from drug markets, may go a long way towards quelling citywide increases in gun violence.


Subject(s)
COVID-19/epidemiology , Gun Violence/statistics & numerical data , COVID-19/virology , Databases, Factual , Drug Trafficking/statistics & numerical data , Humans , Pandemics , Philadelphia/epidemiology , Police , Racism , Residence Characteristics , SARS-CoV-2/isolation & purification
15.
PLoS One ; 17(2): e0263572, 2022.
Article in English | MEDLINE | ID: covidwho-1690720

ABSTRACT

INTRODUCTION: Coronavirus 2019 (COVID- 19) is an acute respiratory viral infectious disease in human being caused by RNA virus that belonged to the family of corona virus. The incidence of this disease was growing exponentially and affects millions of the world population that leads to expose thousands of peoples for death. Thus, this study was targeted to assess the practice of people on COVID-19 infections prevention strategies in the region. METHODS: A community based cross sectional study design was conducted in Benishangul Gumuz Region from May 25 -June 15, 2020. Multistage sampling technique was carried out to select 21 kebeles/ketena and 422 study participants. Data were collected by face to face interview using semi-structured questionnaires. The collected data were entered, cleaned and analyzed using STATA software version 14.0. Descriptive, bi-variable and multivariable multilevel models were applied. Variables with p value < 0.25 in bi-variable analysis were selected as candidates for multivariable analysis. Finally, the variables with p-value < 0.5 were considered as statistically significant, then variables with odds ratio, 95% CI were used to interpret the effect of association. RESULTS: The magnitude of good practice on prevention strategies of COVID- 19 infections was 62.1%. The most frequently practiced prevention strategies for COVID-19 infections were hand washing with water and soap (80.7%), alcohol-based hand rub (68.8%), maintaining social/physical distance (74.2%) and avoiding touching eyes. Individual and community level factors that affecting practice of COVID- 19 infection prevention strategies were discovered. Hence, community level factor was place of origin (AOR = 0.1; 95%CI: 0.03, 0.35) whereas individual level factors were able to read and write (AOR = 0.18; 95%CI: 0.04, 0.81) and being merchant (AOR = 2.07; 95%CI: 1.01, 4.28). CONCLUSION: The level of practice of community towards COVID-19 infections prevention strategies were low as compared with the expected outcome. Individual and community level factors were identified. This implies that social mobilization and community engagement was not effective. Thus, designing appropriate strategies to improve of practice prevention strategies are strongly recommend.


Subject(s)
COVID-19/prevention & control , Health Knowledge, Attitudes, Practice , Adolescent , Adult , Cross-Sectional Studies , Educational Status , Ethiopia/epidemiology , Female , Hand Disinfection , Humans , Logistic Models , Male , Middle Aged , Multilevel Analysis/methods , Odds Ratio , Residence Characteristics/statistics & numerical data , Surveys and Questionnaires , Young Adult
16.
PLoS One ; 17(2): e0263741, 2022.
Article in English | MEDLINE | ID: covidwho-1690714

ABSTRACT

BACKGROUND: Despite their clear lesser vulnerability to COVID-19, the extent by which children are susceptible to getting infected by SARS-CoV-2 and their capacity to transmit the infection to other people remains inadequately characterized. We aimed to evaluate the role of school reopening and the preventive strategies in place at schools in terms of overall risk for children and community transmission, by comparing transmission rates in children as detected by a COVID-19 surveillance platform in place in Catalonian Schools to the incidence at the community level. METHODS AND FINDINGS: Infections detected in Catalan schools during the entire first trimester of classes (September-December 2020) were analysed and compared with the ongoing community transmission and with the modelled predicted number of infections. There were 30.486 infections (2.12%) documented among the circa 1.5M pupils, with cases detected in 54.0% and 97.5% of the primary and secondary centres, respectively. During the entire first term, the proportion of "bubble groups" (stable groups of children doing activities together) that were forced to undergo confinement ranged between 1 and 5%, with scarce evidence of substantial intraschool transmission in the form of chains of infections, and with ~75% of all detected infections not leading to secondary cases. Mathematical models were also used to evaluate the effect of different parameters related to the defined preventive strategies (size of the bubble group, number of days of confinement required by contacts of an index case). The effective reproduction number inside the bubble groups in schools (R*), defined as the average number of schoolmates infected by each primary case within the bubble, was calculated, yielding a value of 0.35 for primary schools and 0.55 for secondary schools, and compared with the outcomes of the mathematical model, implying decreased transmissibility for children in the context of the applied measures. Relative homogenized monthly cumulative incidence ([Formula: see text]) was assessed to compare the epidemiological dynamics among different age groups and this analysis suggested the limited impact of infections in school-aged children in the context of the overall community incidence. CONCLUSIONS: During the fall of 2020, SARS-CoV-2 infections and COVID-19 cases detected in Catalan schools closely mirrored the underlying community transmission from the neighbourhoods where they were set and maintaining schools open appeared to be safe irrespective of underlying community transmission. Preventive measures in place in those schools appeared to be working for the early detection and rapid containment of transmission and should be maintained for the adequate and safe functioning of normal academic and face-to-face school activities.


Subject(s)
COVID-19 , Residence Characteristics , Schools , Basic Reproduction Number , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/transmission , Humans , Incidence , Models, Theoretical , Spain/epidemiology
17.
PLoS Med ; 19(2): e1003904, 2022 02.
Article in English | MEDLINE | ID: covidwho-1686090

ABSTRACT

BACKGROUND: Deaths in the first year of the Coronavirus Disease 2019 (COVID-19) pandemic in England and Wales were unevenly distributed socioeconomically and geographically. However, the full scale of inequalities may have been underestimated to date, as most measures of excess mortality do not adequately account for varying age profiles of deaths between social groups. We measured years of life lost (YLL) attributable to the pandemic, directly or indirectly, comparing mortality across geographic and socioeconomic groups. METHODS AND FINDINGS: We used national mortality registers in England and Wales, from 27 December 2014 until 25 December 2020, covering 3,265,937 deaths. YLLs (main outcome) were calculated using 2019 single year sex-specific life tables for England and Wales. Interrupted time-series analyses, with panel time-series models, were used to estimate expected YLL by sex, geographical region, and deprivation quintile between 7 March 2020 and 25 December 2020 by cause: direct deaths (COVID-19 and other respiratory diseases), cardiovascular disease and diabetes, cancer, and other indirect deaths (all other causes). Excess YLL during the pandemic period were calculated by subtracting observed from expected values. Additional analyses focused on excess deaths for region and deprivation strata, by age-group. Between 7 March 2020 and 25 December 2020, there were an estimated 763,550 (95% CI: 696,826 to 830,273) excess YLL in England and Wales, equivalent to a 15% (95% CI: 14 to 16) increase in YLL compared to the equivalent time period in 2019. There was a strong deprivation gradient in all-cause excess YLL, with rates per 100,000 population ranging from 916 (95% CI: 820 to 1,012) for the least deprived quintile to 1,645 (95% CI: 1,472 to 1,819) for the most deprived. The differences in excess YLL between deprivation quintiles were greatest in younger age groups; for all-cause deaths, a mean of 9.1 years per death (95% CI: 8.2 to 10.0) were lost in the least deprived quintile, compared to 10.8 (95% CI: 10.0 to 11.6) in the most deprived; for COVID-19 and other respiratory deaths, a mean of 8.9 years per death (95% CI: 8.7 to 9.1) were lost in the least deprived quintile, compared to 11.2 (95% CI: 11.0 to 11.5) in the most deprived. For all-cause mortality, estimated deaths in the most deprived compared to the most affluent areas were much higher in younger age groups, but similar for those aged 85 or over. There was marked variability in both all-cause and direct excess YLL by region, with the highest rates in the North West. Limitations include the quasi-experimental nature of the research design and the requirement for accurate and timely recording. CONCLUSIONS: In this study, we observed strong socioeconomic and geographical health inequalities in YLL, during the first calendar year of the COVID-19 pandemic. These were in line with long-standing existing inequalities in England and Wales, with the most deprived areas reporting the largest numbers in potential YLL.


Subject(s)
COVID-19/mortality , Adult , Aged , Cardiovascular Diseases/mortality , Cause of Death , Diabetes Mellitus/mortality , England/epidemiology , Female , Health Status Disparities , Humans , Interrupted Time Series Analysis , Life Expectancy , Male , Middle Aged , Neoplasms/mortality , Residence Characteristics , Respiratory Tract Diseases/mortality , Socioeconomic Factors , Wales/epidemiology
18.
Prev Med ; 156: 106991, 2022 03.
Article in English | MEDLINE | ID: covidwho-1677228

ABSTRACT

Numerous studies have demonstrated that neighborhood context contributes to variations in morbidity and mortality. This body of work includes a burgeoning literature that links adverse neighborhood characteristics (e.g., neighborhood poverty and perceptions of disorder and dangerousness) with poorer sleep outcomes. During the COVID-19 pandemic, many neighborhoods exhibited socioeconomic downturns and escalations in crime and violence. The question is the extent to which these changes in neighborhood conditions have impacted the sleep quality of residents. In this paper, we use original survey data from the 2021 Crime, Health, and Politics Survey (CHAPS), a national probability sample of adults living in the U.S., to formally test whether changes in perceptions of neighborhood dangerousness during the pandemic are associated with sleep quality during the same period. Regression analyses show that while reports of a neighborhood becoming safer during the pandemic are associated with better sleep quality, reports of a neighborhood becoming more dangerous are associated with worse sleep quality. Mediation analyses also indicate that the association between increased neighborhood dangerousness and poorer sleep quality is partially explained by a concurrent deterioration in diet quality, but not increases in alcohol or cigarette consumption. We conclude with a discussion of the implications of our findings for research and policy on neighborhood context and sleep.


Subject(s)
COVID-19 , Pandemics , Adult , Dangerous Behavior , Health Behavior , Humans , Residence Characteristics , SARS-CoV-2
19.
Ecotoxicol Environ Saf ; 232: 113245, 2022 Mar 01.
Article in English | MEDLINE | ID: covidwho-1650571

ABSTRACT

Evidence regarding environmental factors associated with disease severity of COVID-19 remained scarce. This study aimed to investigate the association of residential greenness exposure with COVID-19 severity applying a retrospective cross-sectional study in Wuhan, China. We included 30,253 COVID-19 cases aged over 45 years from January 1 to February 27, 2020. Residential greenness was quantitatively assessed using normalized difference vegetation index (NDVI) and enhanced vegetation index (EVI). A multilevel generalized linear model using Poisson regression was implemented to analyze the association between greenness exposure and disease severity of COVID-19, after adjusting for potential covariates. A linear exposure-response relationship was found between greenness and COVID-19 severity. In the adjusted model, one 0.1 unit increase of NDVI and EVI in the 1000-m buffer radius was significantly associated with a 7.6% (95% confidence interval (CI): 4.0%, 11.1%) and 10.0% (95% CI: 5.1%, 14.7%) reduction of the prevalence of COVID-19 severity, respectively. The effect of residential greenness seemed to be more pronounced among participants with lower population density and economic levels. Air pollutants mediated 0.82~12.08% of the greenness and COVID-19 severity association, particularly to nitrogen dioxide. Sensitivity analyses suggested the robustness of the results. Our findings suggested that residential greenness exposure was beneficial to reduce the prevalence of COVID-19 severity.


Subject(s)
Air Pollution , COVID-19 , Residence Characteristics , Air Pollution/analysis , COVID-19/epidemiology , China/epidemiology , Cross-Sectional Studies , Humans , Middle Aged , Parks, Recreational , Retrospective Studies , SARS-CoV-2 , Severity of Illness Index
20.
J Urban Health ; 99(1): 67-76, 2022 02.
Article in English | MEDLINE | ID: covidwho-1623273

ABSTRACT

Structural racism in police contact is an important driver of health inequities among the U.S. urban population. Hyper-policing and police violence in marginalized communities have risen to the top of the national policy agenda, particularly since protests in 2020. How did pandemic conditions impact policing? We assess neighborhood racial disparities in arrests after COVID-19 stay-at-home orders in Boston, Charleston, Pittsburgh, and San Francisco census tracts (January 2019-August 2020). Using interrupted time series models with census tract fixed effects, we report arrest rates across tract racial and ethnic compositions. In the weeks following stay-at-home orders, overall arrest rates were 39% lower (95% CI: 37-41%) on average compared to rates the year prior. Although arrest rates steadily increased thereafter, most tracts did not reach pre-pandemic arrest levels. However, despite declines in nearly all census tracts, the magnitude of racial inequities in arrests remained unchanged. During the initial weeks of the pandemic, arrest rates declined significantly in areas with higher Black populations, but average rates in Black neighborhoods remained higher than pre-pandemic arrest rates in White neighborhoods. These findings support urban policy reforms that reconsider police capacity and presence, particularly as a mechanism for enforcing public health ordinances and reducing racial disparities.


Subject(s)
COVID-19 , Humans , Pandemics , Residence Characteristics , SARS-CoV-2
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