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1.
Surg Endosc ; 36(12): 9304-9312, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2119131

ABSTRACT

BACKGROUND: The COVID-19 pandemic caused many surgical providers to conduct outpatient evaluations using remote audiovisual conferencing technology (i.e., telemedicine) for the first time in 2020. We describe our year-long institutional experience with telemedicine in several general surgery clinics at an academic tertiary care center and examine the relationship between area-based socioeconomic measures and the likelihood of telemedicine participation. METHODS: We performed a retrospective review of our outpatient telemedicine utilization among four subspecialty clinics (including two acute care and two elective surgery clinics). Geocoding was used to link patient visit data to area-based socioeconomic measures and a multivariable analysis was performed to examine the relationship between socioeconomic indicators and patient participation in telemedicine. RESULTS: While total outpatient visits per month reached a nadir in April 2020 (65% decrease in patient visits when compared to January 2020), there was a sharp increase in telemedicine utilization during the same month (38% of all visits compared to 0.8% of all visits in the month prior). Higher rates of telemedicine utilization were observed in the two elective surgery clinics (61% and 54%) compared to the two acute care surgery clinics (14% and 9%). A multivariable analysis demonstrated a borderline-significant linear trend (p = 0.07) between decreasing socioeconomic status and decreasing odds of telemedicine participation among elective surgery visits. A sensitivity analysis to examine the reliability of this trend showed similar results. CONCLUSION: Telemedicine has many patient-centered benefits, and this study demonstrates that for certain elective subspecialty clinics, telemedicine may be utilized as the preferred method for surgical consultations. However, to ensure the equitable adoption and advancement of telemedicine services, healthcare providers will need to focus on mitigating the socioeconomic barriers to telemedicine participation.


Subject(s)
COVID-19 , Telemedicine , Humans , COVID-19/epidemiology , Pandemics , Tertiary Care Centers , Reproducibility of Results , Telemedicine/methods , Social Class
2.
Vaccine ; 40(46): 6575-6580, 2022 Nov 02.
Article in English | MEDLINE | ID: covidwho-2106122

ABSTRACT

BACKGROUND: We sought to evaluate the trends of HPV vaccination between 03/2019-09/2021 and whether the impact of the COVID pandemic on HPV vaccination varied by race/ethnicity and neighborhood deprivation index (NDI). METHODS: Electronic medical records at Kaiser Permanente Southern California were used to assess monthly volume of HPV vaccine doses administered among children aged 9-12.9yrs, and up-to-date coverage (% vaccinated) by age 13 between 03/2019-09/2021. Modified Poisson models were used to evaluate the interactions between race/ethnicity, NDI and the pandemic periods on HPV vaccine coverage. RESULTS: HPV vaccine doses administered in 2020/2021 have returned to the 2019 level after the initial drop. The average up-to-date coverage in 05/2021-09/2021 (54.8%) remained lower than the pre-pandemic level (58.5%). The associations between race/ethnicity, NDI and HPV vaccine coverage did not vary due to the pandemic. CONCLUSION: HPV vaccine promotion efforts are needed to address COVID-19 pandemic's lasting impact on HPV vaccination coverage.


Subject(s)
COVID-19 , Delivery of Health Care, Integrated , Papillomavirus Infections , Papillomavirus Vaccines , Child , Humans , Pandemics , Papillomavirus Infections/epidemiology , Papillomavirus Infections/prevention & control , Ethnicity , COVID-19/epidemiology , COVID-19/prevention & control , Vaccination , Social Class , California/epidemiology
4.
Am J Epidemiol ; 191(11): 1897-1905, 2022 Oct 20.
Article in English | MEDLINE | ID: covidwho-2097303

ABSTRACT

We aimed to determine whether long-term ambient concentrations of fine particulate matter (particulate matter with an aerodynamic diameter less than or equal to 2.5 µm (PM2.5)) were associated with increased risk of testing positive for coronavirus disease 2019 (COVID-19) among pregnant individuals who were universally screened at delivery and whether socioeconomic status (SES) modified this relationship. We used obstetrical data collected from New-York Presbyterian Hospital/Columbia University Irving Medical Center in New York, New York, between March and December 2020, including data on Medicaid use (a proxy for low SES) and COVID-19 test results. We linked estimated 2018-2019 PM2.5 concentrations (300-m resolution) with census-tract-level population density, household size, income, and mobility (as measured by mobile-device use) on the basis of residential address. Analyses included 3,318 individuals; 5% tested positive for COVID-19 at delivery, 8% tested positive during pregnancy, and 48% used Medicaid. Average long-term PM2.5 concentrations were 7.4 (standard deviation, 0.8) µg/m3. In adjusted multilevel logistic regression models, we saw no association between PM2.5 and ever testing positive for COVID-19; however, odds were elevated among those using Medicaid (per 1-µg/m3 increase, odds ratio = 1.6, 95% confidence interval: 1.0, 2.5). Further, while only 22% of those testing positive showed symptoms, 69% of symptomatic individuals used Medicaid. SES, including unmeasured occupational exposures or increased susceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) due to concurrent social and environmental exposures, may explain the increased odds of testing positive for COVID-19 being confined to vulnerable pregnant individuals using Medicaid.


Subject(s)
Air Pollutants , Air Pollution , COVID-19 , Pregnancy , Female , Humans , Particulate Matter/analysis , SARS-CoV-2 , Air Pollution/adverse effects , Air Pollutants/analysis , New York City/epidemiology , Prevalence , Environmental Exposure/adverse effects , Social Class
5.
J Prev Med Public Health ; 55(5): 455-463, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2066726

ABSTRACT

OBJECTIVES: Economic hardship has a serious impact on adolescents' mental health. The financial impact of the coronavirus disease 2019 (COVID-19) pandemic was more severe for low-income families, and this also impacted adolescents. This study aimed to examine the associations of economic deterioration (ED) caused by the COVID-19 pandemic and low socioeconomic status (SES) with adolescents' suicidal behaviors. METHODS: This study analyzed data from the 2020 Korea Youth Risk Behavior Web-based Survey, which included 54 948 middle and high school students. Odds ratios (ORs) of suicidal ideation, suicidal planning, and suicide attempts related to ED and SES were calculated using multivariable logistic regression. We calculated relative excess risks due to interaction to assess additive interactions. RESULTS: The ORs for suicidal ideation, suicidal planning, and suicide attempts related to combined severe ED and low SES were 3.64 (95% confidence interval [CI], 3.13 to 4.23), 3.88 (95% CI, 3.09 to 4.88), and 4.27 (95% CI, 3.21 to 5.69), respectively. CONCLUSIONS: ED and low SES were significantly associated with suicidal behaviors in adolescents. Although no significant additive interaction was found, the ORs related to suicidal ideation, suicidal planning, and suicide attempts were highest among adolescents from low-income families with severe ED. Special attention is needed for this group, considering the increased impact of economic inequality due to the COVID-19 pandemic.


Subject(s)
Adolescent Behavior , COVID-19 , Adolescent , Cross-Sectional Studies , Electrolytes , Humans , Internet , Pandemics , Republic of Korea/epidemiology , Risk Factors , Risk-Taking , Social Class , Suicidal Ideation
6.
Sociol Health Illn ; 44(8): 1211-1213, 2022 09.
Article in English | MEDLINE | ID: covidwho-2052134
7.
Int J Environ Res Public Health ; 19(19)2022 Sep 20.
Article in English | MEDLINE | ID: covidwho-2043705

ABSTRACT

Since December 2019, COVID-19 has greatly influenced public healthcare systems around the globe in various aspects, including limitation of healthcare accessibility due to lack of both human and financial resources, suspension of clinics, and fear of infection causing healthcare avoidance. The aim of this study was to investigate the impact of COVID-19 on access to healthcare for otorhinolaryngology patients from different socioeconomic status (SES) groups. Otorhinolaryngology patients' disease severity status, diagnosed at the first hospital visit, was investigated during the pre -and post-COVID-19 pandemic era in a single medical center located in Seoul, Korea. An ordinal regression model was used to assess the impact of both SES and the COVID-19 pandemic on otorhinolaryngology diseases. Within the chronic rhinosinusitis group, lower SES was associated with a higher disease severity at the first visit compared to higher SES (OR = 3.25). During the COVID-19 pandemic, while the total number of outpatients was reduced, the severity of these ENT diseases seemed to increase compared to the pre-pandemic severity in every SES group. Our study demonstrates the negative impact a worldwide pandemic can have on healthcare inequity and disease severity, and highlights the importance of re-allocating fundamental resources for those in need during periods of public health crisis.


Subject(s)
COVID-19 , Otolaryngology , COVID-19/epidemiology , Health Services Accessibility , Humans , Pandemics , Social Class
8.
Environ Res ; 215(Pt 2): 114290, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2007684

ABSTRACT

Over two years into the COVID-19 pandemic, it is apparent that some populations across the world are more susceptible than others to SARS-CoV-2 infection and spread. Understanding how populations with varying demographic patterns are impacted by COVID-19 may highlight which factors are most important in targeting to combat global suffering. The first objective of this study was to investigate the association of various socioeconomic status (SES) parameters and confirmed COVID-19 cases in the state of Ohio, USA. This study examines the largest and capital city of Ohio (Columbus) and various small-medium-sized communities. The second objective was to determine the relationship between SES parameters and community-level SARS-CoV-2 concentrations using municipal wastewater samples from each city's respective wastewater treatment plants from August 2020 to January 2021. SES parameters include population size, median income, poverty, race/ethnicity, education, health care access, types of COVID-19 testing sites, and social vulnerability index. Statistical analysis results show that confirmed (normalized and/or non-normalized) COVID-19 cases were negatively associated with White percentage and registered hospitals, and positively associated with registered physicians and various COVID-19 testing sites. Wastewater viral concentrations were negatively associated with poverty, and positively associated with median income, community health centers, and onsite rapid testing locations. Additional analyses conclude that population is a significant factor in determining COVID-19 cases and SARS-CoV-2 wastewater concentrations. Results indicate that community healthcare parameters relate to a negative health outcome (COVID-19) and that demographic parameters can be associated with community-level SARS-CoV-2 wastewater concentrations. As the first study that examines the association between socioeconomic parameters and SARS-CoV-2 wastewater concentrations as well as confirmed COVID-19 cases, it is apparent that social determinants have an impact in determining the health burden of small-medium sized Ohioan cities. This study design and innovative approach are scalable and applicable for endemic and pandemic surveillance across the world.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/epidemiology , COVID-19 Testing , Humans , Pandemics , Social Class , Waste Water
9.
BMJ Open ; 12(8): e064276, 2022 08 17.
Article in English | MEDLINE | ID: covidwho-2001856

ABSTRACT

OBJECTIVES: To assess the frequency of reporting of ethnicity (or 'race') and socioeconomic status (SES) indicators in high-impact journals. DESIGN: Targeted literature review. DATA SOURCES: The 10 highest ranked general medical journals using Google scholar h5 index. ELIGIBILITY CRITERIA: Inclusion criteria were, human research, reporting participant level data. Exclusion criteria were non-research article, animal/other non-human participant/subject or no participant characteristics reported. DATA EXTRACTION AND SYNTHESIS: Working backwards from 19 April 2021 in each journal, two independent reviewers selected the 10 most recent articles meeting inclusion/exclusion criteria, to create a sample of 100 articles. Data on the frequency of reporting of ethnicity (or 'race') and SES indicators were extracted and presented using descriptive statistics. RESULTS: Of 100 research articles included, 35 reported ethnicity and 13 SES. By contrast, 99 reported age, and 97 reported sex or gender. Among the articles not reporting ethnicity, only 3 (5%) highlighted this as a limitation, and only 6 (7%) where SES data were missing. Median number of articles reporting ethnicity per journal was 2.5/10 (range 0 to 9). Only two journals explicitly requested reporting of ethnicity (or race), and one requested SES. CONCLUSIONS: The majority of research published in high-impact medical journals does not include data on the ethnicity and SES of participants, and this omission is rarely acknowledged as a limitation. This situation persists despite the well-established importance of this issue and International Committee of Medical Journal Editors recommendations to include relevant demographic variables to ensure representative samples. Standardised explicit minimum standards are required.


Subject(s)
Ethnicity , Periodicals as Topic , Humans , Journal Impact Factor , Publications , Social Class
10.
Can J Public Health ; 113(6): 878-886, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1994670

ABSTRACT

OBJECTIVES: This study highlights how socioeconomic trends in the emergency department (ED) for low-acuity visits change with the onset of COVID-19, identifies societal inequities exacerbated by the pandemic, and demonstrates the geographical regions where these inequities occur. METHODS: We accessed 1,285,000 ED visits from 12 different facilities across New Brunswick from January 2017 to October 2020. Using a deprivation index developed by Statistics Canada as a measure of socioeconomic status, and controlling for additional factors, we perform a logistic regression to determine the influence of the COVID-19 pandemic on low-acuity visits of individuals from the most deprived quintile (Q5). We constructed a heat map of New Brunswick to highlight regions of high deprivation. RESULTS: The proportion of Q5 individuals in the ethnocultural composition domain accessing the ED for low-acuity visits increased from 22.91% to 24.72% with the onset of the pandemic. Our logistic regression showed the log odds of being considered Q5 in the ethnocultural composition domain when visiting the ED for a low-acuity reason increased by 6.3% if the visit occurred during the pandemic, and increased by 101.6% if the visit occurred in one of the 3 major regions of New Brunswick. CONCLUSION: Individuals visiting EDs for low-acuity reasons during the COVID-19 pandemic were more likely to be from the most diverse quintile in the ethnocultural domain, and the inequities were concentrated in the most urban regions in New Brunswick. This demonstrates that urban areas are where inequities are disproportionately faced for ethnically diverse individuals and demonstrates where policies could be focused.


RéSUMé: OBJECTIFS: Notre étude montre l'évolution des tendances socioéconomiques des visites aux services d'urgence (SU) pour des affections mineures avec l'apparition de la COVID-19 et indique les iniquités sociétales exacerbées par la pandémie et les régions géographiques où ces iniquités se manifestent. MéTHODE: Nous avons eu accès à 1 285 000 visites aux SU de 12 établissements du Nouveau-Brunswick entre janvier 2017 et octobre 2020. À l'aide d'un indice de défavorisation élaboré par Statistique Canada pour mesurer le statut socioéconomique et après avoir apporté des ajustements pour tenir compte des effets d'autres facteurs, nous avons effectué une analyse de régression logistique pour déterminer l'influence de la pandémie de COVID-19 sur les visites de personnes du quintile le plus défavorisé (Q5) pour des affections mineures. Nous avons construit une carte de densité du Nouveau-Brunswick pour représenter les régions très défavorisées. RéSULTATS: La proportion de personnes du Q5 dans le domaine de la composition ethnoculturelle ayant visité les SU pour des affections mineures est passée de 22,91 % à 24,72 % après le début de la pandémie. Selon notre analyse de régression logistique, la probabilité logarithmique pour une personne ayant visité les SU pour une affection mineure d'être considérée comme faisant partie du Q5 dans le domaine de la composition ethnoculturelle augmentait de 6,3 % si la visite avait eu lieu durant la pandémie, et elle augmentait de 101,6 % si la visite avait eu lieu dans l'une des trois grandes régions du Nouveau-Brunswick. CONCLUSION: Les personnes ayant visité les SU pour des affections mineures durant la pandémie de COVID-19 étaient plus susceptibles d'appartenir au quintile le plus diversifié dans le domaine ethnoculturel, et les iniquités étaient concentrées dans les régions les plus urbaines du Nouveau-Brunswick. L'étude démontre que c'est dans les agglomérations urbaines que les personnes d'origines ethniques diverses font face à des iniquités démesurées, et elle indique où les politiques pourraient être ciblées.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Pandemics , Emergency Service, Hospital , Social Class , Logistic Models , Retrospective Studies
11.
BMJ Glob Health ; 7(7)2022 07.
Article in English | MEDLINE | ID: covidwho-1962169

ABSTRACT

Manual scavengers, or 'Safai Karamcharis', as they are known in India, are sanitation workers who manually clean human waste for a living and face considerable occupational health risks. They are subject to deep-seated, caste-based stigma associated with their perceived 'caste impurity' and lack of cleanliness, which result both in consistently dangerous substandard working conditions and lack of social mobility, with women facing greater hardships. The COVID-19 pandemic has further exacerbated their plight. Despite the considerable efforts of social advocates, organised movements and government institutions, reforms and criminalisation have produced mixed results and campaigners remain divided on whether banning manual scavenging is an effective solution. This article reviews the history of attempts to address scavenging in India. Starting in the colonial period and ending with the current government's Swachh Bharat Mission, it highlights how attempts to deal with scavenging via quick-fix solutions like legal bans criminalising their employment, infrastructure upgrades or paternalistic interventions have either failed to resolve issues or exacerbated scavengers' situation by pushing long-standing problems out of view. It argues that meaningful progress depends on abandoning top-down modes of decision-making, addressing the underlying sociocultural and infrastructural factors that perpetuate the ill health and social conditions of manual scavengers, collecting data on the true extent of scavenging, and investing in and providing political agency to communities themselves.


Subject(s)
COVID-19 , Pandemics , Female , Humans , Paternalism , Sanitation , Social Class
12.
Sci Rep ; 12(1): 12133, 2022 07 15.
Article in English | MEDLINE | ID: covidwho-1937443

ABSTRACT

To determine whether immigrant background and socioeconomic status were associated with increased risk to develop severe Coronavirus disease 2019 (COVID-19) requiring mechanical ventilation at the intensive care unit and to study their effects on 90-day mortality. Nationwide case-control study with personal-level data from the Swedish Intensive Care register linked with socioeconomic data from Statistics Sweden and comorbidity data from the national patient register. For each case of COVID-19 treated with mechanical ventilation at the intensive care unit (outcome), 10 population controls were matched for age, sex and area of residence. Logistic and Cox regression were used to study the association between the exposure (immigrant background, income and educational level) and 90-day mortality. In total, 4 921 cases and 49 210 controls were matched. In the adjusted model, the risk of severe COVID-19 was highest in individuals born in Asia (Odds ratio [OR] = 2.44, 95% confidence interval [CI] = 2.20-2.69), South America (OR = 2.34, 95% CI = 1.82-2.98) and Africa (OR = 2.11, 95% CI = 1.76-2.50). Post-secondary education was associated with a lower risk of severe COVID-19 (OR = 0.75, CI = 0.69-0.82) as was the highest (vs. lowest) income quintile (OR = 0.87, CI = 0.77-0.97). In the fully adjusted Cox-regression analysis birth region of Africa (OR 1.38, CI = 1.03-1.86) and high income (OR 0.75, CI 0.63-0.89) were associated with 90-day mortality. Immigrant background, educational level and income were independently associated with acquiring severe COVID-19 with need for mechanical ventilation.


Subject(s)
COVID-19 , Emigrants and Immigrants , COVID-19/epidemiology , COVID-19/therapy , Case-Control Studies , Critical Care , Humans , Social Class , Sweden/epidemiology
13.
Br J Gen Pract ; 72(720): e472-e482, 2022 07.
Article in English | MEDLINE | ID: covidwho-1924319

ABSTRACT

BACKGROUND: COVID-19 has led to rapid changes in healthcare delivery, raising concern that these changes may exacerbate existing inequalities in patient outcomes. AIM: To understand how patients' help-seeking experiences in primary care for colorectal cancer symptoms during COVID-19 were affected by their socioeconomic status (SES). DESIGN AND SETTING: Qualitative semi-structured interviews with males and females across the UK, recruited using purposive sampling by SES. METHOD: Interviews were carried out with 39 participants (20 higher SES; 19 lower SES) who contacted primary care about possible symptoms of colorectal cancer during COVID-19. Data were analysed using framework analysis followed by comparative thematic analysis to explore differences between groups. RESULTS: Three themes were identified with differences between SES groups: 1) how people decided to seek medical help through appraisal of symptoms; 2) how people navigated services; and 3) impact of COVID-19 on how patients interacted with healthcare professionals. The lower SES group expressed uncertainty appraising symptoms and navigating services (in terms of new processes resulting from COVID-19 and worries about infection). There was also potential for increased disparity in diagnosis and management, with other methods of getting in touch (for example, email or 111) taken up more readily by higher SES patients. CONCLUSION: The findings suggest that COVID-19 exacerbated disparities between higher and lower SES participants. This study raises awareness around challenges in help seeking in the context of the pandemic, which are likely to persist (post-COVID-19) as healthcare systems settle on new models of care (for example, digital). Recommendations are provided to reduce inequalities of care.


Subject(s)
COVID-19 , Colorectal Neoplasms , COVID-19/epidemiology , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/epidemiology , Female , Humans , Male , Qualitative Research , Social Class , United Kingdom/epidemiology
14.
Appetite ; 178: 106158, 2022 11 01.
Article in English | MEDLINE | ID: covidwho-1914158

ABSTRACT

In addition to its public health implications, the global COVID-19 pandemic has also produced significant disruptions to individuals' socioeconomic resources and opportunities. Prior research has suggested that low subjective socioeconomic status (SSES) may stimulate appetite and motivate increased energy intake. Here, we tested whether individuals experiencing lower levels of SSES (SSES disadvantage) during a nationwide stay-at-home order for COVID-19 exhibited preferences for larger food portion sizes through perceived disruptions to personal financial and material resources. Data was collected near the conclusion of a nationwide partial lockdown (Singapore's "Circuit-Breaker" from April to June 2020). Participants (N = 295) completed an online survey involving a measure of SSES, the Coronavirus Impacts Questionnaire, and a food portion selection task where participants estimated the portion size they prefer to consume for a range of common foods. SSES disadvantage was associated with selection of smaller average portion sizes. Yet, a significant indirect effect of coronavirus impact was observed in this relationship, such that participants experiencing greater SSES disadvantage selected larger portion sizes through the effect of greater perceived impacts of COVID-19 to one's financial/material resources (controlling for one's actual level of income). These findings further support the idea that perceived deprivation and insecurity of important resources (financial, social, material) may influence intentions to consume greater amounts of energy. Consequently, systematic societal disruptions to such resources may reinforce and perpetuate potentially obesogenic eating behaviors of populations that are especially vulnerable to such shocks (i.e., people experiencing SSES disadvantage).


Subject(s)
COVID-19 , Communicable Disease Control , Humans , Pandemics , Portion Size , Social Class
15.
Public Health Nurs ; 39(6): 1195-1203, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-1896027

ABSTRACT

OBJECTIVE: The aim of this study is to explore the association between economic wellbeing and ethnicity, socioeconomic status, and remoteness during the COVID-19 pandemic. DESIGN: A cross-sectional study via SurveyMonkey was conducted in Australia between August 2020 and October 2020. Descriptive and inferential statistics were used to analyze the data. RESULTS: A total of 1211 individuals responded to the survey. Income loss was significantly associated with those from low socioeconomic status (OR = 1.65; 95% CI 1.01-2.68). Access of superannuation was significantly associated with those in outer regional (OR = 3.61; 95% CI 0.81-16.03) and low socioeconomic status (OR = 2.72; 95% CI 1.34-5.53). Financial inability to pay for services was significantly associated with living in remote areas (OR = 2.26; 95% CI 0.88-5.80). CONCLUSIONS: The economic wellbeing of people who identify as Aboriginal and Torres Strait Islander, live in regional or remote areas, and reside in low socioeconomic areas have been substantially impacted during the pandemic. Findings call for policies to address the underlying social determinants of health.


Subject(s)
COVID-19 , Native Hawaiian or Other Pacific Islander , Humans , Pandemics , Cross-Sectional Studies , COVID-19/epidemiology , Ethnicity , Social Class
16.
Int J Environ Res Public Health ; 19(11)2022 06 01.
Article in English | MEDLINE | ID: covidwho-1892875

ABSTRACT

The mental health (MH) of especially children and adolescents with low socioeconomic status (SES) benefits from access to greenspaces. This study aimed at investigating social inequalities in the association between several types of social infrastructure (SI) and MH in children and adolescents. The sample comprised 12,624 children and adolescents of the KiGGS Wave 2 study (2014-2017). KiGGS provided information on SI (access to playgrounds, sports fields, swimming pools, parks) for all children and the environmental module (GerES V) within KiGGS on the walking time to SI for a subsample. Social inequality was measured by parental SES and the German Index of Socioeconomic deprivation and MH by the Strengths and Difficulties Questionnaire. Ordinal logistic regression analyses showed that access to fewer SI places was associated with higher odds of MH problems. Children and adolescents experiencing high (but not medium or low) socioeconomic deprivation at the municipal level were more likely to have MH problems when having less access to SI places. At the individual level, MH problems in high- and low-SES, but not medium-SES children and adolescents were associated with no access to SI places. Children and adolescents from high socioeconomically deprived areas and with low and high SES might benefit from high-availability SI.


Subject(s)
Mental Health , Social Capital , Adolescent , Child , Cross-Sectional Studies , Germany/epidemiology , Health Surveys , Humans , Social Class , Socioeconomic Factors
17.
J Psychiatr Res ; 152: 25-30, 2022 08.
Article in English | MEDLINE | ID: covidwho-1882279

ABSTRACT

Identifying factors that influence adolescent intentions for COVID-19 vaccination is essential for developing strategic interventions to increase uptake, particularly in subgroups of at-risk adolescents. Attention-deficit/hyperactivity disorder (ADHD) in adolescence is characterized by difficulties regulating attention and behavior, social impairment, and impulsive risk-taking behaviors, which may impact vaccine hesitancy and vaccine uptake. This study examined hesitancy toward COVID-19 vaccines among adolescents with and without ADHD, and explored how ADHD status interacted with malleable social mechanisms and other social determinants of health in predicting vaccine hesitancy. Participants were 196 U.S. adolescents (44.4% male), 45.6% diagnosed with ADHD. Adolescents reported their confidence and willingness toward COVID-19 vaccines from March to May 2021. Adolescents with ADHD reported greater hesitancy and less confidence in COVID-19 vaccine safety compared to adolescents without ADHD (p < .01). Only 61.8% of adolescents with ADHD reported vaccine acceptance, compared to 81.3% of adolescents without ADHD. For all adolescents, those who identified as Black or Latinx and with lower family income had greater hesitancy and reduced confidence, whereas greater COVID-19 concerns, media use, and perceived negative impact on relationships was associated with greater vaccination willingness. Social contextual processes significantly interacted with ADHD status such that for adolescents without ADHD, concerns about COVID-19 were associated with increased confidence in vaccine safety. Being noncompliant with social distancing guidelines was associated with greater vaccine hesitancy, only for adolescents with ADHD. A concerted effort is needed to increase trust, confidence, and social relevance among adolescents, especially those with ADHD and from lower socio-economic backgrounds.


Subject(s)
Attention Deficit Disorder with Hyperactivity , COVID-19 Vaccines , COVID-19 , Vaccination Hesitancy , Adolescent , African Americans , Attention Deficit Disorder with Hyperactivity/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/administration & dosage , Female , Hispanic or Latino , Humans , Male , Social Class , United States
18.
Int J Environ Res Public Health ; 19(9)2022 05 08.
Article in English | MEDLINE | ID: covidwho-1847325

ABSTRACT

This pilot study was conducted on the reported hypothesis that the COVID-19 pandemic outbreak had an impact on the accessibility and quality of healthcare services and exacerbated socioeconomic inequalities. The aim was to determine whether economic status and education had an impact on the perception of access and quality to healthcare services during the COVID-19 pandemic and whether, according to patients, accessibility and quality had changed significantly compared to the pre-pandemic period in Poland. The study was based on the authors' questionnaire and the results were statistically analyzed. Two hundred forty-seven feedback responses were received with a responsiveness rate of 93 percent. Statistically significant differences were found when comparing education level and utilization of healthcare services during the COVID-19 pandemic. A comparison of gender and economic situation, and average monthly income found no statistically significant differences. The outbreak of the COVID-19 pandemic has undoubtedly affected the provision of health services in many countries around the world. One result of the pandemic crisis has been widening socioeconomic inequalities among patients.


Subject(s)
COVID-19 , COVID-19/epidemiology , Health Services , Health Services Accessibility , Humans , Pandemics , Perception , Pilot Projects , Social Class
19.
NCHS Data Brief ; (435): 1-8, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1842692

ABSTRACT

Oral health is an essential component of overall health and well-being (1,2). Along with good oral hygiene, an important factor of oral health is regular dental care (3). However, about 35% of adults aged 18 and over did not have a dental visit in 2019 (4), and predictors such as age, race, sex, and socioeconomic status were associated with delayed dental care among adults in the United States (5). In 2020, many dental practices limited their hours and services in response to the COVID-19 pandemic (6,7). This report uses data from the 2019 and 2020 National Health Interview Survey (NHIS) to describe recent changes in the prevalence of dental visits among adults aged 18-64.


Subject(s)
COVID-19 , Adolescent , Adult , COVID-19/epidemiology , Dental Care , Humans , Oral Health , Pandemics , Social Class , United States/epidemiology
20.
Nihon Koshu Eisei Zasshi ; 69(9): 655-664, 2022 Sep 10.
Article in Japanese | MEDLINE | ID: covidwho-1841686

ABSTRACT

Objective This study aimed to understand the situation of the users of food assistance activities during the COVID-19 pandemic, and to examine the relationship with the changes in socioeconomic conditions.Methods A total of 33,004 (16,065 men and 16,939 men) people aged 20 or older who cooperated with an online survey in February 2021 were included in the analysis. The analysis was conducted by classifying users of one of the following types of food assistance as food assistance users and other users as non-users: eating on site (e.g., children's cafeteria), receiving food at a specific location (e.g., food pantry), or having food delivered to their home (e.g., emergency home food delivery). A multiple logistic regression analysis was used to calculate the adjusted odds ratios (95% confidence interval (CI)) for the association between food assistance use and changes in socioeconomic status, which was assessed based on the employment status and household monthly income just before and during the COVID-19 pandemic.Results The number of users of food assistance was 3,071 (9.3%). Of these, 1,549 (4.7%) were users of children's cafeterias, 1,296 (3.9%) were users of food pantries, and 2,236 (6.8%) were users of emergency home food delivery (with duplicate responses). The adjusted odds ratio for food assistance use was 1.47 (95% CI 1.28-1.70) for those with changes in employment status compared to those with no changes. The adjusted odds ratio for food assistance use was 1.89 (1.65-2.15) for those with reduced income and 1.67 (1.37-2.03) for those with increased household income compared to those with no changes. The adjusted odds ratios for food assistance use were higher for those with changes in employment status and/or household income than those with no changes in both.Conclusions One in ten individuals used food assistance during the COVID-19 pandemic. It was suggested that many of the users of food assistance had changed their employment status or household income during the COVID-19 pandemic. In the future, it will be necessary to establish a public-private system that can provide information on local food assistance to people whose socioeconomic status has changed rapidly.


Subject(s)
COVID-19 , Food Assistance , COVID-19/epidemiology , Child , Cross-Sectional Studies , Food Supply , Humans , Japan/epidemiology , Male , Pandemics , Social Class
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