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1.
BMC Infect Dis ; 21(1): 686, 2021 Jul 16.
Article in English | MEDLINE | ID: covidwho-1571742

ABSTRACT

BACKGROUND: Associations between community-level risk factors and COVID-19 incidence have been used to identify vulnerable subpopulations and target interventions, but the variability of these associations over time remains largely unknown. We evaluated variability in the associations between community-level predictors and COVID-19 case incidence in 351 cities and towns in Massachusetts from March to October 2020. METHODS: Using publicly available sociodemographic, occupational, environmental, and mobility datasets, we developed mixed-effect, adjusted Poisson regression models to depict associations between these variables and town-level COVID-19 case incidence data across five distinct time periods from March to October 2020. We examined town-level demographic variables, including population proportions by race, ethnicity, and age, as well as factors related to occupation, housing density, economic vulnerability, air pollution (PM2.5), and institutional facilities. We calculated incidence rate ratios (IRR) associated with these predictors and compared these values across the multiple time periods to assess variability in the observed associations over time. RESULTS: Associations between key predictor variables and town-level incidence varied across the five time periods. We observed reductions over time in the association with percentage of Black residents (IRR = 1.12 [95%CI: 1.12-1.13]) in early spring, IRR = 1.01 [95%CI: 1.00-1.01] in early fall) and COVID-19 incidence. The association with number of long-term care facility beds per capita also decreased over time (IRR = 1.28 [95%CI: 1.26-1.31] in spring, IRR = 1.07 [95%CI: 1.05-1.09] in fall). Controlling for other factors, towns with higher percentages of essential workers experienced elevated incidences of COVID-19 throughout the pandemic (e.g., IRR = 1.30 [95%CI: 1.27-1.33] in spring, IRR = 1.20 [95%CI: 1.17-1.22] in fall). Towns with higher proportions of Latinx residents also had sustained elevated incidence over time (IRR = 1.19 [95%CI: 1.18-1.21] in spring, IRR = 1.14 [95%CI: 1.13-1.15] in fall). CONCLUSIONS: Town-level COVID-19 risk factors varied with time in this study. In Massachusetts, racial (but not ethnic) disparities in COVID-19 incidence may have decreased across the first 8 months of the pandemic, perhaps indicating greater success in risk mitigation in selected communities. Our approach can be used to evaluate effectiveness of public health interventions and target specific mitigation efforts on the community level.


Subject(s)
COVID-19/epidemiology , Occupations/statistics & numerical data , Social Environment , Transportation/statistics & numerical data , Adult , Aged , Aged, 80 and over , COVID-19/ethnology , Female , Health Status Disparities , Humans , Incidence , Income/statistics & numerical data , Male , Massachusetts/epidemiology , Middle Aged , Movement/physiology , Pandemics , Residence Characteristics/statistics & numerical data , Risk Factors , SARS-CoV-2/physiology , Socioeconomic Factors , Time Factors , Vulnerable Populations/ethnology , Vulnerable Populations/statistics & numerical data , Young Adult
3.
Mol Biol Cell ; 32(22): ae2, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1500972

ABSTRACT

If this was not happening in the midst of the COVID-19 pandemic, I imagine that I would be speaking these words instead of writing them on my laptop. Even so, I am so jazzed for this opportunity! No word or phrase describes what I am feeling in this moment in receiving the 2021 American Society for Cell Biology Prize for Excellence in Inclusivity. It is certainly an honor to be recognized in this way. I am grateful to the Howard Hughes Medical Institute for awarding me additional resources to keep on keeping on. My approach to finding the connection between people and their science certainly could use the monetary support. Resources open doors. At the same time that I am grateful for the attention, I am not exactly sure what to do with the spotlight. Importantly, there are a host of other folks out there also doing amazing things who have never been recognized. Let's work to ensure that their contributions are supported, appreciated, and recognized. Instead of focusing the spotlight on me, I would rather redirect it to recognize my foundational influences. I also hope to encourage the need for institutional approaches beyond celebrating individual accomplishment.


Subject(s)
Awards and Prizes , Cultural Diversity , Social Change , Academies and Institutes , History, 21st Century , Humans , Social Environment
7.
J Res Adolesc ; 31(3): 820-835, 2021 09.
Article in English | MEDLINE | ID: covidwho-1373863

ABSTRACT

Members of the Society for Research on Adolescents COVID-19 Response Team offer this commentary to accompany this special issue of the Journal of Research on Adolescence regarding the impact of the pandemic on adolescents' social, emotional, and academic functioning. In addition to outlining the critical need for scholarly collaboration to address the global impact of this crisis on adolescent development, we argue that a broad investigative lens is needed to guide research and recovery efforts targeting youth development. We then use this broad lens to consider dimensions of the pandemic impact relative to developmental implications within community and policy contexts, educational contexts, social contexts, and family contexts. Finally, we describe guideposts for setting a global, shared research agenda that can hasten research to recovery efforts surrounding the pandemic and youth development.


Subject(s)
COVID-19 , Pandemics , Adolescent , Emotions , Humans , SARS-CoV-2 , Social Environment
8.
Acad Med ; 96(9): 1276-1281, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1371750

ABSTRACT

The clinical learning environment (CLE) encompasses the learner's personal characteristics and experiences, social relationships, organizational culture, and the institution's physical and virtual infrastructure. During the COVID-19 pandemic, all 4 of these parts of the CLE have undergone a massive and rapid disruption. Personal and social communications have been limited to virtual interactions or shifted to unfamiliar clinical spaces because of redeployment. Rapid changes to the organizational culture required prompt adaptations from learners and educators in their complex organizational systems yet caused increased confusion and anxiety among them. A traditional reliance on a physical infrastructure for classical educational practices in the CLE was challenged when all institutions had to undergo a major transition to a virtual learning environment. However, disruptions spurred exciting innovations in the CLE. An entire cohort of physicians and learners underwent swift adjustments in their personal and professional development and identity as they rose to meet the clinical and educational challenges they faced due to COVID-19. Social networks and collaborations were expanded beyond traditional institutional walls and previously held international boundaries within multiple specialties. Specific aspects of the organizational and educational culture, including epidemiology, public health, and medical ethics, were brought to the forefront in health professions education, while the physical learning environment underwent a rapid transition to a virtual learning space. As health professions education continues in the era of COVID-19 and into a new era, educators must take advantage of these dynamic systems to identify additional gaps and implement meaningful change. In this article, health professions educators and learners from multiple institutions and specialties discuss the gaps and weaknesses exposed, opportunities revealed, and strategies developed for optimizing the CLE in the post-COVID-19 world.


Subject(s)
COVID-19/prevention & control , Education, Distance/methods , Education, Medical/methods , Learning , Physical Distancing , Students, Medical/psychology , Cooperative Behavior , Education, Distance/organization & administration , Education, Medical/organization & administration , Humans , Interdisciplinary Placement , Organizational Culture , Social Environment , Social Networking , United States
9.
ANS Adv Nurs Sci ; 44(3): 183-194, 2021.
Article in English | MEDLINE | ID: covidwho-1354311

ABSTRACT

In this article, we apply Agamben's theory of biopower and other related concepts to the COVID-19 pandemic in the United States. We explore the similarities between the COVID-19 pandemic and the pandemic of racism. Concepts such as bios, zoe, homo sacer, and states of exception can be applied to understand inequities among marginalized communities in the COVID-19 pandemic. We recommend that nurses and health care workers use critical conscientization and structural competency to increase awareness and develop interventions to undo the injustices related to biopower faced by many in the COVID-19 pandemic.


Subject(s)
Attitude to Health , COVID-19/epidemiology , Health Personnel/statistics & numerical data , Health Status Disparities , Racism/statistics & numerical data , COVID-19/psychology , Health Personnel/psychology , Humans , Public Health , Racism/psychology , Social Environment , United States
10.
BMJ Glob Health ; 6(Suppl 1)2021 04.
Article in English | MEDLINE | ID: covidwho-1352556

ABSTRACT

Based on the authors' work in Latin America and Africa, this article describes and applies the concept 'structural vulnerability' to the challenges of clinical care and healthcare advocacy for migrants. This concept helps consider how specific social, economic and political hierarchies and policies produce and pattern poor health in two case studies: one at the USA-Mexico border and another in Djibouti. Migrants' and providers' various entanglements within inequitable and sometimes violent global migration systems can produce shared structural vulnerabilities that then differentially affect health and other outcomes. In response, we argue providers require specialised training and support; professional associations, healthcare institutions, universities and humanitarian organisations should work to end the criminalisation of medical and humanitarian assistance to migrants; migrants should help lead efforts to reform medical and humanitarian interventions; and alternative care models in Global South to address the structural vulnerabilities inherent to migration and asylum should be supported.


Subject(s)
Transients and Migrants , Africa , Delivery of Health Care , Humans , Social Environment
11.
BMJ Glob Health ; 6(Suppl 1)2021 04.
Article in English | MEDLINE | ID: covidwho-1352555

ABSTRACT

Health and the capacity to flourish are deeply intertwined. For members of vulnerable migrant groups, systemic inequalities and structural forms of marginalisation and exclusion create health risks, impede access to needed care and interfere with the ability to achieve one's full potential. Migrants often have limited access to healthcare, and they frequently are portrayed as less deserving than others of the resources needed to lead a healthy and flourishing life. Under these circumstances, clinicians, healthcare institutions and global health organisations have a moral and ethical obligation to consider the role they can-and do-play in either advancing or impeding migrants' health and their capacity to flourish. Drawing on case studies from three world regions, we propose concrete steps clinicians and health institutions can take in order to better serve migrant patients. These include recommendations that can help improve understanding of the complex circumstances of migrants' lives, strengthen collaboration between care providers and non-medical partners and transform the social, economic and structural circumstances that impede flourishing and harm health. Developing new strategies to promote the flourishing of precarious migrants can strengthen our collective ability to re-envision and redesign health systems and structures to value the health, dignity and bodily integrity of all patients-especially the most vulnerable-and to promote flourishing for all.


Subject(s)
Transients and Migrants , Delivery of Health Care , Humans , Social Environment
12.
BMJ Glob Health ; 6(Suppl 1)2021 04.
Article in English | MEDLINE | ID: covidwho-1352554

ABSTRACT

This article brings the social science concept of 'deservingness' to bear on clinical cases of transnational migrant patients. Based on the authors' medical social science research, health delivery practice and clinical work from multiple locations in Africa. Europe and the Americas, the article describes three clinical cases in which assumptions of deservingness have significant implications for the morbidity and mortality of migrant patients. The concept of deservingness allows us to maintain a critical awareness of the often unspoken presumptions of which categories of patients are more or less deserving of access to and quality of care, regardless of their formal legal eligibility. Many transnational migrants with ambiguous legal status who rely on public healthcare experience exclusion from care or poor treatment based on notions of deservingness held by health clinic staff, clinicians and health system planners. The article proposes several implications for clinicians, health professional education, policymaking and advocacy. A critical lens on deservingness can help global health professionals, systems and policymakers confront and change entrenched patterns of unequal access to and differential quality of care for migrant patients. In this way, health professionals can work more effectively for global health equity.


Subject(s)
Transients and Migrants , Africa , Europe , Global Health , Humans , Social Environment
13.
J Gerontol B Psychol Sci Soc Sci ; 76(9): 1904-1912, 2021 10 30.
Article in English | MEDLINE | ID: covidwho-1258772

ABSTRACT

OBJECTIVES: Media sources have consistently described older adults as a medically vulnerable population during the coronavirus disease 2019 (COVID-19) pandemic, yet a lack of concern over their health and safety has resulted in dismissal and devaluation. This unprecedented situation highlights ongoing societal ageism and its manifestations in public discourse. This analysis asks how national news sources performed explicit and implicit ageism during the first month of the pandemic. METHOD: Using content and critical discourse analysis methods, we analyzed 287 articles concerning older adults and COVID-19 published between March 11 and April 10, 2020, in 4 major U.S.-based newspapers. RESULTS: Findings indicate that while ageism was rarely discussed explicitly, ageist bias was evident in implicit reporting patterns (e.g., frequent use of the term "elderly," portrayals of older adults as "vulnerable"). Infection and death rates and institutionalized care were among the most commonly reported topics, providing a limited portrait of aging during the pandemic. The older "survivor" narrative offers a positive alternative by suggesting exceptional examples of resilience and grit. However, the survivor narrative may also implicitly place blame on those unable to survive or thrive in later life. DISCUSSION: This study provides insight for policy makers, researchers, and practitioners exploring societal perceptions of older adults and how these perceptions are disseminated and maintained by the media.


Subject(s)
Ageism , Aging , COVID-19 , Information Dissemination/ethics , Social Media , Social Perception , Aged , Ageism/ethics , Ageism/legislation & jurisprudence , Ageism/prevention & control , Ageism/psychology , Aging/ethics , Aging/physiology , Aging/psychology , COVID-19/epidemiology , COVID-19/psychology , Data Mining/ethics , Data Mining/statistics & numerical data , Geriatrics/trends , Humans , Newspapers as Topic , SARS-CoV-2 , Social Environment , Social Media/ethics , Social Media/trends , Social Perception/ethics , Social Perception/psychology , United States , Vulnerable Populations/psychology
14.
J Endocrinol Invest ; 44(12): 2845-2847, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1242833

ABSTRACT

PURPOSE: COVID-19 pandemics and cardiometabolic health are mutually interconnected. Chronic metabolic diseases are known risk factors for increased mortality after SARS-CoV-2 infection. In turn, COVID pandemics imposed sudden changes in lifestyle and social isolation with consequent potential cardiometabolic sequelae. The present study aimed at investigating the impact of changes in lifestyle and social life on metabolic profile in hyperprolactinemic or osteoporotic patients without pre-existing cardiometabolic diseases at the time of COVID-19. METHODS: The primary study outcome measurement was the prevalence of obesity, arterial hypertension, impaired glucose tolerance (IGT) or diabetes mellitus (DM), dyslipidemia and metabolic syndrome after COVID-19 outbreak. Seventy-four patients (21 men and 53 women, aged 51.8 ± 17.8 years) were admitted to the outpatient clinic of the Neuroendocrine Disease Unit at University "Federico II" of Naples, Italy, as per their routine clinical practice because of tumoral and non-tumoral hyperprolactinemia in 52 patients (70.3%), and osteoporosis/osteopenia in 22 (29.7%). Among female patients, 25 (47.2%) were at menopausal age. RESULTS: At the end of lockdown, prevalence of obesity (from 37.8% to 51.3%, p < 0.0001), dyslipidemia (from 28.4 to 48.6%, p = 0.003) and metabolic syndrome (from 14.9 to 27%, p < 0.0001) significantly increased compared to pre-COVID evaluation. No significant change was found in the prevalence of arterial hypertension and IGT/DM. CONCLUSION: SARS-CoV-2 outbreak has led to a rapid increase in the prevalence of metabolic syndrome, potentially contributing to the increased COVID-19 related mortality.


Subject(s)
COVID-19 , Cardiometabolic Risk Factors , Metabolic Syndrome/epidemiology , Pandemics , Quarantine , Adult , Aged , Aged, 80 and over , Dyslipidemias/epidemiology , Female , Health Status , Humans , Hyperprolactinemia/complications , Italy/epidemiology , Life Style , Male , Middle Aged , Obesity/epidemiology , Osteoporosis/complications , Prevalence , Social Environment
16.
Obes Rev ; 22 Suppl 1: e13162, 2021 02.
Article in English | MEDLINE | ID: covidwho-1189772

ABSTRACT

The project 'Obesogenic Environment and Childhood Obesity' (OBECHO), carried out under the leadership of the International Institute of Spatial Lifecourse Epidemiology (ISLE), has reviewed all sufficiently reported studies of obesogenic environmental determinants published prior to 1 January 2019. Findings of the OBECHO project have formed the unprecedentedly inclusive evidence for policy-making and the establishment of the future research agenda regarding the obesogenic environment. Furthermore, the outbreak of the coronavirus disease 2019 (COVID-19) pandemic has made this evidence become an important benchmark record of how youths have interacted with the obesogenic environment in the pre-COVID-19 era. The implementation of lockdown measures worldwide for curbing COVID-19 transmission has been affecting not mere youth's lifestyle behaviours and weight status but, more fundamentally, obesogenic environments and hence youth-environment interaction patterns. However, COVID-19, although causing unfavoured changes, will speed up the transformation of the research landscape from traditional to modern modes for more reliable evidence. We should closely track and study those abnormalities caused by COVID-19 and the accompanying interventions.


Subject(s)
COVID-19/epidemiology , Child Behavior/physiology , Health Behavior/physiology , Obesity/epidemiology , Pediatric Obesity/epidemiology , SARS-CoV-2 , Body Mass Index , COVID-19/prevention & control , Child , Diet , Exercise , Humans , Life Style , Obesity/prevention & control , Patient Isolation , Pediatric Obesity/prevention & control , Sedentary Behavior , Social Environment
17.
Global Health ; 17(1): 46, 2021 04 14.
Article in English | MEDLINE | ID: covidwho-1183549

ABSTRACT

Health innovations are generally oriented on a techno-economic vision. In this perspective, technologies are seen as an end in themselves, and there is no arrangement between the technical and the social values of innovation. This vision prevails in sanitary crises, in which management is carried out based on the search for punctual, reactive, and technical solutions to remedy a specific problem without a systemic/holistic, sustainable, or proactive approach. This paper attempts to contribute to the literature on the epistemological orientation of innovations in the field of public health. Taking the Covid-19 and Ebola crises as examples, the primary objective is to show how innovation in health is oriented towards a techno-economic paradigm. Second, we propose a repositioning of public health innovation towards a social paradigm that will put more emphasis on the interaction between social and health dimensions in the perspective of social change. We will conclude by highlighting the roles that public health could play in allowing innovations to have more social value, especially during sanitary crises.


Subject(s)
Biomedical Technology , COVID-19/therapy , Health Care Reform , Health Priorities , Hemorrhagic Fever, Ebola/therapy , Public Health , Access to Information , COVID-19/prevention & control , Cost-Benefit Analysis , Diffusion of Innovation , Health Equity , Health Services Accessibility , Hemorrhagic Fever, Ebola/prevention & control , Humans , Pharmaceutical Preparations , Social Conditions , Social Environment , Social Values , Technology , Vaccines
18.
Environ Res ; 197: 111160, 2021 06.
Article in English | MEDLINE | ID: covidwho-1182495

ABSTRACT

Public health measures necessary to counteract the coronavirus disease 2019 (COVID-19) pandemic have resulted in dramatic changes in the physical and social environments within which children grow and develop. As our understanding of the pathways for viral exposure and associated health outcomes in children evolves, it is critical to consider how changes in the social, cultural, economic, and physical environments resulting from the pandemic could affect the development of children. This review article considers the environments and settings that create the backdrop for children's health in the United States during the COVID-19 pandemic, including current threats to child development that stem from: A) change in exposures to environmental contaminants such as heavy metals, pesticides, disinfectants, air pollution and the built environment; B) changes in food environments resulting from adverse economic repercussion of the pandemic and limited reach of existing safety nets; C) limited access to children's educational and developmental resources; D) changes in the social environments at the individual and household levels, and their interplay with family stressors and mental health; E) social injustice and racism. The environmental changes due to COVID-19 are overlaid onto existing environmental and social disparities. This results in disproportionate effects among children in low-income settings and among populations experiencing the effects of structural racism. This article draws attention to many environments that should be considered in current and future policy responses to protect children's health amid pandemics.


Subject(s)
COVID-19 , Pandemics , Child , Child Health , Humans , SARS-CoV-2 , Social Environment , United States/epidemiology
20.
JMIR Public Health Surveill ; 6(4): e18878, 2020 10 20.
Article in English | MEDLINE | ID: covidwho-1172920

ABSTRACT

BACKGROUND: The World Health Organization lists vaccine hesitancy as one of 10 threats to global health. The antivaccine movement uses Facebook to promote messages on the alleged dangers and consequences of vaccinating, leading to a reluctance to immunize against preventable communicable diseases. OBJECTIVE: We would like to know more about the messages these websites are sharing via social media that can influence readers and consumers. What messages is the public receiving on Facebook about immunization? What content (news articles, testimonials, videos, scientific studies) is being promoted? METHODS: We proposed using a social media audit tool and 3 categorical lists to capture information on websites and posts, respectively. The keywords "vaccine," "vaccine truth," and "anti-vax" were entered in the Facebook search bar. A Facebook page was examined if it had between 2500 and 150,000 likes. Data about beliefs, calls to action, and testimonials were recorded from posts and listed under the categories Myths, Truths, and Consequences. Website data were entered in a social media audit template. RESULTS: Users' posts reflected fear and vaccine hesitancy resulting from the alleged dangers of immunization featured on the website links. Vaccines were blamed for afflictions such as autism, cancer, and infertility. Mothers shared testimonies on alleged consequences their children suffered due to immunization, which have influenced other parents to not vaccinate their children. Users denied the current measles outbreaks in the United States to be true, retaliating against the government in protests for fabricating news. CONCLUSIONS: Some Facebook messages encourage prevailing myths about the safety and consequences of vaccines and likely contribute to parents' vaccine hesitancy. Deeply concerning is the mistrust social media has the potential to cast upon the relationship between health care providers and the public. A grasp of common misconceptions can help support health care provider practice.


Subject(s)
Anti-Vaccination Movement/psychology , Health Knowledge, Attitudes, Practice , Social Media/instrumentation , Social Media/statistics & numerical data , Anti-Vaccination Movement/statistics & numerical data , Humans , Social Environment
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