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2.
BMJ Open ; 13(6): e066897, 2023 06 06.
Article in English | MEDLINE | ID: covidwho-20233982

ABSTRACT

OBJECTIVES: To (1) understand what behaviours, beliefs, demographics and structural factors predict US adults' intention to get a COVID-19 vaccination, (2) identify segments of the population ('personas') who share similar factors predicting vaccination intention, (3) create a 'typing tool' to predict which persona people belong to and (4) track changes in the distribution of personas over time and across the USA. DESIGN: Three surveys: two on a probability-based household panel (NORC's AmeriSpeak) and one on Facebook. SETTING: The first two surveys were conducted in January 2021 and March 2021 when the COVID-19 vaccine had just been made available in the USA. The Facebook survey ran from May 2021 to February 2022. PARTICIPANTS: All participants were aged 18+ and living in the USA. OUTCOME MEASURES: In our predictive model, the outcome variable was self-reported vaccination intention (0-10 scale). In our typing tool model, the outcome variable was the five personas identified by our clustering algorithm. RESULTS: Only 1% of variation in vaccination intention was explained by demographics, with about 70% explained by psychobehavioural factors. We identified five personas with distinct psychobehavioural profiles: COVID Sceptics (believe at least two COVID-19 conspiracy theories), System Distrusters (believe people of their race/ethnicity do not receive fair healthcare treatment), Cost Anxious (concerns about time and finances), Watchful (prefer to wait and see) and Enthusiasts (want to get vaccinated as soon as possible). The distribution of personas varies at the state level. Over time, we saw an increase in the proportion of personas who are less willing to get vaccinated. CONCLUSIONS: Psychobehavioural segmentation allows us to identify why people are unvaccinated, not just who is unvaccinated. It can help practitioners tailor the right intervention to the right person at the right time to optimally influence behaviour.


Subject(s)
COVID-19 , Social Media , Adult , Humans , United States/epidemiology , COVID-19 Vaccines/therapeutic use , COVID-19/epidemiology , COVID-19/prevention & control , Self Report , Intention , Probability , Vaccination
3.
NCHS Data Brief ; (469): 1-8, 2023 Jun.
Article in English | MEDLINE | ID: covidwho-20233715

ABSTRACT

With the disruptions to access and use of care caused by the COVID-19 pandemic, emergency department (ED) visit rates decreased from 2019 to 2020 among children and adolescents (1). The ED visit rate for children under age 1 year in 2020 was nearly one-half of the rate in 2019, and the rate for those aged 1-17 years decreased over the same period (2). This report uses data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) (3,4) to compare ED visits for children aged 0-17 from 2019 to 2020, by age group, sex, and race and ethnicity, and to assess changes in wait time at ED visits.


Subject(s)
COVID-19 , Adolescent , United States/epidemiology , Humans , Child , COVID-19/epidemiology , Pandemics , Emergency Service, Hospital , Ethnicity
4.
Health Psychol ; 42(7): 496-509, 2023 Jul.
Article in English | MEDLINE | ID: covidwho-20233316

ABSTRACT

The development of effective interventions for COVID-19 vaccination has proven challenging given the unique and evolving determinants of that behavior. A tailored intervention to drive vaccination uptake through machine learning-enabled personalization of behavior change messages unexpectedly yielded a high volume of real-time short message service (SMS) feedback from recipients. A qualitative analysis of those replies contributes to a better understanding of the barriers to COVID-19 vaccination and demographic variations in determinants, supporting design improvements for vaccination interventions. OBJECTIVE: The purpose of this study was to examine unsolicited replies to a text message intervention for COVID-19 vaccination to understand the types of barriers experienced and any relationships between recipient demographics, intervention content, and reply type. METHOD: We categorized SMS replies into 22 overall themes. Interrater agreement was very good (all κpooled > 0.62). Chi-square analyses were used to understand demographic variations in reply types and which messaging types were most related to reply types. RESULTS: In total, 10,948 people receiving intervention text messages sent 17,090 replies. Most frequent reply types were "already vaccinated" (31.1%), attempts to unsubscribe (25.4%), and "will not get vaccinated" (12.7%). Within "already vaccinated" and "will not get vaccinated" replies, significant differences were observed in the demographics of those replying against expected base rates, all p > .001. Of those stating they would not vaccinate, 34% of the replies involved mis-/disinformation, suggesting that a determinant of vaccination involves nonvalidated COVID-19 beliefs. CONCLUSIONS: Insights from unsolicited replies can enhance our ability to identify appropriate intervention techniques to influence COVID-19 vaccination behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Subject(s)
COVID-19 Vaccines , COVID-19 , Qualitative Research , Text Messaging , Vaccination , Humans , United States/epidemiology , Vaccination/psychology , Vaccination/statistics & numerical data , Machine Learning , Adolescent , Young Adult , Adult , Middle Aged , Aged , Demography , Anti-Vaccination Movement/psychology , Behavioral Sciences , COVID-19/prevention & control
5.
Int J Soc Psychiatry ; 69(4): 853-864, 2023 06.
Article in English | MEDLINE | ID: covidwho-20233033

ABSTRACT

BACKGROUND: The COVID-19 pandemic has brought disparities in mental and physical health faced by ethnic minorities to the forefront. In the U.S., Hispanic/Latino communities are plagued by elevated rates of psychiatric conditions and trauma. Exacerbating this burden, common discourse often implicates Hispanic/Latino ethnicity as a causal factor, despite clear evidence of systemic causes, including lack of access to resources, and discrimination. AIMS: To parse apart Hispanic/Latino ethnicity from determinants of wellbeing (such as trauma, financial status, and loneliness), we examined mental and physical health during COVID-19 via an online, anonymous survey available in both English and Spanish. METHODS: We examined wellbeing across three participant groups, including two groups of Hispanic/Latino adults with varying degrees of 'belonging' to the dominant culture in their country of residence: Hispanic/Latino individuals living in Spanish-speaking and/or Central or Latin American countries (Group 1), Hispanic/Latino individuals living in the U.S. (Group 2), and non-Hispanic/Latino individuals living in the U.S. (Group 3). RESULTS: Results demonstrated there were significant differences between groups in specific aspects of wellbeing. Most importantly, results showed Hispanic/Latino ethnicity does not significantly predict psychosocial wellbeing or psychosis risk, and identified several predictors of these outcomes, including U.S. residence, trauma, loneliness, and age. CONCLUSION: Our results demonstrate that Hispanic/Latino ethnicity itself is not a causal factor of poor psychosocial wellbeing or elevated psychosis risk and instead identify several social and systemic causal factors commonly faced by Hispanic/Latino Americans. We suggest that language reporting on minority mental health acknowledge systemic factors as contributing to poor outcome rather than referring to ethnicity as if it were a causal factor.


Subject(s)
COVID-19 , Mental Health , Humans , United States/epidemiology , Pandemics , Ethnicity , Hispanic or Latino/psychology
6.
Surg Endosc ; 37(8): 6558-6564, 2023 08.
Article in English | MEDLINE | ID: covidwho-20240063

ABSTRACT

INTRODUCTION: The COVID-19- pandemic significantly impacted metabolic and bariatric surgery (MBS) practices due to large-scale surgery cancellations along with staff and supply shortages. We analyzed sleeve gastrectomy (SG) hospital-level financial metrics before and after the COVID-19 pandemic. METHODS: Hospital cost-accounting software (MicroStrategy, Tysons, VA) was reviewed for revenues, costs, and profits per SG at an academic hospital (2017-2022). Actual figures were obtained, not insurance charge estimates or hospital projections. Fixed costs were obtained through surgery-specific allocation of inpatient hospital and operating-room costs. Direct variable costs were analyzed with sub-components including: (1) labor and benefits, (2) implants, (3) drug costs, and 4) medical/surgical supplies. The pre-COVID-19 period (10/2017-2/2020) and post-COVID-19 period (5/2020-9/2022) financial metrics were compared with student's t-test. Data from 3/2020 to 4/2020 were excluded due to COVID-19-related changes. RESULTS: A total of 739 SG patients were included. Average length of stay (LOS), Center for Medicaid and Medicare Case Mix Index (CMI), and percentage of patients with commercial insurance were similar pre vs. post-COVID-19 (p > 0.05). There were more SG performed per quarter pre-COVID-19 than post-COVID-19 (36 vs. 22; p = 0.0056). Pre-COVID-19 and post-COVID-19 financial metrics per SG differed significantly for, respectively, revenues ($19,134 vs. $20,983) total variable cost ($9457 vs. $11,235), total fixed cost ($2036 vs. $4018), total profit ($7571 vs. $5442), and labor and benefits cost ($2535 vs. $3734; p < 0.05). CONCLUSIONS: The post-COVID-19 period was characterized by significantly increased SG fixed cost (i.e., building maintenance, equipment, overhead) and labor costs (increased contract labor), resulting in precipitous profit decline that crosses the break-even in calendar year quarter (CQ) 3, 2022. Potential solutions include minimizing contract labor cost and decreasing LOS.


Subject(s)
COVID-19 , Obesity, Morbid , Aged , Humans , United States/epidemiology , Pandemics , Medicare , COVID-19/epidemiology , Length of Stay , Gastrectomy , Retrospective Studies , Obesity, Morbid/surgery
7.
Am J Gastroenterol ; 118(6): 1069-1079, 2023 06 01.
Article in English | MEDLINE | ID: covidwho-20239981

ABSTRACT

INTRODUCTION: Acute infectious gastroenteritis (AGE) is a common reason for outpatient visits and hospitalizations in the United States. This study aimed to understand the demographic and clinical characteristics, common pathogens detected, health care resource utilization (HRU), and cost among adult outpatients with AGE visiting US health systems. METHODS: A retrospective cohort study was conducted using one of the largest hospital discharge databases (PINC AI Healthcare Database) in the United States. Adult patients (aged ≥18 years) with a principal diagnosis of AGE during an outpatient visit between January 1, 2016, and June 30, 2021, were included. Pathogen detection analysis was performed in those with microbiology data available. RESULTS: Among 248,896 patients, the mean age was 44.3 years (range 18-89+ years), 62.9% were female, and 68.5% were White. More than half (62.0%) of the patients did not have any preexisting comorbidity, and only 18.3% underwent stool workup at the hospital. Most patients (84.7%) were seen in the emergency department, and most (96.4%) were discharged home. Within 30 days of discharge, 1.0% were hospitalized, and 2.8% had another outpatient visit due to AGE. The mean cost of the index visit plus 30-day AGE-related follow-up was $1,338 per patient, amounting to $333,060,182 for the total study population. Among patients with microbiology data available (n = 12,469), common pathogens detected were Clostridioides difficile (32.2%), norovirus (6.3%), and Campylobacter spp. (4.0%). DISCUSSION: AGE is a common and costly disease affecting adults of all ages and more females than males, including individuals with or without baseline conditions in a hospital-based outpatient setting. C. difficile was the most common pathogen detected.


Subject(s)
Clostridioides difficile , Gastroenteritis , Male , Adult , Humans , Female , United States/epidemiology , Adolescent , Young Adult , Middle Aged , Aged , Aged, 80 and over , Outpatients , Retrospective Studies , Financial Stress , Gastroenteritis/epidemiology
8.
Kidney360 ; 4(5): 687-699, 2023 05 01.
Article in English | MEDLINE | ID: covidwho-20239599

ABSTRACT

Collapsing Focal Segmental Glomerulosclerosis (FSGS) has been reported relatively frequently in African American (AA) patients with coronavirus disease 2019 (COVID-19), and it is associated almost always with Apolipoprotein L gen 1 (APOL1) high-risk variants. We reviewed the published literature from April 2020 to November 2022 searching for non-African American (non-AA) patients with FSGS associated with COVID-19 (eight White patients, six Hispanic patients, three Asian patients, one Indian patient, and one Asian Indian patient). The following histologic patterns were found: collapsing (n=11), not otherwise specified (n=5), tip (n=2), and perihilar (n=1). Fifteen of the 19 patients had AKI. The APOL1 genotype was reported in only six of the 19 non-AA patients. Three of them (two Hispanic patients and one White patient) with collapsing FSGS had high-risk APOL1 variants. The other three patients (two White patients and one Hispanic patient with the collapsing variant, tip variant, and not otherwise specified) had low-risk APOL1 variants. Among 53 African American patients with collapsing FSGS associated with COVID-19, 48 had high-risk APOL1 variants and five had low-risk APOL1 variants. We conclude that in non-AA patients, FSGS is a rare complication of COVID-19. FSGS associated with COVID-19 can occur rarely with low-risk APOL1 variants in non-AA and AA patients. Non-AA patients reported to be associated with high-risk APOL1 variants possibly reflect inaccuracy of self-reported race with AA admixture because of unknown ancestry. Given the importance of APOL1 in the pathogenesis of FSGS associated with viral infection and to avoid racial bias, it seems appropriate that APOL1 testing be considered in patients with FSGS associated with COVID-19, regardless of self-reported race.


Subject(s)
COVID-19 , Glomerulosclerosis, Focal Segmental , Humans , United States/epidemiology , Glomerulosclerosis, Focal Segmental/genetics , Glomerulosclerosis, Focal Segmental/pathology , Apolipoprotein L1/genetics , COVID-19/genetics , Genotype
9.
Int J Soc Determinants Health Health Serv ; 53(3): 311-322, 2023 Jul.
Article in English | MEDLINE | ID: covidwho-20239578

ABSTRACT

Social protection can buffer the negative impacts of unemployment on health. Have stimulus packages introduced during the COVID-19 pandemic mitigated potential harms to health from unemployment? We performed a systematic review of the health effects of job loss during the first year of the pandemic. We searched three electronic databases and identified 49 studies for inclusion. Three United States-based studies found that stimulus programs mitigated the impact of job loss on food security and mental health. Furloughs additionally appeared to reduce negative impacts when they were paid. However, despite the implementation of large-scale stimulus packages to reduce economic harms, we observed a clear pattern that job losses were nevertheless significantly associated with negative impacts, particularly on mental health, quality of life, and food security. We also observe suggestive evidence that COVID-related job loss was associated with child maltreatment, worsening dental health, and poor chronic disease outcomes. Overall, although we did find evidence that income-support policies appeared to help protect people from the negative health consequences of pandemic-related job loss, they were not sufficient to fully offset the threats to health. Future research should ascertain how to ensure adequate access to and generosity of social protection programs during epidemics and economic downturns.


Subject(s)
COVID-19 , Child , Humans , United States/epidemiology , COVID-19/epidemiology , Pandemics/prevention & control , Quality of Life , Unemployment/psychology , Mental Health
10.
JAMA Netw Open ; 6(6): e2318045, 2023 06 01.
Article in English | MEDLINE | ID: covidwho-20239516

ABSTRACT

Importance: Although telehealth services expanded rapidly during the COVID-19 pandemic, the association between state policies and telehealth availability has been insufficiently characterized. Objective: To investigate the associations between 4 state policies and telehealth availability at outpatient mental health treatment facilities throughout the US. Design, Setting, and Participants: This cohort study measured whether mental health treatment facilities offered telehealth services each quarter from April 2019 through September 2022. The sample comprised facilities with outpatient services that were not part of the US Department of Veterans Affairs system. Four state policies were identified from 4 different sources. Data were analyzed in January 2023. Exposures: For each quarter, implementation of the following policies was indexed by state: (1) payment parity for telehealth services among private insurers; (2) authorization of audio-only telehealth services for Medicaid and Children's Health Insurance Program (CHIP) beneficiaries; (3) participation in the Interstate Medical Licensure Compact (IMLC), permitting psychiatrists to provide telehealth services across state lines; and (4) participation in the Psychology Interjurisdictional Compact (PSYPACT), permitting clinical psychologists to provide telehealth services across state lines. Main Outcome and Measures: The primary outcome was the probability of a mental health treatment facility offering telehealth services in each quarter for each study year (2019-2022). Information on the facilities was obtained from the Mental Health and Addiction Treatment Tracking Repository based on the Substance Abuse and Mental Health Services Administration Behavioral Health Treatment Service Locator. Separate multivariable fixed-effects regression models were used to estimate the difference in the probability of offering telehealth services after vs before policy implementation, adjusting for characteristics of the facility and county in which the facility was located. Results: A total of 12 828 mental health treatment facilities were included. Overall, 88.1% of facilities offered telehealth services in September 2022 compared with 39.4% of facilities in April 2019. All 4 policies were associated with increased odds of telehealth availability: payment parity for telehealth services (adjusted odds ratio [AOR], 1.11; 95% CI, 1.03-1.19), reimbursement for audio-only telehealth services (AOR, 1.73; 95% CI, 1.64-1.81), IMLC participation (AOR, 1.40, 95% CI, 1.24-1.59), and PSYPACT participation (AOR, 1.21, 95% CI, 1.12-1.31). Facilities that accepted Medicaid as a form of payment had lower odds of offering telehealth services (AOR, 0.75; 95% CI, 0.65-0.86) over the study period, as did facilities in counties with a higher proportion (>20%) of Black residents (AOR, 0.58; 95% CI, 0.50-0.68). Facilities in rural counties had higher odds of offering telehealth services (AOR, 1.67; 95% CI, 1.48-1.88). Conclusion and Relevance: Results of this study suggest that 4 state policies that were introduced during the COVID-19 pandemic were associated with marked expansion of telehealth availability for mental health care at mental health treatment facilities throughout the US. Despite these policies, telehealth services were less likely to be offered in counties with a greater proportion of Black residents and in facilities that accepted Medicaid and CHIP.


Subject(s)
COVID-19 , Telemedicine , United States/epidemiology , Child , Female , Pregnancy , Humans , COVID-19/epidemiology , Cohort Studies , Mental Health , Pandemics , Ambulatory Care Facilities
11.
Natl Vital Stat Rep ; 72(4): 1-14, 2023 May.
Article in English | MEDLINE | ID: covidwho-20239350

ABSTRACT

Objectives-This report describes changes in prenatal care use (utilization) in the United States before and during the COVID-19 pandemic by month of birth and the mother's race and Hispanic origin.


Subject(s)
COVID-19 , Prenatal Care , Pregnancy , Female , United States/epidemiology , Humans , Pandemics , Hispanic or Latino , Parturition
12.
Spine (Phila Pa 1976) ; 48(13): 950-961, 2023 Jul 01.
Article in English | MEDLINE | ID: covidwho-20239200

ABSTRACT

STUDY DESIGN: A retrospective cohort study of utilization patterns and variables of epidural injections in the fee-for-service (FFS) Medicare population. OBJECTIVES: To update the utilization of epidural injections in managing chronic pain in the FFS Medicare population, from 2000 to 2020, and assess the impact of COVID-19. SUMMARY OF BACKGROUND DATA: The analysis of the utilization of interventional techniques also showed an annual decrease of 2.5% per 100,000 FFS Medicare enrollees from 2009 to 2018, contrasting to an annual increase of 7.3% from 2000 to 2009. The impact of the COVID-19 pandemic has not been assessed. METHODS: This analysis was performed by utilizing master data from the Centers for Medicare and Medicaid Services, physician/supplier procedure summary from 2000 to 2020. The analysis was performed by the assessment of utilization patterns using guidance from Strengthening the Reporting of Observational Studies in Epidemiology. RESULTS: Epidural procedures declined at a rate of 19% per 100,000 Medicare enrollees in the FFS Medicare population in the United States from 2019 to 2020, with an annual decline of 3% from 2010 to 2019. From 2000 to 2010, there was an annual increase of 8.3%. This analysis showed a decline in all categories of epidural procedures from 2019 to 2020. The major impact of COVID-19, with closures taking effect from April 1, 2020, through December 31, 2020, will be steeper and rather dramatic compared with April 1 to December 31, 2019. However, monthly data from the Centers for Medicare and Medicaid Services is not available as of now. Overall declines from 2010 to 2019 showed a decrease for cervical and thoracic transforaminal injections with an annual decrease of 5.6%, followed by lumbar interlaminar and caudal epidural injections of 4.9%, followed by 1.8% for lumbar/sacral transforaminal epidurals, and 0.9% for cervical and thoracic interlaminar epidurals. CONCLUSION: Declining utilization of epidural injections in all categories was exacerbated to a decrease of 19% from 2019 to 2020, related, in part, to the COVID-19 pandemic. This followed declining patterns of epidural procedures of 3% overall annually from 2010 to 2019.


Subject(s)
COVID-19 , Chronic Pain , Aged , Humans , United States/epidemiology , Chronic Pain/therapy , Chronic Pain/drug therapy , Retrospective Studies , Pandemics , Medicare , COVID-19/epidemiology , Injections, Epidural
13.
MMWR Morb Mortal Wkly Rep ; 72(7): 190-198, 2023 Feb 17.
Article in English | MEDLINE | ID: covidwho-20238937

ABSTRACT

COVID-19 vaccine booster doses are safe and maintain protection after receipt of a primary vaccination series and reduce the risk for serious COVID-19-related outcomes, including emergency department visits, hospitalization, and death (1,2). CDC recommended an updated (bivalent) booster for adolescents aged 12-17 years and adults aged ≥18 years on September 1, 2022 (3). The bivalent booster is formulated to protect against the Omicron BA.4 and BA.5 subvariants of SARS-CoV-2 as well as the original (ancestral) strain (3). Based on data collected during October 30-December 31, 2022, from the National Immunization Survey-Child COVID Module (NIS-CCM) (4), among all adolescents aged 12-17 years who completed a primary series, 18.5% had received a bivalent booster dose, 52.0% had not yet received a bivalent booster but had parents open to booster vaccination for their child, 15.1% had not received a bivalent booster and had parents who were unsure about getting a booster vaccination for their child, and 14.4% had parents who were reluctant to seek booster vaccination for their child. Based on data collected during October 30-December 31, 2022, from the National Immunization Survey-Adult COVID Module (NIS-ACM) (4), 27.1% of adults who had completed a COVID-19 primary series had received a bivalent booster, 39.4% had not yet received a bivalent booster but were open to receiving booster vaccination, 12.4% had not yet received a bivalent booster and were unsure about getting a booster vaccination, and 21.1% were reluctant to receive a booster. Adolescents and adults in rural areas had a much lower primary series completion rate and up-to-date vaccination coverage. Bivalent booster coverage was lower among non-Hispanic Black or African American (Black) and Hispanic or Latino (Hispanic) adolescents and adults compared with non-Hispanic White (White) adolescents and adults. Among adults who were open to receiving booster vaccination, 58.9% reported not having received a provider recommendation for booster vaccination, 16.9% had safety concerns, and 4.4% reported difficulty getting a booster vaccine. Among adolescents with parents who were open to getting a booster vaccination for their child, 32.4% had not received a provider recommendation for any COVID-19 vaccination, and 11.8% had parents who reported safety concerns. Although bivalent booster vaccination coverage among adults differed by factors such as income, health insurance status, and social vulnerability index (SVI), these factors were not associated with differences in reluctance to seek booster vaccination. Health care provider recommendations for COVID-19 vaccination; dissemination of information by trusted messengers about the continued risk for COVID-19-related illness and the benefits and safety of bivalent booster vaccination; and reducing barriers to vaccination could improve COVID-19 bivalent booster coverage among adolescents and adults.


Subject(s)
COVID-19 Vaccines , COVID-19 , Humans , Adult , United States/epidemiology , Adolescent , Vaccination Coverage , COVID-19/epidemiology , COVID-19/prevention & control , SARS-CoV-2 , Vaccination
14.
Geospat Health ; 18(1)2023 05 25.
Article in English | MEDLINE | ID: covidwho-20238775

ABSTRACT

This article examines three spatiotemporal methods used for analyzing of infectious diseases, with a focus on COVID-19 in the United States. The methods considered include inverse distance weighting (IDW) interpolation, retrospective spatiotemporal scan statistics and Bayesian spatiotemporal models. The study covers a 12-month period from May 2020 to April 2021, including monthly data from 49 states or regions in the United States. The results show that the spread of COVID-19 pandemic increased rapidly to a high value in winter of 2020, followed by a brief decline that later reverted into another increase. Spatially, the COVID-19 epidemic in the United States exhibited a multi-centre, rapid spread character, with clustering areas represented by states such as New York, North Dakota, Texas and California. By demonstrating the applicability and limitations of different analytical tools in investigating the spatiotemporal dynamics of disease outbreaks, this study contributes to the broader field of epidemiology and helps improve strategies for responding to future major public health events.


Subject(s)
COVID-19 , United States/epidemiology , Humans , COVID-19/epidemiology , Pandemics , Retrospective Studies , Bayes Theorem , Spatio-Temporal Analysis
15.
PLoS One ; 18(5): e0285729, 2023.
Article in English | MEDLINE | ID: covidwho-20238530

ABSTRACT

OBJECTIVES: Our objectives were to document data availability and reporting on suicide mortality in state prison systems. The United States leads the world in mass incarceration, a structural determinant of health, but lacks real-time reporting of prison health statistics. This absence is particularly notable in suicides, a leading cause of death that carceral policies play a key role in mitigating. METHODS: Suicide data for each state prison system from 2017-2021 were gathered through statistical reports, press releases, and Freedom of Information Act requests. We graded states based on data availability. RESULTS: Only sixteen states provide updated, frequent, granular, freely provided suicide data. An additional thirteen states provided frequently updated data but that had little granularity, was incomplete, or was not freely provided. Eight states provided sparse, infrequent, or outdated data, and thirteen provided no data at all. CONCLUSIONS: The 2000 Death in Custody Reporting Act requires that states provide these data freely, yet the majority of states do not. There is a need for reliable, real-time data on suicides, suicide attempts, and conditions of confinement to better understand the harms of the carceral system and to advocate for change.


Subject(s)
Prisoners , Prisons , Humans , United States/epidemiology , Suicide, Attempted , Cause of Death , Policy
16.
PLoS One ; 18(6): e0286857, 2023.
Article in English | MEDLINE | ID: covidwho-20238046

ABSTRACT

The emergence of COVID-19 in the United States resulted in a series of federal and state-level lock-downs and COVID-19 related health mandates to manage the spread of the virus. These policies may negatively impact the mental health state of the population. This study focused on the trends in mental health indicators following the COVID-19 pandemic amongst four United States geographical regions, and political party preferences. Indicators of interest included feeling anxious, feeling depressed, and worried about finances. Survey data from the Delphi Group at Carnegie Mellon University were analyzed using clustering algorithms and dynamic connectome obtained from sliding window analysis. Connectome refers to the description of connectivity on a network. United States maps were generated to observe spatial trends and identify communities with similar mental health and COVID-19 trends. Between March 3rd, 2021, and January 10th, 2022, states in the southern geographic region showed similar trends for reported values of feeling anxious and worried about finances. There were no identifiable communities resembling geographical regions or political party preference for the feeling depressed indicator. We observed a high degree of correlation among southern states as well as within Republican states, where the highest correlation values from the dynamic connectome for feeling anxious and feeling depressed variables seemingly overlapped with an increase in COVID-19 related cases, deaths, hospitalizations, and rapid spread of the COVID-19 Delta variant.


Subject(s)
COVID-19 , United States/epidemiology , Humans , COVID-19/epidemiology , SARS-CoV-2 , Mental Health , Pandemics , Communicable Disease Control
17.
BMC Res Notes ; 16(1): 96, 2023 Jun 05.
Article in English | MEDLINE | ID: covidwho-20237008

ABSTRACT

OBJECTIVE: COVID-19 has caused tremendous damage to U.S. public health, but COVID vaccines can effectively reduce the risk of COVID-19 infections and related mortality. Our study aimed to quantify the association between proximity to a community healthcare facility and COVID-19 related mortality after COVID vaccines became publicly available and explore how this association varied across racial and ethnic groups. RESULTS: Residents living farther from a facility had higher COVID-19-related mortality across U.S. counties. This increased mortality incidence associated with longer distances was particularly pronounced in counties with higher proportions of Black and Hispanic populations.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , COVID-19/mortality , COVID-19/prevention & control , COVID-19/therapy , COVID-19 Vaccines/therapeutic use , Ethnicity , Health Status Disparities , Hispanic or Latino , United States/epidemiology , Health Services Accessibility , Community Health Centers , Black or African American
18.
PLoS One ; 18(6): e0286881, 2023.
Article in English | MEDLINE | ID: covidwho-20237001

ABSTRACT

COVID-19 incidence disparities have been documented in the literature, but the different driving factors among age groups have yet to be explicitly explained. This study proposes a community-based COVID-19 spatial disparity model, considering different levels of geographic units (individual and community), various contextual variables, multiple COVID-19 outcomes, and different geographic contextual elements. The model assumes the existence of age nonstationarity effects on health determinants, suggesting that health effects of contextual variables vary among place and age groups. Based on this conceptual model and theory, the study selected 62 county-level variables for 1,748 U.S. counties during the pandemic, and created an Adjustable COVID-19 Potential Exposure Index (ACOVIDPEI) using principal component analysis (PCA). The validation was done with 71,521,009 COVID-19 patients in the U.S. from January 2020 through June 2022, with high incidence rates shifting from the Midwest, South Carolina, North Carolina, Arizona, and Tennessee to the West and East coasts. This study corroborates the age nonstationarity effect of health determinants on COVID-19 exposures. These results empirically identify the geographic disparities of COVID-19 incidence rates among age groups and provide the evidentiary guide for targeting pandemic recovery, mitigation, and preparedness in communities.


Subject(s)
COVID-19 , Humans , United States/epidemiology , COVID-19/epidemiology , Incidence , North Carolina , South Carolina , Arizona
20.
MMWR Morb Mortal Wkly Rep ; 72(23): 621-626, 2023 06 09.
Article in English | MEDLINE | ID: covidwho-20236639

ABSTRACT

As of May 7, 2023, CDC's Advisory Committee on Immunization Practices (ACIP) recommends that all children aged 6 months-5 years receive at least 1 age-appropriate bivalent mRNA COVID-19 vaccine dose. Depending on their COVID-19 vaccination history and history of immunocompromise, these children might also need additional doses* (1-3). Initial vaccine safety findings after primary series vaccination among children aged 6 months-5 years showed that transient local and systemic reactions were common whereas serious adverse events were rare (4). To characterize the safety of a third mRNA COVID-19 vaccine dose among children aged 6 months-5 years, CDC reviewed adverse events and health surveys reported to v-safe, a voluntary smartphone-based U.S. safety surveillance system established by CDC to monitor health after COVID-19 vaccination (https://vsafe.cdc.gov/en/) and the Vaccine Adverse Event Reporting System (VAERS), a U.S. passive vaccine safety surveillance system co-managed by CDC and the Food and Drug Administration (FDA) (https://vaers.hhs.gov/) (5). During June 17, 2022-May 7, 2023, approximately 495,576 children aged 6 months-4 years received a third dose (monovalent or bivalent) of Pfizer-BioNTech vaccine and 63,919 children aged 6 months-5 years received a third dose of Moderna vaccine.† A third mRNA COVID-19 vaccination was recorded for 2,969 children in v-safe; approximately 37.7% had no reported reactions, and among those for whom reactions were reported, most reactions were mild and transient. VAERS received 536 reports after a third dose of mRNA COVID-19 vaccine for children in these age groups; 98.5% of reports were nonserious and most (78.4%) were classified as a vaccination error.§ No new safety concerns were identified. Preliminary safety findings after a third dose of COVID-19 vaccine for children aged 6 months-5 years are similar to those after other doses. Health care providers can counsel parents and guardians of young children that most reactions reported after vaccination with Pfizer-BioNTech or Moderna vaccine were mild and transient and that serious adverse events are rare.


Subject(s)
COVID-19 , Child , Child, Preschool , Humans , COVID-19/epidemiology , COVID-19/prevention & control , United States/epidemiology , Vaccination , Vaccines/adverse effects
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