Preferred Information Source Correlates to COVID-19 Risk Misperception.

Inaccurate perceptions of COVID-19 (coronavirus disease 2019) risk may decrease compliance with public health mitigation practices, in turn increasing disease burden. The extent to which public perceptions of COVID-19 risk are inaccurate is not well studied. This study investigates the relationship between preferred information sources and inaccurate COVID-19 risk perception. A cross-sectional online survey of adults in the United States using online snowball techniques was administered between April 9, 2020 and July 12, 2020. Raking techniques were used to generate a representative U.S. sample from 10,650 respondents. Respondents who did not provide an answer to key questions were excluded. The remaining sample included 1,785 health care workers (HCW) and 4,843 non-HCW. Subjective risk was measured as the product of perceived likelihood of COVID-19 infection and perceived harm from infection. Objective risk was measured as a function of the presence of known COVID-19 risk factors. Discrepancies between subjective and objective risk were compared between respondents with different preferred information sources. Chi Square contingency tables and pair-wise correlation were used to evaluate differences to 95% confidence. For HCW and non-HCW, the greatest overestimation of personal COVID-19 risk assessment (p < .05 for all differences) were found in those whose preferred source of information was social media (HCW: 62.1%; non-HCW: 64.5%), followed by internet news sources (HCW: 59.6%, non-HCW%: 59.1%), government websites (HCW: 54%, non-HCW = 51.8%), other sources (HCW: 50.7%, non-HCW = 51.4%), and television news (HCW: 46.1%, non-HCW: 47.6%). Preferred information sources correlate with inaccuracies in personal COVID-19 risk assessment. Public health information campaigns should consider targeting groups whose preferred information sources correlate to higher inaccuracies in COVID-19 risk perceptions. [HLRP: Health Literacy Research and Practice. 2023;7(2):e105-e110.].

Race, employment, and the pandemic: An exploration of covariate explanations of COVID-19 case fatality rate variance.

We derive a simple asymptotic approximation for the long-run case fatality rate of COVID-19 (alpha and delta variants) and show that these estimations are highly correlated to the interaction between US State median age and projected US unemployment rate (Adj. r2 = 60%). We contrast this to the high level of correlation between point (instantaneous) estimates of per state case fatality rates and the interaction of median age, population density and current unemployment rates (Adj. r2 = 50.2%). To determine whether this is caused by a "race effect," we then analyze unemployment, race, median age and population density across US states and show that adding the interaction of African American population and unemployment explains 53.5% of the variance in COVID case fatality rates for the alpha and delta variants when considering instantaneous case fatality rate. Interestingly, when the asymptotic case fatality rate is used, the dependence on the African American population disappears, which is consistent with the fact that in the long-run COVID does not discriminate on race, but may discriminate on access to medical care which is highly correlated to employment in the US. The results provide further evidence of the impact inequality can have on case fatality rates in COVID-19 and the impact complex social, health and economic factors can have on patient survival.

Parental COVID-19 Vaccine Hesitancy in Diverse Communities: A National Survey.

OBJECTIVE: We surveyed a diverse group of US participants to understand parental coronavirus disease 2019 (COVID-19) vaccine hesitancy. METHODS: We administered a telephone and online survey from May 7 to June 7, 2021 using stratified sampling to ensure robust sample sizes of racial and ethnic minorities. Of the 20,280 contacted, 12,288 respondents completed the survey (response rate 61%). We used chi-square tests and adjusted risk ratios to compare results by racial/ethnic group. RESULTS: Overall, 23% of parents stated that they plan to (or have) vaccinated their children; 30% said that they would not vaccinate their children, and 25% were unsure. Latino/a, Native American, and Asian American-Pacific Islander (AAPI) parents were generally more likely to vaccinate their children than Black or White parents. After adjusting for demographic factors, AAPI parents were significantly more likely to vaccinate their children than were others. Of parents who said that they would not vaccinate their child, 55% stated it was due to insufficient research. However, over half of parents stated that they would follow their child's health care provider's recommendations. After adjusting for demographic factors, trust in their primary care doctor was significantly lower among AAPI, Black, and Native American parents than White parents. CONCLUSIONS: Parental vaccine hesitancy was similar overall, but drivers of hesitancy varied by racial/ethnic groups. While the perception that vaccines had been "insufficiently researched" was a major concern among all groups, we found that parents are generally inclined to follow health providers' recommendations. Health professionals can play an important role in COVID-19 vaccine education and should provide access to vaccines.

Perceived risk, political polarization, and the willingness to follow COVID-19 mitigation guidelines.

OBJECTIVE: Risk assessment and response is important for understanding human behavior. The divisive context surrounding the coronavirus pandemic inspires our exploration of risk perceptions and the polarization of mitigation practices (i.e., the degree to which the behaviors of people on the political "Left" diverge from those on the "Right"). Specifically, we investigate the extent to which the political polarization of willingness to comply with mitigation behaviors changes with risk perceptions. METHOD: Analyses use data from two sources: an original dataset of Twitter posts and a nationally-representative survey. In the Twitter data, negative binomial regression models are used to predict mitigation intent measured using tweet counts. In the survey data, logit models predict self-reported mitigation behavior (vaccination, masking, and social distancing). RESULTS: Findings converged across both datasets, supporting the idea that the links between political orientation and willingness to follow mitigation guidelines depend on perceived risk. People on the Left are more inclined than their Right-oriented colleagues to follow guidelines, but this polarization tends to decrease as the perceived risk of COVID-19 intensifies. Additionally, we find evidence that exposure to COVID-19 infections sends ambiguous signals about the risk of the virus while COVID-19 related deaths have a more consistent impact on mitigation behaviors. CONCLUSIONS: Pandemic-related risks can create opportunities for perceived "common ground," between the political "Right" and "Left." Risk perceptions and politics interact in their links to intended COVID-19 mitigation behavior (as measured both on Twitter and in a national survey). Our results invite a more complex interpretation of political polarization than those stemming from simplistic analyses of partisanship and ideology.

Underserved population acceptance of combination influenza-COVID-19 booster vaccines.

Recent data indicates increasing hesitancy towards both COVID-19 and influenza vaccination. We studied attitudes towards COVID-19 booster, influenza, and combination influenza-COVID-19 booster vaccines in a nationally representative sample of US adults between May and June 2021 (n = 12,887). We used pre-qualification quotes to ensure adequate sample sizes for minority populations. Overall vaccine acceptance was 45% for a COVID-19 booster alone, 58% for an influenza vaccine alone, and 50% for a combination vaccine. Logistic regression showed lower acceptance among female, Black/African American, Native American/American Indian, and rural respondents. Higher acceptance was found among those with college and post-graduate degrees. Despite these differences, our results suggest that a combination vaccine may provide a convenient method of dual vaccination that may increase COVID-19 vaccination coverage.

Are Americans less likely to reply to emails from Black people relative to White people?

In this article, we present the results from a large-scale field experiment designed to measure racial discrimination among the American public. We conducted an audit study on the general public-sending correspondence to 250,000 citizens randomly drawn from public voter registration lists. Our within-subjects experimental design tested the public's responsiveness to electronically delivered requests to volunteer their time to help with completing a simple task-taking a survey. We randomized whether the request came from either an ostensibly Black or an ostensibly White sender. We provide evidence that in electronic interactions, on average, the public is less likely to respond to emails from people they believe to be Black (rather than White). Our results give us a snapshot of a subtle form of racial bias that is systemic in the United States. What we term everyday or "paper cut" discrimination is exhibited by all racial/ethnic subgroups-outside of Black people themselves-and is present in all geographic regions in the United States. We benchmark paper cut discrimination among the public to estimates of discrimination among various groups of social elites. We show that discrimination among the public occurs more frequently than discrimination observed among elected officials and discrimination in higher education and the medical sector but simultaneously, less frequently than discrimination in housing and employment contexts. Our results provide a window into the discrimination that Black people in the United States face in day-to-day interactions with their fellow citizens.

The Effects of Gender-Blind Sexism on Rape Myth Acceptance: Results From a Nationally Representative Study.

This study uses a diverse sample that is nationally representative with regards to race and gender (N = 2,000) in an attempt to replicate and confirm Stoll, Lilley, and Pinter's previous finding that gender-blind sexism is correlated with rape myth acceptance. As in the original study, we hypothesized that higher scores on the Gender-Blind Sexism Inventory (GBSI) would be predictive of higher scores on Stoll et al.'s Rape Myth Acceptance Scale (RMA). Gender-blind sexism builds on previous models of contemporary sexism such as hostile and benevolent sexism, modern sexism, and neosexism. It also represents an extension of racialized social system theory that explores the ways contemporary sexism operates in an era of post-racial and post-gender politics via four frames: abstract liberalism, naturalization, cultural sexism, and minimization of sexism. Unlike in the original study, however, our sample also allowed us to control for scores on the Ambivalent Sexism Inventory (ASI), the Modern Sexism Scale (MS), and the Neosexism Scale (NS) in testing this relationship. Our analysis confirmed the hypothesis that gender-blind sexism is predictive of higher rape myth acceptance among participants. Moreover, this study indicates that the GBSI offers additional value over the ASI, MS, and NS, as it was the only index of sexism tested that revealed gender-group differences within its relationship to RMA. Compared to men, women's acceptance of rape myths was more responsive to shifts in the GBSI. We discuss the implications of our findings in terms of rape and sexual assault prevention and policy. We also provide some suggestions for how the GBSI could be used in future studies.

African American Adherence to COVID-19 Public Health Recommendations.

By mid-May 2020, most of the United States had been under shelter-in-place orders for several weeks to decrease the spread of coronavirus 2019 (COVID-19). As states begin to lift these orders to reopen the economy, the risk of a resurgence of COVID-19 may be related to the public's voluntary adherence to public health recommendations. We conducted a nationally representative survey of 604 African Americans to generate a risk assessment based on African Americans' compliance with public health recommendations to frequently wash hands, maintain social distancing, avoid touching face, and wear a mask in public. This is, to our knowledge, the most comprehensive study of African Americans and public health adherence specific to COVID-19. The percent of respondents reporting that they always comply with these recommendations was 72%, 67%, 55%, and 65%, respectively. Based on this threshold, African Americans' level of adherence with COVID-19 public health recommendations suggests they may be at high risk of a resurgence of COVID-19 during reopening, and there is an urgent need for targeted, culturally responsive public health messaging that is accessible to communities of color to help address racial disparities in COVID-19 risk. [HLRP: Health Literacy Research and Practice. 2020;4(3):e166-e170.].

The distribution of mental health service costs for depression in the Alberta population.

OBJECTIVES: In Canada, most mental health services are embedded in the public health care system. Little is known of the cost distribution within the mental health population. Our study aims to estimate the depression care costs of patients with a depression diagnosis, ranking them by the increasing total depression health care costs. METHODS: For fiscal year 2007/08, we extracted administrative health care records from across the continuum, including physicians, outpatient services, and hospitals. Using a unique patient identifier, all service costs were merged for each person. Costs were summed by service categories and then divided by the served population into 10 equal-size groups. Further, we divided costs in the top decile into 10 percentile groups. RESULTS: There were 208 167 people (5.9% of Albertans) who had at least 1 health care visit for depression. The total cost for depression treatment services was $114.5 million, an average $550 per treated person. In the first 9 deciles, most costs were for general practitioners. By the ninth decile, cost per person was about $400. Within the tenth decile, costs increased regularly, and in the top 1 percentile (1% of patients) there was an increase of cost per patient to $25 826 from $5792 in the previous percentile. CONCLUSION: Per person costs were highly skewed. Until the ninth decile, the cost increased slowly, consisting of mainly physician costs. In the last decile, costs increased substantially, mainly because of hospitalizations. Thus both primary care and specialist care play key roles.

The impact of integrating mental and general health services on mental health's share of total health care spending in Alberta.

OBJECTIVE: In April 2003 the Alberta government integrated specialized mental health services, formerly organized independently, with the health regions, which are responsible for general health services. The objective of this article is to determine whether the transfer was associated with an increase or decrease in the share of resources in the region allocated to mental health care relative to total spending for health care. METHODS: The measure of the share for mental health care is the total costs for mental health care resources as a percentage of total health care spending. Resources and spending examined were those that were actually or potentially under the regions' control. Annual costs for mental health services in the province were obtained for a seven-year period (fiscal year [FY] 2000 through FY 2006) from provincial utilization records for all residents in the province. Unit costs were assigned to each visit. The trend in the share measure was plotted for each year. RESULTS: The share for mental health care increased overall from FY 2000 (7.6%) to FY 2003 (8.2%), but returned to pre-FY 2003 levels in the three years after the transfer (7.6%). CONCLUSIONS: Despite concerns expressed before the transfer by federal and provincial reports over the level of expenditures devoted to mental health care, the integration of mental health services with other health services did not result in an increase of the share for mental health care.

Expenditures on mental health and addictions for Canadian provinces in 2003 and 2004.

OBJECTIVE: To measure total public and private expenditures on mental health in each province. METHOD: Data for expenditures on mental health services were collected in the following categories: physician expenditures (general and psychiatrist fees for service and alternative funding), inpatient hospital (psychiatric and general), outpatient hospital, community mental health, pharmaceuticals, and substance abuse. Data for 2 years, 2003 and 2004, were collected from the Canadian Institute for Health Information (hospital inpatient and fees for service physicians), the individual provinces (pharmaceuticals, alternative physician payments, hospital outpatient, and community), and the Canadian Centre on Substance Abuse. Totals were expressed in terms of per capita and as a percentage of total provincial health spending. RESULTS: Total spending on mental health was $6.6 billion, of which $5.5 billion was from public sources. Nationally, the largest portion of expenditures was for hospitals, followed by community mental health expenses and pharmaceuticals. This varied by province. Public mental health spending was 6% of total public spending on health, while total mental health spending was 5% of total health spending. CONCLUSIONS: Canadian public mental health spending is lower than most developed countries, and a little below the minimum acceptable amount (5%) stated by the European Mental Health Economics Network.

The direct public-sector costs for mental health in Alberta.

The purpose of the study was to estimate the direct 2002 fiscal year costs for mental health, services in Alberta. Data were collected on mental health publicly funded services and costs. Mental health services cost $573 million annually, amounting to about 8.4% of all provincial health services. The greatest share of costs was for regional inpatient services and physician services (both at 22%). The more direct method used in this study shows higher estimates of mental health costs than previous studies.