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Buszkiewicz JH, Tseng AS, Dai J, Ismach A, Beese S, Collier SM, Spiker ML, Otten JJ. Association between early-pandemic food assistance use and subsequent food security trajectories among households in Washington State during the first three years of the COVID-19 pandemic. PLoS One 2025; 20:e0321585. [PMID: 40367134 PMCID: PMC12077706 DOI: 10.1371/journal.pone.0321585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 03/09/2025] [Indexed: 05/16/2025] Open
Abstract
BACKGROUND Research on COVID-19's impact on food insecurity has primarily relied on cross-sectional data or long recall periods, with limited investigations into longitudinal patterns or the role of food assistance. METHODS We analyzed longitudinal data from 703 respondents participating in at least three Washington State Food Security Survey waves between June 18, 2020, and January 7, 2023. We assessed food security using the United States Department of Agriculture's six-item module, categorizing respondents' trajectories as persistently food secure, persistently food insecure, or experiencing one or more food insecurity transitions. We categorized food assistance use as never used, used before COVID-19 but not at baseline, did not use before COVID-19 but used at baseline, or always used. We descriptively examined sociodemographic factors linked to each food security trajectory and food assistance use pattern. We assessed associations between food assistance use and food security trajectories using modified Poisson regression. RESULTS We found that 20.2% of respondents were persistently food insecure, and 22.5% experienced one or more food insecurity transitions. Both patterns were more common among respondents who were aged 35 to 64, had a gender identity other than man or woman, were non-Hispanic Black, were single or divorced, had children, had some college education or less, reported $35,000 or less in household income, or were unemployed. In fully adjusted models, respondents who were newly using food assistance early in the COVID-19 pandemic had a higher probability of being persistently food insecure (marginal effect [ME] = 0.320, 95% CI = 0.204, 0.436) or experiencing one or more food insecurity transitions (ME = 0.216, 95% CI = 0.069, 0.363), than those who never used assistance. CONCLUSIONS Our findings highlight the importance of examining food security trajectories and food assistance use patterns and implementing policies that help households new to food assistance programs navigate these systems.
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Affiliation(s)
- James H. Buszkiewicz
- Department of Epidemiology, Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Ashley S. Tseng
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, United States of America
| | - Jane Dai
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington, United States of America
| | - Alan Ismach
- Food Systems, Nutrition, and Health Program, School of Public Health, University of Washington, Seattle, Washington, United States of America
| | - Shawna Beese
- College of Agricultural, Human, and Natural Resources Sciences, Washington State University, Pullman, Washington, United States of America
- College of Nursing, Washington State University, Spokane, Washington, United States of America
| | - Sarah M. Collier
- Food Systems, Nutrition, and Health Program, School of Public Health, University of Washington, Seattle, Washington, United States of America
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, United States of America
| | - Marie L. Spiker
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, United States of America
- Food Systems, Nutrition, and Health Program, School of Public Health, University of Washington, Seattle, Washington, United States of America
| | - Jennifer J. Otten
- Food Systems, Nutrition, and Health Program, School of Public Health, University of Washington, Seattle, Washington, United States of America
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, Washington, United States of America
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Muwonge JJ, Jablonska B, Dalman C, Burström B, Galanti MR, Hollander AC. More or less equal? Trends in horizontal equity in mental health care utilization in Stockholm county, Sweden (2006-2022). Repeated survey-registry linked studies. Int J Equity Health 2025; 24:98. [PMID: 40200310 PMCID: PMC11980088 DOI: 10.1186/s12939-025-02453-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Accepted: 03/18/2025] [Indexed: 04/10/2025] Open
Abstract
BACKGROUND Horizontal equity is defined as equal care for equal needs, regardless of socioeconomic factors. This study investigated trends in horizontal equity in mental health care (MHC) utilization in Sweden from 2006 to 2022. Monitoring equity provides valuable information for healthcare system governance (e.g., planning and resource allocation) necessary for ensuring equitable provision of services. METHODS A total of 81,650 Stockholm residents aged 18-64, who participated in the Hälsa Stockholm surveys of 2006, 2010, 2014 or 2021, were analysed. Their subsequent use of MHC (primary, in- and outpatient specialized care, and psychotropic medication) within six months after survey response was collected from registries between 2006 and 2022. Concentration index (CI) and need-standardized CI (Horizontal inequity index, HI), summative measures of inequalities, were used in this study. HI was estimated using self-reported psychological distress (measured with the General health questionnaire 12 in 2006-2014 and Kessler 6 in 2021) as the primary need indicator, with general health status and long-term limiting illness as additional need indicators. Equivalized disposable household income was used as the ranking variable, while education status, migration status, age, and sex were included as non-need variables that we controlled for in the analyses. RESULTS Lower-income individuals used MHC services more than their higher-income counterparts with comparable levels of psychological distress. These "pro-poor" inequities in the probability of MHC use increased from HI = -0.057 [95% Confidence Limits, CL: -0.079, -0.034] in 2006/2007 to HI = -0.130 [95% CL: -0.159, -0.102] in 2014/2015. By 2021/2022, the "pro-poor" inequities had decreased (HI = -0.034 [95% CL: -0.06, -0.009]), partly due to an increase in MHC use among higher-income groups but a decrease in the lowest income group. Standardizing for additional need indicators reduced the "pro-poor" inequities but maintained the observed trends. Among non-Nordic migrants, "pro-rich" inequities fell between 2006/2007 and 2014/2015 but rose in 2021/2022, with significant "pro-rich" inequities among non-European migrants in 2021/2022 (HI = 0.100 [95% CL: 0.024, 0.176]). Among patients in outpatient services, "pro-poor" inequities in visit frequency decreased over time (2006-2022). CONCLUSION We observed increasingly higher probability of MHC use among lower-income individuals than their higher-income peers with similar (measured) needs from 2006 to 2015. However, during the pandemic (2021/2022), potential access problems led to diminishing of "pro-poor" inequities in the total sample, and to "pro-rich" inequities among non-Nordic migrants. The Covid-19 disruption to the healthcare system-such as restrictions on in-person visits and the rapid transition to digital healthcare services-along with its impact on care-seeking, may explain the trend shifts.
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Affiliation(s)
- Joseph Junior Muwonge
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden.
- Centre for Epidemiology and Community Medicine, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
| | - Beata Jablonska
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Christina Dalman
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Bo Burström
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Aidoo EAK, Wood SF, Issaka B, Agyapong WO. Patient-centered communication and its impact on minority health competence and outcomes in the United States. Sci Rep 2025; 15:11885. [PMID: 40195463 PMCID: PMC11977188 DOI: 10.1038/s41598-025-97536-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2024] [Accepted: 04/04/2025] [Indexed: 04/09/2025] Open
Abstract
While patient-centered communication (PCC) has been recognized for its potential to enhance health and well-being, existing research presents mixed findings, partly due to limited attention to intermediary processes. Additionally, disparities in communication quality leave minority populations at a disadvantage, experiencing less effective communication and lower levels of patient-centeredness. This study addresses these gaps by examining how different PCC functions influence both general and mental health outcomes within minority populations. Furthermore, it investigates the role of health competence as a potential mediator, given its importance in navigating the healthcare system. This study used secondary data from four iterations spanning from 2011 to 2022 (HINTS 4 Cycle 1 - 2011, HINTS 5 Cycle 1 - 2017, HINTS 5 Cycle 4 - 2020, HINTS 6 Cycle 1 - 2022) with a sample size of n = 5501, focusing exclusively on individuals from minority racial backgrounds. The study used ANOVA, chi-square tests, and multiple linear regressions to investigate how different PCC functions and sociodemographic factors affect general health, health competence, and mental health within these populations. The present study revealed that PCC has varying impacts on the reporting of general and mental health within minority populations. Although we observed positive associations, they were not consistent across all the patients. In certain years, specific PCC dimensions demonstrated significant relationships with mental health, emphasizing their influence on mental well-being. Health competence emerged as a crucial mediator between PCC and health outcomes, particularly in terms of general health. This study provides valuable insights into the relationships between PCC and health competence and health outcomes among minority populations. These findings emphasize the importance of tailored healthcare approaches for minority populations, recognizing the multifaceted nature of healthcare interactions.
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Affiliation(s)
| | - Sandra Freda Wood
- Department of Human Communication, Arizona State University, Tempe, US.
| | - Barikisu Issaka
- Department of Advertising and Public Relations, Michigan State University, East Lansing, US
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Kazemi F, Liu J, Nasr IW, Chidiac C, Robinson S, Cohen AR. COVID-19's causal impact on child abuse and socioeconomic status: a Bayesian time series study. Pediatr Res 2025:10.1038/s41390-025-03996-0. [PMID: 40128593 DOI: 10.1038/s41390-025-03996-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Revised: 02/18/2025] [Accepted: 02/24/2025] [Indexed: 03/26/2025]
Abstract
BACKGROUND The COVID-19 pandemic intensified psychosocial stressors, potentially contributing to increased rates of child abuse. This study aimed to compare trends in child abuse/traumatic brain injury (TBI) admissions and socioeconomic status before and after the pandemic. METHODS A 7-year retrospective study was conducted at a Level-1 Pediatric Trauma Center. TBI cases were identified using ICD-10 codes based on the modified CDC framework. Neighborhood disadvantage and injury severity were measured using the Social Deprivation Index (SDI) and Injury Severity Score (ISS), respectively, with higher scores indicating greater disadvantage and severity. A Bayesian structural time series (BSTS) model was employed to assess the causal impact of COVID-19 on monthly child abuse/TBI admissions, SDI, and ISS. RESULTS The study included 560 child abuse cases, with 62.3% involving TBI. Before COVID-19, monthly admissions averaged 5.89 for child abuse and 3.70 for child abuse with TBI, with corresponding SDI scores of 60.07 and 57.60. During the COVID era, monthly averages rose to 8.77 and 5.58 (p = 0.001, p < 0.001), and SDI scores increased to 66.32 and 61.60 (p = 0.053, p = 0.370). BSTS analysis inferred a causal impact of COVID-19 on monthly child abuse admissions (p = 0.001), monthly child abuse admissions sustaining TBI (p = 0.001), an upward trend in average monthly SDI scores (p = 0.033), and a decrease in average monthly ISS (p = 0.001). CONCLUSIONS The study indicates a significant increase in child abuse/TBI admissions and heightened neighborhood disadvantage during the COVID-19 pandemic. IMPACT This study uses Bayesian structural time series analysis to assess the COVID-19 pandemic's causal impact on child abuse and traumatic brain injury (TBI) admissions. The pandemic is linked to increased child abuse admissions and TBI cases, correlating with worsening socioeconomic conditions indicated by higher Social Deprivation Index scores. Admissions did not rise significantly during the early pandemic (first 3 months, p = 0.160), but mid-to-late phases showed a significant increase (p = 0.001). Injury severity, as measured by Injury Severity Score, declined, suggesting less severe injuries during the pandemic. These findings emphasize the need for proactive interventions and continuous surveillance to protect vulnerable populations.
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Affiliation(s)
- Foad Kazemi
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Jiaqi Liu
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Isam W Nasr
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Charbel Chidiac
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shenandoah Robinson
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alan R Cohen
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Amir T, Coffey K, Reiner JS, Sevilimedu V, Mango VL. Utilization of artificial intelligence to triage patients with delayed follow-up of probably benign breast ultrasound findings. Ultrasonography 2025; 44:145-152. [PMID: 39967448 PMCID: PMC11938796 DOI: 10.14366/usg.24206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2024] [Revised: 01/17/2025] [Accepted: 01/21/2025] [Indexed: 02/20/2025] Open
Abstract
PURPOSE This study aimed to evaluate our institution's experience in using artificial intelligence (AI) decision support (DS) as part of the clinical workflow to triage patients with Breast Imaging Reporting and Data System (BI-RADS) 3 sonographic lesions whose follow-up was delayed during the coronavirus disease 2019 (COVID-19) pandemic, against subsequent imaging and/or pathologic follow-up results. METHODS This retrospective study included patients with a BI-RADS category 3 (i.e., probably benign) breast ultrasound assessment from August 2019-December 2019 whose follow-up was delayed during the COVID-19 pandemic and whose breast ultrasounds were re-reviewed using Koios DS Breast AI as part of the clinical workflow for triaging these patients. The output of Koios DS was compared with the true outcome of a presence or absence of breast cancer defined by resolution/stability on imaging follow-up for at least 2 years or pathology results. RESULTS The study included 161 women (mean age, 52 years) with 221 BI-RADS category 3 sonographic lesions. Of the 221 lesions, there were two confirmed cancers (0.9% malignancy rate). Koios DS assessed 112/221 lesions (50.7%) as benign, 42/221 lesions (19.0%) as probably benign, 64/221 lesions (29.0%) as suspicious, and 3/221 lesions (1.4%) as probably malignant. Koios DS had a sensitivity of 100% (2/2; 95% confidence interval [CI], 16% to 100%), specificity of 70% (154/219; 95% CI, 64% to 76%), negative predictive value of 100% (154/154; 95% CI, 98% to 100%), and false-positive rate of 30% (65/219; 95% CI, 24% to 36%). CONCLUSION When many follow-up appointments are delayed, e.g., natural disaster, or scenarios where resources are limited, breast ultrasound AI DS can help triage patients with probably benign breast ultrasounds.
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Affiliation(s)
- Tali Amir
- Breast Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kristen Coffey
- Breast Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jeffrey S Reiner
- Breast Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Varadan Sevilimedu
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Victoria L Mango
- Breast Imaging Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Cavaillon JM, Chaudry IH. Facing stress and inflammation: From the cell to the planet. World J Exp Med 2024; 14:96422. [PMID: 39713080 PMCID: PMC11551703 DOI: 10.5493/wjem.v14.i4.96422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 08/27/2024] [Accepted: 09/19/2024] [Indexed: 10/31/2024] Open
Abstract
As identified in 1936 by Hans Selye, stress is shaping diseases through the induction of inflammation. But inflammation display some yin yang properties. On one hand inflammation is merging with the innate immune response aimed to fight infectious or sterile insults, on the other hand inflammation favors chronic physical or psychological disorders. Nature has equipped the cells, the organs, and the individuals with mediators and mechanisms that allow them to deal with stress, and even a good stress (eustress) has been associated with homeostasis. Likewise, societies and the planet are exposed to stressful settings, but wars and global warming suggest that the regulatory mechanisms are poorly efficient. In this review we list some inducers of the physiological stress, psychologic stress, societal stress, and planetary stress, and mention some of the great number of parameters which affect and modulate the response to stress and render it different from an individual to another, from the cellular level to the societal one. The cell, the organ, the individual, the society, and the planet share many stressors of which the consequences are extremely interconnected ending in the domino effect and the butterfly effect.
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Affiliation(s)
| | - Irshad H Chaudry
- Department of Surgery, University of Alabama Birmingham, Birmingham, AL 35294, United States
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Klaiber P, van Roekel E, DeLongis A, Sin NL. From the COVID-19 lockdown to the new normal: Two-year changes in daily stress and positive event processes. Stress Health 2024; 40:e3423. [PMID: 38773897 DOI: 10.1002/smi.3423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 04/24/2024] [Accepted: 05/10/2024] [Indexed: 05/24/2024]
Abstract
The emergence of the novel COVID-19 disease and the social distancing measures implemented to curb its spread affected most aspects of daily life. Past work suggests that during times of more severe stress, people respond to daily stressors with relatively higher negative affect. However, little is known about how people responded to daily stressors and positive events at different moments in time during the COVID-19 pandemic. Thus, we examined longitudinal changes in daily event-related affect (covariation of daily stressors or positive events with same-day affect) from Spring 2020 (wave 1) to 2022 (wave 2). The sample consisted of 324 adults aged 18-80 (mean = 52 years; 89% women) from the US and Canada who completed weeklong daily diaries at both waves. The results revealed improvements in affective well-being, stressor-related affect (i.e., smaller fluctuations in affect on stressor days vs. nonstressor days), and positive event-related affect (i.e., lower negative affect on days with vs. without positive events). Furthermore, as people gradually resumed their social activities from 2020 to 2022, people reported being exposed to an increased frequency of both stressors and positive events. This study highlights the potential influence of socio-historical phenomena, such as an ongoing pandemic, on the events that people encounter and how they emotionally respond to them.
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Affiliation(s)
- Patrick Klaiber
- Department of Developmental Psychology, Tilburg University, Tilburg, The Netherlands
- Department of Psychology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Eeske van Roekel
- Department of Developmental Psychology, Tilburg University, Tilburg, The Netherlands
| | - Anita DeLongis
- Department of Psychology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Nancy L Sin
- Department of Psychology, The University of British Columbia, Vancouver, British Columbia, Canada
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Vallée A. The impact of the COVID-19 pandemic on the socioeconomic gradient of hypertension. J Public Health Policy 2024; 45:413-430. [PMID: 38831023 DOI: 10.1057/s41271-024-00491-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 06/05/2024]
Abstract
The COVID-19 pandemic has brought into sharp focus the impact of socioeconomic factors on hypertension outcomes. This review examines the implications of the pandemic on the socioeconomic gradient of hypertension and explores the physiological and pathophysiological processes underlying this relationship. Changes in socioeconomic factors have disproportionately affected individuals with lower socioeconomic status, leading to adverse hypertension outcomes. The pandemic-related stressors, coupled with social isolation and disrupted daily routines, have contributed to elevated stress levels among individuals, particularly those with lower socioeconomic status. Equitable access to healthcare, enhancing health literacy and patient empowerment, and addressing social determinants of health are essential components of hypertension management strategies. By recognizing the specific challenges faced by individuals with lower socioeconomic status and implementing targeted interventions, public health efforts can help reduce the socioeconomic gradient of hypertension.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology and Public Health, Foch Hospital, 92150, Suresnes, France.
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Moreno-Vásquez M, Vidal-Alaball J, Saez M, Barceló MA. Impacts of COVID-19 on clinical indicators and mortality in patients with chronic conditions in Catalonia, Spain: A retrospective population-based cohort study. J Glob Health 2024; 14:05020. [PMID: 38900506 PMCID: PMC11189023 DOI: 10.7189/jogh.14.05020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
Background The reallocation of health care services during the coronavirus disease 2019 (COVID-19) pandemic disrupted the continuity of primary care. This study examines the repercussions of the COVID-19 pandemic on clinical indicators within the Catalan population, emphasising individuals with chronic conditions. It provides insights into mortality and transfer rates considering intersectional perspectives. Methods We designed a retrospective, observational population-based cohort study based on routinely collected data from January 2015 to June 2021 for all individuals available in the Information System for Research in Primary Care (Sistema d'Informació per al Desenvolupament de la Investigació en Atenció Primària (SIDIAP)), the largest public primary care database in Catalonia, Spain. We included 6 301 095 individuals, constituting 81.6% of Catalonia's population in 2020. To perform a repeated measurements analysis of the indicators, we focussed on individuals who had one or more indicators in both the pre-pandemic (January 2015 to March 2020) and pandemic periods (March 2020 to June 2021), and those diagnosed with type 2 diabetes mellitus (T2D), high blood pressure, and heart failure. We selected key clinical indicators for analysis, including systolic and diastolic blood pressure, body mass index (BMI), cholesterol (total, high, and low-density lipoprotein), triglycerides, glycosylated haemoglobin, the Barthel index, and cardiovascular risk (Registre Gironí del cor (REGICOR) index). Results Mortality and transfer rates increased during the pandemic, contributing to a decline in the active population in the public health system. We also observed a reduction in pandemic period prevalence of patients with chronic conditions: -26.7% for heart failure, -15.1% for high blood pressure, and -14.6% for T2D. In both pre-pandemic and pandemic periods, 1 632 013 subjects had at least one clinical indicator record. Clinical indicators worsened in patients diagnosed with chronic conditions during the pandemic. Most indicators worsened, with differences between men and women (+9.4% vs +3.7% for the REGICOR index and -14.1% vs -16.6% for the Barthel index in men and in women, respectively), and to a similar extent (or greater in some cases) in individuals without these conditions. Conclusions We used longitudinal data to assess the repercussions of the COVID-19 pandemic on population health while considering a wide range of clinical indicators and socioeconomic determinants. Our analysis shows a deterioration in clinical indicators during the pandemic, particularly in cardiometabolic factors, underscoring the importance of continuous primary care for individuals with chronic conditions.
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Affiliation(s)
- Manuel Moreno-Vásquez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, Manresa, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Josep Vidal-Alaball
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, Manresa, Barcelona, Spain
- Health Promotion in Rural Areas Research Group, Gerencia d’Atenció Primària i a la Comunitat de la Catalunya Central, Institut Català de la Salut, Manresa, Barcelona, Spain
- Faculty of Medicine, University of Vic – Central University of Catalonia, Vic, Barcelona, Spain
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Maria A Barceló
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - PERIS Project collaborative team
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, Manresa, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
- Health Promotion in Rural Areas Research Group, Gerencia d’Atenció Primària i a la Comunitat de la Catalunya Central, Institut Català de la Salut, Manresa, Barcelona, Spain
- Faculty of Medicine, University of Vic – Central University of Catalonia, Vic, Barcelona, Spain
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Prina E, Tedeschi F, Lasalvia A, Salazzari D, Latini S, Rabbi L, Marando F, van Rijn E, Wollgast J, Pisoni E, Bessagnet B, Beauchamp M, Amaddeo F. Relationship between Environmental Conditions and Utilisation of Community-Based Mental Health Care: A Comparative Study before and during the COVID-19 Pandemic in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:661. [PMID: 38928908 PMCID: PMC11203518 DOI: 10.3390/ijerph21060661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/11/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024]
Abstract
(1) Background: Lower socioeconomic status increases psychiatric service use, exacerbated during the COVID-19 pandemic by environmental stressors like air pollution and limited green spaces. This study aims to assess the influence of sociodemographic and environmental factors on mental health service utilisation. (2) Methods: This retrospective study uses an administrative database focusing on community mental health services in Northeast Italy. Spatial and temporal analyses were used to address space-time dependencies. (3) Results: Findings showed that sociodemographic factors like living in rented apartments and lower education levels predicted higher mental health service use. Environmental factors, such as elevated NO2 levels and, before the pandemic, lower solar radiation and tree cover, correlated with increased service utilisation. COVID-19 reduced most of the pre-existing differences associated with these factors across census blocks with a different composition of sociodemographic and environmental factors. (4) Conclusions: These findings contribute to a better understanding of the impact of the environment on public mental health.
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Affiliation(s)
- Eleonora Prina
- Department of Neurosciences, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, 37134 Verona, Italy; (F.T.); (A.L.); (D.S.); (S.L.); (L.R.); (F.A.)
| | - Federico Tedeschi
- Department of Neurosciences, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, 37134 Verona, Italy; (F.T.); (A.L.); (D.S.); (S.L.); (L.R.); (F.A.)
| | - Antonio Lasalvia
- Department of Neurosciences, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, 37134 Verona, Italy; (F.T.); (A.L.); (D.S.); (S.L.); (L.R.); (F.A.)
| | - Damiano Salazzari
- Department of Neurosciences, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, 37134 Verona, Italy; (F.T.); (A.L.); (D.S.); (S.L.); (L.R.); (F.A.)
| | - Sara Latini
- Department of Neurosciences, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, 37134 Verona, Italy; (F.T.); (A.L.); (D.S.); (S.L.); (L.R.); (F.A.)
| | - Laura Rabbi
- Department of Neurosciences, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, 37134 Verona, Italy; (F.T.); (A.L.); (D.S.); (S.L.); (L.R.); (F.A.)
| | - Federica Marando
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (F.M.); (E.v.R.); (J.W.); (E.P.); (B.B.); (M.B.)
| | - Elaine van Rijn
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (F.M.); (E.v.R.); (J.W.); (E.P.); (B.B.); (M.B.)
| | - Jan Wollgast
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (F.M.); (E.v.R.); (J.W.); (E.P.); (B.B.); (M.B.)
| | - Enrico Pisoni
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (F.M.); (E.v.R.); (J.W.); (E.P.); (B.B.); (M.B.)
| | - Bertrand Bessagnet
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (F.M.); (E.v.R.); (J.W.); (E.P.); (B.B.); (M.B.)
| | - Maxime Beauchamp
- European Commission, Joint Research Centre (JRC), 21027 Ispra, Italy; (F.M.); (E.v.R.); (J.W.); (E.P.); (B.B.); (M.B.)
| | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Science, Section of Psychiatry, University of Verona, 37134 Verona, Italy; (F.T.); (A.L.); (D.S.); (S.L.); (L.R.); (F.A.)
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Vameghi M, Saatchi M, Bahrami G, Soleimani F, Takaffoli M. How did we protect children against COVID-19 in Iran? Prevalence of COVID-19 and vaccination in the socio-economic context of COVID-19 epidemic. PLoS One 2024; 19:e0303043. [PMID: 38722835 PMCID: PMC11081304 DOI: 10.1371/journal.pone.0303043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/16/2024] [Indexed: 05/13/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic posed significant risks to children worldwide. This study aimed to assess the COVID-19 protection status of children and explored the relationship between household socio-economic status and COVID-19 morbidity and preventive measures, including vaccination and mask-wearing, in two cities in Iran. METHOD A population-based cross-sectional study was conducted from July to October 2022 among 7 to 18-year-old children and their families in Tehran and Karaj. A total of 3,022 samples were selected using stratified multistage cluster sampling. Data were collected through interviews with children and adults, using questionnaires and was analyzed with Stata software version 14. RESULTS The analysis focused on 2,878 children with a median age of 12. Over half (54%) reported that the pandemic negatively affected their family's financial status, with 45% describing its impact on children's needs as negative or very negative. Just under 50% of respondents consistently wore masks during the study period, and around 54% had received at least one dose of the COVID-19 vaccine. Reasons for not getting vaccinated included concerns about side effects, ineligibility for the target age group, and overcrowding at vaccination sites. The odds of not getting vaccinated were significantly lower for children aged 15-18, with boys more likely to refuse vaccination than girls. CONCLUSION The financial impact of the pandemic in Iran affected families' ability to meet their children's needs. Moreover, low vaccination acceptance rates increased children's vulnerability to health problems and contributed to COVID-19 infections. Efforts should be made to increase vaccination acceptance, particularly among immigrant populations.
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Affiliation(s)
- Meroe Vameghi
- Social Welfare Management Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Saatchi
- Department of Biostatistics and Epidemiology, University of Social Welfare and Rehabilitation Science, Tehran, Iran
- Health in Emergency and Disaster Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Giti Bahrami
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Farin Soleimani
- Paediatric Neurorehabilitation Research Centre, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Marzieh Takaffoli
- Social Welfare Management Research Center, Social Health Research Institute, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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12
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Nam J, Kwon SJ. Expansion of Child Tax Credits and Mental Health of Parents With Low Income in 2021. JAMA Netw Open 2024; 7:e2356419. [PMID: 38381435 PMCID: PMC10882416 DOI: 10.1001/jamanetworkopen.2023.56419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/21/2023] [Indexed: 02/22/2024] Open
Abstract
Importance The 2021 Child Tax Credit (CTC) expansion, as part of the American Rescue Plan Act, offered financial relief through generous monthly tax benefits to families with children amid the COVID-19 pandemic. In light of heightened concerns about mental health during the pandemic, the expanded CTC may have alleviated parental mental health challenges, especially within families with low income. Objective To investigate the association between the 2021 CTC expansion and mental health among parents with low income as measured by depression and anxiety symptoms. Design, Setting, and Participants This repeated cross-sectional study used data from the Household Pulse Survey covering April 14, 2021, to January 10, 2022, in the US. A difference-in-difference-in-differences estimator combined with propensity score matching was used to estimate the association of the expanded CTC with mental health symptoms among households with income less than $35 000. Exposure The monthly payment of expanded CTC from July 15 to December 15, 2021. Main Outcomes and Measures Parental mental health was measured by analyzing depression and anxiety symptoms using logistic regression. Results The weighted sample comprised 546 366 adults (mean [SD] age, 43.02 [14.54] years; 52.9% female). The most common education level was high school or less (36.0%), the highest frequency of household income distribution was $50 000 to $74 999 (16.1%), and the majority of the sample was employed (67.3%). The weighted mean (SD) number of children in the household was 0.92 (1.18). For the full sample, receiving expanded CTC benefits was associated with lower odds of experiencing anxiety symptoms (odds ratio, 0.730; 95% CI, 0.598-0.890). Subgroup analyses indicated that the positive associations of the policy with anxiety symptoms were particularly pronounced among the female, working-age (17-60 years), non-Hispanic White, and higher education groups. However, the policy expansion had no association with depression. Conclusions and Relevance These findings may provide valuable evidence for policy makers to consider when deliberating on the possibility of making the CTC expansion permanent or transforming it into a universal program.
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Affiliation(s)
- Jaehyun Nam
- Department of Social Welfare, Pusan National University, Busan, South Korea
| | - Sarah Jiyoon Kwon
- Crown Family School of Social Work, Policy and Practice, University of Chicago, Chicago, Illinois
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13
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Larnyo E, Tettegah S, Griffin B, Nutakor JA, Preece N, Addai-Dansoh S, Dubon N, Liu S. Effect of social capital, social support and social network formation on the quality of life of American adults during COVID-19. Sci Rep 2024; 14:2647. [PMID: 38302613 PMCID: PMC10834438 DOI: 10.1038/s41598-024-52820-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 01/24/2024] [Indexed: 02/03/2024] Open
Abstract
This study aims to evaluate the effect of social capital (SC), social support (SS), and social network formation (SNF) on the quality of life of American adults during COVID-19. Using a probability sample of American adults aged 49+, 2370 respondents were selected from the National Social Life Health and Aging Project (NSHAP) dataset for analysis using an integrated partial least squares based on structural equation modeling (PLS-SEM)-K-fold cross-validation approach. The analysis showed that social capital assessed using civic engagement, social cohesion, socioeconomic status (SES), social support, and social network formation were significantly and positively associated with American adults' quality of life during the COVID-19 pandemic. Furthermore, the results showed that using the PLS-SEM and K-fold cross-validation approach produced a medium predictive power of the overall model, confirming the importance of SC, SS, and SNF in predicting quality of life-outcomes. These findings suggest that efforts to promote the well-being of American adults, especially older adults, during the pandemic should focus on strengthening social capital, social support and social network formation.
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Affiliation(s)
- Ebenezer Larnyo
- Center for Black Studies Research, University of California, Santa Barbara, Santa Barbara, CA, 93106, USA.
| | - Sharon Tettegah
- Center for Black Studies Research, University of California, Santa Barbara, Santa Barbara, CA, 93106, USA
| | - Brianna Griffin
- University of California, Santa Barbara, Santa Barbara, CA, 93106, USA
| | - Jonathan Aseye Nutakor
- Department of Health Policy and Management, School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang, Jiangsu Province, China
| | - Natasha Preece
- University of California, Santa Barbara, Santa Barbara, CA, 93106, USA
| | - Stephen Addai-Dansoh
- Department of Health Policy and Management, School of Management, Jiangsu University, 301 Xuefu Road, Zhenjiang, Jiangsu Province, China
| | - Natalia Dubon
- University of California, Santa Barbara, Santa Barbara, CA, 93106, USA
| | - Senyuan Liu
- University of California, Santa Barbara, Santa Barbara, CA, 93106, USA
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14
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Strong MN, Constantine M, Donovan A, Wong-Padoongpatt G. Lessons Learned About Trauma Related to Racial Discrimination During COVID-19 in the United States. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1457:343-361. [PMID: 39283436 DOI: 10.1007/978-3-031-61939-7_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/12/2024]
Abstract
Race scholars have discussed how the pandemic has disproportionately burdened marginalized communities and exacerbated pre-existing inequities, particularly for Black Indigenous People of Color (BIPOC) in the United States (U.S.). One glaring social determinant during the time of the COVID-19 is racial discrimination. This chapter will discuss lessons learned regarding the negative impact of discrimination on BIPOC, especially as it pertains to their experiences of trauma. Some of these lessons include (1) the need for clinical psychologist to improve access to treatment through increased research on culturally adaptive interventions, (2) increased research on the effects of race-based trauma on mental health symptomatology, (3) policy and institutional changes that reduce disparities in access to care, and (4) increased education for psychologists around billing procedures for individuals with race-based stress.
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15
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Awad DR, Tang AJ, Venskytis EJ, Levy R, Kitsko DJ, Shaffer AD, Chi DH. Socioeconomic status and pediatric cochlear implant usage during COVID-19. Int J Pediatr Otorhinolaryngol 2024; 176:111800. [PMID: 38007839 DOI: 10.1016/j.ijporl.2023.111800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/28/2023] [Accepted: 11/19/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVE COVID-19 (COVID) delayed access to speech and hearing services. The objective of this study was to identify interactions between socioeconomic status (SES) and cochlear implant (CI) usage during COVID. METHODS Consecutive pediatric patients (age 0-17) with CI and audiology visits between 2019 and 2022 at a tertiary care children's hospital were reviewed. Age, sex, race, insurance type, and proxy measures for SES using zip code were recorded. Hours spent with CI on and in different listening environments were compared between pre-COVID (1/1/2019-12/31/2019), COVID (4/1/2020-3/31/2021), and most recent (6/1/2021-5/31/2022) time periods. RESULTS Most patients were male (32/59, 54 % ears of 48 patients) and White, non-Hispanic (45/59, 76 %). Median age at implant was 2.0 years (range:0.6-12.2). There were no significant differences in hours spent with CI on during COVID compared with pre-COVID. However, children spent more time listening to louder noises (70-79 dB and ≥80 dB) recently compared with during COVID (p = 0.01 and 0.006, respectively). During COVID, children living in areas with greater educational attainment showed smaller reductions in total hours with CI on (β = 0.1, p = 0.02) and hours listening to speech in noise (β = 0.03, p = 0.005) compared with pre-COVID. In the most recent time period, children of minority race (β = -3.94 p = 0.008) and those who were older at implant (β = -0.630, p = 0.02) were more likely to experience reductions in total hours with CI on compared with during COVID. CONCLUSION Interventions which mitigate barriers of implant use and promote rich listening home-environments for at risk populations should be implemented during challenging future social and environmental conditions.
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Affiliation(s)
- Daniel R Awad
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Anthony J Tang
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Emily J Venskytis
- Department of Audiology and Speech-Language Pathology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Rena Levy
- Department of Audiology and Speech-Language Pathology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Dennis J Kitsko
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Amber D Shaffer
- Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - David H Chi
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Division of Pediatric Otolaryngology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
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16
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Pajek J, Mancini K, Murray M. COVID-19 and children's behavioral health: An overview. Curr Probl Pediatr Adolesc Health Care 2023; 53:101491. [PMID: 38040607 DOI: 10.1016/j.cppeds.2023.101491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
The paper reviews the impact of the COVID-19 pandemic on children's and adolescents' well-being. A trauma-informed framework is employed to discuss the emerging evidence of notable changes in youth's psychological, developmental, academic, and social well-being since the start of the COVID-19 pandemic. Children and adolescents have been uniquely affected based on their age at the start of the pandemic. Despite multiple resiliency factors, COVID-19 and its ramifications have had an adverse effect on youth in general and have exacerbated preexisting racial and socioeconomic disparities. This review concludes with recommendations for child health clinicians.
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Affiliation(s)
- Julie Pajek
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA.
| | - Kathryn Mancini
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
| | - Marsheena Murray
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
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17
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Han X, Yang NN, Nogueira L, Jiang C, Wagle NS, Zhao J, Shi KS, Fan Q, Schafer E, Yabroff KR, Jemal A. Changes in cancer diagnoses and stage distribution during the first year of the COVID-19 pandemic in the USA: a cross-sectional nationwide assessment. Lancet Oncol 2023; 24:855-867. [PMID: 37541271 DOI: 10.1016/s1470-2045(23)00293-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/05/2023] [Accepted: 06/14/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND The emergence of COVID-19 disrupted health care, with consequences for cancer diagnoses and outcomes, especially for early stage diagnoses, which generally have favourable prognoses. We aimed to examine nationwide changes in adult cancer diagnoses and stage distribution during the first year of the COVID-19 pandemic by cancer type and key sociodemographic factors in the USA. METHODS In this cross-sectional study, adults (aged ≥18 years) newly diagnosed with a first primary malignant cancer between Jan 1, 2018, and Dec 31, 2020, were identified from the US National Cancer Database. We included individuals across 50 US states and the District of Columbia who were treated in hospitals that were Commission on Cancer-accredited during the study period. Individuals whose cancer stage was 0 (except for bladder cancer), occult, or without an applicable American Joint Committee on Cancer staging scheme were excluded. Our primary outcomes were the change in the number and the change in the stage distribution of new cancer diagnoses between 2019 (Jan 1 to Dec 31) and 2020 (Jan 1 to Dec 31). Monthly counts and stage distributions were calculated for all cancers combined and for major cancer types. We also calculated annual change in stage distribution from 2019 to 2020 and adjusted odds ratios (aORs) using multivariable logistic regression, adjusted for age group, sex, race and ethnicity, health insurance status, comorbidity score, US state, zip code-level social deprivation index, and county-level age-adjusted COVID-19 mortality in 2020. Separate models were stratified by sociodemographic and clinical factors. FINDINGS We identified 2 404 050 adults who were newly diagnosed with cancer during the study period (830 528 in 2018, 849 290 in 2019, and 724 232 in 2020). Mean age was 63·5 years (SD 13·5) and 1 287 049 (53·5%) individuals were women, 1 117 001 (46·5%) were men, and 1 814 082 (75·5%) were non-Hispanic White. The monthly number of new cancer diagnoses (all stages) decreased substantially after the start of the COVID-19 pandemic in March, 2020, although monthly counts returned to near pre-pandemic levels by the end of 2020. The decrease in diagnoses was largest for stage I disease, leading to lower odds of being diagnosed with stage I disease in 2020 than in 2019 (aOR 0·946 [95% CI 0·939-0·952] for stage I vs stage II-IV); whereas, the odds of being diagnosed with stage IV disease were higher in 2020 than in 2019 (1·074 [1·066-1·083] for stage IV vs stage I-III). This pattern was observed in most cancer types and sociodemographic groups, although was most prominent among Hispanic individuals (0·922 [0·899-0·946] for stage I; 1·110 [1·077-1·144] for stage IV), Asian American and Pacific Islander individuals (0·924 [0·892-0·956] for stage I; 1·096 [1·052-1·142] for stage IV), uninsured individuals (0·917 [0·875-0·961] for stage I; 1·102 [1·055-1·152] for stage IV), Medicare-insured adults younger than 65 years (0·909 [0·882-0·937] for stage I; 1·105 [1·068-1·144] for stage IV), and individuals living in the most socioeconomically deprived areas (0·931 [0·917-0·946] for stage I; 1·106 [1·087-1·125] for stage IV). INTERPRETATION Substantial cancer underdiagnosis and decreases in the proportion of early stage diagnoses occurred during 2020 in the USA, particularly among medically underserved individuals. Monitoring the long-term effects of the pandemic on morbidity, survival, and mortality is warranted. FUNDING None.
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Affiliation(s)
- Xuesong Han
- Surveillance and Health Equity Science, American Cancer Society, Kennesaw, GA, USA.
| | - Nuo Nova Yang
- Surveillance and Health Equity Science, American Cancer Society, Kennesaw, GA, USA
| | - Leticia Nogueira
- Surveillance and Health Equity Science, American Cancer Society, Kennesaw, GA, USA
| | - Changchuan Jiang
- Division of Hematology and Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Nikita Sandeep Wagle
- Surveillance and Health Equity Science, American Cancer Society, Kennesaw, GA, USA
| | - Jingxuan Zhao
- Surveillance and Health Equity Science, American Cancer Society, Kennesaw, GA, USA
| | - Kewei Sylvia Shi
- Surveillance and Health Equity Science, American Cancer Society, Kennesaw, GA, USA
| | - Qinjin Fan
- Surveillance and Health Equity Science, American Cancer Society, Kennesaw, GA, USA
| | - Elizabeth Schafer
- Surveillance and Health Equity Science, American Cancer Society, Kennesaw, GA, USA
| | - K Robin Yabroff
- Surveillance and Health Equity Science, American Cancer Society, Kennesaw, GA, USA
| | - Ahmedin Jemal
- Surveillance and Health Equity Science, American Cancer Society, Kennesaw, GA, USA
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Mehta A, Awuah WA, Kalmanovich J, Huang H, Tanna R, Iqbal DJ, Garg T, Bulut HI, Abdul-Rahman T, Hasan MM. Investigating discrepancies in demand and access for bariatric surgery across different demographics in the COVID-19 era. Ann Med Surg (Lond) 2022; 82:104368. [PMID: 36268323 PMCID: PMC9577451 DOI: 10.1016/j.amsu.2022.104368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/11/2022] [Indexed: 11/10/2022] Open
Abstract
Obesity affects over 650 million adults worldwide and increases the risk of cardiovascular events, diabetes, and hypertension. While lifestyle recommendations are popular management options, bariatric surgery has emerged as a standard of care in refractory cases, reported to cause at least a 30% reduction in mortality. In addition, it mitigates obesity-related complications leading to a significant improvement in the quality of life for morbidly obese patients (BMI >40). Despite the numerous benefits, demand and access to bariatric surgery vary across different demographics such as age, gender, and socioeconomic status. This demand and access were further reduced due to the COVID-19 pandemic. This has resulted in cancellations of elective surgeries such as weight loss procedures and promotes a sedentary lifestyle which has short-term and long-term detrimental consequences on the health of obese patients. In the context of the prevalent epidemiological trends, this reduction in bariatric services will disproportionately affect the elderly, males, low SES, and African Americans. This editorial highlights the prevalent discrepancies in demand and access to bariatric surgery amidst the COVID-19 pandemic, and possible recommendations to improve overall access and utilization of bariatric services in morbidly obese patients belonging to all demographics.
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Tuczyńska M, Staszewski R, Matthews-Kozanecka M, Baum E. Impact of Socioeconomic Status on the Perception of Accessibility to and Quality of Healthcare Services during the COVID-19 Pandemic among Poles—Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095734. [PMID: 35565127 PMCID: PMC9104779 DOI: 10.3390/ijerph19095734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/01/2022] [Accepted: 05/06/2022] [Indexed: 12/07/2022]
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.
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Affiliation(s)
- Magdalena Tuczyńska
- SSC of Maxillofacial and Orthopaedics and Orthodontics, Poznan University of Medical Sciences, 61-701 Poznan, Poland
- Correspondence:
| | - Rafał Staszewski
- Department of Hypertension, Angiology and Internal Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| | - Maja Matthews-Kozanecka
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (M.M.-K.); (E.B.)
| | - Ewa Baum
- Department of Social Sciences and the Humanities, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (M.M.-K.); (E.B.)
- Division of Philosophy of Medicine and Bioethics, Poznan University of Medical Sciences, 61-701 Poznan, Poland
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