Relationships Between COVID-19 Infection Rates, Healthcare Access, Socioeconomic Status, and Cultural Diversity


Book Description

"The COVID-19 pandemic has had a disproportionate impact on racial and ethnic minority groups, with high infection rates throughout those communities. There are a complex set of factors that account for COVID-19 disparities. Focusing on infection and death rates alone without also examining health equity, underestimates the true impact of the pandemic. To gain a more clear understanding of COVID-19’s impact in these communities, we analyzed the relationship between state COVID-19 infection rates with social determinants of health: cultural diversity, health care access, and socioeconomic status. Our approach to identifying this relationship was to estimate infection rates by fitting John Hopkins COVID-19 data to an SIR compartmental model commonly used in epidemiology to model infectious disease. These infection rates were then analyzed as a function of state indices with regard to healthcare access, and socioeconomic status, as well as measures of each states cultural diversity. Nationally we do not see a relationship between COVID-19 infection and removal rates to cultural diversity, healthcare access, and socioeconomic status during the time period. However an analysis of states with the highest and lowest infection rates show that more culturally diverse states had higher infection rates during this time period. In addition, states that ranked low in healthcare access had infections an order of magnitude larger than states with good healthcare access. Alternatively, states grouped by low and high socioeconomic status had similar infection rates."--Boise State University ScholarWorks.




Communities in Action


Book Description

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.




Racial and Ethnic Disparities in COVID-19


Book Description

As of June 2020, the coronavirus pandemic has led to more than 2.3 million confirmed infections and 121 thousand fatalities in the United States, with starkly different incidence by race and ethnicity. Our study examines racial and ethnic disparities in confirmed COVID-19 cases across six diverse cities - Atlanta, Baltimore, Chicago, New York City, San Diego, and St. Louis - at the ZIP code level (covering 436 "neighborhoods" with a population of 17.7 million). Our analysis links these outcomes to six separate data sources to control for demographics; housing; socioeconomic status; occupation; transportation modes; health care access; long-run opportunity, as measured by income mobility and incarceration rates; human mobility; and underlying population health. We find that the proportions of black and Hispanic residents in a ZIP code are both positively and statistically significantly associated with COVID-19 cases per capita. The magnitudes are sizeable for both black and Hispanic, but even larger for Hispanic. Although some of these disparities can be explained by differences in long-run opportunity, human mobility, and demographics, most of the disparities remain unexplained even after including an extensive list of covariates related to possible mechanisms. For two cities - Chicago and New York - we also examine COVID-19 fatalities, finding that differences in confirmed COVID-19 cases explain the majority of the observed disparities in fatalities. In other words, the higher death toll of COVID-19 in predominantly black and Hispanic communities mostly reflects higher case rates, rather than higher fatality rates for confirmed cases.




Health at a Glance: Europe 2020 State of Health in the EU Cycle


Book Description

The 2020 edition of Health at a Glance: Europe focuses on the impact of the COVID‐19 crisis. Chapter 1 provides an initial assessment of the resilience of European health systems to the COVID-19 pandemic and their ability to contain and respond to the worst pandemic in the past century.




The Future of Nursing 2020-2030


Book Description

The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.




COVID-19 & BLM


Book Description

In this review of scholarship on healthcare inequality, as well as recent scholarship focused on COVID-19, we find there are clear racial disparities within healthcare, seen within previous trends, as well as the current pandemic. Minorities have historically been at greater risk during prior health crises, as well as being at risk for various underlying health conditions, and now, there are higher rates of infection and mortality amongst minority groups. Socioeconomic factors play an incredibly important role in these disparities, and much of the current discourse does regard socioeconomic status as a primary factor in these trends. However, we find that there is a layer of inequality extending beyond socioeconomic status that is due to systemic racism within healthcare. The complex notion of systemic racism can be further broken down into three primary categories that will be discussed in this thesis: historical, interpersonal, and institutional, all of which are connected, but have contributed to systemic racism in their own unique way, thus requiring their own unique solutions to alleviate racial inequality within healthcare and COVID-19. Historical causes require alleviating mistrust of healthcare through increasing minority representation in healthcare and public outreach to underserved communities. Adapting medical education to systemic racism can improve interpersonal relationships between physicians and minority patients. Finally, to promote true, systemic change, institutional causes must be addressed, through the proper allocation and funding of resources to minority communities, but also with the conscientious provision of healthcare that acknowledges systemic racism in its practice.




Health-Care Utilization as a Proxy in Disability Determination


Book Description

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.




A Republic of Equals


Book Description

In this provocative book, economist Jonathan Rothwell draws on the latest empirical evidence from across the social sciences to demonstrate how rich democracies have allowed racial politics and the interests of those at the top to subordinate justice. He looks at the rise of nationalism in Europe and the United States, revealing how this trend overlaps with racial prejudice and is related to mounting frustration with a political status quo that thrives on income inequality and inefficient markets. But economic differences are by no means inevitable. Differences in group status by race and ethnicity are dynamic and have reversed themselves across continents and within countries. Inequalities persist between races in the United States because Black Americans are denied equal access to markets and public services. Meanwhile, elite professional associations carve out privileged market status for their members, leading to compensation in excess of their skills.




Understanding Racial and Ethnic Differences in Health in Late Life


Book Description

As the population of older Americans grows, it is becoming more racially and ethnically diverse. Differences in health by racial and ethnic status could be increasingly consequential for health policy and programs. Such differences are not simply a matter of education or ability to pay for health care. For instance, Asian Americans and Hispanics appear to be in better health, on a number of indicators, than White Americans, despite, on average, lower socioeconomic status. The reasons are complex, including possible roles for such factors as selective migration, risk behaviors, exposure to various stressors, patient attitudes, and geographic variation in health care. This volume, produced by a multidisciplinary panel, considers such possible explanations for racial and ethnic health differentials within an integrated framework. It provides a concise summary of available research and lays out a research agenda to address the many uncertainties in current knowledge. It recommends, for instance, looking at health differentials across the life course and deciphering the links between factors presumably producing differentials and biopsychosocial mechanisms that lead to impaired health.




Access to Health Care in America


Book Description

Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.