Abstract

Measuring disparities in homicide, National Vital Statistics System ─ United States, 2020

Zewditu Demissie, PhD, MPH, CPH, FACE, Kathleen McDavid Harrison, PhD, MPH, FACE, Hong Zhou, MS, MPH U.S. Centers for Disease Control and Prevention

APHA 2022 Annual Meeting and Expo

Background: Inequities in homicide have been documented; however, measurement of disparities using rigorous approaches is not consistently conducted.

Objective: To address this gap, we assessed various disparity measures using homicide data to inform violence prevention efforts.

Methods: We used CDC’s National Vital Statistics System’s 2020 mortality data to explore racial/ethnic disparities in homicide. Homicides were identified using International Classification of Diseases 10 codes [U01–U02, X85–Y09, Y87.1]. We calculated age-adjusted homicide rates (per 100000 population) overall and by race/ethnicity and sex. Relative and absolute measures of disparity were calculated.

Results: In 2020, 24,576 homicides occurred in the United States. Age-adjusted homicide rates ranged from 1.7 (95% CI: 1.5-1.9) for Asian or Pacific Islander (API) persons to 30.6 (CI 30.1-31.1) for non-Hispanic Black persons. Rates were higher among males (12.6) vs. females (2.9). Compared to non-Hispanic White persons, Black persons experienced the highest rate ratio (9.4) and rate difference (27.4) out of all other racial/ethnic groups. The proportion of homicide attributable to disparity was highest for Black persons compared to API persons. Across all racial/ethnic groups, the overall index of disparity was 106.67; the Gini coefficient was 0.49. Racial/ethnic disparities were generally greater for males compared to females.

Conclusions: Black persons experienced the greatest homicide disparities. Measuring and reporting health disparities is important for setting goals for achieving equity and tracking progress toward those goals. Further, it is critical for fully understanding the burden of violence and helps inform efforts to address underlying drivers of inequities in violence.

Abstract

Evaluating Asthma Care and Health Equity in Illinois through Utilizing EMS Data

Sarah Keeley¹, Marcus Shapiro², Nancy Amerson, MPH³, Cassandra Johnson, MPH², Arlene Keddie, Ms, PhD⁴, Sarah Geiger, Ms, PhD² (1)West Virginia University (2)University of Illinois Urbana-Champaign, (3)Illinois Department of Public Health, (4)Northern Illinois University

APHA 2022 Annual Meeting and Expo

Background
Asthma is a chronic condition that disparately affects people of color in the United States across healthcare services, including Emergency Medical Services (EMS). The Illinois Department of Public Health strives to improve asthma care and health equity for Illinois residents. One way it accomplishes this goal is by identifying disparities and targeting interventions to the geographies most affected.

Objective(s)
This study examined asthma-related EMS visits (visits) for children 5-18 years old in Illinois public schools for racial disparities.

Methods
The data were collected using the EMS database. Visits were limited to public school buildings and ages 5-18 in2021. A visit was defined as such if EMS records reported respiratory symptoms and albuterol administration during the visit. Race was categorized as White (W), African American (AA), or Other (O). Counties were identified by visits per capita. Relative risks by race compared to White were calculated from 2019 population data.

Results
Rock Island, Peoria, Macon, Dekalb, and Vermillion counties were identified as the highest burden counties, having the highest visit rates. Relative risks compared to White by county were: Rock Island (AA: 3.804, O: 5.094), Peoria (AA: 4.627, O:2.437), Macon (AA:2.904, O:1.314) DeKalb (AA:21.644, O:20.486) and Vermillion (AA:11.915, O:0).

Conclusion
This study identified differences in visits by race compared to White. Non-White children have higher rates compared to White children. Visits should be examined annually and in relationship to policy changes within the state. Counties with the greatest disparities should be targeted with interventions.

Abstract

Factors associated with willingness to participate in health-related research studies among African Americans participating in the Florida Registry Aging Study.

Fern Webb, PhD, MS¹, Lori Bilello, PhD, MBA, MHS², Caitlin Murphy, MPH, MS¹, Phildra Swagger, PhD, MBA³, Giovanni Garcia, HSA⁴, Donna Neff, PhD³, Trudy Gaillard, PhD⁴ (1)University of Florida, (2)University of Florida , (3)University of Central Florida, (4)Florida International University

APHA 2022 Annual Meeting and Expo

Background: The Florida Registry for Aging study (FRAS) is designed to increase recruitment and enrollment of older African Americans [AA], Caribbean [CN], and Latino/Hispanic [CN] into NIH-funded clinical research. Willingness to participate (WTP) is highly relevant for public health research given implications for clinical trial enrollment and retainment.

Objectives are to 1) describe WTP in various types of health-related research studies and 2) examine WTP’s association with sociodemographic characteristics (SDC). Secondary objectives are to share community engagement research (CEnR) enrollment strategies used in FRAS.

Methods: FRAS is statewide research program where AA, CN and LN adults > 25+ are invited to complete a 30-item, self-administered online survey. Responses for AA (n=165; 49% of entire) are analyzed. Variables of interests are: WTP in various types of health research studies and SDC. Descriptive and analytic analyses were conducted in SAS v. 9.4.

Results: AA reported a high WTP in research asking questions (86%), involving blood (65%) or genetic samples (57%), using equipment (62%), or having no pay (66%), and less WTP in studies involving medication (35%) or staying overnight (48%). Significant differences were found for WTP: using medication among men (Χ2=6.36, p=.011) and AA reporting no cultural- (Χ2=8.34, p<.004) or spiritual- impact (Χ2=12.9, p<.0003). AA reporting no spiritual- impact were more WTP in studies using equipment (Χ2=4.48, p=.03) or involving staying overnight (Χ2=4.32, p=.04). AA more WTP in research involving genetic samples had lower mean household members (Χ2=1.64, p<.02) and fewer average of children (Χ2=1.53, p=.04).

Conclusion: Overall, AA adults are WTP in health-related research that involves: asking questions, taking blood and genetic samples, using equipment and not receiving pay. However, they were less WTP in research involving medication and overnight stay. Recommendations are to develop clinical trials involving some of these research activities as preferred by AA.

Abstract

Integration of social epidemiology and GIS technology to address inequalities in health outcomes

Jonnell Sanciangco, MSc, GISP, Nomana Khan, MBBS, MPH, Erika Quinones, MPH, MBA Maximus Public Health

APHA 2022 Annual Meeting and Expo

Background:
We have seen an exacerbated recognition of health inequities in the United States and worldwide during the past quarter-century. Early in 2020, our public health team at Maximus assisted our health department partners with transitioning data systems and data management from the pre-pandemic routine collection of infectious disease case data into COVID-19 specific surveillance systems. We integrated our GIS capabilities to identify health disparities and inequities among communities.

Objectives:
1. Discuss how GIS can track the sources of diseases and the movements of contagions.
2. Demonstrate how health agencies can respond more effectively to disease outbreaks by applying GIS technology to identify at-risk populations and target interventions.

Methods:
Our team used GIS to develop mapping models and data visualization tools to support timely, reliable, and high-quality data visualization. Spatial methods also inform our health department partners in their decision-making as part of their response efforts tailored to their respective communities.

Results:
The surveillance data and GIS methodologies illustrated health disparities such as low vaccination rates due to access, limited resources, or inequitable social determinants of health. As a result, we assisted our health department partners in planning and implementing equitable programs and interventions within high-priority communities.

Conclusion:
The application of data analytic tools and GIS has proven instrumental in achieving equitable public health response. Our programs directly impacted the goal of achieving equity by identifying gaps, supporting in defining solutions and interventions, and making the connection between a population’s location and its health equity status.