Abstract

Racial and socioeconomic correlates of COVID symptoms among a large sample of US adults

Daniel Lopez-Cevallos, PhD, MPH,¹ Nicole Jones,² (1) University of Massachusetts Amherst, (2) Oregon State University

APHA 2022 Annual Meeting and Expo

The COVID-19 pandemic has changed life as we know it. In the United States, the pandemic has had a disproportionate impact on communities of color, and among essential “frontline workers. However, there is limited evidence regarding the COVID-19 impacts by socioeconomic characteristics. The purpose of our study was to explore the association between racial/ethnic and socioeconomic status and COVID-19 symptoms in a large sample of US adults. For this purpose, we used secondary de-identified data from the Dynata Global COVID Symptoms project [https://www.dynata.com/global-covid-19-symptom-map/] between July 7 and July 14, 2020 (n = 163,686). The sample included respondents from all fifty US states plus Puerto Rico, Washington DC and the US Virgin Islands. The outcome variable asked about any COVID symptoms, including difficulty breathing, coughing, fatigue, fever, loss of taste or smell. Using the Behavioral Model for Vulnerable Populations as our conceptual framework, we included the following covariates: 1) predisposing factors (age, gender, number of children, race/ethnicity, marital status, and education); and 2) enabling factors (housing conditions, income, employment status, business ownership, and number of cars owned). Multivariable logistic regression analyses were conducted to explore the association between predisposing and enabling factors with COVID-19 symptoms. We found that Latinx ethnicity increased the likelihood of reporting COVID symptoms by 12%. Having an educational level higher than high school resulted in increased likelihood of reporting symptoms (over 17% higher for associate’s/vocational, 6.5% higher for bachelor’s, 21% higher for bachelor's degree or more). In turn, home ownership resulted in 13% lower likelihood of symptoms than renting, while other living situations had 9% higher likelihood of reporting COVID symptoms. Compared to respondents with incomes below $50,000, those with higher income were less likely to report symptoms. Interestingly, business owners were 47% more likely to report COVID symptoms. Lastly, respondents owning just one care were 5% more likely to report symptoms. In conclusion, we provide further evidence of the disproportionate impact of the COVID-19 pandemic by race/ethnicity and socioeconomic status. Our findings point out characteristics other than race/ethnicity that are also relevant to monitor now and in the future, to better understand & address the impacts of the COVID-19 and other pandemics.

Abstract

A data driven approach to COVID-19 Vaccine Equity Initiatives

Abigail Averbach¹, Amy Bettano¹, Arielle Coq¹, Kevin Harlen², Michelle Reid¹ (1)Massachusetts Department of Public Health, (2)Deloitte

APHA 2022 Annual Meeting and Expo

Background: The COVID-19 pandemic amplified underlying public health inequities. To address these inequities, the Vaccine Equity Initiative (VEI) was established by the Massachusetts Department of Public Health (MDPH). MDPH identified 20 municipalities, based on COVID-19 burden and the CDC Social Vulnerability Index, to partner with on the delivery of COVID-19 mitigation and vaccines for populations at high risk for morbidity and mortality.
Methods: Recognizing the demographic and socioeconomic diversity that exists amongst the 20 VEI communities, multiple approaches to sharing and analyzing data were used. These included weekly public-facing municipal-specific vaccination reports stratified by race/ethnicity and age group, and census block group vaccination maps. MDPH partnered with VEI-Community Liaisons, local leaders, and community-based organizations to collaboratively review and reflect on data to develop hyper-local community information and vaccination strategies.

Results: These efforts closed the first dose vaccination rate gap between VEI and non-VEI (n=331) communities from 10 to 4 percentage points, and increased vaccination rates 43 percentage points among Black, Indigenous, and other people of color within VEI communities. These approaches also informed funding strategies and created a pathway to trusting relationships among state, municipal and non-governmental partners.
Conclusions: Making detailed COVID-19 vaccination data available to the VEI communities allowed each community to enact a tailored vaccination strategy, removed the “guessing from local strategy development, and built collaborative bridges between state and local government to maximize impact. With data at the forefront, community-driven interventions were critical to address the structural, behavioral, and informational barriers to getting the COVID-19 vaccine.

Abstract

Equity in OC: A Community-Informed and Data-Driven Initiative to Address Social Determinants of Health in Orange County

Hieu Nguyen, LCSW, MBA¹, Clayton Chau, MD, PhD, MASL¹, Ryan Natividad, MPP¹, Esther Lee, MPH, CHES¹, Eddie Turner² (1)Orange County Health Care Agency, (2)Institute for Healthcare Improvement

APHA 2022 Annual Meeting and Expo

Background: The COVID-19 pandemic exposed deep rooted gaps in Orange County (OC), California caused by underlying health inequities and disparities. Almost 90% of total COVID-19 deaths were adults aged 55 and older, despite being approximately 28% of the OC population. Also, higher case and death incidences were reported in north/central regions of the county.

Methods: In June 2021, the OC Health Care Agency (HCA) received a grant from the CDC. Through this CDC grant, the Office of Population Health and Equity (OPHE) was established within the OC HCA to launch the Equity in Orange County (EiOC) Initiative. The goals of the EiOC Initiative are to collaborate with communities hardest hit by the COVID-19 pandemic and to build collective capacity for the ongoing COVID-19 crisis and any future pandemics. Through Institute for Healthcare Improvement’s improvement science frameworks, OC residents and community partners are poised to select three social determinants of health action areas from Social Progress Index indicators through a modified Delphi process.

Results: Community members overwhelmingly participated in the selection of action areas and collaborated on pertinent interest areas. OPHE became aware of language interpretation and translation needs in the process and pivoted community engagement accordingly. Future activities include recruiting studying the impact of community action, building community collective capacity, and co-designing future engagements.

Conclusions: Diverse OC community partners diligently co-created and co-led sustainable systems change efforts. OC HCA OPHE and the EiOC Initiative are laying the foundation for creating a healthier, more resilient, and more equitable Orange County.

Abstract

Advancing Health Equity across Health and Social Issues: A Call to Action from a Community Leaders Forum Initiative

Renata Schiavo, PhD, MA, CCL¹, Tonya Lewis Lee, JD², Paulette Spencer, MPH, MA³, Teneasha Washington, PhD⁴, Annette Roque-Lewis⁵, Amy Vu, RD, MPH⁶, Essence Carson⁷, Ashley Gomez, MPH, PHD candidate⁸, Alicia Tauro⁹, Radhika Ramesh, MA¹⁰, Denise Morrow, PhD¹¹, Shannon Fleg¹², Von Gordon¹³ (1)1) Health Equity Initiative: 2) Columbia University Mailman School of Public Health; 3) SECI, (2)Author, filmmaker, health equity advocate, (3)Bronx Community Health Network, (4)1) National Center on Health, Physical Activity and Disability; 2) University of Alabama, (5)La Nueva Esperanza, (6)FEAST, (7)WNBA Player, Music Industry Creative, Producer/Artist, Community Leader and Health Equity Champion, (8)1) Brown University; 2) Grameen Primacare, (9)Youth for Unity and Voluntary Action (YUVA)​, (10)Health Equity Initiative, (11)BEMORE, (12)Native Health Initiative, (13)The Winter Institute

APHA 2022 Annual Meeting and Expo

There is an increased understanding about the central role of communities – and community engagement – on advancing health equity and mitigating social and institutional inequities. Communities - and their leaders - are the real “experts on their needs, values, and priorities, and should be empowered to design policies and solutions that address existing health, racial, and social inequities. This presentation focuses on the recommendations and call to action from a Community Leaders Forums series that engages community leaders from U.S. and international community-based organizations. The Forums provide a much-needed space to discuss and advocate for policy and other kinds of community-driven and strength-based solutions to advance health equity during and beyond COVID-19. Recommendations from the Forums are designed to reach policymakers, organizational leaders, grant-making organizations, and/or other leaders and organizations across professions and disciplines who can affect much needed change to mitigate the impact of health, racial, and social inequities. Topics have included racial healing and health equity, the impact of COVID-19 on women and girls, and emerging community needs and policy solutions during COVID-19. The call to action from the forums also provides a blueprint for changemakers, activists and advocates, and includes several actionable items. Implications for community engagement and future directions are also discussed.