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10.1001/jamanetworkopen.2021.7373

http://scihub22266oqcxt.onion/10.1001/jamanetworkopen.2021.7373
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suck abstract from ncbi


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pmid33825836      JAMA+Netw+Open 2021 ; 4 (4): e217373
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  • Association of Human Mobility Restrictions and Race/Ethnicity-Based, Sex-Based, and Income-Based Factors With Inequities in Well-being During the COVID-19 Pandemic in the United States #MMPMID33825836
  • Chakrabarti S; Hamlet LC; Kaminsky J; Subramanian SV
  • JAMA Netw Open 2021[Apr]; 4 (4): e217373 PMID33825836show ga
  • IMPORTANCE: An accurate understanding of the distributional implications of public health policies is critical for ensuring equitable responses to the COVID-19 pandemic and future public health threats. OBJECTIVE: To identify and quantify the association of race/ethnicity-based, sex-based, and income-based inequities of state-specific lockdowns with 6 well-being dimensions in the United States. DESIGN, SETTING, AND PARTICIPANTS: This pooled, repeated cross-sectional study used data from 14?187?762 households who participated in phase 1 of the population-representative US 2020 Household Pulse Survey (HPS). Households were invited to participate by email, text message, and/or telephone as many as 3 times. Data were collected via an online questionnaire from April 23 to July 21, 2020, and participants lived in all 50 US states and the District of Columbia. EXPOSURES: Indicators of race/ethnicity, sex, and income and their intersections. MAIN OUTCOMES AND MEASURES: Unemployment; food insufficiency; mental health problems; no medical care received for health problems; default on last month's rent or mortgage; and class cancellations with no distance learning. Race/ethnicity, sex, income, and their intersections were used to measure distributional implications across historically marginalized populations; state-specific, time-varying population mobility was used to measure lockdown intensity. Logistic regression models with pooled repeated cross-sections were used to estimate risk of dichotomous outcomes by social group, adjusted for confounding variables. RESULTS: The 1?088?314 respondents (561?570 [51.6%; 95% CI, 51.4%-51.9%] women) were aged 18 to 88 years (mean [SD], 51.55 [15.74] years), and 826?039 (62.8%; 95% CI, 62.5%-63.1%) were non-Hispanic White individuals; 86?958 (12.5%; 95% CI, 12.4%-12.7%), African American individuals; 86?062 (15.2%; 95% CI, 15.0%-15.4%), Hispanic individuals; and 50?227 (5.6%; 95% CI, 5.5%-5.7%), Asian individuals. On average, every 10% reduction in mobility was associated with higher odds of unemployment (odds ratio [OR], 1.3; 95% CI, 1.2-1.4), food insufficiency (OR, 1.1; 95% CI, 1.1-1.2), mental health problems (OR, 1.04; 95% CI, 1.0-1.1), and class cancellations (OR, 1.1; 95% CI, 1.1-1.2). Across most dimensions compared with White men with high income, African American individuals with low income experienced the highest risks (eg, food insufficiency, men: OR, 3.3; 95% CI, 2.8-3.7; mental health problems, women: OR, 1.9; 95% CI, 1.8-2.1; medical care inaccessibility, women: OR, 1.7; 95% CI, 1.6-1.9; unemployment, men: OR, 2.8; 95% CI, 2.5-3.2; rent/mortgage defaults, men: OR, 5.7; 95% CI, 4.7-7.1). Other high-risk groups were Hispanic individuals (eg, unemployment, Hispanic men with low income: OR, 2.9; 95% CI, 2.5-3.4) and women with low income across all races/ethnicities (eg, medical care inaccessibility, non-Hispanic White women: OR, 1.8; 95% CI, 1.7-2.0). CONCLUSIONS AND RELEVANCE: In this cross-sectional study, African American and Hispanic individuals, women, and households with low income had higher odds of experiencing adverse outcomes associated with the COVID-19 pandemic and stay-at-home orders. Blanket public health policies ignoring existing distributions of risk to well-being may be associated with increased race/ethnicity-based, sex-based, and income-based inequities.
  • |*COVID-19[MESH]
  • |*Sex Factors[MESH]
  • |Adolescent[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |Communicable Disease Control/*statistics & numerical data[MESH]
  • |Cross-Sectional Studies[MESH]
  • |Ethnicity/*statistics & numerical data[MESH]
  • |Family Characteristics[MESH]
  • |Female[MESH]
  • |Food Security/statistics & numerical data[MESH]
  • |Health Status Disparities[MESH]
  • |Humans[MESH]
  • |Income/*statistics & numerical data[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Racial Groups/*statistics & numerical data[MESH]
  • |SARS-CoV-2[MESH]
  • |Unemployment/statistics & numerical data[MESH]
  • |United States[MESH]


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