Dataset Information

COVID-19 Vaccination Intake and Intention Among Black and White Residents in Southeast Michigan.

ABSTRACT: Using the "3Cs" vaccine hesitancy framework which categorizes determinants of vaccine hesitancy across three dimensions-confidence, complacency, and convenience-we identify factors that shape COVID-19 vaccination intake and intention among Black and white residents in Southeast Michigan. We consider both historical discrimination in medicine and contemporary health and environmental crises (i.e., the Flint Water Crisis) as potential correlates. This study uses data from an online survey conducted between March-April 2021 in Flint and surrounding counties. we find that while historical mistreatment of Black people in healthcare and the Flint Water Crisis were of concern, those factors did not directly impact vaccination intention. Rather, concerns over safety, efficacy, and structural barriers related to access and occupation emerge as responsible for lower vaccination rates among Black residents. Effective vaccination programs require that public health authorities consider multiple factors, including the structural realities faced by racial ethnic minority groups which shape their vaccination decisions.

SUBMITTER: Taylor CAL

PROVIDER: S-EPMC9451110 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

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COVID-19 Vaccination Intake and Intention Among Black and White Residents in Southeast Michigan.

Taylor Cedric A L CAL Sarathchandra Dilshani D Kessler Margaret M

Journal of immigrant and minority health 20220907 2

Using the "3Cs" vaccine hesitancy framework which categorizes determinants of vaccine hesitancy across three dimensions-confidence, complacency, and convenience-we identify factors that shape COVID-19 vaccination intake and intention among Black and white residents in Southeast Michigan. We consider both historical discrimination in medicine and contemporary health and environmental crises (i.e., the Flint Water Crisis) as potential correlates. This study uses data from an online survey conducte ...[more]

PMID: 36071335

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Project description:ObjectiveTo report the clinical characteristics of patients hospitalised with COVID-19 in Southeast Michigan.DesignRetrospective cohort study.SettingEight hospitals in Southeast Michigan.Participants3219 hospitalised patients with a positive SARS-CoV-2 infection by nasopharyngeal PCR test from 13 March 2020 until 29 April 2020.Main outcomes measuresOutcomes were discharge from the hospital or in-hospital death. Examined predictors included patient demographics, chronic diseases, home medications, mechanical ventilation, in-hospital medications and timeframe of hospital admission. Multivariable logistic regression was conducted to identify risk factors for in-hospital mortality.ResultsDuring the study period, 3219 (90.4%) patients were discharged or died in the hospital. The median age was 65.2 (IQR 52.6-77.2) years, the median length of stay in the hospital was 6.0 (IQR 3.2-10.1) days, and 51% were female. Hypertension was the most common chronic disease, occurring in 2386 (74.1%) patients. Overall mortality rate was 16.0%. Blacks represented 52.3% of patients and had a mortality rate of 13.5%. Mortality was highest at 18.5% in the prepeak hospital COVID-19 volume, decreasing to 15.3% during the peak period and to 10.8% in the postpeak period. Multivariable regression showed increasing odds of in-hospital death associated with older age (OR 1.04, 95% CI 1.03 to 1.05, p<0.001) for every increase in 1 year of age and being male (OR 1.47, 95% CI 1.21 to 1.81, p<0.001). Certain chronic diseases increased the odds of in-hospital mortality, especially chronic kidney disease. Administration of vitamin C, corticosteroids and therapeutic heparin in the hospital was associated with higher odds of death.ConclusionIn-hospital mortality was highest in early admissions and improved as our experience in treating patients with COVID-19 increased. Blacks were more likely to get admitted to the hospital and to receive mechanical ventilation, but less likely to die in the hospital than whites.

Project description:ImportanceEpidemiologic evidence regarding the outcomes of dietary sodium intake on mortality remains limited for low-income individuals, particularly Black people.ObjectiveTo investigate the associations of excessive dietary sodium with all-cause and cause-specific mortality among predominantly low-income Black and White Americans.Design, setting, and participantsThis cohort study included participants aged 40 to 79 years from the Southern Community Cohort Study who were recruited at Community Health Centers in 12 southeastern states from 2002 to 2009. Analyses were conducted between March 2022 and June 2023.ExposuresDietary sodium intake was assessed using a validated food frequency questionnaire at baseline.Main outcomes and measuresMultivariable-adjusted Cox regression was used to estimate hazard ratios (HRs) and 95% CIs for mortality outcomes (all-cause, cardiovascular disease [CVD], coronary heart disease [CHD], stroke, heart failure, cancer, and other) associated with sodium intake. Nonlinear associations and population-attributable risk (PAR) of the mortality burden associated with excess sodium were further assessed.ResultsAmong the 64 329 participants, 46 185 (71.8%) were Black, 18 144 (28.2%) were White, and 39 155 (60.9%) were female. The mean (SD) age at study enrollment was 51.3 (8.6) years for Black participants and 53.3 (9.3) years for White counterparts. Mean (SD) dietary sodium intake was 4512 (2632) mg/d in Black individuals and 4041 (2227) mg/d in White individuals; 37 482 Black individuals (81.2%) and 14 431 White individuals (79.5%) exceeded the current dietary recommendations of 2300 mg/d. During a median (IQR) follow-up of 13.8 (11.3-15.8) years, 17 811 deaths were documented, including 5701 from CVD. After adjustment for potential confounders, in Black individuals, HRs per 1000-mg increase in daily sodium intake were 1.07 (95% CI, 1.03-1.10) and 1.08 (95% CI, 1.02-1.14) for deaths from total CVD and CHD, respectively; while in White individuals, the corresponding HRs were 1.08 (95% CI, 1.02-1.14) and 1.13 (95% CI, 1.03-1.23). No significant associations were found for cancer mortality. PAR estimates suggest that sodium intake above the recommended threshold may account for 10% of total CVD, 13% of CHD, and 30% of heart failure deaths in this low-income southern population.Conclusions and relevanceIn this cohort study of 64 329 low-income Americans, nearly 80% of study participants consumed sodium exceeding the current recommended daily amount, which was associated with 10% to 30% of CVD mortality. Public health programs targeted to reduce sodium intake among this underserved population may be beneficial.

Dataset Information

COVID-19 Vaccination Intake and Intention Among Black and White Residents in Southeast Michigan.

Publications

COVID-19 Vaccination Intake and Intention Among Black and White Residents in Southeast Michigan.

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