Dataset Information

Associations of race/ethnicity and socioeconomic factors with vaccination among US adults during the COVID-19 pandemic, January to March 2021.

ABSTRACT: To date, there has been limited data available to understand the associations between race/ethnicity and socioeconomic and related characteristics with novel coronavirus disease (COVID-19) vaccination in the United States. I leveraged the large, nationally-representative cross-sectional surveys of the U.S. Household Pulse Survey between January and March 2021 with relatively complete race/ethnicity and socioeconomic data to examine national trends in levels of COVID-19 vaccine initiation and intention in adults aged 18-85 years. I further estimated the multivariable associations between race/ethnicity, education, income, and financial hardship with the adjusted prevalence odds ratios of: 1) receipt of ≥1 COVID-19 vaccine dose; and 2) among those unvaccinated, the definite intention to receive a vaccine. I observed persistent disparities in vaccine initiation for non-Hispanic Blacks, Hispanics, and non-Hispanic multiracial/other race persons, and vaccine intention for Blacks and multiracial/other race persons, compared to non-Hispanic Whites and Asians. In late March 2021, the prevalence estimates of Hispanics and Blacks receiving a vaccine were 12-percentage points and 8-percentage points lower than for Whites, respectively. Education and income exhibited dose-response relationships with vaccine initiation (P for trend ≤0.01 and <0.001, respectively). Substantial financial hardship was linked to 35-44% lower adjusted odds of vaccination (P<.001). In this large, nationally-representative study, I found persistent racial/ethnic and socioeconomic disparities in vaccine initiation and intention, more than three months after COVID-19 vaccines first became available. Addressing these persistent racial/ethnic and socioeconomic inequities in vaccination is essential to mitigate the pandemic's higher risks of infection and adverse health outcomes in Hispanic, Black, and socioeconomically-disadvantaged communities.

SUBMITTER: Kim D

PROVIDER: S-EPMC9558632 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Associations of race/ethnicity and socioeconomic factors with vaccination among US adults during the COVID-19 pandemic, January to March 2021.

Kim Daniel D

Preventive medicine reports 20221013

To date, there has been limited data available to understand the associations between race/ethnicity and socioeconomic and related characteristics with novel coronavirus disease (COVID-19) vaccination in the United States. I leveraged the large, nationally-representative cross-sectional surveys of the U.S. Household Pulse Survey between January and March 2021 with relatively complete race/ethnicity and socioeconomic data to examine national trends in levels of COVID-19 vaccine initiation and int ...[more]

PMID: 36267818

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Project description:BackgroundPopulations who are incarcerated have experienced disproportionately high coronavirus disease 2019 (COVID-2019) mortality rates compared to the general population. However, mortality rates by race/ethnicity from federal, state, and local carceral settings are largely unavailable due to unregulated reporting; therefore, racial/ethnic inequities have yet to be examined. We aimed to estimate coronavirus disease 2019 (COVID-19) mortality rates among individuals incarcerated in U.S. state prisons by race and ethnicity (RE).MethodsFreedom of Information Act requests to state Departments of Corrections were used to identify deaths from COVID-19 among incarcerated adults occurring from March 1-October 1, 2020. We requested race, ethnicity, and age specific data on deaths and custody populations; sufficient data to calculate age-adjusted rates were obtained for 11 state systems. Race and ethnic specific unadjusted deaths rates per 100,000 persons were calculated overall and by state, based on March 1, 2020 custody populations. Rate ratios (RR) and 95% confidence intervals (95%CI) compared aggregated age-adjusted death rates by race and ethnicity, with White individuals as the reference group.ResultsOf all COVID-related deaths in U.S. prisons through October 2020, 23.35% (272 of 1165) were captured in our analyses. The average age at COVID-19 death was 63 years (SD = 10 years) and was significantly lower among Black (60 years, SD = 11 years) compared to White adults (66 years, SD = 10 years; p < 0.001). In age-standardized analysis, COVID-19 death rates were significantly higher among Black (RR = 1.93, 95% CI: 1.25-2.99), Hispanic (RR = 1.81, 95% CI: 1.10-2.96) and those of Other racial and ethnic groups (RR = 2.60, 95% CI: 1.01-6.67) when compared to White individuals.ConclusionsAge-standardized death rates were higher among incarcerated Black, Hispanic and those of Other racial and ethnic groups compared to their White counterparts. Greater data transparency from all carceral systems is needed to better understand populations at disproportionate risk of COVID-19 morbidity and mortality.

Project description:ImportanceApproximately 10% to 30% of patients with sarcoma present with detectable metastases at diagnosis. However, the extent to which presentation with metastases is due to delayed diagnosis vs other factors remains unclear.ObjectiveTo evaluate whether socioeconomic status, insurance status, or race/ethnicity were associated with the presence of metastases at diagnosis of sarcoma.Design, setting, and participantsThis cross-sectional study used data from the population-based Surveillance, Epidemiology, and End Results program. Adult and pediatric patients with an initial diagnosis of soft-tissue and bone sarcoma between 2001 and 2015 were stratified by age group (pediatric, <20 years; adult, 20-65 years; older adult, >65 years) and sarcoma subtype. Statistical analyses were performed between August 2019 and January 2020.ExposuresSurveillance, Epidemiology, and End Results Census tract-level socioeconomic status index, insurance status, and race/ethnicity.Main outcomes and measuresThe odds of presenting with metastases at diagnosis were calculated.ResultsA total of 47 337 patients with first primary malignant sarcoma were included (24 343 male patients [51.4%]), with 29 975 non-Hispanic White patients (63.3%), 5673 non-Hispanic Black patients (12.0%), 7504 Hispanic patients (15.8%), and 4185 American Indian-Alaskan Native and Asian Pacific Islander patients (8.8%). Liposarcoma in adults was the only subtype and age group combination that demonstrated a significant trend in incidence across socioeconomic status levels (odds ratio, 0.85; 99% CI, 0.76-0.96; P = .001). However, compared with having non-Medicaid insurance, having Medicaid or no insurance in adults was associated with an increased odds of metastases at diagnosis for 6 of the 8 sarcoma subtypes evaluated; osteosarcoma and Ewing sarcoma were the only 2 subtypes in adults for which metastases were not associated with insurance status. In addition, there was an increased risk of presenting with metastases among non-Hispanic Black adults diagnosed with leiomyosarcoma (odds ratio, 1.87; 99% CI, 1.41-2.48) and unclassified sarcomas (odds ratio, 1.65; 99% CI, 1.01-2.67) compared with non-Hispanic White adults that was independent of socioeconomic and insurance status.Conclusions and relevanceThese findings suggest that delayed access to care is associated with advanced stage at diagnosis for several soft-tissue sarcoma subtypes in adults, whereas other factors may be associated with the metastatic progression of osteosarcoma and Ewing sarcoma, as well as the racial disparities observed with metastatic leiomyosarcoma and unclassified sarcomas.

Dataset Information

Associations of race/ethnicity and socioeconomic factors with vaccination among US adults during the COVID-19 pandemic, January to March 2021.

Publications

Associations of race/ethnicity and socioeconomic factors with vaccination among US adults during the COVID-19 pandemic, January to March 2021.

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