Racial Disparities in the Epidemiology of COVID-19 in Georgia: Trends Since State-Wide Reopening.

Objective: To examine county-level factors associated with coronavirus disease 2019 (COVID-19) incidence and mortality in Georgia, focusing on changes after relaxation of "shelter-in-place" orders on April 24, 2020. Methods: County-level data on confirmed COVID-19 cases and deaths were obtained from the Johns Hopkins 2019 Novel Coronavirus Data Repository and linked with county-level data from the 2020 County Health Rankings. We examined associations of county-level factors with mortality and incidence rates (quantiles) using a logistic regression model. This research was conducted in June-July 2020 in Augusta, GA. Results: Counties in the highest quartile for mortality had higher proportions of non-Hispanic (NH)-Black residents (median: 37.4%; interquartile range [IQR]: 29.5-45.0; p<0.01) and residents with incomes less than $20,000 (median: 32.9%; IQR: 26.6-35.0; p<0.01). Counties in the highest quartile for NH-Black residents (38.7-78.0% NH-Black population) showed a 13-fold increase in odds (odds ratio=13.15, 95% confidence interval=1.40-123.80, p=0.05) for increased COVID-19 mortality controlling for income. Conclusions: Although highlighted by the pandemic, racial disparities predated COVID-19, exposing the urgency for diversion of resources to address the systematic residential segregation, educational gaps, and poverty levels experienced disproportionately by Black communities.

Effect of a physician led education invention on colon cancer screening at underserved clinics in Georgia.

OBJECTIVE: Colorectal cancer (CRC) screening rates are much lower at federally qualified health centers (FQHC) than the rest of the nation. The study aim was to determine if a physician led, low cost intervention, can improve CRC screening rates at FQHCs for underserved patients. METHODS: A CRC quality improvement outreach program was conducted at 4 FQHCs. The program included direct provider education sessions, systems process improvements, patient education resources and low cost testing. We analyzed pre and post intervention screening rates for all eligible patients, defined as age 50-74 at average CRC risk. RESULTS: CRC screening rates significantly increased at all sites 3 months following intervention: Site 1: 41%-48.3%, p < .0001; site 2: 31.6%-37.8%, p < .0001; site 3: 30.5%-38.2%, p < .0001 and site 4: 43.9%-46.8%, p = .012. CONCLUSION: The education program successfully increased CRC screening rates in the underserved by 2.9%-7.7% 3 months post-intervention. PRACTICE IMPLICATIONS: This approach of direct provider education sessions, systems process improvements, patient education resources and low cost testing improved underserved CRC screening. Implementation across Georgia would be expected to improve CRC related mortality and morbidity for the state's underserved.

Impact of age, location, and bicycle style on helmet usage by adults.

OBJECTIVE: Our objective was to describe current patterns of bicycle helmet usage in a university community using a direct observation approach. PARTICIPANTS: Cyclists in a university community observed in 2010 and 2011. METHODS: We identified 6 locations in Athens, Georgia, and recorded the type of bicycle, age group, sex, and helmet usage of passing cyclists. We performed univariate and multivariate analysis to identify independent predictors of helmet usage. RESULTS: We observed 433 cyclists: 74 percent male, 74 percent college age, and 45 percent of whom wore a helmet. Helmet usage varied by bicycle type, location of observation, and age group. Independent predictors of bike helmet were on-campus location (0.38, 95% confidence interval [CI]: 0.22-0.66), college-age rider (0.29, 95% CI: 0.15-0.54), and use of a city or leisure bike (0.39, 95% CI: 0.23-0.65). CONCLUSIONS: College-age riders, riders on campus, and those riding a city or leisure-style bike are less likely to wear a helmet. Health promotion efforts aimed at increasing helmet usage should target these groups.