Unmet needs for food, medicine, and mental health services among vulnerable older adults during the COVID-19 pandemic.

OBJECTIVE: To examine sociodemographic factors associated with having unmet needs in medications, mental health, and food security among older adults during the COVID-19 pandemic. DATA SOURCES AND STUDY SETTING: Primary data and secondary data from the electronic health records (EHR) in an age-friendly academic health system in 2020 were used. STUDY DESIGN: Observational study examining factors associated with having unmet needs in medications, food, and mental health. DATA COLLECTING/EXTRACTION METHODS: Data from a computer-assisted telephone interview and EHR on community-dwelling older patients were analyzed. PRINCIPLE FINDINGS: Among 3400 eligible patients, 1921 (53.3%) (average age 76, SD 11) responded, with 857 (45%) of respondents having at least one unmet need. Unmet needs for medications were present in 595 (31.0%), for food in 196 (10.2%), and for mental health services in 292 (15.2%). Racial minorities had significantly higher probabilities of having unmet needs for medicine and food, and of being referred for services related to medications, food, and mental health. Patients living in more resource-limited neighborhoods had a higher probability of being referred for mental health services. CONCLUSIONS: Age-friendly health systems (AFHS) and their recognition should include assessing and addressing social risk factors among older adults. Proactive efforts to address unmet needs should be integral to AFHS.

Evidence for coseismic subsidence events in a southern California coastal saltmarsh.

Paleoenvironmental records from a southern California coastal saltmarsh reveal evidence for repeated late Holocene coseismic subsidence events. Field analysis of sediment gouge cores established discrete lithostratigraphic units extend across the wetland. Detailed sediment analyses reveal abrupt changes in lithology, percent total organic matter, grain size, and magnetic susceptibility. Microfossil analyses indicate that predominantly freshwater deposits bury relic intertidal deposits at three distinct depths. Radiocarbon dating indicates that the three burial events occurred in the last 2000 calendar years. Two of the three events are contemporaneous with large-magnitude paleoearthquakes along the Newport-Inglewood/Rose Canyon fault system. From these data, we infer that during large magnitude earthquakes a step-over along the fault zone results in the vertical displacement of an approximately 5-km2 area that is consistent with the footprint of an estuary identified in pre-development maps. These findings provide insight on the evolution of the saltmarsh, coseismic deformation and earthquake recurrence in a wide area of southern California, and sensitive habitat already threatened by eustatic sea level rise.