COVID-19 Vaccination Intention and Factors Associated with Hesitance and Resistance in the Deep South: Montgomery, Alabama.

Using COVID-19-related survey data collected from residents in the city of Montgomery, Alabama, this study assessed the prevalence of COVID-19 vaccine acceptance, hesitance, and resistance, and identified factors associated with COVID-19 vaccine hesitance and resistance. To analyze the survey data (n = 1000), a consolidation approach (machine learning modeling and multinomial logistic regression modeling) was used to identify predictors of COVID-19 vaccine hesitancy and resistance. The prevalence of vaccine acceptance, hesitancy, and resistance was 62%, 23%, and 15%, respectively. Female gender and a higher level of trust that friends and family will provide accurate information about the COVID-19 vaccine were positively associated with vaccine hesitancy. Female gender and higher trust that social media will provide accurate information about COVID-19 were positively associated with vaccine resistance. Factors positively associated with COVID-19 vaccine hesitance and resistance in the study's geographical area are worrisome, especially given the high burden of chronic diseases and health disparities that exist in both Montgomery and the Deep South. More research is needed to elucidate COVID-19 vaccination attitudes and reasons for non-acceptance of the COVID-19 vaccine. Efforts to improve acceptance should remain a priority in this respective geographical area and across the general population.

Prevalence and Predictors of Co-occurring Hypertension and Depression Among Community-Dwelling Older Adults.

The objectives of this study were to estimate the prevalence of co-occurring hypertension and depression among community-dwelling older adults and to examine predictors of co-occurring hypertension among community-dwelling older adults. A secondary analysis was conducted from a statewide survey of community-dwelling older adults in the state of Alabama. Binomial logistic regression was used to examine predictors of co-occurring hypertension and depression. The prevalence of co-occurring hypertension and depression among community-dwelling older adults was 35%. In the multivariate analysis, non-Hispanic African American ethnicity (OR = 1.690, CI 1.221-2.341) and diabetes (OR = 1.668, CI 1.173-2.372) were positively associated with co-occurring hypertension and depression. Income ≥ $20,000 (OR = 0.544, CI 0.400-0.739), ≥ 3 meals on average per day (OR = 0.576, CI 0.429-0.774), and higher self-ratings of general health (OR = 0.728, CI 0.628-0.843) and physical activity (OR = 0.827, CI 0.694-0.986) were negatively associated with co-occurring hypertension and depression. Public health professionals and clinicians who provide care to older adults in public health, community health, and primary care settings are in ideal positions to develop intervention strategies to curb the prevalence and incidence of co-occurring hypertension and depression in this population. If intervention strategies are not implemented in these respective settings, unfortunately community-dwelling older adults of non-Hispanic African American ethnicity, with diabetes, or with low self-ratings of general health and physical activity will likely suffer from cardiovascular disease at much higher rates than their counterparts.