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1.
Int J Equity Health ; 19(1): 154, 2020 09 09.
Artículo en Inglés | MEDLINE | ID: mdl-32907581

RESUMEN

BACKGROUND: The Arab ethnic minority makes up 21% of Israel's population, yet comprised just 8.8% of confirmed cases and 3.6% of deaths from COVID-19, despite their higher risk profile and greater burden of underlying illness. This paper presents differences in patterns of morbidity and mortality from COVID-19 in the Arab, ultra-Orthodox and overall populations in Israel, and suggests possible reasons for the low rates of infection in the Arab population. METHODS: Data were obtained from the Israeli Ministry of Health's (MOH) open COVID-19 database, which includes information on 1270 localities and is updated daily. The database contains the number of COVID-19 diagnostic tests performed, the number of confirmed cases and deaths in Israel. RESULTS: In the first 4 months of Israel's COVID-19 outbreak, just 2060 cases were confirmed in the Arab population, comprising 8.8% of the 23,345 confirmed cases, or 2.38 times less than would be expected relative to the population size. In contrast, the ultra-Orthodox made up 30.1% of confirmed cases yet just 10.1% of the population. Confirmed case rate per 100,000 was twice as high in the general Jewish population compared to the Arab population. The Arab mortality rate was 0.57 per 100,000, compared to 3.37 in the overall population, and to 7.26 in the ultra-Orthodox community. We discuss possible reasons for this low morbidity and mortality including less use of nursing homes, and effective leadership which led to early closure of mosques and high adherence to social distancing measures, even during the month of Ramadan. CONCLUSIONS: Despite a disproportionate burden of underlying illness, the Arab population did not fulfil initial predictions during the first wave of the COVID-19 outbreak and maintained low numbers of infections and deaths. This contrasts with reports of increased mortality in ethnic minorities and economically disadvantaged populations in other countries, and with high rates of infection in the ultra-Orthodox sector in Israel. Effective leadership and cooperation between individuals and institutions, particularly engagement of community and religious leaders, can reduce a group's vulnerability and build resilience in an emergency situation such as the current pandemic.


Asunto(s)
Adaptación Psicológica , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Disparidades en el Estado de Salud , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Adulto , Anciano , Árabes/psicología , Árabes/estadística & datos numéricos , Femenino , Humanos , Israel/epidemiología , Liderazgo , Masculino , Grupos Minoritarios/psicología , Grupos Minoritarios/estadística & datos numéricos , Rol
2.
Int J Equity Health ; 19(1): 153, 2020 09 09.
Artículo en Inglés | MEDLINE | ID: mdl-32907584

RESUMEN

BACKGROUND: The first wave of the Covid-19 pandemic hit Israel in late February 2020. The present study examines patterns of the first wave of Covid-19 morbidity in Israel at the macro level, during the period of late February to early June 2020, when the first wave has faded out. The analysis focuses on the significance of four sociodemographic variables: socioeconomic status, population density, rate of elderly population and minority status (Jewish / Arab identity) of the population in cities with 5000 residents or more. Additionally, we take a closer look into the association between morbidity rates and one SES component - home Internet access. METHODS: The article is a cross sectional study of morbidity rates, investigated on a residential community basis. Following the descriptive statistics, we move on to present multivariate analysis to explore associations between these variables and Covid-19 morbidity in Israel. RESULTS: Both the descriptive statistics and regressions show morbidity rates to be positively associated with population density. Socioeconomic status as well as the size of elderly population were both significantly related to morbidity, but only in Jewish communities. Interestingly, the association was inverse in both cases. i.e., the higher the SES the lower the morbidity and the larger the elderly population, the lower the community's morbidity. Another interesting result is that overall, morbidity rates in Jewish cities were consistently higher than in Arab communities. CONCLUSIONS: We attribute the low morbidity rates in communities with relatively small elderly populations to the exceptionally high fertility rates in ultra-orthodox communities that sustained increased rates of morbidity; the lower morbidity in Arab communities is attributed to several factors, including the spatial Jewish-Arab segregation.


Asunto(s)
Árabes/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Judíos/estadística & datos numéricos , Grupos Minoritarios/estadística & datos numéricos , Pandemias , Neumonía Viral/epidemiología , Características de la Residencia/estadística & datos numéricos , Anciano , Estudios Transversales , Humanos , Israel/epidemiología , Morbilidad/tendencias , Densidad de Población , Clase Social
6.
J Transcult Nurs ; 31(5): 434-443, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32794439

RESUMEN

Introduction: Race and ethnicity along with social determinants of health have been identified as risk factors for COVID-19. The purpose of this clinical paper is to provide an overview of the National Coalition of Ethnic Minority Nurse Associations (NCEMNA), present COVID-19 epidemiological data on five racial-ethnic groups, identify culturally congruent health care strategies for each group, and provide directions for practice and research. Method: NCEMNA collaborated to provide a clinical paper that addresses information about COVID-19 and culturally congruent health care in five racial-ethnic groups. Results: Every organization presented common themes across the different groups and unique perspectives that each group is faced with during this challenge. Discussion: This article provides an introduction to the issues that minority groups are facing. It is imperative that data are collected to determine the extent of the impact of COVID-19 in diverse communities in the country.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/etnología , Grupos Étnicos/estadística & datos numéricos , Disparidades en el Estado de Salud , Disparidades en Atención de Salud/etnología , Grupos Minoritarios/estadística & datos numéricos , Neumonía Viral/etnología , Infecciones por Coronavirus/prevención & control , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Factores Socioeconómicos , Estados Unidos
7.
Orv Hetil ; 161(32): 1322-1330, 2020 08.
Artículo en Húngaro | MEDLINE | ID: mdl-32750020

RESUMEN

International migration is a current and growing phenomenon, which has become an increasingly critical issue in Europe since 2013 and this has posed new challenges to the healthcare systems of the European Union (EU). The need for 'culturally competent' healthcare systems that can adapt and respond to the needs of a changing population while taking into account cultural, religious, linguistic and gender diversity, has become more and more an agenda across Europe. Nowadays, it is widely accepted that inequalities in health conditions are mainly due to socio-economic factors, and disparities are particularly evident among certain ethnic and cultural minority groups. Additionally, minorities often face difficulties during their attempts in accessing healthcare, including linguistic and cultural barriers. These barriers are primarily manifested in communication and other interactions between the patient and the healthcare provider. Communication difficulties and misunderstandings may lead to frustration and prejudice among caregivers and also to a lack of cooperation from patients, and consequently, may contribute to poorer health outcomes. Therefore, in order to ensure the highest quality of care for migrants, ethnic or other minority populations in our increasingly diverse societies, it is of crucial importance to overcome the difficulties arising from linguistic, cultural and religious differences. To achieve these goals, an important step is the development of intercultural competences within the healthcare system. Our paper discusses the concept, content and opportunities for the development of intercultural competence in clinical and healthcare settings. Orv Hetil. 2020; 161(32): 1322-1330.


Asunto(s)
Barreras de Comunicación , Competencia Cultural , Asistencia Sanitaria Culturalmente Competente , Prestación de Atención de Salud/métodos , Personal de Salud/psicología , Disparidades en Atención de Salud , Relaciones Profesional-Paciente , Calidad de la Atención de Salud , Comunicación , Diversidad Cultural , Europa (Continente) , Humanos , Hungría , Grupos Minoritarios , Multilingüismo , Migrantes
8.
J Prev Med Public Health ; 53(4): 233-235, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32752592

RESUMEN

Since its early stages, the coronavirus disease 2019 (COVID-19) pandemic has posed immense challenges in meeting the public health and healthcare and social care needs of migrants. In line with other reports from United Kingdom and United States, data from Sweden's health authority show that migrants have been disproportionately affected by COVID-19. Following the World Health Organization's statements, as well as the European Public Health Association's call for action, several centres in Sweden's most populated areas have activated tools to implement national plans for community outreach through initiatives targeting migrants and ethnic minority groups. Unconventional means should be promoted to mitigate the impact of COVID-19 on migrants and the health of the public at large.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/terapia , Grupos Minoritarios , Neumonía Viral/terapia , Salud Pública/métodos , Telemedicina/métodos , Migrantes , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Brotes de Enfermedades , Grupos Étnicos , Humanos , Pandemias/prevención & control , Neumonía Viral/diagnóstico , Neumonía Viral/prevención & control , Suecia
11.
Acute Med ; 19(2): 110, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32840263

RESUMEN

We write this letter as doctors and proud members of the Black, Asian and Minority Ethnic (BAME) community from a South Asian background. Recent Office for National Statistics (ONS) data suggest that the BAME population is disproportionately affected by Covid-19. Observations and experiences from within our family and wider community led us to explore how cultural aspects may account for these figures. Both intrinsic and extrinsic factors are likely to contribute to this unfortunate statistic.


Asunto(s)
Grupo de Ascendencia Continental Africana , Grupo de Ascendencia Continental Asiática , Infecciones por Coronavirus/mortalidad , Decepción , Medios de Comunicación de Masas , Neumonía Viral/mortalidad , Betacoronavirus , Grupos Étnicos , Humanos , Grupos Minoritarios , Pandemias , Reino Unido/epidemiología
12.
BMC Infect Dis ; 20(1): 581, 2020 Aug 06.
Artículo en Inglés | MEDLINE | ID: mdl-32762656

RESUMEN

BACKGROUND: Human T-cell lymphotropic virus (HTLV) remains a major safety concern for blood supplies. Despite many HTLV positive cases being reported in southeastern China, the detection of HTLV has not been prioritized in routine blood screening. Additionally, data on the prevalence of HTLV infection among blood donors is also limited. The objective of this study was to investigate the prevalence of HTLV among blood donors in three Chinese provinces through their representative blood centers, to evaluate the feasibility of chemiluminescence immunoassay (CLIA) for blood screening. METHODS: From November 2018 to March 2019, blood plasma samples were collected from Hebei, Changsha, and Shenzhen blood centers and were screened for the HTLV-1/2 antibody using a CLIA and enzyme-linked immunosorbent assay (ELISA). This was followed by confirmatory tests using INNO-LIA HTLV I/II. RESULTS: A total of 59,929 blood donations were collected and screened for HTLV-1/2. The reactive rate of CLIA and ELISA among donations in the Shenzhen blood center (0.0943%, 27/28,621) was higher than Hebei (0.0248%, 4/16,144), and Changsha (0.0198%, 3/15,164) (p < 0.05). After confirmation, 3 samples were confirmed as indeterminate for HTLV antibodies, and only one sample from the Shenzhen blood center was confirmed as HTLV-1. The overall prevalence of HTLV-1/2 was 1.67 per 100,000 (1/59,929). The HTLV-infected blood came from a 32-year-old first-time female donor with a high school degree, who belonged to the SHE ethnic minority and was born in the Fujian province. CONCLUSIONS: In summary, the overall prevalence of HTLV-1/2 among blood donors in the three blood centers in China remains relatively low. However, blood donations with positive or indeterminate results for HTLV antibodies reminded us of the importance of HTLV screening among blood donors in China.


Asunto(s)
Donantes de Sangre , Infecciones por HTLV-I/diagnóstico , Infecciones por HTLV-I/epidemiología , Infecciones por HTLV-II/diagnóstico , Infecciones por HTLV-II/epidemiología , Virus Linfotrópico T Tipo 1 Humano/inmunología , Virus Linfotrópico T Tipo 2 Humano/inmunología , Salud Rural , Adolescente , Adulto , China/epidemiología , Ensayo de Inmunoadsorción Enzimática , Femenino , Infecciones por HTLV-I/etnología , Infecciones por HTLV-I/virología , Infecciones por HTLV-II/etnología , Infecciones por HTLV-II/virología , Humanos , Mediciones Luminiscentes , Masculino , Tamizaje Masivo/métodos , Persona de Mediana Edad , Grupos Minoritarios , Prevalencia , Servicios de Salud Rural , Adulto Joven
14.
PLoS One ; 15(7): e0235190, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32735593

RESUMEN

To examine changes in U.S. medical school basic science faculty over the last 20 years (1998-2018), we undertook an observational study utilizing data from the American Association of Medical Colleges Faculty Roster. Rank (Instructor, Assistant Professor, Associate Professor, and Professor), sex (Female), and race/ethnicity (Asian, Black or African American, Hispanic, Latino, Spanish Origin, or Multiple Race-Hispanic, and White) were analyzed; this reflected a population of 14,047 (1998) to 18,601 (2018) faculty. Summary percent of faculty in various gender, race/ethnicity origin categories were analyzed across years of the study using regression models. We found that females (24.47% to 35.32%) were underrepresented at all timepoints and a minority of faculty identified as Black or African American (1.57% to 1.99%), Hispanic, Latino, Spanish Origin, or Multiple Race-Hispanic (3.03% to 4.44%), or Asian (10.90% to 20.41%). The largest population at all time points was White Male Professors (30.53% to 20.85%), followed by White Male Associate Professors (15.67% to 9.34%), and White Male Assistant Professors (13.22% to 9.75%). Small statistically significant increases were observed among female faculty and faculty at multiple ranks who identified as Black or African American or Hispanic, Latino, Spanish Origin, or Multiple Race-Hispanic. We then completed secondary analyses looking at the interaction of race/ethnicity and Gender. We found: (1) a significant increase (p<0.0001) in both genders who identify as Asian although males had a higher rate of increase (6 point difference, p<0.0001); (2) a significant increase for Black or African American females (P<0.01) not found among males; (3) significant increases (p<0.0001) among both genders of faculty who identify as Hispanic, Latino, Spanish Origin, or Multiple Race-Hispanic although females had an approximately 1% higher rate of increase; and (4) among faculty who identify as White, males had a significant decrease (p<0.0001) while females demonstrated an increase (p<0.0001).


Asunto(s)
Diversidad Cultural , Docentes Médicos/tendencias , Facultades de Medicina/tendencias , Movilidad Laboral , Grupos de Población Continentales/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Docentes Médicos/estadística & datos numéricos , Femenino , Humanos , Masculino , Grupos Minoritarios/estadística & datos numéricos , Facultades de Medicina/organización & administración , Facultades de Medicina/estadística & datos numéricos , Factores Sexuales , Estados Unidos
15.
Nat Commun ; 11(1): 4040, 2020 08 12.
Artículo en Inglés | MEDLINE | ID: mdl-32788583

RESUMEN

Children from lower income backgrounds tend to have poorer memory and language abilities than their wealthier peers. It has been proposed that these cognitive gaps reflect the effects of income-related stress on hippocampal structure, but the empirical evidence for this relationship has not been clear. Here, we examine how family income gaps in cognition relate to the anterior hippocampus, given its high sensitivity to stress, versus the posterior hippocampus. We find that anterior (but not posterior) hippocampal volumes positively correlate with family income up to an annual income of ~$75,000. Income-related differences in the anterior (but not posterior) hippocampus also predicted the strength of the gaps in memory and language. These findings add anatomical specificity to current theories by suggesting a stronger relationship between family income and anterior than posterior hippocampal volumes and offer a potential mechanism through which children from different income homes differ cognitively.


Asunto(s)
Cognición/fisiología , Hipocampo/anatomía & histología , Renta , Adolescente , Niño , Preescolar , Familia , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Modelos Lineales , Masculino , Memoria/fisiología , Grupos Minoritarios , Tamaño de los Órganos , Análisis y Desempeño de Tareas , Vocabulario , Adulto Joven
16.
BMC Infect Dis ; 20(1): 631, 2020 Aug 26.
Artículo en Inglés | MEDLINE | ID: mdl-32842977

RESUMEN

BACKGROUND: The drug resistance and the virologic failure of antiretroviral therapy (ART) are quite severe in Liangshan. A better understanding of the virologic failure of ART and the HIV-1 transmission network dynamics is essential for the surveillance and prevention of HIV. Here, we analyzed the HIV-1 CRF07_BC strain genetic transmission networks and their associated factors among people living with HIV-1 (PLWH) who had virologic failure of ART by using close genetic links. METHODS: The drug-resistant mutations were determined using the Stanford University HIV Drug Resistance Database. HIV-1 pol genes sequences were used for phylogenetic and genotypic drug resistance analysis. The genetic transmission networks were performed by comparing sequences, constructing the phylogenetic tree, calculating the pairwise distance, and visualizing the network. RESULTS: A total of 1050 PLWH with CRF07_BC pol sequences were finally identified and included in the genetic transmission network analysis from 2016 to 2017. Of the 1050 CRF07_BC pol sequences, 346 (32.95%) fell into clusters at a genetic distance of 0.006, resulting in 137 clusters ranging in size from 2 to 40 individuals. Subjects who were widowed or divorced were less likely to form a genetic transmission network (adjusted OR: 0.50), while subjects who had shared a needle ≥ five times were more likely to form a network (adjusted OR: 1.88). CONCLUSIONS: The genetic transmission networks revealed the complex transmission pattern, highlighting the urgent need for transmission monitoring of virologic failure of ART and selection of more effective therapeutic regimens to promote viral suppression.


Asunto(s)
Fármacos Anti-VIH/efectos adversos , Fármacos Anti-VIH/uso terapéutico , Farmacorresistencia Viral/genética , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/transmisión , VIH-1/genética , Grupos Minoritarios , Adolescente , Adulto , China/epidemiología , Estudios Transversales , Femenino , Genes pol , Infecciones por VIH/virología , Humanos , Masculino , Mutación , Filogenia , Insuficiencia del Tratamiento , Adulto Joven
18.
Womens Health (Lond) ; 16: 1745506520953348, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32856564

RESUMEN

BACKGROUND: On account of their racial/ethnic minority status, class, and gender, African-American women of low socioeconomic status are among the least privileged, underserved, and most marginalized groups in the United States. Generally, African Americans continue to experience poorer health outcomes, in which disparities have been attributed to socioeconomic inequities and structural racism. This objective of this study was to explore the lived experiences of low-income African-American women in interacting with the healthcare system and healthcare providers. METHODS: Twenty-two in-depth one-on-one interviews were conducted with low-income African-American women. The audio-recorded interviews were transcribed verbatim. An inductive content analysis was performed, using an analytical software, Dedoose® to enabled hierarchical coding. Codes were grouped into categories which were further analyzed for similarities that led to the emergence of themes. RESULTS: A key finding was the experience of discriminatory treatment. The three themes that emerged relevant to this category were (1) perceived discrimination based on race/ethnicity, (2) perceived discrimination based on socioeconomic status, and (3) stereotypical assumptions such as drug-seeking and having sexually transmitted diseases. CONCLUSION AND RECOMMENDATIONS: Low-income African-American women experience less than satisfactory patient care, where participants attribute to their experience of being stereotyped and their perception of discrimination in the healthcare system and from providers. Patients' experiences within the healthcare system have implications for their healthcare-seeking behaviors and treatment outcomes. Healthcare personnel and providers need to be more aware of the potential for implicit bias toward this population. Healthcare workforce training on culturally responsive patient care approaches and more community engagement will help providers better understand the context of patients from this population and more effectively meet their healthcare needs.


Asunto(s)
Afroamericanos/psicología , Asistencia Sanitaria Culturalmente Competente , Prestación de Atención de Salud , Racismo/psicología , Adulto , Grupos Étnicos/psicología , Femenino , Disparidades en Atención de Salud , Humanos , Persona de Mediana Edad , Grupos Minoritarios/psicología , Aceptación de la Atención de Salud , Percepción , Pobreza , Factores Socioeconómicos , Estados Unidos , Adulto Joven
19.
J Racial Ethn Health Disparities ; 7(5): 822-828, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32789564

RESUMEN

During the COVID-19 pandemic, the data of Department of Health in United Kingdom (UK) showed an increase mortality and morbidity among the Black and Minority Ethnic (BAME) population. This high mortality can be due to social factors, genetic and immunological factors. Metabolic factors like high prevalence of diabetes, obesity, metabolic syndrome and hypertension were also found to contribute to the increased risk of COVID-19 infection in BAME population. In addition, a large number of BAME population are working in jobs that involve regular and daily contact with public, and this may increase risk of encountering COVID-19 infection. Therefore, future research should address all these factors and generate the correct health policy that will allow us to combat the danger of COVID-19. We recommend the establishment of BAME alliance against COVID-19 in order to improve occupational risks and hazards, adequate income protection, culturally and linguistically appropriate public health communications and decreasing barriers in accessing healthcare. The BAME alliance will initially focus on (i) development of central system to record data about COVID-19 patients from BAME population (ii) involvement of healthcare professionals and researchers from ethnic minorities and (iii) multidisciplinary and inter-institution collaboration; for example, civil engineers and architects need to think about house design and ventilation that decrease risk of COVID-19 especially in BAME populations.


Asunto(s)
Grupo de Ascendencia Continental Africana/estadística & datos numéricos , Infecciones por Coronavirus/etnología , Infecciones por Coronavirus/prevención & control , Grupos Étnicos/estadística & datos numéricos , Disparidades en el Estado de Salud , Grupos Minoritarios/estadística & datos numéricos , Pandemias/prevención & control , Neumonía Viral/etnología , Neumonía Viral/prevención & control , Humanos , Factores de Riesgo , Reino Unido/epidemiología
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