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Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Other
This episode from the podcast 99 Percent Invisible reflects on how the COVID-19 pandemic exposed the American public to a long-standing problem: the disjointed nature of the U.S. health system. Because state and local health departments largely operate independently and use their own data collection and analysis tools, health systems across the country lack standardized data definitions and systems. These inconsistencies made it nearly impossible to collect and analyze comprehensive, standardized data on COVID-19 cases, deaths, and vaccines administered amid the pandemic. Health experts featured on this episode believe that the pandemic made the need for an overhaul of America’s informatics system very apparent. When rebuilding this system, it’s important to focus on remedying existing inequalities in data collection and classification that in some cases render the health status of certain populations – think Native American communities and other communities of color – completely invisible in the data. By virtue of being small populations, it can be difficult for health departments to collect sufficient and/or statistically significant data on minority communities. Another issue discussed in this episode is the use of broad racial categories like “other,” “multiple races,” or even “Asian American,” which, if not disaggregated, obscures the health status of diverse populations who are grouped under the same category. Without comprehensive and inclusive health data, it’s difficult to identify disparities and implement policies and programming that promote social mobility and health equity.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
The Community Outreach Specialist (COS) program aimed to increase COVID-19 vaccine uptake among rural communities through targeted outreach efforts. The program trained and deployed community outreach specialists who engaged with community members, provided education about COVID-19 and vaccination, addressed concerns and misconceptions, and facilitated access to vaccination services. The COS program in reaching and engaging with socially vulnerable and medically underserved populations, successfully increasing vaccine acceptance and uptake in these communities by building trust, addressing barriers to vaccination, and tailoring outreach strategies to the local context. The article discusses the importance of community-based approaches, cultural competency, and collaboration with local organizations and leaders in achieving successful vaccine outreach. It also emphasizes the need for sustained efforts to ensure equitable access to vaccination and to address disparities in vaccine uptake among different populations.
Best Practices that show evidence of effectiveness in improving public health outcomes when implemented in multiple real-life settings, as indicated by achievement of aims consistent with the objectives of the activities.
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Systematic Review/Meta-Analysis
This review of state data collection and reporting practices during the COVID-19 pandemic found inconsistencies and gaps in data collected by race and ethnicity. Improved standardization across the U.S.–which may come in the form of a federally-operated centralized database–would address some of the concerns in data representation of all Americans.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Peer Review Study
This study examines a cohort of patients testing for COVID-19 in a large healthcare setting spanning California, Oregon, and Washington between March 1 and December 31, 2020. to determine the sociodemographic and clinical characteristics of these patients. Results found that major healthcare disparities were evident, particularly among Hispanics. Hispanic individuals tested positive at a higher rate, required excess hospitalization and mechanical ventilation, and had higher odds of in-hospital mortality despite younger ages. Targeted, culturally responsive interventions and equitable vaccine development and distribution are needed to address the increased risk of poorer COVID-19 outcomes among minority populations.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
This study examined the sociodemographic characteristics of the residents of Cameron County, Texas, one of the most Hispanic-populated counties in the United States with over 90% of residents identifying as Hispanic. The study analyzed data from March to December 2020, and studied both social determinants of health and COVID-19 mitigation policies, such as the “shelter in place” mandate. The results show that single parents, those living below the poverty level, and those who do not fluently speak English are at a more increased risk of contracting COVID-19. The shelter in place mandate was able to reduce community transmission within three weeks of implementation, but the results of its impact vary greatly by age, sex, and race.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
This study highlights the geographic differences in COVID-19 positivity rates within Los Angeles county, taking into consideration other socio-structural determinants that impact these rates. The data — testing data from the LAC Department of Public Health and American Community Survey data — was analyzed and mapped to include testing rates, race/ethnicity, poverty, insurance status, education, and population/household density. Results found higher COVID-19 positivity rates in communities with higher proportions of Latinx residents, those living below the federal poverty line, and those with high household densities.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
This study details an analysis of data from the University of Maryland family medicine and immediate care (UFM) practices to examine an association between COVID-19 infections and demographic and socioeconomic factors. Results found that Black and Hispanic patients were more likely test positive for COVID-19, and those living in areas with a high Area Deprivation Index score experienced higher risks of infections.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Peer Review Study
This study looks at the perceptions, challenges, barriers, and experiences of undocumented immigrants in the U.S. The study used a snowball sampling of 20 undocumented Asian and Latinx men and women and asked them a series of questions about access to health care and their experience during the COVID-19 pandemic. The results found significant barriers in language comprehension, mistrust of public systems, and socioeconomic factors such as employers with little to no sick leave for those affected by COVID-19.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Peer Review Study
This article looks at the differences in the health care setting choice for COVID-19 testing by race/ethnicity and insurance type. They found disparities in equitable access, with Black individuals more likely to get tested through emergency departments compared to White individuals. Hispanic individuals had the highest likelihood of testing at mobile testing units, and those without a primary care practitioner were more likely to go to a mobile testing unit or emergency department. The implementation of mobile care delivery models may allow for a larger reach to vulnerable populations.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Summary Report/Recommendations
Using available COVID-19 case and vaccination data, the CDC compared three different methodologies for grouping race/ethnicity COVID-19 data. Two of these methodologies are focused on how to group race/ethnicity when fields are missing. The results show that methods that use race information when ethnicity is missing resulted in higher estimated COVID-19 cases, incidence, and vaccination coverage. However, more work must be done to improve upon these methods in order to create more equitable and reliable data.