Not One More Life Trusted Messenger Pilot Program

Although unreliable access to healthy food has been linked to lower lung function, a higher burden of respiratory symptoms, and more frequent respiratory exacerbations in individuals with COPD, its association with COPD prevalence and mortality remains understudied. To determine the associations between food insecurity and COPD prevalence and COPD mortality at the county level in the United States. We obtained 2018 U.S. county-level data on food insecurity prevalence (FI%) and the Food Environment Index (FEI; lower values indicate worse food desert conditions) from County Health Rankings. We then queried the CDC's National Environmental Public Health Tracking and WONDER databases for county-level COPD prevalence (2018) and COPD-related mortality (2018-2020), respectively. We constructed negative binomial regression models adjusted for demographic, socioeconomic, and health factors to examine the associations of FI% and FEI with COPD prevalence and mortality. The mortality model was additionally adjusted for county COPD prevalence. Counties with FI% at or above the median (13.2%) and those with FEI below the median (7.6) had lower median household income, lower primary care physician density, higher average daily PM2.5 concentration, and higher prevalence of poverty, uninsured status, rural residence and cigarette smoking (P < .001 for all analyses). In fully adjusted models, a 1% higher FI% was associated with a 1.62% higher COPD prevalence (95% CI 1.40-1.83%; P < .001), and a 1-unit lower FEI was associated with a 1.85% higher COPD prevalence (95% CI 1.17-2.54%; P < .001). A 1% higher FI% was independently associated with a 3.54% increase in COPD-related mortality (95% CI 2.86-4.22%; P < .001), and a 1-unit lower FEI with a 10.05% increase in COPD-related mortality (95% CI 7.82-12.27%; P < .001). Unreliable food access is associated with higher COPD prevalence and mortality at the county level. These results suggest that improving food access may be a target for improving population-level COPD outcomes.

Background: The magnitude of the impact of COVID-19 is dependent on social, demographic, health, nutrition and even environmental factors. These factors act individually and synergistically to impact the incidence, mortality and morbidity of COVID-19. We aimed to evaluate the variables contributing individually to COVID-19 incidence and mortality utilizing techniques to minimize the effects of interaction between these factors. Method: Data regarding 88 variables for 195 countries over three years were extracted from The Health Nutrition and Population Statistics database and aggregated into a consolidated median. Outliers were eliminated and variables having a completeness of more than 70% were selected. The analysis was done separately for the incidence and mortality of COVID19. Principal component Analysis (PCA) and Elastic net regression were used to identify the most important single variables. The significant variables of the PCA which explained the most variance were identified. Subsequently, variables with the highest importance (using normalized ranked regression coefficients) in the Elastic Net model were selected and the intersecting set of variables common to both models was considered as predictors affecting incidence and mortality of COVID-19. Result: The study revealed communities with a high prevalence of anaemia has a negative correlation with COVID-19 incidence which was furthermore, interestingly seen in multiple age groups. Diphtheria, Tetanus and Pertussis (DTP) Immunization in children was also found to have a negative linear correlation. Conclusion: A negative individual association was seen between anaemia (in multiple age groups) and DTP immunization in children with the incidence and mortality of COVID 19.

BackgroundInequities in COVID-19 incidence, morbidity, and mortality between racial and ethnic groups in the United States (U.S.) have been documented since the start of the pandemic in early 2020. Similarly, disparities by sex for COVID-19 morbidity and mortality have emerged, with men dying at a higher rate than women. Little research has been done to understand how the intersection of sex and race impacts COVID-19 inequities in Massachusetts (MA). This cross-sectional study examined how COVID-19 mortality rates (February 2020- May 2023) and vaccination rates (December 2020-February 2023) varied by sex across racial groups in MA.MethodsUsing Massachusetts Department of Public Health data of all COVID-19 mortality cases and primary series vaccinations in MA from 2020 to 2023, we calculated both age-specific and age-adjusted COVID-19 mortality rates in order to account for differences in age distributions across sex-race groups.ResultsOverall, men across all age-race groups consistently had a higher mortality rate compared to their female counterparts. The age-standardized mortality rate difference between White men and White women is the smallest, with the rate for White men being 1.3 times higher than White women. The age-standardized mortality rate between Hispanic men and Hispanic women varies the largest, with the rate for Hispanic men being 1.7 times higher than Hispanic women. Notably, Black women and White women have similar vaccination rates, yet the age-standardized mortality rate for Black women is 1.4 times the rate of White women.ConclusionsOur findings show that there are disparities at the intersection of sex and race for COVID-19 mortality and vaccination in MA. This highlights the importance for targeted COVID-19 interventions at the intersection of sex and race and the need for detailed COVID-19 reporting by sex within race groups.

Objective: This study aimed to investigate the quantitative effects of outdoor air pollution, represented by 10 µg/m3 increment of PM10, on chronic obstructive pulmonary disease in China, United States and European Union through systematic review and meta-analysis. Methods: Publications in English and Chinese from PubMed and EMBASE were selected. The Cochrane Review Handbook of Generic Inverse Variance was used to synthesize the pooled effects on incidence, prevalence, mortality and hospital admission. Results: Outdoor air pollution contributed to higher incidence and prevalence of COPD. Short-term exposure was associated with COPD mortality increased by 6%, 1% and 1% in the European Union, the United States and China, respectively (p < 0.05). Chronic PM exposure produced a 10% increase in mortality. In a short-term exposure to 10 µg/m3 PM10 increment COPD mortality was elevated by 1% in China (p < 0.05) and hospital admission enrollment was increased by 1% in China, 2% in United States and 1% in European Union (p < 0.05). Conclusions: Outdoor air pollution contributes to the increasing burdens of COPD.10 µg/m3 increase of PM10 produced significant condition of COPD death and exacerbation in China, United States and European Union. Controlling air pollution will have substantial benefit to COPD morbidity and mortality.

IntroductionThis ecological study investigates the association between smoking prevalence and COVID-19 occurrence and mortality in 38 European nations as of May 30, 2020.MethodsData were collected from Our World in Data. Regression analysis was conducted to adjust for potential confounding factors such as economic activity (gross domestic product), the rate of COVID-19 testing, and the stringency of COVID-19 control policies.ResultsThere was a statistically significant negative association between smoking prevalence and the prevalence of COVID-19 across the 38 European nations after controlling for confounding factors (p = 0.001). A strong association was found between the prevalence of COVID-19 per million people and economic activity (p = 0.002) and the rate of COVID-19 testing (p = 0.0006). Nations with stricter policy enactment showed fewer COVID-19 cases per million people, but the association was not significant (p = 0.122). Delaying policy enactment was associated with a greater prevalence of COVID-19 (p = 0.0535). Evidence of a direct association between smoking prevalence and COVID-19 mortality was not found (p = 0.626). There was a strong positive association between COVID-19 mortality rate and the prevalence of COVID-19 cases (p < 0.0001) as well as the proportion of the population over 65 years of age (p = 0.0034) and a negative association with the rate of COVID-19 testing (p = 0.0023).ConclusionsWe found a negative association between smoking prevalence and COVID-19 occurrence at the population level in 38 European countries. This association may not imply a true or causal relationship, and smoking is not advocated as a prevention or treatment of COVID-19.ImplicationsGiven the evidence of this ecological study, and of several other studies that found an underrepresentation of smoking prevalence in hospitalized cases, it may be worth examining, in laboratory experiments and controlled human trials, if nicotine offers any protection against COVID-19. Most importantly, to date, no study, including this one, supports the view that smoking acts as a treatment intervention or prophylaxis to reduce the impact or ameliorate the negative health impacts of COVID-19.

Introduction: A previous study was conducted to examine the relationship between poor air quality in the form of PM2.5 exposure and COVID-19 morbidity and mortality in Yakima County, Washington (USA). Results showed there was a significant correlation (p&lt;0.05) between PM2.5 exposure and COVID-19 hospitalization and mortality in the 12-day lag analysis, however it was not clear if this association remains consistent over time. The purpose of this study was to analyze a second year of PM2.5 exposure and COVID-19 morbidity and mortality in a population significantly impacted by poor air quality (PM2.5) and high COVID-19 morbidity to determine whether the findings of the previous study could be confirmed. Methods: A 12-day lag analysis correlating PM2.5 levels and county-level COVID-19 case counts, hospitalization, and mortality was conducted using Pearson correlation between the period of February 1, 2021 and December 20, 2021 in Yakima, County, Washington, USA. Results: PM2.5 was found to be significantly correlated (p&lt;.011) to COVID-19 morbidity (r = 0.38), hospitalization (r = 0.41), and mortality (r = 0.18). Discussion: This study expands upon and confirm previous preliminary findings examining the association between poor air quality exposure and negative COVID-19 outcomes. Populations exposed to long-term PM2.5 may need additional safeguards from COVID-19 as they may have a higher risk of infection, hospitalization, and mortality.

The coronavirus (COVID-19) pandemic is a global health crisis and biggest challenge facing the world. Station measurements of fine particulate matter (PM2.5) concentration in Baghdad and Kuwait during the period January–July 2020 are analyzed as well as assessment of correlation between PM2.5, weather conditions (air temperature, relative humidity, wind speed), population density and COVID-19 morbidity and mortality. A significant improvement (decrease) has observed during total and partial curfew in PM2.5 at Baghdad by 35%, 12.4%, respectively, from PM2.5 mean during the study period that is less than the WHO recommended PM2.5 level especially in total curfew. This decrease in PM2.5 pollution and people’s mobility in Baghdad at total and partial curfew contributed to decrease injuries and mortality. PM2.5 during total and partial curfew in Kuwait country witnessed increasing by 38.4% and decreasing by 22.3% from the PM2.5 mean, respectively, but still higher than WHO standard level. This increase in PM2.5 at total curfew was related to burning accidents in the oil wells which caused increasing in PM2.5 pollutant and then an increase in number of injuries and mortality during that time. In general during all study period our research found that PM2.5 and wind speed exhibit weak relation with COVID-19 morbidity and mortality but strong relation with increasing temperature and decreasing humidity. The high population density had a good association with increasing daily new cases, mortality due to COVID-19 pandemic. Thus, these factors may be taken into consideration in policy development for the control and prevention of new chains of the Coronavirus pandemic.

First cases of new coronaviral infection were reported in Wuhan, Hubei Province, China in December 2019. The infection had caused the death of more than 100,000 people worldwide by the beginning of April 2020. This review analysed the characteristics of the infection course in adults and children, as well as capabilities of diagnostics, treatment and prevention of COVID-19. It is possible to allocate groups of high risk of development of severe forms of disease (elderly people, people with latent tuberculosis infection, adult patients with severe comorbidity) according to the published data. Currently there is limited epidemiological data on the prevalence, morbidity and mortality of COVID-19 in the child population. However, it is already possible to conclude that 90% of cases in children population have mild, moderate and asymptomatic course of the disease. Treatment of patients with COVID-19 is limited due to the lack of means for etiotropic therapy and the possibility of using of only symptomatic therapy. There are no vaccines for COVID-19 prevention.

Mixed cryoglobulinemia syndrome (MCs) is a rare immunoproliferative systemic disorder with cutaneous and multiple organ involvement. Our multicenter survey study aimed to investigate the prevalence and outcome of COVID-19 and the safety and immunogenicity of COVID-19 vaccines in a large MCs series. The survey included 430 unselected MCs patients (130 M, 300 F; mean age 70 ± 10.96 years) consecutively collected at 11 Italian referral centers. Disease classification, clinico-serological assessment, COVID-19 tests, and vaccination immunogenicity were carried out according to current methodologies. A significantly higher prevalence of COVID-19 was found in MCs patients compared to Italian general population (11.9% vs 8.0%, p < 0.005), and the use of immunomodulators was associated to a higher risk to get infected (p = 0.0166). Moreover, higher mortality rate was recorded in MCs with COVID-19 compared to those without (p < 0.01). Patients' older age (≥ 60 years) correlated with worse COVID-19 outcomes. The 87% of patients underwent vaccination and 50% a booster dose. Of note, vaccine-related disease flares/worsening were significantly less frequent than those associated to COVID-19 (p = 0.0012). Impaired vaccination immunogenicity was observed in MCs patients compared to controls either after the first vaccination (p = 0.0039) and also after the booster dose (p = 0.05). Finally, some immunomodulators, namely, rituximab and glucocorticoids, hampered the vaccine-induced immunogenicity (p = 0.029). The present survey revealed an increased prevalence and morbidity of COVID-19 in MCs patients, as well an impaired immunogenicity even after booster vaccination with high rate of no response. Therefore, MCs can be included among frail populations at high risk of infection and severe COVID-19 manifestations, suggesting the need of a close monitoring and specific preventive/therapeutical measures during the ongoing pandemic.

Increased rates of respiratory disease in schizophrenia: A systematic review and meta-analysis including 619,214 individuals with schizophrenia and 52,159,551 controls

Researchers have begun exploring the impact of societal culture on Covid-19 outcomes (morbidity and mortality). However, emerging findings need integration with prior literature on societal culture and infectious diseases. Moreover, accumulation of knowledge warrants an update while overcoming certain limitations of samples as well as construct validity concerns. Accordingly, hypotheses are derived based on extant evidence proposing the impact of certain cultural practices on Covid-19 outcomes across countries. These hypotheses are tested using the cultural practice scores from GLOBE studies after controlling for certain covariates identified in literature. Multiple regression results reveal that societal culture significantly explains Covid-19 outcomes beyond the explanation due to control variables. Specifically, power distance and institutional collectivism show negative association with both Covid-19 morbidity and mortality. Additionally, performance orientation shows negative association with Covid-19 morbidity. It appears that power distance may ensure conformity to prescribed behaviors and features of performance orientation may facilitate swift and effective containment of Covid-19 cases. The significance of institutional collectivism—but not in-group collectivism—emerging as the form of collectivism showing negative association with Covid-19 outcomes is also discussed.

Introduction Various Chilean cities show deterioration in air quality as a result of forest fires. This study aims to characterize the occurrence of forest fires in Chile and its relationship to children’s respiratory health. Methods Public databases provided the number of emergency care visits (rates by age groups), forest fires (number/month), and other covariates (particulate matter 10 [PM10], temperature, precipitation, wind, and population density) in the Regions of Valparaiso and Metropolitan in the period 2010-2013. Health effects were grouped for acute upper respiratory infections (J00-06) and chronic lower respiratory diseases (J40-46) in children ages &lt; 1 year, 1-4 y, and 5-14 y. Time series analysis was used to determine relative risk of health care visits regionally with the presence of additional forest fires monthly. Results In the Metropolitan Region, there is a 2% increase in emergency care visits for acute obstructive bronchial syndrome with the presence of an additional forest fire per month in children &lt;1 year (RR 1.02 IC 95% 1.02-1.03), a 3% increase in children 1-4 years (RR 1.03 IC 95% 1.03-1.04), and a 5% increase in children 5-14 years (RR 1.05 IC 95% 1.04-1.06). Since the highest number of forest fires occurs during the summer months (mean 5.5 fires/month), the cases of acute obstructive bronchial syndrome in the Metropolitan Region can increase at least 10% during this season, adjusted for covariates of interest. In Valparaiso, the risks are lower and significant only in children 1-4 years (RR 1.01 IC 95% 1.01-1.02). Conclusions In the Metropolitan Region, a dose response relationship is observed with increasing age as a result of the change in forest fires. In the Region of Valparaiso, forest fires do not significantly change the risk of acute obstructive bronchial syndrome. It is possible that the presence of other chemical agents from forest fire contamination that were not measured change the risk of respiratory damage in children in Chile.

The COVID-19 pandemic disproportionately affected older adults in nursing homes, emphasizing the need for comparing various long-term care options. This study compares COVID-19 prevalence and mortality rates in traditional nursing homes, Green Houses (GHs), and nursing homes nested in Continuing Care Retirement Community (CCRC-NHs). CMS data and LTCFocus Data were utilized. COVID-19 case and mortality rates from June 1, 2020, to September 30, 2022, across traditional NHs, GHs, CCRC-NHs in 11 states were included. Poisson regression was utilized to compare risk among types of NHs while adjusting for covariates. The average age of residents of CCRC-NHs and GH was 84.4 and 83.1-years, respectively, higher than those in small (77.5-years) and large (77.6-years) traditional nursing homes (P&amp;lt;.0001). The proportion of female and White residents was significantly higher in CCRC-NHs and GHs than in traditional NH. Compared to GH residents, those in CCRC-NHs (RR 1.50, 95% CI 1.10-2.07), large NHs (RR 1.57, 95% CI 1.14-2.15), and small NHs (RR 1.80, 95% CI 1.32-2.47) had a higher risk of COVID-19 infection, with the highest risk observed in traditional small NHs. There were no statistically significant differences in COVID-19 mortality rates across different types of NHs. This study suggests that nursing home size and care models influence COVID-19 transmission, GHs, with their smaller, person-centered care settings, experienced lower infection rates, highlighting the potential advantages of such environments in pandemic management. Conversely, traditional NHs and CCRC-NH models, with more institutional layouts, may contribute to higher transmission rates suggesting a need for care model reevaluation.

The COVID-19 pandemic, by the nature of this crisis and its primarily sanitary, medical and biological management, offers an exceptional opportunity for observations on the scientific debates surrounding the notion of “race”, used and conceptualised at times as a biological reality, at others as a social construct. Based on a synthetic reading of a variety of scientific productions –in medicine, public health, epidemiology, and social sciences– discussing ethno-racial disparities in COVID-19 related morbidity and mortality, this article shows that these two models of interpretation –biological/genetic and socio-economic/socio-demographic– do not stand in opposition to each other: the relationships between race and identified risk factors in COVID-19 related morbidity and mortality, as recognised by researchers are often conjointly conditioned by both biological mechanisms and socio-economic factors. Furthermore, the intersectional approach –articulating various social relations of race, class, gender, age, disability, etc.– proves to be particularly fruitful in grasping the ethno-racial disparities in COVID-19 related morbidity and mortality.

A systematic review of models of COPD epidemiology