COVID-19 pandemic and the social determinants of health.

Frontiers in epidemiology Pub Date : 2023-05-31 eCollection Date: 2023-01-01 DOI:10.3389/fepid.2023.1139371
John E Meador, Wesley James, Joseph Branson, Jonathan Bennett, Karen Matthews
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Abstract

Hesitancy to receive a COVID-19 vaccination across sub-groups within the US population contributed to higher illness rates and deaths. Specifically, minority groups and those living in rural and remote areas are more vaccine-hesitant populations known to suffer from higher disparities in health. Identifying successful and replicable approaches to promoting vaccination within these subpopulations is critical to ensuring vaccination rates can be maximized in these vulnerable groups. In this paper, we present findings from the Mississippi Recognizing Important Vaccine & Education Resources (RIVERs) project, a multi-state effort to spread accurate information related to COVID-19 vaccinations using a variety of community and media-based methods as well as provide vaccinations. Vaccination rates for Black people in Mississippi exceeded those of White people, likely due to the concerted effort of regional health and community organizations. Propensity score matching is performed to test intervention styles using spatial and temporal data related to approximately 7,000 events across Mississippi and parts of Tennessee and publicly available data on vaccination rates and socio-economic data. We demonstrate that vaccination rates within the vulnerable groups may be closely related to misinformation being spread through local social networks and that interventions carried out by local leaders with high levels of local social capital are best at quashing misinformation at the local level. We recommend that policymakers consider the importance of local efforts as an effective tool in increasing vaccination rates in future pandemics.

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新冠肺炎大流行与健康的社会决定因素
美国人口中各亚群对接种新冠肺炎疫苗的犹豫导致了更高的患病率和死亡率。具体而言,少数群体以及生活在农村和偏远地区的人是更不愿接种疫苗的人群,他们的健康差距更大。确定在这些亚群中推广疫苗接种的成功和可复制的方法对于确保这些弱势群体的疫苗接种率能够最大化至关重要。在这篇论文中,我们介绍了密西西比州认识重要疫苗和教育资源(RIVERs)项目的研究结果,该项目是一项多州努力,旨在使用各种基于社区和媒体的方法传播与新冠肺炎疫苗接种相关的准确信息,并提供疫苗接种。密西西比州黑人的疫苗接种率超过了白人,这可能是由于地区卫生和社区组织的共同努力。使用密西西比州和田纳西州部分地区约7000起事件的空间和时间数据,以及疫苗接种率和社会经济数据的公开数据,进行倾向性得分匹配,以测试干预风格。我们证明,弱势群体的疫苗接种率可能与通过当地社交网络传播的错误信息密切相关,拥有高水平当地社会资本的地方领导人进行的干预最能在地方层面消除错误信息。我们建议政策制定者考虑地方努力的重要性,将其作为在未来流行病中提高疫苗接种率的有效工具。
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