Objective: To assess differences in the prevalence of anxiety/depression symptoms among cancer patients before (2019) and during the COVID-19 pandemic (2020); and the associations between anxiety/depression and sociodemographic and health behavior factors among cancer patients before and during the pandemic. Methods: We analyzed data from the 2019 (n = 856) and 2020 (n = 626) Health Information National Trends Survey, a nationally representative survey of United States adults aged ≥18 years. Only adults with a cancer diagnosis were used in the analyses. Anxiety/depression was assessed using the Patient Health Questionnaire-4 (low/none [0-2], mild [3-5], moderate [6-8], and severe [9-12]) and dichotomized as low/none and current anxiety/depression (mild/moderate/severe). Multivariate analysis was performed. Results:The prevalence of anxiety/depression symptoms among cancer patients was 32.7% before the COVID-19 pandemic and 31.1% during the pandemic. The odds of anxiety/depression among patients with fair/poor health status was higher during the pandemic relative to before (before: odds ratio [OR] = 1.85 vs. during: OR = 3.89). Participants aged 50-64 years (before: OR = 0.29, 95% confidence interval [95% CI] = 0.11-0.76; during: OR = 0.33, 95% CI = 0.11-0.97) and ≥65 years (before: OR = 0.13, 95% CI = 0.05-0.34; during: OR = 0.18, 95% CI = 0.07-0.47) had lower odds of anxiety/depression before and during the pandemic compared to those aged 35-49 years. Hispanics/Latinos had higher odds of anxiety/depression (OR = 2.70, 95% CI = 1.11-6.57) before the pandemic and lower odds of anxiety/depression during the pandemic (OR = 0.2, 95% CI = 0.05-1.01) compared to non-Hispanic Whites. Those who completed high school (before: OR = 0.08, 95% CI = 0.01-0.42), some college (before: OR = 0.10, 95% CI = 0.02-0.42), ≥college degree had lower odds of anxiety/depression symptoms (before: OR = 0.05, 95% CI = 0.01-0.26; during: OR = 0.06, 95% CI = 0.01-0.61) compared to those with less than a high school education.

To evaluate the trends and relationship of inpatient presentations of Social Determinant of Health (SDOH) with superimposed Opioid Use Disorder (OUD), comparing 2012-2014 (ICD-9) and 2016-2017(ICD-10). MethodsWe used the Nationwide Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project (HCUP). We identified OUD among patients with any record of SDOH as the primary or secondary diagnosis using the International Classification of Diseases (ICD)-9/10 codes. A weighted SDOH sample size of 3,002,558 (2.8%) and 1,254,899(1.8%) was included for 2012-2014 and 2016-2017, respectively. The main predictors include census division, race, gender, and covariates, including age, income, disposition, payer, rural-urban classification, and combined SDOH indicator, which was used as a control variable in the regression analysis. The study provides a descriptive analysis of the social determinant of health in relation to OUD. We also evaluated the rate of the presentation by age group and race. ResultsA sample of 367,960 (12%) and 153,535 (12%) OUD presentations with SDOH indicators were identified for 2012-2014 and 2016-2017, respectively. An increase in housing difficulties between 2016-2017 (45%) as compared to 2012-2014 (20%) was observed. A statistically significant higher odds of presentation among black and other races were observed. There was significant variance in the presentation by region with

Social Determinants of Health (SDoH) are socioeconomic indicators that directly or indirectly impact individual and community health outcomes. The distribution of most of these indicators within communities can be traced to public policies. These public policies often lead to diverse inequities with varying impacts on communities across the country. The inequities that arise because of specific public policies can be associated with increased risk factors and poor health outcomes among communities at high risk for these indicators. This study examined inpatient hospitalization and SDoH indicators that put individuals at risk of poor health outcomes. We utilized the National Inpatient Sample (NIS) databases 2012-2014 and 2016-2017 through the Healthcare Cost and Utilization Project (HCUP). The NIS datasets are de-identified to ensure patients' privacy. The HCUP-NIS dataset is a well-established sizable all-payer inpatient dataset for national estimates. It includes primary, secondary inpatient diagnoses as well as demographic information. SDoH indicators were identified using the International Classification of Diseases (ICD), versions 9 and 10 diagnosis codes. The relationship between SDoH indicators such as housing, psychosocial, healthcare access, upbringing, unemployment, social factors, gender, race, income, region, payer, age group, mortality, and severity was evaluated in a regression analysis. A total of 3,002,557 (2012-2014) and 1,254,899 (2016-2017) cases were included in this study. Mental diseases (p < 0.001) were high between 2012-2014 (OR 18.8, 95% CI 18.20-19.42) and 2016-2017 (OR 4.11, 95% CI 3.99-4.23). Native Americans had odds of presentation (p < 0.001) with SDoH indicator between 2012-2014 (OR 1.15, 95% CI 1.12-1.18) and 2016-2017 (OR 1.75, 95% CI 1.70-1.79). The odds of presentation among long income group were high compared to other income categories (p < 0.001) between 2012-2014 (OR 1.15, 95% CI 1.15-1.16) and 2016-2017 (OR 1.26, 95% CI 1.28-1.32). In conclusion, disparities, severity, and mortality risk at presentation were high among minority communities, males, and low-income demographics across all regions of United States

There is limited evolving literature on COVID-19 vaccine uptake and its barriers among sexual minority populations (lesbian, gay, bisexual, transgender, and queer [LGBTQ]), despite their increased COVID-19 risk factors. We assessed the differences in intention to receive the COVID-19 vaccine by self-reported likelihood of contracting COVID-19, anxiety/depression, discrimination frequency, social distancing stress, and sociodemographic factors across sexual orientation. An online national cross-sectional survey was conducted in the United States between 13 May 2021, and 9 January 2022, among adults aged ≥18 (n = 5404). Sexual minority individuals had a lower intention of receiving the COVID-19 vaccine (65.62%) than heterosexual individuals (67.56%). Disaggregation by sexual orientation, however, showed that gay participants had a higher intention of COVID-19 vaccination (80.41%) and lesbian (62.63%), bisexual (64.08%), and non-heterosexual, non-LGB sexual minority (56.34%) respondents had lower intentions of receiving the COVID-19 vaccine than heterosexual respondents. Sexual orientation significantly moderated the association between the perceived likelihood of receiving the COVID-19 vaccine and the self-reported likelihood of contracting COVID-19, anxiety/depression symptoms, and discrimination. Our findings further underline the importance of improving vaccination efforts and access among sexual minority individuals and other vulnerable groups.

BackgroundPediatric pneumonia is a significant cause of inpatient care in the United States. Significant resource utilization and the high cost of care necessitate careful evaluation, especially with continuously decreasing financial resources. Several studies have evaluated subsets and regional impact of these diagnoses, but only a few have evaluated these on a national level.MethodsThis retrospective analysis utilized the 2009–2012 HCUP KID Inpatient Dataset to evaluate the relationship between pneumonia diagnosis and factors affecting cost for patients between 0 and 21. One hundred forty-five thousand one hundred forty-six patients’ charges with primary pneumonia diagnosis were evaluated based on LOS, chronic conditions, severity, mortality and region.ResultsMajority of cases of diagnosis were of unspecified organism: 11,4811 (78%) of the total population. RSV-related pneumonia diagnosis presented second with a total of 8,156 (5.5%). Charges for pneumonia in the Emergency Department (ER) were about $13,104 and non-ER presentation at $10,238. LOS affected total charge and mortality risk for all patient population regardless of age.ConclusionThis nationwide study provides a unique preview of the cost associated with care for pediatric pneumonia. Such information is essential in developing strategies to improve health outcomes and resources allocation.