Background Throughout US history, chronic and infectious diseases have severely impacted minority communities due to a lack of accessibility to quality healthcare and accurate information, as well as underlying racism. These fault lines in the care of minority communities in the US have been further exacerbated by the rise of the COVID-19 pandemic. This study examined the factors associated with COVID-19 vaccine hesitancy by race and ethnicity, particularly among African American and Latinx communities in Eastern Pennsylvania (PA). Methods Survey data was collected in July 2021 in Philadelphia, Scranton, Wilkes-Barre, and Hazleton, PA. The 203 participants (38.7% Black, 27.5% Latinx) completed the 28-question survey of COVID-19 vaccination attitudes in either English or Spanish. Result Out of the 203 participants, 181 participants met all the inclusion criteria, including completed surveys; of these participants, over three-fifths (63.5%) were acceptant of the COVID-19 vaccine whereas the remainder (36.5%) were hesitant. Binary logistic regression results showed that age, concern for vaccine efficacy, race, knowledge on the vaccine, and belief that the COVID-19 virus is serious significantly influenced COVID-19 vaccine hesitancy. Minorities were more likely to be hesitant toward vaccination (OR: 2.8, 95% CI: 1.1, 6.8) than non-Hispanic whites. Those who believed the COVID-19 vaccine was ineffective (OR: 8.3, 95% CI: 3.8, 18.2), and that the virus is not serious (OR: 8.3, 95% CI: 1.1, 61.8) showed the greatest odds of hesitancy. Conclusions Minority status, age less than 45 years, misinformation about seriousness of COVID-19 illness, and concern about vaccine efficacy were contributing factors of COVID-19 vaccine hesitancy. Therefore, understanding and addressing the barriers to COVID-19 vaccination in minority groups is essential to decreasing transmission and controlling this pandemic, and will provide lessons on how to implement public health measures in future pandemics.
Background Buprenorphine is a synthetic opioid frequently used in combination with naloxone for the treatment of opioid use disorder (OUD). Overall buprenorphine distribution has increased nationally; however, pronounced regional differences in this distribution have also been identified. The objective of this study was to analyze buprenorphine distribution by 3-digit zip codes in Pennsylvania from 2010 to 2020. Methods Data was extracted from the Drug Enforcement Administration’s Automated Reports and Consolidated Orders System (ARCOS) by year to gather buprenorphine distribution, in grams per 3-digit zip code, from 2010 to 2020. After compiling this data, a percent change for each 3-digit zip code was calculated to analyze the change in distribution from 2010 to 2020. The total weight of buprenorphine distributed for the state of Pennsylvania over the last decade was calculated. The amount of buprenorphine distributed in grams per each 3-digit zip code was compared to their population densities to analyze if there was any association between population and buprenorphine distribution. Zip codes that were outside of a 95% confidence interval were considered significant (P < .05). Results Pennsylvania pharmacies and hospitals dispensed 116.3 kg of buprenorphine in 2010. That number increased 217.3% to 369.0 kg in 2020. The 155 (Somerset) zip code experienced the largest increase (885%). In contrast, the 190 (Philadelphia) zip code experienced the smallest increase (79%). The 155 (Somerset), 169 (Wellsboro), and 177 (Williamsport) zip codes experienced significantly greater elevations relative to the state average. Conclusion Our analysis uncovered that buprenorphine distribution in Pennsylvania from 2010 to 2020 rose 217%. With the increasing awareness of opioid addiction and the large number of opioid prescriptions in the US, this increase was expected. The zip codes of 155 (Somerset), 169 (Wellsboro), and 177 (Williamsport) showed a statistically significant increase in buprenorphine distribution relative to the overall state average. No zip codes displayed a statistically significant decrease in buprenorphine distribution. Interestingly, some of the more densely populated areas in Pennsylvania were at or below the average state increase of 217%: zip codes 150-152 (Pittsburgh), 228%; 190 (Philadelphia), 79%; 170-171 (Harrisburg), 202%. Furthermore, the statistically significant zip codes of 155 (Somerset), 169 (Wellsboro), and 177 (Williamsport) were among the least densely populated areas of Pennsylvania. Further pharmacoepidemiological research is needed to continue to characterize, and ideally remediate, the pronounced regional variation in buprenorphine distribution.
Background Buprenorphine is a synthetic opioid frequently used in combination with naloxone for the treatment of opioid use disorder (OUD). Overall buprenorphine distribution has increased nationally; however, pronounced regional differences in this distribution have also been identified. The objective of this study was to analyze buprenorphine distribution by three-digit zip codes in Pennsylvania from 2010-2020. Methods Data was extracted from the Drug Enforcement Administrations Automated Reports and Consolidated Orders System (ARCOS) yearly to gather buprenorphine distribution, in grams per 3-digit zip code, from 2010-2020. After compiling this data, a percent change for each 3-digit zip code was calculated to analyze the change in distribution from 2010-2020. The total weight of buprenorphine distributed for the state of Pennsylvania over the last decade was calculated. The amount of buprenorphine distributed in grams per each 3-digit zip code was compared to their population densities to analyze if there was any association between population and buprenorphine distribution. Zip codes that were outside of a 95% confidence interval were considered significant (p < .05). Results Pennsylvania pharmacies and hospitals dispensed 116.3 kg of buprenorphine in 2010. That number increased 217.3% to 369.0 kg in 2020. The 155-zip code (Somerset) experienced the largest increase (885%). In contrast the 190-zip (Philadelphia) experienced the smallest increase (79%). The 155 (Somerset), 169 (Wellsboro), and 177 (Williamsport) zip codes experienced significantly greater elevations relative to the state average. Conclusion Our analysis uncovered that buprenorphine distribution in Pennsylvania from 2010-2020 rose 217%. With the increasing awareness of opioid addiction, and the large number of opioid prescriptions in the US, this increase was expected. The zip codes of 155, 169, 177 showed a statistically significant increase in buprenorphine distribution relative to the overall state average. No zip codes displayed a statistically significant decrease in buprenorphine distribution. Interestingly, some of the more densely populated areas in Pennsylvania were at or below the average state increase of 217% (Pittsburgh 150-152: 228%; Philadelphia 190-191: 79%; Harrisburg 170-171: 202%). Furthermore, the statistically significant zip codes of 155, 169, and 177 were among the least densely populated areas of Pennsylvania. Further pharmacoepidemiological research is needed to continue to characterize, and ideally remediate, the pronounced regional variation in buprenorphine distribution.
Background: Throughout US history, chronic and infectious diseases have severely impacted minority communities due to lack of accessibility to quality healthcare, accurate information, and underlying racism. These fault lines in the care of minority communities in the US have been further exposed by the rise of COVID-19 pandemic. This study examined the factors associated with COVID-19 vaccine hesitancy among African American and Latinx communities in Eastern Pennsylvania (PA). Methods: Survey data was collected in July 2021 in Philadelphia, Scranton, Wilkes-Barre, and Hazleton, PA. The 203 participants (38.7% Black, 27.5% Latinx) completed the 28-question survey of COVID-19 vaccination attitudes in either English or Spanish. Results: Out of a total of 181 participants that met inclusion criteria of completed surveys, results indicate that 63.5% (n=115) were acceptant of the COVID-19 vaccine whereas the remainder 36.5% (n=66) were hesitant. Binary logistic regression results showed that age, concern for vaccine efficacy, race, knowledge on the vaccine, and belief that the COVID-19 virus is serious significantly influenced COVID vaccine hesitancy. Minorities were more likely to be hesitant toward vaccination (OR: 2.77, 95% CI: 1.13, 6.79) than non-Hispanic whites. Those who believed the COVID vaccine was ineffective (OR: 8.29, 95% CI: 3.78,18.2), and that the virus is not serious (OR: 8.28, 95% CI: 1.11, 61.8) showed the greatest odds of hesitancy. Conclusions: Contributing factors of vaccine hesitancy in minority communities were age, concern for vaccine efficacy, and education. Understanding and addressing the barriers to COVID-19 vaccination in minority groups is essential to decreasing transmission and controlling this pandemic.
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