COVID‐19 Disparities and Vaccine Hesitancy in Black Americans: What Ethical Lessons Can Be Learned?

Restrepo, Nicolas; Krouse, Helene J.

doi:10.1177/01945998211065410

Cited by 18 publications

(44 citation statements)

References 79 publications

(118 reference statements)

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“…However, prior literature suggested that such disparities result from factors both within and outside of health care, such as concerns on the safety and the effectiveness of COVID‐19 vaccines, lack of insurance, financial restrictions, and distrust of healthcare systems. 18 , 19 Finally, as the outcome of interest of this study is receipt of at least on dose of COVID‐19, the findings may not entirely reflect the full vaccination status.…”

Section: Discussionmentioning

confidence: 90%

Racial and ethnic and income disparities in COVID‐19 vaccination among Medicare beneficiaries

Cheng

2022

J American Geriatrics Society

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Background Older adults have been disproportionately affected by the COVID‐19 pandemic. Despite the widespread availability and proved effectiveness of COVID‐19 vaccines, the issue of inequity in vaccine uptake in the United States is a potential concern among different populations. This study examined racial and ethnic and income disparities in COVID‐19 vaccination rate among Medicare beneficiaries. Methods Data from the Medicare Current Beneficiary Survey (MCBS) COVID‐19 Winter 2021 Community Supplement were employed ( n = 9606 Medicare beneficiaries, weighted N = 50,512,963). We fitted a logistic regression model to determine the association of vaccination status with beneficiary race and ethnicity and income, after controlled for a set of beneficiary characteristics. Results Compared with non‐Hispanic White respondents, Hispanic respondents (OR = 0.72, 95% CI: 0.54–0.96, p = 0.02) and Black respondents (OR = 0.84, 95% CI: 0.67–1.04, p = 0.11) were less likely to receive COVID‐19 vaccine. In addition, the likelihood of COVID‐19 vaccine uptake for beneficiaries who earn less than $25,000 per year was more than 50% lower than that for those whose annual income was $25,000 or more (OR = 0.44, 95% CI: 0.37–0.53, p < 0.0001). Conclusions Racial and ethnic and income disparities exist in COVID‐19 vaccination rate among Medicare beneficiaries nationally. Community‐based strategies to boost vaccine uptake may target racial and ethnic minorities and socioeconomically disadvantaged groups to reduce such disparities.

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Section: Discussionmentioning

confidence: 90%

Racial and ethnic and income disparities in COVID‐19 vaccination among Medicare beneficiaries

Cheng

2022

J American Geriatrics Society

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“…93 A 2021 review showed that, even with their high rates of COVID-19 vaccine hesitancy, Black individuals were still underrepresented in 62% of studies evaluating such hesitancy. 32 The Food and Drug Administration has recommended measures to enhance the diversity of clinical trial populations, such as incorporating diversity-related consideration in eligibility criteria, enrollment practices, and designs for phase III trials. 94 Finally, employing equity guidelines when designing and evaluating health care interventions can improve the effectiveness of health care interventions across diverse populations.…”

Section: Implications For Health Disparities Research In Otolaryngologymentioning

confidence: 99%

“…93 A 2021 review showed that, even with their high rates of COVID-19 vaccine hesitancy, Black individuals were still underrepresented in 62% of studies evaluating such hesitancy. 32…”

Section: Implications For Health Disparities Research In Otolaryngologymentioning

confidence: 99%

“…The effect of this mistrust has been amplified by the COVID‐19 pandemic, with higher rates of hospitalization and mortality from COVID‐19 among Black individuals vs non‐Hispanic White individuals 31 . In spite of the high rates of morbidity and mortality, a 2021 review revealed very high rates of COVID‐19 vaccine hesitancy among Black participants 32 . Mistrust of health care systems, vaccine information, the government, and the public health system were identified as major concerns leading to vaccine hesitancy.…”

Section: Defining Vulnerable Populationsmentioning

confidence: 99%

“…A recent review demonstrated insufficient inclusion and reporting of diverse subjects in hearing loss trials: in the 1990‐2020 period, 87% of trials did not report race/ethnicity and nearly 30% did not report sex 93 . A 2021 review showed that, even with their high rates of COVID‐19 vaccine hesitancy, Black individuals were still underrepresented in 62% of studies evaluating such hesitancy 32 …”

Section: Implications For Health Disparities Research In Otolaryngologymentioning

confidence: 99%

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Evidence‐Based Medicine in Otolaryngology, Part XIII: Health Disparities Research and Advancing Health Equity

Megwalu¹,

Bergmark

Osazuwa‐Peters

et al. 2022

Otolaryngol.--head neck surg.

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Objective To provide a contemporary resource for clinicians and researchers on health equity research and implementation strategies to mitigate or eliminate disparities in health care. Data Sources Published studies and literature on health disparities, applicable research methodologies, and social determinants of health in otolaryngology. Review Methods Literature through October 2021 was reviewed, including consensus statements, guidelines, and scientific publications related to health care equity research. This research focus provides insights into existing disparities, why they occur, and the outcomes of interventions designed to resolve them. Progress toward equity requires intentionality in implementing quality improvement initiatives, tracking data, and fostering culturally competent care. Priority areas include improving access, removing barriers to care, and ensuring appropriate and effective treatment. Although research into health care disparities has advanced significantly in recent years, persistent knowledge gaps remain. Applying the lens of equity to data science can promote evidence-based practices and optimal strategies to reduce health inequities. Conclusions Health disparities research has a critical role in advancing equity in otolaryngology–head and neck surgery. The phases of disparities research include detection, understanding, and reduction of disparities. A multilevel approach is necessary for understanding disparities, and health equity extensions can improve the rigor of evidence-based data synthesis. Finally, applying an equity lens is essential when designing and evaluating health care interventions, to minimize bias. Implications for Practice Understanding the data and practices related to disparities research may help promote an evidence-based approach to care of individual patients and populations, with the potential to eventually surmount the negative effects of health care disparities.

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Demographic Differences in Emergency Room Epistaxis Treatment Patterns and Outcomes

Herrera,

Mojica,

Sintigo

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveInvestigate the association between demographic characteristics and emergency department (ED) epistaxis management and outcomes.Study DesignRetrospective cohort study.SettingTriNetX US collaborative database.MethodsAdults presenting to the ED for epistaxis were retrospectively followed for 7 days. Spanish‐speaking patients were propensity score matched to English‐speaking patients by demographics and medical history. Outcomes included use of nasal decongestant, nasal packing or cautery, diagnostic nasal endoscopy, endoscopic control of hemorrhage, hospital admission, and mortality. The analysis was also performed with stratification by race and ethnicity.ResultsSpanish‐speaking patients were less likely to receive nasal packing or cautery [odds ratio, OR: 0.78; 95% confidence interval, CI: (0.68; 0.90)] or diagnostic nasal endoscopy [OR: 0.72; 95% CI: (0.52; 0.98)] compared to English‐speaking patients. Black patients were more likely to receive treatment with a nasal decongestant spray [OR: 1.31; 95% CI: (1.27, 1.36)], but less likely to receive any other treatment compared to White patients. Asian patients were less likely to undergo nasal packing or cautery [OR: 0.90; 95% CI: (0.82; 0.99)], but had more ED visits [(1.37; 1.32) P < .01] compared to White patients. Hispanic patients were less likely to be admitted [OR: 0.93; 95% CI: (0.87; 0.98)], and averaged fewer ED visits [(1.27; 1.30) P = <.0001] compared to non‐Hispanic patients.ConclusionWhile demographic trends in ED epistaxis management are nuanced, our results suggest that Spanish‐speaking, Black, Asian, and Hispanic patients are less likely to receive diagnostic and epistaxis control procedures. Additional research is needed to determine the etiology of these differences.

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COVID‐19 Disparities and Vaccine Hesitancy in Black Americans: What Ethical Lessons Can Be Learned?

Cited by 18 publications

References 79 publications

Racial and ethnic and income disparities in COVID‐19 vaccination among Medicare beneficiaries

Racial and ethnic and income disparities in COVID‐19 vaccination among Medicare beneficiaries

Evidence‐Based Medicine in Otolaryngology, Part XIII: Health Disparities Research and Advancing Health Equity

Demographic Differences in Emergency Room Epistaxis Treatment Patterns and Outcomes

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