New research supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) at the National Institutes of Health aims to deepen public understanding of the impact of the coronavirus pandemic and inform the response.
This list of recently published journal articles shows the ways current and former NICHD-funded Population Centers are contributing to this important public health challenge.
Columbia University (Grant P2CHD058486)
Parents and children in households that experienced multiple COVID-19 hardships—job and income loss, caregiving burden, and illness—had the poorest mental health. Gassman-Pines A, Ananat EO, Fitz-Henley J 2nd. COVID-19 and Parent-Child Psychological Well-being. Pediatrics. 2020 Oct; 146(4). Epub 2020 Aug 6. (Also Duke University.)
Duke University (Grant 5P2CHD065563-10)
U.S. counties whose residents were less obese, more physically active, and had other healthy behaviors were more likely to practice social distancing as COVID-19 spread. Bourassa KJ, Sbarra DA, Caspi A, et. al. Social Distancing as a Health Behavior: County-Level Movement in the United States During the COVID-19 Pandemic Is Associated with Conventional Health Behaviors. Ann Behav Med. 2020 Aug 8; 54(8):548-556.
Parents and children in households that experienced multiple COVID-19 hardships—job and income loss, caregiving burden, and illness—had the poorest mental health.
Gassman-Pines A, Ananat EO, Fitz-Henley J 2nd. COVID-19 and Parent-Child Psychological Well-being. Pediatrics. 2020 Oct; 146(4). Epub 2020 Aug 6. (Also Columbia University.)
Adults with pre-existing conditions were much more likely to be hospitalized with COVID-19 if they were in the bottom vs. top income quartile and had a high school diploma vs. a college degree. Wiemers EE, Abrahams S, AlFakhri M, et. al. Disparities in vulnerability to complications from COVID-19 arising from disparities in preexisting conditions in the United States. Res Soc Stratif Mobil. 2020 Oct; 69:100553. Epub 2020 Sep 7.
Johns Hopkins University (Grant R01 HD086013)
A COVID-19 vaccine must have an efficacy of at least 70% to prevent an epidemic and of at least 80% to largely extinguish an epidemic without any other measures, such as social distancing. Bartsch SM, O’Shea KJ, Ferguson MC, et al. Vaccine Efficacy Needed for a COVID-19 Coronavirus Vaccine to Prevent or Stop an Epidemic as the Sole Intervention. Am J Prev Med. 2020;59(4):493-503. doi:10.1016/j.amepre.2020.06.011.
The availability and quality of age- and race-ethnic-specific COVID-19 case and death data varied greatly across states and is sufficient in only California, Illinois, and Ohio. Age distributions in confirmed cases obscured racial-ethnic disparities in COVID-19 case fatality rates. Age standardization narrows racial-ethnic disparities and changes ranking. Public COVID-19 data availability, quality, and harmonization need improvement to address racial disparities in this pandemic. Pathak I, Choi Y, Jiao D, et. al. Racial-ethnic disparities in case fatality ratio narrowed after age standardization: A call for race-ethnicity-specific age distributions in State COVID-19 data. medRxiv. 2020 Oct 4. *Preprint, not peer reviewed.
Pennsylvania State University (Grant P2C HD041025)
Every death from COVID-19 will impact the physical and mental health of approximately nine surviving close family members. Verdery AM, Smith-Greenaway E, Margolis R, et. al. Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States. Proc. Natl. Acad. Sci. U.S.A.. 2020 Jul 28; 117(30):17695-17701. Epub 2020 Jul 10.
Since early March, the average daily increase in the #COVID-19 mortality rate has been significantly higher in rural counties that have the highest percent Black and percent Hispanic populations. Cheng KJG, Sun Y, Monnat SM. COVID-19 Death Rates Are Higher in Rural Counties With Larger Shares of Blacks and Hispanics. J Rural Health. 2020;36(4):602-608. doi:10.1111/jrh.12511
Princeton University (Grant P2CHD047879)
U.S. COVID-19 deaths result in a 1-year reduction in life expectancy at age 65. The Black and Latino populations are estimated to experience declines in life expectancy at birth of 2.69 and 3.66 years, respectively, both of which are several times the 0.84-year reduction for Whites. These projections imply an increase of over 50% in the Black-White life expectancy gap, from 3.6 to 5.5 years, thereby eliminating 20 years of progress made in reducing this differential. Andrasfay T, Goldman N. Reductions in 2020 US life expectancy due to COVID-19 and the disproportionate impact on the Black and Latino populations. Preprint. medRxiv. 2020;2020.07.12.20148387. Published 2020 Sep 15. doi:10.1101/2020.07.12.20148387. *Preprint, not peer reviewed.
University of California, Berkeley (Grant P2CHD073964)
In April 2020, U.S. west coast residents admitted to hospitals with COVID-19 had a high probability of ICU admission (49% males/32% females), long hospital stays, and of mortality (24% males/15% females). Lewnard JA, Liu VX, Jackson ML, et. al. Incidence, clinical outcomes, and transmission dynamics of severe coronavirus disease 2019 in California and Washington: prospective cohort study. BMJ. 2020 May 22; 369:m1923.
COVID-19 is likely to shorten the average U.S. lifespan in 2020 by about 1 year. Unlike HIV/AIDS and opioid epidemics, COVID-19 deaths are concentrated in a period of months rather than spread out over decades. Goldstein JR, Lee RD. Demographic perspectives on the mortality of COVID-19 and other epidemics. Proc Natl Acad Sci U S A. 2020;117(36):22035-22041. doi:10.1073/pnas.2006392117.
Data from India (Tamil Nadu and Andhra Pradesh states) show reported COVID-19 cases and deaths have been concentrated in younger cohorts than would be expected from observations in higher-income countries, even after accounting for demographic differences. Case fatality ratios are 16.6% at ages of 85 years or older. Primary data from low-resource countries are urgently needed to guide control measures. Laxminarayan R, Wahl B, Dudala SR, et. al. Epidemiology and transmission dynamics of COVID-19 in two Indian states. Science. 2020 Nov 6; 370(6517):691-697. Epub 2020 Sep 30.
University of California, Los Angeles (Grant P2C HD041022)
The impact of COVID-19 on U.S. life expectancy at birth amounts to nearly twice the largest single-year decline induced by HIV/AIDS and would bring U.S. life expectancy at birth down to its lowest level since 2008. Heuveline P, Tzen M. Beyond Deaths per Capita: Three CoViD-19 Mortality Indicators for Temporal and International Comparisons. medRxiv. 2020 May 5. *Preprint, not peer reviewed.
Based on analysis of health conditions linked to a severe COVID-19 complications, health disparities emerge early in life, prior to age 65: Non-Hispanic Blacks, adults with a high school degree or less, and low-income Americans in midlife face the highest risks. Wiemers EE, Abrahams S, AlFakhri M, et. al. Disparities in Vulnerability to Severe Complications from COVID-19 in the United States. medRxiv. 2020 May 30. *Preprint, not peer reviewed.
After the U.S. spread of the coronavirus, the proportion of negative tweets referring to Asians increased by 68% (from 9.79% in November to 16.49% in March). In contrast, the proportion of negative tweets referring to other racial/ethnic minorities (Blacks and Latinx) remained relatively stable during this period. Nguyen TT, Criss S, Dwivedi P, et al. Exploring U.S. Shifts in Anti-Asian Sentiment with the Emergence of COVID-19. Int J Environ Res Public Health. 2020;17(19):E7032. Published 2020 Sep 25. doi:10.3390/ijerph17197032.
Among adults with pre-existing conditions, the risk of being hospitalized with COVID-19 is an estimated 3x higher for those with low incomes vs. high incomes, and 60% higher for those with a high school diploma vs. college degree. Wiemers EE, Abrahams S, AlFakhri M, Hotz VJ, Schoeni RF, Seltzer JA. Disparities in vulnerability to complications from COVID-19 arising from disparities in preexisting conditions in the United States. Res Soc Stratif Mobil. 2020;69:100553. doi:10.1016/j.rssm.2020.100553
Greater workplace exposures likely contribute to a higher COVID-19 prevalence among Latino and Black adults and underscore the need for measures to reduce potential exposure for low-paid workers who may lack bargaining power to demand adequate PPE. Goldman N, Pebley AR, Lee K, et. al. Racial and Ethnic Differentials in COVID-19-Related Job Exposures by Occupational Status in the US. medRxiv. 2020 Nov 16. *Preprint, not peer reviewed.
Researchers develop a framework for assessing the effects of hydroxychloroquine and dexamethasone on COVID-19 mortality outside of randomized trials. Hazlett C, Wulf DA, Pasaniuc B, et. al. Credible learning of hydroxychloroquine and dexamethasone effects on COVID-19 mortality outside of randomized trials. medRxiv. 2020 Dec 8. *Preprint, not peer reviewed.
University of Maryland (Grant 5P2CHD041041-18)
LGBTQ young persons face unique mental health challenges driven by the overlapping experience of stressors related to the pandemic- and their sexual and gender minority status. Public health stakeholders should advocate for allocation of pandemic crisis funds to community-based organizations involved in supporting crisis and mental health interventions among LGBTQ young persons and other marginalized groups. Salerno JP, Devadas J, Pease M, et. al. Sexual and Gender Minority Stress Amid the COVID-19 Pandemic: Implications for LGBTQ Young Persons’ Mental Health and Well-Being. Public Health Rep. 2020 Nov/Dec; 135(6):721-727. Epub 2020 Oct 7.
Mental health providers during COVID-19 are essential to the public health workforce and need support. Fish JN, Mittal M. Mental Health Providers During COVID-19 : Essential to the US Public Health Workforce and in Need of Support. Public Health Rep. 2021 Jan/Feb; 136(1):14-17. Epub 2020 Oct 27.
University of Minnesota (Grant P2C HD041023)
For U.S. White mortality in 2020 to reach levels that U.S. Blacks experience outside of pandemics, current COVID-19 mortality levels would need to increase by a factor of nearly 6. Even amid COVID-19, U.S. White mortality is likely to be lower than what U.S. Blacks have experienced every year. Wrigley-Field E. US racial inequality may be as deadly as COVID-19. Proc Natl Acad Sci U S A. 2020;117(36):21854-21856. doi:10.1073/pnas.2014750117.
The COVID-19 global pandemic affected air quality due to extreme changes in human behavior with both fine particulate matter (PM2.5) and nitrogen dioxide (NO2) in the continental United States, showing statistically significant declines in urban areas and counties from states instituting early non-essential business closures. Berman JD, Ebisu K. Changes in U.S. air pollution during the COVID-19 pandemic. Sci. Total Environ. 2020 Jun 1; 739:139864. [Epub ahead of print].
COVID-19 downturns produced increases in unemployment at all ages, but especially among older workers in their 50s and 60s without a college degree and among young adults, with young women most at risk. Repercussions from the pandemic may well challenge assumptions and possibilities for older adults’ working longer. Moen P, Pedtke JH, Flood S. Disparate Disruptions: Intersectional COVID-19 Employment Effects by Age, Gender, Education, and Race/Ethnicity. Work Aging Retire. 2020 Oct; 6(4):207-228. Epub 2020 Sep 12.
University of North Carolina at Chapel Hill (Grant P2C HD050924)
During spring 2020, COVID-19 testing in suburban/rural North Carolina suggested limited but accelerating asymptomatic spread. Low, overall prevalence rates may reflect the success of stay-at-home mandates and effective social distancing. Barzin A, Schmitz JL, Rosin S, et. al. SARS-CoV-2 Seroprevalence among a Southern U.S. Population Indicates Limited Asymptomatic Spread under Physical Distancing Measures. mBio. 2020 Sep 29; 11(5).
Participants in July 2020 focus groups reported high compliance with mask wearing to prevent #COVID-19 but often did not wear them around family, friends, and colleagues. Shelus VS, Frank SC, Lazard AJ, et. al. Motivations and Barriers for the Use of Face Coverings during the COVID-19 Pandemic: Messaging Insights from Focus Groups. Int J Environ Res Public Health. 2020 Dec 12; 17(24).
Strict quarantine in rural China meant barely any COVID-19 but high rates of unemployment, falling household income, rising prices, and disrupted student learning. Wang H, Zhang M, Li R, et. al. Tracking the effects of COVID-19 in rural China over time. Int J Equity Health. 2021 Jan 14; 20(1):35.
Consumers prefer COVID-19 testing strategies that offer 1) Rapid turnaround and 2) both PCR and serology tests with non-invasive methods. Zimba R, Kulkarni S, Berry A, et. al. SARS-CoV-2 Testing Service Preferences of Adults in the United States: Discrete Choice Experiment. JMIR Public Health Surveill. 2020 Dec 31; 6(4):e25546.
People of any age with obesity face a greatly increased risk of severe illness and death from COVID-19 compared to those without obesity: a higher risk of hospitalization (113% higher), being admitted to the ICU (74% higher), and death (48% higher). Popkin BM, Du S, Green WD, et al. Individuals with obesity and COVID-19: A global perspective on the epidemiology and biological relationships. Obes Rev. 2020;21(11):e13128. doi:10.1111/obr.13128.
Decisionmakers have been reluctant to release data regarding COVID-19 cases, deaths, and hospitalizations associated with specific industries, obscuring the role of occupational hazards as root causes of disease and health disparities. Yet a concentration of COVID-19 exposure is among low-wage and essential-worker populations who are disproportionately racial and ethnic minorities and immigrants; the nursing home industry is associated with one-third of COVID-19 deaths. McClure ES, Vasudevan P, Bailey Z, et. al. Racial Capitalism Within Public Health-How Occupational Settings Drive COVID-19 Disparities. Am J Epidemiol. 2020 Nov 2; 189(11):1244-1253.
Racial disparities in COVID-19 deaths are driven by unequal infection risks related to household, community, and workplace exposures. Zelner J, Trangucci R, Naraharisetti R, et. al. Racial disparities in COVID-19 mortality are driven by unequal infection risks. Clin Infect Dis. 2020 Nov 21. [Epub ahead of print].
Apartment dwellers living with children and in 4+ person households were more likely to acquire COVID-19 and be hospitalized early in the pandemic. Nash D, Qasmieh S, Robertson M, et. al. Household factors and the risk of severe COVID-like illness early in the US pandemic. medRxiv. 2020 Dec 4. *Preprint, not peer reviewed.
Adequate use of COVID-19 testing tends to show that a majority of state prisons having higher COVID-19 case rates than their local population. Lemasters K, McCauley E, Nowotny K, et. al. COVID-19 cases and testing in 53 prison systems. Health Justice. 2020 Dec 11; 8(1):24.
University of Pennsylvania (Grant P2CHD044964)
In mid-March 2020, perceptions about COVID-19 health risks and economic consequences in the U.S. population were highly variable by age and education, raising concerns about the ability of the nation to implement and sustain the widespread and restrictive policies required to curtail the pandemic. Ciancio A, Kämpfen F, Kohler IV, et al. Know your epidemic, know your response: Early perceptions of COVID-19 and self-reported social distancing in the United States. PLoS One. 2020;15(9):e0238341. Published 2020 Sep 4. doi:10.1371/journal.pone.0238341.
In March 2020, 29% of U.S. adults showed symptoms of depression and anxiety, mainly driven by concerns about the economic consequences of the pandemic, and less strongly related to worries about personal health and social distancing. These results highlight the importance of economic countermeasures and social policy for mitigating the impact of COVID-19 on U.S. adult mental health over and above an effective public health response. Kämpfen F, Kohler IV, Ciancio A, et. al. Predictors of mental health during the Covid-19 pandemic in the US: Role of economic concerns, health worries and social distancing. PLoS One. 2020 Nov 11; 15(11):e0241895. eCollection 2020.