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January 2022 highlights from the American Journal of Public Health

Date: Dec 29 2021

To request a full copy of any of these studies or for information on scheduling interviews with an expert, contact APHA Media Relations.

American Journal of Public Health January issue highlights:

  • COVID-19 heightened disparities in violence
  • Racial bias among clinicians influences chlamydia screening
  • California communities of color face higher chance of water contamination
  • Adherence to physical distancing guidelines lowers risk of COVID-19

COVID-19 heightened disparities in violence

The COVID-19 pandemic exacerbated levels of violence in disadvantaged communities, according to new research in the January AJPH.

To conduct the study, researchers examined ZIP code-level data in 13 U.S. cities between July 2018 and July 2020, focusing on five violent acts: intentional gun violence, criminal homicide, rape, robbery and aggravated assault. They found that ZIP codes with higher concentrations of low-income households and higher concentrations of either Black residents or people of color experienced substantially higher rates of violence in 2020 than ZIP codes with higher concentrations of high-income households and white residents.

In particular, inequities in gun violence, aggravated assault and homicide increased during the pandemic.

“Our results affirm well-documented associations between the spatial concentration of violence and low-income and marginalized racial/ethnic groups and challenge policy-makers and those interested in improving public health to examine the historical and contemporary processes that contribute to these enduring inequities,” study authors wrote.

[Author contact: Julia Schleimer, Violence Prevention Research Program, University of California-Davis, Davis, California. “Neighborhood Racial and Economic Segregation and Disparities in Violence During the COVID-19 Pandemic”]

Racial bias among clinicians influences chlamydia screening

Racial bias seems to impact which patients are tested for chlamydia, finds a new study published in the January issue of AJPH.

To tease out differences in screening for chlamydia — the most commonly reported sexually transmitted disease in the U.S. — researchers studied data from a cohort of teen and adult women ages 15 to 19 who received care at a 31-clinic network in Pennsylvania and New Jersey between 2015 and 2019. They found that Black females had higher odds of being screened for the disease than their white peers. Clinicians were also more likely to screen Black patients than non-Black ones.

Researchers noted that while the higher screening rates may be viewed as a “favorable outcome,” the differences suggest that providers are using race to assess sexual health needs rather than applying universal screening recommendations.

“Although racial bias may have led to disproportionately higher service delivery to Black adolescents in this study, these same biases may lead to undertreatment of acute pain and criminalization of mental health in other clinical settings,” researchers wrote. “For any health outcome and directionality, implicit racial bias is not benign.”

[Author contact: Sarah Wood, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania. “Inequities in Chlamydia trachomatis Screening Between Black and White Adolescents in a Large Pediatric Primary Care Network, 2015-2019”]

California communities of color face higher chance of water contamination

In California, poor drinking water quality disproportionately impacts communities of color.

In a new study in January’s AJPH, researchers used local data to estimate drinking and groundwater contamination with arsenic, nitrate and hexavalent chromium — all of which can have significant health effects — between 2011 and 2019. The study included both community water systems and domestic well areas. Researchers estimated that more than 1.3 million Californians use domestic wells and more than 370,000 residents rely on drinking water systems that have average contaminant concentrations at or above regulatory standards for one or more of the three contaminants studied.

Places with higher proportions of people of color were associated with greater drinking water contamination. In addition, populations that relied on domestic wells faced greater water quality concerns than those that relied on community water systems.  

Authors noted that, to their knowledge, the study is the first environmental justice analysis of drinking water quality in California communities that rely on both types of water sources. 

“Our study provides further evidence of unequal access to safe drinking water in California,” researchers wrote.

[Author contact: Rachel Morello-Frosch, Department of Environmental Science, Policy and Management, University of California-Berkeley, Berkeley, California. “Inequities in Drinking Water Quality Among Domestic Well Communities and Community Water Systems, California, 2011-2019”]

Adherence to physical distancing guidelines lowers risk of COVID-19

Taking personal prevention measures, such as avoiding crowded gatherings, can mitigate the risk of COVID-19 infection, according to a study in the January issue of AJPH

To conduct the study, researchers examined data gathered from June 2020 to April 2021 for the Understanding America Study COVID-19 survey. They found that those who recently engaged in activities such as going to bars and clubs, attending in-person religious services and gathering with more than 10 people also had a significantly higher risk of being diagnosed with COVID-19, compared to people who did not take part in such activities.

Overall, the study found that each additional high-risk behavior was associated with an 8% to 9% higher risk of COVID-19. And while large gatherings were associated with a greater COVID-19 risk, researchers found that small gatherings were also an important risk factor.

“Our findings demonstrate that even in the presence of structural factors that influence the risk of infection, such as one’s work or living situation, personal mitigation behaviors related to social distancing can influence risk of COVID-19,” they wrote.

[Author contact: Theresa Andrasfay, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California. “Adherence to Social-Distancing and Personal Hygiene Behavior Guidelines and Risk of COVID-19 Diagnosis: Evidence from the Understanding America Study”]

Check out the full list of AJPH research papers that published online in our First Look area.

These articles have undergone peer review, copyediting and approval by authors but have not yet been printed to paper or posted online by issue. AJPH is published by the American Public Health Association and is available at ajph.org.

Complimentary online access to the Journal is available to credentialed members of the media. Address inquiries to APHA Media Relations. A single print issue of the Journal is available for $35 from the Journal’s Subscriptions Department. If you are not a member of the press, a member of APHA or a subscriber, online single-issue access is $30, and online single-article access is $22 at AJPH.org. For direct customer service, call 202-777-2516, or email us.

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