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COVID Infection, Death Linked to Racial Diversity in Nursing Homes

Wednesday, June 16, 2021

New research shows that people in nursing homes with higher concentrations of Black and Latino residents were more than 50% more likely to be infected with COVID and twice as likely to die in the first months of the pandemic, compared to those in homes with predominately white populations. 

The study, which appears in the journal Infection Control & Hospital Epidemiology, was led by Yue Li, Ph.D., a professor in the University of Rochester Medical Center (URMC) Department of Public Health Sciences.  In previous studies, Li and his colleagues have shown that older residents from underrepresented racial and ethnic backgrounds and their caregivers bore the severest brunt from COVID, and linked the COVID toll in nursing homes to staffing levels and quality scores.  The new study examines what unfolded in nursing homes in the early stages of the coronavirus pandemic.

“The widened across-facility disparities in COVID-19 morbidity and mortality during the early pandemic period are just another manifestation of the structural inequalities in nursing home care that have existed for decades,” said Li.

Researchers analyzed cases and death reports for a 10 week period between April 13 and June 19, 2020 in nursing homes in Connecticut, one of the few states to provide weekly counts early in the pandemic. The case and death reports were analyzed for nursing home characteristics, such as number of beds, ownership, percent of Medicare residents, and staffing levels, as well as county COVID case and death data.

The researchers found immediate disparities in nursing home infections and deaths, which increased as the pandemic progressed.  By week 10 of the study data, the infection rate was 54% higher and the death rate was 117% higher in nursing homes with larger proportions of underrepresented residents compared to those with a whiter population.  The disparities persisting even after accounting for differences in the local infection rate and other nursing home characteristics.

Read More: COVID Infection, Death Linked to Racial Diversity in Nursing Homes

Alina Denham & Peter Veazie publish new article in Social Science & Medicine

Monday, June 7, 2021

 Alina Denham, a graduate student in the Health Services Research and Policy PhD Program, and Peter Veazie, PhD, associate professor in health services research and policy at the University of Rochester, has published a new article in Social Science & Medicine, "Understanding how psychosocial factors relate to seeding medical care among older adults using a new model of care seeking"

ABSTRACT: Rationale. Research has identified psychosocial factors related to the use of health services among the older population; however, the specific roles by which these factors drive behavior have not been identified and empirically tested.  Objective. This study tested whether previously identified psychosocial factors decrease or increase the motivational potential to seek care, the motivational sensitivity to perceived access, or the motivational sensitivity to perceived need.  Methods.  The 2014 U.S. Health and Retirement Study was used.  Analysis was based on 2,589 older non-institutionalized respondents (age greater than 64). The dependent variable was the number of healthcare provider visits in the preceding two years. Psychosocial factors included were life satisfaction, social network indicators, optimism, pessimism, positive social support, hopelessness, loneliness, self-efficacy, health efficacy, positive affect, negative affect, and purpose in life.  Covariates included age, sex, and race.  Maximum likelihood estimation of an interpretable structural model was used.  Results.  Results of the study provide evidence that psychosocial variables are related to health care seeking through both motivational potential and sensitivity parameters.  Some psychosocial variables are related to multiple roles.  For example, pessimism is related to a lower motivational potential and is more sensitive to access at higher levels of access, whereas hopelessness is related to a higher motivational potential and more sensitive to need and access at lower levels of each.  Conclusions.  Findings imply psychosocial characteristics are related to health care seeking and utilization of older adults via different roles that can countervail each other, and therefore the influence of interventions can be complex.  To address this, complex interventions may be required.

James Tacci Awarded the ACPM President's Award

Monday, May 24, 2021

James Tacci, MD, JD (Preventive Medicine Residency Program Director) has been awarded the "ACPM President's Award" at the annual ACPM meeting. Congrats Dr. Tacci! 

From the ACPM President Award site:

James A Tacci, MD, JD, MPH, FACPM, FACOEM, is the Medical Director and Executive Medical Policy Director for the New York State Workers’ Compensation Board. He holds a part-time teaching and clinical appointment at the University of Rochester Medical Center, where he serves as the Program Director for the Preventive Medicine Residency and Medical Director of the Travel Medicine Program. He is also an Attorney of Counsel at the law firm of Barclay Damon, LLP.

Dr. Tacci is board certified in Public Health & General Preventive Medicine, as well as Occupational Medicine. He is a past President of the American College of Occupational & Environmental Medicine (ACOEM) and he has served on the governing boards of ACOEM, ACPM, the American Journal of Preventive Medicine and the Occupational & Environmental Health Foundation. Dr. Tacci is a former Chair of the AMA Preventive Medicine Section Council and former member of the Monroe County (NY) Board of Health.

Dr. Tacci received his B.S. from Cornell University, M.D. with distinction from the University of Rochester and J.D. magna cum laude from the Syracuse University College of Law. He completed residency training in General Preventive Medicine and Public Health at the New York State Department of Health, and residency and research fellowship training in Occupational and Environmental Medicine at Harvard University.

Don’t Go Fracking My Heart

Tuesday, April 27, 2021

Study Links Hydraulic Fracking with Increased Risk of Heart Attack Hospitalization, Death

The Marcellus Formation straddles the New York State and Pennsylvania border, a region that shares similar geography and population demographics.  However, on one side of the state line unconventional natural gas development – or fracking – is banned, while on the other side it represents a multi-billion dollar industry. New research takes advantage of this ‘natural experiment’ to examine the health impacts of fracking and found that people who live in areas with a high concentration of wells are at higher risk for heart attacks.

“Fracking is associated with increased acute myocardial infarction hospitalization rates among middle-aged men, older men and older women as well as with increased heart attack-related mortality among middle-aged men,” said Elaine Hill, Ph.D., an associate professor in the University of Rochester Medical Center (URMC) Department of Public Health Sciences, and senior author of the study that appears in the journal Environmental Research.  “Our findings lend support for increased awareness about cardiovascular risks of unconventional natural gas development and scaled-up heart attack prevention, as well as suggest that bans on hydraulic fracturing can be protective for public health.”

Natural gas extraction, including hydraulic fracking, is a well-known contributor to air pollution. Fracking wells operate around the clock and the process of drilling, gas extraction, and flaring – the burning off of natural gas byproducts – release organic compounds, nitrogen oxide, and other chemicals and particulates into the air.  Additionally, each well requires the constant transportation of equipment, water, and chemicals, as well as the removal of waste water from the fracking process, further contributing to air pollution levels.  Fracking wells remain in operation for several years, prolonging exposure to people who work at the wells sites and those who live nearby. 

Read More: Don’t Go Fracking My Heart

Researchers find breastfeeding linked to higher neurocognitive testing scores

Monday, April 26, 2021

New research finds that children who were breastfed scored higher on neurocognitive tests. Researchers in the Del Monte Institute for Neuroscience at the University of Rochester Medical Center (URMC) analyzed thousands of cognitive tests taken by nine and ten-year-olds whose mothers reported they were breastfed, and compared those results to scores of children who were not.

“Our findings suggest that any amount of breastfeeding has a positive cognitive impact, even after just a few months.” Daniel Adan Lopez, Ph.D. candidate in the Epidemiology program who is first author on the study recently published in the journal Frontiers in Public Health. “That's what's exciting about these results. Hopefully from a policy standpoint, this can help improve the motivation to breastfeed.”

Hayley Martin, Ph.D., a fourth year medical student in the Medical Scientist Training Program and co-author of the study, focuses her research on breastfeeding. “There’s already established research showing the numerous benefits breastfeeding has for both mother and child. This study’s findings are important for families particularly before and soon after birth when breastfeeding decisions are made. It may encourage breastfeeding goals of one year or more. It also highlights the critical importance of continued work to provide equity focused access to breastfeeding support, prenatal education, and practices to eliminate structural barriers to breastfeeding.”

Researchers reviewed the test results of more than 9,000 nine and ten-year-old participants in the Adolescent Brain Cognitive Development (ABCD) study. Variations were found in the cumulative cognitive test scores of breastfed and non-breastfed children. There was also evidence that the longer a child was breastfed, the higher they scored.

“The strongest association was in children who were breastfed more than 12 months,” said Lopez. “The scores of children breastfed until they were seven to 12 months were slightly less, and then the one to six month-old scores dips a little more. But all scores were higher when compared to children who didn’t breastfeed at all.” Previous studies found breastfeeding does not impact executive function or memory, findings in this study made similar findings.

“This supports the foundation of work already being done around lactation and breastfeeding and its impact on a child’s health,” said Ed Freedman, Ph.D., the principal investigator of the ABCD study in Rochester and lead author of the study. “These are findings that would have not been possible without the ABCD Study and the expansive data set it provides.”

Read More: Researchers find breastfeeding linked to higher neurocognitive testing scores

School of Nursing Elevates Wharton to Associate Dean for Equity and Inclusion

Monday, January 25, 2021

Mitchell J. Wharton, PhD, RN, FNP-BC, CNS, an accomplished educator, researcher, and clinician, has been named associate dean for equity and inclusion at the University of Rochester School of Nursing, pending approval by the Office of the Provost.

The appointment of Wharton, an assistant professor of clinical nursing and faculty diversity officer at the school, shatters glass ceilings at the school. When he begins his new duties on a part-time basis on February 1, Wharton will be the first male and the first person from a group underrepresented in nursing to serve at the associate dean level of senior administration.

 

“I am honored to have the opportunity to serve students and colleagues by leading the mission to enhance equity and inclusive practices within our school,” said Wharton, who will transition to this position full time in July after fulfilling his current clinical and educational responsibilities for the spring semester. “I look forward to engaging members of the School of Nursing and Rochester communities as we work together to thoughtfully and respectfully develop strategies to increase diversity throughout the nursing workforce and academic nursing pipeline.”

Wharton has been an integral figure in the school’s diversity, equity, and inclusion efforts for the past several years. He has been co-chair of the Council for Diversity, Equity, and Inclusiveness since 2018 and the faculty advisor for the student-led Leading with Integrity For Tomorrow (LIFT) program since 2014. He has also been a co-facilitator for the school’s Racial Equity Series, served on the University of Rochester Medical Center’s Executive Committee for Diversity and Inclusion, and served as the School of Nursing’s representative to the Academic Community Engagement Collaborative. He was honored with the School of Nursing’s Mary Dombeck Diversity Enhancement Faculty Awards in 2020.

Read More: School of Nursing Elevates Wharton to Associate Dean for Equity and Inclusion