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Public Health Crises

COVID-19 Pandemic Mitigation, Community Economic and Social Vulnerability, and Opioid Use Disorder

This project evaluates how the COVID-19 pandemic and associated mitigation policies exacerbated economic and social vulnerabilities, including pre-pandemic individual and community level incidence and risk of opioid use disorder (OUD). Through leveraging Medicare, Medicaid, and commercially insured population claims data and electronic health data, capturing nearly half of the U.S. population from before the pandemic through today, we test the hypothesis that social and economic vulnerabilities, as well as economic side effects of the pandemic will escalate the prevalence of OUD and related harms. Furthermore, we investigate the influence of state-level and county-level COVID-19 mitigation policies on OUD escalation and healthcare access. This examination will allow researchers to understand and identify policy relevant factors that reflect the net health and mortality impacts of the COVID-19 pandemic on OUD diagnoses, treatment initiation and adherence, utilization, and mortality over the short- and longer- terms.

Read more about this project.

RECOVER Initiative

This study utilizes National Covid Cohort Collaborative (N3C) harmonized electronic medical record data from more than 12m patients across more than 70 health systems to analyze the risk factors that are associated with long COVID. We seek to understand new onset conditions (mental health, pain, substance use, chronic conditions) following COVID-19 infection. We also examine the impact of certain medications used to treat COVID-19 on the likelihood of developing long COVID.

Read our Medarxiv preprint.

Read more about this initiative.

See the N3C dashboard.

The Tale of Two Pandemics: Understanding Racial and Ethnic Disparities From the Collision of HIV and COVID-19 in the U.S.

The collision of the COVID-19 pandemic with the existing HIV epidemic in the U.S. has exacerbated the decades old racial/ethnic disparities in HIV. These racialized disparities in the U.S. HIV epidemic are further compounded by the same disparities emerging in COVID-19. We have shown that PLWH appear to be at higher risk of poorer COVID-19 outcomes than persons not living with HIV (PNLWH), and that the odds of incident COVID-19 infection among PLWH are 60% and 118% higher among Black and Latinx persons, respectively, than whites. These racialized disparities are likely largely driven by social determinants of health (SDoH) underlying our health systems—an understanding of the SDoH pathways that elucidate these disparities is urgently needed to develop the next generation of HIV interventions operating at the structural and social levels, and ever more now in the context of COVID-19. The National COVID Cohort Collaborative (N3C) leverages real-world, national data and presents an unprecedented opportunity to inform the NIH priority aims to understand the social and biologic factors that may affect both HIV and COVID-19 outcomes. Our central hypothesis is that the observed racial/ethnic disparities in HIV and COVID-19 occur in a larger context of individuals embedded in social, political, and economic contexts, i.e., SDoH. Understanding these forces, centered on SDoH, allows us to determine the next generation of HIV interventions. Our goal is to identify multilevel, social determinants of racial/ethnic disparities in HIV outcomes (e.g., viral suppression [VS] and hospitalization) during the COVID-19 pandemic.