164 lines
5.4 KiB
YAML
164 lines
5.4 KiB
YAML
abstract: 'Background: Disproportionate risks of COVID-19 in congregate care
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facilities including long-term care homes, retirement homes, and
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shelters both affect and are affected by SARS-CoV-2 infections among
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facility staff. In cities across Canada, there has been a consistent
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trend of geographic clustering of COVID-19 cases. However, there is
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limited information on how COVID-19 among facility staff reflects urban
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neighborhood disparities, particularly when stratified by the social and
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structural determinants of community-level transmission. Objective: This
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study aimed to compare the concentration of cumulative cases by
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geography and social and structural determinants across 3 mutually
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exclusive subgroups in the Greater Toronto Area (population: 7.1
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million): community, facility staff, and health care workers (HCWs) in
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other settings.Methods: We conducted a retrospective, observational
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study using surveillance data on laboratory-confirmed COVID-19 cases
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(January 23 to December 13, 2020; prior to vaccination rollout). We
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derived neighborhood-level social and structural determinants from
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census data and generated Lorenz curves, Gini coefficients, and the
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Hoover index to visualize and quantify inequalities in cases.Results:
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The hardest-hit neighborhoods (comprising 20\% of the population)
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accounted for 53.87\% (44,937/83,419) of community cases, 48.59\%
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(2356/4849) of facility staff cases, and 42.34\% (1669/3942) of other
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HCW cases. Compared with other HCWs, cases among facility staff
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reflected the distribution of community cases more closely. Cases among
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facility staff reflected greater social and structural inequalities
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(larger Gini coefficients) than those of other HCWs across all
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determinants. Facility staff cases were also more likely than community
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cases to be concentrated in lower-income neighborhoods (Gini 0.24, 95\%
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CI 0.15-0.38 vs 0.14, 95\% CI 0.08-0.21) with a higher household density
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(Gini 0.23, 95\% CI 0.17-0.29 vs 0.17, 95\% CI 0.12-0.22) and with a
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greater proportion working in other essential services (Gini 0.29, 95\%
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CI 0.21-0.40 vs 0.22, 95\% CI 0.17-0.28).Conclusions: COVID-19 cases
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among facility staff largely reflect neighborhood-level heterogeneity
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and disparities, even more so than cases among other HCWs. The findings
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signal the importance of interventions prioritized and tailored to the
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home geographies of facility staff in addition to workplace measures,
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including prioritization and reach of vaccination at home (neighborhood
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level) and at work.'
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affiliation: 'Mishra, S (Corresponding Author), Univ Toronto, Dept Med, Div Infect
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Dis, Toronto, ON, Canada.
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Mishra, S (Corresponding Author), Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto,
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ON, Canada.
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Mishra, S (Corresponding Author), St Michaels Hosp, Unity Hlth Toronto, Room 315,209
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Victoria St, Toronto, ON M5B 1T8, Canada.
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Ma, Huiting; Yiu, Kristy C. Y.; Fahim, Christine; Moloney, Gary; Darvin, Dariya;
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Landsman, David; Straus, Sharon; Mishra, Sharmistha, St Michaels Hosp, Unity Hlth
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Toronto, Toronto, ON, Canada.
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Baral, Stefan D., Johns Hopkins Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA.
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Chan, Adrienne K.; Mishra, Sharmistha, Univ Toronto, Dept Med, Div Infect Dis, Toronto,
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ON, Canada.
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Chan, Adrienne K.; Mishra, Sharmistha, Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto,
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ON, Canada.
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Chan, Adrienne K., Univ Toronto, Div Infect Dis, Sunnybrook Hlth Sci, Toronto, ON,
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Canada.
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Chan, Adrienne K.; Mishra, Sharmistha, Univ Toronto, Inst Hlth Policy Management
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\& Evaluat, Toronto, ON, Canada.
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Straus, Sharon, Univ Toronto, Dept Med, Toronto, ON, Canada.
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Mishra, Sharmistha, St Michaels Hosp, Unity Hlth Toronto, Room 315,209 Victoria
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St, Toronto, ON M5B 1T8, Canada.'
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article-number: e34927
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author: Ma, Huiting and Yiu, Kristy C. Y. and Baral, Stefan D. and Fahim, Christine
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and Moloney, Gary and Darvin, Dariya and Landsman, David and Chan, Adrienne K. and
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Straus, Sharon and Mishra, Sharmistha
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author-email: sharmistha.mishra@utoronto.ca
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author_list:
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- family: Ma
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given: Huiting
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- family: Yiu
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given: Kristy C. Y.
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- family: Baral
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given: Stefan D.
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- family: Fahim
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given: Christine
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- family: Moloney
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given: Gary
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- family: Darvin
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given: Dariya
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- family: Landsman
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given: David
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- family: Chan
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given: Adrienne K.
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- family: Straus
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given: Sharon
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- family: Mishra
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given: Sharmistha
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da: '2023-09-28'
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doi: 10.2196/34927
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files: []
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issn: 2369-2960
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journal: JMIR PUBLIC HEALTH AND SURVEILLANCE
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keywords: 'long-term care; nursing home; staff; essential worker; retirement home;
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shelter; congregate living; COVID-19; observational; risk; transmission;
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elderly; older adults; retirement; nurse; health care worker;
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congregate; trend; geography; Canada; Toronto'
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keywords-plus: TRANSMISSION; SARS-COV-2; CANADA; HEALTH; INDEX; HOMES
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language: English
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month: OCT
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number: '10'
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number-of-cited-references: '46'
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orcid-numbers: 'Yiu, Kristy/0000-0002-7378-9773
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Mishra, Sharmistha/0000-0001-8492-5470
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Ma, Huiting/0000-0003-1910-5614'
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papis_id: c6d18de5acac86572d58b0f5a1dd89fc
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ref: Ma2022covid19cases
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times-cited: '1'
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title: 'COVID-19 Cases Among Congregate Care Facility Staff by Neighborhood of Residence
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and Social and Structural Determinants: Observational Study'
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type: article
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unique-id: WOS:000867515600003
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usage-count-last-180-days: '1'
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usage-count-since-2013: '2'
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volume: '8'
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web-of-science-categories: Public, Environmental \& Occupational Health
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year: '2022'
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