Clinical Risk Characteristics and Social Determinants of COVID-19: Evidence from 3 Scientific Articles Chanapong Rojanaworarit DDS, MPH, PhD Department of Population Health, School of Health Professions and Human Services, Hofstra University Introduction
Factors determining transmission of SARS-CoV-2 and occurrence of COVID-19 range from clinical factors (i.e., age, sex, race, risk behavior) to social determinants (i.e., living condition, limited health access). This presentation summarizes evidence from 3 scientific articles regarding these determinants in order to provide information regarding factors to be considered for health interventions to control and prevent the COVID-19 from individual level to population level, especially in the marginalized populations.
Summary of evidence ❖ COVID-19 and international labor trafficking interact in a complex two-way manner that is mediated by sociobiological factors. ❖ In one way, the pandemic magnifies socioeconomic inequalities, such as poverty and unemployment in workers’ countries of origin, which heighten the risk of victimization of workers through labor trafficking. ❖ Conversely, labor trafficking serves as a social origin for COVID-19 through a unique set of social disadvantages–i.e., reluctance to seek medical care due to fear of legal prosecution–that make infected workers potential disease vectors which threaten the health of the host country’s population. ❖ Labor trafficking is a critical but neglected public health issue during COVID-19 pandemic.
Summary of evidence ❖ This article analyzes deficiencies in public health services for international migrant workers (IMWs) during the COVID19 pandemic and provides a policy brief for improvement of the public health system. ❖ The COVID-19 outbreak unveiled unique challenges that make IMWs more vulnerable to COVID-19. ❖ The public health system, challenged by the COVID-19 outbreak among IMWs, manifested deficiencies in the planning and implementation of all essential services. ❖ Delayed detection of the outbreak along with the lack of policy accommodating undocumented IMWs and the lack of access to testing and treatment for COVID-19 resulted in the transmission of disease that harmed the public at large
Summary of evidence Prevalence and risk characteristics of COVID-19 in outpatients: A cross-sectional study of New York-area clinics Chanapong Rojanaworarit, Douglas C. Lambert, Joseph Conigliaro, Eun Ji Kim
❖ Outpatients can be at heightened risk of COVID-19 due to interaction between existing non-communicable diseases in outpatients and infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). ❖ The prevalence of COVID-19 among these outpatients of 3.0% was higher than that of the total population in New York State (2.2%) as of August 28, 2020. ❖ Multivariable analysis revealed adjusted prevalence ratios significantly greater than one for male sex (PR=1.10), age 40 to 64 compared to < 40 (PR =1.19), and racial/ethnic minorities in comparison to White patients (Hispanic: PR=2.76; Black: PR=1.89; and Asian/others: PR=1.56).