Disadvantaged Population Groups Research Articles

The cost of climate change: A generalized cost function approach for incorporating extreme weather exposure into public transit accessibility

Public transit offers urban populations physical accessibility to resources and opportunities. However, at the same time, transit trips often expose users to extreme environmental conditions, such as extreme heat and cold since transit journeys usually include out-of-vehicle trip segments including walking and waiting. Such exposure can be considered as environmental health costs because exposure to weather extremes can lead to adverse health outcomes. Even worse, climate change is increasing the intensity and frequency of extreme weather events. In this context, how can we make public transit accessibility measures ready for climate change? This paper attempts to answer this question by developing a generalized cost function approach combining travel time and environmental health costs into an integrated measure of dual accessibility: a measure of the travel costs of accessing a fixed number of destinations. We synthesize transport science, environmental health, remote sensing, and urban climatology to empower the proposed framework. To demonstrate the utility of the proposed method, we carry out an example study that incorporates transit passengers' extreme cold exposure into accessibility measures in the city of Winnipeg, Manitoba, Canada. Further, we perform a social equity analysis to investigate whether the increase in total integrated costs (i.e., decrease in accessibility) due to the inclusion of environmental health costs disproportionately affects socially disadvantaged population groups. The proposed method enables a more realistic and practical measurement of public transit accessibility under climate change; thereby, improving the readiness and resilience of our society and transport systems for future challenges.

Incorporating equity into transit performance measures: A disaggregated bus route level approach

Marginalized communities usually experience inadequate public transport services in North America. Within these communities, buses play a vital role in everyday activity participation. Unfortunately, transport services that may advance equity by improving coverage and service for disadvantaged population groups and areas are often overlooked in transit planning since they usually underperform in ridership-based metrics.To address this problem, the Toronto Transit Commission (TTC) introduced an equity service policy in 2019 to enhance bus services in vulnerable neighbourhoods known as Neighbourhood Improvement Areas (NIAs). This policy involves augmenting observed ridership counts for buses serving NIAs to improve or protect services for these communities. Although this proposed measure can improve bus services in NIAs, its current form might exclude other equity-deserving riders (EDRs) living outside NIAs, increasing their accessibility barriers.Our study uses quantitative and spatial analytical methods to better understand the equity impacts of this service policy change. We propose moving from the aggregate neighbourhood-based approach using NIAs to a more comprehensive and disaggregated person-based approach. First, we create an alternate method that identifies EDRs at the bus stop level using a fusion of census and travel survey data. We then explore the differences in augmented ridership levels created by the two approaches and evaluate whether the augmented ridership levels are likely to result in meaningful service changes using existing TTC service standards.We found that 2 out of 3 transit riders in Toronto are equity-deserving, with 72% residing outside NIAs. Our approach reveals increased ridership on routes with many EDRs, which receive minimal augmentation under the NIA-based method. Conversely, if all riders in NIAs are considered EDRs, our approach shows a 19% ridership overestimation equivalent to 35,245 users. Based on these results, we recommend creating a dedicated equity tool with an individual-centric focus, identifying areas with low transit service and high EDR percentages. This tool could then be integrated as an equity perspective into annual bus service planning.

Health Care Access and Equity Among Migrants: A Literature Review

Background: Health inequality often occurs among disadvantaged population groups, including migrants. Currently, the migrant population does not always receive adequate health services. In addition, the health care system is not optimized for migrants, especially in terms of language, access, genomic data and the expertise of medical personnel. The health condition of these migrants is a global problem that needs attention if countries want to meet the Sustainable Development Goals (SDGs) targets by 2030. Purpose: to map the latest existing research on the topic of migrant health, both qualitative and quantitative. Methods: narrative literature review and literature search were carried out using an electronic database with the automatic selection feature used in the electronic database according to the specified inclusion criteria. Results: Obtained an overview of inequality in [1] access to health services for migrants in general, [2] utilization of health services and health-seeking behavior, [3] health literacy, [4] health services related to the COVID-19 pandemic, and [5] maternal and child health services. All authors agree on this division of groups. Conclusion: Migrants who do not have documents or are illegal, skin color (black migrants) who migrate to western countries, languages ​​that are not the same, and do not understand their own health conditions due to lack of health education due to language barriers, these factors are obstacles for migrants to achieve equality in countries where migrants have migrated.

Impact of Significant Discounts for Low-Income Groups of Passengers in Railway Transport on the Development of Transport Performances

To achieve the sustainable and green mobility available to everyone regardless of their social situation, it is necessary to regulate the fares by the responsible public authority. Some countries have introduced free fare or significant discounts for selected groups of passengers, such as children, students, and pensioners, which has brought up a question if such a measure is efficient from the social point of view. On one side, this approach would change the transport behaviors of socially disadvantaged groups of population, on the other side, it can lead to an outflow of fully paying passengers due to a lower comfort and quality of services. In this paper, we evaluate the impact of introduced measures in fares on the transport performances of rail passenger transport, using the methods of time series analysis and forecasting.

The subject matter of administrative law as a basic category For distinguishing sectoral principles of administrative law

Problem setting. Administrative law as a fundamental branch of public law is a necessary tool in regulating the activities of public administration bodies, public organizations, enterprises, institutions, and organizations. Its influence is constantly felt by specific individuals. Norms of administrative law protect relations formed under the influence of civil, labor, financial and other branches of law. In recent years, administrative law has been in a state of transformation, a new ideology of relations between the state and the citizen is being formed, the administrative legal doctrine is undergoing fundamental changes, and administrative legislation is being updated. As a result, administrative law has turned from the law of state management into a branch that normatively defines and regulates the rights and obligations of public administration in relation to subjects of civil society. Analysis of recent researches and publications. A significant number of scientists dealt with issues of administrative law, its subject, principles, among which it is worth mentioning the works of such scientists as: V. B. Averyanov, Yu. P. Bityak, V. V. Galunko, R. S. Melnyk, A. A. Pukhtetska and others. However, despite the rather large number of works, questions related to the generalization of scientific positions, which highlight the subject of administrative law as a basic category for determining industry precepts, remain in most cases outside the attention of researchers, which makes it possible to talk about the need to carry out such research. The purpose of research is to clarify the role of the subject of administrative law as a basic category for determining the branch principles of administrative law. Article’s main body. The article is devoted to the peculiarities of the subject of administrative law as a fundamental criterion for determining the principles of administrative law. Of fundamental importance for updating the concept of the subject of administrative law were two theoretical conclusions that were made in the development of the ideas of the Concept of Administrative Reform in Ukraine. The transformation of the subject of administrative law is a factor in updating the content and classification of the principles of administrative law. The subject of administrative law is social relations that arise for the purpose of realizing and protecting the rights of citizens, creation of normal conditions for the functioning of civil society and the state. It follows that the main task of administrative law is to create a priority of legal conditions for ensuring by public administration the rights, freedoms and interests of man and citizen in the sphere of public administration. The subject of administrative law is a wide complex of social relations that arise in connection with the implementation of the functions of the state executive power, the content of which is the management of society. Ukraine’s new management model (with adapted principles of Good Governance) should be aimed at maximizing the scope of public participation in governance, ensuring that economic, social and political priorities are based on consensus in such a way that the voices of all citizens, even the poorest and most socially disadvantaged population groups were taken into account when making state decisions. The article emphasizes the fact that principles are the leading category in the administrative law of all continental European countries. The principles reveal the content of law, reveal the essence of law, its foundations, as well as the regularities of social life and needs, and highlight trends. In the theory of law, the principles of law mean the most general and stable requirements that contribute to the establishment and protection of social values, determine the nature of law and the direction of its further development. Conclusions and prospects for development. The principles of law are a natural phenomenon of legal science, which in their essence are universal and reflect modern approaches to their interpretation. In modern conditions, the principles of law have a universal character, as they must be taken into account by law-making subjects during the creation of norms for the legal regulation of social relations. The peculiarities of the subject of administrative law provide grounds for a new approach to updating and characterizing the principles of administrative law resulting from interdependence and influence on each other.

Exploring "Equigenesis" in the Associations Between Green Space and Kidney Health Among Middle-Aged and Older Adults Using Street View Data.

This study systematically explores the association between community green space and preventing kidney failure among middle-aged and older adults in China, using street view data. The 33 Chinese Community Health Study was used to conduct the analysis. We used street view data to assess street view green space (SVG) exposure and clearly distinguished the difference between grass (SVG-grass) and trees (SVG-tree). The normalized difference vegetation index (NDVI) was also used. Kidney failure was defined as a serum creatinine concentration of above 177mol/L. We used multilevel logistic regression models (controlled for a series of covariates) to examine the associations between SVG and the odds of middle-aged and older adults having kidney failure. We also tested whether middle-aged and older adults from socioeconomically disadvantaged groups are likely to derive greater benefits from the effects of green space ("equigenesis"). The results showed that both SVG (OR = 0.353; 95% CI = 0.171-0.731) and SVG-trees (OR = 0.327; 95% CI = 0.146-0.736) were negatively associated with the likelihood of middle-aged and older adults experiencing kidney failure, but there was no significant evidence of any links between either SVG-grass (OR = 0.567; 95% CI = 0.300-1.076) or the NDVI (OR = 0.398; 95% CI = 0.237-1.058) and kidney failure. Furthermore, the moderation analysis indicated that income and educational attainment have a moderating effect on the association between green space and the improvement of kidney health, which suggests that green space has greater positive effects on the kidney health of disadvantaged groups. To reduce inequalities in relation to kidney disease through urban planning, policymakers are advised to provide more visual green space-especially trees-within the community and to focus in particular on socioeconomically disadvantaged population groups.

Utilization and determinants of adequate quality antenatal care services in India: evidence from the National Family Health Survey (NFHS-5) (2019-21)

BackgroundPregnancy-related complications and insufficiencies in antenatal care services are leading causes of maternal and infant morbidity and mortality in low-resource settings. However, there has been an undue focus on achieving a minimum number of Antenatal Care (ANC) visits without adequate focus on the factors affecting ANC service utilization. This secondary data analysis from the fifth round of the National Family Health Survey (NFHS-5, 2019-21) was conducted to estimate the coverage of adequate quality ANC service and its determinants in India.MethodsThe study sample included 176,877 women aged 15–49 years who had experienced a pregnancy in the last 5 years. The primary outcome variable was the utilization of ANC services by women during their last pregnancy assessed by the frequency of ANC visits and the quality of ANC services. Quality of ANC service utilisation was categorised as adequate quality, inadequate quality and ≥ 4 ANC visits and, inadequate quality and < 4 ANC visits. We performed multinomial logistic regression and reported relative risk ratio (RRR) along with 95% confidence intervals. We adjusted for sampling weight, clustering, and stratification in the sampling design.ResultsThe median (IQR) number of ANC visits attended by a woman during her previous pregnancy was 4 (IQR 3–7). A majority (59.25%) of the women reported availing of ≥ 4 antenatal care (ANC) visits during their previous pregnancy while 6.12% of women reported availing no ANC visits in their last pregnancy. Women aged ≥ 30 years were significantly less likely (aRRR 0.73 95% CI 0.66, 0.80) to receive ANC services of inadequate quality, and < 4 ANC visits. Additionally, any exposure to mass media (aRRR 0.69 95% CI 0.66, 0.73), and having health insurance (aRRR 0.71 95% CI 0.68, 0.75) decreased their risk of receiving inadequate quality ANC services and < 4 ANC visits. Women belonging to the richest wealth quintile (aRRR 0.52 95% CI 0.47,0.58) and those with an intended pregnancy (aRRR 0.62 95% CI 0.58 ,0.66) were at significantly lower risk of utilizing inadequate quality ANC services and < 4 ANC visits.ConclusionAlthough nearly 3 in 5 women in India utilized a minimum mandated ≥ 4 ANC visits during their last pregnancy, only one in five of those received adequate quality of ANC services indicating suboptimal content. However, only one in five women utilized the WHO-mandated ≥ 8 ANC visits for a positive pregnancy experience. Furthermore, 14.3% of the women received ANC services of inadequate quality despite attending ≥ 4 ANC visits in their previous pregnancy. Our study emphasized the importance of the quality of ANC services utilised irrespective of number of ANC visits availed. Efforts should be undertaken to enhance the utilization of antenatal care (ANC) services by implementing media initiatives that aim to raise awareness, particularly among women belonging to disadvantaged population groups.

Vplyv sociálneho prostredia na zdravie znevýhodnených skupín obyvateľstva

Vplyv sociálneho prostredia na zdravie znevýhodnených skupín obyvateľstva

COVID-19 and Public Transport in Auckland, New Zealand: Investigating Vulnerable Population Groups’ Ridership Behavior

Public transit ridership was severely affected during the COVID-19 pandemic in 2020 and the effects have continued since. The present study examines changes to ridership immediately post-pandemic in 2021. Research investigating the effects of COVID-19 on disadvantaged population groups is limited and the present study addresses this knowledge gap. Ridership of socially-disadvantaged groups such as low-income, female, and ethnic minority people is examined using order logit regression models. The study uses data from an online travel survey conducted in Auckland, New Zealand, immediately after all COVID-19-related restrictions were lifted. This allowed the collection of revealed preference data for the post-pandemic period. The regression models included the effects of socio-demographic characteristics of individual riders, travel attributes, and built environment factors. Findings suggest that those with lower income and from an ethnic minority group are likely to continue using transit frequently post-pandemic. Younger riders from the ethnic minority group are less likely to use transit frequently, while pre-COVID-19 they were more likely. Access to transit stops near home and work are significant factors for the ethnic minority group. Higher land use mix near the residence and work locations are found to induce more transit trips for all. It is critical for transit agencies to understand how the usage has evolved post-pandemic. These findings highlight the importance of considering the effects of the pandemic on different disadvantaged groups. Public transport service providers are encouraged to consider equity as they develop strategies to improve transit ridership.

Dental therapist job satisfaction and intention to leave: A cross-sectional study

Dental therapy is a mid-level oral health profession that was introduced to the South African health system more than four decades ago, during the apartheid era. The purpose for the introduction of this profession was to meet the oral health needs of the underserved majority population1,2,3. However, even with the dismantling of apartheid and the creation of a democratic state, disparities in access to basic oral healthcare persist.1 Local studies have reported limited access to oral health services, especially among the disadvantaged and vulnerable population groups where the highest burden of oral diseases has been reported.4,5,6

Administrative and legal relations for the provision of administrative guardianship in the field of higher education

The state guarantees equal access to higher education. Due to the Chernobyl disaster, war, or other circumstances (death of both parents or deprivation of their parental rights, damage to health, which led to limitation of life activities and establishment of disability), we have entrants who do not have the opportunity to exercise their right to higher education on equal terms with other entrants who were not affected by these circumstances.&#x0D; We have a number of legislative acts to regulate these relations to ensure equal access to higher education for socially disadvantaged population groups, among which the Constitution of Ukraine and the Law of Ukraine «On Education» are generally declarative in national legislation. The Law «On Higher Education» already specifies the subjects of administrative guardianship in the field of higher education, as well as their right to a specific type of administrative guardianship in the field of higher education. Exercising his right to equal access to higher education, the subject of administrative guardianship in the field of higher education applies to the institution of higher education with a request to provide a specific type of administrative guardianship in the field of higher education, the institution of higher education takes measures to provide administrative guardianship in the field of higher education. Relations arise, which should be called administrative-legal relations of administrative guardianship in the field of higher education. Why precisely administrative-legal relations, because firstly, these relations are regulated by the norms of administrative law, for example, the norms regulating the procedure for admission to an institution of higher education and relating to subjects of administrative guardianship in the field of higher education are created and approved by the Ministry of Education and Science of Ukraine, that is, by the central body of the executive power, secondly, in the presence of a wide range of rights, the student is in a certain subordination to the institution of higher education, so according to Article 63 of the Law of Ukraine «On Higher Education», the student of the institution of higher education undertakes to observe the statute and internal regulations of the institution of higher education, comply with the requirements for occupational health and safety, safety technology, industrial sanitation, and fire safety provided by the relevant rules and instructions, comply with the requirements of the educational (scientific) program (individual curriculum (if available), observing academic integrity, and achieve the study results determined for the corresponding level of higher education, thirdly, administrative guardianship in the field of higher education is provided at the expense of the state budget, fourthly, administrative-legal relations regarding the provision of administrative guardianship in the field of higher education arise in the presence of administrative-legal norms , which prescribe them. Institutions of higher education under the supervision of the Ministry of Education and Science of Ukraine, as well as persons who are entrants or students of higher education and wish to receive administrative guardianship in the field of higher education, are the subjects of administrative-legal relations regarding administrative guardianship in the field of higher education. This article is dedicated to the study of the topic of administrative-legal relations for the provision of administrative guardianship in the field of higher education, subjects, objects and legal grounds for the emergence, change and termination of these relations.

Relevance of Sociocultural Inequalities and Parents' Origins in Relation to the Oral Health of Preschoolers in Lanzarote, Spain.

Approaching inequalities to achieve health equity requires joint action. Early childhood caries affects disadvantaged population groups. The objective of this study was to determine the relevance of sociocultural inequalities and parental origin with respect to oral health in preschool children in Lanzarote. A transversal epidemiological study was carried out. Sociocultural data and information about parental origin were collected via a questionnaire. The decayed and filled teeth (dft), decayed teeth (dt), filled teeth (ft), restorative index (RI), plaque index (PI) and gingival index (GI) were obtained via an investigator's examination. Statistical analysis of the data indicated that children of semi-skilled manual workers (28.15%) had the highest prevalence of caries (46.9%). Additionally 43.7 of the mothers had second grade and first cycle studies. When relating the medium and high level of education, there were statistically significant differences in relation to the cod index (p = 0.046). When the origin was foreign (48.4%), preschoolers presented 10.7% more active or untreated caries than Spaniards (p = 0.038). Low socioeconomic cultural level and foreign origin is associated with a more deficient state of oral health in preschoolers. Oral health programs are needed to minimize social inequalities.

Refining 2SVCA method for measuring telehealth accessibility of primary care physicians in Baton Rouge, Louisiana

Equity in health care delivery is a longstanding concern of public health policy. Telehealth is considered an important way to level the playing field by broadening health services access and improving quality of care and health outcomes. This study refines the recently developed “2-Step Virtual Catchment Area (2SVCA) method” to assess the telehealth accessibility of primary care in the Baton Rouge Metropolitan Statistical Area, Louisiana. The result is compared to that of spatial accessibility via physical visits to care providers based on the popular 2-Step Floating Catchment Area (2SFCA) method. The study shows that both spatial and telehealth accessibilities decline from urban to low-density and then rural areas. Moreover, disproportionally higher percentages of African Americans are in areas with higher spatial accessibility scores; but such an advantage is not realized in telehealth accessibility. In the study area, absence of broadband availability is mainly a rural problem and leads to a lower average telehealth accessibility than physical accessibility in rural areas. On the other side, lack of broadband affordability is a challenge across the rural-urban continuum and is disproportionally associated with high concentrations of disadvantaged population groups such as households under the poverty level and Blacks.

Patient Experience of Integrated Care: Findings from a Cross-Sectional Study Involving People with Rheumatic and Musculoskeletal Diseases.

Although the patient experience of integrated care has been documented for several chronic conditions, little is known in the context of rheumatic and musculoskeletal diseases (RMDs). This study provides a first overview of the patient experience of integrated care according to the perspective of people living with RMDs in Italy. A cross-sectional survey was administered to 433 participants who reported their experiences together with the importance assigned to different attributes of integrated care. Explorative factor analysis (EFA) and non-parametric ANOVA and ANCOVA statistical tests were employed to account for the differences in the answers provided by sample subgroups. Two factors (namely, "Person-centred care" and "Health service delivery") were extracted in the EFA. Participants attributed high importance to both of them. Overall positive experiences were reported only for Person-centred care. The delivery of health services instead received a poor evaluation. Significantly worse experiences were observed for women and people that were either older, unemployed, with comorbidities or lower self-reported health, or less engaged in their healthcare management. Italians with RMDs described integrated care as an important approach to care. However, further effort is needed to allow them to perceive an actual benefit from integrated care practices. Specific attention should be paid to disadvantaged and/or frail population groups.

Spaces of participation: Exploring the characteristics of conducive environments for citizen participation in a community-based health promotion initiative in a disadvantaged neighborhood.

Research has shown that community participation in health programmes is vital to ensure positive health outcomes and sustainable solutions. This is often challenged by difficulties to engage socially disadvantaged population groups. Through ethnographic fieldwork in a community initiative in a disadvantaged neighbourhood in Copenhagen, Denmark, we explored which factors contributed to a conducive environment for participation. Data material consists of observation notes taken during fieldwork in a community hub from January 2020 until August 2021 and 19 semi-structured interviews with professional stakeholders and participants. We applied the analytical concept of space to elucidate how the organizational, social, and physical environments played important roles in ensuring possibilities for participation. We termed these environments Spaces of Participation. Our results highlight the importance of ensuring spaces that are flexible, informal, and responsive when engaging those who are hard to reach.

Death registration coverage 2019–2021, India

To investigate coverage and factors associated with death registration in India. We used data from the Indian National Family Health Survey 2019-2021. Based on responses of eligible household members, we estimated death registration in 84 390 deaths in all age groups across the country. We used multilevel logistic regression analysis to determine sociodemographic variables associated with death registration at state, district and individual levels. Nationally, 70.8% (59 748/84 390) of deaths were registered. Of 707 districts in our study period, 122 and 53 districts had death registration levels less than 40% in females and males, respectively. The likelihood of death registration was significantly lower for females than males (adjusted odds ratios, aOR: 0.61; 95% confidence interval, CI: 0.59-0.64). Death registration increased significantly with age of the deceased person, with the highest odds in 35-49-year-olds (aOR: 5.05; 95% CI: 4.58-5.57) compared with 0-4-year-olds. Death registration was less likely among rural households, disadvantaged castes, the poorest wealth quintile, Muslims and households without a below poverty level card. Higher education was associated with higher death registration with the greatest likelihood of registration in households with a member with post-secondary school education (aOR: 1.54; 95% CI: 1.42-1.66). District-level factors were not significantly associated with death registration. Sociodemographic characteristics of the deceased person were significantly associated with death registration. Strategies to raise awareness of death registration procedures among disadvantaged population groups and the introduction of a mobile telephone application for death registration are recommended to improve death registration in India.

The status of health services in the 15 counties of Liberia

Aim: Liberia, situated at the West African coast, is composed of 15 counties with an economic gradient steeply decreasing from the Northwest to the Southeast. Health-related activities by government action in the 15 counties concentrate on the areas of family planning, antenatal and delivery care, as well as immunization, health workforce and infrastructure. The differences in this regard between the 15 Liberian counties will be reviewed.&#x0D; Methods: A narrative review is employed, making use of the recent international and national documents, relevant literature and available information from the following primary and secondary sources and databases.&#x0D; Results: The results point to gross differences between the 15 counties of Liberia in terms of health service provision. The overall readiness based on defined indicators for all 701 facilities was 59% with a range between facilities at the level of counties of 50% to 65%; for family planning services 88% (range 65% – 100%); for antenatal care 62% (range 55% – 100%); for immunization coverage 76% (range 66% – 86%). The health workforce of Liberia comprises 11.8 health workers per 10.000 population, WHO target is 23, the counties range from 8.0 to 15.7. Similarly, according to WHO standards, there should be 2 health facilities per 10.000 inhabitants, Liberia comes up to 1.9 however the counties range from 1.1 – 3.0 per 10.000.&#x0D; Conclusions: It is obvious that across almost all areas of women and child health and health services in general there exist large differences between counties, which points to considerable health inequities in this country. The government of Liberia should consider reallocating the available resources per number of population instead of accepting historical developments, however with a correction factor in favou of disadvantaged regions and population groups.

Socio-environmental and clinical features of invasive group A streptococcal disease in the Northern Territory of Australia.

To describe the socio-environmental profile and clinical features of invasive group A streptococcal (iGAS) infections in the Northern Territory (NT) of Australia over 10 years. Cases of iGAS disease diagnosed between 1 May 2011 and 30 April 2021 were retrospectively identified from the NT Notifiable Diseases System and electronic health records accessed. Remoteness of residence, socio-economic index, seasonality and clinical characteristics were recorded. There were 692 cases of iGAS disease identified in the NT during the period 1 May 2011 - 30 April 2021. The age-standardised incidence of iGAS disease was significantly higher in people living in very remote (57.1 cases per 100,000 population, 95% confidence interval [95% CI]: 48.6-65.5) and remote areas (40.9 cases per 100,000 population, 95% CI: 34.7-47.2) than in outer regional areas of the NT (15.7 cases per 100,000 population, 95% CI: 13.4-17.9). People with socio-economic disadvantage were also disproportionately affected, with an incidence of 52.6 cases per 100,000 population (95% CI: 46.2-58.9) in decile 1-3 populations, compared to 8.9 cases per 100,000 population (95% CI: 6.9-10.9) for decile 7-10. For cases with recorded severity data, 135 of 378 (36%) met locally-defined criteria for severe iGAS disease. Recurrent iGAS disease was commonly observed in the dialysis cohort, affecting 17 of the 106 patients during the study period (16% recurrence rate) and causing two deaths. Five molecularly-confirmed clusters of iGAS disease were identified from the study period. iGAS disease is unevenly affecting people in the NT. Those living in areas of socio-economic disadvantage, those in remote and very remote communities, and those receiving dialysis were most affected. It is important that primordial, primary and secondary prevention measures be directed towards supporting these disadvantaged population groups.

Social Vulnerabilities and Spatial Access to Primary Healthcare through Car and Public Transportation System in the Albuquerque, NM, Metropolitan Area: Assessing Disparities through GIS and Multilevel Modeling.

Primary healthcare (PHC) is a keystone component of population health. However, inequities in public transportation access hinder equitable usage of PHC services by minoritized populations. Using the multimodal enhanced 2-step floating catchment area method and data in 2018 and 2019 for spatial access to PHC providers (n = 1166) and social vulnerability markers through census block (n = 543) and tract data (n = 226), a generalized linear mixed-effect model (GLMEM) was constructed to test the effects of sociodemographic and community area correlates on both car and bus transit spatial access to PHCin the Albuquerque, New Mexico (NM) metropolitan area. Results for bus spatial access to PHC showed lower access for Hispanics (B = - 0.097 ± 0.029 [- 0.154, - 0.040]) and non-Hispanic Whites (B = - 0.106 ± 0.032 [- 0.169, - 0.043]) and a positive association between single-family households and bus spatial access (B = 1.573 ± 0.349 [0.866, 2.261]). Greater disability vulnerability (B = - 0.569 ± 0.173 [- 0.919, - 0.259]) and language vulnerability (B = - 0.569 ± 0.173 [- 0.919, - 0.259]) were associated with decreased bus spatial access. For car spatial access to PHC, greater SES vulnerability (B = - 0.338 ± 0.021 [- 1.568, -0.143]), disability (B = - 0.721 ± .092 [- 0.862, - 0.50 9]), and language vulnerability (B = - 0.686 ± 0.172 [- 1.044, - 0.362]) were associated with less car spatial access. Results indicate a disproportionate burden of low PHC access among disadvantaged population groups who rely heavily on public transportation. These results necessitate targeted interventions to reduce these disparities in access to PHC.

YOU DON’T KNOW WHAT YOU DON’T KNOW: BLACK/LATINX CANCER SURVIVORS’ KNOWLEDGE AND USE OF SURVIVORSHIP CARE PLAN

Abstract Compared to Whites, Black and Latinx cancer survivors and their families experience disproportionate adverse effects of cancer and cancer therapy. This is due to extreme psychosocial, physical, emotional, and financial challenges they experience, thus, highlighting racial/ethnic disparity in cancer survivorship. A cancer survivorship care plan (SCP) is important for improving cancer health and quality of life, but the effectiveness of SCP as a tool to address the disproportionately persistent poor health and quality of life of Blacks/Latinx compared to Whites deserve critical attention. This study is part of a larger study on evaluating cancer survivorship in Rhode Island. We explored knowledge and use of SCP among Blacks and Latinx cancer survivors in Rhode Island. The study employed a qualitative descriptive method. Semi-structured interviews in English and Spanish were conducted with a purposive sample of 12 cancer survivors, 8 Latinx and 3 Blacks (Mage = 62 years). Their responses were transcribed and analyzed for themes. The 3 major themes identified were: 1) invisibility of survivors; 2) understanding the needs of cancer survivors; and 3) issues of empowerment. Our findings draw attention to the need for tailored interventions targeting Black/Latinx cancer survivors. One of such interventions include designing programs to increase the accessibility of SCP to help improve quality of life of cancer survivors from disadvantaged population groups.