Ben-Umeh, Kenechukwu C, and Jaewhan Kim. “Income Disparities in COVID-19 Vaccine and Booster Uptake in the United States: An Analysis of Cross-Sectional Data from the Medical Expenditure Panel Survey.” PloS One, U.S. National Library of Medicine, 20 Feb. 2024, www.ncbi.nlm.nih.gov/pmc/articles/PMC10878507/
This study is entitled "Income Disparities in COVID-19 Vaccine and Booster Uptake in the United States". The main objective of this study is to examine how people's income influences those who choose to be vaccinated against COVID-19 and those who do not.
Researchers Kenechukwu C. Ben-Umeh and Jaewhan Kim used data from the 2021 Medical Expenditure Panel Survey (MEPS) to examine vaccination rates among adults in the United States. They found that people with lower incomes were less likely (55%) to receive the COVID-19 vaccine and were even less likely to receive a booster if they had received the first dose. It was also found that this trend was more noticeable among the female population, indicating that women with lower incomes had the greatest difficulty in accessing vaccination. Older adults were more likely to have access to vaccination.
This study took into consideration a large sample of adults, taking into account the various factors that could affect their situation, such as age, sex, race, region, type of health insurance and existing diseases. Through this, it was also possible to conclude from the data that people with Medicaid, Medicare or no insurance were less likely to be vaccinated.
Therefore, the main conclusions of this study were that despite the fact that vaccines are free, significant disparities persist based on income. This is why it is important to remove financial barriers and improve outreach efforts to help ensure a more equitable distribution of vaccines.
“Covid-19 Vaccination Demographics in the United States, National.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, data.cdc.gov/Vaccinations/COVID-19-Vaccination-Demographics-in-the-United-St/km4m-vcsb/about_data.
The dataset “Covid-19 Vaccination Demographics in the United States, National” provides comprehensive data on the demographic characteristics of individuals who received COVID-19 vaccinations across various vaccination sites in the United States. Compiled by the National Center for Immunization and Respiratory Diseases (NCIRD) and available through the CDC, the data spans from December 13, 2020, to May 12, 2023. It includes vaccination records from a wide variety of reputable sources such as clinics, retail pharmacies, health care facilities, and federal facilities. The dataset contains detailed columns such as the date of vaccination reporting, demographic categories (age, sex, and ethnicity), total counts of people receiving at least one dose, completed primary series, and booster doses. It also provides percentages for these metrics, segmented by demographic categories, offering insights into the uptake of vaccinations among different population groups. Despite the extensive scope, the dataset has limitations, including potential data lags and the cessation of updates as of May 12, 2023. This pause in data updates can affect the timeliness and relevance of the information.
The data set is valuable for understanding vaccination patterns and addressing disparities in vaccine distribution. The detailed demographic breakdowns can help identify the distribution of vaccination by a particular demographic or combination of demographics. For our project in specific, this data set is useful for generating a visualization that shows the ethnic distribution of COVID vaccinations uptaken.
Khubchandani, J., Macias, Y. (2021). COVID-19 vaccination hesitancy in Hispanics and African-Americans: A review and recommendations for practice. Brain, Behavior, & Immunity - Health, 15, 100277.
This review article examines COVID-19 vaccine hesitancy among Hispanic and African-American populations in the United States. Khubchandani and Macias conducted a comprehensive review of nationwide studies from February 2020 to February 2021, resulting in the inclusion of 13 studies with a total of 107,841 participants. The authors aimed to quantify the extent of vaccine hesitancy and identify specific sociodemographic and cognitive factors influencing these attitudes within these minority groups.
The review reveals a significantly higher prevalence of COVID-19 vaccination hesitancy among African-Americans (41.6%) and Hispanics (30.2%) compared to the overall adult American population (26.3%). Key factors contributing to vaccine hesitancy include younger age, female gender, lower income and education levels, larger household size, medical mistrust, and exposure to myths and misinformation. Historical racial discrimination and concerns about vaccine safety, efficacy, and side effects further exacerbate hesitancy in these communities.
The authors highlight the disproportionate impact of the COVID-19 pandemic on racial and ethnic minorities, noting higher rates of hospitalization and mortality. They argue that addressing vaccine hesitancy in these groups is critical due to their higher risk and essential roles in the workforce. The article provides several recommendations for practice, such as enhancing trust through respectful and fact-based communication, involving local role models and faith leaders, and ensuring equitable access to vaccines.
The study's methodology involved thorough searches of PubMed, EBSCO Host, and Google Scholar, along with additional hand searches. Despite potential limitations, such as possible omissions of relevant articles and variations in study designs and samples, the review offers valuable insights into the multifaceted nature of vaccine hesitancy among minorities. The findings underscore the need for targeted interventions to improve vaccine uptake in socially disadvantaged populations.
Lillebråten, Andreas et al. “Socioeconomic status and disparities in COVID-19 vaccine uptake in Eastern Oslo, Norway.” Public health in practice (Oxford, England) vol. 5 (2023): 100391. doi:10.1016/j.puhip.2023.100391
This study looked at the influence of socioeconomic status on whether if a person took the COVID-19 vaccine or not in Norway. The study contained a total of 4000 individuals who were selected based on their response to a text message sent to the six Eastern Parishes in Oslo, Norway, and whether if they had been offered the COVID-19 vaccine. The initial text message had been sent out to around 57000 people, from which there was a 9.1% response rate. This was then further filtered down through the above mentioned category to yield the 4000 participants. Whether or not a person had received the vaccine was a binary metric, and it did not account for the number of doses that had been given. From this, the conclusion was formed that those in the above-low-income group had a higher likelihood of taking the vaccine as those in the low-income group. Similar finding had been presented in various countries including the US, UK and Israel. However, it is important to note that this association in Norway was only found among the 18-29 years age group. It was also concluded that in the lowest age group (18-29 years) there was a significantly higher chance of a person taking the vaccine from the higher income group than the lower income one and the higher education level group than the primary education group.
Mathieu, Edouard. "State-by-state data on COVID-19 vaccinations in the United States." Our World in Data, 16 Jan. 2021, https://ourworldindata.org/us-states-vaccinations
This webpage created by Edoubard Mathieu, Head of Data & Research at Our World in Data (an online publication based out of the University of Oxford), showcases a comprehensive resource for tracking COVID-19 vaccination progress across U.S. states. They gathered this data from counties and states that published their vaccination rate on a daily basis and the researchers at (OWD) inputted that information into a GitHub file.
The visualization tools and charts provided on the webpage allow their visitors to compare the state performances, and monitor the progress over time and the speed of the vaccination campaign. This ensures accountability and provides a reliable source of information for media reporting and public awareness. This is crucial for recognizing successful strategies and best practices from states with high vaccination rates. If, god forbid, a pandemic happens again, lagging states could implement the strategies and evaluate the effectiveness of different vaccination campaigns.
This research can contribute to pandemic preparedness by highlighting key factors that influence the vaccination rate, accessibility, and public perception of people who had concerns about it in the beginning. The information provided can guide the development of more efficient vaccination programs and policies, making sure that an effective response in future pandemics.
Na, Ling et al. “Racial and ethnic disparities in COVID-19 vaccine uptake: A mediation framework.” Vaccine vol. 41,14 (2023): 2404-2411. doi:10.1016/j.vaccine.2023.02.079
The study examines how socioeconomic disparities, clinical and psychological factors could have led to in disparities of COVID-19 vaccine uptake between races and ethnicities. The primary motivator behind the study was that it was previously noted that minorities were less confident towards the vaccine. To conduct this study, 6078 individuals were selected from the US from a national longitudinal survey. Following this, the study adjusted for various time-varying mediators which include: income, education, marital status, chronic health condition and psychological factors. It is interesting that they also mediated for perceived trust in vaccines and confidence in vaccine effectiveness, along with perceived risk for infection. The results suggested that without mediating for the aforementioned factors, Hispanic and Black Americans had a slower vaccine take-up rate than did White Americans, Asian Americans or Pacific Islanders. However, once these factors were taken into consideration and they were mediated for the rate was nearly the same. This suggests that the uptake rate of the COVID-19 vaccine is influenced by socioeconomic status, whether a person is chronically ill and other psychological factors. Racial and ethnic inequity to vaccines seems to arise when these factors are not controlled for. Therefore, to reduce this inequity, the causing forces behind these factors should be targeted with various policies.
Ndugga et al. "Latest Data on COVID-19 Vaccinations by Race/Ethnicity." KFF, Jul. 14, 2022, https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-by-race-ethnicity/#:~:text=Across%20the%2036%20states%20for,for%20Black%20people%20(59%25).
This article provides a dense amount of information regarding COVID-19 vaccinations within race. The relevant part of the information includes specific percentages of certain groups of people in the United States who have received COVID-19 vaccines, as this will allow us to identify trends and intuitively understand how vaccination has increased throughout time.
Nevertheless, the article refers to further links that include raw data, allowing us to formalize the given data into insightful visualizations that give more than just a simple intuitive understanding. More specifically, we are given data through downloadable files regarding specific percentages of vaccinations per race. With this information, observing another factor, being death rates by race due to COVID-19, an analysis regarding some correlation between vaccinations and death rates involving race can be made.
Bringing in other factors like socioeconomics can help explain why certain races received a percentage of vaccinations that were different from others, which can be due to accessibility.
Ultimately, performing this analysis can aid in identifying certain areas where public health interventions might be needed. Although the context of this scenario is in the past, looking back can be crucial to prepare for any similar occurrences that may occur in the future.
Onukwugha, Eberechukwu. “Valuing Diversity in Value Assessment: Introducing the PhRMA Foundation Health Disparities Challenge Award.” Journal of Managed Care & Specialty Pharmacy, U.S. National Library of Medicine, Sept. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC10408392/
The article "The effect of unobserved preferences and race on vaccination hesitancy for COVID-19 vaccines: implications for health disparities" examines the factors that different racial groups in the USA take into account when deciding whether to receive the COVID-19 vaccine.
This study was conducted by Eline M van den Broek-Altenburg, Adam J Atherly, Stephane Hess, and Jamie Benson, who seek to understand why blacks are actually affected by COVID-19 and have lower vaccination rates. They are conducting this analysis through a survey of residents of New York, California, Texas and Florida from August 10 to September 3, 2020.
The researchers used latent class analysis to identify and categorize factors that may have influenced people's decision to vaccinate. However, it was a surprise to find that people of color did not avoid the vaccine, but rather white people were very hesitant about it and might avoid it if they heard about problems that might arise.
Also, with this survey it was relatively evident how different factors could be driving different vaccination rates, such as a person's low income level or education level. People with these characteristics were mostly of color so they often had doubts about the effectiveness of vaccines.
This research primarily seeks to highlight the importance of developing more effective and equitable public health policies to improve vaccine acceptance. All this so that all people can clarify their doubts, and be more open to receive the vaccine regardless of race.
Persad G, Emanuel EJ, Sangenito S, Glickman A, Phillips S, Largent EA. Public Perspectives on COVID-19 Vaccine Prioritization. JAMA Netw Open. 2021;4(4):e217943. doi:10.1001/jamanetworkopen.2021.7943
This article explores public opinions on the prioritization of COVID-19 vaccine distribution in the United States. Persad et al. conducted two nationwide online surveys involving 4,735 US adults to gauge preferences regarding which groups should be prioritized for receiving the COVID-19 vaccine. The surveys were conducted by Gallup and the COVID Collaborative in September 2020, providing a comprehensive snapshot of public sentiment during a critical phase of the pandemic.
The study's methodology, involving weighted samples to reflect the sociodemographic characteristics of the US population, ensures robust and representative results. Older respondents were notably less likely than younger ones to prioritize healthy adults aged 65 and older. This finding contrasts with some policy recommendations that emphasize age-based prioritization.
The study found that health care workers and adults with serious comorbid conditions were overwhelmingly prioritized by respondents. Additionally, there was significant support across political affiliations for prioritizing racial and ethnic communities disproportionately affected by COVID-19. The article highlights the broad agreement with the National Academies of Science, Engineering, and Medicine’s framework for equitable vaccine allocation, suggesting that the public supports prioritizing essential workers and vulnerable communities over solely age-based prioritization.
Pratt, M., & Drummond, R. (2023, February 22). Updating ethnic and religious contrasts in deaths involving the coronavirus (covid-19), England: 24 January 2020 to 23 November 2022. Updating ethnic and religious contrasts in deaths involving the coronavirus (COVID-19), England: 4 January 2020 to 23 November 2022. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/updatingethniccontrastsindeathsinvolvingthecoronaviruscovid19englandandwales/24january2020to23november2022
This article references data collected from the Office for National Statistics in the UK, which may form part of the data visualizations I present later on in the project. This article responds to the Office’s article from earlier in the pandemic that previously revealed how non-White racial groups, such as Black and Asian people, experienced higher rates of death than White British people. At the time of this article’s publication last year, racial minorities no longer had higher rates of death, with White British men and women having higher mortality rates than their African counterparts, as well as then their Chinese and Caribbean counterparts in the case of men. Such trends offer a useful comparison between the US and the UK, as the health system in the UK is, in general, much more affordable and equitable. Yet, the earlier trend at the beginning of the pandemic exposed some of the ulterior priorities of the healthcare system in serving those in more privileged groups. While both the US and the UK thus experienced an exacerbation of social inequalities through the pandemic, no evidence like that mentioned in this article suggests that the US has recovered from its healthcare inequalities in the context of COVID-19. Also, this article mentions that Muslim men and women experienced notable decreases in mortality and, for the first time, did not have the highest COVID-19 mortality rate. Religion is a particularly important category leading to differential treatment that may not occur often in analysis, and Muslims in particular have received much discrimination in the UK and Europe. So, this article offers another angle to view discrimination in healthcare that may offer ideas on how to conduct a similar analysis in America that takes into account religion.
“Provisional Covid-19 Death Counts and Rates by Month, Jurisdiction of Residence, and Demographic Characteristics.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, data.cdc.gov/NCHS/Provisional-COVID-19-death-counts-and-rates-by-mon/yrur-wghw/about_data. Accessed 20 June 2024.
This source is titled “Provisional Covid-19 Death Counts and Rates by Month, Jurisdiction of Residence, and Demographic Characteristics,” and it is published by the National Center for Health Statistics (NCHS). It provides comprehensive data on COVID-19 death counts and rates categorized by month and year of death, jurisdiction of residence, and demographic characteristics such as sex, age and race. It is important to note that the reported death counts represent the total number of COVID-19 deaths received and coded as of the date of analysis and may not capture all deaths that occurred within a specific period due to reporting lags and processing delays. The document emphasizes the comparisons of death counts across jurisdictions should be avoided due to variations in data timeliness and reporting practices among states. It also provides information on how rates were calculated using population estimates for 2021.
This source serves as a valuable resource for understanding the impact of COVID-19 across different demographic groups and geographic regions, while also highlighting the complexities and challenges in reporting and interpreting COVID-19 mortality data. Furthermore, for our project, specifically, this source provides key demographic information regarding the ethnic background of the people that died from COVID-19, so this data can be used to create visualizations showing the ethnic distribution of COVID mortalities.
Subica, Andrew M., et al. “Assessing the impact of COVID-19 on the health of Native Hawaiian/Pacific Islander people in the United States, 2021.” Public Health Reports, vol. 138, no. 1, 16 Sept. 2022, pp. 164–173, https://doi.org/10.1177/00333549221123579.
This source is titled “Assessing the impact of COVID-19 on the health of Native Hawaiian/Pacific Islander people in the United States, 2021,” and it is published by the National Center for Biotechnology Information. It provides a look into how Native American and Pacific Islander populations are a widely understudied population, which means that their unique experiences with COVID-19 are correspondingly understudied.
Many datasets have more robust data on four main racial groups: White, Black, Asian, and Hispanic populations. Correspondingly, much of our analysis focused on these four racial groups, as we did not have much data to make conclusions on Native American and Pacific Islander populations. This reveals a structural issue in the composition of the dataset, which itself stemmed from other embedded societal biases, that were perpetuated in our project.
Thus, this source provides an interesting meta-analysis on the biases across racial groups in COVID-19 that are not only present through healthcare outcomes captured in data, but in the data itself (thus the "meta" in meta-analysis). This research paper provides valuable insight into future studies that may reflect on other ways Native Americans and Pacific Islander populations have been uniquely affected in healthcare, as well as how future scientific research and data collection can better capture these unique experiences.
"The COVID Tracking Project." The Atlantic, 2024, https://covidtracking.com/race.
This project provides an examination of existing racial disparities that result in unfavorable health outcomes. More specifically, the article proceeds with listing out dates that portray crucial information about such. For example, as of March 6, 2021, Black people in the United States experienced significantly higher death rates from COVID-19 compared to White people. Even American Indian people had relatively higher death rates.
This contrast highlights a significant disparity in accessibility to resources that greatly impacts health across multiple groups of people. As the scope of the information is within the United States, detailed information about each state is provided as well. That is beneficial to decision-makers, as states who are struggling with higher COVID-19 cases can adopt the measures that a relatively successful state is making in order to reduce negative impact.
Nevertheless, this does not take into account racial disparities. This is an issue, and thanks to the provided data, the impact on the population is prevalent, serving as a way to raise awareness about possible factors that result in such an issue. It is therefore clear why a project like this is necessary.
To continue spreading the message, the project has even provided datasets to allow users to derive their own analyses, allowing the possibility for new visualizations worth addressing.
The COVID Tracking Project. "The COVID Tracking Project." The COVID Tracking Project, https://covidtracking.com/
"Federal COVID Data 101: What We Know About Race and Ethnicity Data" is a COVID Tracking Project that offers an analysis of how COVID-19 has impacted various racial and ethnic groups in the United States. The website talks about the gaps and inconsistencies in the federal data collection and reporting processes, which includes examining the availability of the data on cases, deaths, testing, etc.
The website also mentions how some counties and states have made an effort midway through the pandemic to collect and report race and ethnicity data, hampering efforts to understand and mitigate the disproportionate impact on COVID-19.
This is important for our project because it allows us to see that not all data set available is accurate and reliable especially since most of them have not been looked back on and reviewed in extensive detail to see if there were discrepancies in the reporting process.
By understanding these inconsistencies in race and ethnic data collection related to COVID-19, we can better assess the real impact it had on different and marginalized groups. It’ll help us advocate for laws to address better data collection and reporting practices so that in the future we can have a better public health response.