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While the repercussions of the novel Coronavirus or COVID-19 have been felt across the world over the past few years, the impact has not been consistent. Instead, it has been mediated by the systemic ways in which existing social and structural disparities have failed vulnerable populations globally. Drawing on document analysis and fifteen in-depth interviews (n=15) conducted among the key stakeholders in the city of San Antonio, South Central Texas, this paper reveals how structural violence worsened during the COVID-19 pandemic resulting in making it a syndemic pandemic of high rates of deaths and illnesses among the most vulnerable and disadvantaged groups. A grounded theory approach particularly revealed themes of social suffering such as low income and pre-existing medical conditions that contributed to higher mortality rates, the presence of racism and misinformation, the importance of trustworthy communication channels, and streamlined collaborative partnerships with clear and effective communication through all levels of the government, especially when communicating scientific information. [ABSTRACT FROM AUTHOR]

The research team developed a community-based, intergenerational intervention, the Spanish-language Healthy Buddy Program to alleviate transportation barriers experienced by Latinx older adults. College students were paired with Latinx older adults and helped them identify transportation- and health-related resources in their communities. During COVID-19, the program was implemented in Hillsborough County, Florida, and Dallas-Fort Worth Metroplex and San Antonio, Texas. This paper reports the study process and outcomes using quantitative and qualitative data collected in Texas (n = 25). Individual interviews indicated older adult participants were receptive to the program model and appreciated the roles student buddies played to help improve their mobility. [ABSTRACT FROM AUTHOR]

Purpose: The Joint Committee on Infant Hearing recommends hearing screening before 1 month of age, audiologic diagnosis before 3 months of age, and enrollment in early intervention before 6 months of age (1-3-6 benchmarks of Early Hearing Detection and Intervention [EHDI] programs). Nearly 98% of newborns have their hearing screened, but many, who do not pass or do not complete their newborn hearing screening, fail to complete the EHDI process. Historically, lower socioeconomic level, more complex infant health status, and farther geographical location reduce rates of EHDI follow-up, but levels vary widely across states. This study examined barriers to the EHDI process by comparing census-based variables at the state and regional levels to national and Texas EHDI outcomes, respectively. Method: We used correlational analysis to assess relationships between U.S. Census data (state- and region-specific population and geographic characteristics, sociodemographic and geographic factors, and health and health insurance) and EHDI data (newborn screening, audiologic diagnosis, and early intervention) at the national level and in Texas. Results: Nationally, higher labor force participation, lower unemployment rates, and presence of health insurance significantly correlated with higher rates of completing EHDI benchmarks. Larger population size and density and higher socioeconomic factors coincided with higher rates of completing the EHDI process and lower rates of loss to follow-up (LTF) or loss to documentation in Texas. Conclusions: Population, socioeconomic, and demographic factors significantly correlate with following through with the EHDI process, with weak correlations at the national level and strong correlations at the state level. These findings underscore the need to increase our attention to underserved, economically challenged, and/or geographically distanced families who have children with a higher risk of becoming LTF in the EHDI process. [ABSTRACT FROM AUTHOR]

Introduction: Pediatric patients account for 6-10% of emergency medical services (EMS) activations in the United States. Approximately 30% of these children are not transported to an emergency department (ED). Adult data in the literature reports higher hospitalization and complications following non-transport. Few studies discuss epidemiology and characteristics of pediatric non-transport; however, data on outcome is limited. Our primary aim was to determine outcomes of non-transported children within our urban EMS system before and during the COVID-19 pandemic. Our secondary objective was to explore reasons for non-transport. Methods: This was a prospective, descriptive pilot study. We compared EMS data for September 2019 (pre-COVID-19) to September 2020 (pandemic). Included were children aged 0-17 years who activated EMS and did not receive transport to the primary hospital for the EMS capture area. We defined outcomes as repeat EMS activation, ED visits, and hospital admissions, all within 72 hours. Data was obtained via electronic capture. We used descriptive statistics to analyze our data, chi square for categorical data, stepwise logistic regression, and univariate logistic regression to test for association of covariates with non-transport. Results: There were 1,089 pediatric EMS activations in September 2019 and 780 in September 2020. Non-transport occurred in 633 (58%) in September 2019 and 412 (53%) in September 2020. Emergency medical services was reactivated within 72 hours in the following: 9/633 (1.4%) in 2019; and 5/412 (1.2%) in 2020 (P = 0.77). Visits to the ED occurred in 57/633 (9%) in 2019 and 42/412 (10%) in 2020 (P = 0.53). Hospital admissions occurred in 10/633 (1.5%) in 2019 and 4/412 (0.97%) in 2020 (P = 0.19). One non-transported patient was admitted to the intensive care unit in September 2020 (<1%) and survived. Hispanic ethnicity, age >12 years, and fever were associated with repeat EMS activation. The most common reason for non-transport in both study periods was that the parent felt an ambulance was not necessary (47%). Conclusion: In our system, non-transport of pediatric patients occurred in >50% of EMS activations with no significant adverse outcome. Age >12 years, fever, and Hispanic ethnicity were more common in repeated EMS activations. The most common reason for non-transport was parents feeling it was not necessary. Future studies are needed to develop reliable EMS guidelines for pediatric non-transport. [ABSTRACT FROM AUTHOR]