Access to COVID-19 testing by individuals with housing insecurity during the early days of the COVID-19 pandemic in the United States: a scoping review.
Date
2023-01
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Abstract
Introduction
The COVID-19 pandemic focused attention on healthcare disparities and inequities faced by individuals within marginalized and structurally disadvantaged groups in the United States. These individuals bore the heaviest burden across this pandemic as they faced increased risk of infection and difficulty in accessing testing and medical care. Individuals experiencing housing insecurity are a particularly vulnerable population given the additional barriers they face. In this scoping review, we identify some of the barriers this high-risk group experienced during the early days of the pandemic and assess novel solutions to overcome these barriers.Methods
A scoping review was performed following PRISMA-Sc guidelines looking for studies focusing on COVID-19 testing among individuals experiencing housing insecurity. Barriers as well as solutions to barriers were identified as applicable and summarized using qualitative methods, highlighting particular ways that proved effective in facilitating access to testing access and delivery.Results
Ultimately, 42 studies were included in the scoping review, with 143 barriers grouped into four categories: lack of cultural understanding, systemic racism, and stigma; medical care cost, insurance, and logistics; immigration policies, language, and fear of deportation; and other. Out of these 42 studies, 30 of these studies also suggested solutions to address them.Conclusion
A paucity of studies have analyzed COVID-19 testing barriers among those experiencing housing insecurity, and this is even more pronounced in terms of solutions to address those barriers. Expanding resources and supporting investigators within this space is necessary to ensure equitable healthcare delivery.Type
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Publication Info
Johannesson, Jon M, William A Glover, Cathy A Petti, Timothy H Veldman, Ephraim L Tsalik, Donald H Taylor, Stephanie Hendren, Coralei E Neighbors, et al. (2023). Access to COVID-19 testing by individuals with housing insecurity during the early days of the COVID-19 pandemic in the United States: a scoping review. Frontiers in public health, 11. p. 1237066. 10.3389/fpubh.2023.1237066 Retrieved from https://hdl.handle.net/10161/29286.
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Scholars@Duke
Donald H. Taylor
Don Taylor is a health policy scholar who has studied rural health, identification of underserved areas, and the economics of smoking and cessation. For the past 20 years his work has focused on how society cares for the elderly and to what effect on individuals, families, public programs and inter-generational wealth. More recently he has focused on archival research methods that help to illustrate the role of Race in our history—individual, institutional, national. An emerging interest is consideration of how visual art and fiction might be more effective at making inequality of various types unacceptable culturally in a way that is more effective than data based and more traditional public policy-based appeals. All three of his degrees (Ph.D., Public Health, Health Policy and Management, 1995) are from the University of North Carolina at Chapel Hill. Taylor serves as the Director of the Social Science Research Institute (since 2019) and served two years as the elected leader of the Duke Faculty in the role of the Chair of the Academic Council (2017-19).
Coralei Neighbors
Coralei Neighbors is a second-year Ph.D. candidate in Population Health Sciences at Duke University School of Medicine. Her research focuses on the intersection of infectious diseases, health economics, and global health policy. With a strong foundation in epidemiology and disease surveillance, gained through a Bachelor of Science from Baylor University and a Master of Science in Global Health from Duke University, Coralei has experience in tackling global health challenges through a dual lens of scientific inquiry and policy analysis.
Her research encompasses infectious disease surveillance, economic modeling, and policy evaluation. With experience in both national and international settings, she is currently contributing to infectious disease surveillance initiatives and developing models to assess the economic impact and sustainability of vaccines and other health interventions in diverse populations. Coralei's work aims to inform the development of evidence-based policies to improve global health outcomes.
Gayani Tillekeratne
Global health
Antimicrobial resistance/ stewardship
Acute respiratory tract infections
Emerging infections/ dengue
Warren Alden Kibbe
Warren A. Kibbe, PhD, is chief for Translational Biomedical Informatics in the Department of Biostatistics and Bioinformatics and Chief Data Officer for the Duke Cancer Institute. He joined the Duke University School of Medicine in August after serving as the acting deputy director of the National Cancer Institute (NCI) and director of the NCI’s Center for Biomedical Informatics and Information Technology where he oversaw 60 federal employees and more than 600 contractors, and served as an acting Deputy Director for NCI. As an acting Deputy Director, Dr. Kibbe was involved in the myriad of activities that NCI oversees as a research organization, as a convening body for cancer research, and as a major funder of cancer research, funding nearly $4B US annually in cancer research throughout the United States.
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