Social and policy determinants and impacts on COVID-19 and influenza disparities

项目总结 此K01提案的目的是为Alina Schnake-Mahl，ScD mph提供保护时间和 资源，以继续进行所需的额外培训，以实现她成为独立学者的长期目标 从事卫生政策和社会流行病学，专注于产生证据，为法律和政策提供信息 减少传染病方面的健康不平等现象。这项提议是建立在施纳克-马尔博士作为 在卫生政策方面有专业知识的社会流行病学家。它还利用了她在应用医疗保健方面的经验 研究和评估，以及一个有凝聚力的导师团队，以提高我们对社会的理解 新冠肺炎和流感差异的决定因素。已有超过87.8万人因新冠肺炎入院治疗- 19去年，每年有14万到71万人因流感住院。研究表明， 在新冠肺炎和流感方面发现了巨大的差异，但在两者之间的相互作用方面仍然存在差距 这些差距的社会决定因素。该项目使用多样化和多学科方法来 审查差异的决定因素以及政策暴露对差异的影响。具体目标是： 1)使用多水平分析来描述流感的种族和地理差异的社会决定因素 和新冠肺炎在美国城市的结果；2)使用非实验因果推理方法估计影响 关于美国城市流感和新冠肺炎结果的比率和差异的PSL和租金管制法律；3)使用 基于代理的建模，以了解职业暴露这两个关键社会决定因素之间的联系机制 和住房过度拥挤，以及流感差距。培训目标旨在扩大技能和 通过培训获得传染病流行病学知识、用于政策分析的随意推理方法、 以及系统方法，包括基于代理的建模。在这套互补方法中进行培训 将使候选人在传染病差异领域进行创新研究，作为 未来的R01。拟议的工作有很大的潜力对公共卫生产生重大影响，因为 AIMS将促进我们对新冠肺炎和流感差异的社会决定因素的理解 为政策和干预措施提供强有力的证据基础，以解决这些不平等并减少 新冠肺炎和流感的总体负担。此外，这本K01开发了特定的主题领域(传染性 疾病)和方法(用于政策分析和系统动力学的高级因果推理)的专门知识 延伸到其他传染病表明适用范围超出了本提案的范围。建议数 在获奖期内的工作是可行的和现实的，并将允许Schnake-Mahl博士继续建立 研究技能，扩展专业网络，出版大量出版物，并与其他NIH竞争 资金问题。综上所述，这一K01奖项将支持和激励博士的职业发展活动。 并允许她成功地进入她职业生涯的下一个阶段，成为一名独立的 调查员。

PROJECT SUMMARY The purpose of this K01 proposal is to provide Alina Schnake-Mahl, ScD MPH with the protected time and resources to pursue the additional training needed to reach her long-term goal of an independent academic career in health policy and social epidemiology, focused on generating evidence to inform law and policies that reduce health inequities in infectious diseases. This proposal builds on Dr. Schnake-Mahl’s background as a social epidemiologist with expertise in health policy. It also leverages her experience with applied health care research and evaluation, and a cohesive mentorship team, to improve our understanding of the social determinants of COVID-19 and influenza disparities. Over 878,000 people have been hospitalized for COVID- 19 over the last year, and between 140,000 to 710,000 people are hospitalized for flu annually. Studies have found wide disparities in COVID-19 and influenza, but gaps remain with respect to the interactions between the social determinants of these disparities. This project uses diverse and multi-disciplinary approaches to examine the determinants of disparities and effects of policy exposures on disparities. The specific aims are to: 1) use multilevel analysis to describe the social determinants of racial and geographic disparities in influenza and COVID-19 outcomes in US cities; 2) use non-experimental causal inference methods to estimate the effect of PSL and rent control laws on rates and disparities of influenza and COVID-19 outcomes in US cities; 3) use agent based modeling to understand mechanisms linking two key social determinants, occupational exposures and housing overcrowding, and influenza disparities. The training goals are designed to expand skills and knowledge through training in infectious disease epidemiology, casual inference methods for policy analysis, and systems approaches including agent-based modeling. Training in this set of complementary approaches will position the candidate to pursue innovative research in the area of infectious disease disparities as part of a future R01. The proposed work has substantial potential to make a significant public health impact as these aims will advance our understanding of the social determinants of COVID-19 and influenza disparities and provide a strong evidence-base for policies and interventions that may address these inequities and reduce the overall burden of COVID-19 and influenza. Furthermore, this K01 develops specific topic area (infectious disease) and methods (advanced causal inference for policy analysis and systems dynamics) expertise whose extension to other infectious disease indicates applicability beyond the scope of this proposal. The proposed work is feasible and realistic within the award period and will allow Dr. Schnake-Mahl to continue to build research skills, extend professional networks, generate numerous publications, and compete for other NIH funding. In summary, this K01 award will support and stimulate the career development activities of Dr. Schnake Mahl and allow her to successfully move into the next phase of her career as an independent investigator.