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

项目摘要 本K 01提案的目的是为Alina Schnake-Mahl，ScD MPH提供受保护的时间， 资源，以追求额外的培训需要达到她的长期目标的独立学术 职业生涯在卫生政策和社会流行病学，侧重于产生证据，告知法律和政策， 减少传染病方面的卫生不公平现象。该提案建立在Schnake-Mahl博士作为一名 在卫生政策方面有专长社会流行病学家。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， COVID-19和流感差异的决定因素。超过878，000人因COVID住院治疗- 去年19日，每年有14万至71万人因流感住院。研究 发现COVID-19和流感之间存在很大差异，但在两者之间的相互作用方面仍然存在差距。 这些差异的社会决定因素。该项目采用多种多样的多学科方法， 研究差异的决定因素和政策风险对差异的影响。具体目标是： 1)使用多层次分析来描述流感的种族和地理差异的社会决定因素 和COVID-19在美国城市的结果; 2）使用非实验性因果推理方法来估计影响 PSL和租金控制法对美国城市流感和COVID-19结果的比率和差异的影响; 3）使用 基于代理的建模，以了解机制连接两个关键的社会决定因素，职业暴露 住房过度拥挤和流感不均衡。培训目标旨在提高技能， 通过传染病流行病学培训、政策分析的因果推理方法， 和系统方法，包括基于代理的建模。关于这一套补充办法的培训 将定位候选人在传染病差异领域进行创新研究，作为 未来的R 01拟议的工作有很大的潜力，使一个重大的公共卫生影响，因为这些 目标将促进我们对COVID-19和流感差异的社会决定因素的理解， 为可能解决这些不平等现象和减少贫困的政策和干预措施提供强有力的证据基础。 COVID-19和流感的总体负担。此外，该K 01开发了特定的主题领域（传染性 疾病）和方法（政策分析和系统动力学的高级因果推理）的专业知识， 延伸至其他传染病表明适用范围超出了本建议的范围。拟议 工作是可行的和现实的奖励期内，将允许博士Schnake-Mahl继续建设 研究技能，扩展专业网络，产生大量出版物，并与其他NIH竞争 经费总而言之，K 01奖将支持及激励陈博士的职业发展活动。 Schnake Mahl并允许她成功地进入她作为独立职业生涯的下一阶段 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.