5 research outputs found
Habitabilidad y pol铆tica de vivienda
En esta obra, en la que participan destacados investigadores y profesores, dedicados al estudio de la problem谩tica habitacional se presentan diferentes an谩lisis que permiten conocer cuales son las condiciones de habitabilidad y las caracter铆sticas de la actual pol铆tica de vivienda de M茅xico.
En sus cap铆tulos se abordan los principales desaf铆os que enfrentan las familias mexicanas para acceder a una vivienda digna y decorosa y cuales son los retos econ贸micos, pol铆ticos, territoriales, arquitect贸nicos, ambientales, financieros y culturales de las formas de producci贸n habitacional en M茅xico y en otros pa铆ses, en el marco de una sociedad global
Environmental and societal factors associated with COVID-19-related death in people with rheumatic disease: an observational study
Published by Elsevier Ltd.Background: Differences in the distribution of individual-level clinical risk factors across regions do not fully explain the observed global disparities in COVID-19 outcomes. We aimed to investigate the associations between environmental and societal factors and country-level variations in mortality attributed to COVID-19 among people with rheumatic disease globally.
Methods: In this observational study, we derived individual-level data on adults (aged 18-99 years) with rheumatic disease and a confirmed status of their highest COVID-19 severity level from the COVID-19 Global Rheumatology Alliance (GRA) registry, collected between March 12, 2020, and Aug 27, 2021. Environmental and societal factors were obtained from publicly available sources. The primary endpoint was mortality attributed to COVID-19. We used a multivariable logistic regression to evaluate independent associations between environmental and societal factors and death, after controlling for individual-level risk factors. We used a series of nested mixed-effects models to establish whether environmental and societal factors sufficiently explained country-level variations in death.
Findings: 14 044 patients from 23 countries were included in the analyses. 10 178 (72路5%) individuals were female and 3866 (27路5%) were male, with a mean age of 54路4 years (SD 15路6). Air pollution (odds ratio 1路10 per 10 渭g/m3 [95% CI 1路01-1路17]; p=0路0105), proportion of the population aged 65 years or older (1路19 per 1% increase [1路10-1路30]; p<0路0001), and population mobility (1路03 per 1% increase in number of visits to grocery and pharmacy stores [1路02-1路05]; p<0路0001 and 1路02 per 1% increase in number of visits to workplaces [1路00-1路03]; p=0路032) were independently associated with higher odds of mortality. Number of hospital beds (0路94 per 1-unit increase per 1000 people [0路88-1路00]; p=0路046), human development index (0路65 per 0路1-unit increase [0路44-0路96]; p=0路032), government response stringency (0路83 per 10-unit increase in containment index [0路74-0路93]; p=0路0018), as well as follow-up time (0路78 per month [0路69-0路88]; p<0路0001) were independently associated with lower odds of mortality. These factors sufficiently explained country-level variations in death attributable to COVID-19 (intraclass correlation coefficient 1路2% [0路1-9路5]; p=0路14).
Interpretation: Our findings highlight the importance of environmental and societal factors as potential explanations of the observed regional disparities in COVID-19 outcomes among people with rheumatic disease and lay foundation for a new research agenda to address these disparities.MAG is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant numbers K01 AR070585 and K24 AR074534 [JY]). KDW is supported by the Department of Veterans Affairs and the Rheumatology Research Foundation Scientist Development award. JAS is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant numbers K23 AR069688, R03 AR075886, L30 AR066953, P30 AR070253, and P30 AR072577), the Rheumatology Research Foundation (K Supplement Award and R Bridge Award), the Brigham Research Institute, and the R. Bruce and Joan M. Mickey Research Scholar Fund. NJP is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (T32-AR-007258). AD-G is supported by grants from the Centers for Disease Control and Prevention and the Rheumatology Research Foundation. RH was supported by the Justus-Liebig University Giessen Clinician Scientist Program in Biomedical Research to work on this registry. JY is supported by grants from the National Institutes of Health (K24 AR074534 and P30 AR070155).info:eu-repo/semantics/publishedVersio