Background: Food insecurity research has been mainly examined among young people. The root causes of food insecurity are closely linked to poverty, and social policies and income supplements, including public and private pensions, have been shown to sharply curb food insecurity into later life. However, social, economic, and political trends that are closely connected to social and health inequalities threaten to undermine the conditions that have limited food insecurity among older people until now. Exploring the prevalence and predictors of food insecurity among older people across Canada has important implications for domestic policies concerning health, healthcare, and social welfare. Methods: Data come from the Canadian Community Health Survey 2012 Annual Component (n = 14,890). Descriptive statistics and a generalized linear model approach were used to determine prevalence and estimate the associations between food insecurity—as measured by the Household Food Security Survey Module—and social, demographic, geographic, and economic factors. Results: Approximately 2.4% of older Canadians are estimated to be moderately or severely food insecure. Income was by far the strongest predictor of food insecurity (total household income <$20,000 compared to >$60,000, OR: 46.146, 95% CI: 12.523–170.041, p < 0.001). Younger older people, and those with a non-white racial background also had significantly greater odds of food insecurity (ages 75+ compared to 65–74, OR: 0.322, 95% CI: 0.212–0.419, p < 0.001; and OR: 2.429, 95% CI: 1.438–4.102, p < 0.001, respectively). Sex, home ownership, marital status, and living arrangement were all found to confound the relationship between household income and food insecurity. Prevalence of food insecurity varied between provinces and territories, and odds of food insecurity were approximately five times greater for older people living in northern Canada as compared to central Canada (OR: 5.189, 95% CI: 2.329–11.562, p < 0.001). Conclusion: Disaggregating overall prevalence of food insecurity among older people demonstrates how disparities exist among sub-groups of older people. The seemingly negligible existence of food insecurity among older people has obscured the importance, practicality, and timeliness of including this age group in research on food insecurity. The current research underscores the critical importance of an income floor in preventing food insecurity among older people, and contributes a Canadian profile of the prevalence and predictors of food insecurity among older people to the broader international literature.

Community-level seroprevalence surveys are needed to determine the proportion of the population with previous SARS-CoV-2 infection, a necessary component of COVID-19 disease surveillance. In May, 2020, we conducted a cross-sectional seroprevalence study of IgG antibodies for nucleocapsid of SARS-CoV-2 among the residents of Blaine County, Idaho, a ski resort community with high COVID-19 attack rates in late March and Early April (2.9% for ages 18 and older). Participants were selected from volunteers who registered via a secure web link, using prestratification weighting to the population distribution by age and gender within each ZIP Code. Participants completed a survey reporting their demographics and symptoms; 88% of volunteers who were invited to participate completed data collection survey and had 10 ml of blood drawn. Serology was completed via the Abbott Architect SARS-CoV-2 IgG immunoassay. Primary analyses estimated seroprevalence and 95% credible intervals (CI) using a hierarchical Bayesian framework to account for diagnostic uncertainty. Stratified models were run by age, sex, ZIP Code, ethnicity, employment status, and a priori participant-reported COVID-19 status. Sensitivity analyses to estimate seroprevalence included base models with post-stratification for ethnicity, age, and sex, with or without adjustment for multi-participant households. IgG antibodies to the virus that causes COVID-19 were found among 22.7% (95% CI: 20.1%, 25.5%) of residents of Blaine County. Higher levels of antibodies were found among residents of the City of Ketchum 34.8% (95% CI 29.3%, 40.5%), compared to Hailey 16.8% (95%CI 13.7%, 20.3%) and Sun Valley 19.4% (95% 11.8%, 28.4%). People who self-identified as not believing they had COVID-19 had the lowest prevalence 4.8% (95% CI 2.3%, 8.2%). The range of seroprevalence after correction for potential selection bias was 21.9% to 24.2%. This study suggests more than 80% of SARS-CoV-2 infections were not reported. Although Blaine County had high levels of SARS-CoV-2 infection, the community is not yet near the herd immunity threshold.

Life expectancy has increased in the United States over many decades. The difference in life expectancy between black and white Americans has also decreased, but some states have made much more progress towards racial equality than others. This paper describes the pattern of contributions of six major causes of death to the black-white life expectancy gap within US states and the District of Columbia between 1969 and 2013, and identifies states diverging from the overall pattern. Across multiple causes, the District of Columbia, Illinois, Wisconsin, and Michigan had the highest contributions to black-white inequality, while New York, Massachusetts, and Rhode Island had the lowest contributions and have either achieved or are the closest to achieving black-white equality in life expectancy.

No abstract

We estimated the speed of Zika virus introduction in Brazil by using confirmed cases at the municipal level. Our models indicate a southward pattern of introduction starting from the northeastern coast and a pattern of movement toward the western border with an average speed of spread of 42 km/day or 15,367 km/year.

Background Indoor residual spraying (IRS) is widely used as a vector control measure, although there are conflicting findings of its effectiveness in reducing malaria incidence. The objective of this study was to estimate the effect of multiple IRS rounds on malaria incidence and hemoglobin levels in a cohort of children in rural southeastern Uganda. Methods The study was based upon a dynamic cohort of children aged 0.5–10 years enrolled from August 2011 to June 2017 in Nagongera Subcounty. Confirmed malaria infections and hemoglobin levels were recorded over time for each participant. After each of 4 rounds of IRS, malaria incidence, hemoglobin levels, and parasite density were evaluated and compared with pre-IRS levels. Analyses were carried out at the participant level while accounting for repeated measures and clustering by household. Results Incidence rate ratios comparing post-IRS to pre-IRS incidence rates for age groups 0–3, 3–5, and 5–11 were 0.108 (95% confidence interval [CI], .078–.149), 0.173 (95% CI, .136–.222), and 0.226 (95% CI, .187–.274), respectively. The mean hemoglobin levels significantly increased from 11.01 (pre-IRS) to 12.18 g/dL (post-IRS). Conclusions Our study supports the policy recommendation of IRS usage in a stable and perennial transmission area to rapidly reduce malaria transmission.

No abstract

No abstract