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Structural racism drives higher COVID-19 death rates in Louisiana, study finds

COLLEGE PARK, MARYLAND–Disproportionately high COVID-19 mortality rates among Black populations in Louisiana parishes are the result of longstanding…

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COLLEGE PARK, MARYLAND–Disproportionately high COVID-19 mortality rates among Black populations in Louisiana parishes are the result of longstanding health vulnerabilities associated with institutional and societal discrimination, according to research conducted by an interdisciplinary team under the mentorship of University of Maryland (UMD) Clark Distinguished Chair Deb Niemeier and UMD Associate Professor of Kinesiology Jennifer D. Roberts in the School of Public Health. 

Credit: Guangxiao Hu, Nora Hamovit, Kristen Croft, Jennifer D. Roberts, and Deb Niemeier, University of Maryland.

COLLEGE PARK, MARYLAND–Disproportionately high COVID-19 mortality rates among Black populations in Louisiana parishes are the result of longstanding health vulnerabilities associated with institutional and societal discrimination, according to research conducted by an interdisciplinary team under the mentorship of University of Maryland (UMD) Clark Distinguished Chair Deb Niemeier and UMD Associate Professor of Kinesiology Jennifer D. Roberts in the School of Public Health. 

The team included doctoral students from three different programs at UMD, working together as part of an interdisciplinary fellowship program known as UMD Global STEWARDS, directed by Professor Amy R. Sapkota of the School of Public Health.

“Our results suggest that structural racism and inequities led to severe disparities in initial COVID-19 effects among highly populated Black Louisiana communities, and that as the virus moved into less densely populated Black communities, similar trends emerged,” the researchers concluded in a study published in the Proceedings of the National Academy of Sciences on Monday, June 27. 

Over the course of generations, discrimination in employment, education, housing, and access to medical care has led to higher risks of chronic illnesss (including asthma, diabetes, and obesity) among Black communities, as well as a higher likelihood of suffering a stroke, the authors noted. The Centers for Disease Control and Prevention (CDC) have linked these factors to the likelihood of becoming severely ill from COVID-19.

Both nationally and in Louisiana, Black communities encounter inadequate housing and lower rates of home ownership, reduced access to health care, and lower rates of employment. As exemplified by Cancer Alley, Black families are more likely to live in so-called “fence-line” neighborhoods, located near industrial facilities that expose them to pollutants, and typically encounter reduced air and water quality compared to white Americans. Black families are also more likely to be uninsured and face higher rates of unemployment. These and multiple other factors, all reflecting decades of institutional and societal bias, add up to a combination of stressors that undermine health and, in the case of COVID-19, have made Black communities particularly vulnerable.

To obtain their findings, the team members identified the spatial distribution of social and environmental stressors across Louisiana parishes, and used hotspot analyses to develop aggregate stressors. They then tracked the correlations among stressors, cumulative health risks, COVID-19 mortality rates, and the size of Black populations across Louisiana. The results suggest that COVID-19 mortality rates initially spiked in Black communities with high population densities and moderate levels of aggregate stress. Over time, the rates also increased in less densely populated Black communities with higher levels of aggregate stress.

“We find that Black communities in Louisiana parishes with both higher and lower population densities experience higher levels of stressors leading to greater COVID-19 mortality rates,” the researchers wrote. “Our work using the COVID-19 pandemic, particularly as observed in Louisiana, makes clear that communities with high levels of social, economic, and environmental racism are significantly more vulnerable to a public health crisis.”

The study lead authors include UMD graduate students Kristen Croft (Department of Civil and Environmental Engineering). Nora Hamovit (Department of Biology), and Guangxiao Hu (Department of Geographical Sciences), who worked together on the study as part of the UMD Global STEWARDS (STEM Training at the Nexus of Energy, WAter Reuse and FooD Systems) training fellowship program, which is funded by the National Science Foundation (NSF).

Allen P. Davis, Professor of Civil and Environmental Engineering, is a co-PI for the UMD STEWARDS program, which aims to bring together graduate students from a wide variety of backgrounds to work on collaborative projects. “Each student brings their own area of expertise to the table, resulting in synergy,” Davis said. “That kind of synergy is something you might not get in other disciplinary studies.”

The value of such an approach was evident in the collaboration among the three students.  “As a human geographer, my main focus was on the spatial disparities of structural racism and inequities and their effects on COVID-19 mortalities,” Hu said. “Using hotspot analysis, we identified two groups of parishes with high or low population densities located at different regions of Louisiana. Our research provides policy makers with very useful insights about the disproportionate burden of Black communities and the nonstationary distribution of this disproportion across Louisiana.”

Hamovit performed the initial data analysis that yielded stressor index calculations, which Hu then utilized for hotspot analysis. “Because my PhD research involves large and complex data sets I brought a strength of data organization and analysis to our team,” Hamovit said. Croft played a key role in defining the research topic and utilized her background in stormwater research to pinpoint specific variables that could have a bearing on health. 

Faculty mentors included Niemeier and Roberts. Niemeier, who joined the UMD civil and environmental engineering faculty in 2019 as the inaugural Clark Distinguished Chair, is an internationally-recognized expert on the equity impacts of infrastructure and engineering decisions. She is a member of the National Academy of Engineering and, in 2021, was elected to the American Philosophical Society. Her work, which details how marginalized communities are affected by vehicle emissions, development patterns, climate change, and approaches to disaster preparation and recovery, has helped spur policy and regulatory reforms.

Roberts is founder and director of the  Public Health Outcomes and Effects of the Built Environment Laboratory at UMD. She is also co-founder and co-director of NatureRx@UMD. Her scholarship focuses on the impact of built, social and natural environments, including the institutional and structural inequities of these environments, on physical activity and public health outcomes of marginalized communities. Roberts was recently named to the National Academy of Science’s Response and Resilient Recovery Strategic Science Initiative Strategy Group on COVID-19 and Ecosystem Service in the Built Environment.

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International

Apple Reportedly Shifting Watch And MacBook Production To Vietnam

Apple Reportedly Shifting Watch And MacBook Production To Vietnam

Wary of soaring tensions surrounding out-of-favor countries like China,…

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Apple Reportedly Shifting Watch And MacBook Production To Vietnam

Wary of soaring tensions surrounding out-of-favor countries like China, multinational corporations such as Apple are diversifying production to places with less geopolitical risk.

Nikkei Asia spoke to three sources with direct knowledge of Apple's plans to shift Watch and MacBook production out of China to Vietnam for the first time. 

Apple suppliers Luxshare Precision Industry and Foxconn have already piloted a production run of the Watch in northern Vietnam. 

The move by Apple is a further win for the Southeast Asian country as it already produces iPads and AirPods. 

Two sources told Nikkei Asia that Apple had requested suppliers to set up a MacBook test production line in Vietnam. They said progress in constructing laptop production in the country has been "slow, partly due to pandemic-related disruptions but also because notebook computer production involves a larger supply chain."  

"AirPods, Apple Watch, HomePod and more ... Apple has big plans in Vietnam, apart from iPhone manufacturing," one of the people with direct knowledge of Apple's plans said. "The components for MacBooks have become more modularized than in the past, which makes it easier to produce the laptops outside of China. But how to make it cost-competitive is another challenge."

This trend is called "friendshoring." While it's a play on "offshoring," this isn't about companies moving operations back to the US and Europe, but rather seeking foreign alternatives that retain the benefit of low labor costs but with less international controversy. 

Apple's production diversification comes as the US and China already had an increasingly adversarial relationship before House Speaker Nancy Pelosi's visit to Taiwan sparked anger with Beijing. The fact is, geopolitical and trade war tensions aren't going away anytime soon and will only push Apple further away from China. Though reshoring production to the US is unfeasible because of labor costs, maybe robotics can offset some of those costs or perhaps set up shop in Mexico, where there's abundant cheap labor and healthy demographics. 

A recent Rabobank analysis of friendshoring showed that chief beneficiaries would include countries like Vietnam, India, Brazil, Bangladesh, Indonesia, Mexico, Turkey, Egypt, and South Africa.

Apple's Tim Cook appears to have learned a valuable lesson this year that high exposure of supply chains to China during Beijing's zero-Covid policies and worsening geopolitical tensions with the West is a dangerous cocktail, and the need to diversify production in a trend dubbed friendshoring is essential for survival in a multi-polar world. 

Tyler Durden Wed, 08/17/2022 - 18:30

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International

Apple Reportedly Shifting Apple Watch And MacBook Production To Vietnam

Apple Reportedly Shifting Apple Watch And MacBook Production To Vietnam

Wary of soaring tensions surrounding out-of-favor countries like China,…

Published

on

Apple Reportedly Shifting Apple Watch And MacBook Production To Vietnam

Wary of soaring tensions surrounding out-of-favor countries like China, multinational corporations such as Apple are diversifying production to places with less geopolitical risk.

Nikkei Asia spoke to three sources with direct knowledge of Apple's plans to shift Watch and MacBook production out of China to Vietnam for the first time. 

Apple suppliers Luxshare Precision Industry and Foxconn have already piloted a production run of the Watch in northern Vietnam. 

The move by Apple is a further win for the Southeast Asian country as it already produces iPads and AirPods. 

Two sources told Nikkei Asia that Apple had requested suppliers to set up a MacBook test production line in Vietnam. They said progress in constructing laptop production in the country has been "slow, partly due to pandemic-related disruptions but also because notebook computer production involves a larger supply chain."  

"AirPods, Apple Watch, HomePod and more ... Apple has big plans in Vietnam, apart from iPhone manufacturing," one of the people with direct knowledge of Apple's plans said. "The components for MacBooks have become more modularized than in the past, which makes it easier to produce the laptops outside of China. But how to make it cost-competitive is another challenge."

This trend is called "friendshoring." While it's a play on "offshoring," this isn't about companies moving operations back to the US and Europe, but rather seeking foreign alternatives that retain the benefit of low labor costs but with less international controversy. 

Apple's production diversification comes as the US and China already had an increasingly adversarial relationship before House Speaker Nancy Pelosi's visit to Taiwan sparked anger with Beijing. The fact is, geopolitical and trade war tensions aren't going away anytime soon and will only push Apple further away from China. Though reshoring production to the US is unfeasible because of labor costs, maybe robotics can offset some of those costs or perhaps set up shop in Mexico, where there's abundant cheap labor and healthy demographics. 

A recent Rabobank analysis of friendshoring showed that chief beneficiaries would include countries like Vietnam, India, Brazil, Bangladesh, Indonesia, Mexico, Turkey, Egypt, and South Africa.

Apple's Tim Cook appears to have learned a valuable lesson this year that high exposure of supply chains to China during Beijing's zero-Covid policies and worsening geopolitical tensions with the West is a dangerous cocktail, and the need to diversify production in a trend dubbed friendshoring is essential for survival in a multi-polar world. 

Tyler Durden Wed, 08/17/2022 - 18:30

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Economics

Reduced myocardial blood flow is new clue in how COVID-19 is impacting the heart

Patients with prior COVID may be twice as likely to have unhealthy endothelial cells that line the inside of the heart and blood vessels, according to…

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Patients with prior COVID may be twice as likely to have unhealthy endothelial cells that line the inside of the heart and blood vessels, according to newly published research from Houston Methodist. This finding offers a new clue in understanding covid-19’s impact on cardiovascular health.

Credit: Houston Methodist

Patients with prior COVID may be twice as likely to have unhealthy endothelial cells that line the inside of the heart and blood vessels, according to newly published research from Houston Methodist. This finding offers a new clue in understanding covid-19’s impact on cardiovascular health.

In a new study published today in JACC: Cardiovascular Imaging, Houston Methodist researchers examined the coronary microvasculature health of 393 patients with prior covid-19 infection who had lingering symptoms. This is the first published study linking reduced blood flow in the body and COVID-19.

Using a widely available imaging tool, called positron emission tomography (PET), researchers found a 20% decrease in the ability of coronary arteries to dilate, a condition known as microvascular dysfunction. They also found that patients with prior COVID-19 infection were more likely to have reduced myocardial flow reserve – and changes in the resting and stress blood flow – which is a marker for poor prognosis and is associated with a higher risk of adverse cardiovascular events.

“We were surprised with the consistency of reduced blood flow in post covid patients within the study,” said corresponding author Mouaz Al-Mallah, M.D., director of cardiovascular PET at Houston Methodist DeBakey Heart and Vascular Center, and president elect of the American Society of Nuclear Cardiology. “The findings bring new questions, but also help guide us toward further studying blood flow in COVID-19 patients with persistent symptoms.”

Dysfunction and inflammation of endothelial cells is a well-known sign of acute Covid-19 infection, but little is known about the long-term effects on the heart and vascular system. Earlier in the pandemic, research indicated that COVID-19 could commonly cause myocarditis but that now appears to be a rare effect of this viral infection.

A recent study from the Netherlands found that 1 in 8 people had lingering symptoms post-covid. As clinicians continue to see patients with symptoms like shortness of breath, palpations and fatigue after their recovery, the cause of long covid is mostly unknown.

Further studies are needed to document the magnitude of microvascular dysfunction and to identify strategies for appropriate early diagnosis and management. For instance, reduced myocardial flow reserve can be used to determine a patient’s risk when presenting with symptoms of coronary artery disease over and above the established risk factors, which can become quite relevant in dealing with long Covid.

Next steps will require clinical studies to discover what is likely to happen in the future to patients whose microvascular health has been affected by COVID-19, particularly those patients who continue to have lingering symptoms, or long COVID.

This work was supported, in part, by grants from the National Institutes of Health under contract numbers R01 HL133254, R01 HL148338 and R01 HL157790.

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For more information: Coronary microvascular health in patients with prior COVID-19 infection. JACC: Cardiovascular Imaging. (online Aug. 16, 2022) Ahmed Ibrahim Ahmed, Jean Michel Saad, Yushui Han, Fares Alahdab, Maan Malahfji, Faisal Nabi, John J Mahmarian, John P. Cook, William A Zoghbi and Mouaz H Al-Mallah. DOI: www.doi.org/10.1016/j.jcmg.2022.07.006

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