Study: Fewer Blacks would die from COVID-19 if treated at same hospitals as Whites
By  Brian P. Dunleavy
JUNE 17, 2021 / 1:26 PM

A new study suggests higher COVID-19 death rates among people of color may be partially explained by differences in quality of hospital care. Photo by 1662222/Pixabay


June 17 (UPI) -- Deaths among Black people in the United States with COVID-19 would be 10% lower if they had access to the same hospitals as White people, an analysis published Thursday by JAMA Network Open found.

"Our study reveals that Black patients have worse outcomes largely because they tend to go to worse-performing hospitals," study co-author Dr. David Asch said in a press release.

"Because patients tend to go to hospitals near where they live, these new findings tell a story of racial residential segregation and reflect our country's racial history that has been highlighted by the pandemic," said Asch, the executive director of the Center for Health Care Innovation at the University of Pennsylvania.

Since the start of the pandemic, Black and Hispanic people in the United States have had a higher risk for more severe illness and death from COVID-19, Centers for Disease Control and Prevention data indicates.
Vaccine distribution inequality reflects 'broken' U.S. healthcare system, experts say

This may be due at least in part to higher rates of heart disease, high blood pressure and diabetes in these populations, as people with these health conditions are more likely to die following coronavirus infection, the CDC said.

For this study, Asch and his colleagues examined 10 months of data for more than 44,000 Medicare patients treated at nearly 2,000 hospitals across 41 states and the District of Columbia.

Roughly 33,500 of the patients included in the analysis were White and nearly 11,000 were Black, the researchers said.

RELATED Study: Black adults in rural areas more likely to die from heart-linked causes

The higher rates of death among Black patients was partly explained by lower income levels and higher prevalence of chronic health conditions in those populations.

Approximately 13.5% of Black people hospitalized due to coronavirus infection die from the disease within 30 days of admission, nearly 1% more than White patients, the data showed.

However, had Black patients been admitted to the same hospitals as White patients, and in the same proportion, 12.2% of them would have died, a more than 1% drop -- or more than 10%.

RELATED Black Hispanics at especially high risk for severe COVID-19

The findings echo those of an earlier study by the same team of researchers, which found that differences in hospital death rates were largely determined by the infection rate in the hospital's surrounding community.

If COVID-19 case rates were high in the community so too were local hospital death rates, the researchers said.

This trend may be complicated by the historic practice of "redlining," in which mortgage lenders rejected home financing applications in majority Black neighborhoods, they said.

This resulted in economic stagnation in affected communities and, often, lower access to social services, including medical care within them.

Although Asch and his colleagues did not track where each patient included in their analysis lived, hospitals with the highest COVID-19 death rates were in formerly redlined neighborhoods, they said.

"It's intolerable that we live in a society where Black patients are more likely to go to hospitals where death is also more likely," Asch said.

"Centuries of racism got us to this level of residential segregation, but a step we can take today is to change policies so that all hospitals are not so dependent on local resources to maintain their quality. COVID-19 has provided a lens through which we can see how much more we must travel to reach justice," Asch said.

Plan to raze 4 dams on California-Oregon line clears hurdle


PORTLAND, Ore. (AP) — A proposal to bring down four hydroelectric dams near the California-Oregon border cleared a major regulatory hurdle Thursday, setting the stage for the largest dam demolition project in U.S. history to save imperiled migratory salmon

.

Provided by The Canadian Press

The Federal Energy Regulatory Commission action comes after the demolition proposal almost fell apart last summer, but then a new agreement and additional funding revived it. Thursday's ruling will allow the utility that runs the dams, PacifiCorp, to transfer its hydroelectric license jointly to the nonprofit Klamath River Renewal Corporation, Oregon and California.

Regulators still must approve the actual surrender of the license. Dam removal could start in 2023.

Tribes on the lower Klamath River that have watched salmon struggle applauded the decision. Salmon are at the heart of the culture, beliefs and diet of a half-dozen regional tribes, including the Yurok and Karuk — both parties to the agreement — and they have suffered deeply from that loss.

This week, California accepted a petition to add Klamath-Trinity River spring chinook salmon to the state's endangered species list.

The aging dams were built before current environmental regulations and essentially cut the 253-mile-long (407-kilometer-long) river in half for migrating salmon, whose numbers have been plummeting.

Coho salmon from the river are listed as threatened under federal and California law, and their population has fallen anywhere from 52% to 95%. Spring chinook salmon, once the Klamath Basin’s largest run, has dwindled by 98%.

Fall chinook, the last to persist in any significant numbers, have been so meager in the past few years that the Yurok Tribe canceled fishing for the first time in memory. In 2017, they bought fish at a grocery store for their annual salmon festival.

Another tribe, the Karuk Tribe, said in a statement that the regulators' decision “reflects the hard work of our partnership with PacifiCorp, California, Oregon, and the Yurok Tribe. After this year’s massive fish kill, we need dam removal more than ever."

The dams don't store agricultural water, aren't used for flood control and aren’t part of the 200,000-acre Klamath Project, an irrigation project further north that straddles the Oregon-California border. Removing the structures would affect homeowners who live around man-made lakes created by the dams.

If the dams remained, PacifiCorp would likely have to spend hundreds of millions of dollars to retrofit the structures to comply with today's environmental laws. As it is, the utility has said the electricity generated by the dams no longer makes up a significant part of its power portfolio.

The demolition proposal foundered last summer after regulators initially balked at allowing PacifiCorp to completely exit the project.

A new plan unveiled in November appears to address regulators' concerns that the nonprofit entity overseeing the demolition would struggle if there were any cost overruns or liability issues.

The new plan makes Oregon and California equal partners in the demolition with the Klamath River Renewal Corporation and adds $45 million to the project’s $450 million budget. The states and PacifiCorp, which is owned by billionaire Warren Buffett’s company Berkshire Hathaway, will each provide one-third of the additional funds.

___

Follow Flaccus on Twitter at http://www.twitter.com/gflaccus.

Gillian Flaccus, The Associated Press

Jordan battles to save rare tiny Dead Sea carp


Issued on: 18/06/2021 -

Abdullah Oshoush, an environmental researcher at Jordan's Fifa Nature Reserve, holds specimens of the endangered Dead Sea toothcarp

 Khalil MAZRAAWI AFP

Fifa Nature Reserve (Jordan) (AFP)

Jordan is racing against time to save a tiny rare fish from extinction as falling water levels partly triggered by global warming threaten to dry up its last habitat.

The Dead Sea toothcarp -- scientific name Aphanius dispar richardsoni -- has been on the red list of the International Union for Conversation of Nature since 2014.

The IUCN warns that the "exploitation of spring waters and climate change" are major threats facing the four-centimetre-long, silver-coloured fish.

"This fish is threatened with extinction at the global level. It is endemic here and does not exist elsewhere," said Ibrahim Mahasneh, the manager of the fish's last home, the Fifa Nature Reserve.

Lying some 140 kilometres (85 miles) southwest of Amman in the Jordan Rift Valley and 60 kilometres south of the Dead Sea, the area is the lowest wet reserve on Earth.

Established in 2011, the nature park consists of some 20 square kilometres. It is located some 426 metres (1,400 feet) below sea level and is managed by an independent body, the Royal Scientific Society (RSS).#photo1

Even though the Hashemite kingdom is primarily desert, this area of wetlands is criss-crossed by streams and is home to a variety of plant and wildlife species including birds.

"We have a plan to save and breed this fish... to create a natural habitat for it to breed and at the same time to mitigate the existing threat," added Mahasneh.

"The reserve is the last home for this endangered species of fish," said environmental researcher Abdallah Oshoush who works in the reserve.

- 'Precious treasures' -

The male fish also has a streak of blue along its sides, while the female has incomplete black stripes.

It is not known how many still remain, but "monitoring programs have warned of a clear decline in the presence of this fish in recent years," Oshoush said.

Among the environmental threats causing numbers to drop is the "lowering water level due to low rainfall and the change in its environment, as well as the presence of other fish that feed on it and its eggs."

Researchers are now preparing to open an artificial pond just for the toothcarp so they can grow safely and their eggs are not devoured by predators. Each season, a female produces around 1,000 eggs.#photo2

The aim is then to release the young fish back into the natural environment.

"In Jordan live two unique species of fish that do not exist anywhere else in the world. These are our precious treasures and they must be preserved for our ecosystem," said RSS spokesperson Salem Nafaa.

Two decades ago the RSS, which was established in 1970, succeeded in saving the endangered Aphanuis Sirhani fish in its only habitat in the Azraq reserve, about 110 kilometres (65 miles) east of Amman.

It got its scientific name from the Wadi Sirhan, which extends from the Arabian Peninsula to Azraq, but is commonly known in English as the Azraq killifish.

Only about six centimetres long, it is also silver but the female is spotted while the male has black stripes.

- Predators, birds -

"In the year 2000, there were no more than 500 Azraq killifish in the oasis, which means it was on the verge of extinction," said Nashat Hmaidan, the director of the RSS Biodiversity Monitoring Center.

"It was declining sharply, and it reached just 0.02 percent of the number of fish in the oasis," he said, blaming other predatory fish and migratory birds as well as a fall in water levels.#photo3

The RSS studied the fish's life cycle and determined it needed shallow water to lay eggs, and should be isolated from other species for the best chance of survival.

"We collected 20 fish over two years and put them in a concrete pond designated for breeding."

After the first fish were released back into the waters the team saw its presence had increased from 0.02 percent to nearly 50 percent. It "was a great success," he added.

Twenty years on, the Azraq killifish accounts for almost 70 percent of the fish in the waters. But he cautioned the goal now is that the numbers should "never drop below 50 percent".

© 2021 AFP

Hong Kong democracy paper runs defiant edition day after raid

Issued on: 18/06/2021

The paper and its jailed owner Jimmy Lai have long been a thorn in Beijing's side with unapologetic support for the financial hub's pro-democracy movement

 Anthony WALLACE AFP

Hong Kong (AFP)

Hong Kong's pro-democracy Apple Daily newspaper hit the stands Friday a day after police raided its newsroom, with an extra-large print run and a characteristic message of defiance emblazoned on its front that read: "We must press on".

The paper and its jailed owner Jimmy Lai have long been a thorn in Beijing's side with unapologetic support for the financial hub's pro-democracy movement and scathing criticism of China's authoritarian leaders.

But those same leaders are now determined to see it silenced as they press ahead with a sweeping crackdown on dissent in Hong Kong.

More than 500 officers raided the paper's newsroom on Thursday in an operation authorities said was sparked by articles that allegedly appealed for sanctions against China.

Five executives, including chief editor Ryan Law and CEO Cheung Kim-hung, were arrested under Hong Kong's new national security law on charges of collusion.

Staff returned to a newsroom gutted of many computers and hardrives which had been carted away in police evidence bags.

But they pressed on throughout the night to get the next day's edition out, as they have for the last 26 years.#photo1

This time, they were surrounded by a gaggle of reporters from rival outlets documenting the seemingly inexorable decline of media freedoms in their city, an international media hub.

Editors settled on a simple front page featuring pictures of the five arrested executives with a straight news headline that read: "National security police searched Apple, arrested five people, seized 44 news material hard disks."

Underneath, in a bold yellow font, they printed "We must press on", words the paper said Cheung told staff as he was led away by police in handcuffs.

The company opted for a 500,000 print run -- far beyond its current daily circulation of around 80,000 copies -- hoping that those Hong Kongers who want a greater say in how their city is run might snap up the historic edition.

- 'All sold out' -

In the working class district of Mongkok, dozens of residents were queuing in the early morning hours for the first edition as it was delivered to news stands.#photo2

"Usually we sell around 60 copies but tonight, we just sold 1,800," the owner of one stand, who did not give his name, told AFP.

"Now it is all sold out. We ordered 3,000 so we are still waiting for the rest to come," he added.

A 40-year-old product developer, who gave her first name Polly, said she bought ten copies.

"For many years we enjoyed the freedom of press and we were able to say anything," she told AFP.

"But just within one year it's all different, it has deteriorated so much and everything is happening so quickly," she added.

Another customer, 45-year-old Steven Chow, snapped up three copies.

"You may not like it, but I think you need to let them have their voice and survive, it is important."

Global displacement from war, crises doubles in a decade: UN

Issued on: 18/06/2021 -

An intensifying Islamist insurgency has forced many to flee their homes in Mozambique Alfredo Zuniga AFP/File


Geneva (AFP)

Despite the coronavirus pandemic, the number of people fleeing war and persecution continued rising last year, with global displacement climbing to over 82 million -- double the figure a decade ago, the UN said Friday.

A fresh report from the UN refugee agency showed global displacement figures swelled by around three million in 2020 after an already record-breaking year in 2019, leaving a full one percent of humanity uprooted and displaced.

The report highlighted how drawn-out crises like those in Syria, Afghanistan, Somalia and Yemen were continuing to force people to flee, while eruptions of violence in places like Ethiopia and Mozambique were causing surging displacement.

The fact that the numbers rose for the ninth straight year was all the more devastating because Covid-19 restrictions had been expected to limit displacement.#photo1

During the pandemic, "everything else has stopped, including the economies, but wars and conflict and violence and discrimination and persecution, all the factors that pushed these people to flee, have continued," UNHCR chief Filippo Grandi told AFP.

The UN agency found that by the end of 2020, a record 82.4 million people were living as refugees or asylum seekers, or in so-called internal displacement within their own countries, up from some 40 million in 2011.

- Nearly half under 18 -

A full 42 percent of the world's displaced are girls and boys under the age of 18.

"The tragedy of so many children being born into exile should be reason enough to make far greater efforts to prevent and end conflict and violence," Grandi said.

Some 26.4 million people were living as refugees at the end of 2020, including 5.7 million Palestinians.

Some 3.9 million Venezuelans were also displaced beyond their borders without being considered refugees, while 4.1 million people were registered worldwide as asylum seekers.

But while both refugee and asylum seeker numbers remained relatively flat from 2019, the number of people displaced within their own countries surged by more than two million to 48 million, the report said.

This was perhaps not surprising, given that the factors that generally force people to flee did not disappear during the pandemic, but the possibility to cross borders largely did.

In 2020, at least 164 countries closed their borders because of Covid-19, and more than half of them made no exceptions for asylum seekers and refugees fleeing for their lives.

"In a situation of increased conflict and violence, in a situation in which borders have been difficult to cross because of Covid, inevitably the figure... that has gone up is that of internally displaced people (IDPs)," Grandi told reporters.

- 'Egoistic approach' -

Last year, more than 11 million people were newly displaced -- slightly more than in 2019 -- with most in just a handful of conflict-wracked countries and regions, the report showed.

They include Syria, which after more than a decade of war counts 13.5 million people displaced either inside or outside the country -- more than half of its population and a sixth of the global displacement total.

More than two-thirds of the world's refugees meanwhile come from just five countries: Syria, Venezuela, Afghanistan, South Sudan and Myanmar.

A number of new crises have also sparked significant displacement, the report said, pointing to Ethiopia's violence-hit Tigray region, which saw an exodus into Sudan of over 54,000 people in the final months of 2020 alone.#photo3

Hundreds of thousands of people also escaped deadly jihadist violence in northern Mozambique, while hundreds of thousands more were freshly displaced in Africa's restive Sahel region.

The vast majority of the world's refugees are hosted in countries neighbouring crisis areas, mainly in poorer parts of the world.

Turkey remained the host of the world's largest refugee population totalling some 3.7 million, followed by Colombia with 1.7 million, Pakistan and Uganda with 1.4 million each and Germany with 1.2 million.

While needs are continuously rising, solutions for the displaced seemed to dwindle last year.

Over the course of 2020, only around 3.2 million IDPs and just 251,000 refugees returned to their homes, marking drops of 40 and 21 percent respectively from 2019.#photo4

And only 34,400 vulnerable refugees were resettled in third countries last year -- the lowest level in 20 years, the report said.

"Solutions require global leaders and those with influence to put aside their differences, end an egoistic approach to politics, and instead focus on preventing and solving conflict and ensuring respect for human rights," Grandi said.

Coca-Cola’s Ronaldo fiasco highlights risk to brands in social media age

Stars like the Portugal captain, with 550m followers, are beyond the control of sport sponsors

00:30

'Drink water': Ronaldo's Coca-Cola snub costs company billions – video

Mark Sweney

@marksweney

Fri 18 Jun 2021 06.00 BST

Cristiano Ronaldo’s decision to remove two Coca-Cola bottles from view at a press conference, and dent the value of the fizzy drink maker’s sponsorship of the European Championship, has highlighted the risks brands face associating with sports stars made powerful by the social media era.

The Portugal captain, a renowned health fanatic who eschews carbonated drinks and alcohol, underlined his point by holding a bottle of water while saying “agua”, Portuguese and Spanish for water. The water brand in question happened to be owned by Coca-Cola too, but the damage – by a major sports star with 550 million social media followers – was done.

“It’s obviously a big moment for any brand when the world’s most followed footballer on social media does something like that,” says Tim Crow, a sports marketing consultant who advised Coca-Cola on football sponsorship for two decades. “Coke pays tens of millions to be a Uefa sponsor and as part of that there are contractual obligations for federations and teams, including taking part in press conferences with logos and products. But there are always risks.”

Major brands have never been able to control the actions of their star signings. Nike decided, stoically, to stand by Tiger Woods as the golfing prodigy lost sponsors including Gillette and Gatorade after a 2009 sex scandal. However, Ronaldo’s public snub signifies a different kind of threat to the once cosy commercial balance of power between stars and brands, one born of the social media era.

“Ronaldo is right at the top of social media earners,” says PR expert Mark Borkowski. “It is about the rise of the personal brand, the personal channel, it gives so much bloody power. That’s what has allowed Ronaldo to make a point [about a healthy lifestyle].”

Now 36, the world’s most famous footballer has built an empire that has seen him make more than $1bn (£720m) in football salaries, bonuses and commercial activities such as sponsorships. What is crucial is the global platform social media has given him – half a billion followers on Instagram, Twitter and Facebook – which has freed him from following the commercial rules of clubs, tournaments and their sponsors. He is the highest earner on Instagram, commanding $1m per paid post, and with more than $40m in income from the social media platform annually he makes more than his salary at Juventus.

“People are saying this is about athlete activism and there is some truth to that,” says Crow. “Athletes are taking a more activist view, we are seeing that, most recently in press conferences. And we will see it again.”

On Tuesday, the France midfielder Paul Pogba, a practising Muslim, removed a bottle of Euro 2020 sponsor Heineken’s non-alcoholic 0.0 brand from the press conference table when he sat down to speak to the media after his team’s 1-0 win over Germany. Three years ago, he was one of a group of Manchester United stars who boycotted a contractual event for sponsors to protest at the club’s poor travel arrangements that had affected Champions League games.

Crow says the most important example of athlete activism came last month when Naomi Osaka, the No 2-ranked female tennis player, pulled out of the French Open after being fined $15,000 and threatened with expulsion by organisers for saying she would skip contractual media obligations because of the effect on her mental health.

Osaka, who has more than 4 million social media followers, used Twitter to explain her “huge waves of anxiety” and the “outdated rules” governing players and media conferences, and announce she was pulling out of Roland Garros.

“Activism is now on every sponsor’s radar,” says Crow, who believes Ronaldo’s move could mark the beginning of the end of product placement-laden press conferences.

“My view is that for a long time now having sponsors’ products on the table in front of athletes in press conferences looks outdated and inauthentic and it’s time to retire it,” he says. “This incident highlights that fact. Many of my sponsor clients have mentioned this in the past, particularly those targeting younger consumers. It’s not as if sponsors don’t have enough branding throughout tournaments and events anyway.”

Norway's football clubs to vote on Qatar World Cup boycott



Issued on: 18/06/2021 -

Star forward Erling Braut Haaland and his Norway teammates wore these t-shirts before a World Cup qualifying match JORGE GUERRERO AFP/File


Oslo (AFP)

Will Norwegian football star Erling Braut Haaland stay home or play on what fans have dubbed a "cemetery?" This Sunday, a meeting of Norway's football community will decide whether to boycott next year's World Cup in Qatar.

Under pressure from grassroots activists the Norwegian Football Federation (NFF) has decided to hold an extraordinary congress to decide on whether to pass up football's showpiece event all together.

The games on the pitches in the Middle Eastern emirate will "unfortunately be like playing on a cemetery," according to Ole Kristian Sandvik, spokesman of the Norwegian Supporters Alliance (NSA), invoking a commonly used metaphor among opponents of Norway's participation.

Norway, which has not qualified for a major international competition since Euro 2000, is currently fourth in its World Cup qualifying group behind Turkey, the Netherlands and Montenegro.

So while qualification seems an uphill task, the result of the vote could have an impact on whether Norway and its young star Haaland -- one of the rising stars of world football -- continue to play qualifying matches.

The movement calling for a boycott began north of the Arctic Circle when football club Tromso IL spoke out against turning a blind eye to alleged human rights abuses at the end of February.

"We can no longer sit and watch people die in the name of football," the first division club proclaimed.

Qatar has faced criticism for its treatment of migrant workers, many of whom are involved in the construction of stadiums and infrastructure for the 2022 World Cup, with campaigners accusing employers of exploitation and forcing labourers to work in dangerous conditions.

Qatari authorities meanwhile insist they have done more than any country in the region to improve worker welfare.

"There is no doubt that this World Cup should never have been awarded to Qatar," Tom Hogli, a former professional footballer turned public relations officer for Tromso IL, told AFP.

"The conditions there are abominable and many have lost their lives," he added.

In March, a spokesman for the Qatari organisers put the number of deaths on the construction sites at "three" since 2014, with another 35 having died away from their workplaces, challenging the heavy toll reported by some rights groups.

- Push from fans -

The Tromso call began gathering pace in Norway, where clubs operate under a democratic structure, and under pressure from fans, many teams now say "nei" (no).

According to Sandvik, the fans feel that the deaths on the World Cup sites would have been avoided "if they had not had to build hotels, railways and stadiums".

Nearly half of Norwegians, 49 percent, now say they are in favour of a boycott, while only 29 percent are against it, according to a poll published by newspaper VG on Wednesday.

The Nordic country's national squad has already protested conditions in Qatar, but stopped short of calling for a boycott.

Before recent Norway games, Borussia Dortmund superstar Haaland, captain Martin Odegaard and the rest of the team have worn t-shirts with slogans like "Human rights on and off the pitch."

Other countries, like Germany, the Netherlands and Denmark have also followed suit.

FIFA, on the other hand, argue that awarding the hosting of the World Cup in Qatar has opened the door to social progress.

"We know there is still work to be done, but we need to recognise the significant progress achieved in a very short time," FIFA president Gianni Infantino said in May.

- 'Few successes' -

While the executive committee of the NFF have said they regret Qatar being awarded the World Cup, they oppose a boycott.

President Terje Svendsen said he thought it was "not the right tool to improve the human rights situation or the working conditions in Qatar," when speaking at the federation's ordinary annual congress in March.

According to the NFF, a boycott could end up costing Norway 205 million Norwegian kroner ($24 million, 20 million euros) in fines and compensation as well as lost revenue.

Feeling the pressure from grassroots campaigns, the NFF referred the matter to an extraordinary congress which on Sunday will bring together the eight members of its executive committee, representatives of 18 districts and of hundreds of professional and amateur clubs.

The discussions will be revolve around the findings of an expert committee which, with the exception of two members representing fans, has also come out against a boycott.

"For a boycott to succeed, you need a critical mass behind it, an opposition that calls for it in the country, the UN to put pressure on the authorities, the business world, the trade unions and civil society to put pressure on it in the long term," committee chairman Sven Mollekleiv said in a debate hosted by broadcaster TV2.

"Historically, there are few successes," he said.

Rather than a boycott, the committee recommended 26 measures to consolidate and further the gains made in Qatar but also to ensure that FIFA doesn't become complicit in so called "sportswashing" -- the polishing of a country's public image through a major sporting event.

Some initial supporters of a boycott, like Tromso's Hogli, have since sided with these conclusions, although calls for a complete boycott remain.

 

Unequal hospital quality associated with higher COVID-19 death rate for Black patients

• Download PDF Copy

Reviewed by Emily Henderson, B.Sc.Jun 17 2021

The COVID-19 death rate for Black patients would be 10 percent lower if they had access to the same hospitals as white patients, a new study shows. Researchers from the Perelman School of Medicine at the University of Pennsylvania and OptumLabs, part of UnitedHealth Group, analyzed data from tens of thousands of hospitalized COVID-19 patients and found that Black patients died at higher rates than white patients. But the study, published today in JAMA Network Open, determined that didn't have to be the case if more Black patients were able to get care at different hospitals.

Our study reveals that Black patients have worse outcomes largely because they tend to go to worse-performing hospitals. Because patients tend to go to hospitals near where they live, these new findings tell a story of racial residential segregation and reflect our country's racial history that has been highlighted by the pandemic."

David Asch, MD, study's first author, executive director of Penn Medicine's Center for Health Care Innovation

For many years, housing segregation was explicitly practiced in the United States. "Redlining," a term for the systematic refusal of home financing in majority Black neighborhoods, resulted in the economic stagnation of communities and limitations of upward mobility among the people who live in them. Redlining has cast a long shadow into the decades since it was explicitly made illegal: a recent study showed that three of every four redlined neighborhoods still experience economic hardship, which often includes a lack of access to social resources - including medical care.

Recently, Asch and fellow researchers published another study showing the interwoven nature of where patients get care and whether they survive hospitalization with COVID-19. The study showed that the one factor most explaining differences in hospital mortality rates was the level of virus in a hospital's surrounding community: If there were high COVID-19 case rates in the community, hospital mortality rates were worse.

In the present study, the researchers continued to examine hospital-level differences by examining 10 months of de-identified hospitalization data from more than 44,000 Medicare patients from 1,188 hospitals across 41 states and the District of Columbia. Roughly 33,500 patients were white and nearly 11,000 were Black. Examining inpatient mortality rate in the 30 days after admission for each group and including those discharged to hospice care, the researchers show that the overall mortality for white patients was approximately 12.9 percent and 13.5 percent for Black patients.

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Increased mortality among Black patients was partly explained by lower income levels and more comorbid illness in those populations. However, the authors wrote in their paper that "even if statistical adjustment for patient characteristics explains racial differences in outcome, it does not excuse them if those factors are disproportionately represented in Black populations as a result of racist forces."

Rachel Werner, MD, PhD, executive director of Penn's Leonard Davis Institute of Health Economics and a study co-author, notes that this is not the only issue.

"People often assume that Black-white differences in mortality are due to higher rates of chronic health conditions among Black individuals," she said. "But time and time again, research has shown that where Black patients get their care is much more important and that if you account for where people are hospitalized, differences in mortality vanish."

As a final step, the researchers ran simulations modeling what would happen if the Black patients in the cohort had instead been admitted to the same hospitals as the white patients, and in the same proportion. The mortality rate among Black patients dropped from 13.5 percent to 12.2, a single percentage point drop that translated to the overall mortality risk declining by a tenth.

"Our analyses tell us that if Black patients went to the same hospitals white patients do and in the same proportions, we would see equal outcomes," said Nazmul Islam, PhD, a statistician at OptumLabs who co-authored the study.

While they didn't explicitly track where each patient lived, Asch said that the study provides an index for how residential segregation policies - such as the now illegal loan refusal policies known as "redlining" - continue to affect people of color's access to social services like health care.

"It's intolerable that we live in a society where Black patients are more likely to go to hospitals where death is also more likely," said Asch. "Centuries of racism got us to this level of residential segregation, but a step we can take today is to change policies so that all hospitals are not so dependent on local resources to maintain their quality. COVID-19 has provided a lens through which we can see how much more we must travel to reach justice."

Source:

University of Pennsylvania School of Medicine

Journal reference:

Asch, D.A., et al. (2021) Patient and Hospital Factors Associated With Differences in Mortality Rates Among Black and White US Medicare Beneficiaries Hospitalized With COVID-19 Infection. JAMA Network Open. doi.org/10.1001/jamanetworkopen.2021.12842.

In Raqqa, a Show to Remind the World of Syria’s Children
Thursday June 17th, 2021 by NORTH PRESS (Kurdish Agency)

In an art show organized in Raqqa, Syrian children tried to remind the world of their fate, according to North Press.



On Wednesday, the theater of the Raqqa Center for Culture and Arts witnessed an art show for children under the title Bakra Ahla (tomorrow is better).

The children performed dances, theatrical and lyrical performances through which they sent messages to remind the world of the rights of the children in Syria and “the need to end their suffering.”

The goal of the show was to shed light on the difficult living conditions of the children, said Amira al-Hassan, co-chair of the Child Protection Office in Raqqa.

Hassan claimed that the show included several activities presented by children, and was inclusive for the injured, those who have missing limbs, and those with special needs. That way, they were able to exhibit their talents to the audience and to prove that they are equal participants in society.

Hassan indicated that the Child Protection Office will work during the coming period to intensify its efforts to eliminate the children’s problems, especially child labor.

IMPERIALISM'S LAST STAND
Global powers promise to help Lebanon's crisis-hit army


Issued on: 18/06/2021 

 PHOTO: Members of the Lebanese army are deployed during a protest against the lockdown and worsening economic conditions, amid the spread of the coronavirus disease (COVID-19), in Tripoli, Lebanon January 29, 2021. 

© REUTERS/Mohamed Azakir

Text by: NEWS WIRES

World powers promised on Thursday to support Lebanon's army to prevent its collapse amid the deepest political and economic crisis since the Middle East nation's 1975-1990 civil war, but they did not announce any tangible aid.

The army has long been seen as one of the few institutions in Lebanon that can rally national pride and create unity. Its split along sectarian lines at the start of Lebanon's civil war helped fuel a descent into militia rule.

Lebanese Army Chief Joseph Aoun told Thursday's meeting of world powers, which was organised by France, that the nation faced dire consequences if the country's crisis persisted and military salaries continued to tumble.

"How can a soldier support a family with a salary that does not exceed $90?" he said in a video, published on the army's Twitter account.

"If unmitigated, the economic and financial crisis will inevitably lead to the collapse of all state institutions including the Lebanese Armed Forces, the backbone of the country," he said.

France, which has led international efforts to help Lebanon, arranged the virtual meeting with partners including the United States, Russia, China and European powers and some Gulf Arab states, although not Saudi Arabia.

Participating countries were asked to provide food, medical supplies, spare parts for military equipment and even fuel, although they were not asked to pay salaries directly.

Two diplomats said not much was offered during the meeting, although the majority of countries showed readiness to offer bilateral support in the future. They said a follow-up mechanism would monitor and coordinate any aid.

Paris has sought to ramp up pressure on squabbling Lebanese politicians but has so far failed to push them to form a new government that is vital to unlock foreign aid.

Discontent has been brewing in the security forces as Lebanon's currency has lost 90% of its value against the dollar, driving down soldiers' wages. Many have taken extra jobs. Some have quit.

The French Armed Forces Ministry said participants at Thursday's meeting "highlighted the dire and steadily degrading economic and social conditions in Lebanon."

According to the ministry statement, the participants said the army "remains a crucial pillar of the Lebanese state," adding: "Their cohesiveness and professionalism remain key to preserving the country’s stability from more risks."

The ministry did not respond to a request for further information.

(AFP)