Monday, November 07, 2022

Americans more likely to share COVID-19 misinformation online: SFU study

Peer-Reviewed Publication

SIMON FRASER UNIVERSITY

People living in the United States are more than three times more likely to share misinformation and conspiracy theories about COVID-19 than people in four other English-speaking countries, including Canada, a Simon Fraser University study has found.


When the entire world stopped in early 2020 due to the pandemic, researchers were presented with a rare opportunity to study the sharing of the same conspiracy theories and other misinformation across multiple countries. 

SFU political science professor Mark Pickup, along with colleagues from Colorado State University and McMaster University, focused on five Western, English-speaking democracies: the U.S., Canada, United Kingdom, Australia and New Zealand. 

Researchers found that people in the U.S. were no more likely to report seeing misinformation than people living in any of the other countries but were three times more likely to share these theories with their followers. 

“America is an outlier. Our findings are consistent with recent work about the outsized role that Americans play in sharing misinformation on social media,” Pickup says. 

According to the study, published in the Journal of Quantitative Description: Digital Media, there are a few reasons why Americans stand out from the other countries. 

While people in other countries self-reported that they shared misinformation to make other aware of them or to criticize them, Americans are considerably more likely to share theories to promote or show support for them and use it as a way to connect with others. 

The polarized political landscape of the U.S., which also played out in debates about COVID-19, also correlated with the sharing of misinformation. Those who identified as conservative and those that trusted the Trump government were more likely to share misinformation online.

In all countries, those who have populist attitudes and distrust health officials were more likely to share misinformation than those who do not.

In Canada, the survey found that the number one reason people shared conspiracy theories online was for people to be aware of them and the second-most common reason was to criticize them.

Facebook was the most common platform for sharing misinformation, accounting for more than half of those sharing misinformation in each country.
The results are based on their study of thousands of nationally-representative surveys conducted in each country in July 2020 and January 2021.

 

AVAILABLE SFU EXPERT

MARK PICKUP, professor, political science | mark_pickup@sfu.ca

ABOUT SIMON FRASER UNIVERSITY

As Canada’s engaged university, SFU works with communities, organizations and partners to create, share and embrace knowledge that improves life and generates real change. We deliver a world-class education with lifelong value that shapes change-makers, visionaries and problem-solvers. We connect research and innovation to entrepreneurship and industry to deliver sustainable, relevant solutions to today’s problems. With campuses in British Columbia’s three largest cities—Vancouver, Burnaby and Surrey—SFU has eight faculties that deliver 364 undergraduate degree programs and 149 graduate degree programs to more than 37,000 students. The university now boasts more than 180,000 alumni residing in 145+ countries.

Learning science in a hurry

How Americans learned to acquire coronavirus information for personal health decisions and public policy judgments in the COVID-19 pandemic

Peer-Reviewed Publication

UNIVERSITY OF MICHIGAN

With the onset of the coronavirus pandemic, people were plunged into a situation that required them to acquire information about an emerging scientific issue to assess the adequacy of government actions and programs of significant personal import to each individual. 

There are other important scientific issues like climate change or energy sources, but few involve short-term life or death consequences similar to the COVID-19 pandemic.

An international team led by University of Michigan research scientist Jon Miller found that people who earned a college degree and took the required college science courses gained a general level of biological literacy that enabled them to make more informed policy judgments about the effectiveness of the Trump administration's handling of the COVID-19 pandemic. 

In the last week prior to the 2022 midterm elections, these results are important in understanding how citizens make sense of scientific or technical issues such as viral mutation and transmission and the efficacy of vaccines—and how their government worked to protect them against a deadly virus.

Using a national probability sample of adults, Miller and colleagues asked respondents about the importance of each of a dozen prominent issues ranging from health care to immigration in determining their vote in the 2020 presidential election and then about their views on the substance of each issue. Some of the traditional political issues were completely explained by an individual's partisanship, but the handling of the COVID-19 pandemic displayed an independent influence on vote choice above and beyond partisanship.

Miller's team found that nearly 60% of respondents who had a graduate or professional degree held a strongly critical assessment of the Trump administration's handling of the pandemic, and 45% of those who had completed one to three college science courses were highly critical of the administration's performance. By comparison, just 6% of respondents with one to three college science courses were strongly supportive of the Trump administration's handling of the pandemic.

Reflecting the polarized American political system, partisanship and religious beliefs were strong indicators of respondents’ assessment of the Trump administration's handling of the pandemic. On some issues such as the Affordable Care Act or climate change, the distribution of policy attitudes was nearly identical to ideological partisanship, but on the distribution of the assessment of the government's handling of the COVID-19 pandemic, there was substantial marginal variations that reflected differences in biological knowledge and understanding of the coronavirus. 

Prior biological knowledge aided the acquisition and understanding of emerging news about the COVID-19 pandemic and this information was especially important to the 1 in 4 American adults who think of themselves as "independents" and eschew affiliation with either of the major political parties.

This analysis was published in the International Journal of Lifelong Education. 

In a separate analysis published earlier this year, Miller and his co-authors also examined how Americans decided to get or reject a COVID-19 vaccination. They found that educational attainment, biological literacy and an understanding of the coronavirus were strong positive predictors of willingness to be vaccinated, while religious fundamentalism and conservative partisanship were strong negative indicators of intent to vaccinate.

Sixty-one percent of adults with a bachelor's degree reported that they would definitely or probably get a COVID-19 vaccination, and 70% of adults with graduate/professional degrees reported the same. Just 39% of high school graduates said they were likely to get a vaccination.

More than half (54%) of American adults who completed one to three college science courses—the general education requirement at most universities—indicated they were willing to take the vaccine, while 65% of American adults who took four or more college science courses indicated the same. Seventy-three percent of adults who qualified as literate on a Biological Literacy Scale said they would take the vaccine, while only 44% of adults who did not qualify as biologically literate said they intended to be vaccinated.

"The majority of Americans had never heard of the coronavirus before the pandemic, but these parallel results indicate citizens in the internet era seek information at the time that they need it and the internet makes this possible in a timely manner," Miller said.

Looking at the performance of American adults in acquiring and making sense of complex coronavirus information on relatively short notice, Miller observed that the United States is uniquely positioned to cope with this kind of emergency.

"The U.S. is the only country in the world that requires all of its undergraduates to have a year of science regardless of their major field of study," he said.

Educators and public policy leaders have recognized the long-term benefits of this system, but the COVID-19 pandemic demonstrated its value in a public health emergency, Miller said.

The results of the intent to vaccinate analysis was published in The FASEB Journal (Federation of American Societies of Experimental Biology).

For both analyses, the researchers surveyed a group of 3,141 Americans in March and April 2020, then followed up with the same group in November and December 2020. A total of 2,737 completed the second survey.

Study: Public assessment of the Trump administration's handling of the COVID pandemic: A case study in lifelong learning

 

Study: Public attitude toward COVID-19 vaccination: The influence of education, partisanship, biological literacy, and coronavirus understanding


Possible callout:
Educational attainment, biological literacy and an understanding of the coronavirus were strong positive predictors of willingness to be vaccinated, while religious fundamentalism and conservative partisanship were strong negative indicators of intent to vaccinate, the study shows.

Learning from animal evolution to reproduce materials for vibration damping and acoustic wave control

Peer-Reviewed Publication

POLITECNICO DI TORINO

Learning from animal evolution to reproduce materials for vibration damping and acoustic wave control 

IMAGE: LEARNING FROM ANIMAL EVOLUTION TO REPRODUCE MATERIALS FOR VIBRATION DAMPING AND ACOUSTIC WAVE CONTROL view more 

CREDIT: POLITECNICO DI TORINO

Through millions of years of evolution, nature has produced biological systems with exceptional properties and functionalities. Many organisms have adapted to their particular environment by creating extraordinarily efficient materials and structures. These materials are optimised in terms of their mechanical, thermal, and optical properties in a way that sometimes even technology is still unable to reproduce.

These properties are often achieved by means of “hierarchical” structures, with characteristic lengths ranging simultaneously from the macro- to the nanoscale, hierarchical structures that are easily observed in materials such as wood, bones, spider webs or sea sponges. So far, the focus has mainly been on structures that nature has optimised from the point of view of the “quasi-static” mechanical properties such as, for example, fracture strength, toughness or adhesion, while there are far fewer studies on the dynamic properties such as vibration damping, noise absorption or sound transmission.

In particular, limited knowledge currently exists on how hierarchical structures play a role in the optimisation of natural structures. In the recent article “Optimized structures for vibration attenuation and sound control in nature: A review”, published in the journal Matter, researchers from the Politecnico di Torino Federico Bosia, Antonio Gliozzi and Mauro Tortello, together with colleagues from the Universities of Turin, Trento and the CNRS in Lille, collected and systematised some striking examples, existing in nature, of structural optimisation for wave and vibration control, highlighting some common traits and strategies in different biological systems.

The study will make it possible to “mimic” some of these structures, i.e. to adopt a bio-inspired approach, and to apply it to the design of acoustic metamaterials, i.e., innovative materials that have recently emerged to control sound waves.

Biological structures of interest from this point of view can be classified into three main categories: structures that are extremely resistant to impacts – such as the skull of the woodpecker, the “hammer-like club” of the mantis shrimp, or the structure of some sea shells; structures for perception and predation – spiders, scorpions, moths (one type of moth has evolved to form wings consisting of a natural metamaterial that makes them invisible to the sonar of bats), even elephants, each of which has developed an innovative strategy to generate and exploit vibrations of various frequencies; finally, structures for controlling, focusing and amplifying sound – for example the echo-localisation system of dolphins and the complex and exceptional structure found in mammals: the cochlea. Ultimately, it is often possible to find common traits in the various cases considered, such as heterogeneity of components, variable porosity, hierarchical organisation and efficient resonance mechanisms.

“This review work – comment Federico Bosia, Antonio Gliozzi and Mauro Tortello – helps to better understand the many systems that nature has optimised through millions of years of evolution. A better understanding of their functioning and common traits can help to develop materials that employ what nature has already optimised. This can be useful for a variety of applications involving the manipulation of acoustic or elastic waves, ranging, for example, from systems for protection against seismic waves to others that allow elastic wave energy to be ‘harvested’ at the microscale (energy harvesting)”.

This work was completed as part of the project “BOHEME: Bioinspired hierarchical Metamaterials”, funded by the European Commission (grant no. 863179).

Want to fire up the dance floor? Play low-frequency bass

Peer-Reviewed Publication

CELL PRESS

To find out how different aspects of music influence the body, researchers turned a live electronic music concert into a lab study. By introducing levels of bass over speakers that were too low to hear and monitoring the crowd's movements, scientists found that people danced 11.8 percent more when the very low frequency bass was present. The study appears November 7 in the journal Current Biology.

“I'm trained as a drummer, and most of my research career has been focused on the rhythmic aspects of music and how they make us move,” says first author Daniel Cameron (@Dan_Cameron), a neuroscientist from McMaster University. “Music is a biological curiosity--it doesn't reproduce us, it doesn't feed us, and it doesn't shelter us, so why do humans like it and why do they like to move to it?”

Cameron conducts research at the McMaster LIVELab, which connects science with live performance in a unique research theater. It is equipped with 3D motion capture, a Meyer sound system that can replicate various concert environments, and enhanced speakers that can produce extremely low frequencies, so low they were undetectable to the human ear.

For the Current Biology study, Cameron and colleagues recruited participants attending a LIVELab concert for electronic musical duo Orphx. The concertgoers were equipped with motion-sensing headbands to monitor their dance moves. Additionally, they were asked to fill out survey forms before and after the event. These forms were used to ensure the sound was undetectable, measure concert enjoyment, and examine how the music felt physically.

Throughout the 45-minute concert, the researchers manipulated the very-low bass-playing speakers, turning them on and off every two minutes. They found the amount of movement was 12 percent greater when the speakers were on.

“The musicians were enthusiastic to participate because of their interest in this idea that bass can change how the music is experienced in a way that impacts movement,” says Cameron. “The study had high ecological validity, as this was a real musical and dance experience for people at a real live show.”

The feeling of vibration through touch and the interactions between the inner ear and the brain have close links to the motor system. The researchers speculate these physical processes are at work in the neurological connection between music and movement. This anatomy can pick up on low frequencies and can affect the perception of “groove”, spontaneous movement, and rhythm perception.

“Very low frequencies may also affect vestibular sensitivity, adding to people’s experience of movement. Nailing down the brain mechanisms involved will require looking the effects of low frequencies on the vestibular, tactile, and auditory pathways,” says Cameron.

###

Financial support was provided by the Social Science and Humanities Research Council of Canada, the Natural Sciences and Engineering Research Council of Canada, the Canadian Institutes of Health Research, and the Canadian Institute for Advanced Research.

Current Biology, Cameron et al., “Undetectable very low frequency sound increases dancing at a live concert.” https://www.cell.com/current-biology/fulltext/S0960-9822(22)01535-4 

Current Biology (@CurrentBiology), published by Cell Press, is a bimonthly journal that features papers across all areas of biology. Current Biology strives to foster communication across fields of biology, both by publishing important findings of general interest and through highly accessible front matter for non-specialists. Visit: http://www.cell.com/current-biology. To receive Cell Press media alerts, contact press@cell.com.

Changes in child, adolescent screen time during pandemic

JAMA Pediatrics

Peer-Reviewed Publication

JAMA NETWORK

About The Study: This systematic review and meta-analysis of 46 studies including 29,000 children and adolescents indicates that, on average, screen time increased by 52%, or 84 min/day (1.4 hours/day), during the pandemic. Compared with a pre-pandemic baseline value of 2.7 hours/day, this increase corresponds to a daily average of 4.1 hours/day of screen time across all children and adolescents during the pandemic. Screen time increases were highest for individuals ages 12 to 18 and for handheld devices and personal computers. Practitioners and pandemic recovery initiatives should focus on fostering healthy device habits, including moderating use, monitoring content, prioritizing device-free time, and using screens for creativity or connection.

Authors: Sheri Madigan, Ph.D., of the University of Calgary, is the corresponding author.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamapediatrics.2022.4116)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

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Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2022.4116?guestAccessKey=2bb83659-b469-4a2f-b60e-9480451e3616&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=110722

Seeing clearly into a new realm – researchers prototype a new generation of quantum microscopy

Peer-Reviewed Publication

UNIVERSITY OF TECHNOLOGY SYDNEY

hBN NMR wide 03 

IMAGE: AN ARTIST'S IMPRESSION OF A QUANTUM MICROSCOPE FOR STUDY OF CHEMICAL REACTIONS AND TO IDENTIFY MOLECULAR ORIGIN. view more 

CREDIT: DR MEHRAN KIANINIA

While quantum computing seems like the big-ticket item among the developing technologies based on the behaviour of matter and energy on the atomic and subatomic level, another direction promises to open a new door for scientific research itself – quantum microscopy.

With the advance of quantum technologies, new microscopy modalities are becoming possible – ones that can see electric currents, detect fluctuating magnetic fields, and even see single molecules on a surface.

A prototype of such a microscope, demonstrating high resolution sensitivity, has been developed by an Australian research team headed by Professor Igor Aharonovich of the University of Technology Sydney and Dr Jean-Philippe Tetienne of RMIT University. The team’s findings have now been published in Nature Physics.

The quantum microscope is based on atomic impurities, that following laser illumination, emit light that can be directly related to interesting physical quantities such as magnetic field, electric field or the chemical environment in proximity to the defect.

Professor Aharonovich said the ingenuity of the new approach was that, as opposed to the bulky crystals often employed for quantum sensing, the research team had utilised atomically thin layers, called hexagonal boron nitride (hBN).

“This van der Waals material – that is, made up of strongly bonded two-dimensional layers – can be made to be very thin and can conform to arbitrarily rough surfaces, thus enabling high resolution sensitivity,” Professor Aharonovich said.

“These properties led us to the idea of using ‘quantum-active’ hBN foils to perform quantum microscopy, which essentially is an imaging technique that utilises arrays of quantum sensors to create spatial maps of the quantities they are sensitive to,” Dr Tetienne said.

“Until now, quantum microscopy has been limited in its spatial resolution and flexibility of application by the interfacing issues inherent in using a bulky three-dimensional sensor. By instead utilising a van der Waals sensor, we hope to extend the utility of quantum microscopy into arenas that were previously inaccessible.”

To test the capabilities of the prototype, the team performed quantum sensing on a technologically relevant magnetic material – a flake of CrTe2, a van der Waals ferromagnet with a critical temperature just above room temperature.

The hBN based quantum microscope was able to image the magnetic domains of the ferromagnet, with nanoscale proximity to the sensor, and under ambient conditions – something that was believed to be impossible to date.

Moreover, utilising the unique properties of the hBN defects, a simultaneous temperature map was recorded, confirming that the microscope can be used to perform correlative imaging between the two quantities.

Lead authors for the Nature Physics paper, PhD students Alex Healey (University of Melbourne) and Sam Scholten (University of Melbourne), and early career researcher Tieshan Yang (UTS), said the van der Waals nature of the sensor had allowed the dual sensing of magnetic properties and temperature.

“Because it is very thin, not much heat is able to dissipate through it and any temperature distribution that exists is the same as if the sensor were not there,” they said. “What began as an experimental annoyance ended up being a hint towards a capability of our microscope that is unique among current alternatives.”

“There is a huge potential for this new generation of quantum microscopy,” UTS senior researcher Dr Mehran Kianinia said. “Not only can it operate at room temperature and provide simultaneous information on temperature, electric and magnetic fields, it can be seamlessly integrated into nanoscale devices and withstand very harsh environments, as hBN is a very rigid material.

“The main future applications include high resolution MRI (magnetic resonance imaging) and NMR (nuclear magnetic resonance) that can be used to study chemical reactions and identify molecular origins, as well as applications in space, defence and agriculture where remote sensing and imaging are key.”

The paper, "Quantum microscopy with van der Waals heterostructures", is published in Nature Physics.

Farmers in China, Uganda move to high-yielding, cost-saving perennial rice

Peer-Reviewed Publication

UNIVERSITY OF ILLINOIS COLLEGE OF AGRICULTURAL, CONSUMER AND ENVIRONMENTAL SCIENCES

Perennial rice variety PR25 growing in Menghai, Yunnan, China 

IMAGE: THE DEVELOPMENT OF HIGH-YIELDING PERENNIAL RICE MEANS UP TO EIGHT HARVESTS FROM A SINGLE PLANTING, SIGNIFICANTLY LOWERING LABOR AND COST FOR SMALLHOLDER FARMERS WHILE SIMULTANEOUSLY IMPROVING SOIL QUALITY. RESEARCHERS FROM THE UNIVERSITY OF ILLINOIS, YUNNAN ACADEMY OF AGRICULTURAL SCIENCES, THE INTERNATIONAL RICE RESEARCH INSTITUTE, YUNNAN UNIVERSITY, THE UNIVERSITY OF QUEENSLAND, AND THE LAND INSTITUTE CONTRIBUTED TO THE DEVELOPMENT AND DEPLOYMENT OF PERENNIAL RICE. view more 

CREDIT: PHOTO PROVIDED BY SHILAI ZHANG, YUNNAN UNIVERSITY

URBANA, Ill. – After more than 9,000 years in cultivation, annual paddy rice is now available as a long-lived perennial. The advancement means farmers can plant just once and reap up to eight harvests without sacrificing yield, an important step change relative to “ratooning,” or cutting back annual rice to obtain second, weaker harvest.

A new report in Nature Sustainability chronicles agronomic, economic, and environmental outcomes of perennial rice cultivation across China’s Yunnan Province. Already, the retooled crop is changing the lives of more than 55,752 smallholder farmers in southern China and Uganda.

“Farmers are adopting the new perennial rice because it's economically advantageous for them to do so. Farmers in China, like everywhere else, are getting older. Everyone's going to the cities; young people are moving away. Planting rice is very labor intensive and costs a lot of money. By not having to plant twice a year, they save a lot of labor and time,” says Erik Sacks, professor in the Department of Crop Sciences at the University of Illinois and co-author on the report.

Sacks, along with senior author Fengyi Hu and Dayun Tao, began working to develop perennial rice in 1999 in a collaboration between the Yunnan Academy of Agricultural Sciences and the International Rice Research Institute. In subsequent years, the project grew to include the University of Illinois, Yunnan University, and the University of Queensland. Another partner, The Land Institute, provided perennial grain breeding and agroecology expertise, along with seed funding to ensure continuity of the project.

The researchers developed perennial rice through hybridization, crossing an Asian domesticated annual rice with a wild perennial rice from Africa. Taking advantage of modern genetic tools to fast-track the process, the team identified a promising hybrid in 2007, planted large-scale field experiments in 2016, and released the first commercial perennial rice variety, PR23, in 2018.

The international research team spent five years studying perennial rice performance alongside annual rice on farms throughout Yunnan Province. With few exceptions, perennial rice yield [6.8 megagrams per hectare] was equivalent to annual rice [6.7 megagrams per hectare] over the first four years. Yield began to drop off in the fifth year due to various factors, leading the researchers to recommend re-sowing perennial rice after four years.

But because they didn’t have to plant each season, farmers growing perennial rice put in almost 60% less labor and spent nearly half on seed, fertilizer, and other inputs.

“The reduction in labor, often done by women and children, can be accomplished without substitution by fossil fuel–based equipment, an important consideration as society aims to improve livelihoods while reducing greenhouse gas emissions associated with agricultural production,” Sacks says.

The economic benefits of perennial rice varied across study locations, but profits ranged from 17% to 161% above annual rice. Even in sites and years when perennial rice suffered temporary yield dips due to pests, farmers still achieved a greater economic return than by growing the annual crop.

“That first season, when they planted the annual and the perennial rice side by side, everything was the same, essentially. Yield is the same, costs are the same, there's no advantage,” Sacks says. “But the second crop and every subsequent crop comes at a huge discount, because you don't have to buy seeds, you don't have to buy as much fertilizer, you don’t need as much water, and you don't need to transplant that rice. It's a big advantage.”

Avoiding twice-yearly tillage, perennial rice cultivation also provides significant environmental benefits. The research team documented higher soil organic carbon and nitrogen stored in soils under perennial rice. Additional soil quality parameters improved, as well.

“Modern high-yielding annual crops typically require complete removal of existing vegetation to establish and often demand major inputs of energy, pesticides, and fertilizers. This combination of repeated soil disturbance and high inputs can disrupt essential ecosystem services in unsustainable ways, especially for marginal lands,” says Hu, professor and dean in the School of Agriculture at Yunnan University. “Perennial rice not only benefits farmers by improving labor efficiency and soil quality, but it also helps replenish ecological systems required to maintain productivity over the long term.”

Another piece of the study assessed the low-temperature tolerance of perennial rice, with the goal of predicting its optimal growing zone around the world. Although significant exposure to cold limited regrowth, the research team predicts the crop could work in a broad range of frost-free locations.

Although they’ve already conducted on-farm testing and released three perennial rice varieties as commercial products in China and one in Uganda, the researchers aren’t done refining the crop. They plan to use the same modern genetic tools to quickly introduce desirable traits such as aroma, disease resistance, and drought tolerance into the new crop, potentially expanding its reach across the globe.

"While early findings on the environmental benefits of perennial rice are impressive and promising, more research and funding are needed to understand the full scope of perennial rice's potential," says Tim Crews, Chief Scientist at The Land Institute and study co-author. "Questions about carbon sequestration and persistence and greenhouse gas balances in perennial paddy rice systems remain. Researchers must also make progress on perennializing upland rice, which could curb highly unsustainable soil erosion on farmlands across Southeast Asia. As the work of Dr. Hu's group at Yunnan University progresses, The Land Institute and an ever-growing network of collaborators will continue to support these research and scaling efforts for perennial rice globally."

Sacks adds, “I think now, with perennial rice in farmers’ fields, we have turned a corner. We have been feeding humanity by growing these grains as annuals since the dawn of agriculture, but it wasn’t necessarily the better way. Now we can consciously choose to make a better crop, and a better, more sustainable agriculture. We can fix the errors of history.”

The article, “Sustained productivity and agronomic potential of perennial rice,” is published in Nature Sustainability [DOI: 10.1038/s41893-022-00997-3]. The research was supported by the Land Institute, the National Natural Science Foundation of China, the Yunnan Provincial Science and Technology Department, the National and Yunnan Provincial Administration of Foreign Experts Affairs, and the China Postdoctoral Science Foundation.

The Department of Crop Sciences is in the College of Agricultural, Consumer and Environmental Sciences at the University of Illinois Urbana-Champaign.

Crowded emergency departments may affect patients throughout the hospital

Peer-Reviewed Publication

PENN STATE

UNIVERSITY PARK, Pa. — Prior research has established that crowding in emergency departments can lead to worse outcomes for patients receiving emergency care. Patients in a crowded emergency department become sicker and are more likely to die than those treated in less crowded conditions, but the problems associated with emergency department crowding do not end at the unit’s door. New research from Penn State showed that crowded emergency departments are associated with higher rates of death throughout the hospital.  

In a new article published in the journal Health Services Research, a group of researchers from Penn State and University of California, San Francisco found that patients throughout a hospital are 5.4% more likely to die of any cause on days when that hospital’s emergency department is crowded.  

The researchers examined more than five million discharge records from hospitals across California between October 2015 and the end of 2017. Other than records from the smallest hospitals, records from patients younger than 20 and records from patients transferred between hospitals, all hospital discharges in the state were captured. The researchers found that people were more likely to die on days when the emergency department in their hospital was crowded.   

In the study, the researchers measured crowding by counting the number of people in the emergency department. Conceptually, emergency department crowding is more complex than the number of people in the department; it also involves the level of staffing, the number of inpatient beds available, and the complexity of cases being treated. Still, prior research has shown that the count of people in the emergency department can serve as an effective proxy for all these factors.  

“Though it is understood that a lack of available inpatient beds can lead to emergency department crowding, this is the first time that research has examined whether this crowding was associated with problems throughout the hospital,” said Charleen Hsuan, assistant professor of health policy and administration and lead author of the article. “Since this association was just discovered, we do not know for sure what causes the increase in deaths, but increased workload for the inpatient nurses and doctors seems to be one likely factor.” 

An average of 2.6% of hospital patients died during inpatient stays throughout the study. As the emergency department in a hospital became more crowded, people throughout that hospital became more likely to die. When emergency department occupancy was above average, inpatients in the hospital were 3.1% more likely to die. Then, when emergency departments became more crowded, inpatients were 3.8% more likely to die than the average death rate for all patients. When emergency departments were the most crowded, patients were 5.4% more likely to die.   

“We are not saying that people are dying because of emergency room crowding,” Hsuan said. “The causes of death have not been explored. What these results show, however, is that hundreds more people died every year in these hospitals when emergency departments were crowded than when emergency departments were less full. Whatever the reason or reasons, that phenomenon is clearly important to understand.” 

The researchers said that the situation must be addressed, but they caution that it is too early to implement solutions. One factor is that the data were collected in California, one of the only states in the nation that legislates minimum staffing levels for nurses. It is possible — though this has not been evaluated — that the death rate is even higher when an emergency department is crowded in states where nurse staffing levels are lower. More research is needed to understand both the scope of the problem and the implications of these findings.  

“One thing is clear: emergency department crowding is a whole-hospital problem,” Hsuan said. “When policymakers and hospital administrators think about this problem, they need to consider the impacts on all patients and not just those in the emergency department. Policymakers may need to take a systems perspective on improving the quality of care in hospitals.” 

Joel Segel, associate professor of health policy and administration at Penn State; Renee Hsia, professor of emergency medicine at University of San Francisco, California School of Medicine;  Yinan Wang, doctoral candidate of health policy and administration at Penn State; and Jeannette Rogowski, professor of health policy and administration; also contributed to this research.

This work supported by funding from the National Institute of Minority Health and Health Disparities, the National Center for Advancing Translational Sciences, the American Cancer Society, and the National Heart, Lung, Blood Institute.