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The preface explains why the author decided to undertakedisproportionate impact on vulnerable and disadvantaged communities a study of the impact of the pandemic on vulnerable and disadvantaged communities.
Chapter 1 provides an overview of the COVID-19 pandemic’s disproportionate impact on vulnerable and disadvantaged communities and briefly explains why this was the case. It identifies communities that were among those who were so affected. The chapter explains why the book focuses on the United States with comparative data from other countries that it reflects the greater availability of disaggregated data from this country and its deep income and health inequalities which made many disadvantaged groups particularly vulnerable to the impact of the pandemic. It briefly introduces the vulnerable communities which will be highlighted in the book: children, older adults, women, people of color, and the incarcerated population. The chapter also references relevant public health ethical and human rights standards to assess the situation of disadvantaged communities and the obligations of governments. It additionally underscores the importance of evaluating the policies governments adopted, specifically whether the policies took the situation of various disadvantaged groups into account and sought to reduce the deleterious impact of the pandemic on them.
Offering a concise yet comprehensive overview, this textbook explains the fundamental concepts and frameworks that underpin the field of public health. Chapters define key terms and cover topics such as measuring health, technology, equity, leadership, health systems and reform. Real-world health issues, including COVID-19, obesity, HIV/AIDS and climate change, are used to make abstract ideas more easily digestible. Designed for students and professionals interested in public health, it includes learning objectives, illustrative examples, summaries of key takeaways, and comprehension and discussion questions to aid navigation and learning. An instructor manual and test bank are available as supplementary resources.
Kawasaki disease is the leading cause of acquired heart disease in children worldwide. Previous studies from Chandigarh, India, documented a rising incidence until 2019. The COVID-19 pandemic, with its infection-control measures and emergence of multisystem inflammatory syndrome in children, disrupted established epidemiological trends. We aimed to evaluate the impact of the pandemic on incidence, clinical features, and coronary outcomes in children with Kawasaki disease in the Union Territory of Chandigarh.
Methods:
This study was conducted at the tertiary care teaching institute in North-West India, from January 2020 to December 2024. Demographic, clinical, laboratory, and echocardiographic data were collected. Population estimates were derived from national census projections, and annual incidence rates were calculated for children <5 years and <15 years. Temporal and seasonal trends were analysed using regression models and Chow tests.
Findings:
A total of 442 children with Kawasaki disease were diagnosed during the study period—of these, 60 (median age 40.5 months, 62% male, 63% complete, and 37% incomplete Kawasaki disease) were residents of Chandigarh. Incidence declined markedly during the pandemic (1.7 and 3.4 per 100,000 children <5 years in 2020 and 2021, respectively), followed by a rebound in 2022 (8.4) and 2023 (5.8), and a sharp rise in 2024 (13.9), the highest incidence recorded to date in Chandigarh. Coronary artery abnormalities were detected in 13% of patients, with 3.3% showing persistent lesions at 6 weeks. No deaths occurred, and seasonal patterns remained unchanged compared with 2015–2019.
Interpretation:
Kawasaki disease incidence in Chandigarh declined transiently during the COVID-19 pandemic but rebounded sharply post-pandemic, exceeding the highest previously reported estimates. Despite fluctuations, clinical features and coronary outcomes remained stable. These findings reinforce Kawasaki disease as an endemic childhood vasculitis in Chandigarh, India, and highlight the need for ongoing surveillance and early recognition as an important contributor to acquired heart disease burden in children.
This narrative account of the working career of Kenyan popular “live band” musician Awillo Mike in 2020 explores the contribution that musicking makes to social resilience. Ethnographic and literary methods were used to construct a story of one artist’s struggles to survive and sustain his music career during the COVID-19 pandemic—a story that demonstrates how musicking is an everyday entertainment practice that fulfils deep psychological needs, persisting even in the most difficult circumstances by adapting. The account also contends that musicking directly and indirectly supports community resilience.
This chapter examines the placing of COVID-19 grief through ethnographic vignettes from three distinct contexts: the prolonged search by one woman in Guayaquil, Ecuador, to find and bury her mother’s body; the ritualized micro-eulogies and use of public health data that characterized Kentucky’s state response to the pandemic; and the community efforts to create a national commemorative space in Washington, DC, for lives lost to COVID in the absence of state recognition. Drawing on philosopher Emmanuel Levinas’s notion of the ethical imperative to care for the deceased, we show how individual acts of mourning – what we call “micro-eulogies” – confront the silences and erasures surrounding COVID-19 death. These quotidian practices of naming, honoring, and remembering the dead emerge alongside and against narratives of revisionism and calls to “move on.” In attending to the specificity of these three places – geographic, sociopolitical, symbolic – and the movement of individual and collective grief between the private and the public, the chapter explores what it means for the experience of COVID-19 loss to be located. It argues that localizing pandemic grief is an act of refusal, one that demands a collective reckoning and response.
This paper examines Ghana’s COVID-19 response through a biopolitical and biosecurity lens. Drawing on Michel Foucault’s concept of biopolitics, it analyzes how interventions such as lockdowns, biosurveillance, and vaccination campaigns functioned both as technologies of care and instruments of control, expanding state authority over biological and social life. The study shows that biopolitics in Ghana did not replicate Western models but emerged as a provincialized and context-dependent form of power shaped by infrastructural constraints, informal economies, and postcolonial state formation. Pandemic governance was, therefore, adaptive and improvisational, requiring negotiation between epidemiological control and socioeconomic survival. By bringing biopolitics into dialogue with postcolonial theory and necropolitics, the paper conceptualizes pandemic governance as a hybrid regime in which life-preserving and life-abandoning logics coexist. It thus challenges universalist assumptions and repositions the Global South as central to rethinking the governance of life.
This chapter examines experiences of racial discrimination faced by Asian American families during the COVID-19 pandemic. Grounded in historical and sociopolitical contexts, it explores how the pandemic served as a flashpoint that intensified anti-Asian racism through structural, interpersonal, and digital channels. The authors present an integrated developmental and intersectional framework to analyze how racism impacted youth identity, mental health, family dynamics, and academic outcomes. Emphasis is placed on vicarious and direct discrimination, collective racism, and internalized bias, as well as coping strategies and resilience factors such as ethnic and racial socialization and civic engagement. The role of key microsystems – families, schools, neighborhoods, and digital spaces – is discussed. The chapter highlights ethnic, generational, and socioeconomic diversity within Asian American communities and the differential effects of racism across these lines. It concludes by identifying gaps in current research, calling for longitudinal, context-sensitive studies, and offering policy and intervention recommendations to support the well-being of Asian American youth.
Point-of-care technology (POCT) has expanded rapidly, particularly since the COVID-19 pandemic. However, less is known about which POCT applications and features patients and caregivers prioritize for lung disease management.
Methods:
We refined a patient-facing survey based on feedback from an online focus group recruited through community and advocacy volunteer networks. The survey was then administered via ResearchMatch to uncompensated U.S. volunteers, who indicated interest in lung disease research (April 1 to May 14, 2025; 6,333 invitations). POCT perceptions were measured via a 10-point Likert scale.
Results:
We received 214 responses (3.4% response rate). Respondents were predominantly patients (79%), female (71%), and older than 60 years (59%). Mean ratings suggested strong perceived benefits across nine POCT benefits and low concern across most drawbacks. The greatest concern was insurance coverage for POCT-associated costs (mean score: 6.7/10). Obstructive lung conditions were most frequently prioritized for future POCT applications.
Conclusion:
Among a national sample of ResearchMatch volunteers affected by lung disease, interest in POCT was high, and insurance coverage remained the most salient concern. By describing preferences and concerns of patients, this study informs future design, regulatory approval, and clinical integration. These findings provide evidence for POCT developers, clinicians, and policymakers focused on improving patient-centered care.
The Conclusion reflects on how digital technologies have become inseparable from the rhythms, identities and power structures of the Brussels Bubble and the European Union itself. Drawing on Stefan Zweig’s vision of technology as both a unifier and disruptor, the chapter argues that the EU is now a virtual social field – a polity where governance, diplomacy and community are co-constituted by digital infrastructures. Through ethnographic insights, it reveals five key transformations: the EU as a digitally mediated space; social media as a symbolic economy of insider recognition; diplomats and officials as cyborgs, their bodies and selves extended by devices; the everyday negotiation of digitalisation, where technology is not imposed but adapted and contested; and the necessity of a practice turn for understanding global governance in the digital age.
The chapter underscores that digital tools do not merely facilitate EU politics – they reshape its boundaries, hierarchies and temporalities. From WhatsApp groups to virtual meetings, technology is both a site of empowerment and vulnerability, challenging ideals of transparency, equality and sovereignty. Ultimately, the EU’s future will be negotiated at the intersection of human agency and digital mediation, where the ambivalence of progress and disruption mirrors the complexities of European integration itself.
Personal networks provide crucial support during crises, yet people are embedded in different network types that structure unequal access to such resources. The current study integrates these perspectives to examine whether—and how—network turnover contributed to disparities in mental health across socioeconomic status (SES) groups during the pandemic. Using two-wave panel data from the COVID-19 Pandemic and Social Network Panel Study (2020–2021), an egocentric network study of the college population in Wuhan, we employ random forests and spectral clustering to identify 7 types of core networks based on 43 network variables (i.e., Family, Friend, Restricted, Family & Community, School & Career, Just Activity, and Homebody). We find that as local social-distancing policies tightened, respondents increasingly shifted to Family and Friend networks and withdrew from School & Career and Just Activity. Individual fixed-effect models reveal that these network turnovers have heterogeneous mental health consequences net of observed and time-invariant unobserved confounders. Moving into Family and Friend networks yields the most favorable mental health outcomes for higher-SES groups, whereas benefits are less pronounced and even reversed among lower-SES groups. This pattern is consistent with SES-based differences in social support available in these network types. The current research advances an updated machine-learning approach for identifying personal network typologies. It also shows how the pandemic laid bare unequal resources embedded in personal networks and intensified health-related social inequality, underscoring the need to theorize network effects as contingent on individuals’ social status and the contexts in which networks are formed and embedded.
Changes in the Supplemental Nutrition Assistance Program (SNAP) after the start of the COVID-19 pandemic included emergency benefit allotments and operation waivers. Using five expenditure-based measures of the nutritional quality of food purchases, we tested whether changes in SNAP during the first year of the pandemic were associated with better nutritional quality of food purchases by participating households with children relative to income-eligible nonparticipating households. Most nutritional quality measures declined from 2019 (pre-pandemic) to 2020 (pandemic) with larger decreases for SNAP households. SNAP participation was associated with small negative differences for nutritional quality of food purchases from stores.
The Covid-19 pandemic has negatively affected labour markets, among other aspects of life. This study examines the impact of the discouraged worker effect during the pandemic, focusing on the Turkish labour market from 2018 to 2021. Although few studies exist on this topic, they rely on labour force participation rates, whereas our dataset includes direct questions and data specifically related to the discouraged worker effect, allowing for a microeconomic analysis. Probit regression results show that the discouraged worker effect was stronger during the pandemic, with job seekers being 1.6% more likely to become discouraged than before. Higher education levels generally reduce this likelihood, both before and during the pandemic. While age negatively correlates with discouragement, this effect diminishes with increasing age. Single women were more adversely affected than single men and married women than married men. Higher unemployment rates increase discouragement, as expected, while an increase in the unemployment rate has a greater effect on individuals during the pandemic period. Findings suggest that the pandemic had a disproportionate impact on certain individuals, particularly with respect to education level and gender, while Türkiye’s societal structure may help explain the observed gender-based differences.
This paper is an act of remembrance, a testimony to the horrors inflicted on our lives and bodies as women prisoners of Tihar Jail No. 6, Delhi. It documents the struggles for life and survival of fellow women prisoners, and bears witness to the deaths of Fiza and Jesca. Through these experiences, I argue that the measures introduced in the lockdown prison during the first wave of the COVID-19 pandemic did not merely respond to a public health emergency, but inaugurated a field of penal experimentation that emboldened existing practices of custodial violence and sought to establish a new regime of impunity aligned with Hindutva politics. I demonstrate how isolation cells came to function as de-facto solitary confinement, how the jail manual was effectively suspended, how the right to life was stratified into hierarchies of “deservingness” by High Powered Committees, and how daily prison life was restructured through intensified surveillance.
The National Project on Achievement in Twins (NatPAT) is a twin project based in the United States (US) that began in 2017. Using a cohort sequential design, the overall goal of the initial project was to uncover salient factors, including genetic and environmental influences, which contribute to the co-development of reading and math performance during elementary school. In 2022, the focus of NatPAT pivoted towards a new focus on the COVID-19 pandemic’s short- and long-term impacts on children’s reading achievement. In addition, a genomics data collection began. New enrollment into the registry continues every year, but currently NatPAT follows 1997 twin pairs and their families as they progress through school. The project supports open science principles, with open materials and code, preregistration, and shared data. Here we present the goals of the project, summarize recent results, methods and materials, with a focus on the integration across many different data sources, and future directions of the project.
To examine the impact the COVID-19 pandemic in Ireland on symptoms and functioning in individuals across a range of mental health disorders.
Methods:
A systematic bibliographic search of case reports, cross-sectional and longitudinal studies was conducted between March 12th, 2020, and December 20th, 2024, among studies evaluating the impact of the COVID-19 pandemic on symptoms and functioning for individuals with pre-existing mental health disorders and for those who presented with self-harm or died by probable suicide in the Republic of Ireland. Studies were independently screened by two reviewers according to inclusion and exclusion criteria, with selected variables extracted and summarised. Risk of bias assessments and narrative synthesis of included studies were conducted.
Results:
Twenty-eight studies met inclusion criteria. Findings were heterogeneous and disorder specific. An increase in presentations of self-harm, anxiety disorders, and eating disorders to child and adolescent mental health services and emergency departments was noted, with relative stability of symptoms in other cohorts including bipolar disorder and treatment-resistant schizophrenia. Significant symptom deterioration, with poor quality of life and functioning was demonstrated in individuals with emotionally unstable personality disorder both cross-sectionally and longitudinally.
Conclusions:
Most people with pre-existing mental disorders did not experience significant exacerbation associated with the pandemic, with exception of those with eating disorders and EUPD.
Although patients with lung cancer are at high risk of poor outcomes from COVID-19, little is known about the economic and psychosocial impact of the pandemic on this population. This study had 2 objectives: (1) to identify the prevalence of financial and social disruptions and other adverse COVID-19 experiences in socioeconomically diverse patients with lung cancer; and (2) to examine whether these experiences were associated with physical and psychological symptoms.
Methods
Patients with lung cancer (N = 191) were recruited from a cancer center in the midwestern U.S. from August 2021 to April 2022 to participate in a cross-sectional survey of COVID-19 experiences and symptoms. Path analyses tested associations between COVID-19 experiences and symptoms, adjusting for sociodemographic and medical covariates.
Results
Prevalent COVID-19 experiences included disrupted interactions with family and friends (66.0%), inability to perform daily routines (38.5%), and financial difficulties (18.5%). Greater financial hardship and disruptions to daily activities and social interactions were associated with higher levels of all physical and psychological symptoms. Endorsing more COVID-19 experiences (e.g., job loss, death of loved ones) was only associated with greater anxiety. Despite prevalent hardships, mean levels of physical and psychological symptoms were within normal ranges, except for elevated fatigue.
Significance of the results
Although adverse COVID-19 experiences were common and related to symptom burden, patients with lung cancer showed notable psychological resilience during the pandemic. Oncology clinicians should consider the impact of COVID-19 experiences when providing financial and support services.
Studies conducted during the COVID-19 pandemic highlighted that confinement reduced access to services and increased caregivers’ responsibilities and isolation.
Objectives
This study examines the longer-term impacts among 83 unpaid caregivers of older adults from four Canadian provinces.
Methods
Participants completed an online questionnaire between October 2021 and February 2022, and again 6 months later, on the assistance provided, support received, language of services, and psychological well-being. Additionally, eight caregivers participated in a qualitative interview.
Findings
Most home support services were maintained during the pandemic – some with restricted staffing – except for respite and transportation services. Caregivers increased their assistance during the lockdowns, and this higher involvement persisted in 2022. They perceived a negative impact of the pandemic on their health and that of the care recipient. Participants from official language minority communities described additional challenges accessing services in their preferred language.
Discussion
Greater recognition of caregivers’ needs will help support their role as partners within health organizations.
How do partisan differences in mass behavior and attitudes vary across contexts? Using new individual-level panel data on the COVID-19 pandemic from 54,216 US adults between March 2020 and September 2021, we consider how partisan differences vary according to the personal costs and benefits of behaviors, their public symbolism, and elite-level policy choices. Employing various panel data estimators, including difference-in-differences, we evaluate how partisan gaps evolve across changes to the political and health contexts, including the national vaccine rollout, individual vaccination status, and within-state policy variation. We find partisan divides are substantial even in (ostensibly) apolitical domains, although they are tempered by higher net personal costs to actions, lower public symbolism, and elite policy choices that counter national party cues.
The development of philanthropic foundations in China is constrained by both state corporatism and the ‘administrative absorption of society.’ In this study, we use the term ‘absorptive philanthropic governance’ to describe the process where absorption is combined with intentional space for collaboration within the governance of the philanthropic sector. This concept elucidates how these two elements interact and influence each other to achieve a balance with which civil society organizations retain the capacity for autonomous social initiatives, even under the corporatist state. The COVID-19 pandemic has highlighted these dynamics. Employing interviews and case studies of 13 philanthropic foundations active in China’s COVID-19 disaster relief, we delineate their institutional positioning and identify the unique agendas, mobilization strategies, and social objectives of each type of foundations. The findings reveal both the differentiation among foundations and the resilience of the civil society sector, suggesting that, despite the current heightened political control, the evolving patterns of philanthropic governance in China signal potential for civil society development in the future.