Syndemics and the Commitment to Quitting Equitably

An equity-driven COVID-19 pandemic response includes more than just diagnostics, PPE, vaccines and treatment, especially when considering tobacco use and other risk factors for chronic diseases. It includes focusing on individual factors leading to social inequity that has been long-standing in communities across the country. To ensure health justice, public health needs to address COVID-19 and tobacco as a syndemic and unite efforts toward mitigating the root causes of these social factors that allow health disparities to foster in both epidemics.

Historically, individuals with low income are more likely to smoke, spending as much as 10% of disposable income on tobacco products, which can contribute to maintaining a cycle of poverty, both domestically and globally. Rurality also has an impact, as does racial and ethnic background on likelihood of tobacco use. Recent meta-analysis has also suggested that there is a connection between smoking and COVID-19 progression, meaning that the effects of COVID-19 are more severe in patients with a higher average pack-per-year history. This World No Tobacco Day should mean investing in historically vulnerable communities so they equitably emerge from the root causes that make COVID-19 and tobacco so much more deadly to them.

The HHS InnovationX team worked with the HHS COVID-19 Diagnostics Informatics team to better understand social inequity in the country in the context of COVID-19. Analyzing several key open datasets created the COVID-19 Community Vulnerability Crosswalk, a machine-readable dataset that snapshots several key factors related to geography, demographics and socioeconomics:

This dataset helps display current COVID-19 related impacts with long-standing social disparity data: low-income areas, rural areas, and tribal communities, factors that also influence tobacco disparities. The dataset also weighs these variables using a scoring methodology from recent federal grantmaking, that helps ensure they overlap correctly. You can learn more about this Community Vulnerability Crosswalk project here.

Figure 1 – A look at the most under-resourced communities in the 50 United States during COVID-19

This data-driven innovation illuminates the overlapping impacts on the most under-resourced areas. As COVID-19 diagnostics, PPE, vaccines, and treatment resources are routed to these greatest-need areas, federal, state, local, territorial and tribal public health leaders should also consider how to guarantee that better chronic disease prevention resources be provided to these areas. For tobacco use, this means increasing access to cessation tools like the Food and Drug Administration-approved Nicotine Replacement Therapy and counseling can help reduce the impacts of these long-standing social factors, among other actions.

World No Tobacco Day has historically been an opportunity to celebrate the progress made against the global tobacco epidemic, and this year can help mark progress against the global COVID-19 pandemic. The U.S. Department of Health and Human Services has committed to ending the tobacco epidemic, developing resources like Centers for Disease Control and Prevention’s Tips From Former Smokers and FDA’s The Real Cost, the national Quitline portal (1-800-QUIT-NOW) and Smokefree.gov. These resources provide free information and resources to help individuals in all communities quit using tobacco and remain tobacco free. Considering tobacco as a syndemic with COVID-19 and understanding the upstream social root causes of health disparities can help move us closer improving health and achieving health equity in our most under-resourced communities.

More from: Office of the Assistant Secretary for Health (OASH)

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    The United States filed a forfeiture complaint in the U.S. District Court for the District of Columbia alleging that all oil aboard a Liberian-flagged vessel, the M/T Achilleas (Achilleas), is subject to forfeiture based on U.S. terrorism forfeiture laws. The complaint alleges a scheme involving multiple entities affiliated with Iran’s Islamic Revolutionary Guard Corps (IRGC) and the IRGC-Qods Force (IRGC-QF) to covertly ship Iranian oil to a customer abroad.  Participants in the scheme attempted to disguise the origin of the oil using ship-to-ship transfers, falsified documents, and other means, and provided a fraudulent bill of lading to deceive the owners of the Achilleas into loading the oil in question. 
    [Read More…]
  • The Stability and Security of the Western Balkans
    In Crime Control and Security News
    Antony J. Blinken, [Read More…]
  • John Kerry Virtual Leaders Summit on Climate Opening Remarks
    In Climate - Environment - Conservation
    John Kerry, Special [Read More…]
  • Justice Department Concludes Its Investigation of D.C.-Area Private High Schools’ Decision to Stop Offering Advanced Placement Courses
    In Crime News
    The Department of Justice announced today that it has completed its investigation into whether Georgetown Day School, Holton-Arms School, Landon School, Maret School, National Cathedral School, The Potomac School, St. Albans School, and Sidwell Friends School (jointly, “the Schools”) collectively agreed to stop offering Advanced Placement (AP) courses by 2022 in violation of the Sherman Act.  The Schools announced in June 2018 that they would eliminate AP courses from their curricula by 2022. 
    [Read More…]
  • Veterans Affairs: Use of Additional Funding for COVID-19 Relief
    In U.S GAO News
    What GAO Found The Department of Veterans Affairs (VA) received $19.6 billion in supplemental funding—additional funding above the annual appropriation—in March 2020 to respond to the COVID-19 pandemic. GAO's analysis of VA data shows that through March 2021, VA had obligated $9.9 billion and expended $8.1 billion of the supplemental funding. Department of Veterans Affairs (VA) Reported Obligations and Expenditures of CARES Act and Families First Coronavirus Response Act Funding through March 2021 Note: An obligation is a definite commitment that creates a legal liability to pay, and an expenditure is the actual spending of money. The majority of the obligated supplemental funding ($8.3 billion) was obligated by VA's Veterans Health Administration (VHA) for care provided to veterans by non-VA providers, the additional costs of salaries (such as for overtime) and related expenses of VHA staff, supplies and materials, and support for homeless veterans, due to COVID-19 response. The remaining obligations included costs of VA's transition to telehealth and telework during the COVID-19 pandemic, primarily through the Office of Information Technology (OIT). According to spend plan documents and department officials, VA plans to obligate its remaining $9.7 billion in funding on activities including COVID-19 testing, purchasing supplies and equipment, and distributing COVID-19 vaccines. VA mainly relies on its standard financial management processes to oversee the use of supplemental funds, including establishing new versions of standard financial codes to account for and report on use of funds through VA's financial system. VA also collected details about the use of supplemental funding, such as descriptions of the activities for which funds were obligated, that were not available in its financial system. In addition, the VA components that received the majority of the supplemental funding—VHA and OIT—set up additional processes and issued guidance specific to the use of supplemental funding, such as establishing councils to review funding requests. Why GAO Did This Study As of April 14, 2021, VA reported 224,538 cumulative veteran cases of COVID-19, and 11,366 deaths. The CARES Act and Families First Coronavirus Response Act included supplemental funding for COVID-19 relief, and the Consolidated Appropriations Act, 2021, permitted VA additional flexibility to transfer these funds across the department. The CARES Act also included a provision for GAO to report on its ongoing monitoring and oversight efforts related to the COVID-19 pandemic. This report examines 1) VA's obligations and expenditures of COVID-19 supplemental funding, as well as its plans to obligate remaining funds, and 2) how VA oversees the use of COVID-19 supplemental funds. GAO reviewed VA data on obligations, expenditures, and spend plans for COVID-19 supplemental funding, as well as contracting documentation and documentation on the processes and guidance VA developed to oversee the use of funds. GAO interviewed VA officials responsible for oversight of the supplemental funding, including officials from five regional networks, selected based on funding levels and geography, to gather information about their roles in overseeing the use of and accounting for supplemental funding. VA reviewed a draft of this report and provided a technical comment, which was incorporated as appropriate. For more information, contact Sharon M. Silas at (202) 512-7114 or silass@gao.gov.
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  • Seven charged for roles in a $110 million compound drug scheme
    In Justice News
    A compound pharmacy [Read More…]
  • School Owner Sentenced for Defrauding Department of Veterans Affairs Program Dedicated to Rehabilitating Disabled Military Veterans
    In Crime News
    A Maryland man was sentenced Monday to 30 months in prison and ordered to pay $150,000 in restitution for defrauding a U.S. Department of Veterans Affairs (VA) program dedicated to rehabilitating military veterans with disabilities. 
    [Read More…]
  • Removal Order Upheld Against Tennessee Man Who Served as Nazi Concentration Camp Guard During WWII
    In Crime News
    The Board of Immigration Appeals (BIA) has dismissed the appeal of Tennessee resident Friedrich Karl Berger, a German citizen who was ordered removed from the United States earlier this year on the basis of his service in Nazi Germany in 1945 as an armed guard of concentration camp prisoners in the Neuengamme Concentration Camp system (Neuengamme).
    [Read More…]
  • Secretary Blinkens Call with Saudi Foreign Minister Faisal bin Farhan Al Saud
    In Crime Control and Security News
    Office of the [Read More…]
  • Celebrating International Women’s Day
    In Crime Control and Security News
    Antony J. Blinken, [Read More…]
  • Sanctions Against Businesses Linked to Mexican Cartels
    In Crime Control and Security News
    Michael R. Pompeo, [Read More…]
  • Kenyan National Indicted for Conspiring to Hijack Aircraft on Behalf of the Al Qaeda-Affiliated Terrorist Organization Al Shabaab
    In Crime News
    The Department of Justice announced the unsealing of an indictment charging Cholo Abdi Abdullah with six counts of terrorism-related offenses arising from his activities as an operative of the foreign terrorist organization al Shabaab, including conspiring to hijack aircraft in order to conduct a 9/11-style attack in the United States.  Abdullah was arrested in July 2019 in the Philippines on local charges, and was subsequently transferred on Dec. 15, 2020 in connection with his deportation from the Philippines to the custody of U.S. law enforcement for prosecution on the charges in the indictment.  Abdullah was transported from the Phillippines to the United States yesterday, and is expected to be presented today before Magistrate Judge Robert W. Lehrburger in Manhattan federal court.  The case is assigned to United States District Judge Analisa Torres.
    [Read More…]
  • Secretary Michael R. Pompeo Briefing with the Traveling Press
    In Crime Control and Security News
    Michael R. Pompeo, [Read More…]
  • Former Hilo Correctional Officer Pleads Guilty for Assaulting an Inmate and Conspiring with Other Officers to Cover it Up
    In Crime News
    A former correctional officer at the Hawaii Community Correctional Center pleaded guilty to three felony offenses yesterday for assaulting an inmate; for failing to protect the inmate from being assaulted by three other correctional officers; and for conspiring with those officers to cover it up.
    [Read More…]
  • Former City Officials Sentenced for Accepting Bribes in Exchange for Cannabis Dispensary Permit
    In Crime News
    Two California men were each sentenced today to two years in prison for accepting bribes in return for a guarantee of a city permit to open a commercial cannabis dispensary.
    [Read More…]
  • OECD Working Group on Bribery Issues Report Commending United States for Maintaining Leading Role in the Fight Against Transnational Corruption
    In Crime News
    The Working Group on Bribery of the Organisation for Economic Co-operation and Development (OECD Working Group) issued its Phase 4 Report of the United States today, announced the U.S. Departments of Justice, Commerce, State, and the Securities and Exchange Commission (SEC).
    [Read More…]
  • Six Language Recruiters Indicted for Recruiting Unqualified Linguists for Deployment with U.S. Armed Forces in Afghanistan
    In Crime News
    A federal grand jury in the Eastern District of Virginia returned an indictment Wednesday charging six former employees of a government contractor for their role in a conspiracy to commit wire fraud in connection with a U.S. government contract to recruit and deploy qualified linguists to Afghanistan where they would provide language services in Dari and Pashto to the U.S. military, including interacting with Afghan civilians and military forces.
    [Read More…]
  • Japan Travel Advisory
    In Travel
    Reconsider travel to [Read More…]
  • Judges Focus on Diversity in Clerkship, Internship Hiring
    In U.S Courts
    Federal judges are working to make highly sought-after law clerkships and judicial internships more accessible to a diverse pool of law students.
    [Read More…]
  • Annual Greening Diplomacy Initiative Award Winners
    In Crime Control and Security News
    Office of the [Read More…]
  • Our Deepest Condolences on the Passing of His Highness Sheikh Sabah Al Ahmad Al Sabah
    In Crime Control and Security News
    Michael R. Pompeo, [Read More…]