Tuesday, May 25, 2021

PBS Program on Data and Pandemics

PBS has a good series on how medicine has learned to fight pandemics.  This particular episode focuses on how data is used to understand and limit pandemics.  It starts with how William Farr used data to track a cholera outbreak.  I've embedded this episode here for your enjoyment and information.

**Related Posts**

Income and Life Expectancy. What does it Tell Us About US?



Friday, May 21, 2021

Pennsylvania has Become the First State in the U.S. to Curb the Governor's Emergency Powers


In the 2021 primary election in Pennsylvania there were 2 constitutional amendments on the ballot to limit the Governors emergency powers in times of a pandemic or natural disaster.  The first amendment empowers the state legislature to terminate or extend a disaster declaration with a simple majority without input by the governor. The second amendment places a 21 day limit on a disaster declaration with legislature approval needed for an extension.  A fuller explanation of these amendments can be seen here.




These amendments have been approved with 53% of the vote apiece.  In Cambria County, the first amendment received 62.7% of the vote and the second received 63.3%.  These amendments could have major ramifications for how the state handles future crises such as natural or epidemiological disasters.




For example, in the not so distant future, natural disasters related to climate change could befall this and other states.  A legislature with a majority of climate change deniers can block the governor from taking action beyond 21 days.  There is no way of knowing how many lives Gov. Wolf's disaster declaration saved but it did save lives.  

The graph above shows the daily death counts in Pennsylvania since the pandemic began.  Restrictions were made in March the death counts rose until May and then leveled decreased as personal protective equipment and ventilators became more available.  The restrictions were eased in June and deaths did not rise.  The deaths began to rise after the November election due to mask-less rallies held by the Trump campaign in the state.  Due to this restrictions were then tightened during the Christmas holidays and the deaths decreased in the state (though higher than it was before the election).  Roughly 21% of the state's eligible voters voted in the primary.

The voters who went to the polls and voted yes on these ballot questions (10.8% of the electorate in Pennsylvania) are rebuking Gov. Wolf for listening to scientists such as Rachel Levine.  Levine now works for the Biden Administration as the first transgender department head.  The right has distributed images like the one above to demonize the governor and Dr, Levine.  One has to wonder how much transphobia played a role in this primary.

Our county, Cambria County, still ranks 9th in the state in case mortality and 5th in deaths/100,000 while it voted 63% for both measures.

**Related Posts**



Our Webinar on the Corona Virus Numbers in Cambria County

Thursday, May 13, 2021

Darwin and Corona Virus Vaccine

In addition to my teaching and tracking the corona virus numbers for Cambria County I have been reading the book that is currently tied for first place on my best nonfiction book pollOn the Origin of Species by Means of Natural Selection by Charles Darwin.  For me it is not as dry a read as Moby Dick.  It talks about how species of plants, animals and microorganisms change over time.  

The modifications that appear in organisms appear at random.  Most of these changes are detrimental.  Once in a while a modification to a member of a species gives it an advantage in survival over its rivals.  These traits will be selected for in the population in breeding.  


Viruses and bacteria, with simpler DNA sequences than multicellular organisms can mutate more easily and be modified faster.  I wonder how many who still don't believe in Darwin's theory also believe that the Corona Virus was created by a sinister scientist in Wuhan China.  How many of these are also hesitant to be vaccinated?  As the vaccine has become more available, the 7day average for new full vaccinations has been coming down from 891.1 per day on April 18 to 332.3 per day today.


**Related Posts**



Sunday, May 2, 2021

COVID-19 Cases Have Risen in Cambria County but Deaths Have Not Due to Vaccinations (so far)

The second installment of We Are All In This Together: Pandemic-Johnstown 1918 has come out and can be seen above.  Recently there has been a rise in cases as spring has sprung.  Since the terrible months of December and January, the 7 day average for new cases fell from 214.29 on Dec 11 to 14.29 on March 20.  Since then, the 7 day average has risen to a high of 58.43 on April 19 to 49.29 today as can be seen in the graph below.  This rise has occurred after the vaccine rollout began on Jan 8.























Since the cases have risen, the deaths in the county have remained fairly stable as can be seen in the above graph.  The 7 day average for deaths reached a high of 8.14 deaths per day on Dec 17 (6 days after the spike in cases).  Since March 16, the average has not risen above 1 death per day.  
























The graph above shows the trend in the 7 day average for new cases (black line), testing (red dotted line) and full vaccinations (orange line).  The lines for testing and vaccinations are on a logarithmic scale.  The number of full vaccinations per day has fallen from a high of 855.4 on April 14 to 399.9 today.  On April 13 all Pennsylvanian's over age 16 became eligible to receive the vaccine.  To date 40,920 of 31.43% in Cambria County have been fully vaccinated.

























This graph from the state department of health shows that the majority of cases are between the ages of 20 and 59 throughout the state.  This information is not available at the county level.

























This final graph shows that the vast majority of deaths in PA have been between ages 60 and 99.  The early phases of the vaccine rollout have focused on groups most vulnerable such as the elderly.  The vaccinations seem to be curtailing the number of deaths even though there has been a rise in cases.  The younger age groups still need to be vaccinated to stop the spread of the virus.  

**Related Posts**


Sunday, April 25, 2021

The 1918 Spanish Flu Pandemic in Johnstown


In this Together Cambria has created a series of short films on the 1918 Spanish Flu Pandemic to show how similar it is to what is happening today with the coronavirus.  Above is the first part of a four part series produced by UPJ professor Paul D. Newman.  It was filmed at the Oklahoma House at the Johnstown Flood Museum.  The next three parts will debut on their YouTube channel.  

**Related Posts**

Our Webinar on the Corona Virus Numbers in Cambria County



Friday, April 16, 2021

Some Clues for Racial Disparities for Cambria County

Last week I posted on the racial disparities in health outcomes in Cambria County.  These disparities are primarily what is driving the low rankings for the county in the County Health Rankings.

County Health Rankings provides a wealth of statistics called health factors which provide clues to these disparities.  Here is a list:

  • 9% of the live births in the county from 2013-2019 are low birthweight which is 1% higher then the state rate. 16% of African American births are low birthweight compared to 12% of Hispanic and 6% of Caucasian births. in the county
  • The teen birth rate is 20 per 1,000 live births from 2013-2019 compared to 17/1,000 for PA.  For African Americans it is 54/1,000, 19/1,000 for Hispanics, and 18/1,000 in the county.
  • The drug overdose death rate from 2017-2019 was 52 per 100,000 for the county.  For Pennsylvania it is 37/100,000.  For African-Americans the rate was 112/100,000  and for Caucasians it was 50/100,000.  According to the website Overdose free PA, there were 18 overdose deaths among African Americans (orange bar in the above graph) in the county from 2017-2019 out of 204 total overdose deaths or 8% of the total.

  • The rate of preventable hospital stays per 100,000 Medicare enrollees for 2018 is 5,762 in the county compared 4464 for PA.  The African American Rate is 6,154 while it is 5,779 for Caucasians in the county.
  • The rate of mammography screening is 42% for the county for Medicare enrollees for 2018 while it is 45% for the county.  For African Americans it is 31% compared to 38% for Asians, 50% for Hispanics, and 42% of Caucasians in the county.
  • The rate of flu vaccinations is 41% overall for the county for Medicare enrollees in 2018 compared to 53% for PA.  For African Americans the rate was 36% in the county while it was 45% for Asians and Hispanics and 41% for Caucasians.
  • The overall rate of child poverty was 23% for the county for 2019 while it was 17% for PA.  For African Americans it was 67% in the county while it was 19% for Asians, 42% for Hispanics, and 20% for Caucasians.
  • Median income in the county was $48,800 for 2019 while it was $63,500 in PA.  For African Americans it was 18,900 in the county while for Asians it was $90,000, for Hispanics it was $35,100, and for Caucasians it was $48,100.
  • The injury death rate was 128 per 100,000 for the county from 2015-2019 while it was 89/100,000 for PA.  For African-Americans it was 221/100,000 and 126/100,000 for Caucasians in the county.
  • The homicide death rate was 6/100,000 for the county from 2013-2019 while it was 5/100,000 from 2013-2019.  For African Americans it was 50/100,000 while it was 4/100,000 for Caucasians in the county.
  • For firearm fatalities the rate was 16/100,000 from 2015-2019 while it was 12/100,000 for PA.  For African Americans it was 41/100,000 and 15/100,000 for Caucasians in the county.
  • For reading scores, the average grade level was 3.1 for 3rd graders in both the County and PA in 2018.  For African Americans it was at a 2.2 grade level and 3.2 for Caucasians in the county.
  • For math scores, the average grade level for 3rd graders was 3.1 for both the county and PA in 2018.  For African Americans it was at a 2.0 grade level and 3.2 for Caucasians in the county
  • Finally the % of residents who drive alone to work for the county was 82% from 2015-2019 while it was 76% for PA.  For African Americans, 62% drives alone to work in the county while it was 65% for Hispanics and 84% for Caucasians.  This could be due to African Americans and Hispanics being more likely to rely on public transportation to get to work.
These 14 statistics provide some clues to the nature of the racial/ethnic disparities in Cambria County.  They suggest violence and poverty as the main explanatory factors.  One must be careful not to assume that they tell the whole story.  They do provide some clues to where public health resources need to be allocated.  It remains to be seen how the Coronavirus pandemic will interact with these health issues.

**Related Posts**

The 2021 County Health Rankings are Out


County Health Rankings and Corona Virus Cases: Lower ranked counties have fewer cases in PA (except for Philly)


Holiday Poverty Estimates for Johnstown and Cambria County

Saturday, April 10, 2021

African Americans Still Lag Behind in Life Expectancy in Cambria County

Group

Cambria County

Pennsylvania

U.S.

Overall

76.1

78.4

78.7

Caucasian

76.4

78.9*

78.6

African American

67.3

73.4*

74.7

Hispanic

91.3

85.3*

81.8

*Pennsylvania life expectancy by race numbers are from 2010 (Measure of America, 2013) 

In my book, Wuthering Depths in Johnstown: By the Numbers.  I wrote extensively on the 2020 County Health Rankings for Cambria County (where Johnstown is located).  The number that jumped out at me most was racial disparities in mortality data in Cambria county where African Americans had a life expectancy of 65.6 years, Caucasians 76.2 years, and Hispanics 89.0 years.  

This year's life expectancy numbers from the 2021 County Health Rankings are displayed above in the table above for the years 2017-2019 (corona virus deaths are not included).  Cambria County's overall life expectancy increased from 75.6 to 76.1 years (63rd in PA).  Among counties with life expectancies by race, African American life expectancy increased by 1.7 years to 67.3 (the lowest in PA).  Caucasians increased by 0.2 years to 76.4 (3rd lowest ).  Hispanics increased the most by 2.3 years to 91.3 (5th highest in the state).  

Counties with miniscule racial/ethnic minority populations do not have a breakdown for life expectancy by race.  African Americans comprise 3.5% (10.9% of PA) of the county and Hispanics make up 1.8% (7.8% of PA).  Caucasians comprise 92.6% of the county (75.7% of the state).  Approximately 59% of the African Americans in the county live inside the city of Johnstown

Overall the county is 2.6 years behind the US life expectancy.  Caucasians are 2.2 years behind, African Americans are 7.4 years behind, and Hispanics are 9.5 years ahead of the US rate.  Life expectancy is not included in the overall County Health Rankings for Health Outcomes.  Mortality Measured as Years of Potential Life Lost is factored into the rankings which is a measure related to life expectancy.

Years of potential life lost (YPLL) is the number of years lost if someone dies before age 75.  For example, if someone dies at age 25, they have 50 years for potential life lost.  The overall YPLL rate is 9,700 years per 100,000 for the county.  It is 19,900 years per 100,000 for African Americans and 9,400 years per 100,000 for Caucasians.  

The premature age adjusted death rate for the county is the number of deaths under age 75 per 100,000 for the years 2017-2019.  For Cambria it is 440 deaths/100,000.  For African Americans it is 840 deaths/100,000 and for Caucasians it is 430 deaths/100,000.  For Pennsylvania, the overall rate is 350 deaths/100,000.  This measure is provided by County Health Rankings but not factored into the rankings.

The most shocking mortality rate is the child mortality rate which is the number of deaths under the age of 18 per 100,000 for the years 2016-2019.  For Cambria the rate is 50 deaths/100,000 which is the same as PA's rate.  For African Americans in the county, it is 210 deaths/100,000 (the highest in PA) while for Caucasians it is 40 deaths/100,000.  The rate is more than 5 times higher for African Americans. 

The health factors data for the county provides some clues for this discrepancy.  I will discus it in my next post.

**Related Posts**

Why do African Americans live to be 64.8 years in Cambria County?