Health equity in COVID-19 testing among patients of a large national pharmacy chain
Date
2024-09-11
Journal Title
Journal ISSN
Volume Title
Publisher
Frontiers in Public Health
Abstract
Background: Several social determinants of health and other structural factors drive racial and ethnic disparities in COVID-19 risk, morbidity, and mortality. Public-private collaborations with community pharmacies have been successful in expanding access to COVID-19 testing and reaching historically underserved communities. The objectives of this study were to describe individuals who sought testing for COVID-19 at a national community pharmacy chain and to understand potential racial and ethnic inequities in testing access, positivity, and infection with emerging variants of concern.
Methods: We conducted a cross-sectional study of individuals aged ≥18 who were tested for COVID-19 (SARS-CoV-2) at a Walgreens pharmacy or Walgreen-affiliated mass testing site between May 1, 2021 and February 28, 2022. Positivity was defined as the proportion of positive tests among all administered tests. A geographically balanced random subset of positive tests underwent whole genome sequencing to identify specific viral variants (alpha, delta, and omicron). Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) to compare the likelihood of testing positive and testing positive with an emerging variant of concern across race and ethnicity groups.
Results: A total of 18,576,360 tests were analyzed (16.0% tests were positive for COVID-19; 59.5% of tests were from White individuals and 13.1% were from Black individuals). American Indian or Alaska Native (OR = 1.12; 95%CI = 1.10–1.13), Hispanic or Latino (1.20; 95%CI = 1.120, 1.21), and Black (1.12; 95%CI = 1.12, 1.13) individuals were more likely to test positive for COVID-19 compared to White individuals. Non-White individuals were also more likely to test positive for emerging variants of concern (e.g., Black individuals were 3.34 (95%CI = 3.14–3.56) times more likely to test positive for omicron compared to White individuals during the transition period from delta to omicron).
Discussion: Using a national database of testing data, we found racial and ethnic differences in the likelihood of testing positive for COVID-19 and testing positive for emerging viral strains. These results demonstrate the feasibility of public-private collaborations with local pharmacies and pharmacy chains to support pandemic response and reach harder to reach populations with important health services.
Description
This article was originally published in Frontiers in Public Health by Frontiers Media. The version of record is available at: https://doi.org/10.3389/fpubh.2024.1422914
Copyright © 2024 Singh, Smith-Ray, Ogunkoya, Shah, Harris, Hayes and Mor. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
This research was featured in UDaily on 10/02/24 at: https://www.udel.edu/udaily/2024/october/epidemiology-covid-testing-walgreens-health-equity-disparities/
Keywords
COVID-19, health equity, pharmacy, whole genome sequencing, testing
Citation
Singh T, Smith-Ray RL, Ogunkoya E, Shah A, Harris DA, Hayes KN and Mor V (2024) Health equity in COVID-19 testing among patients of a large national pharmacy chain. Front. Public Health. 12:1422914. doi: 10.3389/fpubh.2024.1422914