Health equity in COVID-19 testing among patients of a large national pharmacy chain

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Author(s)Singh, Tanya
Author(s)Smith-Ray, Renae L.
Author(s)Ogunkoya, Elijah
Author(s)Shah, Amy
Author(s)Harris, Daniel A.
Author(s)Hayes, Kaleen N.
Author(s)Mor, Vincent
Date Accessioned2024-10-10T17:45:18Z
Date Available2024-10-10T17:45:18Z
Publication Date2024-09-11
DescriptionThis 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/
AbstractBackground: 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.
SponsorThe author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National Institute of Aging (NIA) of the National Institutes of Health (Award No. U54AG063546), which funds NIA Imbedded Pragmatic Alzheimer’s Disease and AD-Related Dementias Clinical Trials Collaboratory (NIA IMPACT Collaboratory). Supplemental funding was provided under grant 3U54AG063546-S08. The content was solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Conflict of interest TS, AS, RLS-R, and EO were employed by the company Walgreen Co. DAH has received consulting fees from the company Sanofi for consulting and research unrelated to the present study. KNH has received grant funding paid directly to Brown University for collaborative research from Insight Therapeutics, Sanofi, and Genentech for research on complex insulin regimens, influenza outbreak control, and influenza vaccination in nursing homes. KNH has also served as a consultant for the Canadian Agency for Drugs and Technologies in Health. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
CitationSingh 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
ISSN2296-2565
URLhttps://udspace.udel.edu/handle/19716/35218
Languageen_US
PublisherFrontiers in Public Health
dc.rightsAttribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
KeywordsCOVID-19
Keywordshealth equity
Keywordspharmacy
Keywordswhole genome sequencing
Keywordstesting
TitleHealth equity in COVID-19 testing among patients of a large national pharmacy chain
TypeArticle
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