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      COVID-19 pandemic-related changes in wellness behavior among older Americans

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          Abstract

          Background

          COVID-19 has taken its toll on citizens in all 50 states of the United States. The United States (U.S.) leads the world with 30,291,863 confirmed reported cases and 549,664 deaths as of March 29, 2021 compared to globally confirmed cases at 127,442,926 and 2,787,915 deaths as of March 29, 2021. The U.S. federal government primarily left the response to the virus to individual states, and each implemented varying measures designed to protect health of citizens and the state’s economic well-being. Unintended consequences of the virus and measures to stop its spread may include decreased physical activity and exercise, shifting access and consumption of food, and lower quality-of-life. Therefore, our primary goal was to quantify the impact of COVID-19 on health and well-being by measuring changes in physical activity, mental health-quality of life, food security and nutrition in adults ages 40 and older. We believed shifts in health behaviors would be more prevalent in minorities, less educated, lower socio-economic status, older adults, and those with underlying health conditions, so a secondary goal was to determine the impact of COVID-19 on these sub-populations.

          Methods

          We conducted an online survey with 9969 adults 40 years and older between 9 August and 15 September 2020 in urban areas across the four U.S. census regions. The survey included questions about demographic variables, pre-existing health conditions, physical activity, access to food, quality-of-life, and nutritional food status and asked participants to respond with information from pre-pandemic and pandemic conditions. We used paired-sample t-tests to detect changes in variables after the start of the pandemic and Cohen’s d to determine effect sizes.

          Results

          Our main findings showed a decrease in physical activity since the onset of COVID-19 for minorities and non-minorities. Food security also slightly increased for minorities during the pandemic, but we found no other changes in food security, quality-of-life indicators, or nutritional status of those who responded to this survey.

          Conclusions

          It is concerning that physical activity declined. Such activity helps maintain physical and mental health, and it is also an important time to socialize for many older adults. In many ways, our data indicate that the older adult population in U.S. cities may be more resilient than expected during the pandemic. However, the pandemic could have negative impacts that we did not detect, either due to the survey instrument or the timing of our survey, so the health and well-being of older adults should continue to be monitored in order to mitigate potential negative impacts.

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          Most cited references47

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          Association between mobility patterns and COVID-19 transmission in the USA: a mathematical modelling study

          Summary Background Within 4 months of COVID-19 first being reported in the USA, it spread to every state and to more than 90% of all counties. During this period, the US COVID-19 response was highly decentralised, with stay-at-home directives issued by state and local officials, subject to varying levels of enforcement. The absence of a centralised policy and timeline combined with the complex dynamics of human mobility and the variable intensity of local outbreaks makes assessing the effect of large-scale social distancing on COVID-19 transmission in the USA a challenge. Methods We used daily mobility data derived from aggregated and anonymised cell (mobile) phone data, provided by Teralytics (Zürich, Switzerland) from Jan 1 to April 20, 2020, to capture real-time trends in movement patterns for each US county, and used these data to generate a social distancing metric. We used epidemiological data to compute the COVID-19 growth rate ratio for a given county on a given day. Using these metrics, we evaluated how social distancing, measured by the relative change in mobility, affected the rate of new infections in the 25 counties in the USA with the highest number of confirmed cases on April 16, 2020, by fitting a statistical model for each county. Findings Our analysis revealed that mobility patterns are strongly correlated with decreased COVID-19 case growth rates for the most affected counties in the USA, with Pearson correlation coefficients above 0·7 for 20 of the 25 counties evaluated. Additionally, the effect of changes in mobility patterns, which dropped by 35–63% relative to the normal conditions, on COVID-19 transmission are not likely to be perceptible for 9–12 days, and potentially up to 3 weeks, which is consistent with the incubation time of severe acute respiratory syndrome coronavirus 2 plus additional time for reporting. We also show evidence that behavioural changes were already underway in many US counties days to weeks before state-level or local-level stay-at-home policies were implemented, implying that individuals anticipated public health directives where social distancing was adopted, despite a mixed political message. Interpretation This study strongly supports a role of social distancing as an effective way to mitigate COVID-19 transmission in the USA. Until a COVID-19 vaccine is widely available, social distancing will remain one of the primary measures to combat disease spread, and these findings should serve to support more timely policy making around social distancing in the USA in the future. Funding None.
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            The impact of physical activity on psychological health during Covid-19 pandemic in Italy

            The worldwide spread of COVID-19 has upset the normality of Italian daily life, forcing population to social distancing and self-isolation. Since the containment precautions also concern sport-related activities, home workout remained the only possibility to play sports and stay active during the pandemic. The present study aimed to examine changes in the physical activity levels during self-quarantine in Italy, and the impact of exercise on psychological health. A total of 2974 Italian subjects has completed an online survey, but only 2524 subjects resulted eligible for this study. The questionnaire measured the total weekly physical activity energy expenditure before and during quarantine (i.e. the sum of walking, moderate-intensity physical activities, and vigorous-intensity physical activities) in Metabolic Equivalent Task minutes per week (MET–min/wk) using an adapted version of International Physical Activity Questionnaire and their psychological well-being using the Psychological General Well Being Index. Of the 2524 Italian subjects included in the study, 1426 were females (56.4%) and 1098 males (43.6%). Total physical activity significantly decreased between before and during COVID-19 pandemic (Mean: 2429 vs. 1577 MET–min/wk, ∗∗∗∗p < 0.0001), in all age groups and especially in men (Female, mean: 1994 vs. 1443 MET–min/wk, ∗∗∗∗p < 0.0001; Male, mean: 2998 vs. 1754 MET–min/wk, ∗∗∗∗p < 0.0001). Furthermore, a significant positive correlation was found between the variation of physical activity and mental well-being (r = 0.07541, ∗∗∗p = 0.0002), suggesting that the reduction of total physical activity had a profoundly negative impact on psychological health and well-being of population. Based on this scientific evidence, maintaining a regular exercise routine is a key strategy for physical and mental health during a forced rest period like the current coronavirus emergency.
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              Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China

              Background: As COVID-19 occurs suddenly and is highly contagious, this will inevitably cause people anxiety, depression, etc. The study on the public psychological states and its related factors during the COVID-19 outbreak is of practical significance. Methods: 600 valid questionnaires were received. The Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS) were used. Results: Females' anxiety risk was 3.01 times compared to males (95% CI 1.39-6.52). Compared with people below 40 years old, the anxiety risk of people above 40 years old was 0.40 times (95% CI 0.16-0.99). SDS results indicated that the difference between education level and occupation was statistically significant (p = 0.024, 0.005). Compared to people with a master's degree or above, those with a bachelor's degree group had a depression risk of 0.39 times (95% CI 0.17-0.87). Compared with professionals, industrial service workers and other staff had a depression risk of 0.31 times (95% CI 0.15-0.65) and 0.38 times (95% CI 0.15-0.93). Conclusions: 600 questionnaire participants were psychologically stable. Non-anxiety and non-depression rates were 93.67% and 82.83%, respectively. There were anxiety in 6.33% and depression in 17.17%. Therefore, we should pay attention to the psychological states of the public.
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                Author and article information

                Contributors
                Elgloria.Harrison@lehman.cuny.edu
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                19 April 2021
                19 April 2021
                2021
                : 21
                : 755
                Affiliations
                [1 ]GRID grid.267550.3, ISNI 0000 0001 2298 4918, College of Agriculture, Urban Sustainability and Environmental Sciences, , University of the District of Columbia, ; 4250 Connecticut Ave, NW, Washington, DC 20008 USA
                [2 ]GRID grid.259030.d, ISNI 0000 0001 2238 1260, Lehman College City University of New York, ; 250 Bedford Park Boulevard West, Bronx, NY 10468 USA
                [3 ]GRID grid.253615.6, ISNI 0000 0004 1936 9510, The George Washington University Milken Institute School of Public Health, ; 2175 ‘K’ Street NW, Suite 500, Washington, DC 20037 USA
                Author information
                https://orcid.org/0000-0003-2627-9524
                https://orcid.org/0000-0003-1131-9626
                https://orcid.org/0000-0002-1198-3845
                https://orcid.org/0000-0001-7059-6637
                https://orcid.org/0000-0002-0999-2443
                https://orcid.org/0000-0002-8297-7055
                https://orcid.org/0000-0001-7840-2825
                https://orcid.org/0000-0002-6341-9031
                https://orcid.org/0000-0001-9769-1669
                Article
                10825
                10.1186/s12889-021-10825-6
                8054850
                33874931
                9443ed2e-c0aa-4fd1-b354-5e969b8e691e
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 30 January 2021
                : 8 April 2021
                Categories
                Research
                Custom metadata
                © The Author(s) 2021

                Public health
                coronavirus,resilience,quality-of-life,food security,physical activity,nutrition,senior citizens

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