Nathan D Shippee, Elisheva R Danan, Mark Linzer, Helen M Parsons, Timothy J Beebe, Felicity T Enders
Development and use of a novel tool for assessing and improving researcher embeddedness in learning health systems and applied system improvements
Journal of clinical and translational science
immigrants highincome countries experienced inequities covid19 severe outcomes examined hospitalization death throughout pandemic change vaccine era ontario canada conducted populationbased study using linked immigration health data following two cohorts 20 months january 1 2020 prevaccine september 1 2021 vaccine era used multivariable poisson generalized estimating equation regression estimate adjusted rate ratios arr 95 confidence intervals ci accounting age sex comorbidities calculated agestandardized years life lost asyrs rates immigrant category 11692387 communitydwelling adults prevaccine era cohort 11878304 communitydwelling adults vaccine era cohort 216 214 adults era respectively immigrants females accounted 579 578 sponsored family 684 676 economic caregivers era respectively compared ontarians prevaccine era cohort hospitalization rates highest refugees arr 95 ci 341 339344 caregivers 313 307318 followed sponsored family economic immigrants compared ontarians arrs highest immigrants central america 500 492509 parts south asia 395 389401 jamaica 356 351361 east asians lower arrs mortality arrs similar hospitalization arrs vaccine era arrs attenuated similar lower ontarians refugees regions maintaining higher rates prevaccine era asyrs higher immigrant groups asyrs dropped vaccine era refugees continuing higher rates immigrants particularly refugees experienced greater premature mortality arrs immigrant groups dropped substantially high vaccine coverage achieved vaccine outreach improvements social determinants health needed canadian institutes health research canada research chairs program