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“Since asthma surveillance data were not available at the census tract level for most of Louisiana, we estimated asthma burden using the inpatient discharge data available through LDH.”  (4)

“Case counts are not provided for CTs with a 2018 population of less than 800 to safeguard privacy.” (4)

“To minimize the need for suppression, inpatient discharge data was aggregated for the three most recent years available (2017–2019) and average annual crude rates were calculated for cases where asthma (ICD-10 code J45) was the primary diagnosis, as well as where asthma was any diagnosis.” (4)

“Spearman’s Rank Correlation was utilized to analyze the correlation between various social and environmental vulnerability factors, COVID-19 incidence, and the measures of asthma risk by CT.” (4)

“This was performed by first ranking the values in each dataset using RANK.AVG function in MS Excel 2016, followed by applying the PEARSON function to compare two datasets. Significance was set at alpha less than 0.05 (α < 0.05), with degrees of freedom (df) equal to two less than the total number of data points represented in both datasets” (4)

The research team works for the Section of Environmental Epidemiology and Toxicology, Office of Public Health, Louisiana Department of Health in Baton Rouge. Team members included Arundhati Bakshi; Shanon Soileau; Collete Stewart; Kate Friedman; Collete Maser; Alexis Williams; Kathleen Aubin; and Alicia Van Doren. 

“Currently, much of the environmental focus of the pandemic remains on PM2.5 levels; however, we noted that higher levels of ozone was consistently associated with higher incidence rates of COVID-19, and it was the only environmental factor that appeared to have an additive effect over SVI on COVID-19 incidence (Fig 1).” (11)

“Specifically, our data show a moderately strong positive correlation between SVI due to minority status/language barrier and three health data variables: asthma hospitalization; estimated asthma prevalence; and cumulative COVID-19 incidence at 3 months (Table 2). Interestingly, SVI measures were either negatively or not significantly correlated COVID-19 incidence at the 9-and 12-month time points, indicating that social vulnerability factors may have played a greater role in COVID-19 spread early in the pandemic, but may have been of diminishing importance as the pandemic wore on (Fig 1 and Table 2).” (9)

Bakshi A, Van Doren A, Maser C, Aubin K, Stewart C, Soileau S, et al. (2022) Identifying Louisiana communities at the crossroads of environmental and social vulnerability, COVID-19, and asthma. PLoS ONE 17(2): e0264336. https:// doi.org/10.1371/journal.pone.0264336. 

This document uses data resources from the Center for Disease Control/Agency for Toxic Substances and Disease Registry (CDC/ATSDR), the Environmental Protection Agency (EPA), and the Louisiana Department of Health (LDH).

These data resources include the Social Vulnerability Index (2018 - CDC/ATSDR), the NATA Respiratory Hazard Index (EPA 2014), PM2.5level (average annual concentration in ug/m3, EPA 2016), ozone level (summer seasonal average of daily maximum 8-hour concentration in air in parts per billion, EPA 2016), indoor mold concerns reported to IEQES program (average annual number of calls, LDH 2017-2019), cumulative COVID-19 incidence rate at 3-, 6-, 9- and 12-month increments (LDH March 2020 - March 2021), asthma hospitalization (average annual crude rate, where asthma was a primary diagnosis among hospitalization cases, LDH 2017-2019), and estimated asthma prevalence (average annual crude rate, where asthma was any diagnosis among hospitalization cases, LDH 2017-2019).

The educational program in Haiti organized by Handicap International aims to train citizens of Haiti for careers as rehabilitation technicians and orthopedic technicians. The program is designed to provide a recognized degree allowing graduates to work as technicians under the supervision of physical therapists and orthopedic doctors. 

Handicap International brings aid to places dealing with the aftermath of natural disasters. In this case the Rehabilitiation Technicians pogram was created in response to the 2010 earthquake in Haiti, during which thousands of Hatians needed orthopedic rehabilitation or prosthetics and there was a significant shortange of specialized medical professionals. The program was created to respond to the need for rehabilitation professionals to deal with the immediate aftermath of the earthquake and the continuing care of those permanently disabled.

This program is one of many run by Handicap International, and supported by the United States Agency for International Development. The program was run at Healing Hands for Haiti (http://www.haitilibre.com/en/news-14990-haiti-health-first-in-haiti-tra…), with instructors from the Universidad de Don Bosco in El Salvador. 

The program is funded primarily by Handicap International, with additional funding from the United States Agency for International Development.

The program is devided into two degrees with different requirements, the rehabilitation technician degree is 18 months or in-class instruction and practical experience while the orthopedics technician degree is 2 years. Hatian citizens over the age of 18 are allowed to take the course. At the end of both courses the students must pass the International Society of Prosthetics and Orthotics Exam to graduate. 

The program is targeted for Hatian citizens over the age of 18 with an interest in the rehabilitaiton field as a career. 

The program provides the graduates with a degree, recognized by the Hatian government and the International Society of Prosthetics and Orthetics as officail proof of training and ability in the rehabilitation technician field.