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Health

Nursing properties with extra minority residents had extra Covid deaths: Examine

Nursing homes with more minority residents had more Covid deaths: Study

Derede McAlpin is holding a photo of her mother, Sara McAlpin, 92, who was diagnosed with Covid-19 in Rockville, MD.

Katherine Frey | The Washington Post | Getty Images

Nursing homes with more minority residents reported more than three times as many deaths in Covid as those with more white residents, a large study published on Wednesday found.

The University of Chicago researchers examined 13,312 U.S. nursing homes and analyzed Covid data reported to the Centers for Disease Control and Prevention from May through December. They found that nursing homes where more than 40% of their residents were black or Spanish reported 3.3 times as many deaths and cases in Covid as nursing homes with more white residents.

Nursing homes and other long-term care facilities are hardest hit by the pandemic. Less than 1% of Americans live in such facilities, according to the CDC, but they have caused nearly 40% of all deaths in the United States, according to the COVID Tracking Project.

It is well documented that the pandemic has disproportionately affected the ethnic and racial minorities in the United States. President Joe Biden and his administration have vowed to ensure justice throughout the vaccine distribution process and to prioritize color communities disproportionately affected by the pandemic.

The new study, published on JAMA Network Open, shows how these differences affect nursing homes and has policy implications for vaccine distribution.

The differences were due to some historical factors, the researchers said. For example, minority residents in nursing homes are more likely to live in large facilities that are for-profit, rely more on Medicaid, and “have shortcomings in care,” the researchers said. They added that “Nursing homes in the US are very segregated”

An Empress EMS paramedic loads a suspected COVID-19 patient into an ambulance on April 7, 2020 in Yonkers, New York.

John Moore | Getty Images

“Before the COVID-19 pandemic began, racial differences in the quality of home care were known to be common,” the authors wrote. “Compared to whites, blacks are more likely to be admitted to the lowest quality nursing homes that have lower nursing staffing rates, more serious regulatory deficiencies, and a higher likelihood of being excluded from the Medicaid program.”

The researchers, health economists Rebecca Gorges and Tamara Konetzka, added that the pandemic is a “perfect storm” for residents of nursing homes.

“With minority communities having the highest COVID-19 infection rates and nursing homes in these communities generally being of lower quality, non-white nursing home residents are in the eye of this perfect storm,” they wrote.

The study finds that the death toll of Covid in U.S. nursing homes is likely to decline soon with the introduction of the vaccine. The CDC recommends that states give the vaccine to residents and long-term care workers as a priority before moving on to other segments of the population.

The Federal Pharmacy Partnership for Long-Term Care program allowed states to tap into pharmacies like CVS and Walgreens to help distribute the vaccine. As part of that program, more than 5 million doses have been given to residents and long-term care workers since Tuesday, according to the CDC.

“As vaccination progresses, it will be important for policy makers to consider existing inequalities to ensure that the vaccine distribution process includes a special effort to reach color communities,” the researchers wrote in the study.

They noted some limitations to their study. Institution-level data is publicly available through the CDC, but comprehensive individual-level data is not available. Such data “is needed to understand whether there are intra-facility differences in addition to differences between facilities,” they said.

They added that as of May, the data they analyzed were reported by nursing homes themselves, omitting many of the cases and deaths that had previously occurred. And they said the federal data “didn’t allow any racial classifications other than white, black, and Hispanic.” More detailed data would have enabled further analysis of the data across different racial groups.

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Business

Pandemic heats up state tax competitors to draw companies, residents

Pandemic heats up state tax competition to attract businesses, residents

sturti | E + | Getty Images

Tax competition between states to attract and retain businesses and residents has persisted for decades. The national migration pattern has generally evolved from cold northern states with high taxes to warm southern and southwestern states with low taxes.

Retirees who are no longer tied to a job or are raising children have been an integral part of the caravan of migrants heading south. However, for all but the richest, taxes are usually not the main factor.

“I think most retirees who move are about quality of life,” said Ryan Losi, CPA at Piascik in Richmond, Virginia. “The [lower] Taxes are the icing on the cake for them. “

The icing on the cake, however, is itself becoming the cake for a larger number of Americans. With tax rates expected to rise, government income, property and sales taxes are becoming bigger factors in deciding where to live and work for both individuals and business owners.

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Losi has had numerous calls from wealthy clients – especially business owners – since November to discuss a possible move to a low-tax country.

“I’m not talking about seniors,” he said. “These are people who will earn income for another 20 to 30 years.

“They see their states continue to raise income and corporate taxes, so they want to migrate elsewhere,” he added.

While taxes aren’t the only problem driving migration patterns, they are clearly a consideration.

Last year, California, Connecticut, Illinois, New Jersey and New York were the five states with the highest rates of outbound migration, according to the 2020 National Movers Study published annually by United Van Lines.

Four of these five states were classified by the tax foundation in the bottom five states in terms of the business tax climate in 2021. Illinois ranked 36th.

“High-tax countries are under more pressure today than they have been for a long time,” said Jared Walczak, vice president for state projects at the tax foundation. He said the pandemic and the generally positive remote work experience of millions of Americans over the past year are adding to the pressure.

“The growth of the remote work environment is an extremely big development,” he said. “Increasingly, people and businesses can choose where to settle.”

Most experts expect more people and companies to choose where to pay lower taxes. The relocations of well-known technology companies such as Oracle and Hewlett Packard from California’s Silicon Valley to Texas are just the best-known examples. Any business capable of operating remotely is likely to take its tax footprint far more seriously now.

“If a company is big enough and has offices across the country, it can assign people who work remotely to offices in low-tax countries,” said Walczak. “I think a lot more companies will want to offer their employees remote-friendly circumstances.”

This prospect is likely to keep many state tax administrators awake at night. Six states, including Connecticut, New York, and Pennsylvania, have “convenience” rules that allow them to tax employees of companies in the state even if they do not live or work in the state.

Massachusetts, which has an income tax rate of 5%, introduced such a rule last year in response to the pandemic. It is currently being sued by the state of New Hampshire, which has no income tax and has attracted many remote Massachusetts workers.

The remote working problem is likely to lead to further conflict between state tax authorities. It will certainly challenge high tax countries that seek a faster-eroding tax base.

“High-tax countries are like aircraft carriers – they spin slowly,” Losi said. “If they see more migration, they will have a shortage of income and greater difficulty in funding their obligations. These states are in great trouble.”

Many are currently doing better financially than expected. This is in large part due to federal coronavirus relief packages, particularly state-taxed increased unemployment benefits and healthy property tax revenues and capital gains from the still buoyant property and stock market, Walczak said. 42 states tax capital gains.

He suggests that high-tax countries do not overreact when more residents leave the state.

“If they put taxes on those who are left, it could be a self-fulfilling prophecy that will ensure more people leave,” he said. “California and New York don’t need Florida or Texas tax codes to compete for residents and businesses, but they can’t go in the opposite direction.”

Categories
Health

New York Mayor de Blasio needs to immunize 1 million residents in January

New York Mayor de Blasio wants to immunize 1 million residents in January

A FDNY EMS Fire Department employee receives a COVID-19 Moderna vaccine amid the coronavirus disease (COVID-19) pandemic in the Manhattan neighborhood of New York City, New York, United States. December 23, 2020.

Carlo Allegri | Reuters

New York officials plan to vaccinate 1 million residents against Covid-19 in January. The federal government and drug manufacturers need to accelerate the production and distribution of the vaccine.

Mayor Bill de Blasio said Thursday the city will use schools, pop-up clinics and “whatever it takes” to reach 1 million people in a month.

“We know New York City can vaccinate 1 million people in January and really get this thing going,” de Blasio told CNN. “Every time we vaccinate someone, we’ve come one step closer to the coronavirus in terms of its terrible impact on society.”

IIt’s an ambitious goal considering the city only received 390,425 doses of vaccine and, according to the city, could only administer about 78,000 shots.

“This thing isn’t moving the way it needs to be in the US,” said the mayor. “New York City will show that we can speed this up and vaccinate people at record speed. And we want the whole country to be a part of it because we have to move faster to fight the coronavirus if we want to recover.”

The U.S. government has fallen far short of its original target of delivering at least 20 million Covid vaccine shots before the end of the year – something federal officials have admitted is disappointing. The US has so far distributed 12.4 million doses of vaccine and vaccinated only 2.8 million people with the first Pfizer or Moderna two-shot schedule, according to the Centers for Disease Control and Prevention. U.S. officials say the data is 72 to 96 hours behind due to state and local delays. Even so, it’s still a fraction of the Trump administration’s original goal.

The slower-than-expected adoption of Covid vaccines has been disappointing, said the nation’s leading infectious disease expert, Dr. Anthony Fauci, opposite CNN on Thursday.

“We agree that this number is lower than we had hoped,” Moncef Slaoui, chief advisor to the government’s Operation Warp Speed ​​vaccination program, told reporters on Wednesday. “We know it should be better and we’re working hard to make it better.”

De Blasio’s explanation comes from the fact that health officials in Colorado and California have discovered a new strain of the coronavirus in a few cases in those states. The new variant, which de Blasio said has not yet been found in New York, was first identified in the UK and appears to be far more contagious.

It also comes as the city prepares for its annual New Years Eve celebrations, albeit without the usual crowds. Only a few hundred people, instead of the usual thousands, will be in Times Square with masks and by invitation only for the midnight ball drop for the kick of 2021. De Blasio said the one year that unites all Americans in this divided country is “We want to get rid of the hell of 2020.”