Adults face a higher risk of exposure to COVID-19 than older adults and children due to their labor force participation. This study investigated the uptake of the initial and second doses of the COVID-19 vaccine among adults, stratified by age, race, ethnicity, sex, and their combinations. Data from the Kentucky Immunization Registry were employed to evaluate temporal changes in COVID-19 vaccine uptake among adults in three age groups (college age: 18–24, prime working age: 25–44, and middle age: 45–64) in Jefferson County, Kentucky (2020 population: 782,969). The analysis explored trends by age, race, and ethnicity; intersections of age with race and ethnicity; and interactions of age–race and age–ethnicity with sex. By May 2022, the highest and lowest COVID-19 vaccination rates were observed among White and Black 45–64-year-old adults: 74.8% and 64.0%, respectively, for dose two. The highest and lowest two-dose vaccination rates at ages 25–44 and 18–24 were also among White and Black residents: 67.9% versus 46.0% and 55.2% versus 35.4%, respectively. Disparities in COVID-19 vaccination by race, ethnicity, sex, and their intersections remained evident during the study period. Efforts in vaccine distribution and promotional initiatives should focus on demographically appropriate strategies.

Introduction In this study we provide an epidemiological description of Elevated Blood Lead Levels (EBLLs) in the pediatric population of Jefferson County, KY. To provide a more thorough epidemiological description of this issue, we put together the largest known pediatric blood lead dataset for Jefferson County and evaluated the data using the Center for Disease Control and Prevention’s current Blood Lead Referent Value (BLRV) of > 3.5 mcg/dL. Methods We collected 111,065 rows of pediatric blood lead data from the Louisville Metro Department of Public Health and Wellness. Descriptive and inferential statistics were used to explore the magnitude of this issue. Unadjusted Risk Ratios (RR) were also calculated by specific demographics. Geographic cluster analysis was produced by the Kulldorff spatial scan statistic. Results There are 74,014 unique children in the blood lead dataset, of which 9,823 had at least one blood lead test > 3.5 mcg/dL. Black children had a 77% increased risk for an EBLL compared to white children (Unadjusted Risk Ratio: 1.77; 95% CI: 1.61, 1.95). Additionally, children who live in the northwest corner of Jefferson County, have an estimated 9.37-fold increased risk for an EBLL compared to children who live elsewhere in the county. Discussion The non-random distribution of EBLLs in Jefferson County is likely due to the distribution of Pre-1950 housing which is a known risk factor for remnant environmental lead. This issue may be a consequence of the systematic financial disinvestment of these neighborhoods via redlining during the 20th century. Childhood lead poisoning remains a critical public health issue in Jefferson County, KY.

Wearing a facial mask can limit COVID-19 transmission. Measurements of communities' mask use behavior have mostly relied on self-report. This study's objective was to devise a method to measure the prevalence of improper mask use and no mask use in indoor public areas without relying on self-report. A stratified random sample of retail trade stores (public areas) in Louisville, Kentucky, USA, was selected and targeted for observation by trained surveyors during December 14-20, 2020. The stratification allowed for investigating mask use behavior by city district, retail trade group, and public area size. The total number of visited public areas was 382 where mask use behavior of 2,080 visitors and 1,510 staff were observed. The average prevalence of mask use among observed visitors was 96%, while the average prevalence of proper use was 86%. In 48% of the public areas, at least one improperly masked visitor was observed and in 17% at least one unmasked visitor was observed. The average prevalence of proper mask use among staff was 87%, similar to the average among visitors. However, the percentage of public areas where at least one improperly masked staff was observed was 33. Significant disparities in mask use and its proper use were observed among both visitors and staff by public area size, retail trade type, and geographical area. Observing unmasked and improperly masked visitors was more common in small (less than 1500 square feet) public areas than larger ones, specifically in food and grocery stores as compared to other retail stores. Also, the majority of the observed unmasked persons were male and middle-aged.

Wearing a facial mask can limit COVID-19 transmission. Measurements of communities’ mask use behavior have mostly relied on self-report. This study’s objective was to devise a method for measuring the prevalence of mask-wearing and proper mask use in indoor public areas without relying on self-report. A stratified random sample of retail trade stores (public areas) in Louisville, Kentucky, USA, was selected and targeted for observation by trained surveyors during December 14−20, 2020. The stratification allowed for investigating mask use behavior by city district, retail trade group, and public area size. The average mask use prevalence among observed visitors of the 382 visited public areas was 96%, while the average prevalence of proper use was 86%. In 17% of the public areas, at least one unmasked visitor was among the observed visitors; in 48%, at least one improperly masked visitor was observed. The average mask use among staff was 92%, but unmasked staff were observed in fewer public areas, as an unmasked staff member was observed in 11% of the visited public areas. The average prevalence of proper make use among staff was 87%, similar to the average among visitors. However, the percentage of public areas where at least one improperly masked staff was observed was 33. Significant disparities in mask use and its proper use were observed among both visitors and staff by public area size, retail trade type, and geographical area. Observing unmasked and incorrectly masked visitors was more common in small (less than 1500 square feet) public areas than larger ones, also in food and grocery stores than other retail stores. Also, the majority of the observed unmasked persons were male and middle age adults.