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Full-Text Articles in Entire DC Network

Fall 2021 Oct 2921

Fall 2021

Scientia

A Decade of Progress and Success; Speech Language Pathology Program; COVID-19 Long-Hauler Study; Peer Mentors Initiative; Faculty Update; Expert Engagement: Three CSH initiatives further education and scholarship while supporting communities in need; Strategic Command: Business consultant and med tech expert Stephen Sichak helps others face pandemic challenges; Taking Care: A School of Nursing research team plumbs the pandemic experiences of nurses nationwide


Environmental Impact Of Water And Air Contaminants On Public Health, Astrid-Ines Foamkom, Luis A. Peña Marquez, Maria Sophia Malbas, Esmeralda Rodriguez, Noe Garza, Ney Alliey-Rodriguez Sep 2024

Environmental Impact Of Water And Air Contaminants On Public Health, Astrid-Ines Foamkom, Luis A. Peña Marquez, Maria Sophia Malbas, Esmeralda Rodriguez, Noe Garza, Ney Alliey-Rodriguez

Research Colloquium

Background: Established literature suggests a strong relationship between exposure to air contaminants and physical health. Similarly, numerous studies have demonstrated the effects of water pollution on public health. Texas denizens are often victims of poor air and water quality, yet there are scant studies that have integrated evidence of health tolls caused by air and water pollution across the state. In this study, we assessed the relationship between particulate matter

Methods: The study used data from the 2018 Medicare and Medicaid report which displayed chronic health conditions across all counties in Texas. Additionally, the study also includes collected data on …


Reclaiming Healing Spaces: A Phenomenological Study On The Transformative Power Of Outdoor Therapy From The Lived Experiences Of Black Clinicians Working With Black Clients, Lynn Murphy Sep 2024

Reclaiming Healing Spaces: A Phenomenological Study On The Transformative Power Of Outdoor Therapy From The Lived Experiences Of Black Clinicians Working With Black Clients, Lynn Murphy

Dissertations

This phenomenological study involved assessing the experiences of Black therapists who engaged Black clients in outdoor therapeutic contexts. The study was founded on the existing literature that shows the quality of the therapeutic relationship is pivotal for client retention and the Western standards that have historically favored treatment within indoor environments. To contextualize this research, a comprehensive literature review was commenced, covering topics such as the decolonization of therapy, the historical and present-day relationship between Blacks and the outdoors in the United States, sedentary lifestyles, the psychological benefits of time spent in nature, various types of outdoor therapy, and the …


Phe 302 Social And Environmental Determinants Of Health, Tailisha Gonzalez Aug 2024

Phe 302 Social And Environmental Determinants Of Health, Tailisha Gonzalez

Open Educational Resources

This course is an introduction to the social, behavioral, and commercial factors that influence health. Theoretical and methodological approaches to the study of these determinants will be discussed from a social ecological perspective. Social determinants cover five domains: economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context. Behavioral determinants include such factors as smoking, physical activity, and alcohol use. Commercial determinants include economic and political domains with examples such as cigarette marketing and the placement of toxic waste sites in low-income communities.


Development And Application Of The Sinkhole Hazard Risk Index To Inform Karst Policy And Mitigation Planning, Meghan Puente Aug 2024

Development And Application Of The Sinkhole Hazard Risk Index To Inform Karst Policy And Mitigation Planning, Meghan Puente

Masters Theses & Specialist Projects

Sinkholes are geologic hazards that occur in karst landscapes and can be highly destructive and costly. Sinkhole mitigation plans and development policies are nonexistent at the federal level within the United States and vary significantly at the state level. The lack of a unified standard for sinkhole mitigation planning is partly due to a lack of available data and resources needed to assess sinkhole risk. While there are established sinkhole assessments within the literature, they focus more on the detection and prediction of sinkholes rather than a holistic approach to risk assessment. The goal of this study is to create …


Assessing Environmental Injustice In Kansas City By Linking Paediatric Asthma To Local Sources Of Pollution: A Cross-Sectional Study., Elizabeth Friedman, Brian R. Lee, David Rahn, Beto Lugo Martinez, Atenas Mena Jul 2024

Assessing Environmental Injustice In Kansas City By Linking Paediatric Asthma To Local Sources Of Pollution: A Cross-Sectional Study., Elizabeth Friedman, Brian R. Lee, David Rahn, Beto Lugo Martinez, Atenas Mena

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: A grassroots environmental-justice organisation in Kansas City has been examining the disproportionate exposure to air pollution experienced by residents living fenceline to the largest classification railyard in the USA. Prior analyses showed limited increased risk for asthma exacerbation for patients with asthma living closer to toxic release inventory (TRI) facilities and railyards. In this study, we assessed geographical asthma and environmental disparities, to further explore community-level disparities.

DESIGN: This is a cross-sectional study of population-level asthma rates, which included rates for all asthma encounters and acute asthma encounters (urgent care, emergency department, inpatient admission). Distances from census-tract centroids to …


Public Realm For Enhanced Quality Of Life :Interactive Spaces Combating Climate Change, Amal M . El- Ellithy , Mohamed M. Yossef , And Mai W. Madkour Jul 2024

Public Realm For Enhanced Quality Of Life :Interactive Spaces Combating Climate Change, Amal M . El- Ellithy , Mohamed M. Yossef , And Mai W. Madkour

Journal of Engineering Research

Currently, facing climate change stands as a crucial focus within architecture, urban planning and design .Urban design is constructive endeavor aimed at benefiting the public. The public realm that creates the environment for individuals and communities to effectively, safely, meaningfully and permanently lead their lives .For a prolonged duration the public realm have been formulated to accommodate severe climatic conditions .the reality persists that the essence of a signification public realm continue to be widely disregarded . The aim is to clarify how exceptional quality, effectively designed, and well-managed approaches can be beneficial to implement as a strategy for climate …


Spatial And Temporal Analysis Of Pm 2.5 Concentrations In Chicago Along The Lakefront Trail Using Wearable Air Quality Sensors, Jacob A. Johnson Jul 2024

Spatial And Temporal Analysis Of Pm 2.5 Concentrations In Chicago Along The Lakefront Trail Using Wearable Air Quality Sensors, Jacob A. Johnson

DePaul Discoveries

Mass urbanization and transportation practices have resulted in high amounts of air pollution. Air pollution can have detrimental effects on human health causing respiratory issues as well as other health complications. Certain areas of cities experience more exposure to air pollution which can also cause them to have more health issues and lower life expectancy. These areas are often associated with disinvestment and minoritized communities of color. This research explores patterns of air quality related to environmental justice areas using low-cost wearable air quality monitoring sensors attached to a bicycle. Data was collected along the Lakefront Trail stretching from Irving …


Medical School Watercooler Newsletter - July 3, 2024, Lindsey Lyle Jul 2024

Medical School Watercooler Newsletter - July 3, 2024, Lindsey Lyle

Watercooler Newsletter

This is the July 3, 2024 edition of the Frederick P. Whiddon College of Medicine’s newsletter - Watercooler.

Contents Include

  • Whiddon COM faculty received promotion and awarded tenure
  • USA awarded grant to study race-based disparities in autism care
  • USA neurosurgery selected as site for national joint fusion study
  • Urology conference abstract submissions due Aug. 30


Engaging Antiracist And Decolonial Praxis To Advance Equity In Oregon Public Health Surveillance Practices, Ryan J. Petteway, Daniel López-Cevallos, Mira Mohsini, Andres Lopez, Roberta S. Hunte, Tim Holbert, Kusuma Madamala Jun 2024

Engaging Antiracist And Decolonial Praxis To Advance Equity In Oregon Public Health Surveillance Practices, Ryan J. Petteway, Daniel López-Cevallos, Mira Mohsini, Andres Lopez, Roberta S. Hunte, Tim Holbert, Kusuma Madamala

OHSU-PSU School of Public Health Faculty Publications and Presentations

Public health surveillance and data systems in the US remain an unnamed facet of structural racism. What gets measured, which data get collected and analyzed, and how and by whom are not matters of happenstance. Rather, surveillance and data systems are productions and reproductions of political priority, epistemic privilege, and racialized state power. This has consequences for how communities of color are represented or misrepresented, viewed, and valued and for what is prioritized and viewed as legitimate cause for action. Surveillance and data systems accordingly must be understood as both an instrument of structural racism and an opportunity to dismantle …


Health Equity: Communicating Impaired Water Status, Emily Potter May 2024

Health Equity: Communicating Impaired Water Status, Emily Potter

Virginia Journal of Public Health

Introduction: Land use changes in the Rivanna River and James River Watersheds have increased the number of impaired recreational waters, and there is a disparity in the equitable communication of these impairments to different populations. Ineffective communication contributes to inequities in access to safe, accessible, and affordable water for vulnerable populations, placing public health at risk.

Methods: This study uses secondary data from the Environmental Protection Agency’s Watershed Index Online (WSIO) Indicator Data Tables, Virginia Department of Environmental Quality (DEQ), Rivanna River Association, and James River Association. Correlations, linear regression, and percent change were used to identify statistically significant trends …


Crafting Community Solar Programs To Alleviate Energy Burdens And Empower Communities In Virginia, Elizabeth Anne Sekelsky May 2024

Crafting Community Solar Programs To Alleviate Energy Burdens And Empower Communities In Virginia, Elizabeth Anne Sekelsky

Master's Projects and Capstones

Low to moderate-income (LMI) groups usually suffer from high energy burdens and community solar is a renewable energy strategy that can save LMI groups on their monthly electricity bills. This research explores the intersection of renewable energy and energy justice, specifically the potential for community solar, energy efficiency, and home weatherization to alleviate Virginia's energy burdens. Included is an analysis of incentives, programs, and Greenhouse gas emission goals for the state, investigations on how low-income groups are receiving aid and what is available to them from programs and utilities, suitable sites for solar based on groups in need, and comparisons …


Humanizing Affordable Housing: A Public Health Centered Approach To Affordable Housing, Eiman Mohamed May 2024

Humanizing Affordable Housing: A Public Health Centered Approach To Affordable Housing, Eiman Mohamed

Graduate School of Architecture & Urban Design Theses & Dissertations

This thesis focuses on exploring housing as a determinant of health; thus, the aim is to investigate the historical and current influence of housing design and city planning on occupant health and population health in metropolitan cities. The thesis will primarily examine how housing affects the health of low-income individuals. Historically and presently, this demographic has been disproportionately affected by health issues stemming from overcrowding, substandard housing design, declining neighborhood conditions, and environmental inequities. The goal is to discern the dimensions and standards for healthy housing against which designers and planners can define health outcomes. By acknowledging the factors that …


Toxicological Impacts Of River Chemical Spills In Affected West Virginia Counties, Janice Lorraine Taylor Peters May 2024

Toxicological Impacts Of River Chemical Spills In Affected West Virginia Counties, Janice Lorraine Taylor Peters

Walden Dissertations and Doctoral Studies

Factors such as geographical location/proximity and exposure to external environmental events, as well as poor regulatory processes, are known to increase the risk for cancers among affected populations. There is still a gap in the literature related to the incidence of cancers in specific regions with heavy industrialization and environmental health hazards. In West Virginia, chemical contamination events have occurred in or near water systems. The goal of this quantitative, retrospective study was to discover whether there were any differences in the incidence of disease or adverse health effects and cancers due to chemical contamination in four counties (Kanawha, Mingo, …


Addressing Air Quality Mitigation As A Key Factor In Asthma Management And Prevention, Julia Buckles, Jewel Radford May 2024

Addressing Air Quality Mitigation As A Key Factor In Asthma Management And Prevention, Julia Buckles, Jewel Radford

Doctor of Nursing Practice Projects

Asthma is the most prevalent disease in childhood and disproportionately affects African American (AA) populations in terms of prevalence and frequency of exacerbations. Air quality and environmental factors are strongly associated with the diagnosis and management of asthma and AA children are more likely to live in areas with poor air quality. An air quality flag program was implemented in a daycare located in a county with a predominantly AA population with a high prevalence of asthma diagnoses. The goal of the intervention was to increase staff awareness of air quality and the impact it can have on asthma diagnosis …


Investigation Of The Impact Of Neighborhood Environments On Alzheimer’S Disease And Alzheimer’S Disease-Related Dementias (Ad/Adrd), Darashagam Nahal May 2024

Investigation Of The Impact Of Neighborhood Environments On Alzheimer’S Disease And Alzheimer’S Disease-Related Dementias (Ad/Adrd), Darashagam Nahal

2024 Spring Honors Capstone Projects

There is an increased interest in understanding the impact of neighborhood environments on cognitive functioning, cognitive impairment, and Alzheimer’s disease and Alzheimer’s disease-related dementias (AD/ADRD). Surprisingly, there has yet to be a comprehensive review that consolidates the findings from studies conducted in this specific field. The purpose of this study is to comprehensively investigate the influence of eight neighborhood environments on AD/ADRD. The seven key neighborhood environments that are investigated in this study include: i) socioeconomic status, ii) food environments, iii) physical activity resources, iv) social cohesion, v) crime, vi) non-crime safety, and vii) healthcare services. This research conducts a …


Perceptions Of Environmental Justice And Water Quality In The United States, Paige M. Jewell May 2024

Perceptions Of Environmental Justice And Water Quality In The United States, Paige M. Jewell

Undergraduate Honors Thesis Collection

My thesis explores the comparisons of water quality and environmental justice. A survey was conducted that allowed for demographics, hometown information, and opinions on hometown water quality to be gathered from the Butler community. Based on the findings in the survey and current events found within an extensive literature review, three states were chosen to receive further analysis on their current water quality and environmental justice standards. For these three states, current water pollutants, current solution implementations, population impacted, and community involvement were all looked into and analyzed.


Family Medicine’S Role In Addressing The Intersections Of Redlining And Climate Change, Daryl O. Traylor, Eboni E. Anderson, Brianna Clark, Alex M. Smith, Cooper K. Allenbrand Apr 2024

Family Medicine’S Role In Addressing The Intersections Of Redlining And Climate Change, Daryl O. Traylor, Eboni E. Anderson, Brianna Clark, Alex M. Smith, Cooper K. Allenbrand

Journal of Sustainable Social Change

Redlining, the practice of discriminating against specific neighborhoods based on race and socioeconomic status, leads to persistent environmental hazards and socioeconomic inequalities that have lasting adverse health effects on their populations. Health disparities are further exacerbated through the concentration of environmental hazards, as well as the escalating impact of climate change, which poses an increased risk of respiratory illness, cardiovascular disease, mental health issues, heat-related illness, infectious diseases, food insecurity, and socioeconomic difficulties in redline neighborhoods.

This paper examines the interplay of redlining, climate change, and health disparities, with an emphasis on the enduring consequences for these marginalized communities. Through …


Neighborhood Light At Night And Noise Levels, And Long-Term Sleep Trajectories In The Southern Community Cohort Study, Samuel H Nyarko, Qian Xiao Apr 2024

Neighborhood Light At Night And Noise Levels, And Long-Term Sleep Trajectories In The Southern Community Cohort Study, Samuel H Nyarko, Qian Xiao

Student and Faculty Publications

While light at night (LAN) and noise levels have been linked to suboptimal sleep outcomes, little is known about the link between these factors and long-term suboptimal sleep trajectories. The current study examined the association of neighborhood LAN and nighttime noise with long-term sleep trajectories in a cohort of Black individuals and White individuals predominantly from low-income communities. We used data from the Southern Community Cohort Study (N = 28,759 Black individuals and 16,276 White individuals). Sleep duration was self-reported at baseline and after an average of five years of follow-up, based on which we constructed nine sleep trajectories: normal-normal …


A Fork In The Road: Uncovering The Impact Of Industrial Animal Agriculture On The Physical Health Of Communities Of Color, Mariana Zepeda Mar 2024

A Fork In The Road: Uncovering The Impact Of Industrial Animal Agriculture On The Physical Health Of Communities Of Color, Mariana Zepeda

Population Health Research Brief Series

Nearly all (99%) farmed animals in the U.S. come from Concentrated Animal Feeding Operations (CAFOs). CAFOs are industrial agriculture facilities defined by the U.S. Environmental Protection Agency (EPA) as operations where animals are raised in confinement and meet animal size and waste material thresholds. Communities located near CAFOs, which tend to have high shares of low-income and racial/ethnic minority residents, are at risk of exposure to CAFO-related air and water pollutants. This brief summarizes the health risks for communities located near CAFOs. Additionally, it calls for government regulations that improve transparency, management, and consumer empowerment.


Is Northwest Indiana Prepared To Be A “Climate Haven”?, Luke Carl Jorgensen Jan 2024

Is Northwest Indiana Prepared To Be A “Climate Haven”?, Luke Carl Jorgensen

The Journal of Purdue Undergraduate Research

No abstract provided.


Perspectives From Public Health Practitioners And Advocates On Community Development For Active Living: What Are The Lasting Impacts?, Natalicio Serrano, Laurel Schmidt, Amy A Eyler, Ross C Brownson Jan 2024

Perspectives From Public Health Practitioners And Advocates On Community Development For Active Living: What Are The Lasting Impacts?, Natalicio Serrano, Laurel Schmidt, Amy A Eyler, Ross C Brownson

2020-Current year OA Pubs

PURPOSE: Evidence suggests differential impacts of community development, including gentrification and displacement. Public health practitioners and advocates are key stakeholders involved in the community development process related to active living, yet little is known about their perceptions of its impacts. We explored the perspectives of relevant leaders of public health departments and key community and advocacy organizations on community development, gentrification, and displacement.

APPROACH: Purposive key informant interviews.

SETTING: CDC State Physical Activity and Nutrition (SPAN) funding recipients.

PARTICIPANTS: CDC SPAN recipient leadership (n = 10 of 16) and advocacy organizations they partnered with (n = 7 of 16).

METHOD: …


Environmental Justice In West Louisville, Ky, Ashley Wright Jan 2024

Environmental Justice In West Louisville, Ky, Ashley Wright

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

It is evident that West Louisville and Rubbertown are experiencing environmental exposures and related health impacts. It is important for environmental justice (EJ) areas like West Louisville and Rubbertown to gain increased awareness, due to EJ areas commonly being overlooked and forgotten about because of unjust treatment and lack of involvement. Furthermore, all of the data used for this project was publicly accessible. Community residents and the general public can access these data sources to identify which facilities are emitting toxins, as well as specific hazardous substances that are being released, the location of hazardous sites, cleanup status, and more. …


Machine Learning As A Tool For Early Detection: A Focus On Late-Stage Colorectal Cancer Across Socioeconomic Spectrums, Hadiza Galadima, Rexford Anson-Dwamena, Ashley Johnson, Ghalib Bello, Georges Adunlin, James Blando Jan 2024

Machine Learning As A Tool For Early Detection: A Focus On Late-Stage Colorectal Cancer Across Socioeconomic Spectrums, Hadiza Galadima, Rexford Anson-Dwamena, Ashley Johnson, Ghalib Bello, Georges Adunlin, James Blando

Community & Environmental Health Faculty Publications

Purpose: To assess the efficacy of various machine learning (ML) algorithms in predicting late-stage colorectal cancer (CRC) diagnoses against the backdrop of socio-economic and regional healthcare disparities. Methods: An innovative theoretical framework was developed to integrate individual- and census tract-level social determinants of health (SDOH) with sociodemographic factors. A comparative analysis of the ML models was conducted using key performance metrics such as AUC-ROC to evaluate their predictive accuracy. Spatio-temporal analysis was used to identify disparities in late-stage CRC diagnosis probabilities. Results: Gradient boosting emerged as the superior model, with the top predictors for late-stage CRC diagnosis being anatomic site, …


My World's On Fire, How 'Bout Yours? An Investigation Of How Privilege Fosters And Maintains Climate Denial, Morgan A. Chester Jan 2024

My World's On Fire, How 'Bout Yours? An Investigation Of How Privilege Fosters And Maintains Climate Denial, Morgan A. Chester

Antioch University Dissertations & Theses

The present study investigates the phenomenon of climate denial through a new theoretical framework of privilege. The analysis utilizes a feminist orientation that builds on a historical interpretation through the lens of colonialism. Through the dissection of current multidisciplinary understandings of climate denial and new concepts discovered in the review of academic literature and popular media, a compilation of theory, relationship, and connection is made. Systems of power and privilege are examined and connected to the mechanisms and maintenance of climate denial. The resulting analysis illuminates that settler colonialism, supported by connected ideologies of White supremacy, ableism, and patriarchy inform …


Associations Between The Lived Environment And Health Markers In Ohio Counties, Jake Trzybinski, Darbi Griffith, Brian Johns Jan 2024

Associations Between The Lived Environment And Health Markers In Ohio Counties, Jake Trzybinski, Darbi Griffith, Brian Johns

Scholarship in Medicine - All Papers

Environmental exposures have known to be associated with poor health outcomes in adults, however there is scarce literature on which exposures that are county-specific influence health outcomes in the state of Ohio. There are known longitudinal effects of the environment on a person’s physical and mental health and demonstrated correlations could have the potential to improve health outcomes of those living in communities disproportionately impacted by environmental stressors. Through a retrospective review using County Health Rankings and the defined parameters of rurality, we looked at various measures of environmental exposures and living conditions and their effect on diabetes rates, chlamydia …


Analyzing The Correlation Between Water Violations And Hospitalization Rates, Rebekah Dalton, Jed Speers Jan 2024

Analyzing The Correlation Between Water Violations And Hospitalization Rates, Rebekah Dalton, Jed Speers

Scholarship in Medicine - All Papers

Unsafe water due to violations in water safety can result in illness and ultimately hospitalization. However, there is little data that analyzes regional rates of water violations and their correlation to hospitalization rates. This research aims to analyze the correlation between water violations and hospitalization rates between the Midwest, East and West Coasts, and between Ohio counties that use the Lake Erie water basin and those that use the Ohio River water basin. Methods include the use of data from County Health Rankings and the following statistical tests: paired and unpaired T-tests, ANOVA, and Pearson Correlation test. Results showed that …


An Exploration Of The Sense Of Belonging For African American Women Licensed Clinicians In A Voluntary Professional Counseling Organization, Raushanah Jackson Jan 2024

An Exploration Of The Sense Of Belonging For African American Women Licensed Clinicians In A Voluntary Professional Counseling Organization, Raushanah Jackson

Graduate Research Theses & Dissertations

Due to historical oppression in academe, the voices of African American women have been excluded, or unjustifiably limited, in academic research and from mainstream psychological thought. This study was one aim at understanding the experiences of belonging of women of African American ancestry who were clinically licensed professional members in a volunteer member counseling organization. Centering African American women’s voices was used through a lens of critical race theory and Black Feminist Thought to illuminate the structural, representational, and sociopolitical barriers that African American women face. An Interpretive Phenomenological Analysis approach was used to center the voices of five licensed …


Historic Redlining And Health Outcomes: A Systematic Review, Noa T. Kraus, Sarah Connor, Krista Shoda, Scott Emory Moore, Elliane Irani Dec 2023

Historic Redlining And Health Outcomes: A Systematic Review, Noa T. Kraus, Sarah Connor, Krista Shoda, Scott Emory Moore, Elliane Irani

Faculty Scholarship

Objective: The purpose of this systematic review was to synthesize the existing literature on the associations between historic redlining and modern-day health outcomes across the lifespan. Method: This review searched PubMed and CINAHL for peer-reviewed, data-based articles examining the relationship between historic redlining and any health outcome. Articles were appraised using the JBI critical appraisal checklist. The results were synthesized using a narrative summary approach. Results: Thirty-six articles were included and focused on various health outcomes, including cardiovascular outcomes, breast cancer incidence and mortality, firearm injury or death, birth-related outcomes, and asthma outcomes. Most of the included articles (n = …


Understanding Occupational Injury And Substance Use Issues Among Workers In The Shellfish And Lobster Industries, Tora Johnson, Katherine Weatherford Darling, Debra Kantor, Joseph Spiller, Oliver G. Jones, Lois-Ann Kuntz, Tara Casimir, Amy Dowley, Greyson Kurtz, Lauren Sachs, Linda Silka, Bridie Mcgreavy Dec 2023

Understanding Occupational Injury And Substance Use Issues Among Workers In The Shellfish And Lobster Industries, Tora Johnson, Katherine Weatherford Darling, Debra Kantor, Joseph Spiller, Oliver G. Jones, Lois-Ann Kuntz, Tara Casimir, Amy Dowley, Greyson Kurtz, Lauren Sachs, Linda Silka, Bridie Mcgreavy

Maine Policy Review

In 2022, American lobster (Homarus americanus) and softshell clam (Mya arenaria) harvests contributed $283 million to Downeast Maine’s economy, employing thousands of harvesters. Harvesting is grueling work. Pain from work-related injuries precedes most opioid deaths, and workers in fisheries are disproportionately at risk. Harvesters are typically self-employed and often uninsured or underinsured, complicating access to care. Prior studies have focused on injury risk or drug use among harvesters without revealing how injury, pain and substance use intertwine with cultural, social and regulatory factors. This study examined the socio-ecologically embedded injury/ pain/ substance use process with surveys of harvesters (n=106) and …