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A Public Health Ethics Approach To Substance Use Disorder, Adele Flaherty

Electronic Theses and Dissertations

The goal of the dissertation is to undertake an analysis of substance use disorders that focuses on a public health ethics perspective. The ethical argument focuses upon justifying the use of harm reduction and is primarily concerned with the current opioid crisis. While substance abuse/misuse over the course of history has been identified as a public health concern, this dissertation presents substance use disorders over the course of the lifespan, examining various contexts in which it can affect daily living and health outcomes. It achieves this by analyzing substance use disorders through the lens of the socioecological model of public …

Examining An Intersection Of Environmental Justice And Covid-19 Risk Assessment: A Review, Ashley Ellis

Honors Theses

This study views the risks associated with the novel coronavirus (COVID-19) as an environmental injustice issue due to the connection between existing environmental disparities and the disproportional negative impacts brought upon by the virus. The social and health determinants attributed to those environmental disparities have traditionally been evaluated as individual risk factors, an approach that fails to gauge the complexity of an environmental injustice issue. This study employs the emerging theory of intersectionality, a belief that phenomena cannot be linked to one principal cause but instead an interconnected web of influences, in order to synthesize the multitude of factors believed …

Is Living In A Region With High Groundwater Arsenic Contamination Associated With Adverse Reproductive Health Outcomes? An Analysis Using Nationally Representative Data From India, Jessie Pinchoff, Brent Monseur, Sapna Desai, Katelyn Koons, Ruben Alvero, Michelle J Hindin

Department of Medicine Faculty Papers

Background: Exposure to groundwater arsenic via drinking water is common in certain geographies, such as parts of India, and causes a range of negative health effects, potentially including adverse reproductive health outcomes.

Methods: We conducted an ecological analysis of self-reported rates of stillbirth, recurrent pregnancy loss, and infertility in relation to groundwater arsenic levels in India. We used a gridded, modeled dataset of the probability of groundwater arsenic exceeding 10 μg/L (World Health Organization drinking water limit) to calculate mean probabilities at the district level (n = 599 districts). A spatial integration approach was used to merge these estimates with …

Anthropocentrism: More Than Just A Misunderstood Problem, Helen Kopnina, Haydn Washington, Bron Taylor, John Piccolo

The International Journal of Ecopsychology (IJE)

Anthropocentrism, in its original connotation in environmental ethics, is the belief that value is human-centered and that all other beings are means to human ends. Environmentally-concerned authors have argued that anthropocentrism is ethically wrong and at the root of ecological crises. Some environmental ethicists argue, however, that critics of anthropocentrism are misguided or even misanthropic. They contend: first that criticism of anthropocentrism can be counterproductive and misleading by failing to distinguish between legitimate and illegitimate human interests. Second, that humans differ greatly in their environmental impacts, and consequently, addressing human inequalities should be a precondition for environmental protection. Third, since …

Envh 7234 – Environmental Toxicology, Evans Afriyie-Gyawu

Jiann-Ping Hsu College of Public Health Syllabi

This course introduces students to concepts associated with the lethal and sub-lethal effects of environmental and occupational stressors on humans and other living organisms.

Envh 7233 – Environmental Exposure And Impact Assessment, Atin Adhikari

Jiann-Ping Hsu College of Public Health Syllabi

Introduces students to appropriate design, implementation, and analysis of primary environmental exposures and how they are influenced by public health ethics, equity and disparities. Specific topics covered include designing risk profiles; evaluating dose-response relationships; assessing the contribution of public health ethics, equity and disparities to environmental exposures; and analyzing field exposures of toxins.

Spatial Disparities: The Role Of Nativity In Neighborhood Exposure To Alcohol And Tobacco Retailers, Georgiana Bostean, Luis A. Sánchez, Jason A. Douglas

Sociology Faculty Articles and Research

Studies of retail environment, one of the social determinants of health, document racial/ethnic disparities in exposure to alcohol and tobacco (A and T) retailers, but have largely overlooked nativity. We examined associations between A and T retailer density and rates of foreign-born Latinx and foreign-born Asian residents in California census tracts (N = 7888), using spatial regressions and controlling for population and ecological confounders (e.g., population density, zoning, residential instability, urbanicity). Socio-demographic data came from the American Community Survey (2012–2016); census tract density of A and T retailers came from geocoded addresses from state license data for off-sale alcohol distributors …

A Silent Injustice: Air Pollution As A Contributing Factor Of Covid-19 Health Disparities, Spencer Johnson

The Yale Undergraduate Research Journal

COVID-19, the disease caused by SARS-CoV-2 has had a disproportionate impact on Black communities throughout the United States. This paper suggests that air pollution may be a factor for why Black individuals experience markedly poorer health outcomes after contracting COVID-19. It establishes that not only are Black Americans exposed to disproportionate amounts of air pollution, but also that many air pollution-related ailments are the exact ones that have been clinically proven to make COVID-19 more fatal. AV Whe UniWed SWaWeV diVcXVVeV ZhaW a ³neZ noUmal´ entails for healthcare practice and public health policy, this paper makes the case for why …

Investigation Of Environmental Lead Exposures In Children At A Midwestern City With Superfund Site, Zijian Qin

Theses & Dissertations

Childhood exposure to lead is known to cause a host of adverse health effects in children, with no safe blood lead level indicated. Environmental lead contamination is prevalent throughout the United States and remains a threat to the healthy development of children living in these areas, including children in Omaha, Nebraska. The overall objectives of this dissertation were to characterize potential sources of lead in the community – where children play and where children live through the use of environmental exposure sampling. This dissertation also provides insight into current Nebraska children's blood lead levels and identifies local populational attributes that …

Digital Equity Is An Environmental Justice Issue, Courtney B. Cooper

Master's Projects and Capstones

Digital equity has evolved into a more critical area of focus due to the novel coronavirus (COVID-19) pandemic. The COVID-19 pandemic exacerbated the existing digital divide, or the divide that exists between those who have access to the internet and those that do not, by moving many important services and resources online to reduce the spread of the virus. This shift has created more challenges for communities who either lack or have inadequate access to the internet. Furthermore, it is likely that internet utilization will only increase as we continue to recognize its capabilities. A lack of or inadequate access …

Environmental Justice Analysis Of Drinking Water Policies In Michigan Cities, Annika Paldan

Honors Theses

This thesis examined environmental justice aspects of drinking water policies in four cities across Michigan: Flint, Birmingham, St. Joseph, and Benton Harbor. An overview of the history of the environmental justice movement, environmental racism, and drinking water policies provided the basis for a four-part evaluative criterion to assess environmental justice components at the municipal level. These criteria include (1) housing tenure, (2) age, size, and service line composition of the infrastructure, (3) public participation in the policy process, and (4) emergency management of the city. Findings indicate that environmental justice has come a long way, with cities now incorporating components …

Health Disparities And Covid-19 Pandemic: Increasing Clinical Research Participation Among African Americans, Kashica J. Webber-Ritchey, Abbi D. Lane-Cordova

Journal of Health Disparities Research and Practice

Health disparities in African Americans is a persistent issue. Higher rates and severity of the novel coronavirus-19 [COVID-19] among African Americans only widens health disparities. Effective COVID-19 treatment options are imperative, requiring representation of African Americans in clinical research. However, low participation and under-representation of African Americans is complex in nature. This article describes health disparities, the impact of COVID-19, and participation in clinical research among African Americans. We offer strategies for researchers to enhance the inclusion of African Americans. We also offer strategies in conducting clinical research during COVID-19.

“The Clementine Collective”: A Corner Store Intervention Of Clementine Fruits In A High Need Neighborhood In Staten Island, New York, Heather Butts

Faculty of Health Care & Public Administration Publications

Individuals living in underserved neighborhoods face significant barriers to getting fresh produce. It has been extensively researched that providing individuals with fresh fruits and vegetables can have a positive physical and mental impact on the lives of individuals in underserved neighborhoods and the lives of their families. Unfortunately, individuals who reside in such neighborhoods are often viewed as not being motivated to consume fresh fruits and vegetables, even where barriers to eating such foods are removed. This study aims to determine whether, in the COVID-19 era, individuals in underserved neighborhoods would consume fresh fruits if presented with them in an …

Processes For Implementing Community Health Worker Workforce Development Initiatives, Colleen Barbero, Theresa Mason, Carl Rush, Meredith Sugarman, Aunima R. Bhuiya, Erika B. Fulmer, Jill Feldstein, Naomi Cottoms, Ashley Wennerstrom

School of Public Health Faculty Publications

Introduction: The objective of this observational, cross-sectional study was to identify, document, and assess the progress made to date in implementing various processes involved in statewide community health worker (CHW) workforce development initiatives. Methods: From September 2017 to December 2020, we developed and applied a conceptual model of processes involved in implementing statewide CHW initiatives. One or more outputs were identified for each model process and assessed across the 50 states, D.C., and Puerto Rico using peer-reviewed and gray literature available as of September 2020. Results: Twelve statewide CHW workforce development processes were identified, and 21 outputs were assessed. We …

Area Characteristics And Consumer Nutrition Environments In Restaurants: An Examination Of Hispanic Caribbean Restaurants In New York City, Melissa Fuster, Hanish Kodali, Krishnendu Ray, Brian Elbel, Margaret A. Handley, Terry T. Huang, Glen Johnson

Publications and Research

Hispanics in the USA, particularly those of Caribbean descent, experience high levels of diet-related diseases and dietary risk factors. Restaurants are an increasingly important yet understudied source of food and may present opportunities to positively influence urban food environments. We sought to explore food environments further, by examining the association between neighborhood characteristics and restaurant consumer nutrition environments within New York City’s Hispanic Caribbean (HC) restaurant environments. We applied an adapted version of the Nutrition Environment Measurements Survey for Restaurants (NEMS-R) to evaluate a random sample of HC restaurants (n=89). NEMS-HCR scores (continuous and categorized as low, medium, and high …

Allergy And Anaphylaxis From The Prehospital Perspective, Anthony E. Conrardy

Dissertations and Theses

Anaphylaxis is considered a severe, potentially fatal, systemic allergic reaction that occurs suddenly after contact with an allergy causing substance. It is estimated that up to 5% of the population has experienced anaphylaxis, with 1% of hospitalizations and 0.1% of emergency department patients having fatal outcomes. We characterized the population of patients encountered by the EMS agency (786 patients) that had a provider impression of “allergic reaction” and then utilized logistic regression models to estimate associations with the administration of epinephrine in the prehospital setting. Additionally, we used incident location data for all patient encounters of the EMS agency …

At What Cost: Modern Capitalism And The Future Of Health (Preface), Nicholas Freudenberg

Publications and Research

Freedom of choice lies at the heart of American society. Every day, individuals decide what to eat, which doctors to see, who to connect with online, and where to educate their children. Yet, many Americans don't realize that these choices are illusory at best. By the start of the 21st century, every major industrial sector in the global economy was controlled by no more than five transnational corporations, and in about a third of these sectors, a single company accounted for more than 40 percent of global sales. The available options in food, healthcare, education, transportation, and even online presence …

Chemical Exposure From Manufactured Gas Plants: Public Health Risks?, Aneeza Hussain

Publications and Research

This project aims at identifying the chemicals and their risk factors to public health, which were found underneath Public Place, a brownfield next to the Gowanus Canal. The site is heavily contaminated with coal tar — a toxic chemical by-product of gas manufacturing, which happened at the site for 100 years until the gas plant closed down in the 1960s and the land was seized by the city. Recently, the city has planned to develop Public Place into “Gowanus Green” and which will be comprised of a school and low-income housing units on this site. The aim of this research …

Chemical Exposure From Manufactured Gas Plants: Demographic & Governmental Research, Aneeza Hussain

Publications and Research

There are thousands of brownfields in New York on former Manufactured Gas Plants (MGP) similar to the Public Place site in Gowanus, Brooklyn. Public Place is an active brownfield abutting an EPA Superfund site currently undergoing remediation. After consulting recent literature finding that populations living on and near superfund sites have lower life expectancy that also correlate with “sociodemographic factors” like income and race, we used American Community Survey data to conduct a demographic analysis of census districts within the rezone area. Assessment of current demographic data shows that Gowanus residents living within census districts overlapping with the rezone area …

Evaluating Urban Parks Accessibility And Equity: A Case Study Of Hartford, Ct And New Haven, Ct, Natalie Roach, Mara Tu

Honors Scholar Theses

Public parks provide cities with environmental benefits, positive health effects, recreational opportunities, community building, educational spaces, and public amenities. However, certain populations have been systematically denied their fair share of these benefits because of unjust practices in the creation and maintenance of urban parks. With a lens of environmental justice, the goal of this research was to assess park quality and accessibility of two Connecticut cities, Hartford and New Haven, by gathering publicly available information as well as using GIS tools.

The Trust for Public Land (TPL) has an existing ParkScore rating system that evaluates the quality of a city’s …

A Comprehensive Analysis Of Food Insecurity And Solutions In Worcester, Massachusetts, David Sullivan

School of Professional Studies

Worcester, Massachusetts is a postindustrial city with high levels of potential that faces the persistent obstacle of food insecurity for its low-income and ethnic minority communities. This research thesis examines food insecurity in general and explores data and trends in Worcester, then combines this with conceptual frameworks which explain how socioeconomic factors play into food security. It also explains the systemic inequalities present as a result of food insecurity and critiques academic assumptions surrounding food insecurity. One of these assumptions is that food deserts on their own can explain food insecurity in Worcester and elsewhere, though it has been found …

Pulling The Food System Up By The Roots: How Do We Build An Equitable Food System In The Twin Cities?, Aubrey A. Hagen

Geography Honors Projects

Prior to 2020, food insecurity was already a pervasive problem in the United States, with limited access to adequate, nutritious foods being linked to numerous poor physical and psychological outcomes. With the onset of the Covid-19 pandemic and civil uprisings in response to police brutality and state-sanctioned violence, the Twin Cities communities are facing overlapping crises that threaten individual and community wellbeing and food security. How do we build a just, equitable, and “crisis-proof” food system? Drawing from theoretical frameworks in social epidemiology and radical food geography, this paper assesses how the local food system and community food insecurity in …

Cystic Fibrosis In Context: A Look Into Patient Advocacy, Race, Genetics, And Big Pharma, Kayla Sloan

Annual Undergraduate Conference on Health and Society

Despite more people having Sickle Cell Disease (SCD), the Cystic Fibrosis (CF) community receives more private funding, venture capital contributions, and access to participation in political discussions. This divide makes sense given the racial disparities between the mostly black SCD community and the predominately white group of patients with CF. In this paper, I look at how advocacy organizations and scientists build relationships with patients, the impact of race on the history of these advocacy groups, and how conversations about future biotech initiatives differ due to disparities in disposable capital between the two groups. SCD patients have had to combat …

Hospital Assessment And Response To Environmental Pollution As A Population Health Need: Identifying Prevalence And Predictors In Community Benefit Practices, Sarah Valentine

Doctoral Dissertations

Hospitals have a growing role in improving population health. Environmental pollution is an important determinant of health with disproportionate effects on Communities of Color. This warrants hospital action. To advance such action, it is important to take stock of current hospital engagement with environmental pollution and to identify factors associated with such engagement. I investigated the following. To what extent do New York State (NYS) non-profit hospitals assess, identify, and respond to environmental pollutants as part of community benefit practices? Do factors previously reported as associated with hospital engagement of social determinants predict engagement with environmental pollution as a community …

An Interdisciplinary Approach To Community-Engaged Research Surrounding Lead In Drinking Water In The Mississippi Delta, Kristine L. Willett, Stephanie E. Showalter, Catherine M. Janasie, Josephine P. Rhymes, Kennedy Dickson, John J. Green

Journal of Rural Social Sciences

Childhood lead poisoning is a problem requiring interdisciplinary attention from toxicology, public health, social sciences, environmental law, and policy. In the U.S., Mississippi was ranked as one of the worst states for lead poisoning with limited childhood screening measures. We conducted community-engaged research by working with leaders in the largely rural Mississippi Delta region from 2016-2019 to collect household water samples and questionnaires and involve their communities in lead poisoning risk awareness and outreach. Drinking water from 213 homes was collected and analyzed for pH and lead concentrations. Highest lead concentrations were from households served by private wells, and detectable …

Authentic Youth Engagement In Environmental Health Research And Advocacy, Kathryn M. Cardarelli, Melinda J. Ickes, Luz Huntington-Moskos, Craig Wilmhoff, Angela Larck, Susan M. Pinney, Ellen J. Hahn

Health, Behavior & Society Faculty Publications

Training in environmental health (EH) engages and inspires youth to tackle health promotion and policy change. Yet, there is little guidance on how to successfully nurture and sustain youth engagement. This paper compares four case studies of youth engagement to promote EH in rural and urban communities using the Youth Empowerment Solutions (YES!) framework. Of the case studies in rural (Central Appalachia) and urban (Cincinnati, Ohio) communities, two employ citizen science approaches using PhotoVoice and environmental sampling; one engages youth in a science communication camp; and one focuses on policy advocacy. We compare and contrast these case studies using the …

Environmentally Marginalized Populations: The "Perfect Storm" For Infectious Disease Pandemics, Including Covid-19, Gabriella Y. Meltzer, Oyemwenosa Avenbuan, Christina Awada, Oluwakemi B. Oyetade, Tricia Blackman, Simona Kwon Drph, Mph, Esther Erdei Phd, Judith T. Zelikoff Phd

Journal of Health Disparities Research and Practice

COVID-19 has exacted a severe toll on the United States population’s physical and mental health and its effects have been felt most severely among people of color and low socioeconomic status. Using illustrative case studies, this commentary argues that in addition to COVID-19 health disparities created by psychosocial stressors such as the inability to socially distance and access quality healthcare, environmental justice communities have the additional burden of disproportionate exposure to toxic contaminants that contribute to their higher risk of COVID-19. Environmental contaminants including heavy metals and persistent organic pollutants found contaminating their nearby environments can alter the immune response, …

Identifying Nontraditional Epidemic Disease Risk Factors Associated With Major Health Events From World Health Organization And World Bank Open Data, Roberta Lugo-Robles, Eric C. Garges, Cara H. Olsen, David Brett-Major

Journal Articles: Epidemiology

Health events emerge from host, community, environment, and pathogen factors-forecasting epidemics is a complex task. We describe an exploratory analysis to identify economic risk factors that could aid epidemic risk assessment. A line list was constructed using the World Health Organization Disease Outbreaks News (2016-2018) and economic indicators from the World Bank. Poisson regression employing forward imputations was used to establish relationships with the frequency with which countries reported public health events. Economic indicators demonstrated strong performance appropriate for further assessment in surveillance programming. In our analysis, three economic indicators were significantly associated to event reporting: how much the country's …

Health Reform Reconstruction, Lindsay F. Wiley, Elizabeth Y. Mccuskey, Matthew B. Lawrence, Erin C. Fuse Brown

Faculty Articles

This Article connects the failed, inequitable U.S. coronavirus pandemic response to conceptual and structural constraints that have held back U.S health reform for decades and calls for reconstruction. For more than a half-century, a cramped “iron triangle” ethos has constrained health reform conceptually. Reforms aimed to balance individual interests in cost, quality, and access to health care, while marginalizing equity, solidarity, and public health. In the iron triangle era, reforms unquestioningly accommodated four legally and logistically entrenched fixtures — individualism, fiscal fragmentation, privatization, and federalism — that distort and diffuse any reach toward social justice. The profound racial disparities and …

When Disparities Become Deadly: Spatial Differences In Pm2.5 Levels Within The City Of Pomona, California, Pauline Bekkers

Pomona Senior Theses

This thesis discusses the disparities in particulate matter concentrations between different neighborhoods in the city of Pomona, California, and explores the historical, political and social factors that have shaped these spatial patterns. I argue that urban growth patterns in Pomona, which are historically marked by race and class segregation as a consequence of past discriminatory housing practices, have led to the disproportionate concentrations of air pollutants in low-income, Latino communities in South Pomona.

Due to the absence of a local air quality monitoring system, there is a lack of information about and understanding of how poor air quality may be …