Medicine and Health Sciences Commons^™

A Comparative Study On Mental Health Knowledge Based On Socioeconomic Status In Kisumu Kenya 2019, Mashoud Kaba

Independent Study Project (ISP) Collection

Studies show that people who live in rural Kenya have more positive attitudes toward mental illnesses than people in urban areas. They also had more mental health knowledge. One of the differentiating factors between the two environments is the socioeconomic status of those who live in each area. People in rural areas tend to be of lower socioeconomic status, while those living in urban areas tend to be of a higher socioeconomic status. I wanted to see if the previous findings would be observed if we were looking at people in the same area (strictly urban or rural) with the …

Mining’S Impact On Environmental And Human Health: A Case Study Of Ramba County’S Gold Mine, Vivika Fernes

Independent Study Project (ISP) Collection

This research project aims to gain a greater understanding of the health implications that Ramba County’s goldmine has on miners, their families, and the environment. While this study observes the community-at-large, inclusive of visiting miners and extended family members of workers, it will focus on women who engage in artisanal and small-scale gold mining (ASGM). Millions of people in the developing word depend on ASGM for their livelihood, evident in this case study in Ramba County. However, while gold is associated with wealth, there is great irony in the fact that those working within the mining industry are being exploited …

La Incorporación De La Dimensión Intercultural Para Pacientes Quechuas En El Centro Comunitario De Salud Mental De Calca, Caroline Parker

Independent Study Project (ISP) Collection

Trastornos mentales afectan a una de cada cinco personas del Perú. Sin embargo, entre las personas que indican una necesidad de atención de salud mental, 69%-85% no buscan servicios. Este problema se amplifica en zonas rurales y comunidades indígenas a lo largo del país. Debido a la falta de servicios en estas regiones, y a la ausencia de investigaciones acerca de la salud mental en comunidades indígenas, investigué los servicios para la salud mental en Calca, una provincia en el sur del Perú con una población substantiva de personas indígenas. Mi pregunta principal es: ¿de qué manera el Centro Comunitario …

A Virginia Mountain City Responds To The Challenge Of Improving Health Outcomes, Robert S. Cowell Jr.

Journal of Appalachian Health

In 2012, Roanoke Virginia was becoming a city of haves and have-nots, a place where many were benefitting from revitalization underway but too many were seeing their situation grow worse and becoming even more entrenched. Poverty with levels as high as 50% in some neighborhoods; life expectancy sometimes 14 years shorter than those living just one or two neighborhoods over; and lack of access to fresh food, medical care, and economic opportunities—all within view of the largest hospital in the region was unacceptable.

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Roanoke's Collective Public Health Activities, Michael Lytton

Journal of Appalachian Health

Roanoke is addressing problems that confront many small and medium sized cities in the U.S., especially disparities in health and life expectancy between neighborhoods. These disparities are often legacies of decades of racial and economic segregation, resulting in low-income or disinvested communities. Typically, such neighborhoods have fewer parks, higher vacancy rates and less stable affordable housing stock, inadequate public transit systems, too few clinics, too many fast food restaurants and insufficient access to high quality schools. In Roanoke these are the northwest and southeast quadrants, both federally designated Medically Underserved Areas, and characterized by a large proportion of the city’s …

Decomposing Trends In Child Obesity, Ashley Wendell Kranjac, Robert L. Wagmiller

Sociology Faculty Articles and Research

We unravel the absolute level and relative prominence of two demographic processes that are relevant for childhood obesity, and that will ultimately determine the long-term course and pace of change in child obesity rates. We leverage data from the National Health and Nutrition Examination Survey to decompose change in child obesity from 1971 to 2012. We partition change into that attributable to (1) healthier, more nutritionally and economically advantaged cohorts in the population being replaced by cohorts of children who are less advantaged (between-cohort change), and (2) the health habits, nutrition, and social and economic circumstances of all cohorts of …

A Legacy Of Disease, Arthur L. Frank

Journal of Appalachian Health

In Appalachia, like much of America, there are important health issues that have not always been appropriately predicted or dealt with when they occur. Lifestyle issues in Appalachia lead to obesity and heart disease, not surprisingly due to extensive use of sugary drinks. The current opioid crisis could have been better predicted given the trauma of mining and the past abuse of less-potent narcotics. A continuing major problem in the whole country is inadequate support for preventive health activities.

Improving Access To Addiction Recovery Care In Central Appalachia Through Organizational Collaboration, Katy Stigers

Journal of Appalachian Health

Fahe, a Network of 50+ members throughout Appalachia based in Berea KY, has brought together a coalition to finance, build, and manage several addiction recovery care centers across Kentucky and West Virginia, increase access to employment, and deploy vouchers for supportive services.

Disparities In Quality Of Life By Appalachian-Designation Among Women With Breast Cancer, Robin C. Vanderpool, Ann L. Coker, Heather M. Bush, Sarah E. Cprek

Journal of Appalachian Health

Introduction: Few studies have examined the association of geography and quality of life (QOL) among breast cancer patients, particularly differences between Appalachian and non-Appalachian Kentucky women, which is important given the cancer and socioeconomic disparities present in Appalachia.

Purpose: The purpose of this study was to determine whether women with breast cancer residing in Appalachian Kentucky experience poorer health outcomes in regards to depression, stress, QOL, and spiritual wellbeing, relative to those living in non-Appalachian Kentucky after adjusting for demographic, socioeconomic, and health-related factors.

Methods: Women, aged 18–79, recruited from the Kentucky Cancer Registry between 2009 and 2013 with an …

Investigating The Impact Of The Diseases Of Despair In Appalachia, Michael Meit, Megan Heffernan, Erin Tanenbaum

Journal of Appalachian Health

Introduction: Appalachia is one of the regions most significantly impacted by the opioid crisis. This study investigated mortality due to diseases of despair within the Appalachian Region, with an additional focus on deaths attributable to opioid overdose.

Methods: Diseases of despair include: alcohol, prescription drug and illegal drug overdose, suicide, and alcoholic liver disease/cirrhosis of the liver. Mortality data from the National Center for Health Statistics (NCHS) National Vital Statistics System (NVSS) Multiple Cause of Death database were analyzed for this study, focusing on individuals aged 15–64.

Results: Over the past two decades, the mortality rate due to diseases of …

Root Causes Of Appalachia’S Deaths Of Despair, F. Douglas Scutchfield Md

Journal of Appalachian Health

The U.S. is experiencing a decline in life expectancy, particularly among rural white males in their most productive years. Appalachia is disproportionally represented in mortality rates, accounting for 30% of the U.S. population, but 50% of the excess mortality attributed to the “deaths of despair”: drug overdose, suicide, and alcoholic cirrhosis. A substantial proportion of that excess mortality is related to the current opioid crisis we are experiencing. We have data on evidence-based solutions to the treatment of addiction, but little information on prevention of addiction as well as the other deaths of despair, likely with the same etiologic agent. …

Youth-Sized Lab Coats: When Children Become Doctors Through Adolescent Healthcare Brokering, Lindsey Russell

Social Sciences

Child language brokering refers to the practice of children acting as linguistic and cultural mediators in general settings like school, stores, banks and other personal uses. The primary focus of this paper is “adolescent healthcare brokering,” a term coined in 2016 by researchers Jennifer R. Banas, James W. Ball, Lisa C. Wallis and Sarah Gershon, to refer to the use of children as interpreters for family and community members, specifically in the healthcare setting; these cross-lingual communications may occur during regular physician appointments, trips to the emergency department or at specialized visits in fields such as obstetrics or oncology.

This …

Racial/Ethnic Differences In Multimorbidity Development And Chronic Disease Accumulation For Middle-Aged Adults, Ana R. Quiñones, Anda Botoseneanu, Sheila Markwardt, Corey L. Nagel, Jason T. Newsom, David A. Dorr, Heather G. Allore

Psychology Faculty Publications and Presentations

Multimorbidity–having two or more coexisting chronic conditions–is highly prevalent, costly, and disabling to older adults. Questions remain regarding chronic diseases accumulation over time and whether this differs by racial and ethnic background. Answering this knowledge gap, this study identifies differences in rates of chronic disease accumulation and multimorbidity development among non-Hispanic white, non-Hispanic black, and Hispanic study participants starting in middle-age and followed up to 16 years.

We analyzed data from the Health and Retirement Study (HRS), a biennial, ongoing, publicly- available, longitudinal nationally-representative study of middle-aged and older adults in the United States. We assessed the change in chronic …

Illness And The American Workplace: Issues And Implications For Employers And Employees, Victoria R. Dolan

Student Theses and Dissertations

This project aims to identify American employee experiences and existing workplace policies and cultures surrounding illness, disability, and sick leave. This approach was taken in order to closely examine what looks to be working well for companies and workers, and what could benefit from a more human centric approach in regards to workplace policy and employee support programs. The study of employee experiences in particular represents a gap in the current scholarly literature regarding illness and illness policy in the American workplace, and more accurately represents the experiences for both employees and employers. Furthermore, it assists with distinguishing the types …

Female Genital Mutilation In The United States: Estimating The Number Of Girls At Risk, Phyllis Chesler

Dignity: A Journal of Analysis of Exploitation and Violence

Female genital mutilation (FGM) destroys the capacity of women to experience sexual pleasure. It causes serious medical complications such as bleeding, painful urination, cysts, dangerous and recurrent bladder and urinary tract infections, the growth of scar tissue that make marital intercourse a nightmare and that turns childbirth into an experience of danger and torture. Due to immigration, FGM now poses a potential health crisis in the West, both in Europe and in the United States. To estimate how many girls who live in the West are at risk, one can measure the prevalence of FGM in the non-Western countries where …

“Flowing Along The Wall”: Anarcha-Feminist Bioethics And Resistance In Octavia E. Butler’S Dawn 2019., Theresa Mendez

Master's Theses

Science fiction (sf) texts conversant with the temporal play between past, present, and future push readers to imagine the extremes of human and environmental existence, interaction, and potential. Simultaneously, despite the sf genre’s tendency to traffic in extremes, these texts provoke readers to consider the ways in which these imagined worlds are grounded in history as well as in the contemporary social moment. As Donna Haraway has argued, “the boundary between science fiction and social reality is an optical illusion” (306). This illusory boundary must continue to be traversed in order to consider how sf literatures, particularly those which imagine …

Dusty Shoes: Appalachia Wisdom Fertilizing The Future Of Religious Leadership, Jill Crainshaw

Journal of Appalachian Health

Dust from their journeys through the hills and hollows of Appalachia clings to their shoes and has forever shaped their vocational journeys. This is a refrain I have distilled from the reflections of students who have participated in Wake Forest University School of Divinity’s multicultural contexts course that includes a 10-day sojourn in the mountains of North Carolina.

Identifying Priority And “Bright-Spot” Counties For Diabetes Preventive Care In Appalachia: An Exploratory Analysis, Peter J. Mallow, Michael Topmiller, Jennifer Rankin, Jene Grandmont, David Grolling, Jessica L. Mccann, Mark Carrozza

Journal of Appalachian Health

Introduction: Type 2 diabetes mellitus (T2DM) prevalence and mortality in Appalachian counties is substantially higher when compared to non-Appalachian counties, although there is significant variation within Appalachia.

Purpose: The objectives of this research were to identify low-performing (priority) and high-performing (bright spot) counties with respect to improving T2DM preventive care.

Methods: Using data from the Centers for Medicare and Medicaid (CMS), the Dartmouth Atlas of Health Care, and the Appalachia Regional Commission, conditional maps were created using county-level estimates for T2DM prevalence, mortality, and annual hemoglobin A1c (HbA1c) testing rates. Priority counties were identified using the following criteria: top 33rd …

Serum Cotinine Versus Parent Reported Measures Of Secondhand Smoke Exposure In Rural Appalachian Children, Samrat Yeramaneni, Kimberly Yolton, Kurunthachalam Kannan, Kim N. Dietrich, Erin N. Haynes

Journal of Appalachian Health

Background: Secondhand smoke (SHS) exposure in Appalachian children and associated adverse effects is understudied and not well documented. This study assessed the prevalence of SHS exposure in Appalachian children by parental self-report and internal biological measure.

Methods: SHS exposure was determined in children residing in rural Appalachian communities during their participation in the Communities Actively Researching Exposure Study between 2009 and 2013. Parents reported the number of smokers in the household and number of cigarettes smoked/day. Children ages 7-9 provided a serum sample for cotinine analysis. Parent reported measures and child serum cotinine measures of SHS exposure were compared with …

The Social Determinants Of Health And The Decline In U.S. Life Expectancy: Implications For Appalachia, Steven H. Woolf, Heidi Schoomaker, Latoya Hill, Christine M. Orndahl

Journal of Appalachian Health

For the past century, life expectancy in industrialized countries has increased, and the U.S. has shared in that progress. However, beginning in the 1980s, advances in U.S. life expectancy began to lose pace with peer countries. By 1998, U.S. life expectancy had fallen below the average for Organisation for Economic Cooperation and Development nations. U.S. life expectancy peaked in 2014 and has been decreasing for three consecutive years, a trend not been seen since the influenza pandemic a century ago. Put simply, U.S. health is in decline.

Delivering Health Knowledge And Wisdom From The Hills And Hollows Of Appalachia, F. Douglas Scutchfield Md, Erin N. Haynes, Robert M. Shapiro Ii, Charlotte S. Seidman

Journal of Appalachian Health

There is knowledge in the pages of Appalachia’s hills. This journal is positioned to find and publish those translations. It grows from a need to provide an outlet for scholarship about Appalachia’s health so that knowledge, and occasionally wisdom, is shared with those who care about and are committed to improving the region’s health.

Voices Unheard: Women And Their Children In Nepal’S Incarceration System, Aune Nuyttens, Mikayla Rose

Independent Study Project (ISP) Collection

This research project focused on women in Nepal’s incarceration system. Our goal was to hear and share their stories with the hopes of humanize and de-stigmatize perceptions of female prisoners in and outside of Nepal. A central component to these stories, as we learned, was also the story of prisoner’s children and the NGOs who provide assistance to this vulnerable group of women and their children. The researchers travelled to the east and west of Kathmandu to visit rural and urban prisons in Nepal, and visited various children homes, however the research was based out of Kathmandu, where many of …

Pasantía En Red Oss: Más Que Una Clínica, Saad Ehsan

Independent Study Project (ISP) Collection

RED OSS es una organización en Conchalí, Santiago que provee pruebas rápidas de VIH y actualiza otras pruebas para ETS en una manera gratuita desde 1991. Durante mi pasantía, investigué como una organización disminuye las desigualdades de salud. También aprendí sobre el financiamiento de RED OSS, las pruebas rápidas y el nicho de RED OSS en un país con un sistema pública. Utilicé observaciones y entrevistas para estudiar la clínica. Tuve oportunidades para asistir los talleres para prevenir homofobia y ver las consejerías con un voluntario. También actualicé el sitio web para reflejar los servicios que RED OSS ofrece. En …

Ecological Determinants Of Respiratory Health: Examining Associations Between Asthma Emergency Department Visits, Diesel Particulate Matter, And Public Parks And Open Space In Los Angeles, California, Jason A. Douglas, Reginald S. Archer, Serena E. Alexander

Health Sciences and Kinesiology Faculty Articles

Los Angeles County (LAC) low-income communities of color experience uneven asthma rates, evidenced by asthma emergency department visits (AEDV). This has partly been attributed to inequitable exposure to diesel particulate matter (DPM). Promisingly, public parks and open space (PPOS) contribute to DPM mitigation. However, low-income communities of color with limited access to PPOS may be deprived of associated public health benefits. Therefore, this novel study investigates the AEDV, DPM, PPOS nexus to address this public health dilemma and inform public policy in at-risk communities. Optimized Hotspot Analysis was used to examine geographic clustering of AEDVs, DPM, and PPOS at the …

Betrayed Partners And Men With Poisoned Souls: Interview With A Former Sex Buyer In Germany, Ingeborg Kraus

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Financial Barriers And Utilization Of Medical Services In Prison: An Examination Of Co-Payments, Personal Assets, And Individual Characteristics, Brian R. Wyant Phd, Holly M. Harner

Journal for Evidence-based Practice in Correctional Health

Although research has found that requiring incarcerated individuals to pay fees for medical service decreases use, there are still important unanswered questions about this association: 1) Is the copayment fee a barrier to those seeking medical attention? 2) If so, what individual factors are associated with viewing the copayments as the reason to avoid seeing a medical professional? Using 2012 survey data collected from 45 incarcerated persons housed in a maximum security prison on the East Coast, it was discovered that over 70% of the men surveyed reported avoiding medical services at least once in the past three months due …

Journey To Refuge: Understanding Refugees, Exploring Trauma, And Best Practices For Newcomers And Schools, Trina D. Harlow

NPP eBooks

Pre-K through 12th grade schools within the United States have become much more diverse in recent years. Schools are now commonly not only diverse because of diverse students born in the United States, but also have many immigrant students. A growing number of these immigrant students are resettled children who have refugee status. In schools, these recent immigrants are called newcomers. This book is a culmination of research and anecdotal experiences regarding the refugee issue as it pertains to these students in American schools and schools elsewhere in the world. Scholars, policy makers, educators, those who work in the refugee …

Multiplicative Advantages Of Hispanic Men Living In Hispanic Enclaves: Intersectionality In Colon Cancer Care, Keren M. Escobar, Mollie Sivaram, Kevin M. Gorey

The Journal of Sociology & Social Welfare

We examined Hispanic enclave paradoxical effects on cancer care among socioeconomically vulnerable people in pre-Obamacare California. We conducted a secondary analysis of a historical cohort of 511 Hispanic and 1,753 non-Hispanic white people with colon cancer. Hispanic enclaves were neighborhoods where 40% or more of the residents were Hispanic, mostly first-generation Mexican American immigrants. An interaction of ethnicity, gender and Hispanic enclave status was observed such that the protective effects of living in a Hispanic enclave were larger for Hispanic men, particularly married Hispanic men, than women. Risks were also exposed among other study groups: the poor, the inadequately insured, …

Gay Men And Satisfaction With Health Care Interactions, Michael Huggins

Theses and Dissertations--Nursing

The purpose of this research was to determine relationships among depression, anxiety, self-rated physical and mental health, self-advocacy, internalized homophobia, and quality of patient-provider communication to satisfaction with health care interactions. These were measured while controlling for select demographic variables: age; ethnicity; urban or rural domicile; relationship status; household income; highest educational attainment; health insurance; disclosure to health care provider as a gay man; reason for last healthcare visit; and, general health self-rating. The specific aims of this study were to: 1) identify general characteristics of gay men in this sample; 2) examine how levels of satisfaction with health care …

Delivering Identities: A Symbolic Interactionist Study Of Doulas And The Decline Of Medical Professional Dominance, Madeline Lucie Firkser

Senior Projects Spring 2019

Doulas are non-medically affiliated people who provide emotional, physical, and informational support to people before, during, and after childbirth. The purpose of this study is to understand the role of the doula beyond its typically-assumed value as a superficial or consumerist entity and in relation to the broader maternal health care system available within the United States. Through six in-depth interviews with doulas about their conceptions of their personal identities, as well as their relationships with their medical counterparts and their clients, this project contributes to extant literature on symbolic interactionist linkages between identities and occupations. I examine how doula …