Medicine and Health Sciences Commons^™

Positive And Negative Experiences With Supportive Services And Programming: Gaps And Recommendations From Youth Experiencing Homelessness, Judy Y. Tan, G. Allen Ratliff, Ilsa Lund, Sherilyn Adams, Colette Auerswald, Marguerita Lightfoot

OHSU-PSU School of Public Health Faculty Publications and Presentations

Services for youth experiencing homelessness (YEH) are designed with limited input from the youth themselves. This study explored the experiences and recommendations for services aimed at mitigating the negative effects of homelessness among youth. A total of 45 interviews were conducted with YEH (ages 15 to 24, M = 21.5 years) who experienced at least one night of homelessness. Transcripts were coded by using a modified constructivist grounded theory approach. YEH reported myriad challenges to navigating disjointed programming and misguided policies. Recommendations from YEH for policy and programmatic change include peacekeeping and diffusion training for program staff, trauma-informed approaches, and …

Travelling For Abortion Services In Mexico 2016–2019: Community-Level Contexts Of Mexico City Public Abortion Clients, Laura E. Jacobson Mph, Biani Saavedra-Avendano, Evelyn Fuentes-Rivera, Raffaela Schiavon, Blair Darney

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective: To describe the community context of women who travel to access Mexico City’s public sector abortion programme and identify factors associated with travelling from highly marginalised settings.

Methods: We used data from the Interrupción Legal de Embarazo (ILE) programme (2016–2019) and identified all abortion clients who travelled from outside Mexico City. We merged in contextual information at the municipality level and used descriptive statistics to describe ILE clients’ individual characteristics and municipalities on several measures of vulnerability. We also compared municipalities that ILE clients travelled from with those where no one travelled from. We used logistic regression to identify …

Opioid Agonist Therapy During Hospitalization Within The Veterans Health Administration: A Pragmatic Retrospective Cohort Analysis, Kelsey C. Priest, Travis I. Lovejoy, Honora Englander, Sarah Shull, Dennis Mccarty

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

Hospitalization of patients with opioid use disorder (OUD) is increasing, yet little is known about opioid agonist therapy (OAT: methadone and buprenorphine) administration during admission.

Objective

Describe and examine patient- and hospital-level characteristics associated with OAT receipt during hospitalization in the Veterans Health Administration (VHA).

Participants

A total of 12,407 unique patients, ≥ 18 years old, with an OUD-related ICD-10 diagnosis within 12 months prior to or during index hospitalization in fiscal year 2017 from 109 VHA hospitals in the continental U.S.

Main Measure

OAT received during hospitalization.

Key Results

Few admissions received OAT (n = 1914; 15%) …

Making The Business Case For An Addiction Medicine Consult Service: A Qualitative Analysis, Kelsey C. Priest, Dennis Mccarty

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

As the drug poisoning crisis worsens in North America and opioid use disorder (OUD)-related hospital admissions increase, policymakers and hospital administrators are beginning to recognize the important role of hospitals in the OUD care continuum. This study explores and describes how U.S. addiction medicine physicians created and presented business propositions to hospital administrators to support the development of addiction medicine consult (AMC) services.

Methods

Fifteen qualitative interviews were completed with board-certified or board-eligible addiction medicine physicians from 14 U.S. hospitals. The interviews occurred as part of a broader mixed methods study exploring hospital service delivery for patients admitted with …

Periodic Atlas Of The Metroscape: The Geography Of Health, Joshua Ollinger, Ashley Donald, Randy Morris

Metroscape

Our ability to lead a fulfilling life and pursue our goals is largely shaped by our health. Although we experience these conditions such as illness and disabilities at a very personal level, factors outside of our control are often what determines our health. Known as the Social Determinants of Health, where we are born, work, live, and spend our lives is considered equally if not more important to our health status than medical care and personal health behaviors. As a result, certain communities and populations disproportionately experience burdens. Identifying and increasing awareness of health disparities is an essential step toward …

Civic Engagement Among Orphans And Non-Orphans In Five Low- And Middle-Income Countries, Christine L. Gray, Brian W. Pence, Lynne C. Messer, Jan Ostermann, Rachel A. Whetten, Nathan M. Thielman, Karen O'Donnell, Kathryn Whetten

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Communities and nations seeking to foster social responsibility in their youth are interested in understanding factors that predict and promote youth involvement in public activities. Orphans and separated children (OSC) are a vulnerable population whose numbers are increasing, particularly in resource-poor settings. Understanding whether and how OSC are engaged in civic activities is important for community and world leaders who need to provide care for OSC and ensure their involvement in sustainable development.

Methods: The Positive Outcomes for Orphans study (POFO) is a multi-country, longitudinal cohort study of OSC randomly sampled from institution-based care and from family-based care, and …

Is Housing Making People Sick?: An Overview Of Seven Studies That Raise Questions To Consider As We Incorporate Health Into Planning And Build New Housing To Address Shortages And Energy Efficiency, Merilee D. Karr

Metroscape

The article discusses the unintended consequences of some of the strategies for housing energy efficiency: they can lead to indoor air pollution that is making people sick. As we pursue ways to reduce the cost of housing, we must pursue innovation in building materials and techniques that might reduce the negative health consequences of sealing our homes from the elements.

Potentially Traumatic Experiences And Sexual Health Among Orphaned And Separated Adolescents In Five Low- And Middle-Income Countries, Christine L. Gray, Kathryn Whetten, Lynne C. Messer, Rachel A. Whetten, Jan Ostermann, Karen O'Donnell, Nathan M. Thielman, Brian W. Pence

Community Health Faculty Publications and Presentations

Orphans and separated children (OSC) are a vulnerable population whose numbers are increasing, particularly in sub-Saharan Africa and Asia. Over 153 million children worldwide have lost one or both parents, including 17 million orphaned by AIDS, and millions more have been separated from their parents. As younger orphans enter adolescence, their sexual health and HIV-related risk behaviors become key considerations for their overall health. Importantly, their high prevalence of exposure to potentially traumatic events (PTEs) may put OSC at additional risk for adverse sexual health outcomes. The Positive Outcomes for Orphans study followed OSC randomly sampled from institution-based care and …

The Oregon Health System Transformation: Preliminary Report Of Coordinated Care Organizations In The First Year Implementation, Carlos J. Crespo, Ellen Smit

Community Health Faculty Publications and Presentations

Because of the US Affordable Care Act, 16% of Oregonians without health insurance will be able to obtain coverage through Coordinated Care Organizations (CCO).

Citizenship Documentation Requirement For Medical Eligibility: Effects On Oregon Children, Brigit A. Hatch, Jennifer E. Devoe, Jodi A. Lapidus, Matthew J. Carlson, Bill J. Wright

Sociology Faculty Publications and Presentations

BACKGROUND AND OBJECTIVES: The Deficit Reduction Act (DRA) of 2005 mandated Medicaid beneficiaries to document citizenship. Using a prospective cohort (n=104,375), we aimed to (1) determine characteristics of affected children, (2) describe effects on health insurance coverage and access to needed health care, and (3) model the causal relationship between this new policy, known determinants of health care access, and receipt of needed health care.

METHODS: We identified a stratified random sample of children shortly after the DRA was implemented and used state records and surveys to compare three groups: children denied Medicaid for inability to document citizenship, children denied …

The Association Between Insurance Status And Cervical Cancer Screening In Community Health Centers: Exploring The Potential Of Electronic Health Records For Population-Level Surveillance, 2008-2010, Stuart Cowburn, Matthew J. Carlson, Jodi A. Lapidus, Jennifer E. Devoe

Sociology Faculty Publications and Presentations

Introduction: Cervical cancer incidence and mortality rates in the United States have decreased 67% over the past 3 decades, a reduction mainly attributed to widespread use of the Papanicolaou (Pap) test for cervical cancer screening. In the general population, receipt of cervical cancer screening is positively associated with having health insurance. Less is known about the role insurance plays among women seeking care in community health centers, where screening services are available regardless of insurance status. The objective of our study was to assess the association between cervical cancer screening and insurance status in Oregon and California community health centers …

Putting Regulatory Data To Work At The Service Of Public Health: Utilizing Data Collected Under The Clean Water Act, Jyotsna S. Jagai, Barbara J. Rosenbaum, Suzanne M. Pierson, Lynne C. Messer, Kristen M. Rappazzo, Elena N. Naumova, Danelle T. Lobdell

Community Health Faculty Publications and Presentations

Under the Clean Water Act, the US Environmental Protection Agency (EPA) collects information from states on intended use and impairment of each water body. We explore the feasibility of using these data, collected for regulatory purposes, for public health analyses. Combining EPA impairment data and stream hydrology information we estimated the percent of stream length impaired for any use, recreational use, or drinking water use per county in the US as exposure variables. For health outcomes we abstracted county-level hospitalization rates of gastrointestinal infections, GI (ICD-9CM 001-009 excluding 008.45) and gastrointestinal symptoms, GS (ICD-9CM 558.9, 787) among US adults aged …

Transport And Health: A Look At Three Latin American Cities, Janeth Mosquera Becerra, Rodrigo S. Reis, Lawrence D. Frank, Farah A. Ramirez-Marrero, Benjamin Welle, Eugenio Arriaga Cordero, Fabian Mendez Paz, Carlos J. Crespo, Veronica Dujon, Enrique Jacoby, Jennifer Dill, Lynn Weigand, Carlos M. Padin

Community Health Faculty Publications and Presentations

Transport is associated with environmental problems, economic losses, health and social inequalities. A number of European and US cities have implemented initiatives to promote multimodal modes of transport. In Latin America changes are occurring in public transport systems and a number of projects aimed at stimulating non-motorized modes of transport (walking and cycling) have already been implemented. Based on articles from peer-reviewed academic journals, this paper examines experiences in Bogota (Colombia), Curitiba (Brazil), and Santiago (Chile), and identifies how changes to the transport system contribute to encourage active transportation. Bus rapid transit, ciclovias, bike paths/lanes, and car use restriction are …

Increasing The Relevance Of Research To Underserved Communities: Lessons Learned From A Retreat To Engage Community Health Workers With Researchers, Heather Angier, Noelle Wiggins, Jessica Gregg, Rachel Gold, Jennifer E. Devoe

Community Health Faculty Publications and Presentations

This article presents information on a community retreat developed to seek input from community health workers (CHWs) to increase the relevance of our research to underserved communities in Oregon. Retreats facilitating dialogue between researchers and CHWs could yield important insight to enhance the significance of research for communities.

The Health And Housing Specialist: An Emerging Job Classification To Support Aging In Place In Subsidized Housing, Paula C. Carder, Jenny Weinstein, Jacklyn Nicole Kohon

Institute on Aging Publications

As the U.S. population ages, the availability of workers with a basic understanding of aging and health-related services has not kept pace. This is true in traditional health care organizations such as hospitals and primary care clinics as well as in long-term care settings and senior housing, including subsidized housing, the focus of this report. Nearly 1.8 million older persons receive some form of publicly-subsidized rental assistance. Some subsidized housing providers, including those that operate buildings designated for older persons, are developing new systems of service delivery that would either coordinate or provide health screenings, physical activity programs, nutrition programs, …

Failure Of Intimate Partner Violence Screening Among Patients With Substance Use Disorders, Esther K. Choo, Christina Nicolaidis, Robert H. Jenkinson, Jessi M. Cox, Kenneth J. Mcconnell

School of Social Work Faculty Publications and Presentations

Objectives: This study examined the relationship between substance use disorder (SUD) and intimate partner violence screening (IPV) and management practices in the emergency department (ED). Methods: This was a retrospective cohort study of adult ED patients presenting to an urban, tertiary care teaching hospital over a 4-month period. An automated electronic data abstraction process identified consecutive patients and retrieved visit characteristics, including results of three violence screening questions, demographic data, triage acuity, time of visit, and ICD-9 diagnosis codes. Data on management were collected using a standardized abstraction tool by two reviewers masked to the study question. Multivariate logistic regression …

State Experiences With Affordable Housing Plus Services: Report To Seniors And Persons With Disabilities, On The Move, Paula C. Carder, Erika Zoller

Institute on Aging Publications

Housing developers, providers, policy makers, and advocates, increasingly recognize that for some groups of individuals, access to affordable housing alone is "not enough." That is, some individuals require more than shelter. Examples include individuals who have chronic health conditions (e.g., HIV/AIDS), those with physical or cognitive limitations (e.g., persons with developmental disabilities, adults with physical disabilities), and those who have a combination of health conditions or who cannot thrive in traditional housing (e.g., persons who have been homeless, individuals with chronic mental illness). Increasingly, housing providers, social service agencies, advocates, states, and federal agencies have recognized the need to combine …

Racial Discrepancies In The Association Between Paternal Vs. Maternal Educational Level And Risk Of Low Birthweight In Washington State, Christina Nicolaidis, Cynthia W. Ko, Somnath Saha, Thomas D. Koepsell

School of Social Work Faculty Publications and Presentations

Background: The role of paternal factors in determining the risk of adverse pregnancy outcomes has received less attention than maternal factors. Similarly, the interaction between the effects of race and socioeconomic status (SES) on pregnancy outcomes is not well known. Our objective was to assess the relative importance of paternal vs. maternal education in relation to risk of low birth weight (LBW) across different racial groups.

Methods: We conducted a retrospective population-based cohort study using Washington state birth certificate data from 1992 to 1996 (n = 264,789). We assessed the associations between maternal or paternal education and LBW, adjusting for …