Medicine and Health Sciences Commons^™

Does Using Sofa Score For Ventilator Triage Among Covid 19 Patients Result In Suboptimal Allocation Of Medical Ventilators For The Bipoc Population?, Alexandrea Mp Masocco, Elisabeth Michel, Ebbin Dotson

Journal of Health Disparities Research and Practice

Introduction: Since the COVID-19 pandemic in the United States, Black, and Latinx populations have been disproportionately affected by the COVID-19 pandemic. It can be inferred with high confidence that those most vulnerable are the least likely to receive essential care. Kidney transplant allocation and COVID-19 triage protocols share commonalities in that both protocols involve using multivariate scored criteria with objective and subjective inputs. As such, the similar conclusion in outcomes is concerning. It is worth questioning whether the racial inequalities demonstrated in the COVID-19 pandemic related to access to life-saving ventilators were associated with triage protocols.

Methodology: Using an exploratory …

Opioids In The Las Vegas Metro, Elia Del Carmen Solano-Patricio, Caitlin Saladino, William E. Brown

Health

In 2014, Nevada was one of 7 states selected to participate in a national policy coalition to reduce prescription drug abuse. As a result, the Nevada Department of Health and Human Services (DHHS) and the Southern Nevada Health District (SNHD) created a data dashboard to track opioid prescriptions and opioid-involved overdose incidents. This Fact Sheet synthesizes state-level data from the Nevada Opioid Overdose Surveillance Dashboard and focuses on the Las Vegas Metropolitan Statistical Area (MSA). The data track opioid prescription rates as they correlate to opioid-involved overdose deaths, emergency room visits, and hospitalizations.

Opioids In Nevada, Peter Grema, Caitlin Saladino, William E. Brown

Health

This Fact Sheet presents data from the Washington Post’s Drug Enforcement Administration (DEA) database on opioid shipments in the United States and provides information pertaining to Nevada and each of its 17 regions (16 counties and one independent city). This Fact Sheet compares the Washington Post’s opioid shipment data with opioid prescription rates relative to Nevada’s population in 2010.

Prehypertensive Risk Among African-American Undergraduates: Do The Extra Pounds Really Matter?, Cecile N. Yancu, Amber Debono, Anna K. Lee, Correll Mcrae, Daphne Witherspoon

Journal of Health Disparities Research and Practice

The objective of this study is to examine prehypertension among young African American adults and evaluate the predictive value of easily obtained standard measures of adiposity. Data for this study of 155 primarily African-American undergraduates was collected between April 2010-11. Participants provided family health history and anthropometric measures, including body weight, body mass index (BMI), and waist to hip (WHR) ratio. Percentages were calculated for demographics. The average systolic blood pressure measured over two time periods within a single semester generated prehypertension rates. Univariate and multivariate logistic regression examined the impact of BMI, WHR, weight, and family medical history on …

Racial Disparities In Breast Cancer Survival: The Mediating Effects Of Macro-Social Context And Social Network Factors, Ganga Vijayasiri, Yamile Molina, Ifeanyi B. Chukwudozie, Silvia Tejeda, Heather Pauls, Garth Rauscher, Richard T. Campbell, Richard B. Warnecke

Journal of Health Disparities Research and Practice

ABSTRACT

This study attempts to clarify the associations between macro-social and social network factors and continuing racial disparities in breast cancer survival. The study improves on prior methodologies by using a neighborhood disadvantage measure that assesses both economic and social disadvantage and an ego-network measurement tool that assesses key social network characteristics. Our population-based sample included 786 breast cancer patients (nHWhite=388; nHBlack=398) diagnosed during 2005-2008 in Chicago, IL. The data included census-derived macro-social context, self-reported social network, self-reported demographic and medically abstracted health measures. Mortality data from the National Death Index (NDI) were used to determine 5-year survival.

Based on …

Higher Quality At Lower Cost: Community Health Worker Interventions In The Health Care Innovation Awards, Caitlin Cross-Barnet, Sarah Ruiz, Megan Skillman, Rina Dhopeshwarkar, Rachel Singer, Rachel Carpenter, Suzanne Campanella, Maysoun Freij, Lynne Snyder, Erin Colligan

Journal of Health Disparities Research and Practice

Background: Published evidence regarding cost savings, reduced utilization, and improved quality associated with employing community health workers (CHWs) is largely lacking. This paper presents findings from the Centers for Medicare & Medicaid Services Health Care Innovation Awards (HCIA), with a focus on six diverse programs that employ CHWs. We examine outcomes associated with programs incorporating CHWs into care teams for a broad age range of patients with various health issues such as cancer, asthma, and complex conditions.

Methods: This mixed-methods study used data from claims and site visits to assess the effectiveness of CHW programs. In difference-in-differences analyses of Medicare …

Addressing The Racial Disparity In Birth Outcomes: Implications For Maternal Racial Identity On Birthweight, Wanda M. Burton, Maria Hernandez-Reif, Brad Lian

Journal of Health Disparities Research and Practice

Background: As a widely used marker of health, birthweight has been a persistent racialized disparity with the low birthweight rate of Blacks in Alabama nearly doubling the national average. The purpose of this study was to examine the role of racial identity and acculturation on birthweight in a sample of Black women living in Alabama.

Methods: Black women (n=72) in West Alabama were surveyed about the birthweight of their first born child. Correlation and multiple linear regression analyses were conducted.

Results: Racial identity was the only significant predictor of birthweight. Mothers with a strong racial identity reported having low birthweight …

Risk For Cardiovascular Disease In Blacks With Hiv/Aids In America: A Systematic Review And Meta-Analysis, Calvin Odhiambo, Jessica Davis, Bernard Omolo

Journal of Health Disparities Research and Practice

Cardiovascular disease (CVD) related to HIV infection is becoming a major public health concern in the United Stated. Epidemiologic studies show that prolonged use of Highly Active Antiretroviral Therapy, HIV/AIDS itself, and a combination of traditional vascular risk factors increase the risk for CVD among people with HIV/AIDS. However, little is known about any racial disparities in the risk for CVD in the HIV/AIDS population. We conducted a systematic review and meta-analysis of literature on HIV/AIDS and CVD (June 1, 2010-July 31, 2014) through MEDLINE to examine whether and how HIV-positive African Americans are disproportionately affected by CVD compared to …

Social Determinants Of Health Associated With Hbv Testing And Access To Care Among Foreign-Born Persons Residing In The United States: 2009 - 2012, Kevin M. Greene, Wayne A. Duffus, Jian Xing, Hope King

Journal of Health Disparities Research and Practice

Objectives: To describe how select Social Determinants of Health (SDH) are associated with the burden of hepatitis B virus (HBV) infection among foreign-born persons residing in the United States.

Methods: Multivariate logistic regression was used to examine the Racial and Ethnic Approaches to Community Health (REACH) 2010 Risk Factor Survey data to investigate the independent relationship between SDH and HBV testing and access to care.

Results: HBV infected persons with insurance were more likely to see a physician than those without. Respondents worried about money to pay rent or mortgage were more likely to report HBV infection than …

Using The Theory Of Fundamental Causes To Show The Potential Effects Of Socioeconomic Status On Surgical Outcomes, Mehwish Qasim, A.B.D.

Journal of Health Disparities Research and Practice

Surgical procedures are both costly and common. There are large differences in surgical outcomes both within and between hospitals based on patient characteristics such as measures of income. In both 2000 and 2009, patients residing in low-income communities had worse morbidity and mortality rates, across a wide range of quality indicators. In this review, the author will explicate the Theory of Fundamental Causes as it relates to surgical care, review key empirical findings and address potential limitations of the theory. This review will provide a platform for researchers to discuss current research in surgical disparities using the Theory of Fundamental …

Employment And Economic Development In Southern Nevada, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

Wealth influences a person’s health. People who are higher on the socioeconomic scale tend to have better health outcomes. To improve the health of a community, it is important to understand the employment opportunities of the people living in the community.

Southern Nevada’s economy was hit hard between 2008 and 2012. Unemployment rates in the region exceeded national and peer regions between during this time period. Construction; leisure and hospitality; trade, transportation and utilities; and professional and business service sectors experienced the greatest job loss during the recession. The Education and Health Services sectors did not experience a decrease in …

Healthcare Access And Health Outcomes In Southern Nevada, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

In a publication from the Robert Woods Johnson Foundation, it was recognized that a person’s zip code was a more important predictor of health than their genetic code. Where we live influences not only our access to health care, but other health indicators as well. Clark County has a low primary care physician to population ratio compared to other counties in Nevada and in the US. Clark County also has highest rates of uninsured in the Mountain West and among the highest in the nation.

Southern Nevada fared worse than other Mountain West Metropolitan areas in health indicators and preventative …

Demographic Makeup And Population Projections For Southern Nevada: Understanding The Emerging Healthcare Needs In Our Community, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

Even with a leveling-off of population growth from 2008 to 2011, Southern Nevada had one of the fastest growing populations in the nation over the past decade. While population growth is projected to increase for the next ten years, the rate of growth will be slower than in the past decade. The Hispanic population, as a percentage of the total population, is projected to surpass the White population somewhere near the year 2030. The Southern Nevada population is aging, as the median age in the region increased between 2000 and 2010. The 65+ age group is projected to increase as …

Awareness And Beliefs Regarding Intimate Partner Violence Among First-Year Dental Students, Rhonda J. Everett, Karl Kingsley, Christina A. Demopoulos, Edward E. Herschaft, Christine Lamun, Sheniz Moonie, Timothy J. Bungum, Michelle Chino

Environmental & Occupational Health Faculty Publications

Intimate partner violence (IPV) may affect one to four million individuals per year in the United States, with women accounting for the majority of both reported and unreported cases. Dental professionals are in a unique position to identify many types of IPV because injuries to the head and neck may be indicators or predictors of IPV abuse. Fewer than half of dental programs surveyed have reported having IPV-specific curricula, and most dental students surveyed have reported having little experience or training to recognize IPV. Based on this information, this pilot study sought to assess the awareness and beliefs regarding IPV …

Effectiveness Of A Portable, Large-Area Ultraviolet Germicidal Device, Mark P. Buttner, Thomas Yee, Patricia Cruz, Vanessa Stevens

Nevada Journal of Public Health

Effective disinfection of the hospital environment is a key component in the prevention of healthcare-associated infections. The objective of this project was to evaluate the effectiveness of an ultraviolet germicidal device in reducing the concentrations of culturable bacteria on indoor surfaces. The ultraviolet germicidal device was installed and operated in four experimental trials conducted in a microbiology research chamber. Agar plates inoculated with known concentrations of two test microorganisms were placed on benches inside the chamber at two distances, 1.5 meters and 3.0 meters from the machine, for exposure times of 5 minutes, 10 minutes, and 20 minutes. With test …

Selective Screening Of Type 2 Diabetes For Washoe County’S Hispanic Population, Linda M. Dunn

Nevada Journal of Public Health

Hispanic Americans with unrecognized, asymptomatic diabetes are more likely to experience poor quality of life and diabetic complications such as heart, eye and kidney disease than non-Hispanic whites of similar age. Multiple factors, such as cultural beliefs, lack of knowledge and limited access to health care, contribute to the fact that one-third of total diabetes among Hispanic Americans is undiagnosed. For Washoe County, Nevada, the actual percentage of adult Hispanics with diabetes may be almost 12%. In 2003, the Defeat Diabetes Screening Project provided three screenings targeting the Hispanic population in Reno and Sparks. Seventy-one percent of 348 screened were …

How We Want To Be Treated! What Clark County African American Patients Want Their Health Providers To Know, Charlene A. Day, Joyce Woodson, Erica Archuleta

Nevada Journal of Public Health

Research continues to validate the fact that cultural values and beliefs play a major role in determining the extent to which an individual will engage in healthy behaviors, adhere to medical regimen, and seek care when necessary. A 2000 survey of 950 members of predominately African American churches in Clark County, Nevada (a county which comprises Las Vegas) conducted by the University of Nevada Cooperative Extension found members preferred healthcare providers as a source of information on health-related matters. Yet, research shows that for a variety of reasons, many African Americans do not regularly see a health care professional, and …

Screening For Mental Health Problems Among Incarcerated Youth In Nevada: Practice And Policy, Michelle Chino, Jennifer Personius-Zipoy, Denise Tanata

Nevada Journal of Public Health

Incarcerated youth in Nevada with serious mental health problems are not being effectively identified. The current study examined the utility of simple screening instruments as a mechanism for identifying incarcerated youth who may have a mental health disorder. Adjudicated youth, incarcerated at each of Nevada’s 12 juvenile detention facilities, participated in the study by completing a demographic questionnaire and a standardized mental health screening instrument: the Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2). Findings indicate a high prevalence of mental health disorders among incarcerated juveniles in Nevada. Identifying youth with mental health problems is complicated by the lack of a systematic …

Exercise Determined Promise 2003 Logandale, Nevada Plague Prophylaxis Clinic: Exercising The Strategic National Stockpile, Kay Godby, Mary Ellen Harrell, Bonnie Sorenson, Maureen Fanning, Nancy Gerken, Jane Shunney

Nevada Journal of Public Health

The Department of Defense asked the Clark County Health District (CCHD) to participate in the disaster drill entitled Determined Promise ’03 (DP ‘03) from August 18 -23, 2003. The purpose of this exercise was to test the capacities of the U.S. Northern Command (U.S.Northcom) Homeland defense/homeland security mission and integration of the Joint Task Forces-Civil Support (JTF-CS) with state and local responders. Part of the JTF-CS mission was to coordinate military support to civilian state and local authorities when it was requested.

Protecting Children From Overexposure To Lead In Candy And Protecting Children By Lowering The Blood Lead “Level Of Concern” Standard, Bryan Wagner, Colleen C. Hughes, Robert Sobsey

Nevada Journal of Public Health

The American Public Health Association: Recognizing that in April 2004, the Orange County Register in an investigative report, published for the first time information that the state of California had been testing for lead in candies for decades but had not informed the public about the high lead levels in many candies, candy wrappers and seasonings (sold as a snack item and consumed as candy) imported from Mexico, the Philippines and other countries.

Oral Health Needs And Parental Attitudes, Behavior, And Knowledge Of Lower Ses Children, Mildred Mcclain, Clifford R. Mcclain, Anthony Paventy

Nevada Journal of Public Health

Despite the declining prevalence of dental caries over recent decades, caries remain the most common chronic childhood disease, especially in high-risk (low socio-economic status) populations. This appears to be true even when parents are aware of good oral health habits. The purpose of this study was to gather oral hygiene data on high-risk children in Nevada and to assess parental attitudes and education concerning their children’s oral health. Using visual examinations and a dmft (decayed, missing, filled, teeth) severity index, 235 lower SES children were screened and given treatment recommendations. The screenings showed larger than expected prevalence in both caries …

Findings From The Nutrition Challenge Program, Rayleen Earney, Nicole Bungum, Timothy J. Bungum

Nevada Journal of Public Health

Obesity is an epidemic in the United States. Over 61% of U.S. adults and 58% of Nevada adults have Body Mass Index’s (BMI) that classify them as either overweight or obese (Behavioral Risk Factor Surveillance System [BRFSS], 2005). According to a recent article published in the Journal of the American Medical Association, obesity was the second leading cause of preventable death in the United States behind tobacco use (Mokdad, Marks, Stroup & Gerberding, 2004).

While obesity and overweight are complex, multi-factorial health conditions, an important contributor to the overweight and obesity epidemic is poor dietary habits. One of the major …

Evaluation Of The Impact Of A Health Care Administration Student Practicum, Christopher R. Cochran, Michelle Sotero

Nevada Journal of Public Health

As the health care industry becomes increasingly complex, many leaders and practitioners in the field are worried about the quality and preparation of health care administration graduates (Robbins, Bradley, & Spicer, 2001). Academic health care administration programs prepare students for a professional career in the health care field. One of the biggest challenges for university health care administration programs is to meet industry needs by effectively incorporating practical skills and knowledge into the academic curricula. For students, coursework provides some insight into the demands of the industry, but they also require hands-on experience to be relevant in a highly competitive …

Lead Shot Deposition And Distribution In Southern Nevada, Shawn Gerstenberger, Darren D. Divine

Nevada Journal of Public Health

Densities of lead (Pb) shot in soil and the presence of Pb shot in waterfowl gizzards from past hunting activities at the Overton Wildlife Management Area (OWMA) in southern Nevada were determined. Soil shot densities in fields managed for doves, pheasants and geese, and adjacent fields strictly managed as waterfowl habitat were examined. Soil shot densities ranged from 2,691 to 107,642 Pb shot/ha in waterfowl areas to 649,085 to 862,275 Pb shot/ha in dove management areas. Pb shot deposition rates for the 1998-1999 dove hunting season were also calculated and ranged from 8,970 to 22,559 shot/ha in fields managed primarily …

Adverse Maternal Outcomes For Women With Different Health Insurance Statuses In Nevada, Jay J. Shen, Hong Wei

Nevada Journal of Public Health

Objective. Nevada women with unfavorable health insurance status may face greater barriers than women in the rest of the nation, since the development of healthcare infrastructure in Nevada is running behind population growth. This study examines the relationship between health insurance status and adverse maternal outcomes in Nevada.

Methods. Hospital discharge information of 33,149 women aged 13 or older who delivered in 2004 was abstracted from the 2004 State Inpatient Data for Nevada. A total of 13 measures of complications associated with pregnancy were identified, including preterm labor, hypertensive disorders of pregnancy, gestational diabetes, ante-partum hemorrhage, membrane disorders, cesarean section, …

A Study To Determine If University Athletic Teams In Desert Environments Experience Risky Diet-Related Behaviours, Susan Meacham, Christine Bergman, Marcia M. Ditmyer, Kyle Wilson, Connie Mobley

Nevada Journal of Public Health

Training and competing in desert environments may exacerbate concerns related to disordered eating, supplement use, and hydration in some student athlete populations. A survey administered equitably to both genders solicited self-reported responses from members of 18 different teams over four years from a southwestern United States university athletic program. More than 1,700 athletes responded to 42 items on the questionnaire. Teams, not individual student athletes, were the units of measure for statistical analyses. Initial analysis of results indicated that there were no overt concerns regarding dietary behaviors due to training and competing in the desert environment. Further analysis subjected the …

The Administrative Prevalence Of Autism Spectrum Disorders In Nevada School Districts: A Pooled Time Series Analysis, 1996-2004, John P. Tuman, Sheniz Moonie, Danielle Roth-Johnson

Nevada Journal of Public Health

Objective: To examine the administrative prevalence of Autism Spectrum Disorders (ASD) in all seventeen school districts in Nevada during the period of 1996 to 2004.

Methods: Normalized administrative prevalence rates (per 1,000 children ages 6-17) for ASD, Mental Retardation (MR), Learning Disability (LD), and Speech and Language Impairment (SLI) were calculated. Covariates for board certified pediatricians per 1,000 students, Federal special education funding per student, and other measures of school resources were employed. Models were estimated with pooled Ordinary Least Squares (OLS) regression with panel corrected standard errors. A separate analysis compared pooled OLS results to results from Latent Growth …

The Effects Of Television Food Advertising On Childhood Obesity, Aleathia Cezar

Nevada Journal of Public Health

Children’s food choices are influenced by the media, television advertising, focusing directly at infants and toddlers. This literature review presents multiple studies that explain how TV advertising of fast food, sugary cereals and other foods high in calories, fat, sugar, sodium and low in nutrients are contributing to the increase rates of childhood obesity. It is concluded that children are exposed to high amounts of food advertisements which affect young children’s food choices and poor food consumption. Due to the growing numbers of hours that children sit in front of the television, less physical activity and the epidemic of childhood …

Prevalence And Antimicrobial Agent Susceptibility Of Methicillin-Resistant Staphylococcus Aureus In Healthy Pediatric Outpatients In Las Vegas, Echezona E. Ezeanolue, Mark P. Buttner, Patricia Cruz, Joanne L. Henry, Chad L. Cross, Linda D. Stetzenbach

Nevada Journal of Public Health

Colonization and infection by community-associated resistant strains of Staphylococcus aureus are being reported in epidemic proportions. The purpose of this study was to determine the local prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization in children and to characterize the MRSA isolates in the laboratory with regard to antimicrobial agent susceptibility patterns, and the presence of the mecA and the Panton-Valentine leukocidin (PVL) genes. Nasal swabs were collected at two pediatric clinics from a total of 505 children during health maintenance visits. A brief questionnaire was administered to collect demographic data and pertinent medical, family, and social history. Samples were cultured …

First-Year Compliance With The Nevada Clean Indoor Air Act, Leslie Elliott, Dana Loomis, Andrew B. Bridgforth, Stephanie O’Mara, Louise T. Brock, Brian Hansen, Melanie Marie Minarik, Kathryn Louderback

Nevada Journal of Public Health

Objectives: We quantitatively evaluated compliance with the Nevada Clean Indoor Air Act (NCIAA) by different types of businesses in Nevada and determined whether compliance affected indoor concentrations of benzene and 3-ethenyl pyridine (3-EP), markers of tobacco smoke.

Methods: Managers of 181 businesses in Washoe County, Nevada, were interviewed about business characteristics and practices and policies related to smoking. During unannounced visits, compliance data and air samples (n=66) were collected from interviewed businesses and from an additional sample (n = 56) of businesses without knowledge of the study.

Results: Overall compliance, as defined by the NCIAA, was low (28.2%). Benzene concentrations …