Medicine and Health Sciences Commons^™

Advancing Health Equity In The Us Military, James D. Mancuso, John Young, Jennifer Rusiecki, Shauna Stahlman, Natasha Schvey, Toya Randolph, Candy Wilson, Catherine Witkop, Patrick Hyde, Althea Green, Patcho Santiago, Donald Shell, Tracy Sbrocco

Journal of Health Disparities Research and Practice

Eliminating health disparities and achieving health equity are central to US national health objectives and the Military Health System’s “quadruple aim,” which has readiness as its core aim. Because military service members enjoy universal eligibility for health care, it is sometimes assumed that health disparities do not exist in the Department of Defense (DoD). However, while some studies have shown that disparities have been attenuated or eliminated in the DoD, others suggest that significant disparities remain. Reasons these disparities may remain include that universal eligibility for care does not necessarily result in equal to access to care, and that equal …

Motherhood Together: Effects Of An Adapted Prenatal Curriculum On Mother And Infant Outcomes, Rebecca Lovan, Clare Brown, Keneshia Bryant-Moore, Leslie Mccormack, Nicole Ward, Shannon Kalkwarf, Beverly English, Elizabeth Riley

Journal of Health Disparities Research and Practice

Background: Research shows that pregnant women experiencing housing insecurity are more likely to face barriers to prenatal care that can lead to negative health outcomes for both mother and infant. Previous studies have also shown that prenatal education programs provide pregnant mothers with the knowledge and resources that increase the likelihood of positive health outcomes. An interprofessional healthcare team in Central Arkansas modified an existing prenatal education program to create Motherhood Together, a program specifically tailored for pregnant women facing house insecurity.

Methods: The purpose of this initial evaluation of the Motherhood Together program was to identify the feasibility of …

A Community-Based Participatory Research Project To Increase The Understanding Of The Health Concerns Of African Immigrant Communities In Urban Missouri., Rhonda Belue, Covenant Elenwo, Clayton Adams, Adaobi Anakwe, Kelly Taylor, Sunita Manu, Sidee Conteh

Journal of Health Disparities Research and Practice

Background

African immigrants and refugees experience unique mental and physical health care needs that may be a result of pre-migration history and the acculturation process. The purpose of this project was to collaborate with African immigrant and refugee communities to identify health needs of the communities and lay a foundation for future action.

Methods

Key-informant interviews with five West, East and Central African immigrant and refugee communities included community leaders (n=10) and listening sessions with larger groups of community members totaling approximately 150 participants to identify health care needs. Content analysis was employed to identify themes related to immigrant and …

Us Immigrants’ Experiences With The Covid-19 Pandemic- Findings From Online Focus Groups, Awele Maduka-Ezeh, Ikwesilotuto T. Ezeh, Benjamin E. Bagozzi, Jennifer A. Horney, Somawina Nwegbu, Joseph E. Trainor

Journal of Health Disparities Research and Practice

Objective:

Immigrants in the United States (US) are disproportionately affected by disasters. Yet the effects of one type of disaster—pandemics—have been underexplored in this regard. The purpose of this study was to better understand these effects, with specific attention to the impacts of the COVID-19 pandemic on US immigrants and their social networks.

Design:

Forty-five US immigrants (aged 18 and above) participated across eight online focus groups during spring 2020. Using “criterion of inclusion” sampling, participants were recruited via gatekeeper and snowball sampling methods. Anonymity was maintained throughout all online focus group sessions. Discussions were transcribed and then categorized into …

The Impact Of Food Insecurity Screenings And Community Food Resource Referrals For Patients With Type 2 Diabetes, Miriam Ngozi Ofili, Robin M. Lawson

Journal of Health Disparities Research and Practice

ABSTRACT

Approximately 50 million people in the United States are food insecure, which makes food insecurity (FI) one of the country’s most prevalent health issues. Food insecurity has been shown to be a contributing factor to uncontrolled Type 2 Diabetes (T2D), which affects about 34.1 million adults in the United States. The purpose of this study was to evaluate the effectiveness of integration of an electronic social determinants of health screening and community referral process for adult patients with T2D and FI. The aim was to determine if Hemoglobin A1c (HbA1c) levels are reduced in adult patients with T2D by …

Propelling Adolescents Toward Careers In Healthcare (Patch): A Medical Student Led Pipeline Program For High School Students Underrepresented In Medicine, Maggie Brownrigg, Sagar Patel Md, Kyle Roedersheimer Md, Melissa Wooten Md, Radhika Ghodasara Md, Banks Kooken Md, Iris Cheng Md

Journal of Health Disparities Research and Practice

Despite the growing diversity of the United States population, individuals from many racial and ethnic minority groups and low-income families continue to be underrepresented in the health professions. A diverse healthcare workforce would improve cultural competency and create a system better suited to address the vast health disparities in many disadvantaged communities, yet the current educational pipeline needs to expand opportunities to provide students traditionally underrepresented in medicine (UIM) a path to become a part of the healthcare field. The Propelling Adolescents Towards Careers in Healthcare (PATCH) program was founded to address this gap in the current health professions pipeline …

Sex Differences In Risk Factors For Oral And Pharyngeal Cancer Among Puerto Rican Adults, Maira A. Castaneda-Avila, Cynthia Perez, Jose Vivaldi, Elba C. Díaz, Hilmaris Centeno, Ana P. Ortiz

Journal of Health Disparities Research and Practice

Background: Oral and pharyngeal cancer (OPC) is a frequent type of cancer in Puerto Rico, with the risk being higher in men relative to women. We assessed differences in OPC risk factors implicated in these sex disparities.

Methods: We analyzed data of 740 adult participants (40-65 years) from the San Juan Overweight Adults Longitudinal Study (SOALS). A comprehensive questionnaire was administered to collect information on sociodemographic characteristics, cigarette smoking, binge drinking, oral high-risk HPV infection, fruit and vegetable consumption, sexual behavior, and oral hygiene practices. A full-mouth periodontal examination was also performed. Sixteen OPC known and potential risk factors were …

The Prevalence Of Physical Health Problems Among Youth In The Juvenile Justice System: A Systematic Review., Wadiya A. Udell, Selina Mohammed

Journal of Health Disparities Research and Practice

Justice-involved youth suffer from a range of health problems. Using health and social science databases, we summarize findings from studies reporting rates of physical health problems among youth in the juvenile justice system published between 2006 and 2017. A total of 23 were identified, with the majority examining sexual health problems and focusing on youth confined to correctional facilities. Although fewer studies focused on non-sexual health problems and non-detained youth, findings suggest disparities across some physical health problems impacting youth within various levels of justice system involvement. Given the health risks faced by justice-involved youth and their long-term consequences, more …

Effect Of Socio-Demographics, Health-Related Problems, And Family Structure On Chronic Absenteeism Among Children, Eunjung Lim, James Davis, So Yung Choi, John J. Chen

Journal of Health Disparities Research and Practice

Purpose/Background: From 5 to 7.5 million school children are chronically absent, defined as missing ≥15 days of school within a year. Students miss schools due to various reasons such as health, socioeconomic status, and environmental factors. We examined child’s health and behavior, family structure, and socio-demographics to understand chronic absenteeism.

Materials & Methods: The population included children ages 6 to 17 years from the Medical Expenditure Panel Survey (MEPS) years 2008-2013. Multivariable logistic regressions were used to identify the risk factors of chronic absenteeism, adjusting for the complex sampling design.

Results: Among socio-demographic variables, age ≥14 years, race/ethnicity, lower-income family, …

Apol1 Ckd Risk Alleles In New Mexico African American And American Indian Populations: Racial Disparity, Chien-An A. Hu, Amelia Bierle, Matthew Shultz, Vallabh Shah

Journal of Health Disparities Research and Practice

Purpose/Background: Two haplotypes of human apolipoprotein L1 gene (gene: APOL1; protein: ApoL1) harboring three coding sequence mutations have been demonstrated as risk variants associated with non-diabetic chronic kidney diseases (CKD) in African Americans. The first one, termed G1, is a two non-synonymous SNP haplotype (rs73885319 (A>G; p.S342G) and rs60910145 (G>T; p.I384M). The second one, termed G2, is a two codon deletion haplotype rs71785313 (6-bp in frame deletion) These two coding-sequence variants have been discovered in CKD patients of African ancestry and linked to the pathogenesis of primary focal and segmental glomerulosclerosis (FSGS), hypertension-attributed kidney disease, and HIV-associated nephropathy …

Mountain West Clinical Translational Research-Infrastructure Network: Introduction, Parvesh Kumar

Journal of Health Disparities Research and Practice

The Mountain West (MW) Clinical Translational Research Infrastructure Network (CTR- IN) Program represents a consortium of all of the 13 major public universities across seven Institutional Development Awards (IDeA) states with the overall goal of increasing and enhancing research capacity. The MW CTR-IN Program covers 1/3^rd the U.S. land mass and almost 1/3^rd of all IDeA states stretching across 4 time zones. The 13 major U.S. public partner universities in the 7 IDeA states are as follows: University of Alaska at Anchorage (UAA), University of Alaska at Fairbanks (UAF), University of Montana (UM), Montana State University (MSU), University …

Dental Emergencies In The Current Health Care System, David Singleton, Nawar Shara, Phd

Journal of Health Disparities Research and Practice

A huge problem in the current health system is that Oral care is not currently integrated into the overall health system, given the lack of dental coverage for underserved adults, and the insufficient amount of dentists available for individuals with dental coverage.

The lack of education regarding the importance of oral health and shortage in the number of dentists and dental coverage leads to an influx of patients with mild to severe dental problems at the emergency departments (EDs) across the country. Many studies conclude that by integrating oral health into the overall health system, there would an increase in …

Implementing Autism Screening For Latino Children In Primary Care: Perspectives From Parents And Providers, Mary Troxel, Keri Linas, Diane Jacobstein, Matthew Biel, Sandra H. Soto, Isabella Lorenzo-Hubert, Soraya Dos-Santos, Rocio Mendez, Bruno J. Anthony

Journal of Health Disparities Research and Practice

While Autism Spectrum Disorder (ASD) and other developmental disabilities are being diagnosed at increasing rates, there is strong evidence of disparities in rates of identification and utilization of services by Latino children as compared to non-Latino children. Attempts to reduce these disparities include culturally-informed early screening for ASD risk. In preparation for initiation of a screening program in a primary care setting serving primarily Latino children, focus groups and interviews were conducted with Latino parents (N=31), medical staff (N=15), health care providers (N=4) to better understand the barriers and facilitators to engagement around developmental concerns that contribute to the low …

Disrupting The Intergenerational Transmission Of Trauma Among Alaska Native People: A Conceptual Model For The Family Wellness Warriors Initiative, Lily Ray, Bobbi Outten, Polly Andrews, Katherine Gottlieb

Journal of Health Disparities Research and Practice

Background: Increasing evidence demonstrates the life-long physical, emotional, and social effects of traumatic experiences. In recognition that many health disparities are driven by high rates of traumatic experiences, Alaska Native and American Indian people have created wellness programs that build health by first healing historical and lifetime trauma. Yet, many of these promising community-based interventions are not described in the health sciences literature. Southcentral Foundation’s Family Wellness Warriors Initiative (FWWI) was created by Alaska Native people, addresses traumatic experiences as the root cause of family violence, and builds on cultural strengths. The goal of this study was to build a …

Teaching About Cultural Competence And Health Disparities In An Online Graduate Public Health Course, Anuli Njoku, Drph, Mph, Uchenna Baker, Phd, Med

Journal of Health Disparities Research and Practice

The growing diversity in U.S. society encourages the need for culturally competent healthcare professionals to provide optimal services to a diverse population. This increasing diversity also brings greater awareness to health disparities among distinct subgroups of the U.S. population. Addressing health disparities in the USA will require a multidimensional approach from various sectors, including the field of education. Developing health disparities curricula can help cultivate conscious future health practitioners. Faculty development programs can be integral in equipping faculty to develop curricula on and teach students about health disparities. With a growth in online learning and in the number of adult …

Examining The Impact Of Race And Rurality On Health Differences Among Overweight Youth Accessing Pediatric Endocrinology Care, Kelsee Halpin, Janelle R. Noel-Macdonnell, Yun Yan

Journal of Health Disparities Research and Practice

Methods: This study examines the impact of race and rurality on health differences, including prevalence of prediabetes and type 2 diabetes (T2D), among overweight children accessing pediatric endocrine specialty care. Cross-sectional analysis of overweight/obese youth 10 to 18 years of age receiving pediatric endocrinology consultation for weight gain, hyperglycemia, and/or T2D from 2013 to 2016 at a Midwest tertiary pediatric center.

Results: The 722 patients were 42% white, 25% black, 22% Hispanic; 88% lived in urban areas and 12% in rural areas. Rurality was determined using zip code approximation of Rural-Urban Commuting Area (RUCA) codes. After adjusting for confounders, black …

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 …

Disparities In Access To Primary Care And Emergency Department Utilization In A Large Medicaid Program, Natasha Parekh, Marian Jarlenski, David Kelley

Journal of Health Disparities Research and Practice

Identifying and eliminating disparities are priorities for State Medicaid programs, especially in the context of increased enrollment through Medicaid expansion. We assessed racial, ethnic, regional, and managed care organization (MCO) differences, as well as time trends before and after Medicaid expansion, in primary care and emergency department (ED) utilization in a large Medicaid program. We performed a cross-sectional evaluation of data from Pennsylvania Medicaid from 2011-2015. Three primary care outcomes included: 1) adult access to primary care; 2) adolescent access to primary care; and 3) pediatric access to dental care. Our fourth outcome reflected ED utilization. We observed significant racial …

Nativity Differences In Stress Among Asian And Pacific Islander American Women, Brittany N. Morey, Gilbert C. Gee, Salma Shariff-Marco, Gem M. Le, Alison J. Canchola, Juan Yang, Laura Allen, Sandra Lee, Roxanna Bautista, Trish Quema La Chica, Winston Tseng, Pancho Chang, Scarlett Lin Gomez

Journal of Health Disparities Research and Practice

According to the Stress Process Theory, people who are marginalized in society encounter more stress than those in more advantaged positions. Immigrants are one such marginalized group in the United States (US) who may experience greater psychological stress than their US-born counterparts due to (1) severing of social ties; (2) social disadvantage and marginalization; and (3) adaptation to a new environment. This study examines the disparity in stress by nativity, and how social factors contribute to this disparity for Asian and Pacific Islander (API) women. Data come from the Asian Community Health Initiative, which included a sample of 291 foreign-born …

Integrating Students Into Interdisciplinary Health And Health Disparities Research Teams, Tanya M. Coakley, Allyson Kelley, Robin Bartlett, Terri Shelton, Schenita D. Randolph, Debra C. Wallace

Journal of Health Disparities Research and Practice

Major initiatives by the U.S. Department of Health and Human Services as well as the World Health Organization have produced a large and compelling body of evidence on how to reduce health disparities, which entails having a clear understanding of how social factors shape health and healthcare outcomes. Specifically, there is a need for healthcare professionals to understand social determinants of health (e.g., low socioeconomic status, lack of health insurance, and poor education) and how these lead to disparities in health for people of minority racial and ethnic groups. Little is known about how students are developed as health disparities …

Using Photovoice As A Tool For Community Engagement To Assess The Environment And Explore Environmental Health Disparities, Heather M. Brandt, Venice E. Haynes, Lashanta J. Rice, Dayna Campbell, Edith Williams, *Sacoby Wilson, Saundra H. Glover

Journal of Health Disparities Research and Practice

Photovoice was used as a participatory research method to document perceived local environmental hazards, pollution sources, and potential impact on health among community members to address environmental health disparities. A convenience sample of 16 adults in Orangeburg, South Carolina participated in Photovoice. Photos depicted positive and negative implications of the environment across seven themes: recreation and leisure; food access; hazards and pollution; health, human, and social services; economic issues; beautification; and accommodation and accessibility. Positive and negative photos demonstrated a high level of interest among community members in considering how the environment influences health and health disparities.

Race And “Hotspots” Of Preventable Hospitalizations, Caryn N. Bell, Janice V. Bowie, Roland J. Thorpe Jr.

Journal of Health Disparities Research and Practice

Abstract

Preventable hospitalizations (PHs) are those for ambulatory care-sensitive conditions that indicate insufficiencies in local primary healthcare. PH rates tend to be higher among African Americans, in urban centers, rural areas and areas with more African American residents. The objective of this study is to determine geographic clusters of high PH rates (“spatial clusters”) by race. Data from Maryland hospitals were utilized to determine the rates of PHs in zip code tabulation areas (ZCTAs) by race in 2010. Geographic clusters of ZCTAs with higher than expected PH rates were identified using Scan Statistic and Anselin’s Local Moran’s I. 10 PH …

Improving Access And Utilization Of Data To Support Research And Programs Intended To Eliminate Disparities And Promote Health Equity, Rosaly Correa-De-Araujo

Journal of Health Disparities Research and Practice

Numerous Federal initiatives are addressing health and health care disparities. The ultimate goal is to achieve “a nation free of disparities in health and health care.” Social determinants of health remain mostly responsible for health/health care disparities among population groups within and between countries. In the United States, there is little evidence that disparities associated with such determinants are decreasing, with only 10% of those associated with race/ethnicity and income having demonstrated improvement in recent years. A variety of data sources are available from the Federal and private sectors to support research on disparities, but no single national survey seems …

Exposure To Secondhand Smoke And The Development Of Childhood Caries: Nhanes (2011-2012), Deborah Mattheus Phd, Msn, Pnp, Krupa Gandhi Mph, Eunjung Lim Phd, Maureen Shannon Cnm, Fnp, Phd

Journal of Health Disparities Research and Practice

Dental caries continue to plague young children worldwide with numerous adverse effects including pain, poor growth and development, decreased quality of life as well as the potential for the development of life threatening secondary infections. Factors associated with the development of childhood caries are complex as they relate to social, economic and/or cultural behaviors. Recent evidence has linked secondhand smoke to the development of childhood dental caries. The purpose of the study is to re-examine the association between the frequency and extent of exposure to secondhand smoke with the development of childhood caries in the United States. Cross-sectional data of …

Exploring The Life Course Perspective In Maternal And Child Health Through Community-Based Participatory Focus Groups: Social Risks Assessment, Abraham Salinas-Miranda, Lindsey M. King, Hamisu M. Salihu, Estrellita "Lo" Berry, Deborah Austin, Susan Nash, Kenneth Scarborough, Evangeline Best, Lillian Cox, Georgette King, Carrie Hepburn, Conchita Burpee, Eugene Richardson, Marlo Ducket, Richard Briscoe, Julie Baldwin

Journal of Health Disparities Research and Practice

Little is known about the patterns of risk factors experienced by communities of color and how diverse community contexts shape the health trajectory of women from the early childhood period to the time of their pregnancies. Thus, we conducted a focus group study to identify social risks over the life course that contribute to maternal and child health from the perspective of community members residing in low income urban areas.

Ten community-based participatory focus groups were conducted with residents from selected communities in Tampa, Florida, from September to November 2013. We used the life course perspective to illuminate and explain …

The Effects Of Patient Characteristics On Clinician’S Adherence To Preventive Practice Guidelines, Deshana A. Collett Ph.D,Pa-C, Kenneth M. Tyler Ph.D.

Journal of Health Disparities Research and Practice

ABSTRACT

BACKGROUND: The existence of health disparities confirms that not all patients, regardless of differences in patient demographics, are provided quality healthcare (Agency of Health Care Research and Quality, 2003). Moreover, research suggests that health disparities may be present due to the inadequate delivery of medical services (S. Haist, J. Wilson, M. Lineberry, & C. Griffith, 2007; Van Ryn, Burgess, Malat, & Griffin, 2006). The differences in the delivery of care and services to ethnic minorities and those of low socioeconomic status warrant examining the role healthcare providers play in the causation of these health disparities (Smedley, Stith, & Nelson, …

Women’S Experiences With Prenatal Care: A Mixed-Methods Study Exploring The Influence Of The Social Determinants Of Health, Karen A. D'Angelo, Janelle K. Bryan, Brenda Kurz

Journal of Health Disparities Research and Practice

Background & Purpose: Racial and ethnic disparities pervade birth outcomes in the United States and the state of Connecticut. While Connecticut’s infant mortality rate is less than the national average, rates for the state’s Black/African American and Hispanic/Latino communities exceed it. This study explored how prenatal care in Connecticut may be enhanced to address these disparities.

Methods: In spring 2013, seven focus groups and two semi-structured interviews were conducted (n=47). Participants also self-administered brief surveys. Recruited by local service providers, participants were 18 or older, pregnant and/or in the first year post-partum at the time. Most self-identified as …

Reducing Disparities By Way Of A Cancer Disparities Research Training Program, Lee S. Caplan, Tabia H. Akintobi, Tandeca K. Gordon, Tiffany Zellner, Selina A. Smith, Daniel S. Blumenthal

Journal of Health Disparities Research and Practice

Background: For minority populations, there is a continuing disparity in the burden of death and illness from cancer. Research to address this disparity should be conducted by investigators who can best understand and address the needs of culturally diverse communities. However, minorities are under-represented in health-related research. The goal of this project was to develop and evaluate an approach to motivating and preparing master’s degree students for careers dedicated to cancer disparities research.

Method: A Cancer Disparities Research Training Program (CDRTP) was initiated in 2010. The program consists of coursework, practicum experiences, and research opportunities. Assessment of the curriculum is …

Prevalence Of Oral Cancer In Adolescents Related To Areca (Betel) Nut Chewing, Using Tobacco And Other Additives In Saipan, Northern Marianas Islands: A Review Of Literature, Eloise Lopez, Rosa Tudela, Bsn, Msn, Rn

Journal of Health Disparities Research and Practice

Oral cancer can involve the lip, tongue, mouth and pharynx. It is the sixth most prevalent cancer worldwide. One of the leading causes of Oral Cancerin the Commonwealth of the Northern Mariana Islands (CNMI) is chewing betel nut with tobacco and other additives. The International Agency for Research on Cancer (IARC) linked areca nut, betel quid with tobacco and betel quid without tobacco as carcinogenic to humans.

Areca nut, also known as betel nut comes from the areca palm tree. The use of areca nut is common throughout the Pacific, and is widespread in Papua New …

Addressing Health Disparities Among Homeless In Alachua County Through Community-Based Participatory Research., Meron Hirpa, Omar Iqbal, Haider Ali, Sama I. Ilyas, Nabeel Iqbal, Jeena A. Kar, Tiffany Splatt, Brendan Shortley, Nancy Hardt

Journal of Health Disparities Research and Practice

Introduction. In states such as Florida that did not expand Medicaid, a large number of economically disadvantaged individuals do not qualify for subsidies to buy health insurance through the Affordable Care Act (ACA) ². This leaves the health needs of Florida’s homeless population largely unaddressed. Nearly 48.1% of Alachua County’s homeless population has disabling conditions ¹⁶. This confirms a pressing need to understand the homeless population's healthcare needs, knowledge, and barriers in accessing healthcare. Methods. We used a Community-Based Participatory Research model in conducting health fairs and needs assessment surveys, incentivizing participation, and providing education about existing resources. …