Public Health Commons^™

Expanding The Boundaries Of Food Policy: The Turn To Equity In New York City, Nevin Cohen, Rositsa Ilieva

Publications and Research

Policymakers acknowledge that the food system is multidimensional and that social determinants affect diet-related health outcomes, yet cities have emphasized programs and policies narrowly connected to food access and nutritional health. Over the past fifteen years, the boundaries of food governance have expanded to include a wider range of issues and domains not previously considered within the purview of food policy, like labor, housing, and education policies. This paper illustrates the processes by which this shift occurs by presenting the case of New York City, which has broadened its food governance to a larger set of issues, requiring cross-sectoral initiatives …

A Novel Spatio-Temporal Examination Of Children's Accessibility, Exposure, And Engagement To Parks And Recreation Spaces In Middlesex-London, Ontario, Malcolm K. Little

Electronic Thesis and Dissertation Repository

Children are spending more free time engaged in activities indoors, rather than in outdoor environments such as parks and recreation spaces. Parks and recreation spaces provide amenities that promote physical, cognitive, and social health among children. As it relates to the complexities of children’s living situations, properly measuring children’s levels of interactions with these spaces is poorly understood in geography research.

By examining various attributes of children, this thesis improves on the measurement of children’s levels of interactions with parks and recreation spaces. Research herein utilized household survey data, a high-resolution GIS dataset of environmental factors, and GPS logs from …

Improving Access To Treatment For Opioid Use Disorder In High-Need Areas: The Role Of Hrsa Health Centers, Michael Topmiller, Jennifer Rankin, Jessica L. Mccann, Jene Grandmont, David Grolling, Mark Carrozza, Hank Hoang, Josh Bolton, Alek Sripipatana

Journal of Appalachian Health

Introduction: Despite the opioid epidemic adversely affecting areas across the U.S. for more than two decades and increasing evidence that medication-assisted treatment (MAT) is effective for patients with opioid use disorder (OUD), access to treatment is still limited. The limited access to treatment holds true in the Appalachia region despite being disproportionately affected by the crisis, particularly in rural, central Appalachia.

Purpose: This research identifies opportunities for health centers located in high-need areas based on drug poisoning mortality to better meet MAT care gaps. We also provide an in-depth look at health center MAT capacity relative to need …

Childhood Health And The Changing Distribution Of Foreign Aid: Evidence From Nigeria’S Transition To Lower-Middle-Income Status, Carrie B. Dolan, Mckinley Saunders, Ariel Benyishay

Arts & Sciences Articles

With sustained economic growth in many parts of the developing world, an increasing number of countries are transitioning away from the most subsidized development finance as they exceed income and other qualification requirements. Cross-country evidence suggests that Development Assistance Committee (DAC) donors view the crossing over of the World Bank’s International Development Association (IDA) eligibility threshold to signal that a country needs less aid, with subsequent reductions in both IDA and other donors’ concessional funding. Within the health sector, it is particularly important to understand the implications of these status changes for children under five years of age since improving …

On The Importance Of Context: Examining The Applicability Of Infertility Insurance Mandates In The United States Using A Mixed-Methods Study Design, Nathanael B. Stanley

USF Tampa Graduate Theses and Dissertations

Accessibility of infertility services is disproportionately experienced in the United States. Although there exist state-based health insurance mandates for infertility services, these mandates contain language that disqualify people from using them. In order to better understand why these mandates are not able to reduce the financial burden and bridge the income disparity for using infertility services, the purpose of this study is to add context to the applicability of these insurance mandates through qualitative and quantitative inquiry. Using the Glass and McAtee model of risk regulators as an operational paradigm, this research explores the role of environmental context, or “place”, …

Urban Warfare: Emerging Geopolitical Conundrum, Bert Chapman

Libraries Faculty and Staff Presentations

Urban warfare is as old as human history. It is becoming increasingly important in international political and military planning due to increasing global urbanization and the presence of megacities (urban areas with populations exceeding 10 million) in many global regions and being in areas of recent and potential military conflict. 2018 World Bank data notes that approximately 56% of the world's population lives in urban areas which is up from 34% in 1960. Many of these megacities, including New York City, Los Angeles, Sao Paulo, Mumbai, Shanghai, and Manila are adjacent to oceanic waters and vulnerable to trade and supply …

Investigating Children's Experiences And Participation In A Free Community-Based Physical Activity Program: The Grade 5 Act-I-Pass, Emma E. Ostermeier

Electronic Thesis and Dissertation Repository

Physical activity is an important component of children’s health and development; however, a majority of Canadian children are not meeting the physical activity recommendations. This thesis aimed to identify the factors that influenced children’s enrollment and participation in a free community-based physical activity program, the Grade 5 ACT-i-Pass (G5AP). This thesis consisted of two individual, but interrelated studies. First, focus groups with G5AP participants were used to explore the factors that influenced children’s perceived physical activity levels and participation in the program. Second, a spatially-targeted promotional campaign was developed and implemented to help evaluate the impact of promotions on program …

Cluster Analysis Of Opioid Accessibility In The Carolinas Using Data From The Arcos Database And An Enhanced Two-Step Floating Catchment Area Method, Michael T. Bunker

Electronic Theses and Dissertations

This study takes advantage of transaction level data from the U.S. Drug Enforcement Administration's (DEA) Automation of Reports and Consolidated Orders System (ARCOS) database made newly available under court order by The Washington Post in July 2019. This data details individual shipments of pharmaceutical opioid analgesics from wholesalers to retail distributors. Using the Enhanced 2-Step Floating Catchment Area (E2SFCA) method, this study calculated access to opioid morphine milligram equivalents (MME) per capita for census tracts in North Carolina and South Carolina during the year 2009. This study demonstrated that outlier volumes of opioid analgesics at individual pharmacies are not always …

Detroit Food Metrics Report 2019, Alex B. Hill

Urban Studies and Planning Faculty Research Publications

This report provides a snapshot of data and information on Detroit’s food system as well as trends over time. The report includes a broad range of programs and initiatives that local organizations, the Detroit Food Policy Council, and the City of Detroit are undertaking to address food insecurity, increase healthy food access and awareness, and support a more sustainable and just food system.

Pregnancy In Peril: The Impact Of Conflict On Antenatal Care And Skilled Birth Attendant Utilization In The Democratic Republic Of The Congo And Burundi, Bianca R. Ziegler

Electronic Thesis and Dissertation Repository

As of 2019, over two billion people globally reside in conflict-affected areas, and as a result, face negative health implications. Burundi and the Democratic Republic of the Congo are among those countries classified as fragile and conflict-affected situations, resulting in disproportionally high maternal mortality rates. Grounded in Andersen’s Model of Healthcare Utilization, this thesis employed multivariate binary logistic regressions to examine factors which influence antenatal care and skilled birth attendant usage in these two countries. Findings indicate that women living in high conflict regions were significantly less likely than those in low conflict regions to have their first antenatal care …

Online Grocery Shopping By Nyc Public Housing Residents Using Supplemental Nutrition Assistance Program (Snap) Benefits: A Service Ecosystems Perspective, Nevin Cohen, Katherine Tomaino-Fraser, Chloe Arnow, Michelle Mulcahy, Christophe Hille

Publications and Research

This paper examines adoption of online grocery shopping, and potential cost and time savings compared to brick and mortar food retailers, by New York City public housing residents using Supplemental Nutrition Assistance Program (SNAP) benefits. A mixed methods action research project involving the co-creation of an online shopping club, the Farragut Food Club (FFC), recruited 300 members who registered to shop online using SNAP, and received waivers on delivery minimums and provided technical assistance and centralized food delivery. We conducted a survey (n = 206) and focus groups to understand shopping practices; FFC members collected receipts of groceries over two …

La Maestra’S Circle Of Care: Studying The Impact Of An Integrated Service Model On The Health And Well-Being Of Vulnerable Populations, Zara Marselian

Dissertations

ABSTRACT

There is an urgent need to reform the health care delivery system in the United States, as recognized through current bipartisan efforts. Society’s vulnerable populations especially need health care reform as health care outcomes are the poorest among disadvantaged populations. Moreover, vulnerable populations are twice as likely to develop chronic diseases than the general population and they remain ill due to other contextual, societal factors affecting their ability to achieve health and well-being. This population is subjected to adverse life events that suggest a more comprehensive approach to health and well-being is called for.

The Circle of Care is …

Landscapes Of Danger: A Geospatial Analysis Of Perceived And Realistic Risk In Bryce Canyon National Park, Tia Francis

Graduate Theses and Dissertations

The quantification of risk has inspired a wide breath of literature from the physical sciences, social sciences, and interdisciplinary disciplines like geography. Many attempts to estimate risk via natural hazards either focus on quantifying realistic risk or perceived risk of lay persons, with very little overlap between these paradigms. Due to this, a considerable knowledge gap exists within perceived risk and natural hazards research. This study aims to provide a comprehensive, risk estimation and assessment strategy through a multi-hazard risk assessment of Bryce Canyon National Park (BRCA). This case study analyzed knowledge of risk among visitors with perception surveys and …

280— Exploring The Geographic Distribution Of Childbed Fever Deaths In Mid-19th Century Rochester, Ny, Meaghan Parks

GREAT Day Posters

Childbed fever, formally called puerperal fever or puerperal septicemia, is an infection typically contracted by women after childbirth. Historically, childbed fever was a serious threat to maternal health. Childbed fever is caused by exposure of open wounds or abrasions, which are common after giving birth, to group A and B Streptococcal bacteria. Ignaz Semmelweis discovered that hand washing using a chlorinated solution reduced cases of childbed fever in 1847. This project reviews the instances of death from childbed fever in Rochester, New York from 1837-1860 and later from 1907-1919 and attempts to determine which areas of the city had the …

Accessibility Of Hiv Testing In Baton Rouge Metropolitan Statistical Area, Alina Prigozhina

LSU Master's Theses

This study examines HIV testing accessibility in the Baton Rouge Metropolitan Statistical Area (BR MSA) using the two-step floating catchment area (2SFCA) method to calculate accessibility scores for free, low-cost and all other HIV testing facilities. The two goals of this research are to apply accessibility estimation methods to HIV testing facilities, and to examine the accessibility of HIV testing facilities in the BR MSA. To achieve these goals, this study uses several research methods. The data about HIV testing providers and their locations were collected through Internet searches. By means of a fieldwork, the data were checked, revealing that …

"Urban" Dengue? An Examination Of Perceived Dengue Risk And Notions Of The Urban In Esmeraldas Province, Ecuador, Charlotte Robbins

Senior Theses and Projects

Is dengue fever an urban disease as public health literature suggests? And what does this literature mean by urban? To answer these questions, I compare perceptions of the urban and dengue risk from residents who I interviewed across different sites in Esmeraldas Province, Ecuador. I ground my analysis in four urban frameworks: the bounded city theory, postcolonial theory, assemblage urbanism, and urban political ecology. I find that residents in Esmeraldas Province think about urban spaces very differently from how the Ecuadorian government defines what is urban. In particular, residents discuss government investment in infrastructure and services as an important dimension …

Spatial Patterns In Socio-Economic Factors And Rapid Repeat Pregnancies In Kalamazoo County, Mi, Dennis Donkor

Masters Theses

Rapid repeat pregnancy (RRP) refers to a pregnancy that occurs less than 24 months after a live birth. In the United States, several studies have focused on factors that influence women to rapidly repeat pregnancies at the national and state level. As a result, this study explores spatial patterns in RRP in Kalamazoo County at the block group local level using birth records of moms in the county from 2008 to 2014. The study further investigates individual and neighborhood factors influencing RRP. Results from the hotspot (Getis Ord G*) revealed that block groups in eastside Kalamazoo township are significant hotspots …

Comparing Individual Perceptions Of Food Desert With Quantitative Measures In Omaha, Nebraska., Hector N. Samani, Bradley Bereitschaft

UNO Student Research and Creative Activity Fair

Food deserts have been linked to an increase in chronic diseases such as obesity and diabetes, due to lower access to affordable and healthy foods. The United States Department of Agriculture (USDA) outlines various methods and variables for defining food deserts, in attempts to standardize what constitutes a food desert or their characteristics. The USDA identifies the state of Nebraska as having both rural and urban food deserts, with an increase of food insecurity from 1.1% – 3.0% between 2007 and 2012 and warns of further increase of food deserts and its impact if measures are not taken. However, there …

Google-Truthing To Assess Hot Spots Of Food Retail Change: A Repeat Cross-Sectional Street View Of Food Environments In The Bronx, New York, Nevin Cohen, Michael Chrobok, Olivia Caruso

Publications and Research

Google Street View (GSV) images can be used to “ground-truth” current and historical food retail data from approximately 2007 - when GSV was launched in a few US cities - to the present, facilitating analyses of food environments over time. A review of GSV images of all food retailers listed in a government database of licensed establishments in the Bronx, New York enabled records to be verified, businesses classified, and retail change quantified. The data revealed several trends likely to affect food access and health: increasing overall numbers of food retailers; the growth of dollar stores; and numerous openings, closings, …

Colon Cancer Care Of Hispanic People In California: Paradoxical Barrio Protections Seem Greatest Among Vulnerable Populations, Keren M. Escobar, Mollie Sivaram, Kevin M. Gorey, Isaac N. Luginaah, Sindu M. Kanjeekal, Frances C. Wright

Social Work Publications

Background: We examined paradoxical and barrio advantaging effects on cancer care among socioeconomically vulnerable Hispanic people in California. Methods: We secondarily analyzed a colon cancer cohort of 3,877 non-Hispanic white (NHW) and 735 Hispanic people treated between 1995 and 2005. A third of the cohort was selected from high poverty neighborhoods. Hispanic enclaves and Mexican American (MA) barrios were neighborhoods where 40% or more of the residents were Hispanic or MA. Key analyses were restricted to high poverty neighborhoods. Results: Hispanic people were more likely to receive chemotherapy (RR=1.18), especially men in Hispanic enclaves (RR=1.33) who were also advantaged on …

Supports For Migrant Farmworkers: Tensions In (In)Access And (In)Action, Susana Caxaj, Amy Cohen, Sarah Marsden

Health and Rehabilitation Sciences Publications

Purpose: This study examined the role of support actors in promoting or hindering access to migrant agricultural workers' (MAWs) needs, and, to determine the factors that influence adequate support for this population.
Methodology: Employing a Situational Analysis methodology, we carried out focus groups and interviews with 35 support actors complimented by a community scan (n=28) with public-facing support persons and a community consultation with migrant agricultural workers (MAWs).
Findings: Two major themes were revealed: (In)access and (In)action, and; Blurred Lines in Service Provision. The first illustrated how support actors could both reinforce or challenge barriers for this population through tensions …

State Park Selection As Determined By User Health, Connor Phelan

Master's Theses

The purpose of this study was to determine whether state park difficulty affected location of travel. This study was conducted at three state park locations within the United States. Surveys and on-site examinations were made at the following locations; Wilson State Park, Kansas, Petit Jean State Park, Arkansas, and Kiholo State Park, Hawaii. Park locations were chosen by varying levels of terrain difficulty, as well as a rating from the Recreation Opportunity Spectrum. Participants were asked to report data via iPads on exercise habits, mobility limiting impairments, and frequency of exercise so a ranking of the healthiest participants could be …