Public Health Commons^™

Leaving Home Care: Decision Making, Risk Scenarios & Services Gaps In The Home Care System, Jacey J. Vaughan, Nina M. Silverstein

Gerontology Institute Publications

Home and community-based services (HCBS) enable older and disabled adults to age-in-place in their homes and communities by helping them function independently for as long as possible (Grabowski et al., 2010; Wong & Silverstein, 2011). Previous studies well document that older adults prefer receiving HCBS rather than institutional care at a nursing home (e.g., Walker, 2010; Fox-Grage, Coleman, & Freiman, 2006). Medicaid is a major source of funding for long-term care. Currently, a large proportion of Medicaid funds in most states has been spent on institutional care (National Conference of State Legislatures & AARP, 2009), and older adults and their …

Evaluating The Impact Of Social Determinants On Pedestrian Injury In Clark County, Nevada, Jonathon Lavalley, Courtney Ann Coughenour, Michelle Chino

Health Sciences Graduate Research

In order to understand the social determinants which may impact pedestrian injury rates in an urban, sprawling, western community we conducted an ecologic investigation to compare pedestrian crash rates by social determinants available for census tracts in Clark County, NV.

Poor Women With Sexually Transmitted Infections: Providers’ Perspectives On Diagnoses, Genevieve R. Cox

Sociology

This article presents results from a study of health care providers, mainly nurses and nurse practitioners, who routinely diagnose sexually transmitted diseases (STDs) in rural low-income populations in West Virginia (WV). A qualitative analysis of eighteen semi-structured interviews reveals that providers who consistently work with low-income populations believe patients undergo a negative change in self-image in response to a chronic STD diagnosis. Providers express concerns about a number of issues related to low-income, rural women’s access to sexual health care and see the need for more sexuality education, more funding for free and reduced cost clinics, and more available health …

Il Faut Manger: A Study Of Women’S Body Image And Obesity In Mali, Jennifer Denike

Independent Study Project (ISP) Collection

Africa has long been a region of the world marked by the media as one of rail thin children with distended bellies and older men and women with cracked and wrinkled skin sagging off their bones. Media outlets like BBC, CNN, and the New York Times focus entire sections of their websites to special reports entitled ‘Famine in Africa’2, ‘Food Crisis in Niger’3, and ‘East Africa Famine 2011’4. Photos of children curled up on the ground, ribs and bones protruding at every angle grace the pages of nearly every magazine and newspaper. Nongovernmental organizations plead for donations and host fundraisers …

When Mountain Bellies Grow Round: Localized Knowledge And Behaviors Facilitating Pregnancy And Childbirth In Phaphlu, Nepal, Cailin Marsden

Independent Study Project (ISP) Collection

In attempts to gain a level of understanding of a community’s localized experiences, beliefs, practices, and roles around pregnancy and childbirth, ethnographic fieldwork was conducted with the mothers and fathers of Phaphlu in the Solukhumbu district of Nepal. Aimed at the validation of diverse and localized ways of knowing revealed during the fieldwork period, this paper applies anthropologist Bridgette Jordan’s theoretical framework of authoritative knowledge to the emergent themes of subjectively understood childbirth (knowledge acquisition and flow, role of the husband, and protective behavior.)

The Perfect Storm: How Pro-Abortion Activists In The Netherlands Incite Social Change From International Waters, Julia Ellis‐Kahana

Independent Study Project (ISP) Collection

This project is a sociological ethnography of the Women on Waves foundation, founded in 1999 by Dr. Rebecca Gomperts. As an international non-profit organization, they employ a direct action method: sailing to countries where abortion is illegal and providing safe abortion access. Local women board the ship that then travels 12 miles to international waters, where Dutch law applies, and the abortion pill can be administered legally. Using a feminist perspective, I interviewed five of the women at the organization in addition to the ship’s captain in order to understand the ideological beliefs about the reproductive rights that have inspired …

La Etnia Y Las Cesáreas En Los Partos En El Hospital Público De Arica, Chile, Marisa Westbrook

Independent Study Project (ISP) Collection

The principal objective of this project was to explore the relationship between ethnicity and the causes for Caesarean section in the regional public hospital in Arica, Chile. All births recorded in the maternity register (n=907) were analyzed over a 4-month period in 2011. The regional public hospital had a 27% caesarean section rate, higher than the WHO-recommended 15%. Last names were analyzed and deemed to be either of Aymara descent (n=275) or of European descent (n=632) based on criteria used from CONADI, the National Corporation for Indigenous Development. The overall rate of Caesarean section did not differ between Aymara and …

Effective, Efficient Health Care Reform The United States And Swiss Health Care Systems: A Comparative Analysis What Can The U.S. Learn From The Swiss Experience?, Rebecca Dittrich

Independent Study Project (ISP) Collection

Home to 45 million people without health insurance while still spending 17% of its GDP on health care expenses, the United States has been in need of a massive health care overhaul for quite some time. Some have speculated that the Swiss system may be an ideal model for health care reform, and in fact, many aspects of the newly instated Patient Protection and Affordable Care Act (ACA) do reflect areas of LAMal, Swiss health care law. This paper evaluates the Swiss and United States health care systems (under ACA), their similarities and differences, and the pros and cons of …

Differentiating The Vulnerability Of Kothis And Hijras To Hiv/Aids: A Case Study Of Lucknow, Uttar Pradesh, Poonam Daryani

Independent Study Project (ISP) Collection

The present study aims to begin the process of differentiation between the various subpopulations that fall under the agenda of interventions targeted at Males who have Sex with Males (MSM). This separation is accomplished though an investigation of the sociocultural factors and behavioral patterns impacting the vulnerability of MSM and transgender (TG) 5 communities to HIV/AIDS. Specifically, the situation of kothi and hijra populations are compared in order to understand how the differences in their cultural practices and lifestyles create unique sexual health needs. The study was completed in Lucknow, Uttar Pradesh under the guidance of Bharosa Trust and MAAN …

Migration, Vulnerability And Xenophobia: Central African Refugee And Asylum Seekers’ Access To Health Services In Durban, South Africa, Cathy Kaplan

Independent Study Project (ISP) Collection

In 1998, South Africa passed historic legislation that bridged international conventions on refugees and asylum seekers with the protections and rights defined in the South African Constitution and Bill of Rights. The 1998 refugees act defined specific rights that refugees and asylum seekers are entitled in South Africa, the most important of which include the provision of legal and immigration documentation, employment, adequate housing, and health and social services. When asylum seekers arrive in Durban, many are in the need of immediate health services as a result of long journeys, pre-existing conditions, pregnancy, or illnesses contracted in refugee camps throughout …

Reproductive Health Education In The Kibera Slum: Developing A Slum-Specific Curriculum, Susanna Schneider Banks

Independent Study Project (ISP) Collection

The principal objective of this Independent Study Project is to make recommendations for a slum-specific reproductive health curriculum to be used in primary schools that serve the Kibera Slum in Nairobi, Kenya. In order to obtain data and form a credible basis for the recommendations, interviews were conducted with teachers, focus groups were facilitated with students, and questionnaires were distributed to parents. Additionally, observations were made about the current state of reproductive health education at each school. Data was collected at Kibera School for Girls, a private school in Kibera, and Olympic Primary School, a public school at the edge …

Economic Empowerment And Hiv Prevention Among Young Women And Girls In Kenya: Lessons From The Study Of Economic Empowerment Programs, Samantha Van Putten

Independent Study Project (ISP) Collection

One of the major issues facing Kenya is HIV/AIDS. With recognition by the global community that providing women with economic opportunities can help both those who are HIV positive, as well as in prevention for those who are not infected, programs combining microfinance and HIV education have started to emerge. While women in these programs 3 3 have shown preliminary signs of success, young girls did not respond as well in part due to lack of interest in the particular programs themselves. As such, this study examines two economic empowerment programs for girls and young mothers at the non-governmental organization …

Reproductive Realities: Fulani Women & Contraception, Corrina Regnier

Independent Study Project (ISP) Collection

This paper is the product of three weeks of research on contraception and the lives of married Fulani women in Ngaoundéré, Cameroon. Based on interviews with Fulani women, conducted both in French and in the Fulani language of Fulfulde with the aid of a French interpreter, I discuss the cultural and religious influences on women’s lives that impact their decisions or abilities to use contraception, as well as the ways these influences and realities have changed, are changing, and are expected to change in the future. I also look into the more practical concern of the availability and accessibility of …

“El Tema No Existe”: La Salud Sexual Lésbica En Valparaíso, Chile, Isabel Osgood-Roach

Independent Study Project (ISP) Collection

This independent study project investigates the status of lesbian health care in Valparaíso, Chile. Over the course of three weeks, I conducted interviews with six women who engage in non-heterosexual intimate relationships. These individuals identify on a spectrum of sexual orientation that includes lesbian, bisexual and hetero-dissident. I also participated in a political demonstration organized by Acción Gay supporting a proposed Anti-Discrimination law. Finally, I attended a meeting of the recently formed lesbian health group Colectivo Ropa Tendida to gain insight into an organization working towards visibilizing lesbian realities. To contextualize my investigation, I worked with theories regarding essentialist and …

“La Percepción Social De Vih/Sida En Chile Y Sus Efectos”, Philip Krause

Independent Study Project (ISP) Collection

Research Question—How does the social perception of HIV/AIDs in Chile affect the country’s prevention and treatment programs?

Background-- This paper investigated the social perception of HIV/AIDs in Chile through the opinions of experts who work closely to the issue, including regional and national political professionals, medical professionals on HIV/AIDs treatment teams in hospitals, and leaders of social organizations that had a relationship to HIV/AIDs representation and prevention. The professionals were also asked how they believed this perception affected the efforts of the Chilean government and national organizations in prevention and management of the HIV/AIDs epidemic in Chile. An …

Social Support For Young Carers An Analysis Of The Available Social Support For Children Caring For Aids-Sick And Other-Sick Caregivers In Emoyeni, South Africa., Flannery Mcardle

Independent Study Project (ISP) Collection

The dual epidemics of HIV/AIDS and non-communicable diseases in South Africa are the principal drivers of the worsening orphan epidemic in South Africa. As orphanhood is often far from a singular event but rather one preceded by months or even years of the parent or guardian’s declining health, many children will become the primary caregivers for a sick or dying adult. This study explores the lives of the young carers, specifically, the social support available for these children and how the support available for children caring for AIDS-sick caregivers may differ from that available for children caring for an adult …

Cap Centre : L’Epicerie Sociale, Ana De Pina

Independent Study Project (ISP) Collection

Contrairement à autres study abroad programs, « The School of International Training (SIT) » donne les étudiants Américains une opportunité de découvrir la culture Française, d’apprendre la langue Française, et de s’intègre dans la société Française. Pendant notre séjour en France, nous avons fait de bénévolat dans une association que correspond à nos études aux États-Unis. Aux États-Unis j’étudie la sante publique. Je suis très intéressé pour l’administration des hôpitaux et autres institutions de santé et la relation entre la sécurité sociale et la bonne santé. Donc, pendant trois mois j’ai travaillé au CAP Centre, une épicerie sociale qui aide …

Counting The Cost: Estimating The Number Of Deaths Among Recently Released Prisoners In Australia, Stuart A. Kinner, David B. Preen, Azar Kariminia, Tony Butler, Jessica Y. Andrews, Mark Stoové, Matthew Law

Aboriginal Policy Research Consortium International (APRCi)

Objective: To estimate the number of deaths among people released from prison in Australia in the 2007–08 financial year, within 4 weeks and 1 year of release. Design, participants and setting: Application of crude mortality rates for ex-prisoners (obtained from two independent, state-based record-linkage studies [New South Wales and Western Australia]) to a national estimate of the number and characteristics of people released from prison in 2007–08. Main outcome measures: Estimated number of deaths among adults released from Australian prisons in 2007–08, within 4 weeks and 1 year of release, classified by age, sex, Indigenous status and cause of death. …

Hivstigma.Com, An Innovative Web-Supported Stigma-Reduction Intervention For Gay And Bisexual Men, Barry D. Adam, James Murray, Suzanne Ross, Jason Oliver, Stephen Lincoln, Vicki Rynard

Sociology, Anthropology, and Criminology Publications

An intervention to address stigma directed toward HIV-positive men and to enhance the sexual health of gay and bisexual men was developed through a community-based process involving HIV prevention workers, public health, government, and researchers. The intervention aimed to diminish stigma, create greater support for HIV-positive men, make disclosure safer and easier, discourage reliance on disclosure to prevent transmission, and encourage testing. The question, “If you were rejected every time you disclosed, would you?” was widely disseminated in the gay community and supported by the website, hivstigma.com, to encourage participation in blog-based discussions. Eight bloggers moderated lively discussions over 5 …

Cultural Conceptions Of Health, Caroline Stephens

Independent Study Project (ISP) Collection

Healthcare is a complicated structure, influenced by multiple economic, social and cultural factors. It is problematic enough to determine how to administer healthcare in countries that rely only on the western healthcare system, but it is even more difficult in places such as Madagascar where multiple healthcare systems exist. Today the Malagasy have a culture that combines the many French practices with the traditional Malagasy beliefs, traditions and values. Many Malagasy chose to utilize allopathic medicine, but many others still prefer to go to a traditional healer. By gaining a better understanding of the average Malagasy person’s perceptions of proper …

Healers And Researchers: Towards A More Balanced Relationship, Gracie Tewkesbury

Independent Study Project (ISP) Collection

In my seminar paper, I discussed the benefits for both parties of collaboration between traditional healers and modern scientific researchers. If research is done on the medicinal effects of plants, these cures can be used more safely and effectively by members of the community. This relationship is greatly beneficial in theory, but the reality is less than ideal. Researchers, especially foreign ones, depreciate and exploit the knowledge of healers, and as a result, healers are often distrustful and unwilling to collaborate. The relationship between healers and researchers potentially holds the cures to countless diseases and can contribute directly to greater …

Western Influence, Latent Racism, And Their Impact On Access To Health Care In Madagascar, Jessica Joy

Independent Study Project (ISP) Collection

While the Malagasy commemorate their Independence Day on June 26 as the day they were freed from colonization and allowed to function as their own country with their own cultures and practices, colonization and Western influence has left an indelible mark on Madagascar that continues to exert its power to this day, shaping Malagasy social behaviors, values, and lives. The introduction of the slave trade to Madagascar in the mid-1800s, as well as French colonization, has left behind a thriving latent and structural racism in the country; a Western ideal of beauty, made complete by its valorization of fair skin, …

The Benefits Of Having An Integrated Health Care System In Madagascar, Elizabeth Miller

Independent Study Project (ISP) Collection

For my individual research, I wanted to look into all the benefits that could be offered by collaborating allopathic and traditional healthcare systems and how such a system is accomplished in Madagascar, in order to weigh and to discover the feasibility of using integrated healthcare systems as sustainable development in other parts of the world. Furthermore, as Madagascar sets the example in my research this summer, the use of traditional and modern medicine as an integrated health care system best serves the majority of the Malagasy population for several important reasons.

“Mind The Gap” Addressing The Gap Between Health Care Policy & Health Care Reality In Madagascar & The Way Forward Integrating Traditional Medicine & Ethical Reform Within Health Care, Laura Dillon

Independent Study Project (ISP) Collection

At first glance the health care system in Madagascar looks pretty good. No health care system is perfect, in fact most are far from perfect, but some certainly work better than others. On paper it seems that the current system in Madagascar would be among those that “work better”. Sadly, there is oftentimes a disconnect between what a government writes on paper and what happens in reality; looking around the streets of Antananarivo it quickly became apparent that Madagascar is an example of this disconnect. You do not have to be a health care professional to see the lack of …

How Do Religion And Belief Systems Influence Traditional Medicine And Health Care In Madagascar?, Whitney Franklin

Independent Study Project (ISP) Collection

Religion and beliefs consistently shape social structures, laws, and even medicine. In Madagascar, this is extremely evident when considering traditional medicine but also exists in modern medicine. Christianity and traditional beliefs are the two main systems that have shaped traditional medicine to what it has become today. These opposites function as a duality that becomes apparent when looking at certain events in Madagascar’s history and the examination of the evolution and rituals performed in the different types of traditional medicine. Through the methodology of interviewing traditional healers and gathering historical information from experts in lectures, I can make sure to …

Medical Pluralism In Morocco: The Cultural, Religious, Historical And Political-Economic Determinants Of Health And Choice., Tyler Martinson

Independent Study Project (ISP) Collection

Morocco is a culturally diverse intersection between the African continent, the Arab world and Europe. This multiplicity is mirrored in the country’s pluralistic medical system and beliefs surrounding the concepts of illness and health. Explanations of health are endorsed by culturally specific knowledge and are then naturalized and taken as objective. A synthesis of theoretical descriptions and political-economic of medical pluralism, along with historical analysis, explains the presence of multiple health practices and how a person’s choice of medical practice is heavily influenced by dynamic socio-cultural, religious, historical, political and economic factors. This study will help improve practitioner/client narratives of …

Suburban Poverty: Barriers To Services And Injury Prevention Among Marginalized Women Who Use Methamphetamine, Miriam W. Boeri, Benjamin Tyndall, Denise R. Woodall

Faculty and Research Publications

Objective: This paper aims to identify the needed healthcare and social services barriers for women living in suburban communities who are using or have used methamphetamine. Drug users are vulnerable to injury, violence and transmission of infectious diseases, and having access to healthcare has been shown to positively influence prevention and intervention among this population. Yet little is known regarding the social context of suburban drug users, their risks behaviors, and their access to healthcare.

Methods: The data collection involved participant observation in the field, face-to-face interviews and focus groups. Audio-recorded in-depth life histories, drug use histories, and resource needs …

Chd Knowledge And Risk Factors Among Filipino-Americans Connected To Primary Care Services, Alona Dalusung-Angosta

Nursing Faculty Presentations

Problem:

Despite growing numbers of FAs in the U.S. and high CHD prevalence, only limited studies are available in the the literature.

Contributing factors?

• Lack of knowledge
• Sociodemographic (SD)/Socioeconomic (SE) variables

A Tale Of Two Cities? The Heterogeneous Impact Of Medicaid Managed Care In Kentucky, James Marton, Aaron Yelowitz, Jeffery C. Talbert

University of Kentucky Center for Poverty Research Discussion Paper Series

Does managed care produce lower health care utilization and costs through better aligned financial incentives and alternative delivery methods (the “pure” HMO effect) or by attracting more healthy enrollees (enrollee selection)? The purpose of this paper is to shed new light on this fundamental question using a quasi-experimental approach that exploits the timing and county specific implementation of Medicaid managed care plans in two distinct sub-sets of Kentucky counties in the late 1990s. We find large differences in the relative success of each region in reducing utilization that are likely driven by important differences in plan design. Asthmatic children enrolled …

Chronic Disease Self-Management Programs: Relevance For Persons With Dementia, Nina M. Silverstein, Alison S. Gottlieb

Gerontology Institute Publications

The context for this study is the work of the Healthy Brain Initiative. The CDC has established a cooperative agreement with the Alzheimer’s Association to develop and implement a multifaceted approach to look at cognitive health as a public health issue. Late in 2010, the Association commissioned a review of the major chronic disease prevention programs from a systems approach to begin to understand the source of findings that Medicare beneficiaries with Alzheimer’s and related disorders are much higher cost than those simply with a single chronic disease and no AD. This led to the conclusion that Chronic Disease Self‐Management …