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Sociodemographic Determinants Of Potentially Avoidable Hospitalizations Due To Ambulatory Care Sensitive Conditions Among Hospitalized Patients In The United States, Munira Kashem

Electronic Thesis and Dissertation Repository

Social determinants of health play a crucial role in explaining the variation of potentially avoidable hospitalizations (PAH) due to Ambulatory Care Sensitive Conditions (ACSCs). Utilizing data from the National Inpatient Sample from 2018 to 2020 in the United States, this study conducted retrospective cohort analyses to explore the relationships between sociodemographic factors, specifically income, race, geography, age, and sex and PAH. Our approach used multilevel logistic regression models to adjust for potential confounders and account for clustering of admissions within hospitals. Of the 17,629,891 hospital admissions examined in this study, 1,868,609 (10.6%) were attributable to ACSCs. Our results indicate that …

Association Of Socioeconomic, Racial, And Regional Factors With In-Hospital Management And Outcomes Of Acute Myocardial Infarction Patients In The United States: National Analyses Of 2.8 Million Admissions, Olivia Haldenby

Electronic Thesis and Dissertation Repository

Social determinants of health contribute to variations in clinical outcomes among acute myocardial infarction (AMI) patients. Using the National Inpatient Sample, we conducted retrospective cohort analyses to evaluate the association of income, race, and geography with in-hospital mortality and revascularization procedures among AMI admissions in the United States from 2015 to 2019. Multilevel logistic regression models were used while accounting for hospital clustering and relevant predictors. A sequential model-building approach produced model 1 (unadjusted patient-level exposures), model 2 (lifestyle factors), model 3 (clinical characteristics), and model 4 (fully adjusted hospital-level factors). We identified 2,798,225 AMI hospitalizations (≥18 years) with 1,567,575 …

Examining The Simultaneous Influence Of Individual And Neighborhood Determinants On Cardiovascular Health: A Multilevel Study In Canadian Adults, Sarah Singh

Electronic Thesis and Dissertation Repository

Introduction: Previous studies have found that the cardiovascular health of individuals may be influenced not only by their personal characteristics, but also independently by their social relationships and the neighborhoods in which they reside. Still, it is unclear how these determinants act together to influence cardiovascular health and whether these determinants account for differences in cardiovascular health among Canadian adults.

Objective: The main objectives were: 1) to examine the status of cardiovascular health in Canadian adults and, 2) to describe how individual and neighborhood determinants can: a) act together to influence cardiovascular health and, b) account for differences …

Social Determinants Of Health And Substance Use Among Women Living With Hiv In Canada: Inequalities And Impacts, Mostafa Shokoohi

Electronic Thesis and Dissertation Repository

The objective of this doctoral research was two-fold: 1) to estimate inequalities in social determinants of health (SDoH), health-related quality of life, and substance use among women living with HIV (WLWH) compared to the general population of women; and 2) to assess the impact of the SDoH clusters on illicit drug use and heavy alcohol drinking among WLWH. For the first objective, estimates were obtained from 1,422 WLWH aged 16+ in the 2013-2015 Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS, time-point 1), and then compared with their counterparts estimated in 46,831 general population women in the 2013-2014 …

Storied Bodies In Motion And Stillness: Shifting Meanings Of Physical Activity In Women's Life History Narratives, Shellie Mcparland

Electronic Thesis and Dissertation Repository

Gender is a rarely studied social determinant of health. Qualitative methodologies, while underutilized in health promotion, may facilitate understanding of the gender and health relationship. The purpose of this work is to determine if narrative inquiry is a meaningful approach to study the relationship between femininity and physical activity and to examine this relationship within women’s life histories. Five women between 30 and 40 participated in two semi-structured interviews. Data were analyzed holistically, structurally, and categorically.

This dissertation is comprised of five integrated articles, in which I locate myself epistemologically as researcher through a discussion on the feminist underpinnings of …

Inequalities In Social Determinants Of Health In The Ontario Transgender Population, Rachel E. Giblon

Electronic Thesis and Dissertation Repository

This study examined how everyday living conditions known to influence health outcomes – social determinants of health – differ between transgender Ontarians and the general Ontario population. Previously collected data on social determinants, demographics, health, and health care from trans (n=433) and non-trans individuals (n=39980) living in Ontario were used. Standardized risk differences showed that significantly more trans individuals were underpaid and underemployed, unable to complete their post-secondary education, and had experienced food insecurity, social exclusion and unmet health care needs. Differences were largest comparing trans men to cisgender men of the same age distribution. Findings from this study identified …

Comparison Of Housed And Homeless Patients With An Orthopedic Diagnosis, Susan M. Williams

Electronic Thesis and Dissertation Repository

Studies on homelessness have shown that people who are homeless are admitted to hospital more frequently, for longer periods of time, and at a younger age than people who are housed. Once admitted to hospital, discharge planning is difficult and resource intensive, often leading to discharge back to the streets or a shelter. This puts this population at risk for complications and readmission. Although people who are homeless are prone to orthopedic injuries, there is no research on the outcomes of patients who are homeless with orthopedic injuries. This retrospective, case control study, based on the social determinants of health, …

"Being Stuck": Understanding The Health-Related And Everyday Lived Experiences Of Young Mothers In Rexdale, Ontario Through A Social Determinants Framework, Jaspreet Kaur

Electronic Thesis and Dissertation Repository

The purpose of this study was to gain an understanding of the ways the health-related and everyday lived experiences of young mothers are shaped by various social determinants, and in the context of their neighbourhood. Using a critical qualitative methodology, five mothers between the ages of 17 to 19 were interviewed from Rexdale, a neighbourhood in the City of Toronto characterized by a number of social risk factors(e.g. high rates of visible minorities, unemployment, and teen mothers). In-depth thematic analysis led to the emergence of four themes: 1) Living in Rexdale: Representations and realities; 2) Leaving Rexdale and wanting something …

An Exploration Of The Relationships Between Markers Of Social Status And Position And Hiv Risk Behaviours In African, Caribbean, And Other Black Populations, Shamara M. Baidoobonso

Electronic Thesis and Dissertation Repository

African, Caribbean, and other Black (ACB) people are a priority group for HIV prevention in Canada, but little is known about the epidemiology of HIV risk in this population. The overall goal of this thesis is to guide HIV prevention interventions for ACB communities. It focuses on social factors that impact HIV vulnerability.

This research used data from the Black, African, and Caribbean Canadian Health Study—a mixed methods study that used 30 semi-structured interviews, and a cross-sectional survey using a structured, self-administered quantitative questionnaire to collect information about HIV and health from 188 ACB people.

The first manuscript compares risk …

Differentials In Physical Health Outcomes Among Children In Single-Parent And Dual-Parent Families, Jennifer Lynn Rayner

Electronic Thesis and Dissertation Repository

Children live in increasingly varied family structures and there is some suggestion that children who live with single mothers have poorer health outcomes than children who live with two-parents. The examination of the pathways that link family structure to children’s physical health is important because it will help increase our understanding of why some children are healthier than others. The purpose of this dissertation is to: 1) determine if there are differences in health status between children raised in female-headed single-parent families and children in two-parent families; 2) gain an understanding of why these differences may exist; and, 3) assess …

The Determinants Of First Nation And Inuit Health: A Critical Population Health Approach, Chantelle A.M. Richmond, Nancy A. Ross

Aboriginal Policy Research Consortium International (APRCi)

Environmental dispossession disproportionately affects the health of Canada’s Aboriginal population, yet little is known about how its effects are sustained over time. We use a critical population health approach to explore the determinants of health in rural and remote First Nation and Inuit communities, and to conceptualize the pathways by which environmental dispossession affects these health determinants. We draw from narrative analysis of interviews with 26 Community Health Representa- tives (CHRs) from First Nation and Inuit communities across Canada. CHRs identified six health determinants: balance, life control, education, material resources, social resources, and environmental/ cultural connections. CHRs articulated the role …