Social and Behavioral Sciences Commons^™

Wake Up America: Conceptualizing The Social Determinants Of Sleep, Nicole Eve Bray

Masters Theses

This paper is an attempt to understand racial, ethnic and gender disparities in sleep as a sociological problem. Public health and sociological researchers have looked at the connection between sleep disparities among minorities and the impact it has on health. However, they haven’t explained and applied the social structural factors that cause these disparities, as well as address how stress can serve as a moderator. In my investigation, I found that sleep troubles differ across race, ethnicity and gender. These differences relate to the distinguishable life situations of women and minorities in American society, such as stressful life circumstances that …

(Dis)Connected: Internet Access, Health Disparities, And The Covid-19 Pandemic, Spencer Allen

Sociology Undergraduate Senior Theses

The COVID-19 pandemic fundamentally altered American life. Caused by a novel virus that infected over 29 million people and killed over half a million people between January 20, 2020, and March 8, 2021, the pandemic offered the first opportunity to utilize digital tools on a large scale to protect the American people. Public health agencies leveraged the internet to quickly disseminate rapidly changing health recommendations, and the public responded by moving many of their in-person interactions — attending school and work, socializing, and buying groceries — online. While many scholars have investigated the role that the internet has played in …

Why Not Be Free: The Black Worldmaking Praxis, Research Method, & Manifesto For Developing Music Interventions Against Stress In Black Youth, Armond Epps Dorsey

Dartmouth College Master’s Theses

Why Not Be Free? is an interdisciplinary exploration of music intervention development demonstrating the application of my integrated research and artistic practices through an outlined antiracist method for designing music to reduce stress in Black college youth and a manifesto detailing the compositional process. I draw from Black feminist and womanist thought, music cognition, and public health literature to outline a framework for designing music interventions to reduce stress among Black populations: the Music Medicine Critical Race Praxis. I situate my work among Black speculative artists reimagining experiences in everyday Black life as well as music intervention researchers integrating …

Impact Of Covid-19 On Latinx And Black Communities, Carolina Zuluaga

Dissertations

This critical literature review project explored the impact of COVID-19 on Latinx and Black communities. According to the Centers for Disease Control and Prevention, as of September 28, 2022, around 16% of COVID-19 cases in the United States were among Latinx people, and 14% of cases were among Black people (Centers for Disease Control and Prevention, 2022). Since COVID-19 began, clinicians have become more conscious of the effects of health disparities within racial and ethnic minorities, which has warranted increased advocacy by educating health and mental health providers and creating and providing resources to these communities and clinicians. The review …

Our Story, Our Song: Assessing And Addressing Black Women's Healthcare Experiences., Jason Deakings

Electronic Theses and Dissertations

Despite advancements in medicine and health sciences, health disparities and declining life expectancy persists among Black women in the United States. Researchers and non-traditional healthcare providers suggest alternative healing (e.g., music and Sister Circles) and research methodologies to achieve a culturally conscious, traumainformed, quality, and holistic care and practice. The intersecting identities and cultural responsibility of Black women highly influences the barriers and facilitators on the uptake of healthcare services. Utilizing a community engaged research approach, this qualitative study assessed the healthcare experiences, as well as the role of music in the lived and retold experiences of Black women navigating …

“They’Re Still Trying To Wrap Their Head Around Forever”: An Anatomy Of Hope For Spinal Cord Injury Patients, William A. Lucas

USF Tampa Graduate Theses and Dissertations

This dissertation draws on ethnographic data to investigate the nature of spinal cord injury (SCI) rehabilitation in Central Florida, using participant observation and interview data to understand how people with SCI (pwSCI) conceptualize their own disabilities after experiencing such radical alterations in their subjectivities. Using case studies and ethnographic vignettes, it argues that the extreme double binds in which pwSCI find themselves (where they are personally ordinarily disabled and socially extraordinarily novel; and where they are enabled resources to pursue “hopeful” therapy modalities while being designated as hopelessly disabled) is further polarized by the various legislative regimes of truth in …

Sociodemographic Predictors Of Veterans’ Health-Related Quality Of Life, Tamala Jones Choice

Walden Dissertations and Doctoral Studies

Health-related quality of life (HRQoL) is a theoretical concept that intertwines physical, mental, emotional, and social functioning, with a focus on the impact that health status has on quality of life. Although sociodemographic factors are associated with lower HRQoL, how these factors influence HRQoL in military veterans is less understood. The study’s purpose was to examine the relationships between sociodemographic characteristics (gender, military pay grade, military branch, and geographic location) and perceived HRQoL measured by the SF-8 survey among veterans living in a metropolitan community in the Mid-Atlantic region of the United States. A cross-sectional recruitment study design yielded 90 …

Sexual Orientation, Age, And Race: An Intersectional Approach To Health Disparities, Laura E. Bernstein

Graduate Theses, Dissertations, and Problem Reports

Sexual orientation, age, and race are all identity-based variables that can contribute to health disparities (Dannefer, 2020; Meyer, 2003; Forde et al., 2019). The minority diminished returns (MDR) theory states that marginalized identities (i.e. race and sexual orientation) dampen the positive impact education has on physical and mental health (Assari, 2018). Some evidence suggests that health disparities narrow in older sexual minority adults (Nelson & Andel, 2020a) but this question has not been asked with nationally representative data, and research with older sexual minorities is limited. The present study explored whether 1) age dampens or exacerbates disparities in self-rated health …

Addressing Medical Mistrust Within The Black Community To Improve Their Health Ourcomes, Jillian Weathington

Honors Undergraduate Theses

Mistrust of the healthcare system is increased among the Black population compared to other race/ethnicity groups. Medical mistrust can lead to intensified health inequities and negative health outcomes among this population. Currently, there is limited research that explores ways to address medical mistrust, especially among the Black population. This study investigated medical mistrust to find ways to improve the quality of life amongst the Black population. Twenty-one participants in this study completed a Group Based Medical Mistrust Survey and five of those participants participated in a semi-structured interview. Descriptive and correlation analyses were conducted. The GBMMS was separated into three …

Genealogy Tells: Informing Health And Aging Policies Using East Tennessean Older Women's Family Histories, Perceptions, And Experiences Of Health Inequity, Heather Davis

Doctoral Dissertations

Older women face unique health inequities challenges. This study aims to provide an understanding of older women’s perceptions and situated experiences regarding the gendered health inequities they face and the social determinants (SDH) thereof. It examines how these health inequities are situated in older women’s genealogical (familial) and geographical health and mortality outcomes histories and how their perceptions and experiences of health inequities and their familial mortality outcomes histories are characterized by the geopolitical and social norms in which they live. The purpose of this project is to present policy and decision-makers with insights about and recommendations from older women …

An Analysis Of Income And Healthcare Disparities Across Minority Populations By Incorporating Community Resource Collaboration In Public Policy, Ohioze O. Obadan

Theses and Dissertations

There is widespread literature on the connection between public policy, resource allocation, and income and health inequalities among minority communities. While various services are created to help communities, the distribution and allocation of these services remain elusive, without any collaboration towards a common objective among public policy leaders. This paper investigates the disparities in the access to healthcare within Florida, a state selected because of its documented problems with healthcare access. This thesis research analyzes the income and health inequalities in minority populations in Florida by integrating community resource collaboration into public policy. The study used secondary data from public …

Interrogating Race And Place-Based Inequities In Hiv And Covid-19, Rohan Khazanchi

MD Honors Theses

Over the last four years, I have developed a research focus examining the intersections of race, place, and health. My M.D. Honors Thesis reflects a snapshot of these efforts. In this collection of brief research reports, I leverage area-based measures to investigate structural inequities in three contexts: the HIV epidemic in our hyperlocal community, the early stages of the COVID-19 pandemic, and clinical trials for novel COVID-19 therapeutics. I apply novel social epidemiologic tools to measure and explore disparate outcomes. And, in reflecting upon my findings, I discuss concrete implications for clinicians, researchers, and policymakers alike.

Chapter 1: Neighborhood-Level Deprivation …

A Technology-Based, Mixed Methods Approach To Examining The Psychosocial Determinants Of Maternal Health Disparities, Hannah M. Ming

Theses and Dissertations

Background: Exposure to racism and discrimination in the U.S. increases Black women’s risk for experiencing maternal health disparities. Additionally, racism and discrimination affect maternal psychosocial well-being, creating evidence for a biopsychosocial relationship between racism and maternal health outcomes. However, current research does not define the psychosocial Black maternal self well. Given the dynamic relationship between racism, psychosocial well-being, and Black maternal health outcomes, research must comprehensively examine the Black maternal self. The operationalization of a comprehensive construct for Black maternal psychosocial well-being can improve understanding of the relationship between racism, psychosocial well-being, and Black maternal health outcomes.

Purpose: …

An Analysis Of The 2014 Medicaid Expansion On New York And California's Maternal Mortality Rate, Reshanna Jagroo

Honors Undergraduate Theses

This thesis seeks to investigate the 2014 Medicaid expansion’s effect on maternal mortality rates for New York and California. The CDC reported in 2019 that maternal mortality rates have been increasing. These findings are concerning for mothers and are a problem for developed nations like the United States with improved healthcare. Furthermore, women of color are disproportionately affected relative to white women. Previous research has indicated that healthcare expansions positively affect decreasing death rates among pregnant women.

In this study, I investigate how increased access to healthcare through the 2014 Medicaid expansion under the Affordable Care Act affects maternal mortality …

Social And Biological Determinants Of Pregnancy-Related Mortality And Morbidity In A Rural, Underserved Population, Anna Hansen

Theses and Dissertations--Sociology

Cases of severe maternal morbidity (SMM) and pregnancy-related mortality (PRM) are increasing in the US. Research concerning SMM and PRM has neglected women in Central Appalachia; a largely rural, health-disparate population. The aims of this study are two-fold: (1) Examine patient-level and place-based predictors of SMM/PRM via hierarchical logistic regression modeling, and (2) Elucidate Appalachian healthcare patients’ and providers’ experiences with SMM/PRM, perceptions of contributing factors, and insights on points of intervention.

This study uses a mixed methods approach guided by the WHO’s conceptual framework for action on social determinants of health to identify determinants of SMM and PRM among …

The Impact Of A Relationship Education Program On Health Disparities Among Pregnant Women, Anne Clara Biermann

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Health disparities amongst pregnant individuals of color have long been documented and yet, they persist. While there is growing recognition, the search continues for solutions to close the health disparity gap between White women and women of color. This research is a follow-up to a 2022 study exploring the impact of the MotherWise program on birth outcomes. MotherWise provides an individual-oriented relationship education program and case management service for minority and low-income pregnant women in Colorado. This research further explores a positive trend of the program's impact on preterm birth rates by examining differential effects of participation by race. In …

Academic Health Science Centers And Health Disparities: A Qualitative Review Of The Intervening Role Of The Electronic Health Record And Social Determinants Of Health, Wies Rafi

Theses and Dissertations

Literature on the magnitude of negative health outcomes from health disparities is voluminous. Defined as the health effects of racism, environmental injustice, forms of discrimination, biases in science, and sociological or socioeconomic predictors across populations, health disparities are part of an ongoing and complicated national problem that health equity programs are specifically designed to address. Academic Health Science Centers (AHC) institutions are a complex and unique educational-healthcare ecosystem that often serves as a safety net for patients in vulnerable and lower-income communities. These institutions are often viewed as one of the most uniquely positioned entities in the U.S. with an …

Black Hearts Matter: A Comparative Study Of Sociodemographic, Clinical, And Psychosocial Characteristics In Black And White Persons With Heart Failure, Hannah M Anderson Hughes

Theses and Dissertations

Heart failure (HF) is a chronic, progressive, debilitating illness that disproportionately affects Black individuals, often leading to poor quality of life (QOL). Various sociodemographic, clinical, and psychological characteristics are related to QOL in patients with HF. Because most studies do not include representative Black samples or report findings from racial subgroup analyses, these relationships and any existing racial differences are not well understood. The purpose of this descriptive, comparative study was to explore the relationships among sociodemographic, clinical, and psychological characteristics and QOL in patients with HF and to determine if there were racial differences between Black and White individuals. …

Factors Influencing Latina Healthcare System Distrust, Anthony D. Eldridge

Theses and Dissertations

The Latino community's healthcare engagement continues to be a growing national concern (Velasco-Mondragon et al., 2016). Due to sociocultural circumstances and racial marginalization, Latinas experience disproportionate health disparities and inequalities that may be exacerbated by healthcare system distrust (HSD) (Hacker et al., 2015). Ethnic identity, an established protective factor in Latino culture, may contribute to healthcare system distrust (Ai et al., 2012). Additionally, immigration status has been shown to negatively influence Latino's healthcare experiences leading to HSD (Luque et al., 2018). The present study evaluated the influence of sociodemographic factors and ethnic identity on HSD among Latinas. Ethnic identity and …

Child Life Specialists' Knowledge And Perception Of White Privilege, Renee Elise Jamar Lee

MSU Graduate Theses

This study’s goal was to understand child life specialists’ knowledge and perception of White privilege. The purpose of this study was to examine child life specialists’ understanding of White privilege and to obtain their perspectives on the impact White privilege has on patient- and family-centered care within the hospital setting. Through qualitative interviews, participants defined “White privilege,” shared their perception of “White privilege” and the impact it has on patient- and family-centered care, as well their personal experience with diversity and inclusion training. Additionally, participants created their own personal lists of unearned advantages as an exercise of awareness and acknowledgement …

Assessing The Contribution Of Different Causes Of Death To Life Expectancy Disparities In The United States, Max Tyler Roberts

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

Life expectancy is not the same for all people in the United States. While some enjoy life expectancies of more than 80 years, others are at risk of dying much sooner. The following studies investigate how different causes of death such as homicide, diabetes, heart disease, and drug poisoning contribute across the life span to: 1) life expectancy gaps across different sex, racial, ethnic, and education groups, and 2) life expectancy change over time for different sex, racial, ethnic, and education groups. Each study focuses on a different area of the U.S., with Chapter 2 focusing on the national-level, Chapter …

Understanding The Healthcare Experiences Of Lgbtq+ People: An Adaptation Of The Daily Heterosexist Experiences Questionnaire, Conor Smith

Doctoral Dissertations

LGBTQ+ people's experiences of heterosexism, which are common in the healthcare system, are linked to poor health outcomes. There are no measures of LGBTQ+ people’s experiences in healthcare settings which could be used by healthcare systems and providers to improve the quality of their care for this vulnerable population. The Daily Heterosexist Experiences Questionnaire (DHEQ), developed using the minority stress model, measures the general stressful life experiences of LGBTQ+ people. This project aimed to adapt the DHEQ for use in healthcare settings.

A mixed-methods study was conducted to create the Daily Heterosexist Experiences Questionnaire-Healthcare (DHEQ-H). Semi-structured interviews focused on the …

Examining Health Disparities In A Community-Based Sample Of Children With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (Me/Cfs) Symptomatology, Chelsea Torres

College of Science and Health Theses and Dissertations

Previous literature examining overall health outcomes and outcomes specifically related to adults with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) have found disparities based on sociodemographic characteristics including race/ethnicity, gender, and socioeconomic status. There is currently little information known regarding demographic disparities in health outcomes for youth with ME/CFS symptomatology, though a recent prevalence study found Black and Latinx youth as well as females have higher rates of ME/CFS than White youth and males, respectively. The current study examined 137 youth who screened positive for ME/CFS symptomatology. Multiple linear regressions assessing demographic predictors on fatigue severity, number of symptoms endorsed, and overall …

Procuring Produce In A Rural, Appalachian County: A Thematic Analysis Of Community Member Experiences, Caroline Blincoe

Theses and Dissertations--Nutrition and Food Systems

Rates of obesity and other health disparities are exceptionally high in rural Appalachian counties compared to the nation as a whole. One causal factor of these health disparities in Appalachian counties is the inequitable allocation of healthy food. Food insecurity and the local food environment are large drivers for obesity experienced by Martin County, Kentucky residents. Successful socioecological model (SEM) and policy, systems, and environmental (PSE) interventions have shown promising results in reducing obesity and enhancing food security in this population. Through the transcription of semi-structured focus group interviews, thematic analysis aimed to obtain perspectives on the local food system. …

Health Disparities By Sexual Orientation Components In The United States, Julia Kay Wolf

Graduate Theses, Dissertations, and Problem Reports

Fundamental cause theory encourages researchers to consider broad social conditions that put people at risk of individual-level health-related risks that can lead to health disparities between social groups. Stigma has recently been proposed as a fundamental cause of health disparities as it influences multiple disease outcomes, affects access to resources, and is consistently related to health inequities across historical and geographical contexts. Minority stress theory describes how sexual minorities endure excess stressors in the form of prejudice and discrimination due to their stigmatized status. Considering both frameworks, I explore how stigmatized sexual orientation minority respondents compare to their sexual majority …

Barriers To Integrated Primary Care And Specialty Mental Health Services: Perspectives From Latinx And Non-Latinx White Primary Care Patients, Elizabeth A. Anastasia

Graduate Theses and Dissertations

High need, low access, and rising health care costs reveal the inadequacies of the current mental health system in the U.S. Racial/ethnic minorities, including Latinxs, face substantial disparities in accessing mental health treatment compared with non-Latinx Whites. Integrated primary care (IPC) offers an alternate model for meeting mental health needs by providing care in a way that is accessible to the general population. Though it has been suggested that IPC may reduce health disparities by decreasing barriers to mental health treatment, empirical data relevant to this question are limited. A series of three studies were conducted using a mixed methodology …

Examining The History Of Racial Groups To Understand Health Disparities In Monterey County, Virginia Murillo

Capstone Projects and Master's Theses

The Monterey County Health Department’s Health Equity Scholars Academy aspires to train health workforce leaders to prioritize equity into services. Health inequities occur when there are systematic differences in the health statuses of different populations. These disparities perpetuate negative health outcomes for minority groups. In Monterey County, too few public employees are aware of the types and pervasiveness of health inequities experienced by a significant proportion of the population. A timeline was developed to provide a more accessible way to educate public employees about significant events and policies affecting Monterey County resident’s health. Content from the timeline has been incorporated …

Hiding Under The Sun: Health, Access, And Discourses Of Representation In Undocumented Communities, Jaime Shamado Robb

USF Tampa Graduate Theses and Dissertations

This project examines how undocumented immigrants in the United States communicate health and illness, specifically focusing on health narratives of undocumented immigrants in the South Florida region. In order to do this, I conducted 27 field interviews with undocumented immigrants living in South Florida to gain understanding of how this group meets health and wellness needs. Conversations revolved around prominent themes that highlighted the role of communication that produce stigma towards this group; the complexity of a costly bureaucratic health system, and the fears participants experience that stems from the possibility of deportation. Additionally, participants detailed the role of their …

The Effect Of Acute Interpersonal Racial Discrimination On Smoking Motivation And Behavior Among Black Smokers, Patricia F. Calixte-Civil

USF Tampa Graduate Theses and Dissertations

In comparison to White smokers, Black smokers are more likely to report both discrimination and less success in smoking cessation. No previous study has tested the causal relationship between actual experienced racial discrimination and smoking variables associated with cessation. The goal of this study was to test the casual influence of interpersonal racial discrimination on smoking motivation (i.e., the urge to smoke cigarettes, cessation self-efficacy, and smoking behavior) using a controlled experimental design. We used a virtual ball-playing game to create a laboratory model of racial discrimination. A 2x2 between-subjects factorial design (inclusion/exclusion vs. ingroup/outgroup) was used to randomly assign …

The Effects Of Interpersonal Discrimination On Social Cognition And Depressive Symptoms, Emilia Eva Mikrut

Theses and Dissertations

Interpersonal racial/ethnic discrimination is a risk factor for poor psychological well-being, including symptoms of depression. Emerging research suggests that changes in social cognition, including relational schemas about the self and others that facilitate navigation of the social world, may be one mechanism underlying the relation between exposure to discrimination and psychological distress. Prior studies have often examined the mediating role of one or two negative relational schemas in isolation. However, less is known about the unique and combined effects of multiple dimensions of social cognition on the relation between exposure to interpersonal racial/ethnic discrimination and depressive symptoms. This study tested …