Social and Behavioral Sciences Commons^™

Disparities In Mortality Between Appalachian And Non-Appalachian Regions Of Kentucky, Sonali S. Salunkhe, Sahal Alzahrani, Beatrice Ugiliweneza

Journal of Appalachian Health

Introduction: In the opioid epidemic, the U.S. faces a significant public health crisis, with some areas of the country, such as rural and Appalachian regions, suffering more than others. The differential regional impact of the crisis in Kentucky—a state with both non-metropolitan/metropolitan and Appalachian/Non-Appalachian statuses—has not yet been documented despite such knowledge being essential to the success of overdose prevention efforts.

Purpose: This study compares all-cause, drug- and opioid-related mortality between counties in different regions of Kentucky: Appalachian non-metropolitan, Appalachian metropolitan, non-Appalachian non-metropolitan, and non-Appalachian metropolitan.

Methods: Age-adjusted mortality data from the Centers for Disease Control and Prevention’s Wide-ranging Online …

Carbapenem-Resistant Enterobacterales—Kentucky, 2013–2020: Challenges And Successes, Mary Issac, Andrea Flinchum, Kevin Spicer

Journal of Appalachian Health

Introduction: Carbapenem-resistant Enterobacterales (CRE) are considered urgent, antibiotic-resistant threats in the U.S. and are of global concern. Active collaboration between public health authorities and healthcare facilities and providers will be necessary to prevent and contain these organisms.

Purpose: To describe the epidemiology of CRE in Kentucky and to discuss challenges and successes with building and sustaining an effective prevention and containment program.

Methods: Retrospective descriptive summary of CRE isolates reported by healthcare providers, facilities, and laboratories in Kentucky from 2013 through 2020. Data available from case reporting forms and laboratory testing are summarized.

Results: From 2013 through 2020, 1805 CRE …

Self-Reported Consumption Of Bottled Water V. Tap Water In Appalachian And Non-Appalachian Kentucky, Jason W. Marion

Journal of Appalachian Health

Introduction: Quantitative studies on drinking water perceptions in Appalachia are limited. High-profile water infrastructure failures in the U.S. and Eastern Kentucky, coupled with human-made and natural disasters in the Appalachian Region, have likely impacted opinions regarding tap water.

Purpose: To use existing unexplored data to describe baseline tap water v. bottled water consumption in Kentucky.

Methods: Telephone-based cross-sectional data were obtained from the 2013 Kentucky Health Issues Poll (KHIP) directed by the Foundation for a Healthy Kentucky. Among many items in KHIP, self-reported consumption of bottled water over tap water, reasons for bottled water use, and demographic data were obtained. …

Association Of Diabetes Prevalence With Labor Force Participation Rates In Kentucky Counties, Ryan Montgomery

MPA/MPP/MPFM Capstone Projects

Compared to other states in the USA, Kentucky has one of the highest rates of diagnosed diabetes and one of the lowest levels of labor force participation. This project employs a multivariable linear regression model to estimate the correlation between county-level diabetes prevalence and county-level labor force participation rates in Kentucky counties from 2015-2019, using publicly available data from the Centers for Disease Control’s Behavioral Risk Factor Surveillance System (BRFSS) and the U.S. Census Bureau’s American Community Survey (ACS). Labor force participation rates serve as the dependent variable and diabetes prevalence rates serve as the primary independent variable, alongside nine …

Access To And Use Of Technology For Health: Comparisons Between Appalachian Kentuckians And The General U.S. Population, Robin C. Vanderpool, Lindsay R. Stradtman, Anna Gaysynsky, Quan Chen, Meghan Johnson, Bin Huang

Journal of Appalachian Health

Introduction: Technology may increase the availability of health information and enable health promoting behaviors. However, lack of access to and use of technology may also exacerbate disparities, particularly in rural communities with limited Internet access.

Purpose: The purpose of this study was to compare Internet access, device ownership, and use of technology for health between Appalachian Kentuckians and the general U.S. population.
Methods: Findings from the 2017 Assessing the Health Status of Kentucky (ASK) survey were compared to national estimates from the Health Information National Trends Survey (HINTS) 5, Cycle 1 (2017), with a particular focus on degree of rurality. …

An Assessment Of Kentucky Birth Records, Focusing On Early-Onset Hypertensive Disorders Of Pregnancy, Environmental Metal Exposures, And Geocoding Precision, 2008-2017, Courtney J. Walker

Theses and Dissertations--Epidemiology and Biostatistics

Using live and stillbirth records from Kentucky (2008-2017), this dissertation assessed the county-level prevalence and geospatial patterns of early-onset hypertensive disorders of pregnancy (eHDP); examined the geocoding precision of addresses recorded on birth records, and evaluated the association between individual risk factors and environmental metal exposures on eHDP prevalence. After adjusting for maternal demographic factors and pre-existing health conditions, we observed that eHDP prevalence was 38% higher (aPR=1.38, 95%CI:1.16, 1.64) in counties with the highest prevalence of married women (> 53.8%) compared to lower prevalence areas (31.6%) had a 20% higher prevalence of eHDP(aPR=1.20, 95%CI:1.00, 1.44) compared to counties with …

“We’Re, Like, The Most Unhealthy People In The Country”: Employing An Equity Lens To Reduce Barriers To Healthy Food Access In Rural Appalachia, Kathryn Cardarelli, Emily M. Dewitt, Rachel Gillespie, Heather Norman-Burgdolf, Natalie Jones, Janet Tietyen Mullins

Dietetics and Human Nutrition Faculty Publications

Introduction

Obesity disproportionately affects rural communities, and Appalachia has some of the highest obesity rates in the nation. Successful policy, systems, and environmental (PSE) interventions to reduce obesity must reflect the circumstances of the population. We used a health equity lens to identify barriers and facilitators for healthy food access in Martin County, Kentucky, to design interventions responsive to social, cultural, and historical contexts.

Methods

We conducted 5 focus groups in Martin County, Kentucky, in fall 2019 to obtain perspectives on the local food system and gauge acceptability of PSE interventions. We used grounded theory to identify perceived barriers and …

Measuring The Spread Of Covid-19 In Kentucky: Do We Have The Right Data?, Kenneth R. Troske, Paul A. Coomes

Institute for the Study of Free Enterprise Working Papers

We examine various measures of COVID-19 infections, hospitalizations and deaths, with an emphasis on data for Kentucky. We find that: Data on the number of new reported cases of the disease obtained from convenience samples (as opposed to representative random samples) is an inaccurate measure of the spread of the disease in the State. Using CDC data and national studies, it appears that there were ten times the number of infections in March than reported for Kentucky at the time and by September the State is still capturing only one out of two people infected.

A better measure of new …

Preterm Birth Prevention In Appalachian Kentucky: Understanding Barriers And Facilitators Related To Transvaginal Ultrasound Cervical Length Surveillance Among Prenatal Care Providers, Anna Hansen, Mairead E. Moloney, Cynthia Cockerham-Morris, Jing Li, Niraj R. Chavan

Sociology Faculty Publications

Background: Appalachian Kentucky has higher-than-average rates of preterm birth (PTB)—a health disparity associated with increased maternal and fetal/neonatal morbidity and neonatal mortality. Transvaginal ultrasound (TVU) cervical length measurement is the best predictor of PTB risk, but is underutilized in Appalachia. This study explores prenatal care providers' TVU-related knowledge and practices, and identifies barriers and facilitators, which impact the adoption of this evidence-based technology.

Materials and Methods: This study recruited providers from three Appalachian Kentucky health care sites. Prenatal care providers took part in semistructured interviews and completed brief survey scales. Questions focused on PTB knowledge, TVU-related barriers, and suggestions for …

Did Social-Distancing Measures In Kentucky Help To Flatten The Covid-19 Curve?, Charles J. Courtemanche, Joseph Garuccio, Anh Le, Joshua C. Pinkston, Aaron Yelowitz

Institute for the Study of Free Enterprise Working Papers

In the absence of a vaccine or more effective treatment options, containing the spread of novel coronavirus disease 2019 (COVID-19) must rely on non-pharmaceutical interventions. All U.S. states adopted social-distancing measures in March and April of 2020, though they varied in both timing and scope. Kentucky began by closing public schools and restaurant dining rooms on March 16th before progressing to closing other non-essential businesses and eventually issuing a “Healthy at Home” order with restrictions similar to the shelter-in-place (SIPO) orders adopted by other states. We aim to quantify the impact of these measures on COVID-19 case growth in the …

Boundaries And Infomediaries: A Qualitative Study Of The Information Practices Of Community Health Workers, Robert M. Shapiro Ii

Theses and Dissertations--Communication

Despite successful efforts to treat and manage diseases, public health officials have recently begun a campaign to refocus efforts toward initiatives to alleviate the pressures that are often referred to as social determinants of health. In eastern Kentucky, and in other geographical regions labeled as health professional shortage areas or medically underserved areas, issues stemming from social determinants are compounded with health care systems that are often lacking the human resources to meet basic medical needs. One strategy has been to utilize volunteers and paraprofessionals such as community health workers to lessen the burden on the primary care and hospital …

The Effects Of Opioids On Kentucky's Workforce, Michael W. Clark, Jenny A. Minier, Charles J. Courtemanche, Bethany L. Paris, Michael T. Childress

CBER Research Report

From the executive summary:

Opioid abuse represents a significant and growing public health issue for both the nation and Kentucky. In 2016, opioids contributed to more than 62,000 deaths nationally and 1,406 deaths in Kentucky. National studies have placed the societal costs of opioid abuse at $55.7 billion in 2007 and $78.5 billion in 2013 (Birbaum et al. (2011) and Florence et al. (2016)). These costs included increased health care expenditures, higher criminal justice costs, and lost earnings due to reduced employment and premature deaths. The While House Council of Economic Advisors (2017) estimated the societal costs of opioid abuse …

The Effect Of Smoking On Kentucky’S Workforce, Michael W. Clark, Jenny A. Minier, Charles J. Courtemanche, Bethany L. Paris, Michael T. Childress

CBER Research Report

Excerpt from the Executive Summary:

Smoking has been estimated to increase health care costs in the United States by $167.5 billion annually (Xu et al. 2015). In Kentucky, smoking adds $2.5 billion in health care expenditures each year. Most of these costs were paid by public programs such as Medicaid and Medicare. While these costs are significant, they represent only a portion of the costs that smoking imposes on society. Smoking also leads to poorer labor market outcomes. Smokers are more likely to be unemployed, earn lower wages, and die prematurely than non-smokers. These negative labor market effects reduce economic …

Young, Kathleen Louise "Kay" (Fa 1327), Manuscripts & Folklife Archives

FA Finding Aids

Finding aid and full-text scan of paper (Click on “Additional Files” below) for Folklife Archives Project 1327. Student folk studies project titled “Ginseng: A Treasured Kentucky Herb That Goes to China” about the business of buying and selling ginseng in Grayson County, Kentucky and the growing and harvesting of ginseng in Simpson County, Kentucky. Photos include the growing stages of the ginseng plant, the harvesting process, and the informants.

Francis, Jim (Fa 1316), Manuscripts & Folklife Archives

FA Finding Aids

Finding aid only for Folklife Archives project 1316. [“Supernatural Legends from Hopkins County, Kentucky”] collected by Jim Francis for a folk studies class at Western Kentucky University. Titles include: "My Grandfather was a Fire-Drawer," "Haunted House of Carbondale," and "Raven Hill Cemetery.”

Comparative Spending Of Medicaid Dollars On Child Participants Of Kentucky’S Sobriety Treatment And Recovery Teams Program Versus A Matched Comparison Group., Matthew Thomas Walton

Electronic Theses and Dissertations

Child protective services agencies have long observed the complicating role that parental substance use and addiction plays in cases of child maltreatment. Families who struggle with these problems present unique challenges for child welfare professionals. These families are typically more difficult to engage, more likely to have children removed from the home, and have poorer outcomes when compared to other families. These poorer outcomes often include health problems. Addiction has well-known effects on health, and the specific manifestations of these problems for parents have been documented for years in child protection casework. However, what has been less investigated are the …

The Economic Impact Of Diabetes In Kentucky, Michael W. Clark, Jenny A. Minier, Charles J. Courtemanche, Bethany L. Paris, Michael T. Childress

CBER Research Report

Excerpt from the Executive Summary:

The Kentucky Department of Public Health is responsible for improving the health and safety of Kentucky’s residents by preventing disease and injuries and encouraging healthy lifestyles. The department administers nearly 150 programs that address critical health issues affecting Kentuckians. These programs screen newborns for health problems, prevent the spread of infectious diseases, promote oral health, and provide numerous other services.

Diabetes represents a growing health concern for the nation and Kentucky. It is a chronic condition that causes blood sugar levels to rise and contributes to other serious health conditions such as heart and kidney …

Everybody’S Working (But The Weakened): An Assessment Of Medicaid Work Requirements And Their Administrative Burdens, Samuel Misleh

MPA/MPP/MPFM Capstone Projects

Although Medicaid work requirements are currently halted in both Arkansas and Kentucky, this analysis utilizes the data available to make an assessment and estimate of what Kentucky’s Medicaid enrollment will look like if work requirements similar to those Arkansas had are ever implemented. The relative severity of the administrative burden of such requirements provide a tool for comparison, and a difference-in-differences analysis of the change in Medicaid enrollment between Arkansas and West Virginia, a state that has not implemented and currently has no plans to implement Medicaid work requirements, provide the bases for this estimate. After coding the work requirements …

Craig, Patricia (Fa 1183), Manuscripts & Folklife Archives

FA Finding Aids

Finding aid only for Folklife Archives Project 1183. Student paper titled “Folk Remedies” in which Patricia Craig gathers together traditional herbal remedies and folkloric practices as they relate to health and healing. Craig collected information from close relatives, friends, and other residents of Muhlenberg County.

Smith, Jerry W. (Fa 1162), Manuscripts & Folklife Archives

FA Finding Aids

Finding aid only for Folklife Archives Project 1162. Student folk studies project titled “Home Remedies of Butler County” which includes survey sheets with brief descriptions of folk remedies in Butler County, Kentucky. Sheets may include a remedy, brief description, informant’s name,

address and text classification.

Marcum, Joe (Fa 1161), Manuscripts & Folklife Archives

FA Finding Aids

Finding aid only for Folklife Archives Project 1161. Student folk studies project titled “Folklore Collection Project: [Old Recipes and Remedies]” which includes survey sheets with brief descriptions of recipes or remedies in Logan County and Warren County, Kentucky. Sheets may include a recipe, remedy, brief description, informant’s name, address and text classification.

Gillan, Robert Lee, 1916-2009 (Sc 3183), Manuscripts & Folklife Archives

MSS Finding Aids

Finding aid and scan (Click on "Additional Files" below) for Manuscripts Small Collection 3183. Letter, 7 August 2006, of Robert Lee Gillan, Thorntown, Indiana, to Martha Harrison. He refers to his interest in genealogy and relates anecdotes about “Aunt Nancy,” an African American woman and caregiver to local families in Barren County, Kentucky. He includes particulars of some of her household advice, folk medicinal treatments and beliefs. He notes that she is buried in Lyons (Lyon) Cemetery.

Exploring Evolutionary Medicine Through 19Th Century Medical Collections: Applications In Archival Studies, Taylor Sturgill

Special Collections Research Center Learning Lab Student Research

Evolution has been a paradox in the field of science, but, the study of evolutionary medicine applies both the evolutionary game theory and medicine. This study was conducted to explore evolution by analyzing two 19th century collections of medical formulations and prescriptions while compared to the trend of public health and pathogenic mechanisms. Analysis of organic structure in historical prescriptions, descriptive epidemiology in Kentucky, and the idea of the germ theory will be used explicitly to show the evolutionary change of health and disease. Results of this study provided an outlook on ingredients that stimulate the body as a whole …

Rct Testing Bystander Effectiveness To Reduce Violence, Ann L. Coker, Heather M. Bush, Patricia G. Cook-Craig, Sarah A. Degue, Emily R. Clear, Candace J. Brancato, Bonnie S. Fisher, Eileen A. Recktenwald

Obstetrics and Gynecology Faculty Publications

Introduction: Bystander-based programs have shown promise to reduce interpersonal violence at colleges, yet limited rigorous evaluations have addressed bystander intervention effectiveness in high schools. This study evaluated the Green Dot bystander intervention to reduce sexual violence and related forms of interpersonal violence in 26 high schools over 5 years.

Design: A cluster RCT was conducted.

Setting/participants: Kentucky high schools were randomized to intervention or control (wait list) conditions.

Intervention: Green Dot−trained educators conducted schoolwide presentations and recruited student popular opinion leaders to receive bystander training in intervention schools beginning in Year 1.

Main outcome measures: The primary outcome was sexual …

Boyd, Douglas A., B. 1970 (Fa 1002), Manuscripts & Folklife Archives

FA Finding Aids

Finding aid only for Folklife Archives Project 1002. Group interview with several Tyler family members who were physicians in Owensboro and Daviess County, Kentucky, as well as friends and family of the doctors. People share folkways related to medical practice and stories by and about the Tyler family. The copyright for this interview is retained by the interviewer; this copy is for research purposes only.

Spears, Sandra (Fa 999), Manuscripts & Folklife Archives

FA Finding Aids

Finding aid only for Folklife Archives Project 999. Project titled: “Folk Medicine in Allen County.” Includes survey sheets with brief descriptions of folk remedies and beliefs in Allen County, Kentucky. Sheets include a brief description, informant’s name, and the motif index number.

Castillo, Jesse (Fa 983), Manuscripts & Folklife Archives

FA Finding Aids

Finding aid only for Folklife Archives Project 983. Project titled: “Folklore Collection.” Includes survey sheets with brief descriptions of folk remedies, sayings, and ghost stories from Warren County, Kentucky, Pennsylvania and Texas.

Deweese, Wanda (Fa 923), Manuscripts & Folklife Archives

FA Finding Aids

Finding aid only for Folklife Archives Project 923. Paper titled: “Folk Medicine.” Project includes paper with introduction of folk medicine beliefs, remedies, and superstitions in Barren County and Metcalfe County, Kentucky.

Jenkins, David (Fa 918), Manuscripts & Folklife Archives

FA Finding Aids

Finding aid only for Folklife Archives Project 918. Project titled: “Folk Medicine Beliefs.” Includes paper with introduction of folk medicine beliefs and superstitions in Warren County, Kentucky.

Wheeley, Suzanne (Fa 912), Manuscripts & Folklife Archives

FA Finding Aids

Finding aid only for Folklife Archives Project 912. Project titled: “Folk Beliefs Collection.” Project includes note cards with brief descriptions of songs, beliefs, sayings, tales, and occurrences from Hancock County and Warren County, Kentucky. Note cards include a brief description, informant’s name, and some have the motif index number.