Medicine and Health Commons^™

Health Care Use Experiences Of Ethnoculturally Diverse Immigrant Older Adults: A Meta-Ethnography, Lorna De Witt, Kathryn A. Pfaff, Roger Reka, Noeman Ahmad Mirza

Nursing Publications

Purpose

Current and predicted continued dramatic increases in international migration and ethnocultural diversity of older adult cohorts pose challenges for health care services. Review studies on ethnoculturally diverse older adults and health care show a lack of focus on their service use experiences. This study aims to report a meta-ethnography that addresses this knowledge gap through answering the review question: How do ethnoculturally diverse older adults who are immigrants experience health care services?

Design/methodology/approach

The authors applied a seven-phase method of meta-ethnography to guide the review. The authors conducted two literature searches (April 2018 and June 2020) in MEDLINE, CINAHL, …

A Statewide Study Of Disparities In Local Policies And Tobacco, Vape, And Cannabis Retail Environments, Georgiana Bostean, William R. Ponicki, Alisa A. Padon, William J. Mccarthy, Jennifer B. Unger

Sociology Faculty Articles and Research

The current study: (1) assesses sociodemographic disparities in local policies related to tobacco and cannabis retail, and (2) examines the cross-sectional association between policy strength and retailer densities of tobacco, e-cigarette (vape), and cannabis retailers within California cities and county unincorporated areas (N = 539). We combined (a) American Community Survey data (2019 5-year estimates), (b) 2018 tobacco, vape, and cannabis retailer locations from a commercial data provider, (c) 2017 tobacco and vape retail environment policy data from American Lung Association, and (d) 2018 cannabis policy data from California Cannabis Local Laws Database. Conditional autoregressive models examined policy strength associations …

Assessment Of Personal Care Product Use And Perceptions Of Use In A Sample Of Us Adults Affiliated With A University In The Northeast, Adana A. M. Llanos, Amber Rockson, Kylie Getz, Patricia Greenberg, Eva Portillo, James A. Mcdonald, Dede K. Teteh, Justin Villasenor, Carolina Lozada, Jamirra Franklin, Vaishnavi More, Zorimar Rivera-Núñez, Carolyn W. Kinkade, Emily S. Barrett

Health Sciences and Kinesiology Faculty Articles

Evidence supports unequal burdens of chemical exposures from personal care products (PCPs) among some groups, namely femme-identifying and racial and ethnic minorities. In this study, we implemented an online questionnaire to assess PCP purchasing and usage behaviors and perceptions of use among a sample of US adults recruited at a Northeastern university. We collected PCP use across seven product categories (hair, beauty, skincare, perfumes/colognes, feminine hygiene, oral care, other), and behaviors, attitudes, and perceptions of use and safety across sociodemographic factors to evaluate relationships between sociodemographic factors and the total number of products used within the prior 24–48 h using …

Hiv And Housing Insecurity In Louisiana, Hui-Peng Liew, Leslie E. Green

Journal of Rural Social Sciences

This study sought to assign the parishes in Louisiana into distinctive spatial-temporal clusters based on their trends in HIV prevalence and percentages of households with severe housing problems and to assess the parish’s resilience and susceptibility to HIV infection given its pre- existing sociodemographic conditions. Results revealed that trends in the HIV prevalence rates and percentages of households with severe housing problems differed across the five distinct spatial-temporal clusters. The percentage of households with severe housing problems and the percentage of non-Hispanic Black population were positively associated with the HIV prevalence rate while the reverse was true for the percentage …

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 …

The Effect Of Covid-19 On Depression In Hispanic Vs. Non-Hispanic Populations In South Jersey, Rana Cheikhali, Daniel Casal

Rowan-Virtua Research Day

The COVID-19 pandemic has been challenging for Americans and the world as a whole. It has especially taken a toll on mental health. Studies show that the incidence of depression in the United States was three times greater during the pandemic compared to pre-pandemic times. One specific community in the United States that has been greatly affected by the pandemic is the Hispanic American community. Many Americans across the country have received federal surveys that aim to determine the social and economic impacts of COVID-19. Results revealed that the Hispanic population had the greatest rise in mental illness, with 40% …

Perceived Covid-19 Threat Across The Intersections Of Age, Race/Ethnicity, And Gender, Christina Varghese

Sociology and Criminology Undergraduate Honors Theses

Studying how perceived threat of the novel coronavirus 2019 (COVID-19) differs across intersections of age and race/ethnicity as well as age and gender will create a basis for identifying subgroups at greater risk of negative mental health outcomes. I analyzed nationally representative survey data collected in February 2021 from the Pew Research Center’s American Trends Panel (N=9,069). To measure perceived threat, the respondents were asked whether COVID-19 is considered 0) no threat, minor threat, or 1) major threat for personal and population health. Race/ethnicity, gender, and age categories are used as independent variables. Results from logistic regression models indicate that …

Citizenship Matters: Non-Citizen Covid-19 Mortality Disparities In New York And Los Angeles, Jason A. Douglas, Georgiana Bostean, Angel Miles Nash, Emmanuel B. John, Lawrence M. Brown, Andrew M. Subica

Health Sciences and Kinesiology Faculty Articles

U.S. non-citizen residents are burdened by inequitable access to socioeconomic resources, potentially placing them at heightened risk of COVID-19-related disparities. However, COVID-19 impacts on non-citizens are not well understood. Accordingly, the current study investigated COVID-19 mortality disparities within New York (NYC) and Los Angeles (LAC) to test our hypothesis that areas with large proportions of non-citizens will have disproportionately high COVID-19 mortality rates. We examined ecological associations between March 2020–January 2021 COVID-19 mortality rates (per 100,000 residents) and percent non-citizens (using ZIP Code Tabulation Areas (ZCTA) for NYC and City/Community units of analysis for LAC) while controlling for sociodemographic factors. …

Disability And Health In African Americans: Population Research And Implications For Occupational Therapy Community-Based Practice, Emily Schulz, Debarchana Ghosh, Eddie M. Clark, Beverly R. Williams, Randi Williams, Lijing Ma, Crystal L. Park, Cheryl L. Knott

The Open Journal of Occupational Therapy

Background: Population-based research and community-based interventions are integral to occupational therapy’s scope of practice, yet they are underdeveloped in actual implementation. Therefore, this paper focuses on some health challenges facing the African American population, guided by the Person-Environment-Occupation-Performance Model.

Method: Using data from an observational cross-sectional nationwide telephone survey of African American adults, we examined differences between African Americans who are receiving disability payments (RDP) and those who are employed full time (FTE) on several physical health behaviors and psychosocial health indicators. We further compared the differences between African Americans RDP versus those FTE on those physical health …

Social Isolation, Residential Stability, And Opioid Use Disorder Among Older Medicare Beneficiaries: Metropolitan And Non-Metropolitan County Comparison, Tse-Chuan Yang, Carla Shoff, Seulki Kim

Department of Sociology: Faculty Publications

Research has shown that the prevalence of opioid use disorder (OUD) may rise substantially as society ages, but this issue receives the least attention in the literature. To address this gap, this study utilizes county-level data from multiple data sources (1) to investigate whether social isolation is associated with OUD prevalence among older Medicare beneficiaries, (2) to examine whether and how residential stability moderates the association between social isolation and OUD prevalence in US counties, and (3) to determine if there are any differences in these associations between metropolitan and nonmetropolitan counties. The results show that social isolation is a …

What Predicts How Safe People Feel In Their Neighborhoods And Does It Depend On Functional Status?, Alfredo J. Velasquez, Jason A. Douglas, Fangqi Guo, Jennifer W. Robinette

Health Sciences and Kinesiology Faculty Articles

Feeling unsafe in one's neighborhood is related to poor health. Features of the neighborhood environment have been suggested to inform perceptions of neighborhood safety. Yet, the relative contribution of these features (e.g., uneven sidewalks, crime, perceived neighborhood physical disorder) on perceived neighborhood safety, particularly among people with disabilities who may view themselves as more vulnerable, is not well understood. We examined whether sidewalk quality assessed by third party raters, county-level crime rates, and perceived neighborhood disorder would relate to neighborhood safety concerns, and whether functional limitations would exacerbate these links. Using data from the 2012/2014 waves of the Health and …

Should I Stay Or Should I Go? Mexican Return Migration Across The Life Course, Mara G. Sheftel

Dissertations, Theses, and Capstone Projects

Foreign-born individuals make up a growing share of older adults in the US. Older immigrants offer an important vantage point from which to investigate integration because outcomes at older ages can be considered “final” measures providing empirical evidence for theoretical understandings of the forces impacting immigrant trajectories. However, considering the non-negligible portion of immigrants that ultimately return to their country of origin it is impossible to get the full range of immigrant outcomes without considering returnees. Further, patterns of return may differ across the life course with distinct economic, social, and health considerations at older ages. However, the impact of …

Senior Center Response To Covid-19: Nutrition, Ceara Somerville, Saralyn Collins, Caitlin Coyle, Jan Mutchler, Center For Social And Demographic Research On Aging, University Of Massachusetts Boston

Center for Social and Demographic Research on Aging Publications

Older adults across the U.S. are at risk of malnutrition, which can have lasting effects on health. Councils on Aging (COAs) are at the forefront of meeting the nutritional needs of older adults in their communities. The COVID-19 pandemic has not only limited older adults’ access to food, but it has also affected COAs’ abilities to get nutritious food out to seniors. Despite the hurdles presented by the global pandemic, Massachusetts COAs have continued their efforts to meet the nutritional needs of older adults.

Senior Center Response To Covid-19: Technology, Ceara Somerville, Saralyn Collins, Caitlin Coyle, Jan Mutchler, Center For Social And Demographic Research On Aging, University Of Massachusetts Boston

Center for Social and Demographic Research on Aging Publications

The COVID-19 pandemic has made the use of technology critical to remain socially connected with others while remaining physically distance. Senior centers in Massachusetts have had to think outside of the box and adapt their programs and services to be provided remotely, by phone, email, social media, and video calls. Moreover, senior centers have become responsible for helping older adults overcome their hesitations with using technology to keep them engaged and connected while physical gathering spaces have been closed.

Senior Center Response To Covid-19: Social Engagement And Outreach, Ceara Somerville, Saralyn Collins, Caitlin Coyle, Jan Mutchler, Center For Social And Demographic Research On Aging, University Of Massachusetts Boston

Center for Social and Demographic Research on Aging Publications

Social isolation can have devastating effects on an individual’s mental and physical wellbeing. The COVID-19 outbreak has put older adults at greater risk of isolation and has pushed efforts to address isolation to the forefront of public health in Massachusetts. Senior centers have been working to end isolation in their communities long before COVID-19 and have continued that work in the face of a global pandemic. This fact sheet describes what Massachusetts senior centers are doing during the pandemic to address isolation among older community members.

Reporting Of Eating Disorder Deaths, Katherine Mobley, Amy Hord

Symposium of Student Scholars

Those affected by eating disorders experience disturbances in eating behaviors which are often related to underlying psychiatric disorders such as anxiety, depression, or obsessive-compulsive disorder (Parekh, 2017, Drieberg et al., 1998 p.53). The duplicitous nature of the disorder makes it difficult to diagnose, and the tole it takes on an individual’s physical health makes its mortality rate the second highest among psychiatric disorders (Guinhut et al., 2021 p.130). Even if the correct education and resources are accessible to certain individuals, negative stigmatization about the disorder can make sufferers unlikely to seek help (Becker et al., 2010). Findings from analysis of …

County-Level Factors That Influenced The Trajectory Of Covid-19 Incidence In The New York City Area, Ashley Wendell Kranjac, Dinko Kranjac

Sociology Faculty Articles and Research

More than a century of research has shown that sociodemographic conditions affect infectious disease transmission. In the late spring and early summer of 2020, reports of the effects of sociodemographic variables on the spread of COVID- 19 were used in the media with minimal scientific proof attached. With new cases of COVID-19 surging in the United States at that time, it became essential to better understand how the spread of COVID-19 was varying across all segments of the population. We used hierarchical exponential growth curve modeling techniques to examine whether community socioeconomic characteristics uniquely influence the incidence of reported COVID-19 …

Neighborhoods Matter; But For Whom? Heterogeneity Of Neighborhood Disadvantage On Child Obesity By Sex, Ashley W. Kranjac, Catherine Boyd, Rachel T. Kimbro, Brady S. Moffett, Keila N. Lopez

Sociology Faculty Articles and Research

Although evidence suggests that neighborhood context, particularly socioeconomic context, influences child obesity, little is known about how these neighborhood factors may be heterogeneous rather than monolithic. Using a novel dataset comprised of the electronic medical records for over 250,000 children aged 2–17 nested within 992 neighborhoods in the greater Houston area, we assessed whether neighborhoods influenced the obesity of children differently based on sex. Results indicated that neighborhood disadvantage, assessed using a comprehensive, multidimensional, latent profile analysis-generated measure, had a strong, positive association with the odds of obesity for both boys and girls. Interactions revealed that the relationship between disadvantage …

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 …

Estimating The Impacts Of Acculturation On The Health Of Immigrants In The United States, Tingting He

Electronic Theses and Dissertations

The growth in the immigration population in the U.S. has transformed American demographic profile and has led to magnification in health disparities in the United States. The main purpose of this dissertation is to examine the relationship between acculturation and health behavior, mental health outcomes, and access to health care service among immigrants in the U.S. Relying on the acculturation framework, the dissertation intends to increase the understanding of health disparities and health patterns among immigrants. The dissertation utilizes the secondary data from National Health Interview Survey (NHIS) data to examine the effects of acculturation on health of immigrants. Measures …

Decomposing Differences In Coronavirus Disease 2019-Related Case-Fatality Rates Across Seventeen Nations, Ashley Wendell Kranjac, Dinko Kranjac

Sociology Faculty Articles and Research

As of 1 November 2020, estimated case-fatality rates associated with coronavirus disease 2019 are not uniformly patterned across the world and differ substantially in magnitude. Given the global spatial heterogeneity in case-fatality rates, we applied the Blinder-Oaxaca regression decomposition technique to identify how putative sociodemographic, structural, and environmental sources influence variation in case-fatality rates. We show that compositional and associational differences in country-level risk factors explain a substantial proportion of the coronavirus disease 2019-related case-fatality rate gap across nations. Asian countries fair better vis-à-vis case-fatality rate differences mainly due to variation in returns to sociodemographic, structural, and environmental sources among …

Practice-Based Learning: Medico-Legal Evidence Collection As Part Of Post-Rape Care In Refugee Contexts, Michael Gaitho, Ronald Kotut, Anne Ngunjiri, Jane T. Thiomi, Josephine Ngebeh, Chi-Chi Undie

Reproductive Health

Health care providers collect an array of documentation and specimens to support criminal investigations. Such documentation and specimens are referred to as “medico-legal” or “forensic” evidence, and in the case of rape, include a survivor’s documented injuries and emotional state at the time of examination, as well as samples and specimens from the survivor’s body or clothing. For survivors of rape and defilement who want to obtain legal justice, medico-legal evidence is critical. In African countries, health providers and the police are depended upon to ensure such evidence is collected, but medico-legal evidence collection can present challenges. Evidence-based interventions are …

Practice-Based Learning: Establishing Simple Monitoring Systems To Support Sgbv Programming In Refugee Settings, Chi-Chi Undie, Josephine Ngebeh, Jane Harriet Namwebya, Michael Gaitho, George Odwe, Nachela Chelwa, Harriet Birungi, Michael Mbizvo

Reproductive Health

Implementers of sexual and gender-based violence programs in refugee settings are typically eager to learn about the extent to which their programs are making a difference in the lives of those they serve. Basic monitoring information can help address this imperative without unduly burdening program implementers with time-consuming evaluations. The Sauti/VOICE project is guiding adaptation and implementation of evidence-based SGBV interventions in refugee contexts. These interventions are implemented by UNHCR partners in eight countries in the East, Horn, and Great Lakes region of Africa. Although Sauti/VOICE is primarily focused on integrating tested SGBV interventions into refugee contexts, monitoring the implementation …

Important Lessons On Fgm/C Abandonment From Four Research Studies In Egypt, Nada Wahba, Nahla G. Abdel-Tawab, Abeer Salem

Reproductive Health

Female genital mutilation/cutting (FGM/C) continues to be a widespread practice in Egypt. According to the 2014 Egypt Demographic and Health Survey, the prevalence of FGM/C was 92 percent among ever-married women aged 15–49. However, Egypt continues to witness a drastic surge in the medicalization of FGM/C, with 74 percent of women aged 19 years and younger circumcised by medical practitioners, compared to 55 percent in 1995. This policy brief provides key results and recommendations of four studies conducted by the Population Council/ Egypt under the Evidence to End FGM/C project, in coordination with Egypt’s National Population Council. The four studies …

Commentary: Using Law More Effectively Towards Abandonment Of Fgm/C In Kenya, Agnes K. Meroka-Mutua

Reproductive Health

Female genital mutilation/cutting (FGM/C) is considered a harmful cultural practice and a form of violence against women. Kenya has an FGM/C prevalence rate of 21 percent, but levels vary by ethnic group. Kenya has adopted a robust legal framework for the prohibition of FGM/C, including passage of the Prohibition of FGM Act in 2011, a detailed law that criminalizes carrying out FGM/C and associated offenses. Kenya relies on the human rights–based approach and criminalization in its legal framework for the prohibition of this practice. Despite extensive legal provisions, Kenya has prosecuted fewer than 100 cases, raising concerns with the law’s …

Lessons From A Five-Year Research Programme On Fgm/C And Their Relevance For Policy And Programmes In Kenya, Dennis Matanda, Agnes K. Meroka-Mutua, Samuel Kimani

Reproductive Health

The Sustainable Development Goals target the elimination of all forms of harmful practices, including female genital mutilation/cutting (FGM/C) by 2030. Kenya has made progress in addressing the elimination of FGM/C through ratification of global instruments and enactment of the Prohibition of FGM Act in 2011 and other supportive laws. The Act created the foundation for the establishment of the Anti-FGM Board, which provides policy leadership and coordination of anti-FGM/C programs in Kenya. More recently, the President of Kenya issued a decree for accelerated elimination of FGM/C by 2022. This synthesis report highlights how evidence generated over the last five years …

There Must Be Something In The Water: A Comparative Study Of Ground Water Contamination In The U.S.A. And Canada, Kathleen Spooner

Honors Theses

The regions of Nova Scotia and New Hampshire are naturally susceptible to arsenic water contamination due to their geological makeup. These locations are relatively rural, with many of their citizens reporting low incomes and lacking education, the majority of which are unaware of the risk of arsenic poisoning. There is also a high dependency on private wells which are not regulated in terms of water quality under federal law in both countries. Arsenic water pollution is undetectable as it is both odorless and tasteless and potentially very dangerous, and therefore water testing must be performed on wells, which is currently …

Myocardial Infarction And Treatment Adherence Rates Across Sociodemographic & Health Indicators, Deborah Shim, Ashley Wendell Kranjac

Student Scholar Symposium Abstracts and Posters

Trends on first myocardial infarction and rates of adherence to treatment across age were estimated. Data sourced from the National Health and Nutrition Examination Survey (NHANES), 1999-2016, were used to determine the patterned age trends of patients’ first myocardial infarction as well as their subsequent willingness to comply with treatments, such as weight loss. Demographic characteristics and socioeconomic status were taken into account and integrated as they play a key role in contextualizing and understanding these health trends. Preliminary historical trend analyses across 9 waves of data spanning 17 years indicate that patients are increasingly presenting with myocardial infarction earlier …

Two Implementation Models Of Workers' Health Education Programs In Egypt: What Works? What Doesn't Work?, Nahla G. Abdel-Tawab, Norhan Bader, Elizabeth Tobey, Aparna Jain

Reproductive Health

This brief presents findings from two models of workers’ health education programs implemented by the Evidence Project/Population Council in Egypt. The two interventions aimed to increase family planning (FP) service demand among young people aged 18–35 in Port Said and urban Souhag. In Port Said, male and female factory workers who were trained as peer educators shared family planning/reproductive health (FP/RH) information with fellow factory workers, distributed communication materials, and provided referrals to infirmary nurses trained in FP counseling. In Souhag, male and female peer educators were trained to provide integrated FP/RH and livelihood workshops to job seekers. Results of …

Abriendo Futuros: A Program For Rural Indigenous Girls In Yucatan, Mexico, Fabiola Romero, Ludivine Cicolella, Silvana Larrea, A. Fallone, Isabel Vieitez Martínez

Poverty, Gender, and Youth

The Abriendo Futuros (AF) program builds on the Council’s global experience of designing and implementing successful girl-centered programs in Africa, Asia, the Middle East, and Latin America and the Caribbean. AF aims to improve the living conditions of Mayan girls (10–18 years) and contribute to the achievement of gender equity in the Yucatan. The program’s community-focused strategy seeks to empower girls through interpersonal communication and participatory workshops. Girls in selected communities are divided into age groups (10–14 and 15–18) that meet weekly with a mentor in safe spaces. The program’s mentors are young women aged 20–30 from the communities, who …