Medicine and Health Commons^™

The Contribution Of Racism-Related Stress And Adversity To Disparities In Birth Outcomes: Evidence And Research Recommendations, Sabrina R. Liu, Laura M. Glynn

Psychology Faculty Articles and Research

Currently, racial and ethnic differences in adverse birth outcomes and infant mortality are some of the largest and most persistent health disparities in the United States. This narrative review article synthesizes existing literature to present a conceptual model of how racism-related stress and adversity are critical determinants of such disparities. We describe how historical and ongoing racism has created conditions wherein women of color are disproportionately exposed to chronic, multilayered stress and adversity and how the biological consequences of exposure to these stressors confers risk for adverse birth outcomes. Next, we identify important priorities and considerations for future research, including …

Policing And Health: Police Encounters As A Fundamental Cause Of Racial Health Disparities, Richard S. Carbonaro

Doctoral Dissertations

Structural racism has taken many forms throughout American history and to this day continues to drive social, economic, and health inequalities. Mass incarceration is a modern tool of social marginalization with well documented and deep-rooted racial inequalities. Research has continually shown that mass incarceration negatively impacts the health of disadvantaged communities. Even police stops, the most common and mundane form of criminal justice contact has been linked with deleterious health outcomes at the individual and community level. In this dissertation, I identify specific social and biological mechanisms connecting encounters with the police and health outcomes. In the first chapter, I …

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 …

Can I Buy My Health? A Genetically Informed Study Of Socioeconomic Status And Health, Jennifer W. Robinette, Christopher R. Beam, Tara L. Gruenewald

Psychology Faculty Articles and Research

Background

A large literature demonstrates associations between socioeconomic status (SES) and health, including physiological health and well-being. Moreover, gender differences are often observed among measures of both SES and health. However, relationships between SES and health are sometimes questioned given the lack of true experiments, and the potential biological and SES mechanisms explaining gender differences in health are rarely examined simultaneously.

Purpose

To use a national sample of twins to investigate lifetime socioeconomic adversity and a measure of physiological dysregulation separately by sex.

Methods

Using the twin sample in the second wave of the Midlife in the United States survey …

Self-Reported Health Among Sexual Minorities In The United States, Christopher Burton

Electronic Theses and Dissertations

Previous literature on LGBTQ+ people (lesbian, gay, bisexual, transgender, queer/questioning, and other sexual minorities) reports that this community experiences greater health problems than heterosexuals. LGBTQ+ people experience higher rates of chronic conditions, STIs, addiction, poor mental health, and cancer, which highlights the importance of capturing data regarding health. A growing concern is that social surveys fail to find meaningful ways to gather gender and sexuality data to understand possible health disparities for LGBTQ+ people. This study uses data from the General Social Survey to examine the physical and mental health outcomes of LGB people compared to straight people in a …

Addressing Diabetes Distress In Self-Management Programs: Results Of A Randomized Feasibility Study, Ranjita Misra, Samantha Shawley-Brzoska, Raihan Khan, Brenna O. Kirk, Sijin Wen, Usha Sambamoorthi

Journal of Appalachian Health

Background: West Virginia ranks 1st nationally in the prevalence of hypertension (HTN; 43.8%) and diabetes (16.2%). Patients with type 2 diabetes mellitus (T2DM) are distressed over physical and psychological burden of disease self-management.

Methods: This study investigated the effectiveness of an intervention to reduce diabetes distress and outcomes [glycemic control, blood pressure (BP)] among T2DM adults with comorbid HTN. Participants were randomized to a 12-week diabetes and hypertension self-management program versus a 3-month wait-listed control group. Trained health coaches and experts implemented the lifestyle program in a faith-based setting using an adapted evidence-based curriculum. Twenty adults with T2DM and HTN …

Neighborhood Safety Concerns And Daily Well-Being: A National Diary Study, Jennifer W. Robinette, Jennifer R. Piazza, Robert S. Stawski

Psychology Faculty Articles and Research

People living in unsafe neighborhoods often report poor health. The reasons for this are multi-faceted, but one possibility is that unsafe neighborhoods create a situation of chronic stress, which may deplete people's resources to cope with the daily stressors of life. How people respond to daily stressors (e.g., with increased self-reported negative affect and physical symptoms) is positively associated with health problems and may thus be one pathway linking perceptions of neighborhood safety to poor health. The current study investigated the relationship between neighborhood safety concerns, daily stressors, affective well-being, and physical health symptoms in a national sample of adults …

Black And White Health Disparities: Racial Bias In American Healthcare, Yasmeen Almomani

Bridges: An Undergraduate Journal of Contemporary Connections

This paper explores the historical implications of race in American society that have led to implicit racism in the healthcare system. Racial bias in healthcare against Black people is a factor in the health disparities between Black and white people in America, such as the gap in life expectancy, infant death, and maternal mortality. Black people are more likely to report racial discrimination from healthcare providers, which is a reason for the decreased quality of care received. The past justifications of slavery, the Tuskegee syphilis study, and the medical experimentations on Black women are horrifying but were considered acceptable in …

Science In Service Of Man: Towards An Understanding Of Medicine As An Institution Of Control, Amanda M. Strother

University Honors Theses

This paper applies the theoretical work of Frantz Fanon to discuss healthcare as an institution that upholds the will of the dominant authority in the contemporary United States. The use of Fanon's work outside of its original context is justified by applying the internal colonialism theory. Correctional healthcare is discussed as an area of overtly controlling and dehumanizing medical care, highlighting caregiver loyalty to correctional authority and reciprocal distrust between prison physicians and patients. This inquiry proposes that clinical healthcare displays the same power relationships through loyalty to the business of healthcare and the reciprocal distrust between physicians and patients …

The Medical Treatment Of Obesity: On The Page & In The Office, Shayla J. Staley

University of New Orleans Theses and Dissertations

This paper sought out the causes of weight discrimination in healthcare. Through content analysis of medical journals, the study illuminated several causes. These causes were used to create a concept matrix surrounding the medicalization of fatness that illustrated how these concepts are defined relationally, as well as how they combine to form the medical conception of the “obesity epidemic”. The concept matrix carries an indirect influence upon weight stigma that can lead to weight discrimination when fat folks seek out healthcare.

Racial And Ethnic Disparities In Opioid Use For Adolescents At Us Emergency Departments, Michael T. Phan, Daniel M. Tomaszewski, Cody Arbuckle, Sun Yang, Candice D. Donaldson, Michelle A. Fortier, Brooke Jenkins, Erik Linstead, Zeev N. Kain

Pharmacy Faculty Articles and Research

Background

Racial/ethnic disparities in the use of opioids to treat pain disorders have been previously reported in the emergency department (ED). Further research is needed to better evaluate the impact race/ethnicity may have on the use of opioids in adolescents for the management of pain disorders in the ED.

Methods

This was a cross-sectional study using data from the National Hospital Ambulatory Medical Care Survey from 2006 to 2016. Multivariate models were used to evaluate the role of race/ethnicity in the receipt of opioid agonists while in the ED. All ED visits with patients aged 11–21 years old were analyzed. …

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 …

Recovering From Substance Abuse In Arkansas: The Accessibility And Affordability Of Drug Treatment Programs, Whitney King

Graduate Theses and Dissertations

This thesis is going to examine how people recover from drug addiction and see if there are any similarities due to their socioeconomic statuses at the time of recovery. This research addresses the following questions: How accessible and affordable are drug addiction recovery programs and rehabilitation facilities in Arkansas for mid- to low-income individuals? What are the social costs for people who can’t obtain drug rehabilitation services? The goal of this research is to explore whether there is a lack of affordable recovery programs in the state of Arkansas. This project utilizes survey responses as well as in-depth interviews with …

The Relationship Between Perceived Neighborhood Disorder And Type 2 Diabetes Risk Across Different Racial/Ethnic Groups, Min Yu, Jennifer N. Robinette

Student Scholar Symposium Abstracts and Posters

Approximately 32 million Americans have Type 2 Diabetes and that number is growing rapidly. Type 2 Diabetes is sensitive to environmental factors, and higher prevalence rates are often observed in disordered neighborhoods (i.e., those with more trash and vandalism). Through discriminatory practices such as redlining, racially restrictive covenants, urban renewal, and gentrification, marginalized racial/ethnic groups are more likely to live in disordered neighborhoods compared to non-Hispanic Whites. These disparities may also contribute to similar disparities in Type 2 Diabetes rates. Yet, research indicates that there may be racial/ethnic differences in the interpretation of neighborhood disorder as a threat to health …

Contextualizing The Health Of U.S. Farmworkers, Gabrielle Hyde

Undergraduate Theses, Capstones, and Recitals

Farmworkers often exist in vulnerable social and occupational positions that make accessing health care a challenge. This literature review seeks to outline the health of U.S. farmworkers in the context of these vulnerabilities through a review of the existing literature. It provides a short background to understand how we have become reliant on immigration to feed our nation and to give a snapshot of where these farmworkers come from and what their health concerns are. A key topic in this literature review is the social context of these health burdens including the attitudes of providers, farmworker’s perceptions of their own …

Examining The Impact Of Socioeconomic Variables On Covid-19 Death Rates At The State Level, James L. Doti

Economics Faculty Articles and Research

This study uses a step-wise regression model to identify the socioeconomic variables most significant in explaining COVID-19 death rates on a state-level basis. The regression tests cover the 1/1/2020 to 12/1/2020 period as well as the first and second halves of 2020. This study also uses the Oxford stringency index to measure more precisely the efficacy of governmental mandates at the state level. The results in this study rigorously showed that while the density variables were the most significant explanatory variables during the first half of the year, their significance fell during the second half. Use of the Oxford stringency …

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 …

Child Obesity Moderates The Association Between Poverty And Academic Achievement, Ashley W. Kranjac, Dinko Kranjac

Sociology Faculty Articles and Research

Childhood overweight and obesity are major public health problems in the United States. Children who experience poverty are 1.5 times more likely to suffer with overweight and 1.6 times more likely to have obesity. The extent to which overweight or obesity exacerbates the negative influence of socioeconomic inequality on child academic outcomes has not yet been examined. We estimated the effect of poverty on math and reading achievement trajectories using the Early Childhood Longitudinal Study (ECLS) Kindergarten class of 1998−1999 survey data and multilevel growth curve modeling techniques. Our findings indicate that the impact of obesity status is more pronounced …

Review Of Let Us Dream: The Path To A Better Future, Bill Droel

The Journal of Social Encounters

No abstract provided.

Battle For The Bible, Battle For The Soul Of Humanity, Patricia M. Mische

The Journal of Social Encounters

No abstract provided.

After Covid-19: Mitigating Domestic Gender-Based Violence In Egypt In Times Of Emergency, Diana Magdy, Hind Ahmed Zaki

Faculty Journal Articles

In times of crises and emergencies, violence against women tends to increase. The outbreak of COVID-19 has resulted in severe precautionary measures such as social isolation, physical distancing, staying at home, curfews and lockdowns, which brought “normal” life to a halt and created a temporary convergence between the public and the private. The pandemic has forced the global community to turn its gaze back to the private, and compelled them to pay attention to the old/new problem of gender-based violence, particularly, domestic violence that spiked during the pandemic. Against such a backdrop, and using a critical feminist lens that analyzes …

Executive Summary- Social Protection In Egypt: Mitigating The Socio-Economic Effects Of The Covid-19 Pandemic On Vulnerable Employment, Dina Makram-Ebeid, Amr Adly, Nadine Sika, Hania M Sholkamy, Samer Atallah

Faculty Journal Articles

This is the executive summary of an interdisciplinary project between the fields of development economics, political economy, labor sociology, development anthropology and public health. It reviews the social protection available to vulnerable employees and their households in Egypt and suggests ways to adapt them in light of the COVID 19 pandemic. The research focuses on four areas a) employment security b) social assistance c) health insurance d) gendered mitigations. The project will map the impact of the crisis on vulnerable employees and their households and propose policy interventions to alleviate the socio-economic effects of the pandemic through the publication of …

Healthcare Of Indigenous Amazonian Peoples In Response To Covid-19: Marginality, Discrimination And Revaluation Of Ancestral Knowledge In Ucayali, Peru, Doreen Montag, Marco Barboza, Lizardo Cauper, Ivan Brehaut, Isaac Alva, Aoife Bennett, José Sanchez-Choy, Juan Pablo Sarmiento Barletti, Pilar Valenzuela, José Manuyama, Italo García Murayari, Miguel Guimaraes Vásquez, Celso Aguirre Panduro, Angela Giattino, Edwin Julio Palomino Cadenas, Rodrigo Lazo, Carlos A. Delgado, Alfonso Nino, Elaine C. Flores, Maria Amalia Pesantes, Juan Pablo Murillo, Luisa Elvira Belaunde, Sergio Recuenco, Robert Chuquimbalqui, Carol Zavaleta-Cortijo

World Languages and Cultures Faculty Articles and Research

"Systematic and persistent discrimination against Indigenous Peoples translates into differential health outcomes when analysed through ethnicity and/or mother tongue.1 In Peru, morbidity and mortality rates among Indigenous Peoples for COVID-19 appear to confirm this.2 The COVID-19 pandemic has highlighted the historical structural violence against Indigenous Peoples that currently takes a disproportionate toll in the Peruvian Amazon. This equally applies to Indigenous Andean Peoples and Afro Peruvians. Indigenous Peoples in voluntary isolation and those in initial contact are at highest health risk in this pandemic as they have no previous immunity against common infectious diseases, and lack access to public healthcare …

Neither “Post-War” Nor Post-Pregnancy Paranoia: How America’S War On Drugs Continues To Perpetuate Disparate Incarceration Outcomes For Pregnant, Substance-Involved Offenders, Becca S. Zimmerman

Pitzer Senior Theses

This thesis investigates the unique interactions between pregnancy, substance involvement, and race as they relate to the War on Drugs and the hyper-incarceration of women. Using ordinary least square regression analyses and data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates, I examine if (and how) pregnancy status, drug use, race, and their interactions influence two length of incarceration outcomes: sentence length and amount of time spent in jail between arrest and imprisonment. The results collectively indicate that pregnancy decreases length of incarceration outcomes for those offenders who are not substance-involved but not evenhandedly -- benefitting white …

Survey Deficiencies As Quality Indicators In Oregon Assisted Living Communities, Ozcan Tunalilar, Sunny C. Lin, Paula C. Carder

Institute on Aging Publications

Background and Objectives License inspection data have commonly been used as a quality measure for nursing homes but has not yet been used to assess the quality of assisted living/residential care (AL/RC) communities. Drawing on resource dependency theory, we test the hypothesis that structural and environmental characteristics influence AL/RC quality as measured by deficiency citations (“deficiencies”) issued during license inspections.

Research Design and Methods Using data from 526 licensed AL/RC communities in Oregon that received a license inspection visit between 2008 and 2016, we examined the prevalence of deficiencies by type and year. We estimated regression models to identify structural …

Other People’S Families: How Social Ties Shape Entrance Into The Medical Profession, Lillian Sims

Theses and Dissertations--Educational Policy Studies and Evaluation

Not enough members of low-income, rural, and minoritized populations are successfully prepared for and recruited into medical school, exacerbating issues of unequal access to healthcare and limiting access to the profession. While a multitude of factors contribute to this problem, early social exposure to others in a field can act as a key contributor to career interest and a key advantage for entering the profession. Meanwhile, students without early social exposure to healthcare may take unconventional paths to medical school or may struggle to fit into the unique culture of medicine when they do enter training, especially if they belong …