Medicine and Health Commons^™

Inter-Institutional Analysis Of Skin Of Color Representation In Dermatological Lecture Content At Md And Do Medical Schools, Oluwafunke Oluwatosin Ogunremi, Blake Fredericksen, John Komas, Sana Ismail, Siri Knutsen-Larson Md, Valeriy Kozmenko Md, Afia Albin Do

Aesculapius Journal (Health Sciences & Medicine)

The purpose of this study was to analyze the lecture materials provided in medical schools through a diversity lens. Skin pathologies manifest distinctively on various shades of skin and physicians must be equipped with the proper knowledge to identify and diagnose these conditions accurately and promptly. For most medical students, images in prominent textbooks and lecture slides are their first encounter with disease presentations. Therefore, it is important to analyze the diversity of skin tones in the content that is being delivered. Specifically, the use of images featuring darker skin tones compared to those depicting lighter skin tones. This study …

Impact Of Social Determinants Of Health On Healthcare Disparities In Florida, Kayla L. Haydon, Catarina Jim, Joel J. Mantilla, Noel C. Barengo

American Journal of Non-Communicable Diseases

Objective

Healthcare disparities disproportionately affect underserved and marginalized communities due to social determinants of health (SDoH), contributing to significant differences in health outcomes and life expectancy within different communities in Florida. This observational study aimed to understand the impact of SDoH, such as race/ethnicity, income level, and education attainment on healthcare access in Florida.

Methods

Self-reported data from the 2020 Behavioral Risk Factor Surveillance System were pooled to evaluate disparities in healthcare access by race/ethnicity, income, and education level in Florida.

Results

Health status and healthcare access vary based on characteristics related to SDoH, including race/ethnicity, income level, and educational …

Perceived Neighborhood Disorder And Type 2 Diabetes Disparities In Hispanic, Black, And White Americans, Min Ying Yu, Alfredo J. Velasquez, Belinda Campos, Jennifer W. Robinette

Psychology Faculty Articles and Research

Introduction: Approximately 32 million Americans have type 2 diabetes, and that number continues to grow. Higher prevalence rates are observed among certain subgroups, including members of marginalized racial/ethnic groups as well as residents of disordered neighborhoods (i.e., those with more trash and vandalism). Institutionalized discriminatory practices have resulted in disproportionate representation of marginalized racial/ethnic groups in disordered neighborhoods compared to non-Hispanic Whites. These neighborhood disparities may partially contribute to health disparities, given that signs of neighborhood disorder often relate to a general withdrawal from the neighborhood, minimizing opportunities for both physical and social engagement. Yet, research suggests variability across …

Parabens Promote Protumorigenic Effects In Luminal Breast Cancer Cell Lines With Diverse Genetic Ancestry, Jazma L. Tapia, Jillian C. Mcdonough, Emily L. Cauble, Cesar G. Gonzalez, Dede K. Teteh, Lindsey S. Treviño

Health Sciences and Kinesiology Faculty Articles

Context

One in 8 women will develop breast cancer in their lifetime. Yet, the burden of disease is greater in Black women. Black women have a 40% higher mortality rate than White women, and a higher incidence of breast cancer at age 40 and younger. While the underlying cause of this disparity is multifactorial, exposure to endocrine disrupting chemicals (EDCs) in hair and other personal care products has been associated with an increased risk of breast cancer. Parabens are known EDCs that are commonly used as preservatives in hair and other personal care products, and Black women are disproportionately exposed …

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 …

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 …

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. …

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 …

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: …

The Role Of Ethnicity And Nativity In The Correspondence Between Subjective And Objective Measures Of In-Home Smoking, Vincent Berardi, Georgiana Bostean, Lydia Q. Ong, Britney S. Wong, Bradley N. Collins, Melbourne F. Hovell

Psychology Faculty Articles and Research

Studies are needed to understand the association between self-reported home smoking bans and objective measures of in-home smoking according to smokers’ ethnicity/nativity. Data came from a trial that used air particle monitors to reduce children’s secondhand smoke exposure in smokers’ households (N = 251). Linear regressions modeled (a) full home smoking bans by ethnicity/nativity, and (b) objectively measured in-home smoking events, predicted by main and interaction effects of self-reported home smoking bans and ethnicity/nativity. Among smokers reporting < a full ban, US-born and Foreign-born Latinos had fewer in-home smoking events than US-born Whites (p < 0.001). Participants who reported a full smoking ban had a similar frequency of smoking events regardless of ethnicity/nativity. Results indicate that self-reported home smoking bans can be used as a proxy for in-home smoking. Establishing smoking bans in the households of US-born White smokers has the largest impact on potential exposure compared to other ethnicity/nativity groups.

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 …

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 …

Moving Past The Binary: Transgender And Gender Non-Conforming Students’ Experiences Of And Perspectives On College Campus Fitness Centers, Rachel E. Petterson

Honors Projects

Transgender and gender non-conforming (TGNC) people face various mental and physical health disparities. Despite this, spaces related to health and wellness are not always inclusive. Similarly, college campuses are often not as inclusive or accommodating as they should be. This study looks at the experiences of TGNC students at campus fitness centers. Through both quantitative and qualitative data gathered through an online survey, it aims to better understand the following: the presence of inclusive facilities; the perceived importance of facility variables; use of campus fitness facilities by TGNC students; what improvements they would like to see; and how any of …

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 …

Discordance In Perceptions Of Barriers To Breast Cancer Treatment Between Hispanic Women And Their Providers, Swapna Reddy, Mary Saxon, Nina Patel, Matthew Speer, Tiffany Ziegler, Nirali Patel, Madison Ziegler, Stephany Esquivel, Andrea Daniella Mata, Asha Devineni, Pooja Paode, Nitika Thawani, Subhakar Mutyala

Journal of Patient-Centered Research and Reviews

Despite comparable screening and incidence rates that are 26% below that of non-Hispanic Whites, Hispanic women present with breast cancer at more advanced stages of disease, representing a continuing and troubling health disparity for this population. Reducing these disparities warrant more innovative research approaches to better understand perspectives of Hispanic patients regarding barriers to treatment and how these perspectives compare to those of their providers. A pilot qualitative study was conducted at a major urban cancer center in Arizona that measured both patient and provider perspectives regarding barriers to treatment. Through a multimethod qualitative analysis, researchers surveyed patients and providers …

Covid-19 Treatment Resource Disparities And Social Disadvantage In New York City, Jason A. Douglas, Andrew M. Subica

Health Sciences and Kinesiology Faculty Articles

Black and Hispanic communities in the U.S. have endured a disproportionate burden of COVID-19-related morbidity and mortality. Racial and ethnic health disparities such as these are frequently aggravated by inequitable access to healthcare resources in disadvantaged communities. Yet, no known studies have investigated disadvantaged communities' access to COVID-19-related healthcare resources. The current study accordingly examined racial and ethnic differences in (1) April 2020 COVID-19 total and positive viral test rates across 177 New York City (NYC) ZIP Code Tabulation Areas (ZCTA); and (2) November 2019–April 2020 licensed and intensive care unit (ICU) hospital bed access across 194 NYC ZCTAs. Pairwise …

The Intergenerational Transmission Of Discrimination: Children’S Experiences Of Unfair Treatment And Their Mothers’ Health At Midlife, Cynthia G. Colen, Qi Li, Corinne Reczek, David R. Williams

Department of Sociology: Faculty Publications

A growing body of research suggests that maternal exposure to discrimination helps to explain racial disparities in children’s health. However, no study has considered if the intergenerational health effects of unfair treatment operate in the opposite direction—from child to mother. To this end, we use data from mother-child pairs in the National Longitudinal Survey of Youth 1979 to determine whether adolescent and young adult children’s experiences of discrimination influence their mother’s health across midlife. We find that children who report more frequent instances of discrimination have mothers whose self-rated health declines more rapidly between ages 40 and 50 years. Furthermore, …

How Professional Physical Therapist Education Programs Develop Cultural Competence Within Their Students: An Exploratory Concurrent Mixed Methods Study, Dustin E. Domingo

Dissertations

Purpose: The purpose of this exploratory concurrent mixed methods study was to describe experiences that shape the factors of cultural intelligence (CQ) as perceived by students of professional physical therapist education programs. In addition, it was the purpose of this study to determine whether any particular factor of cultural intelligence influenced one’s overall cultural competence according to the cultural competence continuum by Cross et al. (1989).

Methodology: Students in a professional physical therapist education program completed a questionnaire, which included Likert scale questions, open ended questions, and a 37-item self-assessment based on the expanded cultural intelligence scale by Van Dyne …

Ecological Determinants Of Respiratory Health: Examining Associations Between Asthma Emergency Department Visits, Diesel Particulate Matter, And Public Parks And Open Space In Los Angeles, California, Jason A. Douglas, Reginald S. Archer, Serena E. Alexander

Health Sciences and Kinesiology Faculty Articles

Los Angeles County (LAC) low-income communities of color experience uneven asthma rates, evidenced by asthma emergency department visits (AEDV). This has partly been attributed to inequitable exposure to diesel particulate matter (DPM). Promisingly, public parks and open space (PPOS) contribute to DPM mitigation. However, low-income communities of color with limited access to PPOS may be deprived of associated public health benefits. Therefore, this novel study investigates the AEDV, DPM, PPOS nexus to address this public health dilemma and inform public policy in at-risk communities. Optimized Hotspot Analysis was used to examine geographic clustering of AEDVs, DPM, and PPOS at the …

Higher Quality At Lower Cost: Community Health Worker Interventions In The Health Care Innovation Awards, Caitlin Cross-Barnet, Sarah Ruiz, Megan Skillman, Rina Dhopeshwarkar, Rachel Singer, Rachel Carpenter, Suzanne Campanella, Maysoun Freij, Lynne Snyder, Erin Colligan

Journal of Health Disparities Research and Practice

Background: Published evidence regarding cost savings, reduced utilization, and improved quality associated with employing community health workers (CHWs) is largely lacking. This paper presents findings from the Centers for Medicare & Medicaid Services Health Care Innovation Awards (HCIA), with a focus on six diverse programs that employ CHWs. We examine outcomes associated with programs incorporating CHWs into care teams for a broad age range of patients with various health issues such as cancer, asthma, and complex conditions.

Methods: This mixed-methods study used data from claims and site visits to assess the effectiveness of CHW programs. In difference-in-differences analyses of Medicare …

Social Determinants Of Health Associated With Hbv Testing And Access To Care Among Foreign-Born Persons Residing In The United States: 2009 - 2012, Kevin M. Greene, Wayne A. Duffus, Jian Xing, Hope King

Journal of Health Disparities Research and Practice

Objectives: To describe how select Social Determinants of Health (SDH) are associated with the burden of hepatitis B virus (HBV) infection among foreign-born persons residing in the United States.

Methods: Multivariate logistic regression was used to examine the Racial and Ethnic Approaches to Community Health (REACH) 2010 Risk Factor Survey data to investigate the independent relationship between SDH and HBV testing and access to care.

Results: HBV infected persons with insurance were more likely to see a physician than those without. Respondents worried about money to pay rent or mortgage were more likely to report HBV infection than …

Ethnicity Matters: Implications For Understanding And Acting Upon Disparities In Health Affecting Black Men In The United States, Helen V. S. Cole

Dissertations, Theses, and Capstone Projects

Compared to non-Hispanic whites, non-Hispanic blacks have higher rates of mortality from heart disease, cancer, cardiovascular disease, and HIV/AIDS. Black men have a life expectancy approximately 4.7 years than the life expectancy of non-Hispanic white men, due in part to higher prevalence of chronic disease among black men. Many factors are hypothesized to contribute to disparities in health between races, including differences in socioeconomic status; culturally-linked behaviors such as diet, substance use, and physical activity; access to quality healthcare and other resources; and experiences of racism, both institutional and interpersonal. However, in public health research, race is usually treated as …

Ethnic Differences In Medicinal Plant Use Among University Students: A Cross-Sectional Survey Of Self-Reported Medicinal Plant Use At Two Midwest Universities, Rachel Craft, Katrina C. Mcclure, Steven Corbett, Maria Pontes Ferreira, Ashley M. Stiffarm, Kelly Kindscher

Wayne State University Associated BioMed Central Scholarship

Background: Numerous surveys of medicinal plant use among college students abound, but none compare use between students enrolled in two different Universities with significantly different ethnic compositions. The objective of this study is to compare medicinal plant use between two different ethnic college populations and explore differences between student medicinal plant users and non-users for comparison with previous research.

Methods: Students (n = 721) at a large research university (n = 498) and a Pan-Tribal University for Native Americans (n = 233) completed surveys in October 2011 to assess past year medicinal plant use. The Mann-Whitney U test, Chi Square …

Unequally Distributed Psychological Assets: Are There Social Disparities In Optimism, Life Satisfaction, And Positive Affect?, Julia K. Boehm, Ying Chen, David R. Williams, Carol Ryff, Laura D. Kubzansky

Psychology Faculty Articles and Research

Socioeconomic status is associated with health disparities, but underlying psychosocial mechanisms have not been fully identified. Dispositional optimism may be a psychosocial process linking socioeconomic status with health. We hypothesized that lower optimism would be associated with greater social disadvantage and poorer social mobility. We also investigated whether life satisfaction and positive affect showed similar patterns. Participants from the Midlife in the United States study self-reported their optimism, satisfaction, positive affect, and socioeconomic status (gender, race/ethnicity, education, occupational class and prestige, income). Social disparities in optimism were evident. Optimistic individuals tended to be white and highly educated, had an educated …

What You Don’T Know Can Hurt You: Early Life Course Racial Health Disparities In Undiagnosed Diabetes, Anna C. Bellatorre

Department of Sociology: Dissertations, Theses, and Student Research

This dissertation addresses several issues related to racial health disparities in undiagnosed diabetes in American young adults in a three-article format. The first chapter examines rates of diabetes severity across age-matched samples of young adults from two large nationally representative studies. Although the purpose of this study was to explore the impact of nonresponse on prevalence estimates, I find that the prevalence discrepancies have less to do with which respondents are missing blood samples and more to do with the samples coming from initial samples that are not equivalent.

The second chapter uses an adaptation of the Stress Process Model …

Challenging Inequality: Professor Fernando De Maio Explores The Statistics Behind Health Disparities

DePaul Magazine

According to the World Health Organization's commission on the social determinants of health, "reducing health inequalities is ... an ethical imperative. Social injustice is killing people on a grand scale." Fernando De Maio, associate professor of sociology at DePaul University, explores this concept by examining avoidable health inequalities in the global sphere. He uses sociological methods to analyze empirical data and hopes statistics can be used to bring about policy change.

Structure Matters: Examining Illness Behavior Using Parsons's Sick Role, Angela D. Byrd

Masters Theses & Specialist Projects

Although Talcott Parsons’s sick role theory, as described in 1951 in The Social System, has been severely criticized for its inapplicability to chronic illnesses, a portion of the theory is still a relevant and necessary factor in terms of understanding and treating chronic illness today. Using data from the 2012 National Health Interview Survey, this study looks at the individual effects of sex, age, race, cohabitation, education and region of residence on the likelihood of chronically ill patients considering themselves limited in their amount or kind of work as an indicator of sick role adaptation. Results show statistically significant relationships …

Health Disparities As We Age: A Life Course Comparison Of Canadian Early Boomers With Pre-Boomers, Susan Mcdaniel, Amber Gazso, Hugh Mccague, Ryan Barnhart

Population Change and Lifecourse Strategic Knowledge Cluster Discussion Paper Series/ Un Réseau stratégique de connaissances Changements de population et parcours de vie Document de travail

Despite a large and growing research literature documenting health disparities by socio-economic status (SES) and income inequalities, research on how these relationships play out moving from mid to later life is meager. Even less is known about how the early Baby Boom cohort compares with the Pre-Boomer cohort as they age in a period of accelerating inequalities, where the wealthy are becoming wealthier and the incomes of those in the middle and at the bottom are stagnating. In this paper, we follow individuals in two cohorts, those born 1947-1951 and those born 1932-36 over the period covering eight cycles of …

Racial Differences In Preventive And Complementary Health Behaviors And Attitudes, Steven E. Shive, Grace X. Ma, Yin Tan, Jamil I. Toubbeh, Lalitha Parameswaran, Lalitha Parameswaran, Joe Halowich

Journal of Health Disparities Research and Practice

Screening tests have been developed for many diseases—the presence of cancer, especially—but are differentially utilized among racial/ethnic groups. In addition to standard medical screening techniques, some patients opt to use Complementary and Alternative Medicine (CAM) for prevention and treatment. The purpose of the current study is to examine racial/ethnic disparities in primary and secondary preventive health behaviors, determine differences in use of complementary and alternative health regimens, and determine which health attitudes and health self-management factors are associated with use of complementary alternative medicine. If differences among ethnic/racial groups in perceived health status, preventive health care behaviors, and use of …

Transdisciplinary Approaches To Ameliorating Racial Disparities In Prostate Cancer Outcomes, Chanita H. Halbert, Katrina Armstrong, John Holmes, David Fenstermacher, Janet Weiner, Carmen Guerra, J. S. Schwartz, Jerry C. Johnson, Edmund Weisberg, Chantal Montagnet, Benita Weathers, Charnita Zeigler-Johnson, Ernestine Delmoor, Timothy R. Rebbeck

Journal of Health Disparities Research and Practice

Though prostate cancer is the second leading cause of cause cancer deaths among men in the US, it ranks first among African American men in terms of incidence, morbidity, and mortality. To address this and other complex health issues, some researchers advocate transdisciplinary research as a framework for analysis; however, few examples exist that indicate how the framework should be applied. This report uses prostate cancer outcomes as a paradigm to describe how such a framework can be used to identify determinants of racial disparities. By integrating diverse scientific disciplines, methods, and analytic approaches from psychology, sociology, epidemiology and genetics, …