Digital Commons Network^™

From Fields To Flu: Mapping H5n1 Zoonotic Risk In California Rice Fields, Mariati Messinger

Walden Dissertations and Doctoral Studies

Highly Pathogenic Avian Influenza (HPAI) H5N1 threatens agriculture, wildlife, and public health in California, where flooded rice fields in the Central Valley provide surrogate wetland habitat for migratory waterfowl and may create ecological interfaces for viral spillover into poultry systems. This quantitative ecological study examined whether county-level rice acreage, Lesser Snow Goose activity, and their interaction were associated with poultry HPAI H5N1 outbreak incidence during complete winter seasons available for analysis. Guided by One Health and disease ecology frameworks, secondary data from USDA, eBird, PRISM, and public surveillance sources were analyzed for 36 county-winter observations using negative binomial regression, logistic …

Spatiotemporal Patterns Of Vaccine Uptake For Measles Outbreaks In Katsina State, Nigeria, Zeenat Kabir Asma'i

Walden Dissertations and Doctoral Studies

Measles remains a public health concern in Nigeria despite the availability of effective vaccines, yet limited research has comprehensively examined spatiotemporal patterns and contextual determinants of vaccination coverage and measles incidence in Katsina State. Guided by the socioecological model, this quantitative ecological study examined spatiotemporal patterns of measles incidence among children aged 9–59 months of age across 183 wards in 34 local government areas of Katsina State, Nigeria, from 2018 to 2022. Confirmed cases (n = 376) were analyzed using negative binomial regression and spatial methods, including Moran’s I, SaTScan, and geographically weighted regression (GWR). Urban wards had higher incidence …

The Relationship Between Access To Basic Safe Drinking Water And Under-Five Mortality In Indonesia: An Ecological Study, Jasmin Jadevra Fezantino, Raquel Amanda Salmasari, Hanania Carrisa, Zahra Annisaa Hudaya

Jurnal Nasional Kesehatan Lingkungan Global

Infant mortality remains a worrying public health issue, particularly in areas with poor access to drinking water and sanitation. In 2020, Papua Province recorded an infant mortality rate of 49.04 per 1,000 live births and West Papua 47.23. These figures are far above the national average. This study aims to determine the relationship between access to safe drinking water and infant mortality rates in provinces in Indonesia. This study used an ecological design with secondary data from the 2023 Indonesian Health Survey and the 2023 Directorate of Public Health. The analysis was descriptive and followed by a Spearman correlation test. …

Spatial Mapping Of Malaria Cases And Risk Factors Of Its Spread In West Java Province In 2019: An Ecological Study, Nazhira Haliza Putri, Azkia Afiatun Najah Wahyudi, Suhayla Bilqisth Abdi, Mutmainnah Mutmainnah, Nasywan Grananda Rahmantoro, Grace Napitupulu

Jurnal Nasional Kesehatan Lingkungan Global

Malaria is a significant health problem in Indonesia, especially in West Java Province which is at high risk due to its population density and environmental conditions. The incidence of malaria is associated with climate factors (rainfall, humidity, and air temperature). This study aims to study the spatial mapping of malaria cases and their relationship with climate factors. This study used an ecological study design. Secondary data from the West Java Health Office and the West Java Central Statistics Agency in 2019. Univariate and bivariate analysis with the study population covering the entire population of West Java, with a sample of …

Patterns And Determinants Of Measles Among Suspected Cases In Jakarta: Insight From Surveillance Data 2022-2024, Widya Inayah, Nurhayati Adnan Prihartono, Retno Henderiawati, Oktaviana Nugraheni, Dwi Gayatri

Jurnal Epidemiologi Kesehatan Indonesia

Measles remains a public health concern in Indonesia, including Jakarta, contributing to the country’s disease burden. Sustained transmission during 2022-2024, despite reported vaccination coverage above  90%, suggests the presence of vulnerable groups. This study aimed to describe patterns and identify factors associated with laboratory-confirmed measles in Jakarta during 2022-2024. A cross-sectional study was conducted using routine surveillance data from all individuals reported as suspected measles cases during the study period. Descriptive analysis summarizes the distribution, while multivariable analysis identifies associated factors. Of the 4,194 suspected cases of measles, 22.8% were laboratory-confirmed positive. Showed a fluctuating temporal pattern, increasing from 20.6 …

Quantifying Black Carbon Concentrations In Georgia And Analyzing Associated Public Health Risks, Khloe R. Osborne

Honors Theses

Quantifying Black Carbon Concentrations in Georgia and Analyzing Associated Public Health Risks

One of the most daunting challenges of the industrial world is air pollution. Within this broad spectrum, there is an inhalable particle group named PM2.5, which contains black carbon. Black carbon has evidence that supports the generation and worsening of adverse health impacts, which may include birth complications, cognitive deficits in children, pulmonary aggravation, asthma, cardiovascular issues, neurological degenerative patterns, and cancer risk. This is especially seen in vulnerable populations, like children, elderly, and those who already suffer from weakened health, many of which reside in the southern …

Spatial Distribution Patterns Of Determinants Of Hypertension In West Java In 2023, Meirina Nur Asih Susanti, Wahyu Septiono

Preventia: The Indonesian Journal of Public Health

Hypertension is a public health issue that is unevenly distributed across regions. The high prevalence in West Java (34.4%) with a large population makes the management of hypertension crucial. Differences in economic and environmental conditions are thought to influence the distribution of hypertension, thus requiring spatial analysis. This study used an ecological approach by analyzing data from districts/cities in West Java in 2023. Secondary data were used to measure hypertension prevalence and to assess socioeconomic and environmental factors. The analysis was conducted using univariate Moran's Index, Local Indicators of Spatial Association (LISA), and the Spatial Autoregressive Model (SAR). The prevalence …

Using Geospatial Environmental And Income Variables As Predictors Of Diabetes In Appalachia, John Kunicki Huth

Walden Dissertations and Doctoral Studies

Diabetes remains disproportionately prevalent in Appalachia, and macroenvironmental contributors remain poorly understood. Guided by spatial epidemiology, this quantitative, cross-sectional ecological study examined whether county-level environmental factors including distance to mine, distance to landfill, distance to water, mean annual precipitation, mean annual temperature, forest classification, distance to impervious surface, and median income were independently and collectively associated with diabetes cases per capita in West Virginia, used as a surrogate for Appalachia. Research questions addressed environmental predictors of diabetes cases per capita with and without controlling for median income. Publicly available county-level data from 53 West Virginia counties representing adults aged 20 …

Space-Time Analysis Of Burgeoning Us Atrial Septal Defect Rates Driven By Cannabis, Albert Stuart Reece, Kenneth Hulse

Research outputs 2022 to 2026

Atrial septal defect (ASD) has become increasingly common in the USA and now affects 1 in 11.3 children in some places, but space–time analysis has not been applied to this emerging trend. ASD rate (ASDR) data were obtained from the National Birth Defects Prevention Network 2003–2020. Substance (cigarettes, alcohol, cannabis, analgesics, cocaine) use data were obtained from the National Survey of Drug Use and Health. Income data were obtained from the US Census. Analysis was limited to the Non-Hispanic White population by technical factors. Time-sequential univariate and bivariate maps were prepared for both covariates and outcomes and their combinations. Spatial …

Impact Of Cannabis And Cannabis Legalization On Us Atrial Septal Defect Rates, Albert Stuart Reece, Hulse

Research outputs 2022 to 2026

Atrial septal defect (ASD) affects 1:11.3 children in some US states; however, the antecedents of these trends are yet to be identified. A total of 1882 ASD rates (ASDRs) for 2003–2020 were sourced from the National Birth Defects Prevention Network reports. A total of 406,893 ASDs are reported. Substance (cigarettes, binge alcohol, cannabis, cannabinoids, analgesics, cocaine) exposure data were taken from the National Survey of Drug Use and Health. Income and ethnicity data were derived from the US Census. Adjustment was performed by mixed effects, survey and generalized additive regression. Causal analysis was by inverse probability weighting and E-values. Data …

Quality Of Prenatal Care, Provider Preference, And Preeclampsia Among African American Women In Georgia, Lyteasha Bass

Walden Dissertations and Doctoral Studies

African American women experience disproportionately high rates of preeclampsia in the United States; however, the contributions of prenatal care provider type, health care access, and quality of care to this disparity were insufficiently defined. Guided by the quality health outcomes model, this quantitative case-control study used primary data to examine associations between these factors and the occurrence of preeclampsia among African American women age 18–40 who had given birth within the previous 5 years in Georgia. Descriptive statistics and binary and multinomial logistic regression analyses were conducted. Prenatal care quality was measured using the Quality of Prenatal Care Questionnaire (QPCQ), …

Environmental Predictors Of Human Lyme Disease Incidence Across Appalachian Counties In Kentucky, Virginia, And West Virginia, 2000-2019, Karlie D. Rennison

Theses and Dissertations--Epidemiology and Biostatistics

This ecological study examined county-level environmental, landscape, and host-related predictors of Lyme disease incidence across Kentucky, Virginia, and West Virginia from 2000-2019. Lyme disease is an emerging public health concern in the Appalachian region, where geographic expansion and shifting ecological conditions may influence disease risk.

Lyme disease case rates (per 10,000 population) were analyzed in relation to climate variables, land cover metrics, host density measures, and rurality using publicly available data sources. Descriptive and regression analyses were conducted to evaluate associations between candidate predictors and disease incidence.

Substantial geographic variation in Lyme disease incidence was observed, with higher case rates …

Understanding The Syphilis Resurgence Among Females Of Childbearing Age: Informing Prevention Efforts In New York State, Salvatore Currenti

Electronic Theses & Dissertations (2024 - present)

Syphilis is caused by Treponema pallidum and transmitted through direct contact with infected mucosal lesions and via vertical transmission during pregnancy (i.e., congenital). Transmission of syphilis to an infant during pregnancy (i.e., congenital syphilis [CS]) can lead to early fetal death, stillbirth, neonatal death, preterm birth, low birthweight, and congenital infection in infants. The United States (U.S.) is experiencing epidemic increases in both females of reproductive age with syphilis and infants with CS. In New York State (NYS), these trends have also occurred, especially after COVID-19 emergence, and increases in reported cases and incidence rates are comparable to national statistics. …

Prenatal Exposure To Nicotine And Postpartum Depression: A Systematic Review And Meta-Analysis, Reem Sharaf-Alddin, May Salama, Denise Mckinney, George Saade, Qi Zhang

Health Behavior, Policy & Management Faculty Publications

Purpose: Postpartum Depression (PPD) is the most common mental health complication of childbirth, and has short-term and long-term consequences for mother, child, and the entire family. PPD is a function of several factors. Prenatal exposure to nicotine (PEN) by Active Tobacco Smoking (ATS), Secondhand Smoking (SHS), or Electronic Nicotine Products (ENPs) is a major potential risk factor. This systematic review and meta-analysis aim to summarize and evaluate all evidence regarding the association between PEN and PPD.

Methods: We searched the following databases, PubMed, Medline, Cochrane, EMBASE, and CINHAL, for studies published between Jan.1st ,2000&Sep.19th ,2024, with the outcome PPD. Studies …

Analisis Spasial Sebaran Kejadian Diare Berdasarkan Faktor Iklim Di Kota Batam Tahun 2020-2023, Syofetim Esther Novi Triyanti

Jurnal Nasional Kesehatan Lingkungan Global

Diarrhea is the leading cause of morbidity in coastal regions. Batam City is highly vulnerable to climate change. This study aims to analyze the relationship between rainfall, air humidity, population density, safe drinking water facilities, and access to latrines with the incidence of diarrhea and the spatial distribution based on climate factors in Batam City from 2020 to 2023. The study used an ecological study design with subdistricts as the unit of analysis. Aggregate secondary data were obtained from the Batam City Public Health Office, Statistics Indonesia (BPS) Batam City, and NASA POWER. The analysis of the data included univariate …

Hubungan Faktor Iklim, Faktor Polutan Dan Faktor Sosioekonomi Terhadap Proporsi Pneumonia Balita Provinsi Dki Jakarta Tahun 2013 – 2022, Fayza Chairunnisa Permana, Zakianis Zakianis, Laila Fitria, Erni Pelita Fitratunnisa

Jurnal Nasional Kesehatan Lingkungan Global

In 2022, the Province of DKI Jakarta ranked fourth with the highest coverage of pneumonia in toddlers (53.2%), exceeding Indonesia's toddler pneumonia coverage (38.78%). Pneumonia is influenced by various risk factors, including environmental factors such as climate and weather conditions as well as air pollution, and social and behavioral factors such as toddler characteristics, parental socioeconomic status, and access to health care services. This study aimed to analyze the relationship between climate factors (air temperature, relative humidity, rainfall, and air pressure), pollutant factors (PM₁₀, SO₂, CO, O₃, NO₂), and parents' socioeconomic …

Hubungan Ruang Terbuka Hijau Dengan Prevalensi Diabetes Melitus Di Provinsi Dki Jakarta Tahun 2022, Nurcholiza Hayati, Zakianis Zakianis, Al Asyary, Yulia Fitria Ningrum

Jurnal Nasional Kesehatan Lingkungan Global

Background: Diabetes Mellitus is a metabolic disease characterized by high blood sugar levels. According to Riskesdas (2018), Jakarta has the highest prevalence rate at 2.6%. Objective: To analyze the relationship between green open spaces, socio-economic factors, demographics, and physically active residents with the prevalence of diabetes mellitus. Method: An ecological study design with the unit of analysis is districts and the population consisting of 44 districts in DKI Jakarta Province in 2022. The dependent variable is the prevalence of diabetes mellitus, and the independent variables include education, employment status, population density, gender, age, physically active residents, the area of green …

The Role Of Fast-Food Consumption, Residential Fast-Food Exposures, And Urinary Essential Trace Heavy Metals In Colorectal Cancer (Crc) Outcomes., Jeevan Adhikari

Electronic Theses and Dissertations

Background: Colorectal cancer (CRC) is a public health concern. Within the United States (US), fast-food consumption and environmental exposure to heavy metals have increased. The impact of fast-food consumption frequency from fast-food restaurants, residential fast-food exposures, and urinary essential trace heavy metals in relation to CRC outcomes have not yet been rigorously evaluated in the US. Methods: Within the LEAPS-CRC study, we used geographic information systems (GIS) and logistic regression to study the association of fast-food consumption, residential proximity to a fast-food outlet, and urinary essential trace metals with CRC incidence. Additionally, within Kentucky Cancer Registry (KCR) CRC cases, the …

Analisis Potensial Kejadian Luar Biasa Dbd Berdasarkan Kasus Dbd 5 Tahun Terakhir 2019-2024 : Studi Ekologi Di Kota Lubuklinggau Provinsi Sumatera Selatan, Sely Anggraini, Tri Yunis Miko Wahyono, Fitria Fitria, Nadia Putri

Jurnal Epidemiologi Kesehatan Indonesia

Dengue Hemorrhagic Fever (DHF) is an endemic disease in Indonesia, with a high potential for outbreaks, particularly in tropical and densely populated regions such as Lubuklinggau City. This study aimed to assess the outbreak potential of DHF in Lubuklinggau by analyzing the five-year trend of minimum and maximum case numbers (2019–2023) and comparing them with 2024 data using the epidemic threshold approach. A descriptive ecological study design was employed, with all primary health centers (puskesmas) in the city as units of analysis. Data sources included annual DHF surveillance reports from the District Health Office, field observations, demographic data from the …

Exploring Factors Influencing Care And Outcome Among Stroke Patients In Tennessee, Omodele Agbejimi

Electronic Theses and Dissertations

Introduction: Stroke is the fifth leading cause of death in Tennessee. Socioeconomic variables influence the delivery of stroke treatment and its outcomes. Despite advances in acute stroke care, the burden of stroke keeps increasing. This study aimed to explore literature on factors contributing to stroke care and outcomes in the U.S., assess the determinants of stroke patients’ outcomes, and examine the geographical disparities in stroke hospitalization and stroke death rate and their association with stroke care accessibility in Tennessee.

Methods: A scoping review was conducted using socio-ecological models to explore literature on factors contributing to stroke care and outcomes. A …

Distribusi Kejadian Diare Pada Balita Dan Kualitas Sumber Air Minum Di Indonesia: Studi Ekologi, Nadia Z. Sabira, Naijla I. Shaliha, Sandrina H. Salsabila, Wellsa D. Kusumaningrum

Jurnal Nasional Kesehatan Lingkungan Global

Background: Diarrhea is an infectious disease with the third highest mortality rate in children under 5 years of age globally. The Indonesian Ministry of Health states that 88% of deaths from diarrhea in children are caused by poor sanitation practices and inadequate quality of drinking water sources. This study aims to describe the distribution of the quality of drinking water sources and the prevalence of diarrhea in all provinces in Indonesia. Methods: This study used an ecological study approach with secondary aggregate data from Survei Kesehatan Indonesia (SKI) 2023 and Studi Kualitas Air Minum Rumah Tangga (SKAM RT) 2020. The …

Diarrhea Risk Factors Of Toddlers In Jember District, 2022, Annisa Fitrah Aini, Yunus Ariyanto, Adistha Eka Noveyani

Preventia: The Indonesian Journal of Public Health

Diarrhea is a disease characterized by passing feces three or more times a day. The occurrence of diarrhea is also influenced by sociodemographic factors (nutritional status) and environmental factors (access to clean water, access to sanitary latrines, and living in flood-prone areas). The purpose of this research focuses on finding risk factors for diarrhea and mapping the risk factors of diarrhea. This study used an ecological study design, in which the population is all sub-districts in Jember. Secondary data were used in this research. The data were analyzed using statistical correlation analysis using SPSS and mapping using GIS software. The …

Racial Disparity And Environmental Influences On Perinatal Health In Jefferson County, Kentucky., Felicia A Pugh

Electronic Theses and Dissertations

Background: Severe maternal morbidity (SMM) risk has tripled over the past 30 years. Adverse infant birth outcomes in the U.S. have also increased with substantial Black-White disparities. Objectives: This work compares the frequency of adverse maternal and infant birth outcomes by maternal race (Black vs White) and examines associations between maternal ambient heavy metal exposures and birth outcomes in Jefferson County, Kentucky, 2017-2022. Methods: Jefferson County inpatient hospital delivery and birth certificate records of self-identified Black or White birthing parents were used. Incidence of SMM, stillbirth, preterm birth (PTB), and small for gestational age (SGA) with 95% confidence intervals (CI) …

Assessing The Relationship Between The Incidence Of Campylobacteriosis And Ecological Risk Factors In Tennessee, Emmanuel Angmorteh Mensah

Electronic Theses and Dissertations

Background: Campylobacteriosis although is the leading causes of bacterial diarrheal illnesses, have not gained prominent awareness and there are gaps in the understanding of transmission routes for sporadic, non-outbreak cases and their risk factors at the communal level to humans. This study, therefore, aimed to identify the campylobacteriosis risk factors and risk perception from the existing literature in the United States, determine the incidence and ecological risk factors for campylobacteriosis zip code level in Tennessee, and to perform spatiotemporal analysis of campylobacteriosis incidence cases in Tennessee.

Method: To achieve the first aim, a scoping review was conducted to synthesize …

Adolescent Sleep Health, Mental Health, And Cardiovascular Disease Risk In Adulthood, Prince Nii Ossah Addo

Theses and Dissertations

Background: Insufficient sleep and poor sleep quality are major public health issues among adolescents in the United States (U.S.). Mental health and substance use challenges are also common among adolescents, particularly those with sleep problems. Although exposures in adolescence have been evidenced to significantly impact future health, little is known about how adolescent sleep health, mental health, and substance use influence future cardiovascular disease (CVD) risk. We, therefore, examined the association between sleep health in adolescence and CVD risk in adulthood and assessed whether the association is mediated by depressive symptoms and substance use in adolescents. Further, we explored the …

Critical Appraisal Of Multidrug Therapy In The Ambulatory Management Of Patients With Covid-19 And Hypoxemia. Part Ii: Causal Inference Using The Bradford Hill Criteria, Eleftherios Gkioulekas, Peter A. Mccullough, Colleen Aldous

School of Mathematical & Statistical Sciences Faculty Publications

We continue the critical appraisal of three published case series of 119 COVID-19 patients with hypoxemia, treated in the United States, Zimbabwe, and Nigeria with similar ivermectin-based multidrug treatments, to assess the available evidence supporting a causal relationship between treatment and reduction in hospitalizations and mortality. A narrative review was conducted to assess the Bradford Hill criteria for a causal association. We used a previously proposed refinement of the Bradford Hill criteria that reorganized them into three categories of direct, mechanistic, and parallel evidence. The efficacy of the two most aggressive ivermectin-based multidrug protocols is supported by the Bradford Hill …

Associations Between Atmospheric Ozone, Pm2.5 And Prevalence Of Diabetes In Georgia, United States, Kingsley A. Kalu, Jingjing Yin, Atin Adhikari

Journal of the Georgia Public Health Association

Objective:

This study examines the association between two air pollutants (PM_2.5 and ozone), and the prevalence of adult diabetes mellitus in relation to various confounding factors.

Methods:

We collected diabetes prevalence data from the 2015 County Health Ranking and Georgia Health Data Hub. A negative binomial regression analysis was conducted to examine the associations between the county-level dependent variable “adult diabetes” (for adults aged> 18 years diagnosed with Type 1 and Type 2 diabetes) and two independent county-level variables: percentage of days ³ NAAQS for ozone and PM_2.5 concentration levels while controlling for confounders.

Results:

At the county …

Environmental And Behavioral Determinants Of Congenital Defects: An Ecologic Study In Kentucky, Amelia G. Floyd

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Congenital defects are a significant contributor to infant morbidity and mortality. The multifactorial etiology of such defects presents complex challenges for public health. This ecologic study investigates the association between environmental and behavioral exposures and congenital defects rates at the county level in Kentucky from 2010 to 2019. The Kentucky Department for Public Health, Office of Vital Statistics, provided all relevant defect data. County-level exposure data was collected from multiple sources.

Descriptive and geospatial analyses revealed substantial geographic variability, with notable high defect rates in northeastern Kentucky. Negative binomial regression models identified behavioral and socioeconomic factors to be the strongest …

Associations Of Natural Vegetation In Relation To Colorectal Cancer Hotspots And Colorectal Cancer Survival., Johnnie Newton

Electronic Theses and Dissertations

Background: Across Kentucky, county-level geographic disparities in colorectal cancer (CRC) incidence and outcomes exist. Given the heterogeneity of lifestyle, socioeconomic (SES), and environmental factors within a county, more granular approaches should be used to identify local areas with a high CRC burden and identify the area-level factors that may contribute to geographic disparities. Studies reported that living in greener areas is associated with beneficial health outcomes, including lower mortality. Despite growing evidence that natural vegetation (greenness) exposure is associated with increased physical activity and obesity, two well-known CRC risk factors, epidemiological studies investigating the association of residential greenness exposure with …

An Ecological Study Of Determinants Of The Incidence Of Tuberculosis In Malang Raya Area, Lucky Radita Alma, Vita Olivionita, Hartati Eko Wardani

Preventia: The Indonesian Journal of Public Health

The Malang Raya area (Batu City, Malang City, and Malang Regency) is one of the areas in East Java where the TB rate remains quite high. It is 3,461 cases in 2020. This study aimed to find out the correlation between coverage of healthy houses, coverage of households with healthy lifestyle, population density, air temperature, humidity, and rainfall with the incidence of tuberculosis in Malang Raya in 2021. The study used an ecological study design approach. Secondary data were collected from the Health Office and the Central Bureau of Statistics (Badan Pusat Statistika/BPS) of Malang City, Malang Regency and Batu …