Digital Commons Network^™

Prenatal Exposure To Pm2.5 Concentration And Risk Of Preterm Birth In New Mexico; A Seasonal Pattern And Spatio-Temporal Modeling., Onyedikachi J. Okeke

Mathematics & Statistics ETDs

This study investigates the association between prenatal PM2.5 exposure and preterm birth risk in New Mexico (2014–2021). Using descriptive statistics, time series models, and spatial analyses, findings show an average preterm birth rate of 14.87 per 1,000 live births, with moderate correlation (r = 0.727) between PM2.5 levels and very preterm births. While traditional models revealed no significant global effect, spatial methods such as Geographically Weighted Regression (GWR) and Multiscale GWR uncovered strong spatial heterogeneity. PM2.5 effects varied by county (coefficients: -0.00154 to 0.00150), with clustering evident in 2018–2019 (Moran’s I = 0.155–0.174). Results highlight the limitations of global models …

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 …

The Relationship Between Climate And Dengue Hemorrhagic Fever Incidence Rate In Malang Regency In 2022-2024, Aticobhita C. Pramono, Suprijandani Suprijandani, Marlik Marlik, Pratiwi Hermiyanti

Jurnal Epidemiologi Kesehatan Indonesia

Dengue Hemorrhagic Fever (DHF) is an infectious disease that poses a public health problem in tropical regions and is influenced by climatic factors such as temperature, rainfall, humidity, and wind speed. In 2023, Malang Regency recorded 1,018 cases with an incidence rate (IR) of 38.2 per 100,000 population. This study aims to analyze the relationship between climatic factors and the DF IR for the 2022–2024 period using an ecological design and Spearman’s correlation analysis. Climate data were obtained from the BMKG, while DF data were obtained from the Health Office. The results showed that only air temperature was significantly associated …

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 …

A Proposed Mhealth Intervention To Address Patient Barriers To Colposcopy Attendance: Qualitative Interview Study Of Clinic Staff And Patient Perspectives, Jennifer Hemler, Rachel Wagner, Brittany Sullivan, Myneka Macenat, Erin Tagai, Jazmarie Vega, Enrique Hernandez, Suzanne Miller, Kuang-Yi Wen, Charletta Ayers, Mark Einstein, Shawna Hudson, Racquel Kohler

Department of Medical Oncology Faculty Papers

BACKGROUND: Cervical cancer disparities persist among minoritized women due to infrequent screening and poor follow-up. Structural and psychosocial barriers to following up with colposcopy are problematic for minoritized women. Evidence-based interventions using patient navigation and tailored telephone counseling, including the Tailored Communication for Cervical Cancer Risk (TC3), have modestly improved colposcopy attendance. However, the efficacious TC3 intervention is human resource-intense and could have greater reach if adapted for mobile health, which increases convenience and access to health information.

OBJECTIVE: This study aimed to describe feedback from clinic staff members involved in colposcopy processes and patients referred for colposcopy regarding adaptions …

Exploring The Link Between Low-Income Communities And Increased Cancer Risk From Nitrate Contamination In Drinking Water: A Review, Anna Wiggins, Rena Phillips, Michael L. Phillips, Wei-Hsiung Yang

South Atlantic Division GME Research Day 2025

No abstract provided.

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 …

A Study Of Glyphosate, Pesticide Mixtures, And Metabolic Health Outcomes: Integrating Epidemiologic, Mechanistic, And Ecological Evidence On Environmental Drivers Of Metabolic Health, Sarah Otaru

Electronic Theses & Dissertations (2024 - present)

Glyphosate, the most extensively used herbicide worldwide, has become a ubiquitous environmental contaminant. Although initially considered safe due to its specific biochemical target in plants, emerging evidence suggests that chronic, low-level human exposure may disrupt metabolic processes. Simultaneously, the global rise in metabolic disorders such as metabolic syndrome (MetS), obesity, and type 2 diabetes, has created a pressing need to identify novel, potentially modifiable environmental contributors. This dissertation investigates the relationship between glyphosate and metabolic health through a triangulated framework that integrates individual-level epidemiological analysis, systematic synthesis of mechanistic evidence, and ecological evaluation of pesticide mixtures.

The first study employed …

Under-Five Malaria And Malnutrition Syndemic In Rajasthan, Nandini Sinha

Public Health Theses

Background: The syndemic of severe acute malnutrition (SAM) and malaria in under-five children in Rajasthan presents a critical public health challenge. Current SAM and malaria programs are implemented as siloed interventions despite the potential benefits of integrated approaches. A better understanding of the interactions between these factors is important to strengthen the delivery of integrated services.

Objective: This study investigates the relationship between under-five SAM and malaria infections at the block level in Rajasthan to inform targeted, integrated interventions. By running regression analysis, we will identify associations between these co-occurring health threats to guide state-level policy integration. To the best …

Impact Of Tobacco Control Policies On Socioeconomic Inequalities In Smoking Prevalence And Quit Ratios: An Ecological Study In The European Union (2009–2020), Ariadna Feliu, Esteve Fernandez, Irene Tamí-Maury, Cristina Martinez

Faculty, Staff and Student Publications

Background: Tobacco control efforts have succeeded in reducing smoking prevalence and increasing smoking cessation rates in the European Union Member States (EU27). However, the impact of these policies has been unequal across different income groups.

Methods: Ecological study with the country as unit of analysis. We used the Tobacco Control Scale (TCS) in EU27 in 2010 and the prevalence of smoking and quit ratios from the Eurobarometer surveys (2009, n=27 788; and 2020, n=28 288). We analysed the relationship between the TCS scores (2010) and smoking indicators and their relative changes (between 2009 and 2020) using scatter plots and multiple …

The Relationship Between Food Insecurity And Low Birthweight Across Us Counties And Related Racial Disparities, Marissa A. Beldon, Shondra L. Clay, M. Courtney Hughes, Kathryn Mazurek

Faculty Articles, Papers, and Other Scholarship

Objective

To explore the relationship between low birthweight (LBW) and food insecurity across US counties and determine whether this relationship differs between Black and White women.

Methods

LBW data was derived from the 2013–2019 National Center for Health Statistics and National Vital Statistics System Birth Files. Food insecurity data was derived from Feeding America’s 2013–2019 Map the Meal Gap project. Analyses included descriptive statistics and regression models.

Results

Data were available for 3037 US counties. Food insecurity significantly predicted county-level LBW (t(3035) = 44.48, P <  .001) and explained 39.46% of the variance in LBW (F(13,035) = 1978.03, P <  .001, R = .63). Food insecurity predicted LBW for …

Faktor Kontributor Prevalensi Stunting: Studi Kasus Jawa Timur Tahun 2022, Sofiyulloh Sofiyulloh, Martya Rahmaniati

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Malnutrisi, termasuk stunting, masih menjadi masalah kesehatan yang mempengaruhi kemajuan pembangunan berkelanjutan. Stunting, akibat kekurangan gizi berkepanjangan dan infeksi berulang, menghambat pertumbuhan anak. Di Indonesia, prevalensi stunting pada tahun 2022 adalah 21,6% dan masih belum mencapai target. Dan Jawa timur, angka stunting di 2022 adalah 19,2%, mendekati angka nasional pun masih belum mencapai target. Penelitian ini bertujuan mengidentifikasi faktor-faktor yang berkontribusi terhadap stunting di Jawa Timur, dengan fokus pada faktor soial ekonomi dan kesehatan. Data sekunder dari Kementerian Kesehatan, dan Dinas Kesehatan Jawa Timur dianalisis menggunakan uji korelasi. Hasil menunjukkan bahwa Indeks Pembangunan Manusia (IPM) dan rata-rata lama sekolah memiliki …

Stroke Pada Lansia Di Indonesia: Gambaran Faktor Risiko Berdasarkan Gender (Ski 2023), Annisa Darmawati, Sabarinah Prasetyo, Miftahun Najah

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Stroke merupakan masalah kesehatan di Indonesia dengan prevalensi 8,3 kasus per seribu penduduk. Penelitian ini bertujuan untuk memperoleh gambaran faktor risiko stroke pada lansia berdasarkan gender, dengan fokus pada faktor yang dapat dimodifikasi seperti aktivitas fisik, pola makan, kebiasaan merokok, dan pemeriksaan tekanan darah rutin. Penelitian ini menggunakan data sekunder dari Survei Kesehatan Indonesia (SKI) 2023 yang dirancang potong lintang. Sampel studi ini adalah subjek berusia ≥60 tahun (lansia) yang melaporkan diri atau didiagnosis stroke. Hasilnya memperlihatkan subyek laki – laki (54,7%) dan perempuan (45,3%) pada sampel lansia penderita stroke. Lansia stroke yang termasuk kategori lansia muda pada laki – …

Impact Of Racial, Ethnic, And Socioeconomic Disparities On Presentation And Survival Of Hcc: A Multicenter Study, Nicole E Rich, Patricia D Jones, Hong Zhu, Tanushree Prasad, Amy Hughes, Sandi Pruitt, Caitlin C Murphy, Karim Seif-El-Dahan, Darine Daher, Gloria Figueroa, Stephanie Castaneda, Lisa Quirk, Michael Gonzales, Osiris Carranza, Samantha Bourque, Nargis Baset, Adam C Yopp, Amit G Singal

Faculty, Staff and Student Publications

BACKGROUND: Racial and ethnic disparities have been reported for HCC prognosis, although few studies fully account for clinically important factors and social determinants of health, including neighborhood socioeconomic status.

METHODS: We conducted a retrospective multicenter cohort study of patients newly diagnosed with HCC from January 2010 through August 2018 at 4 large health systems in the United States. We used multivariable logistic regression and cause-specific Cox proportional hazard models to identify factors associated with early-stage HCC presentation and overall survival.

RESULTS: Of 2263 patients with HCC (37.6% non-Hispanic White, 23.5% non-Hispanic Black, 32.6% Hispanic, and 6.4% Asian/other), 42.0% of patients …

Racial Residential Segregation And Covid-19 Health Outcomes: Evidence From The State Of Georgia, Palak Patel, Simon Medcalfe, Catherine P. Slade

Journal of the Georgia Public Health Association

ABSTRACT

Background:

According to the Georgia Department of Public Health (GDPH), the state of Georgia reported 563,658 cumulative COVID-19 cases and 9,845 total deaths in 2020. Decades of research on racial disparities in health outcomes suggest we should not be surprised with the disproportionate number of cases, hospital visits, and deaths of non-white and Black Georgia residents. Racial disparities in health are often defined by a Social Determinants of Health (SDOH) model. One understudied SDOH is racial residential segregation. In this study we explore the relationship between racial residential segregation and COVID-19 health outcomes. Our paper addresses critical challenges for …

Birth Defect Trends Within Texas Public Health Region 11, 2000-2019: An Analysis Of Texas Department Of State Health Services Public Data, Jonathan M. Hebert, Miguel A. Lopez, Padmanabhan Rengasamy

Research Colloquium

Background: South Texas is a medically underserved area with pockets of low socioeconomic status and poor access to healthcare, including prenatal care. This paper aims to monitor the changes in prevalence for cardiac, circulatory, gastrointestinal, genitourinary, and neural tube birth defects in this region in the last two decades to monitor the effectiveness of current public health efforts.

Methods: Public data on 20 birth defects from the Texas Department of State Health Services were obtained for decades 2000-2010 and 2010-2019 in Texas Public Health Region 11 and the remaining regions of Texas. Prevalences and odds ratios for all birth defects …

It's A Man's World: The Association Between Safe Sex Practices, Relationship Power, & Resilience Among African American Emerging Adults Between 18-24 In The Deep South, Jessica Morgan

All ETDs from UAB

The purpose of this dissertation was to examine the impact that power imbalance has on safe sex practices among African American emerging adults. The objectives included: provide a thorough review of preexisting literature that explores the impact of power imbalance on safe sex practices among African American women; understand the impact that power imbalance has on safe sex practices among African American emerging adults comparing data from men and women; and understand if resilience is associated with power imbalance among African American emerging adult women in the United States. Utilizing a retrospective, cross-sectional, quantitative study design, three methods were used …

Association Of Self-Reported Disease Severity With Depression And Anxiety Among Copd Patients, Yousef Saad Aldabayan, Antonieto Alaban, Eduardo Fabella, Amal Ismael Abdelhameed

Makara Journal of Health Research

Background: This study was conducted to estimate the proportion of patients who experience a high impact from chronic obstructive pulmonary disease (COPD) on their health status and those who also experience symptoms of depression and anxiety. It also sought to determine whether the health impact of the disease is associated with anxiety and depression.

Methods: An analytical cross-sectional study was conducted among 177 randomly selected patients with COPD seeking treatment in various primary health centers in Al Ahsa, Saudi Arabia. The COPD Assessment Test (CAT) was used to determine the impact of COPD on health generally, and the …

A Systematic Review: Longevity And Quality Of Life In Blue Zones, Salmaan Mulla

Theses and Graduate Projects

Ikaria, Loma Linda, Sardinia, Okinawa, and Nikoya. These 5 cities around the world are famed for their increased longevity and quality of life and are termed “Blue Zones”. Blue zones are areas around the world noted for their population of centenarians, overall long life expectancy and high quality of life compared to the average population. Studying these communities offer insights into the commonalities they share to better understand the unique aspects of living a healthy, fulfilling and long life. A comprehensive literature review was conducted using Google Scholar, with the search terms “Ikaria, Greece longevity; Loma Linda, California longevity; Sardinia, …

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 …

Environmental Factors (Rurality, Distribution Of Prescribers, And Altitude) Of People Who Died By Suicide In Montana, 2013- 2022, Anne N. Brown

Electronic Theses and Dissertations

Introduction: Suicide is increasingly prevalent in rural areas across the United States, especially in the western Rocky Mountain states. The connection between suicide and rural residency is not well understood, nor is the relationship between the distribution of prescribers, altitude, and suicide. Purpose: This retrospective quantitative study aimed to describe the characteristics of individuals who died by suicide in Montana and investigate the associations among rurality, distribution of prescribers, altitude, and suicide rate. Methods: Montana suicide mortality data for 2013-22 was used to describe individual characteristics. A second dataset was created for each Zip Code Tabulation Area (ZCTA) level in …

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 …

Spatiotemporal Analysis Of Hpv Vaccination And Associated Neighborhood-Level Disparities In Texas-An Ecological Study, Ryan Ramphul, Abigail S Zamorano, Saswati Upadhyay, Manali Desai, Cici Bauer

Faculty, Staff and Student Publications

BACKGROUND: HPV is responsible for most cervical, oropharyngeal, anal, vaginal, and vulvar cancers. The HPV vaccine has decreased cervical cancer incidence, but only 49% of Texas adolescents have initiated the vaccine. Texas shows great variation in HPV vaccination rates. We used geospatial analysis to identify areas with high and low vaccination rates and explored differences in neighborhood characteristics.

METHODS: Using Anselin's Local Moran's I statistic, we conducted an ecological analysis of hot and cold spots of adolescent HPV vaccination coverage in Texas from 2017 to 2021. Next, we utilized a Mann-Whitney U test to compare neighborhood characteristics of vaccination coverage …

Restoring, Protecting, And Expanding Abortion Access In The United States: Seeking Consensus Through The Delphi Method, Sarah Pickering

Dissertations and Theses

Background: The Dobbs v. Jackson Women’s Health Organization Supreme Court decision exacerbated inequitable access to abortion in the US. Agreement is needed on which strategies should be prioritized to restore, protect, and expand abortion access.

Methods: We convened a multidisciplinary, geographically diverse Delphi panel of clinical, research, policy, legal, and advocacy experts to reach consensus (i.e., agreement >67%) on recommended actions. Using feedback from three rounds of surveys, and input from a select expert advisory group (N=10), we iteratively refined the statements and recommendations.

Results: The panel (N=85) developed 25 consensus statements and 32 recommendations for action by advocates, funders, …

Application Of Methods To Population-Based Surveys To Reduce Bias In Estimates Of Sars-Cov-2 Infection Burden In The Population, Saba Qasmieh

Dissertations and Theses

BACKGROUND: Population-based surveys designed to randomly sample the population can be a critical and complementary tool to traditional surveillance approaches. Probability-based surveys enable the measurement of SARS-CoV-2 testing and outcomes that avoid issues around self-selection into testing, making them an effective approach to address ascertainment bias in passive surveillance. For surveys to be a useful and reliable surveillance tool for understanding the burden and distribution of SARS-CoV-2 infection, they need to capture prevalence estimates that are both valid and reliable to be optimally informative for public health measures. The dissertation was undertaken to address three main gaps that have implications …

Trends In Fatal Opioid-Related Overdose In American Indian And Alaska Native Communities, 1999-2021, Cici Bauer, Ghada H Hassan, Ric Bayly, Jack Cordes, Dana Bernson, Cedric Woods, Xiaona Li, Wenjun Li, Leland K Ackerson, Marc R Larochelle, Thomas J Stopka

Faculty, Staff and Student Publications

INTRODUCTION: Opioid-related overdose mortality rates have increased sharply in the U.S. over the past two decades, and inequities across racial and ethnic groups have been documented. Opioid-related overdose trends among American Indian and Alaska Natives require further quantification and assessment.

METHODS: Observational, U.S. population-based registry data on opioid-related overdose mortality between 1999 and 2021 were extracted in 2023 using ICD-10 codes from the U.S. Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research multiple cause of death file by race, Hispanic ethnicity, sex, and age. Segmented time series analyses were conducted to estimate opioid-related overdose mortality growth …

Extreme Temperature And Other Environmental Factors On Diabetes Admissions, Donghong Gao

Legacy Theses & Dissertations (2009 - 2024)

Background: Although total environmental factors have been linked with adverse health outcomes, the impacts of temperature and other total environmental factors on diabetes-related hospitalizations and emergency department (ED) visits remain inconclusive.Objective: This dissertation aims to Aim 1) test the associations between extreme heat and diabetes hospitalizations in the summer and its transitional months, identify populations vulnerable to extreme heat’s effects, and examine the modification effects of greenness on the heat-diabetes associations in warm months (Chapters 3 and 4); Aim 2) investigate the associations between extreme cold and diabetes hospitalizations in the winter and its transitional months, identify populations vulnerable to …

Stillbirth Mortality By Robson Ten-Group Classification System: A Cross-Sectional Registry Of 80 663 Births From 16 Hospital In Sub-Saharan Africa, Claudia Hanson, Kristi Annerstedt, Maria Alsina, Muzdalfat Abeid, Hussein Kidanto, Helle Alvesson, Andrea Pembe, Peter Waiswa, Jean-Paul Dossou, Effie Chipeta

Centre of Excellence in Women and Child Health

Objective To assess stillbirth mortality by Robson ten-group classification and the usefulness of this approach for understanding trends.

Design Cross-sectional study.

Setting Prospectively collected perinatal e-registry data from 16 hospitals in Benin, Malawi, Tanzania and Uganda.

Population All women aged 13–49 years who gave birth to a live or stillborn baby weighting >1000 g between July 2021 and December 2022.

Methods We compared stillbirth risk by Robson ten-group classification, and across countries, and calculated proportional contributions to mortality.

Main outcome measures Stillbirth mortality, defined as antepartum and intrapartum stillbirths.

Results We included 80 663 babies born to 78 085 women; …

Incidence And Seasonality Of Kawasaki Disease In Children In The Philippines, And Its Association With Ambient Air Temperature, Aden Kay Celis-Seposo, Lina Madaniyazi, Xerxes Seposo, Masahiro Hashizume, Lay Myint Yoshida, Michiko Toizumi

Ateneo School of Medicine and Public Health Publications

Background

Despite an unknown cause, Kawasaki disease (KD) is currently the primary leading cause of acquired heart disease in developed countries in children and has been increasing in recent years. Research efforts have explored environmental factors related to KD, but they are still unclear especially in the tropics. We aimed to describe the incidence of KD in children, assess its seasonality, and determine its association with ambient air temperature in the National Capital Region (NCR), Philippines from January 2009 to December 2019.

Methods

Monthly number of KD cases from the Philippine Pediatric Society (PPS) disease registry was collected to determine …