Digital Commons Network^™

Dissemination Of An Electronic Manual To Build Capacity For Implementing Farmers’ Markets With Community Health Centers, M Aaron Guest, Darcy Freedman, Kassandra A. Alia, Heather M. Brandt, Daniela B. Friedman

Faculty Publications

Community-university partnerships can lend themselves to the development of tools that encourage and promote future community health development. The electronic manual, "Building Farmacies," describes an approach for developing capacity and sustaining a community health center-based farmers' market that emerged through a community-university partnership. Manual development was guided by the Knowledge to Action Framework and experiences developing a multivendor, produce-only farmers' market at a community health center in rural South Carolina. The manual was created to illustrate an innovative solution for community health development. The manual was disseminated electronically through 25 listservs and interested individuals voluntarily completed a Web-based survey to …

Use Of Geographical Information Systems To Identify Counties In Georgia With High Risk For Childhood Lead Poisoning, R. Christopher Rustin, Christy Kuriatnyk, Byron Lobsinger, Simone Charles

Journal of the Georgia Public Health Association

Background: For children in Georgia, lead poisoning is a substantial public health problem. Primary risk factors include low socioeconomic status and poor-quality housing built prior to 1978. The Environmental Health Team of the Georgia Department of Public Health (DPH) utilized geographical information system (GIS) technology and census housing data to identify counties in which children have high risk for lead poisoning. The purpose of this research was to update and refine previous maps developed with older technology and on a different geographic scale so that targeted public health interventions can be developed.

Methods: Data related to stratified and median housing …

Wdph Summer Internship Report, Samantha Arsenault

Mosakowski Institute for Public Enterprise

The Mosakowski Institute is working with the Worcester Division of Public Health (DPH) in an effort that merges classroom skills and real world experience to improve the health of the Greater Worcester community. During the summer of 2015, thirteen Clark students interned with the DPH working on five projects that advanced goals of the Community Health Improvement Plans in the areas of healthy eating and activing living; substance abuse and mental health; health equity and health disparities; violence prevention, and more. More information about the summer 2015 internship projects can be found in the report.

Ecpat: Development And Testing Of Mobile Technology To Engage Youth In Active Living Policy, Systems, And Environmental Health Promotion Efforts, Gina M. Besenyi

Theses and Dissertations

Modifying the built environment is a promising way to promote youth physical activity and reduce obesity. Parks, in particular, are key intervention venues given their low cost and legislated ubiquity. Creating healthy communities, including better parks, will require the interest and participation of multiple constituencies, including youth. Creation of mobile technology environmental audit tools can provide a more interactive way for youth to engage with communities and facilitate participation in participatory action research (PAR) and health promotion efforts.

The purpose of the first study was to describe the development and validity and reliability testing of an electronic version of the …

Pubh 6532 - Environmental Health (Online), Atin Adhikari

College of Public Health: Faculty Syllabi (2014-2021)

Survey of specific environmental conditions and factors that contribute to the development of health problems in communities. Health effects, policy issues, intervention strategies and control programs for community environmental health protection are discussed.

Envh 7237 - Risk Assessment And Communication, Marina E. Eremeeva

College of Public Health: Faculty Syllabi (2014-2021)

Course introduces students to the qualitative and quantitative skills necessary to evaluate the probability of injury, disease, or death in individuals or in the general population from exposure to environmental contaminants. Hazard identification, exposure assessment, dose-response evaluation, and risk characterization processes are emphasized. Risk communication training includes developing practical skills in assessing health concerns and explaining potential health risks or risk management to the general public.

Envh 7231 - Air Quality, Simone M. Charles

College of Public Health: Faculty Syllabi (2014-2021)

Introduces students to chemical, physical, and biological principles of air quality, as well as potential sources of contamination and the resulting effects. The course will also introduce environmental policies pertinent to air issues along with current remediation strategies to ameliorate pollution.

Envh 7232a - Water Quality, Asli Aslan

College of Public Health: Faculty Syllabi (2014-2021)

This course is designed for graduate students and it will provide students with an introduction and overview of the key areas of water quality and health. Students will gain an understanding of the physical, chemical and biological principles of water quality, the potential impact on health of water pollution, and local, national and international environmental policies pertinent to water issues along with current treatment and remediation strategies to ameliorate pollution. The major topics include introduction to water quality and health; physical and chemical agents in water, emerging infectious diseases related to water quality, drinking and recreational water quality criteria, drinking …

Pubh 6532 - Environmental Health, Evans Afriyie-Gyawu

College of Public Health: Faculty Syllabi (2014-2021)

Survey of specific environmental conditions and factors that contribute to the development of health problems in communities. Health effects, policy issues, intervention strategies and control programs for community environmental health protection are discussed.

Environmental Justice And Community-Based Participatory Research In Texas Borderland Colonias, Adelita G. Cantu, Margaret A. Graham, Ann V. Millard, Isidore Flores, Meaghan K. Mugleston, Iris Y. Reyes, Ester C. Carbajal

Anthropology Faculty Publications

Objective

An innovative academic-community partnership studied daily decisions in communities of mostly Spanish-speaking, low-income residents of colonias in Hidalgo County, TX, about risk of exposure to fish contaminated by PCBs at an Environment Protection Agency (EPA) Superfund site.

Design and Sample

The team used focus group interviews with colonia residents and content analysis to assess knowledge of risk related to the Superfund site, the Donna Reservoir and Canal System.

Results

(1) many lacked knowledge of the Superfund site contamination; (2) a few participants fished at the lake, knew people who did so, and consumed the catch, but most participants feared …

Environmental And Health Disparities In Appalachian Ohio: Perceptions And Realities, Michele Morrone, Natalie A. Kruse, Amy E. Chadwick

Journal of Health Disparities Research and Practice

Background. Appalachia is a region of the United States that faces significant environmental and health disparities. Understanding these disparities and the social determinants that contribute to them will help public health practitioners make better decisions. The purpose of this research is two-fold. First, through secondary data analysis, we document environmental and health disparities as well as demographic and economic conditions that may contribute to these disparities between Appalachian and non-Appalachian Ohio. Second, we examine perceptions of environmental health practitioners about the differences in environmental conditions between Appalachian and non-Appalachian Ohio.

Methods. We gathered secondary data about economics, health, and the …

Do Air Pollutant Emissions Lead To An Increase In Total Personal Health Care Costs By State?, Dana Jespersen

MPA/MPP/MPFM Capstone Projects

Total personal health care costs are increasing in the United States every year. Currently personal health care costs are predicted to increase at a national average rate of 6.5 percent. This is on track with the historical data. The increase has returned to the 6.0 percent mark after falling down to an increase of 3.7 percent in 2013. Recovering from the recession and the implementation of the Affordable Care Act has contributed to the steady increase back up to the average 6 percent increase per year. When looking at individual states, all averaged around the 6 to 8 percent increase …

Soil Arsenic And Lead Concentrations And Preterm Birth: Investigating Racial Disparities, Sources, Neighborhood Effects, And Spatial Patterns, Pamela Harley Thornton Davis

Theses and Dissertations

Preterm birth, generally defined as birth at <37 weeks of gestation, is an important public health issue that has multiple risk factors related to characteristics of both the mother and her environment. The purpose of this dissertation was to examine potential sources of spatially interpolated (kriged) environmental concentrations of arsenic (As) and lead (Pb) in residential soils and preterm birth in a Medicaid population of mothers giving birth in South Carolina (SC) from 1996-2001. The first objective was to investigate if a racial disparity existed for estimated soil As and Pb concentrations, after adjusting for proximal and distal sources of these metals (including distance and direction to industrial facilities) in a subset of SC Medicaid mothers living in areas of SC where soil samples were collected and analyzed for these metals. The second objective was to test the hypothesis that estimated soil As and Pb concentrations were associated with increased odds of early (<34 weeks) and late (34-36 weeks) preterm births in the same subset of SC Medicaid mothers, after adjusting for individual and neighborhood level risk factors, and examine if measure of neighborhood deprivation and racial residential segregation modified these associations. The third objective was to examine if early and all preterm births, aggregated at the county level, varied spatially and/or temporally in SC for all Medicaid mothers giving birth from 1996-2001 in Bayesian models.

For the first objective, black mothers had significantly higher estimated As and Pb soil concentrations than white mothers in the study population (adjusted betas were 0.12 and 0.22 for As and Pb, respectively; all p<0.006), and proximal sources of metals (e.g., percent of Census block group are covered by roads) were more strongly associated with estimated soil As and Pb concentrations than composite As and Pb releases from industrial facilities categorized by distance from and direction to Census block groups in which maternal residences were located.

For the second objective, estimated soil concentration of neither As nor Pb were associated with increased odds of early or late preterm birth after adjusting for maternal and neighborhood level risk factors. Only individual level covariates were associated with these birth outcomes, and associations were stronger for early as compared to late preterm births. Neighborhood deprivation and racial …

Southern Chivalry: Perception Of Health & Environmental Justice In A Small Southern Neighborhood, Brian S. Brijbag

USF Tampa Graduate Theses and Dissertations

This paper analyzes heath risk and how it is communicated to, and understood within, a predominantly African American neighborhood in central Florida. Residents accuse the county department of public works of purposeful contamination and discrimination over a period of 30 years. I raise the questions of how risk is perceived and what roles race or class may play. I also developed a model for risk communication that includes all stakeholders. Finally, I expand the conversation of health disparities to include issues of widening gaps in perceptions of health.

This was examined by looking at the following:

1. The lack of …

The Public Health Exposome: A Population-Based, Exposure Science Approach To Health Disparities Research, Paul D. Juarez, Patricia Matthews-Juarez, Darryl B. Hood, Wansoo Im, Robert S. Levine, Barbara J. Kilbourne, Michael A. Langston, Mohammad Z. Al-Hamdan, William L. Crosson, Maurice G. Estes, Sue M. Estes, Vincent K. Agboto, Paul Robinson, Sacoby Wilson, Maureen Y. Lichtveld

Sociology Faculty Research

The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death. It uses a social-ecological framework that builds on the exposome paradigm for conceptualizing how exogenous exposures “get under the skin”. The public health exposome approach has led our …

"Wake Up The Knowledge That You Have": An Assessment Of Community Food Security In Fellsmere, Florida, Susan Marie Tyler

USF Tampa Graduate Theses and Dissertations

In the global industrial agricultural system many people lack access to high-quality nutritious foods and food production techniques are often inefficient and reliant on harsh chemical inputs. While numerous strategies exist to address the disparities present in the global food system, increasingly researchers and practitioners are looking to local food systems for solutions to strengthen community food security (CFS). CFS emphasizes small-scale production strategies such as farmer's markets, community gardens, and consumer supported agriculture. As these efforts evolve, research is needed to understand how these strategies affect communities. To explore a local CFS initiative, qualitative data were collected from community …

Participation, Information, Values, And Community Interests Within Health Impact Assessments, Nicole Iroz-Elardo

Dissertations and Theses

Health impact assessment (HIA) has emerged in the U.S. as one promising process to increase social and environmental justice through addressing health equity issues within planning. HIA practice is guided by values such as democracy and equity and grounded in broad social determinants of health. The most readily applied definition of democracy is problematic because it implies an element of direct, participatory engagement with the public. This is at odds with HIA practice that largely relies on stakeholder engagement strategies.

This dissertation critically examines the engagement strategies of three transportation planning HIA cases to more fully understand how the HIA …

Exposure To Fine Particulate Matter During Pregnancy And Risk Of Preterm Birth Among Women In New Jersey, Ohio, And Pennsylvania, 2000–2005, Kristen M. Rappazzo, Julie L. Daniels, Lynne C. Messer, Charles Poole, Danelle T. Lobdell

Community Health Faculty Publications and Presentations

Background: Particulate matter < 2.5 micrometers in aerodynamic diameter (PM2.5) has been variably associated with preterm birth (PTB).

Objective: We classified preterm births into four categories (20–27, 28–31, 32–34, and 35–36 weeks completed gestation) and estimated risk differences (RD) for each category in association with a 1-µg/m3 increase in PM2.5 exposure during each week of gestation.

Methods: We assembled a cohort of singleton pregnancies that completed at least 20 weeks of gestation during 2000-2005 using live birth certificate data from three states (Pennsylvania, Ohio, and New Jersey) (n = 1,940,213; 8% PTB). We estimated mean PM2.5 exposures for each week of gestation from monitor-corrected Community Multi-Scale Air Quality modeling data. RDs were …

Power To The People? An Evaluation Of State-Level Environmental Justice Policies, Angela Michelle Hines

Graduate Theses and Dissertations

Communities of color in America lacking economical, educational, and political power have been largely invisible in the process of making major policy decisions. This is lack of access to decision-making venues has been viewed by many as the reason behind marginalized populations bearing the brunt of many societal burdens. The Environmental Justice Movement legitimized the claims of inadequate access to the decision-making process concerning environmental conditions in which African-Americans lived and worked. Through the use of disruptive actions reminiscent of those used throughout the Civil Rights Movement, the plight of communities plagued by the daily presence of hazardous waste gained …

Strategies To Reduce The Harmful Effects Of Extreme Heat Events: A Four-City Study, Jalonne L. White-Newsome, Sabrina Mccormick, Natalie R. Sampson, Miatta A. Buxton, Marie S. O'Neill, Carina J. Gronlund, Kathryn C. Conlon, Edith A. Parker

Environmental and Occupational Health Faculty Publications

Extreme heat events (EHEs) are becoming more intense, more frequent and longer lasting in the 21st century. These events can disproportionately impact the health of low-income, minority, and urban populations. To better understand heat-related intervention strategies used by four U.S. cities, we conducted 73 semi-structured interviews with government and non-governmental organization leaders representing public health, general social services, emergency management, meteorology, and the environmental planning sectors in Detroit, MI; New York City, NY; Philadelphia, PA and Phoenix, AZ—cities selected for their diverse demographics, climates, and climate adaptation strategies. We identified activities these leaders used to reduce the harmful effects of …

Lethal But Legal: Corporations, Consumption, And Protecting Public Health (Preface), Nicholas Freudenberg

Publications and Research

Decisions made by the food, tobacco, alcohol, pharmaceutical, gun, and automobile industries have a greater impact on today's health than the decisions of scientists and policymakers. As the collective influence of corporations has grown, governments around the world have stepped back from their responsibility to protect public health by privatizing key services, weakening regulations, and cutting funding for consumer and environmental protection. Today's corporations are increasingly free to make decisions that benefit their bottom line at the expense of public health.

Lethal but Legal examines how corporations have impacted -- and plagued -- public health over the last century, first …

Strategies Employed By Inner-City Activists To Reduce Alcohol-Related Problems And Advance Social Justice, Laurie Drabble, Denise Herd

Faculty Publications

This study explored strategies employed by activists engaged in efforts to change policies and laws related to selling and promoting alcoholic beverages based on in-depth interviews with 184 social activists in seven U.S. major cities. Nine strategies aimed at improving local conditions and influencing policy were described by activists across regional contexts. Grassroots mobilization was central to all other strategies, which included the creation or enforcement of laws, meeting with elected officials, media advocacy, working with police/law enforcement, education and training, direct action, changing community norms, and negotiating with store owners.

Elucidating Perceived And Actual Cancer Risk In Disadvantaged Neighborhoods Differentially Impacted By Environmental Hazards To Inform Future Public Health Interventions, Lashanta J. Rice

Theses and Dissertations

In the United States, racial and ethnic minorities, economically disadvantaged and medically underserved groups bear a disproportionate amount of the cancer burden. Myriad social and environmental factors attribute to these disparities including disparate exposures to environmental pollutants, which account for two percent of all cancer deaths nationally. There is empirical evidence demonstrating risk perceptions and cancer worry are shaped by race/ethnicity and social and environmental experiences. Cancer risk perceptions among Non-Whites, especially Blacks compared to Whites is lower for various reasons. Low perceived cancer risk may explain persistent cancer disparities, since protective health behaviors are higher among persons who perceive …

A Comparison Of Water-Related Perceptions And Practices Among Residents Living In Colonias In West Texas And South New Mexico, Relying On Container Or Well Water, Lydia Berenice Garcia

Open Access Theses & Dissertations

ABSTRACT

In the U.S. - Mexico border region, colonia residents must cope with the lack of clean water supply and other basic sanitary services. Because of the lack of infrastructure, colonia residents rely on alternative water supplies including either private wells or hauled water stored in large above-ground containers. Little is known about residents' perceptions of their water supplies, their use practices, and how water-related use and perceptions might differ between colonia residents relying on well water or container water. The purpose of this study was to examine the water-related perceptions and practices of people living in colonias, and to …

The Mosakowski Institute For Public Enterprise Five Year Report, Mosakowski Institute

Mosakowski Institute for Public Enterprise

This report contains the highlights of the first five years of Clark University’s Mosakowski Institute for Public Enterprise. It includes a description of the Institute’s founding, its commitment to use-inspired research, transformational educational experiences, and community connectedness, the Institute’s leadership and finances, and a listing of projects undertaken and faculty partners.

Social Ecological Constraints To Park Use In Communities With Proximate Park Access, J. Aaron Hipp, Deepti Adlakha, Ravikumar Chockalingam

Brown School Faculty Publications

Evidence correlates physical activity, psychological restoration, and social health to proximity to parks and sites of recreation. The purpose of this study was to identify perceived constraints to park use in low-income communities facing significant health disparities, but with proximate access to underutilized parks. The authors used a series of focus groups with families, teens, and older adults in neighborhoods with similar demographic distribution and parks over 125 acres in size. Constraints to park use varied across age groups as well as across social ecological levels, with perceived constraints to individuals, user groups, communities, and society. Policies and interventions aimed …

Allostatic Load Amplifies The Effect Of Blood Lead Levels On Elevated Blood Pressure Among Middle-Aged U.S. Adults: A Cross-Sectional Study, Ami R. Zota, Edmond R. Shenassa, Rachel Morello-Frosch

Environmental and Occupational Health Faculty Publications

Background

Scientists and regulators have sought to understand whether and how physiologic dysregulation due to chronic stress exposure may enhance vulnerability to the adverse health effects of toxicant exposures. We conducted a cross-sectional study to determine whether allostatic load (AL), a composite measure of physiologic response to chronic exposure to stress, amplifies the effect of lead exposure on blood pressure among middle-aged adults.

Methods

We analyzed associations between blood lead levels and blood pressure in a nationally representative sample of 8,194 U.S. adults (aged 40-65 years) participating in the National Health and Nutritional Examination Survey, 1999--2008. Outcomes were elevated systolic …

Livestock-Associated Methicillin And Multidrug Resistant Staphylococcus Aureus Is Present Among Industrial, Not Antibiotic-Free Livestock Operation Workers In North Carolina, Jessica L. Rinsky, Maya Nadimpalli, Steve Wing, Devon Hall, Dothula Baron, Lance B. Price, Jesper Larsen, Marc Stegger, Jill Stewart, Christopher D. Heaney

Environmental and Occupational Health Faculty Publications

Objectives

Administration of antibiotics to food animals may select for drug-resistant pathogens of clinical significance, such as methicillin-resistant Staphylococcus aureus (MRSA). In the United States, studies have examined prevalence of MRSA carriage among individuals exposed to livestock, but prevalence of multidrug-resistant S. aureus (MDRSA) carriage and the association with livestock raised with versus without antibiotic selective pressure remains unclear. We aimed to examine prevalence, antibiotic susceptibility, and molecular characteristics of S. aureus among industrial livestock operation (ILO) and antibiotic-free livestock operation (AFLO) workers and household members in North Carolina.

Methods

Participants in this cross-sectional study were interviewed and provided a …

Empowerment-Based Positive Youth Development: A New Understanding Of Healthy Development For African American Youth, Raphael Travis Jr., Tamara Leech

Department of Public Health Scholarship and Creative Works

A shift occurred in research about adolescents in the general population. Research is moving away from deficits toward a resilience paradigm and understanding trajectories of positive youth development. This shift has been less consistent in research and practice with African American youth. A gap also exists in understanding whether individual youth development dimensions generate potential in other dimensions. This study presents an empowerment-based positive youth development model. It builds upon existing research to present a new vision of healthy development for African American youth that is strengths-based, developmental, culture-bound, and action-oriented. It emphasizes the relationship between person and environment, the …

Public Health Aspects Of The Daugherty Water For Food Institute Strategic Plan, Eleanor G. Rogan, Bruce Grogan, Terry Huang, Alan Kolok, Risto Rautiainen, Oscar Araz, Christopher Fisher, Andrew Jameton, Ashish Joshi, Sharon Meaker-Medcalf, Jim P. Stimpson, Melissa Tibbits

Reports: College of Public Health

The University of Nebraska College of Public Health is committed to contributing to the research, service and education programs of the Daugherty Water for Food Institute. The College can offer a wide variety of expertise that can contribute to programs related to water, food and health. This document has been written to highlight the areas in which College faculty have particular interests, knowledge and experience to contribute.