Digital Commons Network^™

Food Deserts' And 'Food Swamps' In Hillsborough County, Florida: Unequal Access To Supermarkets And Fast-Food Restaurants, Dana Beth Stein

USF Tampa Graduate Theses and Dissertations

Research has shown that the suburbanization of supermarkets has created `food deserts', defined as areas where socially disadvantaged individuals lack access to nutritious food outlets. Additionally, the growing presence of fast-food restaurants has created `food swamps', or areas where socially disadvantaged individuals encounter an overabundance of unhealthy food outlets. While previous studies have analyzed either `food deserts' or `food swamps' using conventional statistical techniques, a more comprehensive approach that includes samples of both healthy and unhealthy entities and considers the variety of available food options is necessary to improve our understanding of the local food environment and related disparities.

This …

Self-Insurance And The Potential Effects Of Health Reform On The Small-Group Market, Kathryn Linehan

National Health Policy Forum

The Patient Protection and Affordable Care Act (PPACA) as amended by the Health Care Education Reconciliation Act of 2010 makes landmark changes to health insurance markets. Individual and small-group insurance plans and markets will see the biggest changes, but PPACA also affects large employer and self-insured plans by imposing rules for benefit design and health plan practices. Over half of workers—most often those in very large firms—are covered by self-insured health plans in which employers (or employee groups) bear all or some of the risk of providing insurance coverage to a defined population of workers and their dependents. As PPACA …

Racial Disparities In Healthcare: Challenges Faced By Hispanic Populations, Kaitlin Mcdowell

Honors Projects

No abstract provided.

The Ingredients Of Change: A Political Ecology Approach To Diabetes In The Somali Community Of Minnesota, Mina Tehrani

Geography Capstone Projects

In the early 1990’s, due to political circumstances at home, Somali immigrants and refugees began arriving in the state of Minnesota in large numbers. Over the past two decades, Somali immigrants have come to comprise one of the most populous ethnic groups in the Twin Cities, and are the largest Somali population in the world outside of Eastern Africa. Although quantitative data is unavailable, qualitative evidence and testimonies of healthcare professionals support the conclusion that Somali immigrants in Minnesota suffer from higher rates of diabetes than non-immigrant groups and than they likely did before migration. Why might this be the …

Racial, Ethnic, And Socioeconomic Disparities In Exposure To Fast Food In Hillsborough County, Florida, Dana Oppenheim Stein, Jayajit Chakraborty

Florida Public Health Review

Recent studies have linked the alarming obesity epidemic in the U.S. to the growth of the fast-food restaurant industry, which offers convenient service alongside inexpensive and high-calorie food. As the number of fast-food outlets increases, research demonstrates that their geographic location plays a significant role in creating obesogenic environments, potentially exposing socially disadvantaged groups to unhealthy nutrition choices provided by these outlets. Whereas previous studies have examined the distribution of positive health amenities such as supermarkets and health-food stores, there is a growing need to evaluate the socio-demographic characteristics of neighborhoods that contain negative health entities such as fast-food outlets. …

Our Health Matters: Promoting The Health Of Sexual Minority Women In The New Media Landscape, Brenda Kane

Electronic Theses and Dissertations

The shifts occurring in the mediascape and the field of public health offer new opportunities for promoting the health and wellness of sexual minority women. As a population that has historically been underserved by the healthcare system, sexual minority women face multiple barriers to achieving positive health outcomes. They are often less likely to access preventive healthcare services and more likely to engage in risky behaviors that are detrimental to health than heterosexual women. Despite the significant health disparities among sexual minority women, studying this population has not been a priority in health research and there is little research-based evidence …

Phenotypic And Genotypic Analysis Of In Vitro Selected Artemisinin Resistant Plasmodium Falciparum, Matthew Scott Tucker

USF Tampa Graduate Theses and Dissertations

Artemisinin and its derivatives provide faster clearance of parasitemia than any other antimalarial drugs and these drugs are part of frontline combination therapies in areas where drug-resistant Plasmodium falciparum exists. Clinical resistance to artemisinins is emerging on the Thailand-Cambodia border, making it imperative to investigate mechanisms of artemisinin resistance. Previous work in our laboratory showed ring-stage parasites enter a dormant state after exposure to artemisinin. We hypothesize that this period of dormancy is directly related to recrudescence and prolonged parasite clearance times in patients, and possibly resistance. The target of artemisinin is currently unknown, and potential resistance mechanisms are not …

Preventive Care Utilization Among Black Women : Perceived Beliefs, Benefits And Barriers To Mammography Screening, Rowandalla Y. Dunbar

Loma Linda University Electronic Theses, Dissertations & Projects

Blacks, in comparison to other racial or ethnic groups, suffer higher rates of illness and death from many preventable or treatable diseases. Despite the significantly higher rates of mortality and disease, Blacks are least likely to utilize clinical preventive care services. Black women, who are more likely to have advanced breast cancer at time of diagnosis (Chu, Lamar, & Freeman, 2003) are least likely to seek mammography screening (National Health Interview Study, 2000). Allen, Bastani, Bazargan and Leonard (2002) examined predictors of mammography screening among women 40 years old and older residing in the South Central area of Los Angeles, …

Crouching Tiger Hidden Goiter Belt: A Critique Of Health Care And Universal Salt Iodization In The Tsum Valley, Julian Goetz, Vanessa Soetanto

Independent Study Project (ISP) Collection

The Tsum Valley, opened to visitors in 2008, has only recently begun the process of modernization. The health of the population is still not stable with regards to nutrition, and the health care system is still inadequate due to geographic conditions of remoteness and difficulty of access. The health condition is further exacerbated by political interactions affecting iodine consumption. This paper presents original information collected via interviewing processes throughout the valley and in Kathmandu over the course of a four-week period. The results include the inadequacy of health care facilities in treating endemic health issues and of the failure of …

Finding The Right Fit: Unique Challenges Faced By Health Ngos In The Health System Of Lamu District, Lauren Hartel

Independent Study Project (ISP) Collection

This study examines how nongovernmental organizations and community-based organizations in Lamu District interact with the governmentally structured health care system at the district level. This is done through participatory observation, interviews and removed observation of NGOs, CBOs and government officials. From these observations, this study then identifies major challenges faced by health NGOs that inhibit them from performing to the best of their ability, and at times even compromise the health of the people they are trying to help. The results of this study show that in Lamu District, the most relevant challenges are continuity of care, dissemination of information, …

Injury In Nevada, Michelle Chino, Jonathon Lavalley, Darlene R. Haff, Deborah A. Harris, Andrea R. Rivers

School of Public Health Faculty Research

Injury is a major threat to health and safety. In a typical day in the US, 400 people will die as the result of an injury, 7,500 will be hospitalized due to an injury, and more than 150,000 will suffer an injury severe enough to restrict activities and seek medical attention. Many of these deaths, hospitalizations, and disabling events will be the result of motor vehicle crashes. Others will result from vio­lence, falls, drowning, and poisoning – all of which are considered injuries.

The costs of injury are high. In the United States, the cost of injuries is estimated to …

Rural America: A Look Beyond The Images, John A. Gale Ms

Access / Insurance

The issues faced by patients and providers in rural health care differ greatly from those of urban counterparts. They also differ across rural communities. Understanding these differences, and the differences among rural populations across America, is critical to providing health services to rural Americans, who are often impeded by economic factors, cultural and social differences, educational shortcomings and isolation in their efforts to lead normal, healthy lives. The challenges provide opportunities for Catholic health care to make a difference in the lives and health of some of the nation's most vulnerable citizens.

Envisioning Nevada’S Future: Goals & Strategies For Advancing Our Quality Of Life, Nevada Vision Stakeholder Group, Moody’S Analytics

Brookings Mountain West Publications

Nevada’s severe downturn has brought to light many of the long-term challenges facing the state. Not only is its economy subject to painful swings, but Nevada’s primary drivers— consumer services (primarily gaming, hospitality and housing) and resource extraction—will provide less support than they have in past business cycles. Less economic vitality will make it harder to offer Nevadans the quality of life they expect.

The importance of the economy to quality of life is equally clear—quality of life is a hollow promise without a healthy and supportive economy. Similarly, a proper fiscal structure—both in terms of spending and revenues—is critical …

The Role Of Unrealistic Optimism In Explaining Preventive Behaviors In High Versus Low Endemic Malaria Settings In Belize, Daniel G. Handysides

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Of all the diseases an individual can encounter in the world, malaria is one of the most destructive. Simple measures like sleeping under a bednet would greatly reduce the burden (Abeku, 2007). When people estimate their risk relative to others, they are most often unrealistically optimistic, which may explain why those at risk often fail to perform behaviors, such as using a bednet that will reduce their risk. However, one study showed that people at high risk for malaria held pessimistic perceptions of their risk for the disease, but the reasons for this finding are unclear (Morrison, Ager, & …

Assessing Mississippians’ Preparedness For Disasters Using The Citizen Corps National Survey 2009, Carl Huston Mangum Ii

Dissertations

Disaster preparedness, a shared responsibility of all citizens and disaster agencies, is the most critical component in minimizing risk and damage from disaster. Mississippi has been affected by some of the most devastating disasters in American history, both in terms of physical destruction and human life. The purpose of this study was to assess Mississippians’ disaster preparedness by replicating The 2009 Citizen Corps National Survey (CCNS). The 65 question 2009 CCNS was slightly modified to survey 678 randomly selected Mississippians about the Citizen Corps Personal Disaster Preparedness Model: Demographics, Volunteering, Drills/Exercises, Community Plan, Household Plan, Disaster Supplies, Prevention, Self-efficacy, Reliance, …

Examining The Interrater Reliability Of The Comprehensive Inventory Of Mental Health And Recovery And Rehabilitation Services (Cimhrrs), Robert W. Johnson

Department of Psychology: Dissertations, Theses, and Student Research

This dissertation is one step in the continuing development, evaluation, and validation of the Comprehensive Inventory of Mental Health and Recovery and Rehabilitation Services (CIMHRRS). The CIMHRRS is an instrument to guide comprehensive assessment of programs that provide integrated services to people with serious mental illness (SMI).

The project described in this dissertation evaluated three key aspects of its performance in real world application: practical feasibility, internal consistency and reliability, and ability to distinguish between different programs. Investigators utilized a combination of principles and methods, associated with psychometric scale development, field methods, and program evaluation. Using a structured site review …

The Development And Use Of A Geographic Information System For Evaluating The Association Between Pesticide Exposure And Prostate Cancer, Kristen Wells

Theses and Dissertations

Abstract 1 – A Geographic Information System for Evaluating Residential Pesticide Exposure and Prostate Cancer Incidence Agricultural pesticide exposure is hypothesized to be a risk factor for prostate cancer, and such exposures are of particular concern for men living in farming communities where large-scale pesticide applications occur. Prostate cancer incidence data were obtained from the State Health Registry of Iowa for the years 1996 through 2006, and county and census tract level age-adjusted incidence rates were calculated. Historical crop-specific land use records and pesticide sales data for the state of Iowa during 1990 were integrated into a geographic information system …

Assessing Community Health Center (Chc) Assets And Capabilities For Recruiting And Retaining Physicians: The Chc Community Apgar Questionnaire, David Schmitz, Ed Baker, Ayaka Nukui, Benjamin Tverdy

Public and Population Health Faculty Publications and Presentations

Community factors play a key role in the recruitment and retention of physicians. While prior workforce studies often investigated characteristics of the candidate-physician, the initial Critical Access Hospital Community Apgar Questionnaire (CAH CAQ) study identified community factors at critical access hospitals which help determine the success of achieving and maintaining an adequate local physician workforce. The goals of the current study are to identify opportunities for improvement in physician retention and recruitment in Idaho’s Community Health Center (CHC) systems and to develop a better understanding of the community factors in this dynamic process.

Keeping Health Insurance After A Job Loss: Cobra Continuation Coverage And Subsidies, Kathryn Linehan

National Health Policy Forum

Many Americans under 65 have health insurance through an employer. Beginning in 1985, a federal law known as COBRA required that eligible workers and their dependents have the option to continue employer-based group health coverage when employment is terminated. Because premiums for COBRA coverage can be very expensive, the 111th Congress included provisions in the American Recovery and Reinvestment Act of 2009 (and subsequent legislation) to temporarily subsidize premiums for those who have lost their jobs since September 2008. This issue brief outlines the eligibility rules for COBRA as well as the current COBRA subsidies. It also discusses the possible …

Health Care Shortage Designations: Hpsa, Mua, And Tbd, Eileen Salinsky

National Health Policy Forum

A wide variety of federal programs designed to improve access to health care services rely on specific criteria to designate areas and populations eligible for funding and other types of aid. Two related yet distinct designations, the Health Professional Shortage Area (HPSA) and the Medically Underserved Area (MUA), are most commonly used to identify underserved people or places. This background paper reviews the methodologies currently utilized in these designations, identifies the federal programs that use these designations to allocate resources, describes proposals that have been advanced to consolidate and improve these designations, and discusses key issues and challenges for future …

The Places Of Birth: Navigating Risk, Control, And Choice, Hannah E. Emple

Geography Honors Projects

Through qualitative research in the Twin Cities, Minnesota and a literature review grounded in health and feminist geography, this paper analyzes how women, their families, and health care providers view and navigate places of birth. Over four million births occur annually in the United States, making birth the most common reason for hospitalization of women. Although 99% of women in the U.S. give birth in hospitals, a small but vocal minority seek alternative places to birth – primarily at home. Where to give birth is a contested subject infused with social and political significance. I suggest that place is highly …

Enhanced Food Marketing To Children On The Internet: A Content Analysis, Sarah A. Ochsner

UNLV Theses, Dissertations, Professional Papers, and Capstones

In light of the continuing epidemic of childhood obesity, aggressive food marketing strategies have come under increased scrutiny as a possible contributing factor. It has been acknowledged in numerous studies, that poor nutrient quality of food and beverages dominate children's programming. The growth in child-specific media envoys has further increased favorable opportunities to market food and beverages to children, notably less regulated and parentally unsupervised. According to the U.S. Census Bureau, 65% of children aged 6-11 have home access to the Internet; and today, the majority of food manufacturers operate websites appealing to children. The Institute of Medicine issued a …

Stigma And Therapy Completion For Latent Tuberculosis Among Haitian-Origin Patients, Jeannine Coreil, Michael Lauzardo, Heather Clayton

Florida Public Health Review

A prospective cohort study of LTBI treatment conducted within the Haitian population of South Florida investigated the predictive association between illness-related stigma among patients near the beginning of treatment and completion of preventive therapy. Factors associated with perceived stigma were also investigated. Ninety patients from Broward and Palm Beach counties were administered a questionnaire that included items related to illness history, perceptions and understanding of latent tuberculosis, and a 25-item stigma scale adapted from previously developed measures of tuberculosis-related stigma. Therapy completion was determined through a follow-up chart review. Data analyses compared patients who completed therapy with those who defaulted …

Wku Scholar, Pamela Napier, Editor-In-Chief

WKU Scholar

No abstract provided.

A Gis Analysis Of The Environmental Variables Related To Rift Valley Fever Outbreaks, Jacqueline Florette Jackson

Health Services Research Dissertations

Rift Valley fever is a mosquito-borne disease that causes widespread febrile illness and mortality in domestic animals as well as humans (Gaff, 2007). Rift Valley fever virus was first isolated in 1931 (Daubney, 1931), and since then, outbreaks have occurred in sub-Saharan Africa, southern Africa, Egypt, Saudi Arabia, Yemen and Madagascar, proving it to be a virus able to invade ecologically diverse regions (Gaff, 2007). The potential introduction of Rift Valley fever into the United States suggests the potential for human infection and major economic disruption. It is important to understand the role environmental variables have played in historical outbreaks …

Climate Change, Environmental Justice, And Vulnerability: An Exploratory Spatial Analysis, Sacoby M. Wilson, Roland Richard, Lesley Joseph, Edith M. Williams

Faculty Publications

Research has demonstrated that vulnerable populations including disadvantaged populations of color live in areas that may place them at higher risk of exposure to social and environmental hazards. Due to climate change, these populations may experience worse health outcomes and environmental health disparities. The purpose of this project was to explore the use of Geographic Information Systems (GIS) to assess areas that may be vulnerable to climate change across the United States. We employed ArcGIS 9.3 to create vulnerability scores for areas across the country that may be that may be impacted by climate change at the county level in …

Changing Po2licy: The Elements For Improving Childhood Asthma Outcomes, Anne Rossier Markus, Meagan Lyon, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Childhood asthma is a serious and chronic health issue that affects one in seven U.S. children and their families, compromising their health and quality of life and placing a heavy financial burden on families as well as an enormous strain on the health care system. Treating, managing, and ultimately preventing and reducing the burden of asthma represents a critical test of the ability of the U.S. health system – health insurers, clinical care providers, and public health agencies – to work together. Our investigation found that, as a country, we already know enough to act and improve life for the …

Smart Density: A More Accurate Method Of Measuring Rural Residential Density For Health-Related Research, Peter M. Owens, Linda Titus-Ernstoff, Lucinda Gibson, Michael L. Beach, Sandy Beauregard, Madeline A. Dalton

Dartmouth Scholarship

Studies involving the built environment have typically relied on US Census data to measure residential density. However, census geographic units are often unsuited to health-related research, especially in rural areas where development is clustered and discontinuous. We evaluated the accuracy of both standard census methods and alternative GIS-based methods to measure rural density.

Adolescent Pregnancy Prevention In San Jose, Costa Rica : Assessment Of An Educational Intervention, Alexandra Devin Mainiero

UCHC Graduate School Masters Theses 2003 - 2010

This thesis explores adolescent pregnancy in San Jose, Costa Rica and examines a school-based pregnancy prevention intervention. The relationships between school, gender and risk of adolescent pregnancy are also analyzed, and recommendations are made for effective pregnancy prevention programming. The Purral region of Guadalupe on the outskirts of San Jose, Costa Rica, suffers a higher rate of adolescent pregnancy compared to the rest of the country. In response to this problem, the International Health Central American Institute (IHCAI) implemented a sexual health education program in two local secondary schools in 2006. Very little information about the program is available. It …

Friendship's 3-Tier Healthcare System: An Innovative Approach To Delivering Healthcare To Geographically And Socially Remote Areas, Runa Khan

Social Space

The hardest communities to reach and treat often live in the most remote, harsh landscapes. On the nomadic islands of the Brahmaputra in Bangladesh, poor migratory communities are so cut off from urban centres that medical treatment is virtually unheard of. Runa Khan, Executive Director of Bangladeshi NGO Friendship, shares the difficult and inspired journey to build a mobile healthcare system using hospital ships, mobile clinics and community medics.