Digital Commons Network^™

Seroprevalence Of Severe Acute Respiratory Syndrome Coronavirus-2 (Sars-Cov-2) Among Healthcare Providers Prior To The Vaccine Era In An Integrated Midwestern Healthcare System, Elie A. Saade, Xiaochun Zhang, Jaime H. Noguez, Lisa M. Stempak, Daniel Tisch, Christine Schmotzer, Robert A. Salata

Faculty Scholarship

We performed severe acute respiratory coronavirus virus 2 (SARS-CoV-2) antinucleocapsid IgG testing on 5,557 healthcare providers and found a seroprevalence of 3.9%. African Americans were more likely to test positive than Whites, and HCWs with household exposure and those working on COVID-19 cohorting units were more likely to test positive than their peers.

Survey Of Nationwide Public Perceptions Regarding Acceptance Of Wastewater Used For Community Health Monitoring In The United States., A. Scott Lajoie, Rochelle H. Holm, Lauren B. Anderson, Heather D. Ness, Ted Smith

Faculty and Staff Scholarship

To assess the levels of infection across communities during the coronavirus disease 2019 pandemic, researchers have measured severe acute respiratory syndrome coronavirus 2 RNA in feces dissolved in sewer water. This activity is colloquially known as sewer monitoring and is referred to as wastewater-based epidemiology in academic settings. Although global ethical principles have been described, sewer monitoring is unregulated for health privacy protection when used for public health surveillance in the United States. This study used Qualtrics XM, a national research panel provider, to recruit participants to answer an online survey. Respondents (N = 3,083) answered questions about their knowledge, …

The Covid-19 Pandemic: Exploring E-Learning Experience During Schools Closure In Tanzania, Fabian Gallus Mahundu

Journal of Humanities and Social Sciences

of parents and guardians in supporting their children’s e-learning activities during the COVID-19 lockdown in Tanzania. The study adopted an exploratory qualitative research design. Data were collected using telephone interviews and open-ended questions (using google forms), which inquired parents’ and guardians’ experience in supporting home based e-learning activities among students during the COVID-19 lockdown. The paper argues that giving students free access to online learning materials during COVID-19 lockdowns is paramount. However, parents’ and guardians’ support through sharing one’s phones must be monitored to safeguard learners from accessing irrelevant materials. Findings show that parents and guardians had different experiences in …

Applying Transformative Evaluation To Assess Service Provided To African Americans Through The Snap-Ed Program, Matthew Greene

LSU Doctoral Dissertations

Obesity and food insecurity are disproportionately experienced by African Americans compared to white Americans. African Americans encounter multiple barriers to healthful eating in their food environment, in part due to structural racism. Four studies were undertaken to understand how SNAP-Ed may best address the needs of African Americans and whether the program is serving African Americans in Louisiana equitably. In the first study, a scoping review was conducted to describe nutrition interventions addressing structural racism experienced by African Americans and compare them to the Getting to Equity in Obesity Prevention Framework. Nearly all included studies focused on PSE change interventions …

What’S Next For Tobacco Control Efforts? Health Equity Related Lessons Learned From A National Qualitative Study On Tobacco Control And Prevention, Courtney A. Parks, Hollyanne E. Fricke, Alethea Chiappone, Jennie L. Hill, Amy L. Yaroch

Journal of Health Disparities Research and Practice

Context: Despite gains in the tobacco prevention and control movement, tobacco products remain a threat, with specific populations at greater risk.

Objective: The purpose of this paper is to examine the role that leaders in the tobacco prevention and control movement have played in progress achieved to date and identify recommendations for the future using a health equity framework. The purpose of this paper is to examine the role that leading organizations in the tobacco prevention and control movement have played in progress achieved to date, identify future recommendations within the context of current public health priorities (e.g., obesity prevention), …

The Resilience Of Diversified Clusters: Reconfiguring Commodity Networks In Rural China During The Covid-19 Pandemic, Zhanping Hu, Qian Forrest Zhang

Research Collection School of Social Sciences

We conceptualize typical rural communities in China as diversified economic clusters. In normal times, economic actors in these communities rarely cooperate with each other, but are integrated into separate commodity chains. These “diversified clusters”, however, show resilience and flexibility when an external shock—the COVID-19 pandemic—disrupts the spatial connections throughout the existing commodity chains. In this study, we use primary field data collected from one typical rural community in Northern China to show how economic diversity, aided by social networks and space-shrinking technologies, allowed for the vertical commodity chains to be reconfigured temporarily into localized horizontal commodity networks to cope with …

The 2025 Michigan State Oral Health Plan, Ellen Sugrue Hyman Jd

The Journal of the Michigan Dental Association

This feature article explores the 2025 Michigan State Oral Health Plan (SOHP), a comprehensive initiative developed by the Michigan Oral Health Coalition (MOHC) and a statewide coalition, including the Michigan Dental Association (MDA). With a focus on enhancing oral health for all Michigan residents, the SOHP prioritizes addressing economic and racial disparities. The plan, guided by three key goals—Increasing Awareness and Education, Dental-Health Integration, and Access and Infrastructure—aims to improve oral health outcomes. The article discusses the plan's development process, key findings highlighting existing disparities, workforce challenges, and the strategic implementation of the SOHP through collaborative efforts and workgroups.

Travel Ban Effects On Sars-Cov-2 Transmission Lineages In The Uae As Inferred By Genomic Epidemiology, Andreas Henschel, Samuel F. Feng, Rifat A. Hamoudi, Gihan Daw Elbait, Ernesto Damiani, Fathimathuz Waasia, Guan K. Tay, Bassam H. Mahboub, Maimunah Hemayet Uddin, Juan Acuna, Eman Alefishat, Rabih Halwani, Herbert F. Jelinek, Farah Mustafa, Nawal Alkaabi, Habiba S. Alsafar

Research outputs 2022 to 2026

Global and local whole genome sequencing of SARS-CoV-2 enables the tracing of domestic and international transmissions. We sequenced Viral RNA from 37 sampled Covid-19 patients with RT-PCR-confirmed infections across the UAE and developed time-resolved phylogenies with 69 local and 3,894 global genome sequences. Furthermore, we investigated specific clades associated with the UAE cohort and, their global diversity, introduction events and inferred domestic and international virus transmissions between January and June 2020. The study comprehensively characterized the genomic aspects of the virus and its spread within the UAE and identified that the prevalence shift of the D614G mutation was due to …

Characteristics And Birth Outcomes Of Pregnant Adolescents Compared To Older Women: An Analysis Of Individual Level Data From 140,000 Mothers From 20 Rcts, Nadia Akseer, Emily Catherine Keats, Pravheen Thurairajah, Simon Cousens, Ana Pilar Bétran, Brietta M. Oaks, David Osrin, Ellen Piwoz, Exnevia Gomo, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Adolescence is a critical period of maturation when nutrient needs are high, especially among adolescents entering pregnancy. Using individual-level data from 140,000 participants, we examined socioeconomic, nutrition, and pregnancy and birth outcomes for adolescent mothers (10-19 years) compared to older mothers in low and middle-income countries.
Methods: This study was conducted between March 16, 2018 and May 25, 2021. Data were obtained from 20 randomised controlled trials of micronutrient supplementation in pregnancy. Stratified analyses were conducted by age (10-14 years, 15-17 years, 18-19 years, 20-29 years, 30-39 years, 40+ years) and geographical region (Africa, Asia). Crude and confounder-adjusted means, …

Changes In Adolescent Birth Rates Within Appalachian Subregions And Non-Appalachian Counties In The United States, 2012–2018, Nathan Hale, Kathleen Tatro, Sylvester Olubolu Orimaye, Michael Smith, Michael Meit, Kate E. Beatty, Amal Khoury

Journal of Appalachian Health

Background: Adolescent births are associated with numerous challenges. While adolescent birth rates have declined across the U.S., disparities persist and little is known about the extent to which broader declines are seen within Appalachia.

Purpose: The purpose of this study was to examine the extent to which adolescent birth rates have declined across the subregions of Appalachia relative to non-Appalachia.

Methods: We conducted a retrospective study of adolescent birth rates between 2012 and 2018 using county-level vital records data. Differences were examined across the subregions of Appalachia and among non-Appalachian counties. Multiple regression models were used to examine changes in …

Clinical Geography: A Commentary Response, Jessica M. Finlay, Graham D. Rowles

Graduate Center for Gerontology Faculty Publications

No abstract provided.

Angiotensin Blockade Therapy And Survival In Pancreatic Cancer: A Population Study, Scott W Keith, Vittorio Maio, Hwyda A Arafat, Matthew Alcusky, Thomas Karagiannis, Carol Rabinowitz, Harish Lavu, Daniel Z. Louis

College of Population Health Faculty Papers

Background: Pancreatic cancer (PC) is one of the most aggressive and challenging cancer types to effectively treat, ranking as the fourth-leading cause of cancer death in the United States. We investigated if exposures to angiotensin II receptor blockers (ARBs) or angiotensin I converting enzyme (ACE) inhibitors after PC diagnosis are associated with survival.

Methods: PC patients were identified by ICD-9 diagnosis and procedure codes among the 3.7 million adults living in the Emilia-Romagna Region from their administrative health care database containing patient data on demographics, hospital discharges, all-cause mortality, and outpatient pharmacy prescriptions. Cox modeling estimated covariate-adjusted mortality hazard ratios …

Using Culturally Focused Storytelling To Empower Appalachian Kentucky Youth To Understand And Address Cancer Disparities In Their Communities, Lauren K. Collett, Lauren Hudson, Chris Prichard, Nathan L. Vanderford

Markey Cancer Center Faculty Publications

Kentucky has the highest cancer incidence and mortality rates in the nation with the Appalachian region of the state being most affected. These rates are driven by health behaviors and inequities in social determinants of health. Herein, Appalachian Kentucky students with the University of Kentucky’s Appalachian Career Training in Oncology (ACTION) program were engaged in a storytelling exercise by writing culturally framed essays. Students discussed their personal experiences with cancer and their thoughts on the causes of and potential solutions to Appalachian Kentucky’s cancer disparities. Content analysis was used to identify common themes, subthemes, and subtopics in the essays regarding …

The Ctsa University Of Texas Health Science Center (Uthsc) Northeast—Tyler And Rio Grande Valley Success Story: How Rural, Underserved Academic Communities Rapidly Built A Robust Engine For Collaborative Covid-19 Clinical Research, Steven Idell, David D. Mcpherson, Jessica Martin, Andrew N. Dentino, Luis Ostrosky- Zeichner, Julia V. Philley, Paul Mcgaha, Megan Devine, Jacqueline Bronicki, Daniel D. Karp

School of Medicine Publications

In 2018, The University of Texas Health Science Center– Tyler and University of Texas Rio Grande Valley were invited to develop clinical research units for an existing Clinical and Translational Science Award (CTSA) consortium with the objective to equip medically underserved, economically disadvantaged communities and subsequently to deploy COVID-19 clinical trials in response to a public health emergency.

The Problem Of The Color Line: Spatial Access To Hospital Services For Minoritized Racial And Ethnic Groups, Jan M. Eberth, Pelvin Hung, Gabriel A. Benavidez, Janice Probst, Whitney E. Zahnd, Mary-Katherine Mcnatt, Ebony Toussaint, Melinda A. Merrell, Elizabeth L. Crouch

Faculty Publications

Examining how spatial access to health care varies across geography is key to documenting structural inequalities in the United States. In this article and the accompanying StoryMap, our team identified ZIP Code Tabulation Areas (ZCTAs) with the largest share of minoritized racial and ethnic populations and measured distances to the nearest hospital offering emergency services, trauma care, obstetrics, outpatient surgery, intensive care, and cardiac care. In rural areas, ZCTAs with high Black or American Indian/Alaska Native representation were significantly farther from services than ZCTAs with high White representation. The opposite was true for urban ZCTAs, with high White ZCTAs being …

Spatial Epidemiology: An Empirical Framework For Syndemics Research, Shikhar Shrestha, Cici X C Bauer, Brian Hendricks, Thomas J Stopka

Faculty, Staff and Student Publications

Syndemics framework describes two or more co-occurring epidemics that synergistically interact with each other and the complex structural social forces that sustain them leading to excess disease burden. The term syndemic was first used to describe the interaction between substance abuse, violence, and AIDS by Merrill Singer. A broader range of syndemic studies has since emerged describing the framework's applicability to other public health scenarios. With syndemic theory garnering significant attention, the focus is shifting towards developing robust empirical analytical approaches. Unfortunately, the complex nature of the disease-disease interactions nested within several social contexts complicates empirical analyses. In answering the …

Acceptability Of Op/Na Swabbing For Sars-Cov-2: A Prospective Observational Cohort Surveillance Study In Western Australian Schools, Hannah M. Thomas, Marianne J. Mullane, Sherlynn Ang, Tina Barrow, Adele Leahy, Alexandra Whelan, Karen Lombardi, Matthew Cooper, Paul G. Stevenson, Leanne Lester, Andrea Padley, Lynn Sprigg, David Speers, Adam J. Merritt, Juli Coffin, Donna Cross, Peter Gething, Asha C. Bowen

Research outputs 2022 to 2026

Objectives: When the COVID-19 pandemic was declared, Governments responded with lockdown and isolation measures to combat viral spread, including the closure of many schools. More than a year later, widespread screening for SARS-CoV-2 is critical to allow schools and other institutions to remain open. Here, we describe the acceptability of a minimally invasive COVID-19 screening protocol trialled by the Western Australian Government to mitigate the risks of and boost public confidence in schools remaining open. To minimise discomfort, and optimise recruitment and tolerability in unaccompanied children, a combined throat and nasal (OP/Na) swab was chosen over the nasopharyngeal swab commonly …

Learning From South Korea’S Covid-19 Response: Why Centralizing The United States Public Health System Is Essential For Future Pandemic Responses, Meghan Ricci

Seattle Journal of Technology, Environmental, & Innovation Law

The COVID-19 pandemic revealed stark differences in governmental preparedness across the globe. The United States, once thought of as a global leader in public health, had the theoretical skill and efficiency to handle the pandemic but failed to utilize those skills and resources during an actual health crisis. In the spring of 2020, everyone watched the U.S.’s reaction to the unfolding of the COVID-19 pandemic due to its historic placeholder as a global leader and innovator. However, the performance of the U.S. in response to the global pandemic disappointed both global commentators and U.S. citizens. This paper will compare the …

Using A Stochastic Continuous-Time Markov Chain Model To Examine Alternative Timing And Duration Of The Covid-19 Lockdown In Kuwait: What Can Be Done Now?, Mustafa Al-Zoughool, Tamer Oraby, Harri Vainio, Janvier Gasana, Joseph C. Longenecker, Walid Al Ali, Mohammad Alseaidan, Susie Elsaadany, Michael G. Tyshenko

School of Mathematical & Statistical Sciences Faculty Publications

Background

Kuwait had its first COVID-19 in late February, and until October 6, 2020 it recorded 108,268 cases and 632 deaths. Despite implementing one of the strictest control measures-including a three-week complete lockdown, there was no sign of a declining epidemic curve. The objective of the current analyses is to determine, hypothetically, the optimal timing and duration of a full lockdown in Kuwait that would result in controlling new infections and lead to a substantial reduction in case hospitalizations.

Methods

The analysis was conducted using a stochastic Continuous-Time Markov Chain (CTMC), eight state model that depicts the disease transmission and …

Geographic Determinants Of Colorectal Cancer In Louisiana, Denise Danos, Claudia Leonardi, Xiao Cheng Wu

School of Public Health Faculty Publications

Purpose: Currently, rural residents in the United States (US) experience a greater cancer burden for tobacco-related cancers and cancers that can be prevented by screening. We aim to characterize geographic determinants of colorectal cancer (CRC) incidence in Louisiana due to rural residence and other known geographic risk factors, area socioeconomic status (SES), and cultural region (Acadian or French-speaking). Methods: Primary colorectal cancer diagnosed among adults 30 years and older in 2008–2017 were obtained from the Louisiana Tumor Registry. Population and social and economic data were obtained from US Census American Community Survey. Rural areas were defined using US Department of …

Detroit Food Metrics Report 2020 (With 2021 Update), Alex B. Hill, Amy Kuras

Urban Studies and Planning Faculty Research Publications

This report provides a snapshot of data and information on Detroit’s food system as well as trends over time. The report includes a broad range of programs and initiatives that local organizations, the Detroit Food Policy Council, and the City of Detroit are undertaking to address food insecurity, increase healthy food access and awareness, and support a more sustainable and just food system.

Exploring The Relationship Between Historical Redlining And Place-Based Reproductive Health Inequities: A Qualitative Gis Approach, Kristi L. Roybal

Electronic Theses and Dissertations

Individual-level risk factors and characteristics do not fully explain racial, ethnic, and socioeconomic inequities in preterm birth in the United States, and evidence suggests that medical advancements, increased access to prenatal care, and high per-capita spending on health care have done little to reduce these inequities. Health inequities research has shifted its attention from individual-level factors that influence health outcomes to the social determinants of health. Neighborhoods, considered an important upstream social determinant of health, can influence health outcomes through their social, service, and physical environments, and have been consistently linked to birth outcomes. Despite increased attention to neighborhood influences …

Access, Socioeconomic Environment, And Death From Covid-19 In Nebraska, He Bai, Michelle M. Schwedhelm, John-Martin Lowe, Rachel Lookadoo, Daniel R. Anderson, Abigail Lowe, James V. Lawler, M. Jana Broadhurst, David Brett-Major

Journal Articles: Epidemiology

Our study assesses whether factors related to healthcare access in the first year of the pandemic affect mortality and length of stay (LOS). Our cohort study examined hospitalized patients at Nebraska Medicine between April and October 2020 who were tested for SARS-CoV-2 and had a charted sepsis related diagnostic code. Multivariate logistic was used to analyze the odds of mortality and linear regression was used to calculate the parameter estimates of LOS associated with COVID-19 status, age, gender, race/ethnicity, median household income, admission month, and residential distance from definitive care. Among 475 admissions, the odds of mortality is greater among …

Health And Technology: Online Platform To Facilitate Access To Care And Prevention For Chronic Non-Communicable Conditions In Rwanda, Arnaud Michel Nibaruta Mdp

Regis University Student Publications (comprehensive collection)

Rwanda is confronted with a growing problem of non-communicable diseases (NCD). It is important that people in Rwanda have access to effective prevention and treatment. This paper explores a program that would use a digital platform to facilitate access to information, services, and products that would help NCD at risk populations in Rwanda to access appropriate prevention and care. The program was developed based on the author’s experience in Rwanda’s healthcare industry, the information from review of literature as well as key informant interviews (NCD patients, advocates, and caregivers) and a survey with health professionals. The research conducted highlighted that …

Examining Structural Racism As A Cause Of Health Inequities Among Pacific Island Peoples In The United States And Aotearoa New Zealand: An Exploratory Comparative Case Study, Jake Ryann Cambia Sumibcay

CGU Theses & Dissertations

Native Hawaiians and Pacific Islanders (NHPI) in the United States are known to experience profound and persistent disparities across most indicators of socioeconomic status and health when compared to the majority population. Similarly, the Indigenous Māori and Pacific peoples in Aotearoa New Zealand parallel the same experiences. Reducing disparities and improving health equity among racial/ethnic minority populations have been regarded as a national priority in both the United States and New Zealand. Improved population health data have provided insights into the social determinants of health (SDoH), which has unveiled multiple factors that contribute to health disparities, including income, education, residential …

Jue Insight: Migration, Transportation Infrastructure, And The Spatial Transmission Of Covid-19 In China, Bingjing Li, Lin Ma

Research Collection School Of Economics

This paper evaluates the impacts of migration flows and transportation infrastructure on the spatial transmission of COVID-19 in China. Prefectures with larger bilateral migration flows and shorter travel distances with Hubei, the epicenter of the outbreak, experienced a wider spread of COVID-19. In addition, richer prefectures with higher incomes were better able to contain the virus at the early stages of community transmission. Using a spatial general equilibrium model, we show that around 28% of the infections outside Hubei province can be explained by the rapid development in transportation infrastructure and the liberalization of migration restrictions in the recent decade.

Comparative Effectiveness Study Of Acute Ischemic Stroke Care Between Stroke Belt And Non-Stroke Belt Hospitals Using The Get With The Guidelines-Stroke Program, Michael Earl Brown Jr

Walden Dissertations and Doctoral Studies

Stroke is a leading cause of mortality in the United States, particularly in a cluster of states termed the stroke belt. This study examined the efficacy of the Get With The Guidelines (GWTG)-Stroke program in stroke belt hospitals (SBHs) compared to non-stroke belt hospitals (NSBHs) regarding disparities related to mortality and acute ischemic stroke (AIS) treatment (i.e., recombinant tissue-type plasminogen activator [r-tPA] rates, Door-to-Needle [DTN], Door-to-Imaging [DTI]). Use of the GWTG-Stroke program was assessed to determine if SBHs and NSBHs were quantitatively equivalent in terms of specific core stroke measures. This quantitative employed an equivalence study design with over 2.9 …

The Risk Factors For Hiv In African American Transgender Women In Connecticut, Oliver Kunda

Walden Dissertations and Doctoral Studies

AbstractThe human immunodeficiency virus (HIV) incidence rate is 70 times higher for African American transgender women than in the general population. Despite decades of outreach and intervention effort to reduce HIV incidence in the transgender community by the lesbian, gay, bi-sexual, transexual, queer, plus (LGBTQ+) community and public health organizations, the HIV prevalence rate for transgender women remains high at 38%. The purpose of this qualitative exploratory case study was to gain insights into how attitude, subjective social norms, and perceived behavioral control influence HIV risk behaviors of African American transgender women in Connecticut. Ajzen’s theory of planned behavior provided …

Suicidal Ideation Among American Indian And Alaska Natives In The United States, Lacie Lashawn Tillman

Walden Dissertations and Doctoral Studies

Suicidal ideation is a silent public health issue across the United States. Evidence suggests that suicidal ideation is a predictor of suicide attempt and completion. Suicide is a leading cause of death among American Indians and Alaska Natives (AIs/ANs) in the United States, especially among younger people. Alcohol and illicit drug use, coupled with poor social conditions, can lead to suicidal ideations—and sometimes suicide completion. Using social cognitive theory, this quantitative cross-sectional study compared variables within the 2017, 2018, and 2019 National Survey on Drug Use and Health to determine the effect that alcohol and/or illicit drug use has on …

Lead Toxicity, Attention–Deficit Hyperactivity Disorder, And Gun Violence Among Young African American Men, Gwendolyn Hooker-Mcintosh

Walden Dissertations and Doctoral Studies

Violence among adolescents and young adults is a major public health concern in the United States, but it disproportionally affects African Americans. This racial disparity is especially concerning in New Orleans, Louisiana, where fatal and nonfatal shootings have been consistent since 2010 for young African American men. Also, Louisiana ranks third in the nation in prevalence of attention–deficit hyperactivity disorder (ADHD) among children. African Americans in New Orleans have lived in areas known to have greater concentrations of lead in the soil, and African American children and their parents have a lower level of awareness of lead toxicity. The purpose …