Digital Commons Network^™

Delayed Hypertension Diagnosis And Its Association With Cardiovascular Treatment And Outcomes, Yuan Lu, John E. Brush Jr, Chungsoo Kim, Yuntian Liu, Xin Xin, Chenxi Huang, Mitsuaki Sawano, Patrick Young, Jacob Mcpadden, Mark Anderson, John S. Burrows, Jordan R. Asher, Harlan M. Krumholz

Department of Medicine Faculty Publications

Importance Hypertension is a major risk factor for cardiovascular disease, yet delays in diagnosis may limit timely treatment initiation and increase cardiovascular risk.

Objectives To examine the timing of clinical hypertension diagnosis, its association with antihypertensive medication prescribing, and its association with long-term cardiovascular outcomes.

Design, Setting, and Participants This retrospective cohort study analyzed electronic health record (EHR) data from an integrated health care system. Adults aged 18 to 85 years with at least 2 outpatient blood pressure (BP) readings of 140/90 mm Hg or more recorded at least 30 days apart from January 1, 2010, to December 31, 2021, …

Consumption Of The Food Groups With The Revised Benefits In The New Wic Food Package: A Scoping Review, Qi Zhang, Priyanka T. Patel, Bidusha Neupane, Caitlin M. Lowery, Futun Alkhalifah, Faezeh Mahdavi, Esther May Sarino

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background: On 18 April 2024, the United States Department of Agriculture (USDA) published the first food package changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in over a decade, which reduced some food benefits (juice, milk, canned fish, and infant fruits and vegetables) and offered substitutes (cash-value vouchers (CVVs) or cash-value benefits (CVBs) to redeem for fruits and vegetables, cheese, soymilk, or other dairy products). Methods: To assess the impact of the changes on the consumption and redemption of these food groups, a systematic search was conducted, identifying 23 peer-reviewed publications between 2010 and 2024. …

Politics In Public Health: Growing Partisan Divides In Covid-19 Vaccine Attitudes And Uptake Post-2021 Presidential Inauguration, Hongbin Fan, Zhongliang Zhou, Guanping Liu, Chi Shen, Qi Zhang

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives: To investigate whether the 2021 U.S. presidential inauguration contributed to a widening of partisan divides in COVID-19 vaccine attitudes and uptake. Methods: We leverage the presidential inauguration as a natural experiment and analyze data from the Household Pulse Survey and CDC vaccination records. Using a difference-in-differences framework with continuous treatment, we examine how the transition differentially affected state-level vaccine refusal rates and county-level vaccination rates, based on varying levels of partisanship as measured by the Trump-Biden vote gap. Results: Following Biden's inauguration, vaccine refusal declined more in pro-Biden states. Distrust in government and vaccines accounted for approximately 80% of …

Pediatric Cancer Incidence, Temporal Trends, And Mortality In The United States By Health Disparities Indicators, Seer (1973-2014), Prachi P. Chavan, Laurens Holmes Jr.

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background: Pediatric cancer incidence has been increasing in the United States, despite improvement in pediatric cancer survival. This steady increase in incidence trends is not completely understood but maybe associated with social and environmental factors. In this study we aimed to assess the cumulative incidence, temporal trends, and mortality rates in pediatric cancer. Additionally, we examined sub-group variability in both incidence and mortality rates. Methods: Data from Surveillance, Epidemiology, and End Results (SEER) −18 from 1973–2014 were used for the purpose of analysis in this study. Age-adjusted incidence rates were used to assess temporal trends in cancer among children aged < 1–19 years. Univariable and multivariable binomial regression models were used to examine the association between race and cancer mortality while adjusting for potential confounders. Results: There were 92,594 cancer diagnoses during this period. White children comprised 74,758, (80.7%), black children 10,030, (10.8%), and other races 6648, (7.2%). Overall the age-adjusted cumulative incidence was slightly higher among white children (16.4%) than black children (12.4%) and other (13.0%). Children aged 15–19 years and those in metropolitan regions were more likely to be diagnosed with pediatric cancer. Relative to females, males were 16% more likely to die from the disease [adjusted Risk Ratio (aRR): 1.16, 95% Confidence Interval (CI): 1.09–1.22]. Additionally, compared to white children, black children had higher mortality rates [(aRR): 1.37, 99% CI: 1.23–1.52]. Conclusions: There is an increasing trend in pediatric cancer incidence; while white children have the highest incidence, black children and males indicated a survival disadvantage, indicative of racial and sex variability in overall pediatric cancer in the United States.

Analyzing The Centers For Disease Control And Prevention Mortality Data Using Weekly Exceedance In Mortality Count And Weekly Change In Mortality Indicator: A Time Series Study, Aditya Chakraborty, Mohan D. Pant

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background and Aims

Cause-specific mortality (CSM) count prediction plays a vital role in the context of public health policy. In this study, we introduce a new analytical approach, which is divided into three phases to answer specific questions regarding CSM due to 14 specific causes by computing different simple, compound, and conditional probabilities.

Methods

A multivariate time series forecasting model was developed using the CDC weekly mortality count data. A binary data matrix was constructed for 14 causes of death (COD) as a function of weeks by combining the observed and forecasted mortalities. We introduced two new concepts: Weekly Exceedance …

The Importance Of Supply Chain Management In Improving Maternal, Newborn, And Child Health, Tamah Kamlem, Katie M. Mercer

Eagles Talking About the Public’s Health

No abstract provided.

Exploring The Challenges And Interventions For Type 1 Diabetes In Young Children, Patra Chisom Ezeamii, Nenrot Gopep, Ho-Jui Tung

Eagles Talking About the Public’s Health

No abstract provided.

Harmonizing Healing: Integrating Traditional/Cultural Remedies And Western Medicine For Chronic Pain Management In Immigrant Populations, Doreen Ugwu, Samuel T. Opoku

Eagles Talking About the Public’s Health

No abstract provided.

Healthy Homes, Healthy Lives: An Essential Call To Action For Public Health, Samuel Mbadu, Santino Oifoh, Katie M. Mercer, Atin Adhikari

Eagles Talking About the Public’s Health

No abstract provided.

The Important Role Of Health State Departments In The Surveillance And Control Of Tick-Borne Diseases, Seun Abiola, Marina Eremeeva

Eagles Talking About the Public’s Health

No abstract provided.

The Silent Transition: Lack Of Awareness Of Perimenopause Leaves Women Unprepared, Tara Hassani Goodarzi, Joanne Chopak-Foss

Eagles Talking About the Public’s Health

No abstract provided.

Enhancing Malaria Prevention: Barriers To Expanding Vaccine Access In Sub-Saharan Africa, Nenrot Gopep, Patra Chisom Ezeamii, Ho-Jui Tung

Eagles Talking About the Public’s Health

No abstract provided.

Domestic Violence And Mental Health: A Complementary Perspective, Olayemi Aloba, Jacob Gakpo, Katie M. Mercer

Eagles Talking About the Public’s Health

No abstract provided.

From Judgment To Support: Advocating For Mothers Of Children With Behavioral Disorders, Alisha Riggins, Jessica Guerrette, Nazish Masud, Tobi Oloyede, Sarah Sejoro, Joanne Chopak-Foss, Logan Cowan

Eagles Talking About the Public’s Health

No abstract provided.

An Emerging Obstacle To Childhood Obesity Control And Prevention, Queeneth C. Edwards, Jian Zhang

Eagles Talking About the Public’s Health

The rise of telehealth has created both opportunities and challenges as healthcare providers seek to balance the convenience of telemedicine with the need for effective and comprehensive care.1-3 This commentary highlights the implications of telehealth for addressing pediatric obesity, a pressing public health issue.

Breaking The Cycle: Public Health Solutions For Homeless Youth And Foster Care Survivors, Alysia D. Williams, Bettye Apenteng

Eagles Talking About the Public’s Health

No abstract provided.

Bullying As A Public Health Crisis: Linking Aces To Long-Term Health Consequences, Doreen Ugwu, Dziyana Nazaruk

Eagles Talking About the Public’s Health

No abstract provided.

Buyer Be Aware: An Underutilized Tool In The Public Health Protection Toolkit, Padde Musa, Jacob Gakpo, Samuel T. Opoku, Bettye A. Apenteng

Eagles Talking About the Public’s Health

No abstract provided.

Leveling The Playing Field: The Critical Role Of Ada Compliance In Graduate Education, Victoria Davis, Katie M. Mercer, Amber J. Culpepper

Eagles Talking About the Public’s Health

No abstract provided.

Applying The Ecological Model Of Medical Encounters To Understand Patient-Centered Communication For Older Korean Migrants In The U.S., Seulgi Park

Electronic Theses & Dissertations (2024 - present)

Patient-Centered Communication (PCC) is defined as an approach that places patients at the center of communication with healthcare providers. PCC has been recognized as a strategy to address disparities experienced by minority populations. However, despite its associations with positive health outcomes and ethical significance, there has been a paucity of research on PCC in minority populations such as older Korean migrants in the U.S. Understanding PCC within this group may contribute to improving healthcare communication tailored to their needs. This dissertation aimed to (1) explore the expectations of PCC in primary care settings among older Korean migrants in the U.S., …

The Role Of Music In Public Health, Joy Allen Phd, Mt-Bc

All MHI Citations

Music is emerging as a critical yet underutilized determinant of public health. Evidence demonstrates that music-based interventions reduce hospital stays, medication use, and staff burnout while improving patient outcomes, caregiver well-being, and population-level health indicators. Despite these proven benefits, the field remains fragmented and underfunded, limiting its capacity to scale. This paper reframes music as a pillar of public health and argues for systems-level investment in infrastructure, workforce development, and cross-sector innovation. Drawing on the work of the Berklee Music and Health Institute, we highlight how translational research, accessible evidence tools, and interdisciplinary training are advancing equity-driven, sustainable approaches to …

Polygenic Risk Scores Of Grip Strength In Men And Women With Or At Risk For Hiv, Sreevidya Sadananda Sadasiva Rao

Electronic Theses & Dissertations (2024 - present)

Background: Adequate hand function among older adults is necessary for the successful completion of activities of daily living and can affect whether an older adult is able to live independently. Current research highlights grip strength, the strength people have in their hands, as a robust predictor of morbidity and mortality, and explores the decline in grip strength over time. A person’s family history and genes (DNA) affect how much grip strength they have. Previous studies have identified genes that affect grip strength, mainly in European ancestry populations. In this study, we examined whether these genetic elements predict grip strength in …

Non-Profit Hospital Spending On Community Health Improvement: Catalysts, Impediments, And Opportunities In New York State, Isaac H. Michaels

Electronic Theses & Dissertations (2024 - present)

This dissertation assesses the distribution and determinants of spending by non-profit hospitals in New York State on community health improvement services and community benefit operations. Utilizing the Social Ecological Model of Health, this study considers multiple levels of influence on this spending, including organizational and community characteristics. Using quantitative analysis, it examines cross-sectional, spatial, and longitudinal patterns in spending and identifies organizational and community-level factors influencing it. Qualitative analysis investigates operational factors affecting spending, including individual and interpersonal influences. The results of this mixed-methods study can inform hospital administrators, public health officials, policymakers, and communities in optimizing policies and decision-making …

Association Of Non-Communicable Diseases With Severe Covid-19 Among People Living With And Without Diagnosed Hiv/Aids In New York State, Ravi Kumar Balu

Electronic Theses & Dissertations (2024 - present)

Background: People living with diagnosed HIV (PLWDH) have a higher chance of co-infections and co-morbidities than the general population. When SARS-CoV-2 was first reported in China in December 2019 and later declared a pandemic, it was speculated that PLWDH might be more prone to SARS-CoV-2 infection and severe disease outcomes given their increased vulnerability to other respiratory infections like influenza, pneumococcal pneumonia and tuberculosis. However, several facets of COVID-19 disease in PLWDH are incompletely understood, including whether non-communicable diseases (NCDs) are strong risk factors for severe disease outcomes and death as they are in the general population.

Methods: The data …

Food Rescue, Food Waste, And Policy In New York: A Mixed-Methods Study Of Food System Impacts, Mariana Torres Arroyo

Electronic Theses & Dissertations (2024 - present)

This dissertation investigates how food donation policies in New York State influence the recovery, redistribution, and waste of surplus fresh produce, with a focus on fruits and vegetables. Using an interdisciplinary, systems-based approach that integrates system dynamics modeling with qualitative, community-engaged research, the study analyzes the effectiveness and unintended consequences of three major policies: Nourish New York, the Farm to Food Bank tax credit, and the Food Donation and Food Scraps Recycling Law.

Chapter 2 uses simulation modeling to examine how the tax credit and waste ban affect produce recovery and redistribution. Results show that while both policies can boost …

Differences In Mental Health Care Use Between Urban And Rural Populations In New York State, 2017-2022, Anna J. Papa

Electronic Theses & Dissertations (2024 - present)

Objective

This study aimed to determine whether rural New York State residents receive mental health care at the same rate as urban residents, how poverty rates in New York State relate to rurality and mental health care use, and how pre-pandemic mental health care use rates compare to 2022 use rates. The goal was not to estimate the burden of disease, nor to estimate the number of patients engaged in care in each zip code, but to highlight the potential differences in service use between urban and rural New York State Office of Mental Health clients.

Methods

A secondary analysis …

How Do Young Adults With Drug Use Disorder (Dud) Utilize Treatment? Exploring And Examining Lived Experiences Towards Treatment Completion In Indonesia, Dewi Kartikawatiningsih

Electronic Theses & Dissertations (2024 - present)

In Indonesia which has the highest rate of drug addiction in Southeast Asia, there is currently little knowledge about how young adults perceive the barriers faced when completing treatment or how treatment providers' perspectives influence their treatment completion. Understanding and identifying barriers to treatment completion is essential to making drug treatment more effective. The purpose of this study is to explore the perspectives and live experiences of young adults with DUD and their addiction counselors to develop a deeper understanding of treatment needs. This study interviewed 33 clients and 15 counselors from the rehabilitation center of the Badan Nasional Narkotika …

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 …

Molecular Epidemiologic Studies Of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (Me/Cfs), Anil Kumar

Electronic Theses & Dissertations (2024 - present)

Background: Myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS) is a disabling multisystem complex disorder with no known etiology or approved treatment. Our studies aimed to assess the link between ME/CFS and autoimmune disease (AID) and cancer, and to identify potential biomarkers and biological mechanisms to further explore pathophysiology of this diseases.

Methods: All analyses were done using data from a case-control study of ME/CFS conducted by Dr. Roxana Moslehi and her collaborators. In our first study we estimated the cumulative incidences of AID and cancer among first degree relatives of 60 cases and 61 controls and compared cumulative …

Assessment Of The Psychometric Properties Of The Mask Usability Scale: A Measure Of The Perceived Usability Of N95 Respirators Among Healthcare Students And Staff, Lorna Kwai Ping Suen, Wai Hang Kwok, Ignatius Tak Sun Yu, Sony Nai Yeung So, Kin Cheung, Paul Hong Lee, Lily Yuen Wah Ho, Ka Yan Ko, Sukki Ho, Simon Ching Lam

Research outputs 2022 to 2026

Aim: To test the reliability and construct validity of the Mask Usability Scale in healthcare students and staff. Design: A methodological study involving repeated measures. Methods: The study included two batches of participants: (1) 283 university nursing students and (2) 1753 participants composed of students (61%) and clinical staff (39%). All participants underwent N95 respirator fit tests and user seal checks. They also responded to the Mask Usability Scale, which comprises 11 items evaluated using Likert scales. The internal consistency was assessed using Cronbach's alpha and item–total correlation test. Test–retest reliability was evaluated by the intraclass correlation coefficient (ICC). The …