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Associations Between Health-Seeking Behaviors And Social Support For Adult Black Women In The United States, Patricia Saint Cyr-Hager

Walden Dissertations and Doctoral Studies

A persistent gap exists involving health outcomes for Black women in the United States, regardless of socioeconomic status when compared to Black men and White women. This qualitative case study involved exploring the influence of social support on health-seeking behaviors among Black women. Sixteen participants, between ages 22 to 49 from nine states, were recruited. Data was collected using semi-structured interviews based on the social support theory. An analysis of the network composition showed that family members (including mothers, fathers, sisters, and partners), friends, community support groups not connected to social media, and online community support groups were the most …

The Association Between E-Cigarette Use And Community Mattering Among Adolescents In Maine, April Hughes

Walden Dissertations and Doctoral Studies

E-cigarette use among U.S. high school students is a significant public health issue. Factors such as mattering, sexual orientation, and gender identity (SOGI) influence e-cigarette use among adolescents, yet few studies have explored the relationship between mattering and e-cigarette use when considering SOGI. This quantitative study explored the association between past 30-day e-cigarette use and mattering among Maine high schoolers while controlling for SOGI and grade level. This correlational cross-sectional study used the 2023 Maine Integrated Youth Health Survey data, and the socioecological model served as the theoretical foundation. A multivariate binary logistic regression analysis indicated a significant association between …

Causal Functional Mediation Analysis With An Application To Functional Magnetic Resonance Imaging Data, Yi Zhao, Xi Luo, Michael E Sobel, Martin A Lindquist, Brian S Caffo

Faculty, Staff and Student Publications

A primary goal of task-based functional magnetic resonance imaging (fMRI) studies is to quantify the effective connectivity between brain regions when stimuli are presented. Assessing the dynamics of effective connectivity has attracted increasing attention. Causal mediation analysis serves as a widely implemented tool aiming to delineate the mechanism between task stimuli and brain activations. However, the case, where the treatment, mediator, and outcome are continuous functions, has not been studied. Causal mediation analysis for functional data is considered. Semiparametric functional linear structural equation models are introduced and causal assumptions are discussed. The proposed models allow for the estimation of individual …

Food Apartheid And The Retail Food Environment In The Bronx, Aissatou Barry

CUNY Mexican Studies Institute

This project examines the structural mechanisms that contribute to unequal food access, both historical and ongoing, in the South Bronx, and applies the food apartheid framework created by Bronx food activist Karen Washington. This paper applies the framework to two food retail initiatives in NYC: the New York State Regional Hub and the New York City FRESH food program to assess whether their policies address the structural mechanisms that contribute to food inequality. I ask: How does the unequal distribution of healthy food access in the Bronx reflect broader patterns of racial and economic exclusion? To what extent do current …

Uji Kelayakan Teknis Dan Performa Auvest: Rompi Pendingin Otomatis Berbasis Wearable Thermoelectric Cooler Untuk Mitigasi Risiko Heat Stress, Muchammad Adam Wildan, Amelia Avril Rayhana, Nadia Hanifan Nabila, Bian Shabri Putri Irwanto

National Journal of Occupational Health and Safety

Heat stress is a serious threat to construction workers that can reduce productivity and even threaten lives. Existing cooling vest innovations still have limitations, such as weight, manual systems, and the risk of leakage. This study aims to analyze the effectiveness of the Automatic Vest (AUVEST), an automatic cooling vest based on Wearable Thermoelectric Cooler and the Internet of Things (IoT), in preventing the risk of heat stress. The method used is experimental with trials on one construction worker in indoor and outdoor environments. AUVEST is equipped with temperature sensors (DS18B20, TMP102) and humidity (DHT11), whose data is processed by …

Us Drug Policy Does Not Align With Experts' Rankings Of Drug Harms: A Multi-Criteria Decision Analysis, Michael Broman, Alan K. Davis, Stacey Armstrong, Adam Levin, Kaltum Ahmed, Gustavo A. Angarita, Brooke J. Arterberry, Cecilia Bergeria, Mitch Earleywine, Kathryn S. Gex, Tom Gregoire, Jamey J. Lister, David S. Mathai, Nicky J. Mehtani, Nathan Menke, Charles D. Nichols, Hillary Shaub, Alayna P. Tackett, Brandon Weiss, Nefize Yalin, Lawrence D. Phillips

School of Medicine Faculty Publications

Background United States drug policy is primarily based on the Controlled Substances Act of 1970 and largely contradicts scientific evidence about how to mitigate drugs' harms. Expert consensus on drug harms could inform policy that improves the health of people who use drugs while reducing negative societal impacts of drug use. Therefore, this study adapted and extended the relevant 2010 United Kingdom multi-criteria decision analysis, rating drug harms by criteria comprising health and social impacts to people who use drugs and their families, communities, and society.Methods Seventeen experts on drug use in the US, including three with lived experience of …

Analisis Faktor Yang Berhubungan Dengan Pemberian Vaksinasi Polio Pada Anak Usia 0 - 59 Bulan Di Wilayah Cakupan Vaksinasi Tinggi (Dki Jakarta) Dan Rendah (Di. Yogyakarta), Mayla S. Zahrie, Zakianis Zakianis, Budi Haryanto, Yulia Fitria Ningrum

Jurnal Nasional Kesehatan Lingkungan Global

Polio vaccination coverage in Indonesia was uneven across provinces. Based on data from the 2017 Indonesian Health Profile, the coverage of complete oral polio vaccination for infants in Indonesia reached 91,7%, while polio injection vaccination reached only 46,8%. DKI Jakarta was one of the regions with high oral polio vaccination coverage (101.7%), whereas DI Yogyakarta was among the regions with low oral polio vaccination coverage (73.3%). This study aimed to determine the factors associated with polio vaccination among children under five years old in DKI Jakarta and DI Yogyakarta in 2017 using IDHS data from 2017. The study used a …

Analisis Spasial Sebaran Kejadian Diare Berdasarkan Faktor Iklim Di Kota Batam Tahun 2020-2023, Syofetim Esther Novi Triyanti

Jurnal Nasional Kesehatan Lingkungan Global

Diarrhea is the leading cause of morbidity in coastal regions. Batam City is highly vulnerable to climate change. This study aims to analyze the relationship between rainfall, air humidity, population density, safe drinking water facilities, and access to latrines with the incidence of diarrhea and the spatial distribution based on climate factors in Batam City from 2020 to 2023. The study used an ecological study design with subdistricts as the unit of analysis. Aggregate secondary data were obtained from the Batam City Public Health Office, Statistics Indonesia (BPS) Batam City, and NASA POWER. The analysis of the data included univariate …

What Bereaved People Have Found Helpful Following Death Of A Loved One In A Hospital: A Survey Study, Jon Swanson Phd, Mindy Flanagan Phd, Rachel Pfafman Mph, Mba

Other Specialties

Given the individual and public health impact of bereavement, discovering what people perceive as helpful after loss can improve interventions. In contrast to national projects, this project focused on two hospitals in a Midwestern hospital system.

A survey was developed to assess the work of chaplains with next of kin following a death, to assess the awareness and helpfulness of persons and organizations in the community, and to ask what people had done, said, or given that was helpful, or what respondents wished people had done. From a list of 283 people invited to respond, 52 completed the survey.

Survey …

Perbedaan Faktor Lingkungan Sosial Dan Perilaku Seksual Pranikah Pada Siswa Sma Perkotaan Dan Perdesaan Di Samarinda, Syaniah Syaniah, Annisa Nur Rachmawati, Lies Permana, Nur Rohmah, Rina Tri Agustini

Perilaku dan Promosi Kesehatan : Indonesian Journal of Health Promotion and Behavior

Background. Based on the 2023 GSHS data, 7.1% of adolescents aged 13–17 in Indonesia have had sexual intercourse, of which 66.2% are male and 33.8% are female. Adolescent premarital sexual behaviour is influenced by internal and external factors. Differences in social determinants may lead to behavioural variations between groups within a population.

Aim. To identify differences in peer influence, parental roles, and mass media (as social environmental factors), as well as premarital sexual behaviour among urban dan rural high school students in Samarinda

Method. This comparative cross-sectional study involved 274 respondents, consisting of 206 respondents from three urban high schools …

Hubungan Faktor Iklim, Faktor Polutan Dan Faktor Sosioekonomi Terhadap Proporsi Pneumonia Balita Provinsi Dki Jakarta Tahun 2013 – 2022, Fayza Chairunnisa Permana, Zakianis Zakianis, Laila Fitria, Erni Pelita Fitratunnisa

Jurnal Nasional Kesehatan Lingkungan Global

In 2022, the Province of DKI Jakarta ranked fourth with the highest coverage of pneumonia in toddlers (53.2%), exceeding Indonesia's toddler pneumonia coverage (38.78%). Pneumonia is influenced by various risk factors, including environmental factors such as climate and weather conditions as well as air pollution, and social and behavioral factors such as toddler characteristics, parental socioeconomic status, and access to health care services. This study aimed to analyze the relationship between climate factors (air temperature, relative humidity, rainfall, and air pressure), pollutant factors (PM₁₀, SO₂, CO, O₃, NO₂), and parents' socioeconomic …

Hubungan Ruang Terbuka Hijau Dengan Prevalensi Diabetes Melitus Di Provinsi Dki Jakarta Tahun 2022, Nurcholiza Hayati, Zakianis Zakianis, Al Asyary, Yulia Fitria Ningrum

Jurnal Nasional Kesehatan Lingkungan Global

Background: Diabetes Mellitus is a metabolic disease characterized by high blood sugar levels. According to Riskesdas (2018), Jakarta has the highest prevalence rate at 2.6%. Objective: To analyze the relationship between green open spaces, socio-economic factors, demographics, and physically active residents with the prevalence of diabetes mellitus. Method: An ecological study design with the unit of analysis is districts and the population consisting of 44 districts in DKI Jakarta Province in 2022. The dependent variable is the prevalence of diabetes mellitus, and the independent variables include education, employment status, population density, gender, age, physically active residents, the area of green …

Hubungan Antara Personal Hygiene, Kondisi Sanitasi Lingkungan, Dan Kepadatan Hunian Dengan Kejadian Penyakit Berbasis Lingkungan Pada Warga Binaan Di Lembaga Pembinaan Khusus Anak Kelas Ii Jakarta, Zihan Kamila Maharani, Laila Fitria, Budi Hartono

Jurnal Nasional Kesehatan Lingkungan Global

Environmental-based diseases are often found in environments with poor sanitation and low personal hygiene, including in Lembaga Pembinaan Khusus Anak (LPKA). This study aims to examine the relationship between personal hygiene, environmental sanitation conditions, and housing density with the incidence of environmentally based diseases among the residents of LPKA Kelas II Jakarta. This research employed a quantitative approach with a cross-sectional design. The sample consisted of 31 participants selected using a total sampling technique. Data were collected through questionnaires and observation, and analyzed using the chi-square test. The results showed a significant relationship between length of stay and the incidence …

Assessing The Impact Of Substance Abuse On Occupational Injuries Using Workers Compensation Claims In Ohio, Samson Agboola

Walden Dissertations and Doctoral Studies

Occupational injuries remain prevalent across various industries, resulting in significant financial burdens for both organizations and employees through increased workers’ compensation claims. One potential contributing factor is substance use in the workplace, which has been linked to decreased productivity, impaired judgment, and workplace conflict. Despite these risks, the relationship between substance use and occupational injuries remains underexplored. As such, grounded in constructivism and interpretivism, this study investigated the extent to which substance use influences injury outcomes and whether its role is underestimated in workplace incident reporting by analyzing worker’s compensation claims in Ohio. A mixed-methods approach was employed, combining a …

Mental Health And Beliefs About Abortion Access Following Changes To Reproductive Healthcare Laws In 2022: Findings From Oklahoma, Munjireen S. Sifat, Laili K. Boozary, Tina N. Le, Julia Mcquoid, Brittany Zaring-Hinkle, Sarah Tonkin, Lizbeth Benson, Bingjing Mao, Motolani Ogunsanya, Ruosi Shao, Amy M. Cohn, Allyson Shortle, Darla E. Kendzor

School of Public Health Faculty Publications

INTRODUCTION: A secondary analysis of cross-sectional survey data was conducted to characterize beliefs about abortion access in Oklahoma, measure stress associated with the overturn of Roe vs. Wade (2022), and evaluate the potential relationship between post-Roe stress (PR stress) and mental health. METHODS: From August through September 2022, adult Oklahomans (N = 1793) were surveyed about their sociodemographic characteristics, beliefs about abortion access, frequency of past-month stress related to the overturn of Roe vs. Wade, and mental health. Beliefs about abortion access were characterized overall and within sociodemographic groups. The relationship between PR stress and mental health was evaluated, and …

Implementasi Pelaksanaan Program I-Help (Integrated Help Promoting School) Pada Sekolah Menengah Pertama Di Jakarta, Rachma Dhiyaa' Arroyyan, Sarah Handayani

Perilaku dan Promosi Kesehatan : Indonesian Journal of Health Promotion and Behavior

Background. The I-HELP (Integrated Help Promoting School Programs) initiative is a school-based behavioural change intervention that integrates health values and belief-related variables into daily school activities. This program was developed as a follow-up to the collaboration between Universitas Muhammadiyah Prof. DR. Hamka (UHAMKA) and SEAMEO RECFON.

Aim. his study aims to describe implementation of the I-HELP (Integrated Help Promoting School Programs) at the junior high school level in Jakarta in 2022.

Method. This qualitative research employed a case study design conducted at SMP Muhammadiyah 4 and SMP Muhammadiyah 36 Jakarta. Data collection techniques included in-depth interviews, focus group discussions (FGDs), …

Social Learning Theory Dan Status Merokok Pelajar Smp Negeri, Alya Putri Ansyari, Nur Rohmah, Lies Permana, Annissa Nurrachmawati, Rina Tri Agustini

Perilaku dan Promosi Kesehatan : Indonesian Journal of Health Promotion and Behavior

Background. The prevalence of adolescent smokers aged 10–18 in Indonesia increased from 7.2% in 2013 to 9.1% in 2018. Approximately 70 million people in the country are active smokers, with 7.4% of them aged 10–18 years.

Aim. This study aims to investigate the association between knowledge, attitude and subjective norms with smoking status among students at a public junior high school in Samarinda.

Method. This study uses a cross-sectional design with a quantitative approach. A total of 159 respondents were randomly selected using proportionate stratified random sampling. Data were collected through interviews using a structured questionnaire and …

Efikasi Diri Dalam Melakukan Diet Sehat Pada Masyarakat Desa Cipacing, Sumedang, Hilmi Khairun Nisa, Neti Juniarti, Adelse Prima Mulya

Perilaku dan Promosi Kesehatan : Indonesian Journal of Health Promotion and Behavior

Background. Noncommunicable diseases (NCDs) account for 57 million deaths (71%) worldwide and 73% of all deaths in Indonesia. Eating habits are one of the factors contributing to the incidence of NCDs. In the process of improving a healthy lifestyle, including a healthy diet, self-confidence or self-efficacy in maintaining a healthy diet is necessary.

Objective. This study aims to identify the level of self-efficacy in maintaining a healthy diet among the community in Cipacing Village, Sumedang.

Methods. This study was conducted using a quantitative descriptive research design among the community of Cipacing Village, Sumedang Regency, West Java. The sample was …

Mental Health And Beliefs About Abortion Access Following Changes To Reproductive Healthcare Laws In 2022: Findings From Oklahoma, Munjireen Sifat, Laili K. Boozary, Tina N. Le, Julia Mcquoid, Brittany Zaring-Hinkle, Sarah Tonkin, Lizbeth Benson, Bingjing Mao, Motolani Ogunsanya, Ruosi Shao, Amy M. Cohn, Allyson Shortle, Darla E. Kendzor

Department of Medical Oncology Faculty Papers

INTRODUCTION: A secondary analysis of cross-sectional survey data was conducted to characterize beliefs about abortion access in Oklahoma, measure stress associated with the overturn of Roe vs. Wade (2022), and evaluate the potential relationship between post-Roe stress (PR stress) and mental health.

METHODS: From August through September 2022, adult Oklahomans (N = 1793) were surveyed about their sociodemographic characteristics, beliefs about abortion access, frequency of past-month stress related to the overturn of Roe vs. Wade, and mental health. Beliefs about abortion access were characterized overall and within sociodemographic groups. The relationship between PR stress and mental health was evaluated, and …

Knowledge Of Cpr And Code Status Discussions In Traumatically Injured Older Adults: Does Health Literacy Matter, Mokunfayo O Fajemisin, Ashna S Karpe, Stephanie Martinez Ugarte, Gabrielle E Hatton, Krislynn Mueck, Lillian S Kao, Martin L Blakely, Gina H Khraish, Aanand Naik, Shreyans Sanghvi, Jessica L Lee, Thaddeus J Puzio

Faculty, Staff and Student Publications

Code Status Discussions (CSDs), CPR understanding, and health literacy is understudied in traumatically injured older adults. We hypothesized that traumatically injured older adults and their families would have limited understanding of CPR and code status, and that lower health literacy would be associated with reduced advance care planning knowledge. We surveyed injured adults ≥65 or their surrogates to assess baseline code status, health literacy, and CPR discussions. Univariate and multivariable analyses were conducted. Among 201 respondents 55% had low health literacy. Only 38% had discussions about CPR, and 21% were asked about code status during admission. Surrogates similarly overestimated CPR …

Perbandingan Faktor Risiko Gangguan Kesehatan Gigi Dan Mulut Pada Usia 20-59 Tahun Berdasarkan Wilayah Di Indonesia: Analisis Survei Kesehatan Indonesia (Ski) Tahun 2023, Khadijah Qurrata Ayun, Asri Adisasmita Prof

Jurnal Epidemiologi Kesehatan Indonesia

Oral and dental health is one of the indicators of health, well- being, and quality of life. In addition, poor oral health can increase the economic burden, including treatment costs, loss of work productivity, and worsen the burden of other diseases. Globally, the average prevalence of dental and oral diseases is around 45%. In 2023, dental and oral health problems in Indonesia reach 57,6%. This study aims to analyze risk factors for dental and oral health disorders among people aged 20-59 years based on regions in Indonesia. This study uses a cross- sectional design. The secondary data used is data …

Health Education On Operative Cataract Care: A Scoping Review, Luh Putu Prima Widya Ridwanti, I Ketut Swarjana, I Gusti Ngurah Made Kusuma Negara, Putu Gde Yudara Sandra Putra

Jurnal Epidemiologi Kesehatan Indonesia

Cataract is the leading cause of blindness worldwide, requiring surgery and appropriate patient and family education to ensure proper operative care. This literature review aimed to identify health education on operative cataract care. The type of this study is a scoping review using the PubMed database, ScienceDirect, and other sources that were published in the last 10 years (2015-2024). The PICO model (P: patients and families; I: audiovisual, booklets, leaflets, and others; C: standard care or education; O: knowledge and skills in cataract operative care) was used. The keywords used to search for articles are cataract surgery AND video OR …

Analisis Cakupan Penemuan Kasus Tuberkulosis (Treatment Coverage) Berdasarkan Faktor Demografis Dan Komorbiditas Di Puskesmas Ciracas Tahun 2023-2024, Anggie Hardiyanti, Helda Helda, Mufti As Siddiq M. Irzal, Mareska Monica

Jurnal Epidemiologi Kesehatan Indonesia

Tuberculosis (TB) remains a major global and national health burden, with case detection coverage still below target in several regions. The success of TB control programs largely depends on achieving adequate treatment coverage. In East Jakarta, Ciracas Primary Health Center recorded a treatment coverage of 75% (497 cases) in 2023, the lowest among ten centers, and an increase to 84% (509 cases) in 2024, though still below the national target of 90%. To analyze TB case detection coverage based on demographic factors and comorbidities (diabetes mellitus and Human Immunodeficiency Virus) at Ciracas Primary Health Center during 2023–2024. This study …

Socio-Demographic Determinants Of Hospitalization Severity Among Type 2 Diabetes Mellitus-Related Hospitalization Visits In Indonesia: A Cross-Sectional Analysis Of Using Bpjs Health Secondary Data, 2023, Nadia Putri, Asri C. Adisasmita, Fitria Fitria, Sely Anggraini

Jurnal Epidemiologi Kesehatan Indonesia

Type 2 diabetes mellitus (T2DM) is a chronic disease with high prevalence and contributes significantly to the burden of inpatient care in Indonesia. The severity of T2DM-related hospitalization as classified under the INA-CBGs system, is an important indicator for assessing disparities in access to care and the health system’s response to vulnerable populations. This study aims to analyze the relationship between socio-demographic characteristics and the severity of T2DM-related hospitalization visits based on 2023 Social Security Administering Body for Health (BPJS Health) data. This study employed a cross-sectional design using secondary data from the 2023 BPJS Health Sample Data. The unit …

Kejadian Luar Biasa Gondongan Di Sd Islam X Samarinda, 2024, Rudy Agus Riyanto, Irfansyah Baharuddin Pakki, Mela Sabena, Meli Pasiakan, Erlina Erlina, Rima Andriani

Jurnal Epidemiologi Kesehatan Indonesia

Mumps outbreaks are a public health issue that still frequently occur in elementary school settings, particularly among children with low immunization coverage. Therefore, a comprehensive epidemiological understanding is needed as a basis for control. This research aims to describe the epidemiological picture and causative factors of the mumps outbreak that occurred at Islamic Elementary School X in Samarinda City in 2024, using a case series design. The outbreak occurred from April to October 2024, while epidemiological data collection and case verification were conducted from December 2nd to 8th, 2024. The analysis uses surveillance data, field observations, and questionnaires administered to …

Hubungan Kehamilan Usia Remaja Dengan Kelahiran Prematur Di Rsud Cengkareng Jakarta Barat Tahun 2022: Sebuah Studi Kohort Retrospektif, Anna Triana, Sudarto Ronoatmodjo

Jurnal Epidemiologi Kesehatan Indonesia

Premature birth is leading causes of neonatal mortality. According to the World Health Organization (WHO), global premature birth rates reached 9.9% in 2020, it’s rising compared to preterm birth rates in 2010. One of the risk factors for preterm birth is the mother's age, which pregnant adolescents are more at risk of giving birth to preterm babies due to physiological, psychological, and socioeconomic immaturity. This study is an analytical study with a retrospective cohort design to determine the relationship between adolescents pregnancy and preterm birth. This study was conducted in Cengkareng General Hospital West Jakarta using patient’s medical record data. …

Psychological Resilience As A Predictor Of Occupational Stress Among Teaching Staff In Course X, Indah Kusuma Wardani, Fajaria Nurcandra, Dr. Dyah Utari, Afif Amir Amrullah

Jurnal Epidemiologi Kesehatan Indonesia

Workplace stress is a common condition that may be triggered by the demands of professional involvement. Psychological resilience functions as a protective factor that enables individuals to maintain their level of work engagement despite experiencing job-related stress arising from work–life imbalance. This study aimed to examine the relationship between psychological resilience and occupational stress among teaching staff at Course X. The research employed a quantitative approach with a cross-sectional design, utilizing chi-square testing and Cox regression analysis, with a total sample of 98 participants. Data collection was conducted from April to June 2024. The instruments used included the Workplace Stress …

Environmental Health Risks To Children In Sub-Saharan Africa: A Scoping Review Of Evidence And Gaps In Global Interventions, Tadius C. Chitambwe, Dewi Susanna

Jurnal Epidemiologi Kesehatan Indonesia

Sub-Saharan Africa’s (SSA) children experience a disproportionate burden of environmental health risks, contributing to over half of global under-five deaths despite representing only 27% of live births ¹. This scoping review synthesised evidence from sixty-seven (67) eligible studies (2010–2025) to map out environmental exposures affecting children (0–18 years) in Sub-Saharan Africa, and to identify gaps in global interventions. Included studies focused on children (0-18 years) in SSA, addressed one or more of the four predefined environmental exposure domains (air pollution, WASH, toxic chemicals, climate-related risks), and reported on child health outcomes or interventions. Guided by the PRISMA and Arksey …

Documenting Death: Maternal Mortality And The Ethics Of Care In Tanzania (Adrienne E. Strong 2020), Luluk Oktavia, Megawati Sukarno

Paradigma: Jurnal Kajian Budaya

In recent decades, global efforts to reduce maternal mortality have become a primary focus in health development agendas. However, challenges in providing quality healthcare remain complex, especially in resource-limited countries. Adrienne E. Strong’s book, Documenting Death: Maternal Mortality and the Ethics of Care in Tanzania, offers an ethnographic perspective on the relationship between bureaucratic structures, resource constraints, and healthcare practices in Tanzania. This review examines Strong’s key concepts, such as good enough care, documented care, and fierce care, which highlight the ethical dilemmas faced by healthcare workers in delivering care under administrative pressures and limited facilities. The critique of the …

Hurricane Helene, One Year Later: Lived Experience, Geraldine A. Miller

Journal of Appalachian Health

Ashe County is located in the northwestern corner of North Carolina (NC), bordered by Virginia and Tennessee. The county is isolated, mountainous, and historically has lacked good highway access. Hurricane Helene, a category 4 hurricane at landfall, struck Western NC on September 27, 2024, resulting in flooding and wind damage that destroyed local communities in terms of land, homes, bridges, water, electricity, etc. with a damage of $59.6 billion.⁶ One year later, the recovery from the hurricane continues draining individuals and communities of their time, energy, and money. Geri Miller reflects on her hurricane impact experiences a year later. …