Digital Commons Network^™

Air Pollution And Public Health: Global Evidence And Implications, Mohammed Obaid Al-Mansoori

Al-Bahir

Globally, the issue of air pollution keep being one of most serious challenges that affecting environment and human health, coming from emissions of industries, transport, agriculture and also from the fuel people use in homes, in addition to natural events that make the situation worse. This review try to bring together the available evidences about the sources, types, and the health impacts of the main air pollutants, including the gaseous ones like SO₂, O₃, NO₂, and CO, and the particulate matter (PM₁₀, PM₂.₅). Exposure for short or long time to these pollutants is linked with many harmful outcomes, such as …

Bio 340 Final Project: Rural Population Structure And Food Production Interact To Shape Global Undernourishment, Ava Ripanti

Biology Student Scholarship

Ava Ripanti - Environmental Biology '27

Undernourishment remains a major global public health challenge, reflecting the proportion of a population lacking sufficient dietary energy intake. While food availability is central to food security, undernourishment is also shaped by structural and socioeconomic factors such as population distribution and access to resources. Although rural populations are closely tied to agriculture, they often experience higher food insecurity due to limited infrastructure, market access, and healthcare. Prior research emphasizes that broader determinants, particularly inequality and development, are stronger predictors of undernourishment than agricultural output alone, that food insecurity exists in both rural and urban …

Geographic Variation In Adrd Prevalence And Mortality And Their Association With Social Vulnerability Across Us Counties: A Spatial Epidemiological Analysis Using Norc And Cdc Svi Data, Dean Kyne

Sociology Faculty Publications

Introduction: Geographic disparities in Alzheimer’s disease and related dementias (ADRDs) remain insufficiently understood at the national scale, limiting efforts to address inequities in dementia burden across USA communities. This study examined county-level variation in ADRD prevalence and mortality and evaluates the association between social vulnerability and these outcomes.

Methods: This cross-sectional ecological study analyzes 2020 county-level ADRD prevalence and all-cause mortality among Medicare beneficiaries from the NORC Dementia DataHub. The analytic sample included 3,108 USA counties in the contiguous USA and the District of Columbia. ADRD outcomes included (1) prevalence of highly likely ADRD and (2) prevalence of all determinations, …

Lower Suicidal Ideation Linked To Easier Access To Urban Green Spaces During The Covid-19 Pandemic: A Nationwide Study In Japan, Zheng Xian, Tomoki Nakaya, Clive E. Sabel, Ryo Okubo, Kun Liu, Jinguang Zhang, Takahiro Tabuchi

School of Geography, Earth and Environmental Sciences

Urban green spaces (UGSs) have been linked to improved mental health and lower suicide rates, yet their protective role during large-scale crises remains underexplored. We examined associations of UGS accessibility with long-term and pandemic induced new-onset suicidal ideation during the early phase of the COVID-19 pandemic in urban Japan, using data from a nationwide health survey of 17,376 participants (August 2020). Modified Poisson regression models estimated prevalence ratios (PRs) for suicidal ideation by UGS accessibility (area, number, and type) within 5, 10, and 15-minute walking thresholds from home, controlling for individual and area-level confounders. UGS accessibility exhibited dose-response relationships with …

The Strength Of The Association Between Obesity And Mortality From Diabetes Among Adults In Florida, Diego A. Garcia, Jacob Bleasdale Phd,Ms,Ches, Cristobal Cintron Msc, Drph

High Impact Practices Student Showcase Spring 2026

Background: Diabetes mellitus is a leading cause of preventable death across the United States, with obesity being directly tied to this condition as one of its most significant and modifiable risk factors. Although national-level evidence strongly supports this association, Florida-specific population data is still limited.

Methods: County-level adult obesity prevalence and age-adjusted diabetes mortality data were obtained directly from the Florida Health CHARTS website (FL DOH,2024) for all Florida counties. The Pearson correlation (r) was used to evaluate the strength of association between the variables

Results: A statistically significant, moderate-positive correlation was found between adult obesity rates …

Endocrine-Disrupting Chemicals And Thyroid Cancer, Özge Baş Aksu, Mustafa Şahi̇n

Turkish Journal of Medical Sciences

Environmental endocrine-disrupting chemicals (EDCs) have emerged as a critical global health concern because of their role in various diseases, including thyroid cancer. Defined as exogenous substances that disrupt endocrine system functions, EDCs can affect multiple generations through mechanisms such as hormone receptor modulation, altered hormone synthesis, and epigenetic modifications.The increasing global incidence of thyroid cancer has heightened interest in environmental factors, with EDC exposure recognized as a significant contributor. Compounds such as heavy metals, persistent organic pollutants, per- and polyfluoroalkyl substances, and bisphenol A play crucial roles in disrupting thyroid homeostasis. Emerging evidence underscores the synergistic effects of multiple EDC …

Investigating Environmental And Socioeconomic Contributors To Adult Obesity In The Rio Grande Valley, John Nicholas Cauba, Jihoo Woo, Russel Wiggins, Shizue Mito

School of Medicine Publications

Obesity in the Rio Grande Valley (RGV) of Texas remains a critical public health concern, with rates (46.9%) significantly exceeding those of Texas (36%) and the U.S. (34%) (p < 0.001). This study used 2024 County Health Rankings data to analyze environmental and socioeconomic contributors to obesity across 240 Texas counties, with a population-weighted focus on Hidalgo, Cameron, Starr, and Willacy counties. The RGV exhibited markedly poorer access to exercise, higher rates of physical inactivity, lower Food Environment Index scores (FEI = 4.3 vs. 5.7 in Texas), higher rates of uninsurance, worse patient-to–primary care physician (PCP) ratios (2152:1 vs. Texas 1660:1), and increased preventable hospitalizations. Multiple linear regression identified physical inactivity (β = 0.6, p = 0.01) and access to exercise (β = −0.02, p = 0.02) as significant predictors of obesity. Notably, higher uninsured rates were associated with lower reported obesity, likely due to underdiagnosis in the absence of routine care. These findings emphasize the need for targeted interventions addressing food access, environmental and recreational infrastructure, along with healthcare infrastructure in the RGV, where socioeconomic disadvantage and structural barriers magnify the impact of national obesity trends on the regional level.

Investigating The Spatial Distribution Of Food Insecurity And Its Associated Factors Across Mississippi Counties, Elizabeth C. Swindell, Riley Morgan, Dylan Barker, Ruaa Al Juboori

Journal of Public Health in the Deep South

Background: Mississippi has one of the highest rates of food insecurity in the United States, with many counties experiencing significant disparities in access to healthy food. Therefore, understanding the spatial distribution of these disparities is essential for developing targeted interventions.

Purpose: This study aims to investigate the spatial distribution of food insecurity and its associated social and health factors across Mississippi counties to identify areas in need of intervention.

Methods: Cross sectional study was conducted using publicly available datasets to examine food insecurity and its associated factors at the county level. Pearson correlations and bivariate Moran’s I were used to …

Birth Defect Trends Within Texas Public Health Region 11, 2000-2019: An Analysis Of Texas Department Of State Health Services Public Data, Jonathan M. Hebert, Miguel A. Lopez, Padmanabhan Rengasamy

Research Colloquium

Background: South Texas is a medically underserved area with pockets of low socioeconomic status and poor access to healthcare, including prenatal care. This paper aims to monitor the changes in prevalence for cardiac, circulatory, gastrointestinal, genitourinary, and neural tube birth defects in this region in the last two decades to monitor the effectiveness of current public health efforts.

Methods: Public data on 20 birth defects from the Texas Department of State Health Services were obtained for decades 2000-2010 and 2010-2019 in Texas Public Health Region 11 and the remaining regions of Texas. Prevalences and odds ratios for all birth defects …

Water Justice And Equity: The Disproportionate Effects Of Pollution On Black, Indigenous, And Other Communities Of Color, Rae Cade

Theses, Dissertations and Culminating Projects

Access to clean drinking water is a basic human right, regardless of an individual’s background. Yet, discriminatory practices in the United States have disproportionately burdened Black, Indigenous, and other people of color (BIPOC) with contaminated sources of water. Understanding how and why water is disproportionately contaminated in areas with increased diversity, and identifying and targeting areas of environmental injustice, are essential steps for ensuring future water equity. Here, I examine the drivers of inequitable access to clean drinking water within the northeastern United States. In chapter one, I look at the historical drivers of land inequity within the United States. …

Exposure To Air Pollution And Risk Of Respiratory Tract Infections In The Adult Danish Population—A Nationwide Study, Kathrine A. Kaspersen, Sussie Antonsen, Henriette T. Horsdal, Bertram Kjerulff, Jørgen Brandt, Camilla Geels, Jesper H. Christensen, Lise M. Frohn, Clive E. Sabel, Khoa M. Dinh, Ole Hertel, Torben Sigsgaard, Carsten B. Pedersen, Christian Erikstrup

School of Geography, Earth and Environmental Sciences

Objectives: The association between air pollution and risk of respiratory tract infection (RTI) in adults needs to be clarified in settings with low to moderate levels of air pollution. We investigated this in the Danish population between 2004 and 2016. Methods: We included 3 653 490 persons aged 18–64 years in a nested case-control study. Exposure was defined as the average daily concentration at the individual's residential address of CO, NO_X, NO₂, O₃, SO₂, NH₃, PPM_2.5, black carbon, organic carbon, mineral dust, sea salt, secondary inorganic aerosols, SO …

Influence Of Seasonality And Public-Health Interventions On The Covid-19 Pandemic In Northern Europe, Gerry A. Quinn, Michael Connolly, Norman E. Fenton, Steven J. Hatfill, Paul Hynds, Coilín Óhaiseadha, Karol Sikora, Willie Soon, Ronan Connolly

Articles

Background: Most government efforts to control the COVID-19 pandemic revolved around non-pharmaceutical interventions (NPIs) and vaccination. However, many respiratory diseases show distinctive seasonal trends. In this manuscript, we examined the contribution of these three factors to the progression of the COVID-19 pandemic. Methods: Pearson correlation coefficients and time-lagged analysis were used to examine the relationship between NPIs, vaccinations and seasonality (using the average incidence of endemic human beta-coronaviruses in Sweden over a 10-year period as a proxy) and the progression of the COVID-19 pandemic as tracked by deaths; cases; hospitalisations; intensive care unit occupancy and testing positivity rates in six …

Poor Water Quality Persists In Diverse Urban Communities, Rae Cade, Danlin Yu, Kyle Whyte, Pankaj Lal, Cortni Borgerson

Department of Earth and Environmental Studies Faculty Scholarship and Creative Works

While humans need water to survive, water can also efficiently transmit microbial diseases and heavy metals to consumers. Over 50,000 water violations occurred in 2020 and such burdens were not borne equally amongst consumers. Yet, the factors that drive such variation remain unclear. We examined the interactions between water quality and inherited equity gaps in one of the most diverse urban areas in the United States. We used publicly available drinking water datasets to determine which contaminant was most prevalent between 2010–2020 and who was significantly more likely to be affected by this contamination. We found that a lack of …

Predicting Suicide In Counties: Creating A Quantitative Measure Of Suicide Risk, Kate Mobley, Gita Taasoobshirazi

Faculty Articles

Rising rates of suicide over the past two decades have increased the need for wide-ranging suicide prevention efforts. One approach is to target high-risk groups, which requires the identification of the characteristics of these population sub-groups. This suicidology study was conducted using large-scale, secondary data to answer the question: using the research on suicide, are there variables studied at the community level that are linked to suicide and are measurable using quantitative, demographic data that are already collected and updated? Data on deaths from suicide in U.S. counties for the years 2000, 2005, 2010 and 2015 were analyzed using multiple …

Religious Freedom Vs. Compelled Vaccination: A Case-Study Of The 2018-2019 Measles Pandemic Or The Law As A Public Health Response, Barbara Pfeffer Billauer Esq.

Catholic University Law Review

Following the recent decision in Roman Catholic Diocese v. Cuomo,^[1] clear guidance regarding the state’s powers to act during a pandemic is wanting. I look here to the 2018–2019 global measles epidemic, with a focus on the New York and Israeli experiences, for that guidance. Measles rates increased dramatically during the 2018–2019 season, both in the United States and globally. This phenomenon reflects a general decline in worldwide vaccination and an increase in vaccine resistance stoked by anti-vax groups. In the United States, the epidemic targeted ultra-Orthodox Jewish communities, as it did in Israel. This Article evaluates the …

The Nexus Of Climate Change, Covid-19, And Environmental Justice On Children's Health, Emma Pennea, Laura Anderko, Caroline Moore, Ruth Mcdermott-Levy

Journal of Applied Research on Children: Informing Policy for Children at Risk

Climate change poses a threat to children, who are increasingly vulnerable, depending on adults to protect them from the impacts of these changes including extreme weather events, poor air and water quality and risk to mental health. Children living in poverty carry additional burdens and risks, living in environments that consistently experience poor air and water quality from polluting industries, compounded by the effects of climate change. COVID-19 has placed additional challenges to children’s health and increases the complexity of addressing climate change and environmental justice. The intersection between climate change and COVID-19 exacerbates these existing disparities by impacting children's …

Making The Invisible Visible: Ageism As A Social Determinant Of Elder Abuse, E-Shien Chang

Yale Graduate School of Arts and Sciences Dissertations

Background: Elder abuse affects one in six community-dwelling older adults globally every year and can lead to great bodily and psychological harm and death. Despite elder abuse has been recognized as a global health problem, there are several knowledge gaps that have impeded the development of elder abuse prevention science. At the structural level, evidence regarding the effects of broader societal attitudes, laws and policies in enabling abusive acts toward older persons is lacking but critical for tailored preventions. At the individual level, existent research has disproportionately focused on victims rather than abusers, a problematic trend given abuser characteristics can …

Association Between Community-Based Self-Reported Covid-19 Symptoms And Social Deprivation Explored Using Symptom Tracker Apps: A Repeated Cross-Sectional Study In Northern Ireland, Jennifer M. Mckinley, David Cutting, Neil Anderson, Conor Graham, Brian Johnston, Ute Mueller, Peter M. Atkinson, Hugo Van Woerden, Declan T. Bradley, Frank Kee

Research outputs 2014 to 2021

Objectives: The aim of the study was to investigate the spatial and temporal relationships between the prevalence of COVID-19 symptoms in the community-level and area-level social deprivation. Design: Spatial mapping, generalised linear models, using time as a factor and spatial-lag models were used to explore the relationship between self-reported COVID-19 symptom prevalence as recorded through two smartphone symptom tracker apps and a range of socioeconomic factors using a repeated cross-sectional study design. Setting: In the community in Northern Ireland, UK. The analysis period included the earliest stages of non-pharmaceutical interventions and societal restrictions or 'lockdown' in 2020. Participants: Users of …

Insufficient Sun Exposure Has Become A Real Public Health Problem, Lars Alfredsson, Bruce K Armstrong, D. Allan Butterfield, Rajiv Chowdhury, Frank R. De Gruijl, Martin Feelisch, Cedric F. Garland, Prue H. Hart, David G. Hoel, Ramune Jacobsen, Pelle G. Lindqvist, David J. Llewellyn, Henning Tiemeier, Richard B. Weller, Antony R. Young

Chemistry Faculty Publications

This article aims to alert the medical community and public health authorities to accumulating evidence on health benefits from sun exposure, which suggests that insufficient sun exposure is a significant public health problem. Studies in the past decade indicate that insufficient sun exposure may be responsible for 340,000 deaths in the United States and 480,000 deaths in Europe per year, and an increased incidence of breast cancer, colorectal cancer, hypertension, cardiovascular disease, metabolic syndrome, multiple sclerosis, Alzheimer's disease, autism, asthma, type 1 diabetes and myopia. Vitamin D has long been considered the principal mediator of beneficial effects of sun exposure. …

The Risk Spiral Model: Systemic Factors That Feed Mass Incarceration, High Risk Behaviors, Hiv And Other Sexually Transmitted Infections For African American Males, Lauresa Washington Mccoy

MUSC Theses and Dissertations

The U.S. corrections system continues to have an over representation of black males. A long legacy of practices, including convict leasing, lynchings, and police brutality, have shaped the history of African American males and the criminal justice system (Mauer, 1999). Few studies exist on the impact of mass incarceration in African American communities and its contributory impact on the degradation of the public health infrastructure within these communities. In this qualitative study, the researcher will capture and analyze the flow of African American males before, during and after incarceration and the associated prevalence of Human Immunodeficiency Virus, other Sexually Transmitted …

Research Support Infrastructure: Implementing A Clinical Research Coordinating Center, Julio A. Ramirez, Paula Peyrani, William A. Mattingly, Forest W. Arnold, Timothy L. Wiemken, Robert R. Kelley, Leslie A. Wolf, Ruth M. Carrico, Andrea Reyes-Vega

Faculty and Staff Scholarship

Insufficient infrastructure is one of the challenges facing investigators in the field of clinical research. At the University of Louisville (UofL) Division of Infectious Diseases, we developed a multidisciplinary coordinating center with the aim to support investigators in all aspects of the clinical research process. The objective of this article is to describe the composition and the role of the different units of the UofL Clinical Research Coordinating Center. The different components of the Center can serve as a template for institutions interested in developing a clinical research support infrastructure.

Epid 7133 – Epidemiologic Research Methods I (3 Credits), Logan Cowan

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

This course will focus on epidemiologic methods - primarily methods used in observational studies using existing data, cohort studies, case-control studies and randomized controlled trials. With respect to cohort studies, topics covered include cohort identification, ascertainment of exposure status, follow-up of cohort members, measuring outcomes, sources of bias and interpretational issues. Case-control topics include issues around defining cases and controls, control of confounding, and sources of bias/systematic error. Topics around randomized trials include randomization procedures, defining and assembling treatment/intervention arms, selecting study subjects and approaches to data collection. Other topics covered in this course include surveillance and ecologic studies. Pros …

Epid 7133 - Epidemiologic Research Methods I, Kelly L. Sullivan

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

This course will focus on epidemiologic methods - primarily methods used in observational studies, cohort studies, case-control studies and randomized controlled trials. With respect to cohort studies, topics covered include cohort identification, ascertainment of exposure status, follow-up of cohort members, measuring outcomes, sources of bias and interpretational issues. Case-control topics include issues around defining cases and controls, control of confounding, and sources of bias/systematic error. Topics around randomized trials include randomization procedures, defining and assembling treatment/intervention arms, selecting study subjects and approaches to data collection. Other topics covered in this course include surveillance and ecologic studies. Pros and cons of …

The Relationship Between Access To Healthcare And Heart Disease Mortality In Kentucky, 2012-2014, Nima Farsi

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Cardiovascular disease is the cause for a large portion of the mortalities in the United States. Furthermore, Kentucky has one of the highest heart disease mortality rates out of all 50 U.S. States. This study hypothesized that heart disease mortality in Kentucky counties has a positive relationship with lack of accessibility to healthcare. Furthermore, this ecological study hypothesized that because there is no available usual source of a healthcare providers and ultimately a lack of accessibility to receive diagnostic/preventative services for this population, the high rate of cardiovascular disease mortality in Kentucky is dependent on access to healthcare services.

This …

An Ecologic Study Of Access To Acute Stroke Care, Mortality And Its Correlates In The Stroke Belt, Jeffrey E. Levy

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Importance: Stroke is leading cause of death in the United States, but quick access to treatment has been shown to result in better outcomes and improved mortality. Among the many barriers to access, geographic proximity to hospitals certified in stroke care may also play a role.

Objectives: To calculate county-level measures of accessibility to certified stroke hospitals using GIS, and to examine its relationship with county stroke mortality while controlling for other county-level potential confounders.

Methods: Ecologic study using county mortality rates and census data to recreate stroke death counts for use in traditional, and a geographically …

Statistical Analysis Of Rabies Submissions In Kentucky And Weather As A Potential Predictor Of Positive Cases, Hannah Free

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background

The rabies virus is a zoonotic pathogen that is nearly 100 percent fatal once symptoms occur. Because it is still active in wildlife populations in Kentucky, the need for preventive measures and surveillance is critical. Temperature and precipitation have been shown to affect rabies. This study examined rabies submissions in Kentucky, weather and geographical distribution to both describe and predict cases.

Methods

Data from the University of Kentucky Veterinary Diagnostics laboratory were used to assess rabies submissions from 2005 through 2015. These submissions were anonymously submitted by the public and the Florescent Antibody Test was used to determine infection …

Ebola Virus - Epidemiology, Diagnosis, And Control: Threat To Humans, Lessons Learnt, And Preparedness Plans - An Update On Its 40 Year's Journey, Raj Kumar Singh, Kuldeep Dhama, Yashpal Singh Malik, Muthannan Andavar Ramakrishnan, Kumaragurubaran Karthik, Rekha Khandia, Ruchi Tiwari, Ashok Munjal, Mani Saminathan, Perumal Arumugam, Sunil Kumar Joshi

Bioelectrics Publications

Ebola virus (EBOV) is an extremely contagious pathogen and causes lethal hemorrhagic fever disease in man and animals. The recently occurred Ebola virus disease (EVD) outbreaks in the West African countries have categorized it as an international health concern. For the virus maintenance and transmission, the non-human primates and reservoir hosts like fruit bats have played a vital role. For curbing the disease timely, we need effective therapeutics/prophylactics, however, in the absence of any approved vaccine, timely diagnosis and monitoring of EBOV remains of utmost importance. The technologically advanced vaccines like a viral-vectored vaccine, DNA vaccine and virus-like particles are …

Diagnostic Prevalence Of Diabetes Among Older Adults In Rural Appalachia, Gabriella Hodges

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background

The rural, mountainous Appalachian region continuously has poorer health outcomes than the rest of the United States. This is true for many chronic diseases including diabetes: the 7th leading cause of death in the United States. This study assessed differences in the prevalence of diagnosed diabetes between older adults in rural, Appalachian counties and rural, non- Appalachian counties.

Methods

Data for the year 2013 was extracted from the Centers for Medicare and Medicaid Services (CMS) Public Use Files for Medicare beneficiaries (September 2015), which provides county level prevalence for diabetes as well as several other conditions among Medicare fee-for-service …

Viral Zoonoses That Fly With Bats: A Review, Alfonso Calderon, Camilo Guzman, Jorge Salazar-Bravo, Luiz Tadeu Figueiredo, Salim Mattar, German Arrieta

MANTER: Journal of Parasite Biodiversity

Emerging infectious diseases are a growing threat to human health and a great challenge for global medical attention systems. Governmental agencies in tropical regions with abundant zoonotic pathogens should implement an active vigilance/monitoring model in bat reservoir populations because of their species richness, abundance and dispersal capabilities. Chiropterans represent approximately 20% of all mammal species, the second largest order in terms of number of species after rodents. Importantly, bats constitute natural reservoirs for potential infection of humans of several infectious disease agents such as Coronavirus, Filovirus, Lyssavirus, Paramyxovirus, and Flavivirus. Local disease outbreaks caused by new pathogens can …

The Link Between Smoking, Lung Cancer And Socioeconomic Factors In Kentucky, Shreya Berlia

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background and Purpose

Lung cancer is the leading cause of cancer death and the second most diagnosed cancer in both men and women in the United States. An estimated 158,080 deaths from lung cancer are expected to occur in 2016, which will account for approximately 1 in 4 of all cancer deaths. The 1- and 5-year relative survival rates for lung cancer are 44% and 17%, respectively. The incidence rate for lung cancer has been declining since the mid-1980s in men, but only since the mid-2000s in women. Tobacco smoke is the leading cause of preventable disease and death in …