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Decreasing Obesity And Obesity Stigma: Socio-Demographic Differences In Beliefs About Causes Of And Responsibility For Obesity, Christy F. Brady Mar 2016

Decreasing Obesity And Obesity Stigma: Socio-Demographic Differences In Beliefs About Causes Of And Responsibility For Obesity, Christy F. Brady

Sociology Faculty Publications

Obesity is a stigmatized condition, and research has shown that obesity stigma varies based on the perceived cause of obesity. It is important that public health professionals develop policy and campaigns that resonate with specific populations while avoiding an increase in harmful stigma. This study identifies socio-demographic differences in causal attributions of obesity and beliefs about responsibility for obesity. Using data from a survey of 923 people in the United States conducted by ABC New/Time Magazine, attributions of cause and responsibility are analyzed using Ordinary Least Squares regression. Beliefs about cause and responsibility fall on a continuum from primarily individual …


The Educated Citizen And Global Public Health Issues: One Model For Integration Into The Undergraduate Curriculum, Rosemary M. Caron Mar 2016

The Educated Citizen And Global Public Health Issues: One Model For Integration Into The Undergraduate Curriculum, Rosemary M. Caron

Health Management & Policy

The Educated Citizen Initiative proposes that an understanding of public-health issues is a core component of an educated citizenry and is essential to develop one’s societal responsibility. This initiative supports the Institute of Medicine’s recommendation that “all undergraduates should have access to education in public health.” Furthermore, the Liberal Education and America’s Promise (LEAP) framework developed by the Association of American Colleges and Universities supports the “integration of public-health education into general and liberal education with an aim to produce an educated citizenry.” The LEAP framework is implemented by teaching about the role of social determinants in a population’s health …


Breanne Ward, Breanne Ward, Kelsey Duinkerken Jan 2016

Breanne Ward, Breanne Ward, Kelsey Duinkerken

Jefferson Nursing Oral Histories

Though she originally decided to become an accountant during college, Breanne Ward soon realized she would rather be in a field where she could work more closely with people. She chose nursing because she wanted the opportunity to physically care for others. Ms. Ward was accepted as a nursing student in Jefferson’s Full-time Accelerated Coursework Track (FACT) program, during which time she discovered an interest in community health through both her non-hospital clinical experiences and volunteering with Jeff HEALTH (Helping East Africa Link To Health). After working in the Thomas Jefferson University Hospital and completing her Master’s in Community Systems …


The Association Between Latent Tuberculosis Infection And Diabetes Mellitus Control In The United States, Whitney L. Remy Jan 2016

The Association Between Latent Tuberculosis Infection And Diabetes Mellitus Control In The United States, Whitney L. Remy

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

Rationale: Diabetes mellitus (DM) is recognized as a common comorbid condition for tuberculosis (TB). Those with comorbid conditions are more likely to develop active TB, to have trouble with treatment, and to have more severe symptoms.

Objective: To measure the prevalence and distribution of latent tuberculosis infection (LTBI) and DM control in the United State and test their association when measured by tuberculin skin test (TST) or QuantiFERON®-TB Gold In-Tube blood test (QFT-GIT) and by HbA1c, respectively. Literature Review: One-third of the world population is infected with TB. Ten percent of TB cases worldwide are linked to diabetes mellitus. Studies …


Enough Smoke: Implementation Of An Evidence-Based Smoking Cessation Program In Owsley County, Kentucky, Meghan Fay Johnson Jan 2016

Enough Smoke: Implementation Of An Evidence-Based Smoking Cessation Program In Owsley County, Kentucky, Meghan Fay Johnson

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

In 1964, the first United States (U.S.) Surgeon General’s Report explicitly stating the dangers of smoking, including an increased risk of lung cancer, was released. Fifty years later, the U.S. continues to carry the significant health and economic burdens for failing to heed this public health warning. Owsley County, Kentucky, located in the heart of the Appalachian is one of the most impoverished and medically underserved counties in the U.S., ranking last in almost every category of overall health outcomes in the state. The county is also entirely rural, with no major cities within an 80-mile radius. In every health …


Hurricane Sandy : Public Health Staff Perceptions Of Impact And Recommendations For Future Preparedness, New York State, Asante Shipp Hilts Jan 2016

Hurricane Sandy : Public Health Staff Perceptions Of Impact And Recommendations For Future Preparedness, New York State, Asante Shipp Hilts

Legacy Theses & Dissertations (2009 - 2024)

Abstract


Injuries Among Security And Law Enforcement Personnel In The Private Versus Public Sectors, William S. Witt Jan 2016

Injuries Among Security And Law Enforcement Personnel In The Private Versus Public Sectors, William S. Witt

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

Background and Objectives: Data collected through workers’ compensation may be useful for occupational injury surveillance. This study examined whether differences existed between the public and private sectors of the security and law enforcement industry in Kentucky.

Methods: Using a cross-­‐sectional design, workers’ compensation data from the Kentucky Department of Workers’ Claims was analyzed to evaluate differences in demographic and injury characteristics, as well as award outcomes, stratified by industry sector. The dataset included all workers’ compensation first reports of injury and claims filed by security and law enforcement personnel in Kentucky from 2005 to 2015. Statistical analyzes included chi-­‐square and …


Eat Well, Keep Moving: Decreasing Childhood Obesity In Fulton County, Kentucky, Sandra Onekhena Jan 2016

Eat Well, Keep Moving: Decreasing Childhood Obesity In Fulton County, Kentucky, Sandra Onekhena

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

With the high rates of childhood obesity in Fulton County, the Purchase District Health Department proposes the implementation of the Eat Well and Keep Moving Program in all the county’s elementary schools among fourth and fifth graders. It is an interdisciplinary, evidence-based program that will be aimed at our short-term goal of increasing knowledge about nutrition and physical activity and inspiring positive behavioral change. It works by integrating lessons and activities about proper nutrition and activity into various aspects of the children’s lives — in the classroom, cafeteria, at home and in the community. We hope to see children move …


Colorectal Cancer Prevention In The North Slope Borough Of Alaska Utilizing The Flu-Fit Intervention, Jennifer Jenkins Jan 2016

Colorectal Cancer Prevention In The North Slope Borough Of Alaska Utilizing The Flu-Fit Intervention, Jennifer Jenkins

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

The intention of the Flu-FIT intervention is to increase colorectal cancer screening rates by combing two annual activities into one visit that doesn’t necessitate a doctors visit. The original study increased colorectal cancer screening rates by 14 percentage points and this program should be able to show similar results in the North Slope Borough of Alaska. The North Slope Borough has the highest incidence rate of colorectal cancer in the United States, and this proposed intervention could lead to a reduction in that rate by increasing screening and knowledge about colorectal cancer in the community.


Identifying Predictors Of Functional Limitations Associated With Depression, Anxiety, And Emotional Problems In Us Adults, Jillian Richardson Jan 2016

Identifying Predictors Of Functional Limitations Associated With Depression, Anxiety, And Emotional Problems In Us Adults, Jillian Richardson

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

Depressive disorders are characterized as sharing affected mood, and somatic (e.g. sleep pattern, appetite, and unintentional changes in weight) and cognitive alterations from previous normal daily functioning that are clinically significant. Anxiety disorders are characterized by excessive fear, general or specific anxiety, and related behavioral disturbances that are also clinically significant. This project attempts to identify risk factors that may predict what groups are most likely to be affected by depression and/or anxiety.

Sponsored by the CDC, the National Health Interview Survey collects general health information for non-institutionalized individuals living in the US. Variables for use in logistic regression model …


"Life Skills Training" Prescription Drug Abuse Prevention Among Youth In Bell County, Kentucky, Arveen Kaur Jan 2016

"Life Skills Training" Prescription Drug Abuse Prevention Among Youth In Bell County, Kentucky, Arveen Kaur

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

Prescription Drug Abuse (PDA) has become a serious public health concern and a major epidemic in the United States (U.S.). According to the 2014 National Survey on Drug Use and Health (NSUDH), approximately 15 million people (aged 12 or older) used prescription drugs in the past year and 6.5 million in past month. Out of these, 2 million Americans (aged 12 or older) either abused prescription drugs or were dependant on them. Almost 5% of adolescents (1.1 million) between the age group 12-17 abused prescription painkillers in 2014. Nationally, Kentucky is among the top five states with highest age-adjusted overdose …


“Exchange Northern Ky”: An Evidence-Based Needle & Syringe Exchange Program Serving The Northern Kentucky Area Development District, Amanda Hunter Jan 2016

“Exchange Northern Ky”: An Evidence-Based Needle & Syringe Exchange Program Serving The Northern Kentucky Area Development District, Amanda Hunter

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

Intravenous drug users (IDUs) account for nearly 16% of new HIV infections in the United States and almost one half (48%) of newly reported acute hepatitis C virus (HCV) infections have been found to be IDU related.1 Within the Northern Kentucky Area Development District, hepatitis C infections have soared with an incidence of more than 1,000 newly reported cases during 2015 alone.4 Rigorous scientific evidence complied by the U.S. Department of Health & Human Services has indicated that one of the most unique and effective strategies for the curtailing HIV incidence among IDUs is by ensuring users’ access to …


Predictors Of Excessive Alcohol Consumption Among U.S. Business Travelers, Jennifer Clore Barrickman Jan 2016

Predictors Of Excessive Alcohol Consumption Among U.S. Business Travelers, Jennifer Clore Barrickman

Walden Dissertations and Doctoral Studies

Excessive alcohol consumption (EAC) is an important public health problem. Several researchers have examined work-related influences on EAC, but few have investigated the predictors of EAC related to business travel. This study measured the association between EAC and frequency of business travel, duration of business travel, and job industry among U.S. business travelers. Research was conducted within the social-ecological theoretical framework. Snowball sampling was used to gather data from 187 business travelers. Data were evaluated using bivariate analysis to assess the association between measures of EAC and each independent variable. Multiple logistic regression was used to adjust for covariates. Respondents …


Acculturation, Inflammation, And Depression Among Hispanic Adults In The United States, Kristin Marie Marano Jan 2016

Acculturation, Inflammation, And Depression Among Hispanic Adults In The United States, Kristin Marie Marano

Walden Dissertations and Doctoral Studies

Disparities exist in the recognition and treatment of depression among Hispanics in the United States, creating a social, ethical, economic, and public health burden. This study was designed to generate an improved understanding of the causes of and/or contributors to depression within this population. It was specifically designed to 1) assess the prevalence and severity of depression among Hispanic adults in the United States relative to adults of other race/ethnicities in the United States; 2) clarify the inconsistent results in the literature concerning the relationship between acculturation and depression among Hispanic adults in the United States; and 3) fill a …


Department Of Community Health Sciences Medical College (Report 2009 - 2016), Department Of Community Health Sciences, Medical College Jan 2016

Department Of Community Health Sciences Medical College (Report 2009 - 2016), Department Of Community Health Sciences, Medical College

Department of Community Health Sciences Archives

This report comprehensively documents the academic, research, and service accomplishments of the Department of Community Health Sciences (CHS) at the Aga Khan University from 2009 to 2016. It highlights the department’s mission to strengthen public health education and systems through innovative programs, strategic partnerships, and impactful research. Topics covered include CHS faculty profiles, educational programs, strategic initiatives, community outreach, grant-funded projects, and the vision for establishing a School of Public Health.


Hepatitis C Virus In Mexican Americans: A Population-Based Study Reveals Relatively High Prevalence And Negative Association With Diabetes, Gordon P. Watt, Kristina Vatcheva, Laura Beretta, Jen-Jung Pan, Michael Fallon, Joseph B. Mccormick, Susan P. Fisher-Hoch Jan 2016

Hepatitis C Virus In Mexican Americans: A Population-Based Study Reveals Relatively High Prevalence And Negative Association With Diabetes, Gordon P. Watt, Kristina Vatcheva, Laura Beretta, Jen-Jung Pan, Michael Fallon, Joseph B. Mccormick, Susan P. Fisher-Hoch

School of Mathematical & Statistical Sciences Faculty Publications

This study aimed to estimate the prevalence and risk factors for hepatitis C virus (HCV) infection in Mexican Americans living in South Texas. We tested plasma for the presence of HCV antibody from the Cameron County Hispanic Cohort (CCHC), a randomized, population-based cohort in an economically disadvantaged Mexican American community on the United States/Mexico border with high rates of chronic disease. A weighted prevalence of HCV antibody of 2·3% [n = 1131, 95% confidence interval (CI) 1·2-3·4] was found. Participants with diabetes had low rates of HCV antibody (0·4%, 95% CI 0·0-0·9) and logistic regression revealed a statistically significant negative …


Promoting Mental Health And Preventing Mental Illness In General Practice, Kurt C. Stange Jan 2016

Promoting Mental Health And Preventing Mental Illness In General Practice, Kurt C. Stange

Faculty Scholarship

This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity. files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert ‘Think Tank’ convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk …


Assessment Of The Knowledge And Skills Of School Personnel To Respond To Diabetic Emergencies In Georgia Public Schools, Alesha Wright Jan 2016

Assessment Of The Knowledge And Skills Of School Personnel To Respond To Diabetic Emergencies In Georgia Public Schools, Alesha Wright

College of Graduate Studies: Theses & Dissertations

Diabetes is a common chronic disease that affects children in the United States. As children with diabetes attend school, the ability to appropriately manage their diabetes is essential to preventing life-threatening health complications. The purpose of the study was to assess school personnel’s knowledge of diabetes and perceived self-competence in performing diabetes management skills in response to a diabetic emergency. For the present study, a diabetic emergency was operationalized to include hypoglycemia, hyperglycemia, or diabetic ketoacidosis. A cross-sectional survey design, utilizing a fifty-two item self-administered questionnaire that accentuated the causes and symptoms of diabetes, definition of hypoglycemia and hyperglycemia, and …


Determinants Of Obesity In Latinos In Anchorage Alaska, Andrea Appa Dec 2015

Determinants Of Obesity In Latinos In Anchorage Alaska, Andrea Appa

Student Projects for Graduate Degrees

Determinants of obesity can be complex and group specific. There is limited data about the Latino population and the health needs of Latinos in the state of Alaska. The goal of this project was to better understand the determinants of obesity in Latinos, including the impact of dietary choices, financial status, mental health, and exercising in the levels of obesity of Latinos. The investigator used Statistical Package for the Social Sciences (SPSS) to study the association of several variables in the Behavioral Risk Factor Surveillance System (BRFSS). After data exploration, univariate analysis and logistical regression were conducted for selected variables …


Sickeningly Sweet: Analysis And Solutions For The Adverse Dietary Consequences Of European Agricultural Law, Emile K. Aguirre Dec 2015

Sickeningly Sweet: Analysis And Solutions For The Adverse Dietary Consequences Of European Agricultural Law, Emile K. Aguirre

Journal of Food Law & Policy

Sixty-nine percent of adults in the United States, sixty-four percent in the United Kingdom, and over one-third worldwide are overweight or obese. These staggering figures continue to grow, with accompanying emotional, physical, and economic consequences, both for individuals and society as a whole. The role law plays in facilitating this global trend is significant, and yet puzzlingly, little recognized or understood The current food system is profoundly structurally flawed: it establishes unhealthy dietary behaviors as the default option for consumers. This Article is the first to examine how agricultural law has facilitated these unhealthier diets for the past fifty years, …


Effects Of Competing News Media Frames Of Weight On Antifat Stigma, Beliefs About Weight, And Support For Obesity-Related Public Policies, David Frederick, Abigail C. Saguy, Gaganjyot Sandhu, Traci Mann Nov 2015

Effects Of Competing News Media Frames Of Weight On Antifat Stigma, Beliefs About Weight, And Support For Obesity-Related Public Policies, David Frederick, Abigail C. Saguy, Gaganjyot Sandhu, Traci Mann

Psychology Faculty Articles and Research

Objectives: In the popular news media, public health officials routinely emphasize the health risks of obesity and portray weight as under personal control. These messages may increase support for policies designed to reduce rates of obesity, but can also increase antifat stigma. Less often, the media cover "Health at Every Size" or "Fat Rights" perspectives, which may have the opposite effects. We investigated how exposure to different "fat frames" shifts attitudes about weight and support for obesity policies. Methods: Across four experiments (N = 2187), people read constructed news articles framing fatness as negative (unhealthy, controllable, acceptable to …


Nutrition And Education In An Urbanizing Nation, Molly Pritz Oct 2015

Nutrition And Education In An Urbanizing Nation, Molly Pritz

Independent Study Project (ISP) Collection

Child malnutrition is a growing public health issue in Nepal, particularly in urban areas. Not eating enough, or not eating enough of healthy foods, can have life-long implications on development and cognitive ability. Because of its relevance to development within the country, many donor organizations and non-governmental organizations are working to promote child nutrition education programs. The purpose of this research is to investigate the implementation and structure of urban child nutrition educational programs involving treatment and prevention in Kathmandu, Nepal. Through qualitative interviews and field observations with three primary organizations, this research analyzes the patterns and disconnects between various …


Imagining Global Health With Justice: In Defense Of The Right To Health, Eric A. Friedman, Lawrence O. Gostin Oct 2015

Imagining Global Health With Justice: In Defense Of The Right To Health, Eric A. Friedman, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The singular message in Global Health Law is that we must strive to achieve global health with justice—improved population health, with a fairer distribution of benefits of good health. Global health entails ensuring the conditions of good health—public health, universal health coverage, and the social determinants of health—while justice requires closing today’s vast domestic and global health inequities. These conditions for good health should be incorporated into public policy, supplemented by specific actions to overcome barriers to equity.

A new global health treaty grounded in the right to health and aimed at health equity—a Framework Convention on Global Health (FCGH)—stands …


Exposure To Elemental Carbon, Organic Carbon, Nitrate, And Sulfate Fractions Of Fine Particulate Matter And Risk Of Preterm Birth In New Jersey, Ohio, And Pennsylvania (2000–2005), Kristen M. Rappazzo, Julie L. Daniels, Lynne C. Messer, Charles Poole, Danelle T. Lobdell Oct 2015

Exposure To Elemental Carbon, Organic Carbon, Nitrate, And Sulfate Fractions Of Fine Particulate Matter And Risk Of Preterm Birth In New Jersey, Ohio, And Pennsylvania (2000–2005), Kristen M. Rappazzo, Julie L. Daniels, Lynne C. Messer, Charles Poole, Danelle T. Lobdell

Community Health Faculty Publications and Presentations

Background: Particulate matter ≤ 2.5 μm in aerodynamic diameter (PM2.5) has been consistently associated with preterm birth (PTB) to varying degrees, but roles of PM2.5 species have been less studied.

Objective: We estimated risk differences (RD) of PTB (reported per 106 pregnancies) associated with change in ambient concentrations of elemental carbon (EC), organic carbon (OC), nitrates (NO3), and sulfates (SO4).

Methods: From live birth certificates from three states, we constructed a cohort of singleton pregnancies at or beyond 20 weeks of gestation from 2000 through 2005 (n = 1,771,225; 8% PTB). We estimated mean species exposures for each week of …


Utilizing Dental Hygienists To Improve Health Outcomes In Long-Term Care, Diana V. Macri Sep 2015

Utilizing Dental Hygienists To Improve Health Outcomes In Long-Term Care, Diana V. Macri

Publications and Research

Poor oral health practices contribute to negative health outcomes for residents of long-term care facilities. The abundance of current information on the oral–systemic connection underscores the need for improved oral hygiene among all citizens but specifically for older adults, who face challenges for self-care due to sensory, mobility, endurance and cognitive deficits. Dental hygienists are oral disease prevention specialists and are trained to perform dental procedures that significantly improve a person’s oral health. Dental hygienists are legally permitted to provide many oral healthcare services to residents of long-term care facilities independent of dentist supervision or in collaborative agreements with dentists. …


Sociodemographic Factors To Dengue Hemmorrhagic Fever Case In Indonesia, Desy Nuryunarsih Aug 2015

Sociodemographic Factors To Dengue Hemmorrhagic Fever Case In Indonesia, Desy Nuryunarsih

Kesmas

Demam berdarah dengue (DBD) adalah penyebab utama rawat inap dan kematian pada anak-anak. Indonesia adalah salah satu negara yang oleh WHO dikategorikan hyperendemicity dengan empat serotipe virus tersebar di daerah perkotaan. Faktor sosiodemografi dianggap sebagai faktor pendukung terjadinya DBD di Indonesia. Studi ini menggunakan data sekunder yang diunduh dari Basis Data Kesehatan Provinsi tahun 2010 Kementerian Kesehatan Republik Indonesia untuk menentukan korelasi antara ketiga faktor sosiodemografi dengan insiden DBD. Penelitian ini menggunakan metode kuantitatif deskripsi korelasi. Hasil penelitian menunjukkan bahwa dua faktor sosiodemografi terpilih memiliki korelasi linier dengan insiden DBD. Analisa regresi multivariat menunjukkan kecilnya korelasi antara insiden DBD dengan …


Academic-Community Partnerships Effectiveness Evaluated Beyond The Ivory Walls, Rosemary M. Caron, Jessica Ulrich-Schad, Catherine C. Lafferty Aug 2015

Academic-Community Partnerships Effectiveness Evaluated Beyond The Ivory Walls, Rosemary M. Caron, Jessica Ulrich-Schad, Catherine C. Lafferty

Sociology, Social Work and Anthropology Faculty Publications

Community-based participatory research (CBPR) has furthered our understanding of the working principles required for academic-community partnerships to address persistent public health problems. However, little is known about how effective these partnerships have been in eliminating or reducing community-based public health issues. To contribute to the literature in this area, the authors conducted a survey of U.S. schools and programs in public health and community groups working with these academic partners to: (1) identify the most common local public health issues addressed; (2) examine the characteristics of the partnership and the actual or perceived benefits and challenges for each partner; (3) …


Public Relations In Government-Based Public Health: Testing Contingency Theory During H1n1 Response, 2009-2010, Terri Lea Sasser Aug 2015

Public Relations In Government-Based Public Health: Testing Contingency Theory During H1n1 Response, 2009-2010, Terri Lea Sasser

Dissertations

The primary purpose of this study is to describe public relations programs in state and local government-based health departments nationwide. Using the H1N1 communications and public relations activities as a frame, or basis of comparison, this study will further seek to identify if Contingency Theory of public relations may be an apt descriptor of public relations activities during this particular response effort. This study uses Contingency Theory as a theoretical perspective to explain the strategic management of the organization-public relationships and add to the body of knowledge about Contingency Theory of public relations in the field of health communications. Contingency …


Medicaid Crowd-Out Of Other Public Health Spending: Modeling Economic & Health Effects, Glen P. Mays Jul 2015

Medicaid Crowd-Out Of Other Public Health Spending: Modeling Economic & Health Effects, Glen P. Mays

Health Management and Policy Presentations

MOTIVATION: Thirty states are expanding Medicaid eligibility under the Affordable Care Act (ACA) as of 2015, and while federal funds cover most costs for newly eligible recipients, states must share the additional costs of covering previously-eligible state residents who enroll in Medicaid. States, together with their local government counterparts, also provide the vast majority (87%) of public sector funds for public health programs designed to promote health and prevent disease and injury on a population-wide basis. Fiscal constraints and generous federal matching funds create strong budgetary incentives for states to channel their health-related spending to Medicaid rather than to other …


The Dangerous Right To Food Choice, Samuel R. Wiseman Jul 2015

The Dangerous Right To Food Choice, Samuel R. Wiseman

Scholarly Publications

Scholars, advocates, and interest groups have grown increasingly concerned with the ways in which government regulations—from agricultural subsidies to food safety regulations to licensing restrictions on food trucks—affect access to local food. One argument emerging from the interest in recent years is that choosing what foods to eat, what I have previously called “liberty of palate,” is a fundamental right.1 The attraction is obvious: infringements of fundamental rights trigger strict scrutiny, which few statutes survive. As argued elsewhere, the doctrinal case for the existence of such a right is very weak. This Essay does not revisit those arguments, but instead …