Medicine and Health Sciences Commons^™

The Association Of Demographics, Social And Personal/Family Characteristics With Treatment Utilization Among Young Adults With Opioid Use Disorder In The United States, Marva L. Frederick

Dissertations, Theses, and Capstone Projects

Background

Opioid use disorder is a life-threatening medical condition and an ongoing public health problem in the United States. Treatment is necessary to combat opioid use disorder and to minimize the health-associated problems. Opioid use disorder is treatable with life-extending medications. Studies that examined treatment utilization among young adults with opioid use disorder in the United States was scarce. This study investigated the characteristics posited in the Andersen Behavioral Model of health utilization which may be associated with treatment utilization, among young adults with opioid use disorder in the United States. The urgency posed by the continuing opioid crisis in …

The Effects Of Health-Related Fitness On School Attendance In New York City 6th-8th Grade Youth, Emily M. D'Agostino

Dissertations, Theses, and Capstone Projects

Background: Only 42% of youth ages 6-11 in the United States meet the World Health Organization’s recommendation for ≥60 minutes of daily moderate to vigorous physical activity. Estimates for adolescents ages 12-19 are even lower, ranging from 8-17%. Literature suggests low levels of youth health-related fitness (fitness) may negatively impact attendance, potentially due to reduced physical and psychosocial wellness. Nationally, 10-15% of (5-7.5 million) students are chronically absent, meaning that they miss ≥10% of the school year (or ≥20 days of school per year). Moreover, 20-30% of students in high-poverty, urban school districts do not attend school regularly (≥6 days …

The Impact Of Foster Care On Depression: An Examination Of Placement Type And Mental Health Service Utilization Among Children And Adolescents, Kisha Cummings

Dissertations, Theses, and Capstone Projects

Background: Children and adolescents in foster care with a history of complex trauma such as neglect, emotional, physical, and sexual abuse have a greater odds of being clinically diagnosed with depression in adulthood compared to children and adolescents without such a history. The current study examines the prevalence of depression in a national sample of children and adolescents aged 7 to 17 years. This study asks whether a) foster care is associated with a greater prevalence of depression among children and adolescents in foster care compared to children and adolescents not in foster care; b) there is an association between …

Multilevel Analysis Of Individual, Neighborhood, And Health Care Facility Characteristics Associated With Achievement And Maintenance Of Hiv Viral Suppression Among Persons Newly Diagnosed With Hiv In New York City, Ellen W. Wiewel

Dissertations, Theses, and Capstone Projects

Objective

To investigate the effect of individual, health care facility, and neighborhood characteristics on achievement and maintenance of HIV viral suppression, among New York City residents aged 13 years and older diagnosed with HIV between 2006 and 2012.

Methods

I used individual-level data from the New York City HIV surveillance registry and Case Surveillance-Based Sampling, facility-level data from the surveillance registry, and neighborhood-level data from the U.S. Census and American Community Survey. The outcomes of interest were first viral suppression after diagnosis (Aims 1 and 3; ≤400 copies/mL) and virologic failure after first suppression among persons who achieved suppression (Aim …

Effect Of The New York City Overdose Prevention Program On Unintentional Heroin-Related Overdose Death, 2000-2012, Anne Elizabeth Siegler

Dissertations, Theses, and Capstone Projects

Background: Drug overdose mortality is the leading cause of injury death in both the United States (US) and New York City (NYC). Heroin-related overdoses make up the majority of overdoses in NYC. Since 2006, when a law was passed that allowed for layperson administration of naloxone, an opioid antagonist, heroin-related overdose deaths have decreased in NYC. No studies to date have investigated a possible association between the implementation of this intervention and heroin-related overdose mortality.

Objectives: To investigate the possible association between overdose prevention programs (OPPs) and heroin-related overdose mortality in NYC, using interrupted time series and geospatial analytic …

Housing And The Environment: Smoking Triggers And Tobacco Smoke Exposure, Shannon Farley

Dissertations, Theses, and Capstone Projects

Background: Despite decades of smoking prevalence declines and more recent smoke-free indoor and outdoor air laws, smoking causes 400,000 preventable deaths and secondhand smoke (SHS) exposure leads to 40,000 deaths from respiratory and cardiovascular disease among non-smokers annually. Built and social environment factors linked to smoking include tobacco retailer density and neighborhood poverty. Housing environments including multiunit housing are linked to SHS exposure and adverse health outcomes.

Objectives: To investigate possible associations of different environmental factors with smoking, SHS exposure, and SHS-related health outcomes.

Methods: Many data sources were used: New York City Community Health Survey, Department of Consumer Affairs, …

Diagnostic Procedures Using Radiation And Risk Of Thyroid Cancer: Causal Association Or Detection Bias? An Examination Of Population Cancer Trends And Data From The Nyc Fire Department, Rachel Zeig-Owens

Dissertations, Theses, and Capstone Projects

Background: Thyroid cancer (TC) is a common cancer diagnosis in the United States, whose incidence is increasing. Disaster and radiation treatment studies show high doses of radiation can cause TC. Some diagnostic procedures, whose use is increasing, expose individuals to low-dose radiation but can also incidentally detect subclinical TC. Evidence regarding low-dose radiation risk is limited.

Objectives: To investigate the possible association of greater use of diagnostic procedures with TC, either causally through radiation exposure or via incidental detection.

Methods: Two data sources were used: National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) data and Fire Department of the …

Risk Factors And Costs Influencing Hospitalizations Due To Heat-Related Illnesses: Patterns Of Hospitalization, Michael T. Schmeltz

Dissertations, Theses, and Capstone Projects

The objective of this dissertation was to identify individual and environmental risk factors, investigate outcomes and hospital resource use, including costs, and document the pattern of heat-related illness hospitalizations in the United States. The main data source for the study population was the 2001-2010 Nationwide Inpatient Sample (NIS). The study population for heat-related illnesses (HRIs) consists of patients in the NIS with at least one diagnosis of a heat-related illness (ICD-9 codes 992.0 - 992.9) from 2001 to 2010. Outcome analysis included a study population of patients who had primary or secondary diagnoses of diabetes, cardiovascular diseases, respiratory illnesses, nephritic …

Intra- And Intergenerational Effects Of Migration And The Role Of The Psychosocial Environment In The Development Of Perinatal Depression, Hannah R. Simons

Dissertations, Theses, and Capstone Projects

Background: Perinatal depression is a significant public health issue that affects women and their families. Studies conducted outside of the United States (US) have found a higher prevalence of perinatal depression in immigrant compared to native-born women. US studies have been less consistent but have relied on convenience samples and lacked appropriate comparison groups.

Objectives: To characterize the relationship between migration to the US and risk for perinatal depressive symptomatology and to examine the role of the post-migration psychosocial environment on the occurrence of perinatal depressive symptoms.

Methods: The dissertation used two data sources, the NYC Pregnancy Risk Assessment Monitoring …

The Revolving Door Pattern Of Jail Incarceration And Homelessness And Its Influence On Mortality And Morbidity Among New York City Adults, Sungwoo Lim

Dissertations, Theses, and Capstone Projects

Objectives

The purpose of this dissertation study was to identify timing and sequencing of jail incarceration and homelessness by utilizing sequence analysis and to test whether a particular trajectory contributes to mortality risk and discontinuity of HIV care.

Methods

The main data source was an existing matched dataset, constructed using administrative data from the New York City (NYC) Departments of Health and Mental Hygiene, Correction, and Homeless Services. The study cohort consisted of 15,620 NYC adults with recent histories of both jail incarceration and homelessness. Monthly experiences of jail incarceration, homelessness, and community-dwelling in 2001-03 were summarized into trajectory groups …