Medicine and Health Sciences Commons^™

The Business Cycle And Health: An Analysis Of How Macroeconomic Conditions Impact Health Outcomes In The U.S., Talitha Kumaresan

Honors Theses

The U.S. spends about twice as much per person on healthcare, yet the disease burden remains higher in the U.S. than in comparable countries (Sawyer and Cox 2018; Sawyer and Gonzales 2017). Although health status is perceived to be an outcome of individual decision making, the business cycle also affects health. While the effect of macroeconomic shocks on health outcomes has been studied extensively, results remain inconclusive. This analysis uses longitudinal data over 30 years and panel data models to examine the effect of macroeconomic conditions on obesity, diabetes, hypertension, depression, congestive heart failure, and heart attack or myocardial infarction. …

Hazardous Waste Site Proximity And Type 2 Diabetes: From Youths To Adults, Theresa Ann Johnson

Walden Dissertations and Doctoral Studies

Type 2 diabetes has reached epidemic proportions in adults and youths. Persistent organic pollutants and endocrine-disrupting chemicals (EDCs), such as pesticides, dioxins, and organochlorines, are omnipresent and persist in the environment with potential for human exposure via contaminated air, waterways, soil, and human food supply. EDCs have been correlated with diabetes incidence and risks. Residential proximity to hazardous waste sites (HWS) has been correlated with increased hospital admission rates for diabetes. The study used a sample population (N = 1,724), ages ≥ 12 years from the 2005-2012 Continuous NHANES and HWS data from the National Priorities List of Superfund Sites. …

Leptin Level Variance In Adults With And Without Cancer, Vilisa Chatman-Terry

Walden Dissertations and Doctoral Studies

Abstract

In 2018, health statistics revealed that, despite the many preventive measures established,

cancer was the second leading cause of death in the United States and the leading cause

of death in 22 states, exceeded only by heart disease. With obesity/leptin levels reaching

pandemic levels worldwide, and cancer having a well-known association with obesity,

both chronic diseases represent a large proportion of public health challenges. Guided by

the social ecological model, the purpose of this cross-sectional, quantitative study was to

examine if a significant difference exists in leptin levels among adults with different

types of obesity-associated and common cancers and …

Behavioral And Socio-Ecological Determinants Of Depression At Different Stages Of The Life Course, Xiao Cong

Legacy Theses & Dissertations (2009 - 2024)

Background:

Racial Disparities In The Diagnosis And Treatment Of Type 1 Diabetes In Black American Youth, Kierra Mitchell

Scripps Senior Theses

Introduction: Rates of childhood-onset type 1 diabetes (T1D) are steadily increasing among American youth, yet Black Americans are more likely to suffer from serious T1D-related complications caused by poor glycemic control. The aim of this thesis is to determine the external factors that are causing discrepancies in the development, diagnosis, treatment, and long-term management of T1D in Black youth.

Methods: Epidemiological studies were compiled from the American Diabetes Association, Center for Disease Control (CDC), International Diabetes Foundation (IDF), Kaiser Family Foundation (KFF), and the Claremont Colleges Library network to identify the sociocultural aspects that negatively affect long-term glycemic control in …

Exploring H.Pylori Seropositivity As A Risk Factor For Type 2 Diabetes, Virginia Chaidez, Yumou Qiu

Journal of Health Disparities Research and Practice

Background: In the US, the percentage of adults with diagnosed diabetes are higher in members of racial and ethnic minority groups compared to non-Latino Whites. Understanding why such disparities exist has been less forthcoming.

Methods: Secondary data analysis was conducted using the National Health and Nutrition Examination Survey (NHANES) 1999-2000 cross-sectional data.

Results: H.pylori seropositivity was highest in Mexican Americans (43.7%), lowest in non-Hispanic Whites (18.1%). Diabetes was highest in non-Hispanic Blacks (5.9%); lowest in non-Hispanic whites (4.3%). H.pylori seropositivity was associated with greater likelihood of having type 2 diabetes (1.927, 95% CI 1.142, 3.257) compared to H.pylori negative in …

The Indigenous Determinants Of Health As Predictors For Diabetes And Unmet Health Needs Among Urban Indigenous People: A Respondent-Driven Sampling Study In Toronto, Ontario, Stephanie Rachael Mcconkey

Electronic Thesis and Dissertation Repository

National statistics commonly present Indigenous peoples as a falsely homogenous group of people experiencing disproportionate ill health when compared to non-Indigenous peoples. There are significant gaps in statistical information regarding the health services access barriers experienced by Indigenous people that disrupts the quality of care they receive or prevents them from accessing care altogether. Our Health Counts Toronto is a community-based study that employed respondent-driven sampling (RDS) methodologies to sample 917 urban Indigenous adults. Prevalence estimates and prevalence ratios were calculated using RDS-II weights and adjusting for clustering by shared recruiter in SAS 9.4 and SAS-callable SUDAAN 11.0 software. This …

Perfluoroalkyl Substances And Kidney Function In Chronic Kidney Disease, Anemia, And Diabetes, Baqiyyah N. Conway, Ashley N. Badders, Tina Costacou, John M. Arthur, Kim E. Innes

Faculty & Staff Scholarship

Background: Anemia often complicates chronic kidney disease (CKD), leading to insufficient tissue oxygenation and hypoxic injury, the factor thought to underlie progression from CKD to renal failure. Perfluorocarbons are potent oxygen transporters used in organ preservation and synthetic blood development. Data are scarce on their relationship with kidney function, especially in diabetes where anemia and hypoxia are more prevalent. We investigated the relationship of perfluoroalkyl acids (PFAS) with kidney function and variation by diabetes and anemia status.

Methods: Data on 53,650 adults (5,210 with diabetes) were obtained from the C8 Health Project. CKD was defined as an estimated glomerular filtration …

Oral Glucose Insulin Secretion Test For Identifying Patients With Insulin Resistance, David Kershner

Walden Dissertations and Doctoral Studies

Insulin resistance is an increasing public health issue with the current literature, suggesting reduced sensitivity of insulin leads to adult onset diabetes and associated downstream pathologies that reduce life expectancy. The main objectives of this study were to evaluate the ability of the Oral Glucose Insulin Secretion Test (OGIST) to identify insulin resistance and examine differences in the insulin sensitivity based on gender, age, and ethnicity. This study was supported by the insulin resistance theory which focuses on the reduced ability of insulin to bind to the cellular insulin receptor, reducing the sensitivity of insulin. The OGIST lab results of …

Prevalence Of And Trends In Diabetes Among Veterans, United States, 2005–2014, Ying Liu, Sonica Sayam, Xiaonan Shao, Kesheng Wang, Shimin Zheng, Ying Li, Liang Wang

ETSU Faculty Works

Diabetes is a highly prevalent chronic disease among US adults, and its prevalence among US veterans is even higher. This study aimed to examine the prevalence of and trends in diabetes in US veterans by using data from the US National Health and Nutrition Examination Survey from 2005 through 2014. The overall prevalence of diabetes and undiagnosed diabetes was 20.5% and 3.4%, respectively, and increased from 15.5% in 2005–2006 to 20.5% in 2013–2014 (P = .04). Effective prevention and intervention approaches are needed to lower diabetes prevalence among US veterans and ultimately improve their health status.

The Role Of Pre-Existing Type 2 Diabetes Mellitus In Colorectal Cancer Stage And Survival In Elderly Americans: A Seer-Medicare Population-Based Study 2002-~2011, Sanae El Ibrahimi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Diabetes is a common comorbid condition among colorectal cancer (CRC) patients, yet its effects in CRC outcomes, particularly stage at diagnosis, risk of death and variations by diabetes severity (complications vs no complications) and Hispanic ethnicity have not been adequately studied. The purpose of this study was to investigate the association between pre-existing T2DM and advanced stage at diagnosis in elderly patients with CRC; to examine whether diabetes is an independent predictor of poor survival from all-cause and CRC-specific mortality; to assess whether variations exist by diabetes severity and to analyze the outcomes for the Hispanic group.

The Surveillance Epidemiology …

Stress Exposure And Physical, Mental, And Behavioral Health Among American Indian Adults With Type 2 Diabetes, Melissa L. Walls, Kelley J. Sittner, Benjamin D. Aronson, Angie K. Forsberg, Les B. Whitbeck, Mustafa Al'absi

Pharmacy Faculty Scholarship

American Indian (AI) communities experience disproportionate exposure to stressors and health inequities including type 2 diabetes. Yet, we know little about the role of psychosocial stressors for AI diabetes-related health outcomes. We investigated associations between a range of stressors and psychological, behavioral, and physical health for AIs with diabetes. This community-based participatory research with 5 AI tribes includes 192 AI adult type 2 diabetes patients recruited from clinical records at tribal clinics. Data are from computer-assisted interviews and medical charts. We found consistent bivariate relationships between chronic to discrete stressors and mental and behavioral health outcomes; several remained even after …

Vitamin D Status And Demographic And Lifestyle Determinants Among Adults In The United States (Nhanes 2001-2006), Yan Cao, Katie L. Callahan, Sreenivas P. Veeranki, Yang Chen, Ying Liu, Shimin Zheng

Shimin Zheng

This study looked at risk factors associated with vitamin D levels in the body among a representative sample of adults in the U.S., NHANES III (2001-2006) data were used to assess the relationship between several demographic and health risk factors and vitamin D levels in the body. The Baseline-Category Logit Model was used to test the association between vitamin D level and the potential risk factors age, education, ethnicity, poverty status, physical activity, smoking, alcohol, obesity, diabetes and total cholesterol with both genders. Vitamin D insufficiency and deficiency were significantly associated with age, race, education, physical activity, obesity, diabetes and …

Association Between Diabetes And Cancer In Indian And Us Populations Using Longitudinal Study Design, Shraddha S. Vyas

Theses and Dissertations

Background: There is growing evidence of association between diabetes and cancer. No studies have been conducted in India evaluating this association. With the current epidemiologic, nutritional and economic transition in India, it becomes extremely important to examine this association in an Indian population. Additionally, difference in association exists based on different cancer subtypes. Research has shown that diabetes is associated with an increased risk of colorectal cancer. However most of these studies suggest detection bias to be one of the probable reasons for this association. Additionally, the common risk factors shared by both these conditions are considered to one of …

Dna Methylation Signatures Of Chronic Low-Grade Inflammation Are Associated With Complex Diseases, Symen Ligthart, Carola Marzi, Stella Aslibekyan, Michael M. Mendelson, Karen N. Conneely, Toshiko Tanaka, Elena Colicino, Lindsay L. Waite, Roby Joehanes, Weihua Guan, Jennifer A. Brody, Cathy Elks, Riccardo Marioni, Min A. Jhun, Golareh Agha, Jan Bressler, Cavin K. Ward-Caviness, Brian H. Chen, Tianxiao Huan, Kelly Bakulski, Elias L. Salfati, Whi-Empc Investigators, Giovanni Fiorito, Charge Epigenetics Of Coronary Heart Disease, Simone Wahl, Katharina Schramm, Jin Sha, Dena G. Hernandez, Allan C. Just, Jennifer A. Smith, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Background: Chronic low-grade inflammation reflects a subclinical immune response implicated in the pathogenesis of complex diseases. Identifying genetic loci where DNA methylation is associated with chronic low-grade inflammation may reveal novel pathways or therapeutic targets for inflammation.

Results: We performed a meta-analysis of epigenome-wide association studies (EWAS) of serum C-reactive protein (CRP), which is a sensitive marker of low-grade inflammation, in a large European population (n = 8863) and trans-ethnic replication in African Americans (n = 4111). We found differential methylation at 218 CpG sites to be associated with CRP (P < 1.15 × 10^–7) in the discovery panel …

Diabetes Is Associated With Cerebrovascular But Not Alzheimer's Disease Neuropathology, Erin L. Abner, Peter T. Nelson, Richard J. Kryscio, Frederick A. Schmitt, David W. Fardo, Randall L. Woltjer, Nigel J. Cairns, Lei Yu, Hiroko H. Dodge, Chengjie Xiong, Kamal Masaki, Suzanne L. Tyas, David A. Bennett, Julie A. Schneider, Zoe Arvanitakis

Sanders-Brown Center on Aging Faculty Publications

INTRODUCTION: The relationship of diabetes to specific neuropathologic causes of dementia is incompletely understood.

METHODS: We used logistic regression to evaluate the association between diabetes and infarcts, Braak neurofibrillary tangle stage, and neuritic plaque score in 2365 autopsied persons. In a subset of >1300 persons with available cognitive data, we examined the association between diabetes and cognition using Poisson regression.

RESULTS: Diabetes increased odds of brain infarcts (odds ratio [OR] = 1.57, P < .0001), specifically lacunes (OR = 1.71, P < .0001), but not Alzheimer's disease neuropathology. Diabetes plus infarcts was associated with lower cognitive scores at end of life than infarcts or diabetes alone, and diabetes plus high level of Alzheimer's neuropathologic changes was associated with lower mini-mental state examination scores than the pathology alone.

DISCUSSION: This study supports the conclusions that diabetes increases the risk of cerebrovascular but not Alzheimer's disease pathology, and at least some of diabetes' relationship to …

Decade-Long Trends (1999-2009) In The Characteristics, Management, And Hospital Outcomes Of Patients Hospitalized With Acute Myocardial Infarction With Prior Diabetes And Chronic Kidney Disease, Mayra Tisminetzky, David D. Mcmanus, Alon Dor, Ruben Miozzo, Jorge L. Yarzebski, Joel M. Gore, Robert J. Goldberg

Jorge L. Yarzebski

BACKGROUND: Despite the increasing magnitude and impact, there are limited data available on the clinical management and in-hospital outcomes of patients who have diabetes mellitus (DM) and chronic kidney disease (CKD) at the time of hospitalization for acute myocardial infarction (AMI). The objectives of our population-based observational study in residents of central Massachusetts were to describe decade-long trends (1999-2009) in the characteristics, in-hospital management, and hospital outcomes of AMI patients with and without these comorbidities.

METHODS: We reviewed the medical records of 6,018 persons who were hospitalized for AMI on a biennial basis between 1999 and 2009 at all eleven …

The Association Between Antidepressant Medications And A1c Among Individuals With And Without Diabetes, Jamie Kammer

Legacy Theses & Dissertations (2009 - 2024)

While depression is known to increase the risk of diabetes and worsen glycemic control, the effect of antidepressants on these outcomes is unclear. Within the past few years, a cross-sectional study performed in a large, nationally-representative sample of individuals without diagnosed diabetes concluded that there are no differences between antidepressant users and non-users with regard to a number of diabetes-related outcomes including A1C, a measure of average glucose levels over the past few months commonly used to detect and monitor diabetes. The current set of studies was conducted to determine whether replicating this research in a higher-risk population or using …

The Waist To Height Ratio Is A Better Anthropometric Index Of Abdominal Obesity And Its Association With The Prevalence Of Diabetes Among Asian Americans, Yu Xiao

All Master's Theses

There is limited information about diabetes prevalence among Asian Americans. Diabetes risk factors include abdominal obesity (AO), which can be assessed by measuring waist circumference (WC) or waist-to-height-ratio (WHtR). The purpose of this study was to compare the prevalence of diabetes among Asians with non-Asians in the United States and compare WC and WHtR as predictors of diabetes. Data from the National Health and Nutrition Examination Survey (NHANES) 2011-14 was analyzed using SAS 9.2. There were 8,615 adult non-pregnant non-Asians and 1,224 Asians included in this study. Despite a lower prevalence of obesity among Asians compared to non-Asians (12% vs …

Diabetes Management Regimens And Cardiovascular Disease Risk In African American Men, Joseph Garilus

Walden Dissertations and Doctoral Studies

One of the most common health complications related to diabetes is the development of cardiovascular disease (CVD). Studies addressing the association between adherence to diabetes management regimens and the risk of CVD among minority populations are limited. This cross-sectional study was conducted to examine the association between diabetes management regimens and risk of CVD among African American men. The health belief model was used to frame the study. Data were collected from the Behavioral Risk Factor Surveillance System database for the states of Missouri and Ohio. Multiple logistic regression analysis was used to assess the association between adherence to diabetes …

Risk Of Alzheimer's Disease Among Older Hispanic/Latinos With Diabetes, Kathy Bianco

Walden Dissertations and Doctoral Studies

Alzheimer's disease (AD) is the 6th leading cause of death in older Americans. Currently there is no cure for AD, and even though the specific cause is unknown, diabetes mellitus type 2 (DM2) is regarded as a risk factor. Hispanics have a higher incidence of DM2 and possibly AD. I chose a life course theoretical model for this quantitative cross-sectional study to illuminate the variables most pertinent to a pathway from good health to poor health. The variables chosen were hypertension (HTN), obesity, smoking, stroke, dyslipidemia, and lower educational attainment. The research questions were used to examine biologic, metabolic, sociologic, …

Perceptions Of Behavioral And Lifestyle Changes Among African American Women With Type 2 Diabetes, Myriam Almonor

Walden Dissertations and Doctoral Studies

The prevalence of type 2 diabetes (T2D) continues to rise and is predicted to increase to 30 million people by 2030 in the United Sates alone. African Americans (AA) have one of the highest prevalence rates of T2D among all ethnic groups. African American Women (AAW) are 100% more likely to develop T2D compared with their white counterparts. The aim of this study was to quantitatively investigate the relationship of the perceptions of AAW not previously identified that could lead to a reduction in risk of T2D among AAW. A cross-sectional study of 183 AAW 20 to 65 years old …

Inflammatory Markers Associated With Disease Progression Of Cardiorenal Syndrome, Srikanta Banerjee

Walden Dissertations and Doctoral Studies

An increase in cellular inflammatory biomarkers directly increases the risk of cardiovascular disease (CVD). Using the social ecological and biomedical theories, the study examined quantitatively how specific inflammatory biomarkers are associated with cardiorenal syndrome (CRS), a potential complication of hypertension and diabetes, and how sociodemographic factors modify this association in the U.S. adult population. A retrospective secondary data analysis of the data collected from National Health and Nutrition Examination Survey (NHANES) 1999-2010 was utilized to evaluate these hypotheses. High sensitivity C-reactive protein, homocysteine (hcy), and fibrinogen had a modifying effect on Type 4 (chronic reno-cardiac etiology), Type 2 CRS (chronic …

Differentiating Demographic Factors In Latino Patients With Type 2 Diabetes, Carol Lynne Manning

Walden Dissertations and Doctoral Studies

The American Diabetes Association (ADA) data suggest that Latinos share a greater burden of disease than do non-Latino Whites with type 2 diabetes. As a result of poor glycemic control, Latinos also suffer consequences such as blindness, kidney disease, and limb amputation more often than do other ethnic groups. The purpose of this study was to compare demographic factors of Latinos with well-controlled type 2 diabetes, as measured by a HgbA1c of 7 or less (n = 118) to Latinos not well controlled (n = 105). This cross sectional study used a secondary data set with a sample selected from …

Knowledge, Attitudes, Beliefs, And Behaviors Of Diabetes Among Afro-Caribbeans Near Brooklyn, Sophia I. Allen

Walden Dissertations and Doctoral Studies

Literature has found that some minority groups with diabetes have a negative perception of medical professionals when a health problem occurs. This trend is particularly problematic with the diabetes epidemic in the United States. African Americans are more than 2 times as likely to die from diabetes than are Whites, and diabetes prevalence has increased exponentially in New York City where a majority of Afro-Caribbeans live. To address this problem, a cross-sectional design was used to recruit Afro-Caribbeans diagnosed with type 2 diabetes across 7 churches to examine whether shared knowledge, attitudes, beliefs, and behaviors about diabetes screening and its …

A Staff Development Program: Diabetes And Tb Education And Screening, Relyndo Manalo Salcedo

Walden Dissertations and Doctoral Studies

There is a growing body of evidence on the positive association between diabetes and tuberculosis (TB), especially in populations with low socioeconomic status. According to the CDC and the WHO, diabetes is increasingly seen as a global epidemic, one that poses a threat to global TB control. The goal of this DNP project was to develop a program to educate clinical staff on the importance of early identification of diabetic and TB patients. The logic model was chosen as the framework for this project because it allows the planner to rationally observe each stage of a project's development. The program …

Predictors Of Knowledge Of Stroke And Intent To Call 911 Among African Americans, Hyacinth Idu Hyacinth

Walden Dissertations and Doctoral Studies

Stroke is associated with significant health disparity and predominantly affects the elderly. Stroke outcome is significantly improved if an individual is able to get "clot-bursting" medication. A significant predictor of an on-time arrival to the emergency room for treatment in the event of a stroke is the ability to accurately recognize stroke signs and symptoms. The purpose of this study was to determine the factors (demographic, socioeconomic, and educational) that predict the knowledge of stroke signs/symptoms and intent to call 911 in the event of a stroke. The study was grounded in the social ecological theoretical model and analyzed archived …

Health Promoting Lifestyle Profile Of Asian Indians In The U.S. : Analysis Of Data From The Diabetes Among Indian Americans Study, Sanghamitra Siddharam Savadatti

Legacy Theses & Dissertations (2009 - 2024)

This dissertation sought to investigate the associations between health promoting lifestyle behaviors and chronic cardiometabolic conditions among Asian Indians residing in the U.S.

Longitudinal Association Between Television Watching, Computer Use And Meal Frequency And Risk Markers In Diabetes Among Youth With Diabetes, Chao Li

Theses and Dissertations

BACKGROUND AND OBJECTIVES: Television watching and computer use are considered to be the main sedentary behaviors in children and youth. However, their longitudinal impact on HbA1c and serum lipids among youth with type 1 diabetes (T1D) and type 2 diabetes (T2D) are under-studied. Sedentary behavior is normally assessed by questionnaire in large epidemiological studies, however, its measurement by questionnaire has not been evaluated among youth with diabetes. Also, no recent studies have evaluated the optimal meal frequency for glycemic control in youth with T1D and T2D; for this reason nutritional guidelines on meal frequency for youth with diabetes are vague. …

Vitamin D Status And Demographic And Lifestyle Determinants Among Adults In The United States (Nhanes 2001-2006), Yan Cao, Katie L. Callahan, Sreenivas P. Veeranki, Yang Chen, Ying Liu, Shimin Zheng

ETSU Faculty Works

This study looked at risk factors associated with vitamin D levels in the body among a representative sample of adults in the U.S., NHANES III (2001-2006) data were used to assess the relationship between several demographic and health risk factors and vitamin D levels in the body. The Baseline-Category Logit Model was used to test the association between vitamin D level and the potential risk factors age, education, ethnicity, poverty status, physical activity, smoking, alcohol, obesity, diabetes and total cholesterol with both genders. Vitamin D insufficiency and deficiency were significantly associated with age, race, education, physical activity, obesity, diabetes and …