Medicine and Health Sciences Commons^™

Cigarette Smoking Behaviors And Nicotine Dependence At The Intersection Of Sexual Identity And Sex In The United States: Findings From The National Survey On Drug Use And Health, Ollie Ganz, Jonathan A. Schulz, Sarah J. Ehlke, Jessica L. King Jensen, Andrea C. Villanti

Psychology Faculty Publications

Introduction: Cigarette smoking is disproportionately high among lesbian, gay, and bisexual (LGB) adults. Yet, collapsing these identities into a monolith can disguise important within group disparities (e.g., lesbian/gay versus bisexual female). The purpose of this study is to report recent national prevalence estimates and trends of cigarette smoking behaviors and nicotine dependence by sexual identity and sex. Methods: Data were from the 2015–2019 National Survey on Drug Use and Health (n = 210,392; adults 18+), a nationally representative, repeated cross-sectional study of substance use and mental health in the U.S. We examined bivariate and multivariable associations between sexual identity and …

Effectiveness Of Telemedicine In Diabetes Management: A Retrospective Study In An Urban Medically Underserved Population Area (Umupa), Lisa Ariellah Ward, Gulzar H. Shah, Jeffery A. Jones, Linda Kimsey, Hani M. Samawi

Department of Health Policy and Community Health Faculty Publications

This paper examines the efficacy of telemedicine (TM) technology compared to traditional face-to-face (F2F) visits as an alternative healthcare delivery service for managing diabetes in populations residing in urban medically underserved areas (UMUPAs). Retrospective electronic patient health records (ePHR) with type 2 diabetes mellitus (T2DM) were examined from 1 January 2019 to 30 June 2021. Multiple linear regression models indicated that T2DM patients with uncontrolled diabetes utilizing TM were similar to traditional visits in lowering hemoglobin (HbA1c) levels. The healthcare service type significantly predicted HbA1c % values, as the regression coefficient for TM (vs. F2F) showed a significant negative association …

Affirmatively Furthering Health Equity, Mary Crossley

Articles

Pervasive health disparities in the United States undermine both public health and social cohesion. Because of the enormity of the health care sector, government action, standing alone, is limited in its power to remedy health disparities. This Article proposes a novel approach to distributing responsibility for promoting health equity broadly among public and private actors in the health care sector. Specifically, it recommends that the Department of Health and Human Services issue guidance articulating an obligation on the part of all recipients of federal health care funding to act affirmatively to advance health equity. The Fair Housing Act’s requirement that …

Prisons, Nursing Homes, And Medicaid: A Covid-19 Case Study In Health Injustice, Mary Crossley

Articles

The unevenly distributed pain and suffering from the COVID-19 pandemic present a remarkable case study. Considering why the coronavirus has devastated some groups more than others offers a concrete example of abstract concepts like “structural discrimination” and “institutional racism,” an example measured in lives lost, families shattered, and unremitting anxiety. This essay highlights the experiences of Black people and disabled people, and how societal choices have caused them to experience the brunt of the pandemic. It focuses on prisons and nursing homes—institutions that emerged as COVID-19 hotspots –and on the Medicaid program.

Black and disabled people are disproportionately represented in …

Hs-4100 - Global Health Issues, Jose Nanin

Open Educational Resources

This syllabus includes OER materials and college policies for a fully online course that takes a comprehensive look at global health issues. In this course, the assessment of health issues are analyzed from various perspectives including geographic, ethnic, religious, human rights, socioeconomic, social, cultural, and political influences. Students learn about global environmental causes and consequences of infectious diseases, major diseases, mental illness, natural disasters, malnutrition, drug and alcohol addiction, violence and injuries.

The Social Dimensions Of Reproductive Health: Analyzing Disparities In Morocco Through Health Indicators And Social Determinants, Mila Sicorsky

Independent Study Project (ISP) Collection

This paper explores the social dimensions of reproductive health in Morocco through a look at its health indicators and social determinants. Existing literature discusses reproductive health differences that run on economic, social, and cultural lines. In this paper, I shed light on how best to measure and understand these disparities. The research shows that reproductive health in Morocco is most accurately indicated by maternal mortality rates (MMR), access to prenatal and postnatal visits, and access to adequate family planning. It also finds that location of residence, economic status, and women’s status are key social determinants of reproductive health in Morocco. …

Covid-19’S Effects On New York City’S Food System: Lessons For Public Health Responses, Nevin Cohen, Nicholas Freudenberg

Publications and Research

The COVID-19 pandemic disrupted food availability and affordability and changed the daily food practices of New Yorkers. Eleven surveys of samples of 1,000 New York City adults from March 13 through June 28 illustrate three effects on food access and food insecurity: (1) closing restaurants, schools, and other sources of prepared foods reduced access and changed shopping patterns, food expenditures, and diets; (2) economic disruption exacerbated food insecurity and increased demand for food assistance; and (3) altered food practices affected diets and health. These impacts were disproportionately borne by vulnerable populations. This paper reports survey responses illustrating the effects of …

Ecological Determinants Of Respiratory Health: Examining Associations Between Asthma Emergency Department Visits, Diesel Particulate Matter, And Public Parks And Open Space In Los Angeles, California, Jason A. Douglas, Reginald S. Archer, Serena E. Alexander

Health Sciences and Kinesiology Faculty Articles

Los Angeles County (LAC) low-income communities of color experience uneven asthma rates, evidenced by asthma emergency department visits (AEDV). This has partly been attributed to inequitable exposure to diesel particulate matter (DPM). Promisingly, public parks and open space (PPOS) contribute to DPM mitigation. However, low-income communities of color with limited access to PPOS may be deprived of associated public health benefits. Therefore, this novel study investigates the AEDV, DPM, PPOS nexus to address this public health dilemma and inform public policy in at-risk communities. Optimized Hotspot Analysis was used to examine geographic clustering of AEDVs, DPM, and PPOS at the …

Are Our Policy Makers On Board? What Policy Makers Think Of The Social Determinants, Health Disparities, And Health In All Policies, M. Lelinneth B. Novilla, Michael C. Goates, Spencer Calder, Tabetha Ellis, Kraymer Eppich, Laura A. Galvao, Noyra Melissa Quintana, David Mateos

Faculty Publications

BACKGROUND: We impact our health by “how we manage our affairs in society.”¹ The unequal distribution of power, money, and resources creates a collective social milieu with disparities in health between and within countries. Tackling health inequities require addressing the health implications of the “toxic combination of poor social policies and bad politics.”¹ But how do U.S. policy makers view the social determinants of health?

OBJECTIVE: Determine U.S. policy makers’ awareness for the social determinants of health, health inequities, and health in all policies; identify the social determinants of health perceived as legislative priorities; list factors identified/perceived …

Local Health Departments’ Activities To Address Health Disparities And Inequities: Are We Moving In The Right Direction?, Gulzar H. Shah, John P. Sheahan

Health Policy and Management Faculty Publications

Context: Health disparities are among the critical public health challenges.

Objectives: To analyze the extent to which local health departments (LHDs) perform activities for addressing health disparities, changes in proportion of LHDs’ performing those activities since 2005, and factors associated with variation in such engagement.

Methods: We used the 2013 National Profile of LHDs Survey to perform Logistic Regression of activities LHDs performed to address health disparities.

Results: About 20 percent of LHDs did not perform any activity to address health disparities. Significant decreases occurred since 2005 in the proportion of LHDs that performed health disparity reduction/elimination activities for four …

Research Brief: "Disparities In The Consequences Of Sarcopenia: Implications For African American Veterans", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief shows why more research should be done on African American veterans who have sarcopenia. In policy and practice, African American veterans should tell their healthcare providers about their geriatric medical needs, and health professionals should inform their veteran patients about how to avoid muscle wasting that can lead to sarcopenia; the VA should provide criteria for diagnosing sarcopenia among aging veterans. Suggestions for future research include analysis of the relation between myosteatosis and diabetes, as well as focusing on understanding the effects of sarcopenia on African American veterans.

Community-Engaged Public Health Research To Inform Hospital Campus Planning In A Low Socioeconomic Status Urban Neighborhood, Jeri Brittin, Sheila Elijah-Barnwell, Yunwoo Nam, Ozgur Araz, Bethany Friedow, Andrew Jameton, Wayne Drummond, Terry T.-K. Huang

Architecture Program: Faculty Scholarly and Creative Activity

Objective: To compare sociodemographic and motivational factors for healthcare use and identify desirable health-promoting resources among groups in a low socioeconomic status (SES) community in Chicago, IL. Background: Disparities in health services and outcomes are well established in low SES urban neighborhoods in the United States and many factors beyond service availability and quality impact community health. Yet there is no clear process for engaging communities in building resources to improve population-level health in such locales. Methods: A hospital building project led to a partnership of public health researchers, architects, and planners who conducted community-engaged research. We collected resident data …

Towards A Framework Convention On Global Health, Lawrence O. Gostin, Eric A. Friedman, Kent Buse, Attiya Waris, Moses Mulumba, Mayowa Joel, Lola Dare, Ames Dhai, Devi Sridhar

Georgetown Law Faculty Publications and Other Works

A global health treaty, a Framework Convention on Global Health (FCGH)–grounded in the right to health, with the central goal of reducing immense domestic and global health inequities–could serve as a robust global governance instrument to underpin the United Nations post-2015 Millennium Development Goals (MDGs). It would ensure for all people the three essential conditions for a healthy life–public health, health care, and the positive social determinants of health–while advancing good governance, responding to drivers of health disadvantages for marginalized populations, elevating health in other legal regimes, and enhancing people's ability to claim their rights.

The legally binding nature of …

Advancing The Right To Health Through Global Organizations: The Potential Role Of A Framework Convention On Global Health, Eric A. Friedman, Lawrence O. Gostin, Kent Buse

Georgetown Law Faculty Publications and Other Works

Organizations, partnerships, and alliances form the building blocks of global governance. Global health organizations thus have the potential to play a formative role in determining the extent to which people are able to realize their right to health.

This article examines how major global health organizations, such as WHO, the Global Fund to Fight AIDS, TB and Malaria, UNAIDS, and GAVI approach human rights concerns, including equality, accountability, and inclusive participation. We argue that organizational support for the right to health must transition from ad hoc and partial to permanent and comprehensive.

Drawing on the literature and our knowledge of …

Gokids Boston Youth Fitness, Training, And Research Center, Gokids Boston, University Of Massachusetts Boston

Office of Community Partnerships Posters

GoKids Boston embodies innovation and leadership in youth health through life-changing programs, groundbreaking research, exceptional training opportunities, and dedication to the community with a focus on eliminating health disparities.

Cultural Competency In Health Care: Framework, Training And Evaluation - A Review Of The Literature, Diana Salas Coronado

Center for Social Policy Publications

Healthcare professionals are now more aware of the challenges they face when providing healthcare services to a culturally and racially diverse population. Cultural competency has emerged as a framework for understanding health disparities among racial and ethnic groups in particular, but also for women, the elderly, sexual orientation and gender identity, people with disabilities, and religious minorities. Although there are several definitions of cultural competency, each emphasizes the need for healthcare systems and providers to be aware of and responsive to patients’ cultural perspectives and backgrounds. One example defines cultural competency as “a set of congruent behaviors, attitudes, and policies …

Towards A Framework Convention On Global Health: A Transformative Agenda For Global Health Justice, Lawrence O. Gostin, Eric A. Friedman

Georgetown Law Faculty Publications and Other Works

International law has responded weakly to the inequities in health care, public health, and the broader determinates of health that collectively cause the greatest loss of lives and human potential every year. Approximately one-third of global deaths can be attributed to enduring and unconscionable inequities. Despite significant progress in improving global health over the past several decades, these inequities persist. Current global governance for health is inadequate to the task of resolving these inequities, from lack of accountability and enforcement to inadequate funding and the absence of leadership required to respond to the threats to health that arise from other …

Better Health, But Less Justice: Widening Health Disparities After National Federation Of Independent Business V. Sebelius, Emily W. Parento, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

At the time it was enacted in 2010, the Patient Protection and Affordable Care Act (ACA) was widely applauded by health activists, as it meant that the United States would at last join the overwhelming majority of industrialized countries in providing its population with guaranteed access to affordable health care. Roughly half of the increase in access to health insurance was to come from the expansion of Medicaid eligibility to all U.S. citizens and legal residents with income below 138% of the Federal Poverty Level. However, the Supreme Court’s 2012 ruling in National Federation of Independent Business v. Sebelius ( …

Women’S Health Disparities And Midwifery Care, Adeola Oni-Orisan, Dorothy Hiersteiner, Althea Swett

Publications from the Center for Women in Politics and Public Policy

This fact sheet was developed for the roundtables project “Midwifery Care in New England: Addressing the Needs of Underserved and Diverse Communities of Women.” Sponsored by the U.S. Department of Health and Human Services (HHS) Office on Women’s Health (Region I), this initiative addresses the challenges and opportunities related to the provision of midwifery care to underserved and vulnerable populations of women. The project aims to increase our understanding of regional midwifery workforce needs in the context of ensuring that all women living in New England have access to timely, affordable, and high-quality health care.

The September 2010 roundtables were …

Women’S Health Disparities And Midwifery Care: Spotlight On Connecticut, Dorothy Hiersteiner, Kaye Inandan

Publications from the Center for Women in Politics and Public Policy

Although Connecticut’s Medicaid programs, Husky A and B, are essential providers of coverage for maternity care, there are still major racial and ethnic disparities in access to, use of, and quality of prenatal care in Connecticut. The cesarean birth rate in the state is almost 9% higher than the US average. African American/black and Hispanic mothers experience comparatively high rates of low birth weight births. Furthermore, Connecticut is home to a substantial rural population which experiences unique challenges to accessing adequate health care. While 75% of the Connecticut population is non-Hispanic white, 9% is African American/black, 12% is Hispanic and …

Women’S Health Disparities And Midwifery Care: Spotlight On Maine, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

With a large percentage of its population living in rural areas, Maine faces obstacles to providing adequate prenatal and maternity care to many women. The vast majority (96.2%) of Maine residents are non-Hispanic white, 1.2% are African American/black, 1.4% are Hispanic and 1.2% have other racial/ethnic backgrounds.

Women’S Health Disparities And Midwifery Care: Spotlight On Massachusetts, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

As a result of Massachusetts’ 2006 health insurance coverage law, there has been a significant decrease in the uninsurance rate for women of color. Access to and use of health care for all women in the Commonwealth has also increased. Despite these coverage and access gains, major racial/ethnic disparities in health conditions and outcomes still exist among women, especially in the use and quality of prenatal care, the occurrence of preterm and low birth weight births, and infant mortality rates. The proportion of Massachusetts births that were cesarean deliveries in 2007 was 8% higher than the national rate. Compared to …

Women’S Health Disparities And Midwifery Care: Spotlight On New Hampshire, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

New Hampshire faces significant obstacles to serving the nearly 6% of the population living in medically underserved areas. In addition, many residents of New Hampshire are uninsured, limiting their access to vital medical care. According to 2007-8 data, the racial/ethnic breakdown of New Hampshire residents is: 1% African American/black, 2% Hispanic, 94% non-Hispanic white and 3% Other. In 2005, 5.9% of the total New Hampshire population was foreign born.1 Since 1996, New Hampshire has seen increases in low birth weight births, cesarean births2, and infant mortality with racial/ethnic disparities reflected in most maternal and infant indicators.

Women’S Health Disparities And Midwifery Care: Spotlight On Vermont, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

In Vermont, racial and ethnic dispariti es in low birth weight and preterm birth rates exist alongside racial and ethnic disparities in health insurance coverage and use of preventative care. As of 2005, the percentage of racial and ethnic minorities in Vermont was approximately 3.3%, compared to 25% for the nation as a whole. In 2005, 3.4% of the Vermont population was foreign born.

Women’S Health Disparities And Midwifery Care: Spotlight On Rhode Island, Dorothy Hiersteiner

Publications from the Center for Women in Politics and Public Policy

Rhode Islanders face unique health disparities based on race, ethnicity and location. Just over six percent (6.3%) of the Rhode Island population is living in Primary Care Health Professional Shortage Areas (HPSAs), according to 2008 data. Native American and African American/black communities face particular health disparities, specifically in the areas of reproductive and infant health. In 2008, 79% of the Rhode Island population was non-Hispanic white, while 5% was African-American/black, 11% was Hispanic and 5% had other racial/ethnic backgrounds. In 2005, 12.4% of the total Rhode Island population was foreign born.

Poverty And Health Outcomes Among Hispanics In Massachusetts, Christopher Christian

Gastón Institute Publications

The Hispanic population of Massachusetts is now close to becoming the largest ethnic minority group in the state. The 1990 statewide Census count found that the Hispanic population doubled in the past ten years and now comprises 4.8% of the total state population (287,349 residents) as compared to 2.5% in 1980.

Growth in the Hispanic population has not been coupled with advancements in health status. Hispanic residents are disproportionately affected by many adverse health outcomes, such as high infant mortality, a high incidence of substance abuse, sexually transmitted diseases, homicides, AIDS, and other chronic illnesses. This paper highlights some of …