Open Access. Powered by Scholars. Published by Universities.®
- Keyword
-
- Doctor of Philosophy (PhD) School of Public Health (190)
- Doctor of Public Health (DrPH) School of Public Health (126)
- Master of Science in Public Health (MSPH) School of Public Health (32)
- Master of Science (MS) School of Public Health (21)
- Obesity (12)
-
- HIV (11)
- Adolescents (7)
- African American (7)
- COVID-19 (7)
- Hypertension (7)
- Mortality (7)
- HPV (6)
- Power (6)
- Cancer (5)
- Epidemiology (5)
- Left ventricular hypertrophy (5)
- Physical activity (5)
- Pregnancy (5)
- Sample size re-estimation (5)
- Screening (5)
- Alabama (4)
- Coronary heart disease (4)
- Heart failure (4)
- Longitudinal (4)
- Birth outcomes (3)
- Black (3)
- Blood pressure (3)
- COPD (3)
- Daphnia (3)
- Diabetes (3)
- Publication Year
Articles 1 - 30 of 370
Full-Text Articles in Medicine and Health Sciences
Utilization Of Romosozumab During Covid-19 Pandemic Among U.S. Medicare Beneficiaries, Ye Liu
Utilization Of Romosozumab During Covid-19 Pandemic Among U.S. Medicare Beneficiaries, Ye Liu
All ETDs from UAB
Osteoporosis is increasingly recognized as a major public health issue in the aging U.S. population. Shortly after the licensure of romosozumab, an injectable medication indi-cated for women with postmenopausal osteoporosis at high risk of fracture administered by health care provider monthly, the COVID-19 pandemic broke out, which caused ma-jor disruptions to the delivery of health care across the nation. The pandemic dispropor-tionately affected minority and economically disadvantaged communities, exacerbating many pre-existing health disparities. Romosozumab has the highest dosing frequency among common injectable osteoporosis medications in the U.S. that require an office visit for injection, making romosozumab adherence more susceptible to …
The Association Between Cardiovascular Disease Risk And Fractures In Postmenopausal Women, Rafeka Hossain
The Association Between Cardiovascular Disease Risk And Fractures In Postmenopausal Women, Rafeka Hossain
All ETDs from UAB
Background: Fragility fractures pose a significant healthcare and economic burden in the United States. While age and bone mineral density (BMD) are the primary established risk factors for fragility fractures, the relationship between cardiovascular disease (CVD) and fractures remains underexplored. The primary objective of this analysis was to estimate the association of CVD risk with fractures in postmenopausal women. Methods: Utilizing 30 years of data from the WHI, Atherosclerotic Cardiovascular Disease (ASCVD) risk scores were computed using baseline age, race, systolic blood pressure, total cholesterol, high-density lipoprotein, diabetes, anti-hypertension medications, and smoking. Fracture outcomes encompassed any clinical fracture, major osteoporotic …
Trends In Reported Sexual Behaviors Among Alabama High School Students From 2011-2021, Sarah Franklin
Trends In Reported Sexual Behaviors Among Alabama High School Students From 2011-2021, Sarah Franklin
All ETDs from UAB
Background: Sexual health education is associated with better outcomes among adolescents proper use of contraception, STI prevention methods, and lower rates of teenage pregnancy and STIs. In Alabama, sexual health education is not mandated in public schools. It is unknown how the lack of mandated sexual education has impacted trends in the sexual health of Alabama high school students. Methods: Using 2011-2021 data from the Youth Risk Behavior Survey (YRBS), this study evaluated trends in sexual behaviors, including: 1) sexual history, 2) current sexual activity, 3) risky or protective sexual behaviors, and 4) history of HIV testing, over time among …
Psychometric Evaluation Of A Perceived Barriers To Medication Adherence Instrument And Association Between Perceived Barriers And Patient Characteristics, Lynn Andreae
All ETDs from UAB
Medication adherence is an important component of diabetes management, yet nonadherence is common and has substantial patient and economic costs. In order to achieve meaningful improvements in medication adherence, clinicians and researchers need good ways of both identifying those at risk of nonadherence and ascertaining the specific reasons driving nonadherence in those patients. Current options for self-reported medication adherence are limited in their vulnerability to response bias, which may lead to overestimation of adherence. A measure that assesses perceived barriers to medication adherence may be a useful alternative, as it may identify patients at risk of nonadherence while reducing socially …
Understanding Disparities In Hypertension Treatment Cascade And Validating Blood Pressure Measurement Among Persons Living With Or At Risk For Hiv, Jessica Blair
All ETDs from UAB
In the United States, 44% of adult women >18 years have hypertension. Although non-Hispanic Black adults were more likely to be aware of and treated for hypertension compared to non-Hispanic White adults, Black individuals had the highest prevalence of uncontrolled hypertension. Persons living with HIV have a higher prevalence of hypertension, which is a major modifiable risk factor for cardiovascular disease. Similar to the geographic distribution of hypertension in the US, people living in the South have higher incidence of both hypertension and HIV diagnoses compared to other US regions. Furthermore, accurate diagnosis of hypertension and initiation of treatment is …
Examining Anti-Racist Attitudes In Maternity Care Workers, Angelina Aduke Toluhi
Examining Anti-Racist Attitudes In Maternity Care Workers, Angelina Aduke Toluhi
All ETDs from UAB
Racism in maternity care has been identified as one of the major contributors to the persistent racial disparities in maternal health outcomes in the United States (US). Antiracism is a term used to describe the practice of actively identifying and opposing racism with the goal of changing policies, attitudes, behaviors, and beliefs that continue to foster racist ideas and actions. The results of this convergent mixed method research study reveal that racism and other forms of racial discrimination during maternity care may lead to adverse pregnancy outcomes in Non-Hispanic Black (NHB) pregnant patients in Southern US. In the first aim, …
Screening For And Addressing Social Determinants Of Health In Hospitals Participating In Accountable Care Organizations, Heather Lee
All ETDs from UAB
There is a growing recognition among hospitals, payers, and policymakers in the United States that addressing social needs of patients is important to improving quality of care, patient outcomes, and lowering health care spending. Accountable care organizations (ACOs) may be especially incentivized to address social needs of patients to meet population health goals related to patient outcomes and costs. This cross-sectional study used data from the American Hospital Association Annual Survey to explore to explore how hospitals participating in or leading ACOs are screening for and addressing individual-level HRSNs of patients and to understand the extent to which ACOs are …
Using Hope To Cope: Chronic Stress, Religious Coping, And Masked Hypertension In African American Adults: The Jackson Heart Study, Miriam Miles
All ETDs from UAB
USING HOPE TO COPE: CHRONIC STRESS, RELIGIOUS COPING, AND MASKED HYPERTENSION IN AFRICAN AMERICAN ADULTS: THE JACKSON HEART STUDY ABSTRACT Chronic stress experienced at home or work has been associated with acute increases in blood pressure (BP) measured in the doctor’s office. Few data are available on the association of chronic stress with BP measured outside of the office setting. Religious coping, applying religious beliefs to adapt to stressful situations, and functional and structural social support may protect against MHT by promoting active coping behaviors and increasing emotional well-being. High levels of religious involvement and high social support have been …
Predictive Modeling Using Clinical Data And Compositional Microbiome Data, Li Zhang
Predictive Modeling Using Clinical Data And Compositional Microbiome Data, Li Zhang
All ETDs from UAB
This dissertation focuses on developing predictive modeling using data from two areas: clinical data and microbiome data. Compositional data in real life are mainly represented by relative proportions. With the advancement of next-generation sequencing (NGS) technology, researchers can now collect a large volume of metagenomic sequencing data, which is valuable for investigating associations between the microbiome and host diseases. Current methods for dealing with such data are either constrained by generalization or limited by application. In the first part, to address this, we propose Bayesian compositional generalized linear models for analyzing microbiome data (BCGLM). This model incorporates a structured regularized …
Access To And Service Utilization Of Alabama Medicaid's Section 1115 Demonstration Waiver Program, Sarah Lee Bowler
Access To And Service Utilization Of Alabama Medicaid's Section 1115 Demonstration Waiver Program, Sarah Lee Bowler
All ETDs from UAB
Background: Much research has been done investigating health disparities in the field of publicly-funding family planning. However, no longitudinal analysis has been conducted to examine the impact of Alabama Medicaid’s Section 1115 demonstration waiver on access to care, experience of barriers reported by enrollees, and repeat utilization of services. Methods: Medicaid enrollment and visit claims data were used to answer the questions related to access and service utilization. Annual Plan First survey data were used to investigate the experience of barriers to care among enrollees. For all three research questions, descriptive statistics were calculated, and linear probability models were used …
Social Determinants Of Health And Blood Pressure Control In Black And White Us Adults, Oluwasegun Philip Akinyelure
Social Determinants Of Health And Blood Pressure Control In Black And White Us Adults, Oluwasegun Philip Akinyelure
All ETDs from UAB
Black adults in the US have 2 to 3 times higher rates of cardiovascular disease (CVD) mortality compared to White adults. Most of the excess CVD mortality in Black adults has been attributed to their higher prevalence of hypertension and uncontrolled blood pressure (BP). In October 2020, the US Surgeon General published a Call-to-Action to improve hypertension control and identified social determinants of health (SDOH) as a major contributor to Black:White disparities in hypertension control. Prior research has showed that SDOH are associated with excess hypertension risk among Black compared with White adults, but data on their association with BP …
Acute Placental Inflammation And Growth Outcomes In Preterm Infants, Emily Gunawan
Acute Placental Inflammation And Growth Outcomes In Preterm Infants, Emily Gunawan
All ETDs from UAB
Background. Acute placental inflammation (API) has been associated with various adverse outcomes in preterm infants. However, little is known about how API affects their body composition and growth outcomes. This study aims to examine the association between API and growth outcomes in preterm infants. Methods. We conducted a retrospective cohort study of mother-infant dyads born < 326/7 weeks of gestation with fat mass (FM) accretion measured using air displacement plethysmography at term-equivalent age. API severity including maternal inflammatory response (MIR) and fetal inflammatory response (FIR) was staged according to criteria by Society for Pediatric Pathology based on placental pathology reports. We examined the differences in characteristics of mother-infant dyads by API severity using ANOVA or the Kruskall-Wallis test. The association between API severity and growth outcomes was analyzed using linear regression models and adjusted for statistically significant confounders. Mediation analyses were used to study the direct and indirect association of API and growth outcomes via gestational age. Results. Among 375 mother-infant dyads analyzed, 104 (28%) dyads had MIR. FIR was found in 82% of dyads with MIR. Adjusted models indicated that API severity progression was positively associated with FM accretion. Gestational age partially (49%) iv mediated the association between API severity and FM z score (indirect effect: b=0.12, 95% CI: 0.05-0.19; direct effect: b=0.12, 95% CI: 0.01-0.25). Conclusions. API severity is associated with growth outcomes and helps to accurately predict body composition in preterm infants.
Understanding How Multi-Level Factors Influence Cancer Clinical Trial Enrollment Decisions By Patients Living In Higher Disadvantaged Areas, Nicole Caston
All ETDs from UAB
Cancer clinical trials offer current patients with cancer new treatment and novel interventions to treat their cancer, while advancing the care of future patients. Clinical trials test new drugs against the standard of care to determine drug efficacy and safety. There are many groups of patients who are either unrepresented or underrepresented in cancer clinical trials and there is a plethora of reasons they are not represented. One underrepresented population of interest is patients with cancer who live in highly disadvantaged neighborhoods. Previous research found that when compared to patients who live in areas of lower disadvantage, patients living in …
Identifying The Factors Influencing Hiv Testing And Safe Sex Practices: An Ecological Approach, Shekwonya Evelyn Samuel
Identifying The Factors Influencing Hiv Testing And Safe Sex Practices: An Ecological Approach, Shekwonya Evelyn Samuel
All ETDs from UAB
Introduction: HIV (Human Immunodeficiency Virus) is a sexually transmitted infection (STI) that is still a major health issue in the United States and the world. Emerging adults are more likely to engage in risky sexual behaviors such as multiple sexual partners and unprotected sex. HIV testing contributes to ending the HIV epidemic by identifying at-risk individuals and promoting early diagnosis.Methods: Secondary data analyses of the City Health II dataset were conducted to 1) identify the association between HIV testing and risky sexual behaviors among Black/African American emerging adults ages 18-25 years living in Birmingham metro area, 2) use social network …
Neighborhood Disadvantage, Sleep Quality, And Shift Work: The Reasons For Geographic And Racial Differences In Stroke (Regards) Study, Rebecca Williams
Neighborhood Disadvantage, Sleep Quality, And Shift Work: The Reasons For Geographic And Racial Differences In Stroke (Regards) Study, Rebecca Williams
All ETDs from UAB
The first study used data (n=14,609) from the REasons for Geographic and Racial Differences in Stroke (REGARDS) to test the associations among Area Deprivation Index (ADI) and self-reported total sleep time (TST), sleep efficiency (SE), and number of restless nights within the last week. The second study (n=12,496) tested the associations among ADI, shift work status, and restlessness.Regression models were fit to examine associations between ADI and SE or TST or restlessness, as well as assess the relation between ADI and SE in clinically meaningful categories. Moderation analyses indicated whether sex or race impact the association between ADI and sleep. …
Socioeconomic Challenges Of Long Covid, Justin Catt
Socioeconomic Challenges Of Long Covid, Justin Catt
All ETDs from UAB
Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection or PASC, is a condition resulting from a SARS-CoV-2 infection characterized by continuing or novel symptoms across multiple organ systems occurring at least four weeks after infection. Symptoms of Long COVID can include cognitive impairment, memory loss, and fatigue. Although associations between COVID-19 and social determinants of health have been studied, noting that disadvantaged socioeconomic or racial groups have higher incidence and mortality rates from COVID-19, the associations between Long COVID and social determinants of health have not been robustly examined. Using data from the Household Pulse Survey in Summer …
Antimicrobial Resistance In Type Ii Diabetic Patients In Southeastern U.S., Onyebuchi Angela Elegede
Antimicrobial Resistance In Type Ii Diabetic Patients In Southeastern U.S., Onyebuchi Angela Elegede
All ETDs from UAB
Background: In the Southern and Appalachian regions of the United States, antibiotic prescription rates surpass the national average, coinciding with a higher prevalence of Type II diabetes (DM2). Although international research has previously described the correlation between DM2 and increased risk of antimicrobial-resistant (AMR) infections, comprehensive studies on this relationship are lacking in the U.S. The objective of this study was to investigate the association between AMR infections and DM2 and examine the association in two DM2 positive racial groups. This study also examined the differences in the prevalence of clindamycin resistance of methicillinresistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus …
Parenting Through A Pandemic: A Mixed Methods Analysis Of Covid-19’S Impact On Stress, Coping, Resiliency, And Mental Health Among University Student-Parents, Jordin Ann Lane
All ETDs from UAB
The COVID-19 pandemic has taken a toll on the mental health of university students and continues to have a profound impact to this day. The transition from in-person traditional courses to online courses and campus closures, coupled with feelings of isolation, fear of contracting COVID-19, and uncertainty of the future has further intensified the mental health of college students. The effects of federal and state regulations, such as stay-at-home orders, influenced the mental health and general well-being of many Americans, specifically those who take on a dual role as a student and a parent. Unfortunately, literature pertaining to the effects …
Navigating Missed Visits In Hiv Primary Care: Exploring Risk Factors Associated With Missed Visits, Jiaying Hao
Navigating Missed Visits In Hiv Primary Care: Exploring Risk Factors Associated With Missed Visits, Jiaying Hao
All ETDs from UAB
The HIV care continuum is a public health model that outlines the steps or stages people with HIV go through from diagnosis to achieving and maintaining viral suppression. Retention in care, a key component of the HIV care continuum, is critical in achieving good health outcomes for people with HIV (PWH) and preventing HIV transmission. Consistent HIV care is essential for the health of PWH as a part of retention in care. De-spite no standard measure for retention in care to PWH, the missed (no-show) vis-its/appointments is one of the most commonly used methods for evaluating retention in HIV care. …
Impact Of Malaria Rapid Diagnostic Test On The Receipt Of Antimalarials Among Children Aged 6-59 Months In Nigeria From 2010 To 2021, Sandra Chibuzor Olisakwe
Impact Of Malaria Rapid Diagnostic Test On The Receipt Of Antimalarials Among Children Aged 6-59 Months In Nigeria From 2010 To 2021, Sandra Chibuzor Olisakwe
All ETDs from UAB
Background: Nigeria has the highest malaria burden globally, and antimalarials have been commonly used to treat malaria without parasitological confirmation. In 2012, Nigeria implemented RDTs to reduce use of antimalarials for those without malaria and to increase the use of artemisinin-combination therapies (ACTs) for malaria treatment. In this study, we examined trends in antimalarial receipt among children aged 6-59 months during a 12-year period of increasing RDT availability. Methods: We conducted a cross-sectional analysis using nationally representative Nigeria Malaria Indicator Survey (NMIS) data from 2010 (before RDT implementation), 2015, and 2021. NMIS surveys used histidine-rich protein 2 (HRP2)- based RDTs …
Maternal, Infant, And Early Childhood Home Visiting And School Readiness In Alabama, Heather H. Johnson
Maternal, Infant, And Early Childhood Home Visiting And School Readiness In Alabama, Heather H. Johnson
All ETDs from UAB
This study examined the relationship between home visiting and school readiness in Alabama. Topics included a scoping review of the home visiting literature, statistical analyses of Alabama’s Teaching Strategies GOLD® (GOLD) data to determine if there were differences in performance among children who received home visiting compared to those who did not, and the development of a Key Driver Diagram (KDD) to inform improvement in home visiting practices that support school readiness. The scoping review of the literature indicated an absence of consistent definitions and measurement of the concept of school readiness. Through thematic analysis of the articles, contextual factors …
The Genetic Epidemiology Of Complex Lung Diseases, Ava Claire Wilson
The Genetic Epidemiology Of Complex Lung Diseases, Ava Claire Wilson
All ETDs from UAB
This research utilizes precision medicine techniques to advance our understanding of Chronic Obstructive Pulmonary Disease (COPD) and Idiopathic Pulmonary Fibrosis (IPF) with the overall goal of improving the etiology of and identifying molecular targets and pathways in COPD and IPF to help improve patient outcomes. We aimed to 1) identify novel drug targets and uncover potential mechanisms by which pirfenidone and nintedanib attenuate fibrosis by performing an integrative ‘omics analysis of transcriptomics and proteomic responses to TGFb1-stimulated lung fibroblasts; 2) define a skeletal muscle fiber shift phenotype in both males and females with COPD and begin to disentangle underlying mechanisms …
Perceptionf Of Multipurpose Prevention Technologies Aimed At Hiv/Sti/Unintended Pregnancy Among African American Women In The Deep South, Kristina Wilbekin Walker
Perceptionf Of Multipurpose Prevention Technologies Aimed At Hiv/Sti/Unintended Pregnancy Among African American Women In The Deep South, Kristina Wilbekin Walker
All ETDs from UAB
Sexual and reproductive health (SRH) needs for women are not being met globally. In addition to efforts towards providing widespread access to currently available contraceptives and sexually transmitted infection (STI) treatment or prevention products, another focus is the development of multipurpose prevention technologies (MPTs). These MPTs are combination methods that prevent pregnancy, and protect against HIV and/or additional STIs. The objective of this dissertation research was to assess factors related to sexual and reproductive decision-making that may influence interest in MPTs and inform MPT implementation strategies for African and African American (AA) women. The first aim of this research, I …
The Costly Performance Of Strength: An Exploration Of Mental Health Treatment Utilization Among Black Women In The Deep South, Amber N. Martin
The Costly Performance Of Strength: An Exploration Of Mental Health Treatment Utilization Among Black Women In The Deep South, Amber N. Martin
All ETDs from UAB
Introduction: Strength is indoctrinated into the cultural tapestry of Black women, dating back to slavery, and passed down through intergenerational socialization. The incessant need for Black women to be strong diminishes their psychological health leading to poorer quality of life. Further, historical injustices and unethical practices in mental healthcare continue to perpetuate the need for Black women to perform in strength. The performance of strength is one explanation for the grave mental health disparities among Black women offering an opportunity to better understand their mental health needs. This project aims to center Black women within the cultural contextualization of the …
Unintended Pregnancy, Postpartum Contraception, And Healthcare Utilization Among Young Married Women Affected By Hiv In Kenya, Liza M. Kimbo
Unintended Pregnancy, Postpartum Contraception, And Healthcare Utilization Among Young Married Women Affected By Hiv In Kenya, Liza M. Kimbo
All ETDs from UAB
Women with an unintended pregnancy are at risk of a repeat unintended pregnancy. Although use of postpartum contraception is an effective way to prevent repeat unintended pregnancies, the majority of unintended pregnancies globally occur in women who are not using contraception. Unintended pregnancies can have negative health and social consequences for both women and their children. This study aimed to better understand the use of postpartum contraceptives and healthcare services by married women with unintended versus intended pregnancy in south-western Kenya, with a special focus on young women. The study followed an exploratory sequential mixed methods design. In the first …
Social Vulnerability And Racial Disparities In Overall Survival Among Endometrial Cancer Patients, Alfonsus Adrian Hadikusumo Harsono
Social Vulnerability And Racial Disparities In Overall Survival Among Endometrial Cancer Patients, Alfonsus Adrian Hadikusumo Harsono
All ETDs from UAB
Introduction. Social vulnerability (SV) refers to potential negative effects on communities caused by external stresses on human health. The CDC/ATSDR Social Vulnerability Index (SVI) scores communities on 15 social indicators in 4 themes: (1) socioeconomic status (SES), (2) household composition and disability, (3) minority status and language, and (4) housing type and transportation. An overall score ranging from 0 (least vulnerable) to 1 (most vulnerable) is calculated to estimate vulnerability. We investigated whether SV as measured by the SVI can explain why black endometrial cancer (EC) patients survive less well than do white EC patients. Methods. We studied the survival …
The Effect Of Weather Events On Dengue Fever In Brazil 2014-2022, Maryclare Gabel
The Effect Of Weather Events On Dengue Fever In Brazil 2014-2022, Maryclare Gabel
All ETDs from UAB
Dengue fever is a mosquito-borne infectious disease that is spread through the bite of an infected Aedes aegypti or Aedes albopictus mosquito. Half the world's population lives in a dengue fever risk zone. There are an estimated 100 million symptomatic dengue fever cases each year, with 40,000 deaths reported. Brazil reports the highest annual dengue fever cases in Latin America. In 2022, Brazil recorded 2.36 million dengue fever cases, the highest number of cases ever recorded in the country. We designed a retrospective ecological study to evaluate the temporal trends and the association between weather events and dengue fever incidence …
Mediation Analysis Using Marginalized Zero-Inflated Poisson Model, Andrew Sims
Mediation Analysis Using Marginalized Zero-Inflated Poisson Model, Andrew Sims
All ETDs from UAB
Mediation analysis has become exponentially more popular over the last decade as researchers are interested in establishing mechanistic pathways for intervention. Standard statistical methods emphasize quantifying and testing whether a specific exposure impacts a particular health outcome. Mediation analysis addresses the question ‘How is the exposure causing the outcome?’ by examining the extent to which an intermediate variable, called a mediator, influences the relationship between an exposure and an outcome. While multiple mediation strategies exist, the counterfactual approach to mediation allows for mediation effects to be estimated directly with nonlinearities and interactions. The counterfactual approach allows for the effect of …
The Impact Of Diabetes On At-Fault Motor Vehicle Collisions In Older Adults: Visual Function, Medication, And Crash Characteristics, Thomas A. Swain
The Impact Of Diabetes On At-Fault Motor Vehicle Collisions In Older Adults: Visual Function, Medication, And Crash Characteristics, Thomas A. Swain
All ETDs from UAB
Older drivers represent one of the fastest growing age groups of drivers in the United States. Crash risk among older adults, who have the highest prevalence of vision impairment, has been shown to be related to worse visual function. Diabetes mellitus is a chronic health condition affecting more than 23.1 million Americans, and one in three have pre-diabetes. Persons with diabetes are at increased risk of conditions which cause vision loss. Research indicates those with diabetes have higher rates of MVCs. Despite the increased MVC risk among each of these groups, work has yet to evaluate if diabetes modifies the …
Social Vulnerability And Trust Associated With African American Secondary Syphilis Cases Reported In Alabama, United States, 2020-2022, Givanta Tribit
Social Vulnerability And Trust Associated With African American Secondary Syphilis Cases Reported In Alabama, United States, 2020-2022, Givanta Tribit
All ETDs from UAB
Introduction: Syphilis is a sexually transmitted infection (STI) that can cause serious health problems, including neurological disorders, blindness, and fetal abnormalities. Routine STI screenings can help prevent its spread. Despite effective treatments, syphilis cases have risen sharply in the last decade, particularly among marginalized communities. Understanding the ecological and contextual factors contributing to syphilis incidence could inform prevention efforts and improve healthcare outcomes for all. Methods: Retrospective secondary data analyses, at the county level, from 2020 to 2022, were conducted to assess for mean differences among social vulnerability index (SVI) scores, SVI scores by four primary categories, Black Belt regional …