Medicine and Health Sciences Commons^™

Healthy Food Options At Dollar Discount Stores Are Equivalent In Quality And Lower In Price Compared To Grocery Stores: An Examination In Las Vegas, Nv, Courtney Coughenour, Timothy J. Bungum, M. Nikki Regalado

Public Health Faculty Publications

Food deserts indicate limited access to and affordability of healthy foods. One potential mediator is the availability of healthy food in non-traditional outlets such as dollar-discount stores, stores selling produce at the fixed $1 price. The purpose of this study was to compare availability, quality, price differences in ‘healthier’ versus ‘regular’ food choices, price per each food item, and summary score in dollar-discount stores to grocery stores in Las Vegas using the NEMS-S; a protocol consisting of three subscores—availability, quality, price of healthier versus regular food, and a summary score. [...] see article for full abstract

Limited Contribution Of Health Behaviours To Expanding Income-Related Chronic Disease Disparities Based On A Nationwide Cross-Sectional Study In China, Qing Wang, Jay J, Shen, Kaitlyn Frakes

Public Health Faculty Publications

This study estimated the association of income and prevalence of cardiovascular diseases (CVD) and hypertension, and then quantified the contribution of health behaviors to the association in China. Using the 2013 survey of the China Health and Retirement Longitudinal Study (CHARLS), a logit model was applied to examine income-related health disparities in relation to CVD and hypertension. A four-step regression method was then constructed to measure the role of health behaviors in income-related health disparities. Using indirect effects, mediation by health behaviors was examined. Income-related health disparities in chronic diseases were found to exist in China. Specifically, individuals in the …

Bibliometric Analysis Of Gaps In Research On Asbestos-Related Diseases: Declining Emphasis On Public Health Over 26 Years, Ro-Ting Lin, Matthew John Soeberg, Lung-Chang Chien, Scott Fisher, Jukka Takala, Richard Lemen, Tim Driscoll, Ken Takahashi

Public Health Faculty Publications

Objectives The global burden of asbestos-related diseases (ARDs) is significant, and most of the world’s population live in countries where asbestos use continues. We examined the gaps between ARD research and suggestions of WHO and the International Labour Organization on prevention. Methods From the Web of Science, we collected data on all articles published during 1991–2016 and identified a subset of ARD-related articles. We classified articles into three research areas—laboratory, clinical and public health—and examined their time trends. For all and the top 11 countries publishing ARD-related articles, we calculated the proportions of all ARD-related articles that were in each …

Nonlinear Associations Between Working Hours And Overwork-Related Cerebrovascular And Cardiovascular Diseases (Ccvd), Ro-Ting Lin, Lung-Chang Chien, Ichiro Kawachi

Public Health Faculty Publications

Long working hours are recognized as a risk factor for cerebrovascular and cardiovascular diseases (CCVD). We investigated the relationship between working hours and different CCVD severity outcomes—death, disability, and illness—across industries in Taiwan from 2006 to 2016. We applied a generalized additive mixed model to estimate the association between working hours and the rate of each severity outcome, adjusted for salary, unemployment rate, time, and a random intercept. Industry-average working hours were significantly associated with each outcome level of overwork-related CCVD, especially when monthly working hours increased from 169 (relative risk [RR] = 1.46, 95% confidence interval [CI] 1.002–2.12) to …

Pediatric To Adult Healthcare Transitioning For Adolescents Living With Hiv In Nigeria: A National Survey, Okikiolu A. Badejo, William A. Menson, Nadia A. Sam-Agudu, Jennifer Pharr, Salome Erekaha, Tamara Bruno, Gift Nwanne, Olabanjo Ogunsola, Jude Ilozumba, Olusegun Busari, Echezona E. Ezeanolue

Public Health Faculty Publications

Introduction The period of transition from pediatric to adult care has been associated with poor health outcomes among 10–19 year old adolescents living with HIV (ALHIV). This has prompted a focus on the quality of transition services, especially in high ALHIV-burden countries. Due to lack of guidelines, there are no healthcare transition standards for Nigeria’s estimated 240,000 ALHIV. We conducted a nationwide survey to characterize routine transition procedures for Nigerian ALHIV. Materials and methods This cross-sectional survey was conducted at public healthcare facilities supported by five local HIV service implementing partners. Comprehensive HIV treatment facilities with ≥1 year of HIV …

Use Of A Unique Farmers’ Market Program Targeting Lower-Income Community Members, Brittany Lawrence, Anna E. Greer, Anne Marie Zimeri, Daphne C. Hernandez, Sangnam Ahn, Shaakira Jones, Matthew Lee Smith

Public Health Faculty Publications

We examined use of a farmers’ market that leverages community partnerships to provide free produce to lower-income persons. Participants (n = 422) were asked to complete a questionnaire and given an ID number, which was used to track market use from 2014 to 2015. Chi square tests were used to examine associations between 2014/2015 market use and reasons for market use, financial support received, and how attendees had learned about the market. Ordinal regression was used to identify household characteristics associated with increased market attendance. Although the proportion of lower-income attendees declined over the study period, a substantial proportion of …

Lagged Influence Of Fine Particulate Matter And Geographic Disparities On Clinic Visits For Children’S Asthma In Taiwan, Lung-Chang Chien, Yu-An Chen, Hwa-Lung Yu

Public Health Faculty Publications

Recent studies have revealed the influence of fine particulate matter (PM2.5) on increased medication use, hospital admission, and emergency room visits for asthma attack in children, but the lagged influence of PM2.5 on children’s asthma and geographic disparities of children’s asthma have rarely been discussed simultaneously. This study investigated the documented diagnosis of children’s asthma in clinic visits for children aged less than 15 years old that were associated with PM2.5 in two counties located in west-central Taiwan during 2005–2010. The result shows that PM2.5 had a significant lagged effect on children’s asthma for up to 6 days. A significantly …

Identifying Windows Of Opportunity For Active Living And Healthy Eating Policies In Connecticut, 2016, Anna E. Greer, Ann-Uriel Knausenberger

Public Health Faculty Publications

We examined the relative importance of 23 community issues among elected officials and health directors in Connecticut in 2016. For this cross-sectional study, 74 elected officials (40.7% response rate) and 47 health directors (62.7% response rate), who were purposively sampled, completed a questionnaire to rate their perceived importance of 23 community issues. Eight of these issues were related to active living, healthy eating, or obesity. We used χ2 tests to evaluate differences in responses. Compared with elected officials, health directors significantly more often perceived obesity, access to healthy groceries, poor nutrition, lack of pedestrian walkways, and pedestrian safety as important. …

Biomedical Informatics Applications For Precision Management Of Neurodegenerative Diseases, Justin B. Miller, Guogen Shan, Joseph Lombardo, Gustavo Jimenez-Maggoria

Public Health Faculty Publications

Modern medicine is in the midst of a revolution driven by “big data,” rapidly advancing computing power, and broader integration of technology into healthcare. Highly detailed and individualized profiles of both health and disease states are now possible, including biomarkers, genomic profiles, cognitive and behavioral phenotypes, high-frequency assessments, and medical imaging. Although these data are incredibly complex, they can potentially be used to understand multi-determinant causal relationships, elucidate modifiable factors, and ultimately customize treatments based on individual parameters. Especially for neurodegenerative diseases, where an effective therapeutic agent has yet to be discovered, there remains a critical need for an interdisciplinary …

Statistical Advances In Clinical Trials And Clinical Research, Guogen Shan, Sarah Banks, Justin B. Miller, Aaron Ritter, Charles Bernick, Joseph Lombardo, Jeffrey L. Cummings

Public Health Faculty Publications

Introduction New treatments for neurodegenerative disease are urgently needed, and clinical trial methods are an essential component of new drug development. Although a parallel-group study design for neurological disorder clinical trials is commonly used to test the effectiveness of a new treatment as compared to placebo, it does not efficiently use information from the on-going study to increase the success rate of a trial or to stop a trial earlier when the new treatment is indeed ineffective. Methods We review some recent advances in designs for clinical trials, including futility designs and adaptive designs. Results Futility designs and noninferiority designs …

Problem Drinking, Alcohol-Related Violence, And Homelessness Among Youth Living In The Slums Of Kampala, Uganda, Monica Swahn, Rachel Culbreth, Nazarius Mbona Tumwesigye, Volkan Topalli, Eric R. Wright, Rogers Kasirye

Public Health Faculty Publications

This paper examines problem drinking, alcohol-related violence, and homelessness among youth living in the slums of Kampala—an understudied population at high-risk for both alcohol use and violence. This study is based on a cross-sectional survey conducted in 2014 with youth living in the slums and streets of Kampala, Uganda (n = 1134), who were attending Uganda Youth Development Link drop-in centers. The analyses for this paper were restricted to youth who reported current alcohol consumption (n = 346). Problem drinking patterns were assessed among youth involved in alcohol-related violence. Mediation analyses were conducted to examine the impact of homelessness on …

Childhood Health Status And Adulthood Cardiovascular Disease Morbidity In Rural China: Are They Related?, Qing Wang, Jay Shen

Public Health Faculty Publications

Cardiovascular diseases (CVDs) are among the top health problems of the Chinese population. Although mounting evidence suggests that early childhood health status has an enduring effect on late life chronic morbidity, no study so far has analyzed the issue in China. Using nationally representative data from the 2013 China Health and Retirement Longitudinal Study (CHARLS), a Probit model and Two-Stage Residual Inclusion estimation estimator were applied to analyze the relationship between childhood health status and adulthood cardiovascular disease in rural China. Good childhood health was associated with reduced risk of adult CVDs. Given the long-term effects of childhood health on …

Unemployment Rate, Smoking In China: Are They Related?, Qing Wang, Jay Shen, Christopher R. Cochran

Public Health Faculty Publications

Background: Studies on the relationship between unemployment rate and smoking have yielded mixed results. The issue in China has not been studied. This study aims to examine the influence of unemployment rate on smoking in China. Methods: Logit model and two-stage least squares (2SLS) estimation were used to estimate the effects. Estimations were done for 4585 individual over 45 using data from China Health and Retirement Longitudinal Study conducted in Zhejiang and Gansu provinces in 2008 and 2012. Results: A percent increase in the unemployment rate resulted in the increase in the likelihood of smoking by a combined 9.1 percent …

An Analysis Of Global Youth Tobacco Survey For Developing A Comprehensive National Smoking Policy In Timor-Leste, Decio Ribeiro Sarmento, Degninou Yehadji

Public Health Faculty Publications

Background: Smoking is a global public health concern. Timor-Leste is facing a rapidly growing epidemic of tobacco use. The trend of smoking in Timor-Leste seems to be increasing and the magnitude of the problem affects people who smoke before reaching adulthood. One of the factors implicated in the continuously rising trend of smoking among young people in Timor-Leste is clearly due to unavailability of restrictive laws and regulations. Therefore, our study sought to analyze available dataset from the Global Youth Tobacco Survey (GYTS) for developing a comprehensive national smoking policy in order to lower smoking risks among young people in …

Blood Transcriptomics And Metabolomics For Mersonalized Medicine, Shuzhao Li, Andrei Todor, Ruiyan Luo

Public Health Faculty Publications

Molecular analysis of blood samples is pivotal to clinical diagnosis and has been intensively investigated since the rise of systems biology. Recent developments have opened new opportunities to utilize transcriptomics and metabolomics for personalized and precision medicine. Efforts from human immunology have infused into this area exquisite characterizations of subpopulations of blood cells. It is now possible to infer from blood transcriptomics, with fine accuracy, the contribution of immune activation and of cell subpopulations. In parallel, high-resolution mass spectrometry has brought revolutionary analytical capability, detecting N10,000 metabolites, together with environmental exposure, dietary intake, microbial activity, and pharmaceutical drugs. Thus, the …

Associations Between Self-Reported Gastrointestinal Illness And Water System Characteristics In Community Water Supplies In Rural Alabama: A Cross-Sectional Study, Christine E. Stauber, Jessica C. Wedgworth, Pauline Johnson, Julie B. Olson, Tracy Ayers, Mark Elliot, Joe Brown

Public Health Faculty Publications

Background: Community water supplies in underserved areas of the United States may be associated with increased microbiological contamination and risk of gastrointestinal disease. Microbial and health risks affecting such systems have not been systematically characterized outside outbreak investigations. The objective of the study was to evaluate associations between self-reported gastrointestinal illnesses (GII) and household-level water supply characteristics.
Methods: We conducted a cross-sectional study of water quality, water supply characteristics, and GII in 906 households served by 14 small and medium-sized community water supplies in Alabama’s underserved Black Belt region.
Results: We identified associations between respondent-reported water supply interruption and any …

A Novel Method For Quantifying The Inhaled Dose Of Air Pollutants Based On Heart Rate, Breathing Rate And Forced Vital Capacity, Roby Greenwald, Matthew Hayat, Jerusha Barton, Anastasia Lopukhin

Public Health Faculty Publications

To better understand the interaction of physical activity and air pollution exposure, it is important to quantify the change in ventilation rate incurred by activity. In this paper, we describe a method for estimating ventilation using easily-measured variables such as heart rate (HR), breathing rate (fB), and forced vital capacity (FVC). We recruited healthy adolescents to use a treadmill while we continuously measured HR, fB, and the tidal volume (VT) of each breath. Participants began at rest then walked and ran at increasing speed until HR was 160–180 beats per minute followed by a cool down period. The novel feature …

Principles Of Tobacco Control: Extinguishing The Habit, Michael Eriksen, Carrie F. Whitney, Ellie Faustino

Public Health Faculty Publications

Principles of Tobacco Control: Extinguishing the Habit, explores the history of tobacco as well as today’s issues—from the rise of novel tobacco products such as e-cigarettes to regulations surrounding tobacco’s use, marketing and other aspects of industry behavior. This digital publication also examines the harm caused by tobacco use and offers solutions for successful tobacco control. Dr. Michael Eriksen, an international expert on tobacco research and policy and Dean of the School of Public Health at Georgia State University, is the lead author of this resource, which contains interactive features, including video, graphics and links to additional articles and …

A Pilot Study To Examine The Disparities In Water Quality Between Predominantly Haitian Neighborhoods And Dominican Neighborhoods In Two Cities In The Dominican Republic, Jessica Brown, Ryan Johnson, Dominique Smith, Kim Ramsey-White

Public Health Faculty Publications

Abstract: Worldwide, diarrheal disease is a leading cause of death affecting over 1.7 million individuals annually. Much of this can be attributed to lack of clean water, sanitation and hygiene. Nearly all of these deaths occur in countries with developing economies. This public health problem is apparent in the island of Hispaniola; the island that is shared by Haiti and the Dominican Republic. Significant gaps in income between the countries have resulted in Haitians migrating into the Dominican Republic. While there has been increased migration into the Dominican Republic, many of the neighborhoods remain segregated. A cross-sectional analysis was conducted …

Whooping Cough Dynamics In Chile (1932-2010): Diseasetemporal Fluctuations Across A North-South Gradient, Mauricio Lima, Sergio Estay, Rodrigo Fuentes, Paola Rubilar, Hélène Broutin, Gerardo Chowell

Public Health Faculty Publications

Background: The spatial-temporal dynamics of Bordetella pertussis remains as a highly interesting case in infectious disease epidemiology. Despite large-scale vaccination programs in place for over 50 years around the world, frequent outbreaks are still reported in many countries.

Methods: Here, we use annual time series of pertussis incidence from the thirteen different regions of Chile (1952–2010) to study the spatial-temporal dynamics of Pertussis. The period 1975–1995 was characterized by a strong 4 year cycle, while the last two decades of the study period (1990–2010) were characterized by disease resurgence without significant periodic patterns. Results: During the first decades, differences in …

Disaggregating Health Inequalities Within Rio De Janeiro, Brazil, 2002-2010, By Applying An Urban Health Inequality Index, Martin Botz, Megumi Kano, Heribert Ramroth, Christovam Barcellos, Scott R. Weaver, Richard Rothenberg, Monica Magalhães

Public Health Faculty Publications

An urban health index (UHI) was used to quantify health inequalities within Rio de Janeiro, Brazil, for the years 2002-2010. Eight main health indicators were generated at the ward level using mortality data. The indicators were combined to form the index. The distribution of the rank ordered UHI-values provides information on inequality among wards, using the ratio of the extremes and the gradient of the middle values. Over the decade the ratio of extremes in 2010 declined relative to 2002 (1.57 vs. 1.32) as did the slope of the middle values (0.23 vs. 0.16). A spatial division between the affluent …

Smoking Cessation For Chinese Men And Prevention For Women, Jeffrey Koplan, Michael Eriksen

Public Health Faculty Publications

No abstract provided.

Alcohol Policies And Alcoholic Cirrhosis Mortality In The United States, Scott E. Hadland, Ziming Xuan, Jason G. Blanchette, Timothy C. Heeren, Monica H. Swahn, Timothy S. Naimi

Public Health Faculty Publications

Introduction Stronger alcohol policies predict decreased alcohol consumption and binge drinking in the United States. We examined the relation- ship between the strength of states’ alcohol policies and alcoholic cirrhosis mortality rates.

Methods We used the Alcohol Policy Scale (APS), a validated assessment of policies of the 50 US states and Washington DC, to quantify the efficacy and implementation of 29 policies. State APS scores (the- oretical range, 0–100) for each year from 1999 through 2008 were compared with age-adjusted alcoholic cirrhosis death rates that oc- curred 3 years later. We used Poisson regression accounting for state-level clustering and adjusting …

Estimating The Risk Of Middle East Respiratory Syndrome (Mers) Death During The Course Of The Outbreak In The Republic Of Korea, Kenji Mizumoto, Masaya Saitoh, Gerardo Chowell, Nishiura H. Miyamatsu, Hiroshi Nishiura

Public Health Faculty Publications

Objectives: A large cluster of the Middle East respiratory syndrome (MERS) linked to healthcare setting occurred from May to July 2015 in the Republic of Korea. The present study aimed to estimate the case fatality ratio (CFR) by appropriately taking into account the time delay from illness onset to death. We then compare our estimate against previously published values of the CFR for MERS, i.e., 20% and 40%. Methods: Dates of illness onset and death of the MERS outbreak in the Republic of Korea were extracted from secondary data sources. Using the known distribution of time from illness onset to …

Real-Time Characterization Of Risks Of Death Associated With The Middle East Respiratory Syndrome (Mers) In The Republic Of Korea, 2015, Kenji Mizumoto, Akira Endo, Gerardo Chowell, Yuichiro Miyamatsu, Masaya Saitoh, Hiroshi Nishiura

Public Health Faculty Publications

Background: An outbreak of the Middle East respiratory syndrome (MERS), comprising 185 cases linked to healthcare facilities, occurred in the Republic of Korea from May to July 2015. Owing to the nosocomial nature of the outbreak, it is particularly important to gain a better understanding of the epidemiological determinants characterizing the risk of MERS death in order to predict the heterogeneous risk of death in medical settings. Methods: We have devised a novel statistical model that identifies the risk of MERS death during the outbreak in real time. While accounting for the time delay from illness onset to death, risk …

Mortality Rates And The Causes Of Death Related To Diabetes Mellitus In Shanghai Songjiang District: An 11-Year Retrospective Analysis Of Death Certificates, Meiying Zhu, Jiang Li, Zhiyuan Li, Wei Luo, Dajun Dai, Scott Weaver, Christine E. Stauber, Ruiyan Luo, Hua Fu

Public Health Faculty Publications

Background: China is one of the countries with the highest prevalence of diabetes in the world. We analysed all the death certificates mentioning diabetes from 2002 to 2012 in Songjiang District of Shanghai to estimate morality rates and examine cause of death patterns. Methods: Mortality data of 2654 diabetics were collected from the database of local CDC. The data set comprises all causes of death, contributing causes and the underlying cause, thereby the mortality rates of diabetes and its specified complications were analysed. Results: The leading underlying causes of death were various cardiovascular diseases (CVD), which collectively accounted for about …

Investigation Of E. Coli And Virus Reductions Using Replicate, Bench-Scale Biosand Filter Columns And Two Filter Media, Mark Elliott, Christine E. Stauber, Francis A. Digiano, Anna Fabiszewski De Aceituno, Mark Sobsey

Public Health Faculty Publications

The biosand filter (BSF) is an intermittently operated, household-scale slow sand filter for which little data are available on the effect of sand composition on treatment performance. Therefore, bench-scale columns were prepared according to the then-current (2006–2007) guidance on BSF design and run in parallel to conduct two microbial challenge experiments of eight-week duration. Triplicate columns were loaded with Accusand silica or crushed granite to compare virus and E. coli reduction performance. Bench-scale experiments provided confirmation that increased schmutzdecke growth, as indicated by decline in filtration rate, is the primary factor causing increased E. coli reductions of up to 5-log10. …

Protobacco Media Exposure And Youth Susceptibility To Smoking Cigarettes, Cigarette Experimentation, And Current Tobacco Use Among Us Youth, Erika B. Fulmer, Torsten B. Neilands, Shanta R. Dube, Nicole M. Kuiper, Rene A. Arrazola, Stanton A. Glantz

Public Health Faculty Publications

Purpose: Youth are exposed to many types of protobacco influences, including smoking in movies, which has been shown to cause initiation. This study investigates associations between different channels of protobacco media and susceptibility to smoking cigarettes, cigarette experimentation, and current tobacco use among US middle and high school students.
Methods: By using data from the 2012 National Youth Tobacco Survey, structural equation modeling was performed in 2013. The analyses examined exposure to tobacco use in different channels of protobacco media on smoking susceptibility, experimentation, and current tobacco use, accounting for perceived peer tobacco use.
Results: In 2012, 27.9% of respondents …

Psychosocial Stress And Changes In Estimated Glomerular Filtration Rate Among Adults With Diabetes Mellitus, Francis B. Annor, Katherine E. Masyn, Ike S. Okosun, Douglas W. Roblin, Michael Goodman

Public Health Faculty Publications

Background: Psychosocial stress has been hypothesized to impact renal changes, but this hypothesis has not been adequately tested. The aim of this study was to examine the relationship between psychosocial stress and estimated glomerular filtration rate (eGFR) and to examine other predictors of eGFR changes among persons with diabetes mellitus (DM).
Methods: Data from a survey conducted in 2005 by a major health maintenance organization located in the southeastern part of the United States, linked to patients’ clinical and pharmacy records (n ¼ 575) from 2005 to 2008, was used. Study participants were working adults aged 25–59 years, diagnosed with …

Assessing The Risk Of Observing Multiple Generations Of Middle East Respiratory Syndrome (Mers) Cases Given An Imported Case, Nishiura H. Miyamatsu, Y. Miyamatsu, Gerardo Chowell, M Saitoh

Public Health Faculty Publications

To guide risk assessment, expected numbers of cases and generations were estimated, assuming a case importation of Middle East respiratory syndrome (MERS). Our analysis of 36 importation events yielded the risk of observing secondary transmission events at 22.7% (95% confidence interval: 19.3–25.1). The risks of observing generations 2, 3 and 4 were estimated at 10.5%, 6.1% and 3.9%, respectively. Countries at risk should be ready for highly variable outcomes following an importation of MERS.