Improving Minors' Access To Treatment For Opioid Use Disorder: A Policy Analysis, Sara Jane Hamilton

Master's Projects and Capstones

As the opioid epidemic continues to have devastating effects on our communities, medications to treat opioid use disorder (MOUDs) are severely underutilized especially for adolescents. Unlike adults, minors need parental approval before obtaining MOUDs presenting a key barrier to timely treatment. Being able to treat adolescents as soon as they are ready is critically important for people with OUD, and while cost and other barriers have been addressed in the literature, there is a paucity on how parental consent affects the accessibility of treatment. This paper aims to explore a potential policy in California that addresses the lack of access …

The Health Impacts Of The Trump Administration Among California Immigrants, Claudia M. Calhoon

Dissertations and Theses

Immigration policy was a marquee issue in the US presidential administration of Donald Trump. Trump’s administration employed both policy and rhetoric related to immigrants to mobilize voters, alter immigration policies and practices, and sustain a narrative of a nation under attack by immigrants. Administration officials were able to undertake these approaches because of existing immigration law, but they did so in more explicitly punitive ways than in recent administrations. The goal of this dissertation is to explore the health impacts of the administration’s practices and their effects. Paper 1 analyzes the immigration rhetoric and policies of US president Donald Trump …

Syphilis And Congenital Syphilis Among Women In San Bernardino County, Valerie Alfaro

Electronic Theses, Projects, and Dissertations

Background: Syphilis is a sexually transmitted infection that mostly affects individuals from a lower income status. San Bernardino County has a high poverty rate and a high rate of Congenital Syphilis. Pregnant women who test positive for Syphilis run the risk of passing the infection on to the fetus. Babies born with Congenital Syphilis may experience many complications, and therefore, the treatment is more intense. The best prevention for Congenital Syphilis is regular screening during pregnancy.

Methods: This study used quantitative research based on secondary data collected from San Bernardino County, Department of Public Health. Data were gathered by an …

An Analysis Of Water Quality At Orange County, California Beaches, Naomi Meurice

Pomona Senior Theses

Beaches in Southern California are highly recreated by residents and visitors, making beaches socially and economically important. Public health departments in coastal communities are in charge of measuring water quality and ensuring it is safe for users. Research in the past has indicated that beach water quality gets worse after storms, with bacteria levels jumping on the day of a storm and staying high for up to five days. Studies have shown these spikes in bacteria to be associated with storm runoff, with beaches closer to runoff discharge locations experiencing more impact. However, prior research has not considered the period …

Ethnic Disparities In Early-Onset Gastric Cancer: A Population-Based Study In Texas And California, Anna Tavakkoli, Sandi L Pruitt, Anh Q Hoang, Hong Zhu, Amy E Hughes, Thomas A Mckey, B Joseph Elmunzer, Richard S Kwon, Caitlin C Murphy, Amit G Singal

Journal Articles

BACKGROUND: Incidence rates of gastric cancer are increasing in young adults (age <50 >years), particularly among Hispanic persons. We estimated incidence rates of early-onset gastric cancer (EOGC) among Hispanic and non-Hispanic White persons by census tract poverty level and county-level metro/nonmetro residence.

METHODS: We used population-based data from the California and Texas Cancer Registries from 1995 to 2016 to estimate age-adjusted incidence rates of EOGC among Hispanic and non-Hispanic White persons by year, sex, tumor stage, census tract poverty level, metro versus nonmetro county, and state. We used logistic regression models to identify factors associated with distant stage diagnosis.

RESULTS: Of …

Medical Necessity Of Residential Treatment For Anorexia: Can Parity Be Achieved?, Abbey Derechin

Northwestern Journal of Law & Social Policy

This Note examines the statutory landscape of mental health parity in the United States. The lens of this Note is through the mental illness of anorexia. Parity laws mandate analogous limitations between mental and physical illness. Therefore, because anorexia has many physical manifestations, it serves as a nice juxtaposition to physical illnesses. This Note will argue for broad interpretation of the Mental Health Parity and Addiction Equity Act (MHPAEA) through comparative analysis of counterpart statute, the California Mental Health Parity Act (CMHPA). It will explore how courts have interpreted the CMHPA broadly to suggest that the MHPAEA should be interpreted …

California’S Urban And Rural Asthma Healthcare Access And Asthma Management During Covid-19 Pandemic, Stacey R. Varga

Walden Dissertations and Doctoral Studies

A lack of adequate healthcare access can negatively affect asthma management. The purpose of this study was to understand whether there was an association between source of care and asthma management. This study provides important insights concerning the changing landscape of how individuals receive asthma treatment and manage their asthma during a pandemic. Asthma management and asthma care have been studied; however, results have been inconclusive in relation to the barriers to health that are experienced among various adult age groups. Identifying additional subgroup characteristics could provide insight into where health practitioners, practice management, and policymakers direct healthcare resources. The …

Public Protests And The Risk Of Novel Coronavirus Disease Hospitalizations: A County-Level Analysis From California, Linh N. Bui, Rachel L. Berkowitz, Wendy Jilek, Andrew J. Bordner, Kristen M. J. Azar, Alice Pressman, Robert J. Romanelli

Faculty Research, Scholarly, and Creative Activity

The objective of this study was to assess the relationship between public protests and county-level, novel coronavirus disease (COVID-19) hospitalization rates across California. Publicly available data were included in the analysis from 55 of 58 California state counties (29 March–14 October 2020). Mixed-effects negative binomial regression models were used to examine the relationship between daily county-level COVID-19 hospitalizations and two main exposure variables: any vs. no protests and 1 or >1 protest vs. no protests on a given county-day. COVID-19 hospitalizations were used as a proxy for viral transmission since such rates are less sensitive to temporal changes in testing …

California's Master Plan For Aging, Health Reimagined: A Case For Seniors To Age-In-Place, Remonia A. Bowie

Master's Projects and Capstones

Abstract

In 2021 Worldwide, communities face a singular yet common challenge; and this is the significant aging of their senior adult populations. Current evidence from the literature suggests that older adults prefer to stay in their homes as they age. However, the facilitators and challenges older people encounter in realizing their aging goals have been inadequately addressed by the current body of literature given the projected increase in the number of older people in the United States preferring to age from their homes. Aging adults are vulnerable to daily frustration, which could negatively impact their aging process. However, knowledge of …

What’S In Wildfire Smoke?: A Toxicologist Explains The Health Risks And Which Masks Can Help, Luke Montrose

Public Health and Population Science Faculty Publications and Presentations

Smoke is turning the sky hazy across a large swath of the country as dozens of large fires burn, and a lot of people are wondering what’s in the air they’re breathing.

As an environmental toxicologist, I study the effects of wildfire smoke and how they differ from other sources of air pollution. We know that breathing wildfire smoke can be harmful. Less clear is what the worsening wildfire landscape will mean for public health in the future, but research is raising red flags.

Addressing Maternal Mortality Rates Of Black Women In The Us: California's Example, Selah Laigo

Humanities and Cultural Studies | Senior Theses

This essay examines California’s legislation, activism, and the role of women’s clinics in serving Black communities in the fight against maternal mortality. Maternal mortality is a death related to pregnancy or childbirth. In the United States, maternal mortality rates have been increasing since the beginning of the 21st century and there is a significant racial disparity with Black women being at greater risk. Despite national rates increasing, California has managed to decrease maternal mortality rates (MMR) since the early 2000s by adopting legislation and policies that work to decrease preventable deaths, multidisciplinary maternity care for the protection of Black women, …

Gardasil Vaccine Trends Within Nevada, California, And The U.S.: A Comparative Study, Karen S. Gutierrez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite decreasing incidence in cervical cancer in the U.S., there continues to be an increase in public health concern for cervical cancer worldwide. Recent studies report that individuals are disproportionately affected based on region, sex, and race. Additionally, the human papillomavirus (HPV) attributable cancers may be reduced between 70% and 90% through the universal use of HPV-vaccines. In order to expand current knowledge and implement intervention programs in Nevada, it is critical to examine the associations among the Gardasil vaccine, cervical cancer screening, and adverse events following immunization as well as to understand the different socio-demographic subgroups affected. To our …

Food Insecurity And Healthy Food Availability In The State Of Ohio, Yanley Sánchez

Scholarship in Medicine - All Papers

Objective: This research study aims to determine the impact of food insecurity and healthy food availability in the state of Ohio. It investigates how food insecurity in Ohio has changed between 2016 and 2020. It also investigates how food insecurity correlates with education level by looking at high school graduation rates. It also investigates how Ohio, a state with a high level of food insecurity, compares to California which has low levels of food insecurity. This study also compares how food insecurity differs in rural and urban counties throughout the state of Ohio.

Methods: ANOVA with posthoc will be conducted …

A Community-Wide Collaboration To Reduce Cardiovascular Disease Risk: The Hearts Of Sonoma County Initiative., Allen Cheadle, Michelle Rosaschi, Dolores Burden, Monica Ferguson, Bo Greaves, Lori Houston, Jennifer Mcclendon, Jerome Minkoff, Maggie Jones, Pam Schwartz, Jean Nudelman, Mary Maddux-Gonzalez

Articles, Abstracts, and Reports

PURPOSE AND OBJECTIVES: Collaboration across multiple sectors is needed to bring about health system transformation, but creating effective and sustainable collaboratives is challenging. We describe outcomes and lessons learned from the Hearts of Sonoma County (HSC) initiative, a successful multi-sector collaborative effort to reduce cardiovascular disease (CVD) risk in Sonoma County, California.

INTERVENTION APPROACH: HSC works in both clinical systems and communities to reduce CVD risk. The initiative grew out of a longer-term county-wide collaborative effort known as Health Action. The clinical component involves activating primary care providers around management of CVD risk factors; community activities include community health workers …

Cancer Risk Factors And Screening Behavior Among Korean Americans In The Sf Bay Area, Nhayoung Hwang, Hyunju Kim, Eugenia Yoo, Denny Cha, Winston Tseng Phd, Susan L. Ivey Md, Mhsa

Journal of Health Disparities Research and Practice

Background: Korean Americans (KA) have the highest prevalence of death from cancer among Asian American ethnic groups in the U.S. This KA prevalence rate is also substantially higher than that of non-Hispanic whites, yet little is known about their cancer risk factors. This paper is one of the first studies to explore cancer risk factors and screening behaviors of Korean Americans in the San Francisco Bay Area.

Methods: A survey instrument was created using items from the California Health Interview Survey (CHIS) from 2009-2012, which were translated into Korean. A cross-sectional survey assessing the prevalence of cancer risk factors and …

Quantifying Influenza Exposure Within Hospitals And Nursing Homes, Drew Taylor Dickinson

Public Health Theses

Abstract

Background: Influenza acquisition in hospitals and nursing homes (NHs) highlights the need for infection prevention to protect patients from contagious diseases while under the care of a healthcare facility. We quantified influenza exposure in both settings and compared facility-onset influenza rates in order to determine if risks of acquiring influenza differed by type of healthcare facility since infection prevention practices are less standardized and less rigorous in NHs.

Methods: We conducted a retrospective cohort study of California hospital and NH inpatients during the 2015-2016 influenza season, defined as the peak influenza month, plus the two adjacent months, using claims …

Ethical Cannabis Lawyering In California, Francis J. Mootz Iii

St. Mary's Journal on Legal Malpractice & Ethics

Cannabis has a long history in the United States. Originally, doctors and pharmacists used cannabis for a variety of purposes. After the Mexican Revolution led to widespread migration from Mexico to the United States, many Americans responded by associating this influx of foreigners with the use of cannabis, and thereby racializing and stigmatizing the drug. After the collapse of prohibition, the federal government repurposed its enormous enforcement bureaucracy to address the perceived problem of cannabis, despite the opposition of the American Medical Association to this new prohibition. Ultimately, both the states and the federal government classified cannabis as a dangerous …

Barriers To Receipt Of Prenatal Tetanus Toxoid, Reduced Diptheria Toxoid, And Acellular Pertussis Vaccine Among Mothers Of Infants Aged < 4 Months With Pertussis — California, 2016, Sarah New, Kathleen Winter, Kathleen Harriman, Anya Gutman, Amber Christiansen, Sarah Royce

Epidemiology and Environmental Health Faculty Publications

No abstract provided.

Ethnic Differences In Risk Factors For Obesity Among Adults In California, The United States, Liang Wang, Jodi L. Southerland, Kesheng Wang, Beth A. Bailey, Arsham Alamian, Marc A. Stevens, Youfa Want

Arsham Alamian

Little attention has been given to differences in obesity risk factors by racial/ethnic groups. Using data from the 2011-2012 California Health Interview Survey, we examined differences in risk factors for obesity among Whites, Latinos, Asians, and African Americans among 42,935 adults (24.8% obese). Estimates were weighted to ensure an unbiased representation of the Californian population. Multiple logistic and linear regression analyses were used to examine the differences in risk factors for obesity. Large ethnic disparities were found in obesity prevalence: Whites (22.0%), Latinos (33.6%), African Americans (36.1%), and Asians (9.8%). Differences in risk factors for obesity were also observed: Whites …

Wic Participant Fruit And Vegetable Intake In California, Lindsay Estrada

Walden Dissertations and Doctoral Studies

Low-income populations in the United States consume less healthful diets than higher-income populations, specifically relating to fruit and vegetable consumption. The supplemental nutrition program Women, Infants, and Children (WIC) is intended to bridge this gap by providing nutrition education and vouchers for nutritious foods. The purpose of this study was to determine if the 2009 WIC food package revisions impacted fruit and green vegetable consumption in 18 to 24-year-old females in California. Using the social ecological model as a guide, a population of WIC (N = 115) and non-WIC (N = 276) participants from the California Behavioral Risk Factor Surveillance …

Predictors Of Nutritional Counseling Among Adolescents By Physicians In California, Jean Kigozi

Walden Dissertations and Doctoral Studies

The prevalence of obesity in the United States was stable at 17% from 2011-2014 among approximately 13 million children and adolescents 12-19 years of age, according to the Centers for Disease Control and Prevention. Nutritional counseling has been recommended, and while most physicians agree that it is necessary, it is not happening consistently. The purpose of this study was to examine the association between dietary intake, physical activity, and body mass index (BMI) characteristics of youth 12-17 years old in California and the receipt of nutritional counseling. Social cognitive theory guided this quantitative cross-sectional analysis of archived data from 814 …

Implementation Of A Fruit And Vegetable Voucher Program In San Francisco, Alexandra Kambur

Master's Projects and Capstones

Chronic disease has emerged as the predominant public health challenge of the 21st century. Chronic diseases like cardiovascular disease, cancer, type 2 diabetes and obesity have maintained their top positions as the leading causes of poor health, disability, death, and high health-care expenditures for over a decade. Health and hunger go hand-in-hand. Today over 15 million households in the United States struggle with food insecurity, meaning they do not have sufficient access to food that meets their dietary needs for an active and healthy life. The issue of food insecurity in cities like San Francisco, California is exacerbated by the …

A Descriptive Study Of The Elderly In California Substance Abuse Treatment Programs, David Berenschot

Electronic Theses, Projects, and Dissertations

As gerontologists may know, there are a great deal of studies and a variety of academic literature on the misuse of alcohol and prescription medication amongst the elderly population. While there is a plethora of information on alcohol and prescription misuse, there is little reported data about the prevalence of other substance misuse experienced by this population. This study aims to help to fill that gap in the data by using quantitative methods to describe the scope of substance abuse of individuals 55-years or older. This study utilizes data from the Treatment Data Set Admission (TEDS-A). The TEDS-A is a …

The Role Of Neighborhood Characteristics In Late Stage Melanoma Diagnosis Among Hispanic Men In California, Texas, And Florida, 1996-2012, Valerie M. Harvey, Clinton W. Enos, Jarvis T. Chen, Hadiza Galadima, Karl Eschbach

Community & Environmental Health Faculty Publications

Background. Hispanics diagnosed with cutaneous melanoma are more likely to present at advanced stages but the reasons for this are unknown. We identify census tracts at high risk for late stage melanoma diagnosis (LSMD) and examine the contextual predictors of LSMD in California, Texas, and Florida. Methods. We conducted a cross-sectional study using geocoded state cancer registry data. Using hierarchical multilevel logistic regression models we estimated ORs and 95% confidence intervals for the impact of socioeconomic, Hispanic ethnic concentration, index of dissimilarity, and health resource availability measures on LSMD. Results. We identified 12,493 cases. In California, late …

Spatiotemporal Dynamics Of The Southern California Asian Citrus Psyllid (Diaphorina Citri) Invasion., Brett R. Bayles, Shyam M. Thomas, Gregory S. Simmons, Elizabeth E. Grafton-Cardwell, Mathew P. Daugherty

Global Public Health | Faculty Scholarship

Biological invasions are governed by spatial processes that tend to be distributed in non-random ways across landscapes. Characterizing the spatial and temporal heterogeneities of the introduction, establishment, and spread of non-native insect species is a key aspect of effectively managing their geographic expansion. The Asian citrus psyllid (Diaphorina citri), a vector of the bacterium associated with huanglongbing (HLB), poses a serious threat to commercial and residential citrus trees. In 2008, D. citri first began expanding northward from Mexico into parts of Southern California. Using georeferenced D. citri occurrence data from 2008-2014, we sought to better understand the extent of the …

Ethnic Differences In Risk Factors For Obesity Among Adults In California, The United States, Liang Wang, Jodi L. Southerland, Kesheng Wang, Beth A. Bailey, Arsham Alamian, Marc A. Stevens, Youfa Want

ETSU Faculty Works

Little attention has been given to differences in obesity risk factors by racial/ethnic groups. Using data from the 2011-2012 California Health Interview Survey, we examined differences in risk factors for obesity among Whites, Latinos, Asians, and African Americans among 42,935 adults (24.8% obese). Estimates were weighted to ensure an unbiased representation of the Californian population. Multiple logistic and linear regression analyses were used to examine the differences in risk factors for obesity. Large ethnic disparities were found in obesity prevalence: Whites (22.0%), Latinos (33.6%), African Americans (36.1%), and Asians (9.8%). Differences in risk factors for obesity were also observed: Whites …

The Carrot And The Stick? Strategies To Improve Compliance With College Campus Tobacco Policies, Amanda Fallin-Bennett, Maria Roditis, Stanton A. Glantz

Nursing Faculty Publications

Objective: Tobacco-free policies are being rapidly adopted nationwide, yet compliance with these policies remains a challenge. This study explored college campus key informants' experiences with tobacco policies, and their perceived benefits, drawbacks, and outcomes. Participants: The sample for this study was 68 key informants representing 16 different California universities with varying tobacco policies (no smoking indoors and within 20 feet of entrances, designated smoking areas, 100% smoke-free, and 100% tobacco-free). Methods: Qualitative, descriptive study. Semistructured interviews were transcribed verbatim and analyzed using content analysis. Results: Strategies to improve compliance ranged from a social approach to a …

The Eco-Epidemiology Of Pacific Coast Tick Fever In California, Kerry A. Padgett, Denise L. Bonilla, Marina E. Eremeeva, Carol A. Glaser, Robert S. Lane, Charsey Cole Porse, Martin B. Castro, Sharon L. Messenger, Alex Espinosa, Jill Hacker, Anne Kjemtrup, Bonnie Ryan, Jamesina J. Scott, Renjie Hu, Melissa Hardstone Yoshimizu, Gregory A. Dasch, Vicki Kramer

Environmental Health Sciences Faculty Publications

Rickettsia philipii (type strain “Rickettsia 364D”), the etiologic agent of Pacific Coast tick fever (PCTF), is transmitted to people by the Pacific Coast tick, Dermacentor occidentalis. Following the first confirmed human case of PCTF in 2008, 13 additional human cases have been reported in California, more than half of which were pediatric cases. The most common features of PCTF are the presence of at least one necrotic lesion known as an eschar (100%), fever (85%), and headache (79%); four case-patients required hospitalization and four had multiple eschars. Findings presented here implicate the nymphal or larval stages of D …

Palliative Chemotherapy Among People Living In Poverty With Metastasised Colon Cancer: Facilitation By Primary Care And Health Insurance, Kevin M. Gorey, Emma Bartfay, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, Eric J. Holowaty, Nancy L. Richter, Madhan K. Balagurusamy

Social Work Publications

Background: Many Americans with metastasised colon cancer do not receive indicated palliative chemotherapy. We examined the effects of health insurance and physician supplies on such chemotherapy in California.

Methods: We analysed registry data for 1199 people with metastasised colon cancer diagnosed between 1996 and 2000 and followed for 1 year. We obtained data on health insurance, census tract-based socioeconomic status and county-level physician supplies. Poor neighbourhoods were oversampled and the criterion was receipt of chemotherapy. Effects were described with rate ratios (RR) and tested with logistic regression models.

Results: Palliative chemotherapy was received by less than half of the participants …

Walking Mediates Associations Between Neighborhood Activity Supportiveness And Bmi In The Women's Health Initiative San Diego Cohort., Jordan A. Carlson, Rosemay A. Remigio-Baker, Cheryl A M Anderson, Marc A. Adams, Gregory J. Norman, Jacqueline Kerr, Michael H. Criqui, Matthew Allison

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To investigate whether walking mediates neighborhood built environment associations with weight status in middle- and older-aged women.

METHODS: Participants (N=5085; mean age=64 ± 7.7; 75.4% White non-Hispanic) were from the Women's Health Initiative San Diego cohort baseline visits. Body mass index (BMI) and waist circumference were measured objectively. Walking was assessed via survey. The geographic information system (GIS)-based home neighborhood activity supportiveness index included residential density, street connectivity, land use mix, and number of parks.

RESULTS: BMI was 0.22 units higher and the odds ratio for being obese (vs. normal or overweight) was 8% higher for every standard deviation …