Medicine and Health Sciences Commons^™

It’S Up To The States: The Role Of State-Based Safety Net Programs In Maternal Health Outcomes, Brooklyn Hall

Honors Theses

This thesis explores the relationship between state-based safety net programs and maternal health outcomes in the United States. Using the case studies of five states, namely Mississippi, Alabama, Wisconsin, Minnesota, and California, this research examines how variations in programs such as Medicaid, the Earned Income Tax Credit (EITC), Temporary Assistance for Needy Families (TANF), and Paid Family Leave (PFL) influence maternal mortality rates and overall maternal health outcomes. The analysis shows that states with more generous and comprehensive safety net programs, like California and Minnesota, tend to report lower maternal mortality rates. In contrast, states with less robust programs, such …

The Legacy Of Lead: Lead Exposure's Harmful Effects And Its Concentration In Poc Communities, Layla Sophronia Barber

Student Theses 2015-Present

This thesis examines the disproportionate burden of lead exposure carried by low income, POC communities. The systemic nature of this problem is a symptom of a longstanding legacy of environmental injustice in the United States. Decades of federal neglect are reflected in the higher statistics of lead exposure and poisoning in predominantly black communities. While it is understood that lead exposure poses a serious threat to physical health and early cognitive development, there is a discouraging lack of urgency to remove the toxin from non-wealthy communities. The material covered by this thesis aims to identify and correct the discriminatory social …

Bio 340 Final Project: Rural Population Structure And Food Production Interact To Shape Global Undernourishment, Ava Ripanti

Biology Student Scholarship

Ava Ripanti - Environmental Biology '27

Undernourishment remains a major global public health challenge, reflecting the proportion of a population lacking sufficient dietary energy intake. While food availability is central to food security, undernourishment is also shaped by structural and socioeconomic factors such as population distribution and access to resources. Although rural populations are closely tied to agriculture, they often experience higher food insecurity due to limited infrastructure, market access, and healthcare. Prior research emphasizes that broader determinants, particularly inequality and development, are stronger predictors of undernourishment than agricultural output alone, that food insecurity exists in both rural and urban …

Serological Evidence Of Onchocerca Volvulus Exposure And Entomological Indicators Of Parasite Transmission, Didier Kapuku Bakajika

Walden Dissertations and Doctoral Studies

No abstract provided.

The Effect Of A Superficial Biochar Layer On Soil Radon Exhalation: A Preliminary Investigation Into A Passive Residential Radon Mitigation Strategy, Nicholas Richmond Nelson

Honors Theses

Residential radon exposure is a leading cause of lung cancer worldwide, yet home testing and mitigation remain infrequent. Active mitigation systems can be costly, and existing passive radon-resistant construction techniques, while cost-effective, are not always sufficient to reduce indoor radon to below the recommended EPA threshold of 4.0 pCi/L (148 Bq/m3). This initial work examines the potential for a superficial biochar layer placed beneath a house foundation during construction to reduce soil radon exhalation and subsequent indoor radon concentration. Biochar is also being explored as an admixture to concrete, and this study investigates radon transmission through concrete with varying biochar …

Modeling Individual Self-Protective Behavior During Epidemics, Geonsik Yu, Michael J. Garee, Mario Ventresca, Yuehwern Yih

Faculty Publications

Protecting public health from infectious diseases requires collective action, as individual behaviors—such as vaccination and mask-wearing—directly influence disease dynamics. During the COVID-19 pandemic, unexpected public responses often undermined the effectiveness of interventions, highlighting the need to understand collective behavioral patterns and motivations to design more effective mitigation strategies. This study presents an agent-based simulation model that captures how individuals adjust self-protective behaviors based on evolving opinions about disease risk and examines how these decisions interact with external factors, such as public health interventions, to shape collective outcomes. To improve the representativeness of the simulated population, multiple datasets were integrated to …

Colorectal Cancer Screening: Implementation And Evaluation Of A Screening Algorithm In A Rural Family Practice Clinic, Mollie M. Tate, Whitney Dubas

Doctor of Nursing Practice Projects: College of Nursing

Background: Colorectal cancer (CRC) is the second leading cause of cancer-related mortality in the United States and disproportionately affects rural populations. Although more than 90% of cases occur in adults older than 50 years, increasing incidence among younger adults prompted an update to national guidelines recommending screening beginning at age 45. Rural residents face multiple barriers to colorectal cancer screening (CRCS), including limited access to care, transportation challenges, lack of insurance, and absence of standardized screening processes in primary care. These barriers contribute to lower screening rates, delayed diagnosis, and poorer outcomes. Evidence demonstrates that CRCS reduces CRC morbidity and …

Menstrual Hygiene Screening Needs Assessment In South Dakota, Mariah Shafer, Denyelle Kenyon

Scholarship Pathways Program

Menstrual Hygiene Screening Needs Assessment In South Dakota

Mariah M. Shafer, MD | DenYelle Kenyon Ph.D. Assoc Dean, Community Health and Engagement, MPH Program Director.

 Introduction: Menstrual hygiene management (MHM) is essential to women’s reproductive health; literature demonstrates there are mental, social, and economic consequences to inadequate MHM in rural and developing countries. Emerging studies show that US women who are impoverished, experiencing homelessness, or incarcerated also face poor MHM. To understand implications of poor MHM in South Dakota, a largely rural state, a thorough gynecologic health history is essential; this needs assessment explores the scope of MHM questions asked …

Using Geospatial Analysis To Compare Metropolitan Greenspace And Adolescent Obesity, Rachel Schild, Denyelle Kenyon, Zachary Schild

Scholarship Pathways Program

Using Geospatial Analysis and Machine Learning to Compare Metropolitan Greenspace and Rates of Adolescents with Obesity

 Rachel Schild MD | DenYelle Kenyon PhD

 Introduction: Insufficient outdoor activity, influenced by limited access to exercise-friendly greenspaces, may contribute to increasing childhood obesity rates. However, rigorous evaluation of greenspace quality on a citywide scale is lacking. This study aims to characterize greenspace vegetation types and correlate them with adolescent obesity outcomes, identifying optimal characteristics for promoting health. This data could aid city planners in optimizing greenspace allocation and improving vegetation choices.

Methods: Satellite imagery and municipal data were used to map ten cities, …

Examining The Rural Workforce: Comparing Admissions Strategies And Training Pathways In U.S. Medical And Dental Education, Charolyn A. Harris

Honors Theses

Access to healthcare in rural and underserved communities remains a significant challenge in the United States, particularly in dental care, where workforce shortages are more pronounced. This study examines how medical and dental education programs develop rural healthcare providers, focusing on admissions strategies and training pathways. Using a structured scoping review and secondary data analysis, this research compares how each field incorporates known predictors of rural practice, such as rural background and training experiences, into workforce pipeline development. Findings indicate that while both medical and dental education recognize rural background as a strong predictor of rural practice, medical education more …

A Transgenerational Analysis Of Factors Influencing Fertility Among Jamaican Men, Shanique Deniellia Essuman

Walden Dissertations and Doctoral Studies

No abstract provided.

Short-Term Bayesian Influenza Forecasting In A Hospital Environment Using A Linear Kalman Filter., Shankar Kaleeswaran Mani, Grzegorz A Rempala, Eben Kenah, Fernanda L Schumacher

Ambulatory and Primary Care Articles

Accurately forecasting the weekly number of influenza (flu) lab tests and positive cases is important for hospitals as they work to plan staffing, manage supplies, and provide timely patient care. In this paper, we describe a practical use of a Bayesian Kalman filter to forecast weekly flu tests and positives in a hospital setting. Using data from a large hospital system in Ohio, we show that this approach, which blends real-time hospital information with historical patterns, offers a dependable way to anticipate flu-related patient volume as far as four weeks ahead.

Illness Perception, Depression, And Anxiety Among Middle-Aged Adults With End-Stage Chronic Kidney Disease, Zioleyda Soto

Walden Dissertations and Doctoral Studies

No abstract provided.

The Ethical Imperative Of Public Health Institutions To Protect The Reproductive Autonomy Of Vulnerable Populations, Kennethea Wilson

Electronic Theses and Dissertations

This dissertation establishes the ethical responsibility of public health institutions to safeguard reproductive autonomy, especially among vulnerable populations. While reproductive decision-making is traditionally framed within individual clinical encounters, this work contends that reproductive autonomy is fundamentally a matter of public health ethics. Socioecological determinants, including social, legal, environmental, and structural factors, often constrain individuals’ ability to make meaningful reproductive choices, leading to preventable harm.

Reproductive autonomy is defined as the capacity to make informed decisions about whether and when to conceive, as well as how to parent. The dissertation critiques the sufficiency of clinical ethics frameworks, such as informed consent …

Medical Providers’ Perspective On Barriers Faced By Intellectual And Developmental Disabled (Idd) Patients From Medically Underserved Backgrounds, Mayra A. Flores

Rowan-Virtua Research Day

•Complexities of obtaining healthcare access can be difficult for all patients across the board, so much so that it’s viewed as a maze. Studies have shown that these challenges are added on for medically underserved communities.2-3 Some of these challenges include insurance, language barriers, appointment availability, stigma, financial limitations and lack of transportation.2 •Identify the barriers that patients with intellectual and developmental disabilities (IDD) from medically underserved backgrounds face in healthcare access. •Intellectually and developmentally disabled patients from medically underserved communities face exacerbated barriers in healthcare access. •Participating medical providers from the Regional Integrated Special Needs Center (RISN) – Sewell …

How Do Adverse Social Determinants Of Health Influence 30-Day Hospital Readmission Rates Among Patients With Heart Failure?, Noor Baig

Rowan-Virtua Research Day

Heart failure is one of the leading causes of hospitalization in the United States, with nearly 1 in 4 patients readmitted within 30 days of discharge. Clinical severity largely accounts for this risk, but social determinants of health (SDOH), including income, housing stability, transportation access, and health literacy, also play a role in post-discharge outcomes. This review synthesized seven cohort, observational, and qualitative studies from PubMed (2018–2025) examining the relationship between SDOH and 30-day readmission in heart failure patients.

Several patterns emerged across the literature. Neighborhood socioeconomic disadvantage, measured through ADI and SDI, was independently associated with higher readmission and …

Premenstrual Disorders In Females With Neurodevelopmental Conditions: A Systematic Review, Akhila Archakam, Nikhila Archakam, Harshal Parmar, Wesley Kim

Rowan-Virtua Research Day

Background: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are prevalent conditions associated with substantial functional impairment and psychiatric morbidity. Symptoms are driven by heightened sensitivity to cyclical fluctuations in estrogen and progesterone rather than absolute hormone levels. Individuals with neurodevelopmental conditions, particularly attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), may exhibit altered neurobiological and emotional regulation pathways that increase vulnerability to these hormonal changes; however, this relationship has not been systematically synthesized.

Methods: A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Embase, and Cochrane CENTRAL were searched from 2000–2026 for studies evaluating associations between ADHD, …

Health Outcomes In Heat-Intense Areas In Response To Socioeconomic Status, Victoria Zheng, Chandni Patel, Emily Fried, Jayanth Ambat, Lincoln Opara, Rohan Gupta

Rowan-Virtua Research Day

Background: As ambient temperature rises, regions experiencing extreme heat face serious health concerns. This disproportionately affects lower socioeconomic status (SES) individuals in urban areas. This review examines how these “heat islands” affect the health outcomes for those in different socioeconomic statuses.

Methods: The databases used were PubMed, Embase, and Medline, and were searched with keywords such as “heat islands”, “social inequality”, “SES”, and “health outcomes”. After compiling, articles were screened using the inclusion criteria of ages, gender, peer-reviewed and English-written publications, from any location, social determinants as a primary outcome, and directly compared heat with social determinants of health. Articles …

Challenges For Older Veterans In Disaster-Prone Rural Areas, Umayma Saifuddin, Joshua Ehrenberg, Elizabeth Tran Phung

Rowan-Virtua Research Day

Purpose: To describe a case in which an elderly veteran was unable to receive necessary health services due to environmental factors and routine natural disaster in his rural coastal town. Methods: A case report is presented. Results: A 95 year-old WWII veteran with a complex medical history and numerous disabilities including hearing impairment, visual impairment, and chronic pain struggles to receive proper care as he lives in a small coastal town. The patient’s son lives an hour away and this area is prone to flooding, making accessing health services extremely challenging. In order to respect the patient’s wishes to remain …

Assessment Of Health Disparities Among Community Clinic Patients In Southern New Jersey, Hetasvi Saraiya, Priyal Gajera, Mahhum Naqvi, Nils Brolis

Rowan-Virtua Research Day

Introduction:

The Rowan Community Health Center (RCHC) is a student-run free clinic that provides primary care services to uninsured and underserved populations in southern New Jersey. Access to quality healthcare remains a persistent challenge for these communities due to social and economic barriers1 . This study aims to identify and analyze the most common health disparities and barriers to care. The primary outcome of this study was to assess health disparities and barriers to care, secondary outcomes included characterizing chief complaints and identifying alternative care options patients would pursue if not seen at the clinic

Methods:

This survey-based study was …

Improving Engagement In Community Activities At Whitetail Springs Memory Care Community, Kylie T. Klavon

Public Health Capstone Projects

The purpose of this project, in collaboration with Whitetail Springs Memory Care Community, is to encourage consistent attendance and engagement among residents and staff in community activities, thereby enhancing residents’ well-being through greater meaningful engagement. This was done by assessing communication gaps between the clinical and activities teams, developing an educational infographic and scheduling template, and conducting an interactive presentation introducing these deliverables. This project was facilitated by observing current engagement and communication procedures at Whitetail Springs. After observations, brief interviews were conducted with the Life Enrichment Director and the Health Services Director to understand where each team needs support …

Developing A Comprehensive Resource Guide For Caregivers Within The Area Agency On Aging, Aiden R. Murphy

Public Health Capstone Projects

This project developed a new universal caregiver resource guide for caregivers within the Area Agency on Aging, in order to improve resource navigation and workflow efficiency. Resources were collected, verified, and organized into a new, streamlined guide via the ARIA chatbot, covering multiple needs. Caregiver resources were collected and verified by the capstone student and mentor, Michael Kroeker, and organized into a centralized knowledge base within the ARIA chatbot. A mixed methods evaluation was conducted utilizing a 5-point Likert scale with three quantitative questions and one open-ended qualitative question. The data was given to the SeniorLine staff, who wanted to …

Using Group Activities To Improve Engagement And Help Alleviate Loneliness Among Older Adults At Macedonia Face, Taylor Corcoran

Public Health Capstone Projects

Introduction: Social isolation and loneliness are increasing public health concerns due to their association with heightened risk for chronic disease and their disproportionate impact on Black older adults (BOA). This project was designed to develop, implement, and evaluate the effectiveness of culturally relevant, low-cost activities on engagement rates among older adults during unscheduled program periods at the Macedonia Family Community Enrichment Center (FACE).

Methods: This project used a mixed methods approach over a 4-week implementation period. Three activities were introduced by the student facilitator, including UNO!, Name That Tune (NTT), and coloring pages. Engagement was measured by comparing the …

Seasonal Variation And Size Distribution Of Particulate Matter In The Mississippi Delta: Implications For Source Attribution, Abigail E. Barnett

Honors Theses

This study examines seasonal patterns of particulate matter in the Mississippi Delta using data from PurpleAir sensors, with a focus on particle size distributions across PM₁.₀, PM₂.₅, and PM₁₀. The purpose of this research is to evaluate whether particulate trends in the region reflect signatures consistent with wildfire smoke or are better explained by local environmental and agricultural factors.

Daily average concentrations were analyzed and grouped by season to compare spring and summer conditions. Results show that all particle size fractions increased from spring to summer. However, PM₁₀ concentrations remained consistently higher than PM₂.₅ in both seasons. The PM₂.₅/PM₁₀ ratio …

Brief Review : Listening Closely--Stethoscopes, Hygiene Gaps, And The Unfinished Work Of Healthcare-Associated Infection Prevention, James Espinosa, Swet Patel, Robin Lahr, Sergey Medlenov, Russell Mordecai, James Lee, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

Healthcare-associated infections (HAIs) remain a persistent patient safety challenge. While hand hygiene has received sustained institutional focus, stethoscope hygiene remains inconsistently addressed despite longstanding evidence of contamination. Stethoscopes function as portable, patient-to-patient devices that may serve as under-recognized fomites in emergency and inpatient settings. Prior pilot work demonstrated that clinicians were unable to reliably distinguish between disposable and standard stethoscopes, and that perceived acoustic degradation from a diaphragm barrier was minimal. These findings suggest that acoustic concerns may not represent a primary barrier to hygiene-enhancing strategies. This brief review examines the literature surrounding stethoscope contamination and cleaning behavior, frames the …

Improving Pediatric Vaccination Rates In The United States, Maanasi Dudi

Rowan-Virtua Research Day

Pediatric vaccination has been one of the most effective public health strategies for preventing infectious diseases and reducing childhood morbidity and mortality. However, vaccination rates have dropped in recent years, due to increasing vaccine hesitancy, as well as interruptions in regular healthcare during the COVID-19 pandemic. This has been reflected in primary care settings, where pediatricians are seeing more parents refuse vaccinations.

This literature review examines current trends in pediatric vaccination rates, factors contributing to vaccine hesitancy, and interventions that have been used to improve vaccination uptake. A systematic search of peer-reviewed literature was conducted on PubMed to identify studies …

Impact Of Spanish-Speaking Medical Interpreters On Healthcare Access, Outcomes, And Equity In Patients With Limited English Proficiency, Emily Fried, Catherine Awad, Rebecca Moore

Rowan-Virtua Research Day

Impact of Spanish-Speaking Medical Interpreters on Healthcare Access, Outcomes, and Equity in Patients with Limited English Proficiency

Background

Limited English proficiency (LEP) is a significant barrier to equitable healthcare in the United States and is associated with reduced access to care, poorer clinical outcomes, and increased healthcare disparities. The Spanish-speaking population represents the largest proportion of LEP patients, making language access a crucial component of high-quality care. Language discordance between patients and providers contributes to impaired communication, increased medical errors, and decreased utilization of preventative services1-4.

Objectives

The objective of this study was to evaluate the impact of Spanish-speaking professional …

The Obstacles Of Performing A Retrospective Chart Review, Emily Reilly, Robert Hudrick D.O.

Rowan-Virtua Research Day

Introduction: This research project "Comparing timing of care for skin cancer patients with limited English proficiency who require interpretation during medical visits to patients with English proficiency" was accepted under the CREATE Grant. The hypothesis was that patients who require medical interpretation during their visits would show a longer period of time between noticing a skin lesion to definitive diagnosis. Previous research has shown improved health care outcomes, but has mixed results on patient satisfaction and health care experience. This poster aims to detail the limitations faced during the execution of a retrospective chart review from the perspective of a …

Health Disparities In Pediatric Epilepsy: A Narrative Review Of Barriers To Equitable Care, Nikhila Archakam, Akhila Archakam, Wesley Kim, Harshal Parmar

Rowan-Virtua Research Day

Epilepsy affects approximately 1% of children in the United States, representing over 456,000 pediatric patients with active seizure disorders. Despite advances in antiseizure medications and surgical interventions, the benefits of these developments are not distributed equally across racial, socioeconomic, and geographic groups. A narrative review of the literature was conducted using PubMed, Scopus, Embase, and Medline using search terms including "pediatric epilepsy," "health disparities," "health equity," "social determinants of health," "race," "socioeconomic status," and "access to care." Articles were included if they focused on pediatric populations aged 0 to 17, addressed at least one disparity domain, and were published between …

Racial Inequities In Maternal Health And Birth Outcomes In South Jersey, Yariza Orellana, Amenata Dukuray, Christine Ortiz

Rowan-Virtua Research Day

Racial disparities in maternal morbidity and mortality remain a persistent public health issue in the United States, with Black non-hispanic women experiencing a 2.4 to 3.3 greater risk of pregnancy-related complications compared to their white counterparts. In New Jersey, these disparities are similarly pronounced, with severe maternal morbidity occurring at more than twice the rate among non-Hispanic Black mothers. These inequities extend beyond maternal outcomes and contribute to adverse infant health outcomes, including stillbirth, preterm birth, and low birth weight. This study was conducted using databases such as PubMed and Google Scholar, as well as public health sources including the …