Medicine and Health Sciences Commons^™

Relationship Between Caregiver Burden And Socioeconomic Status, Nikitha Pappachen, Maithri Goud

Rowan-Virtua Research Day

In this study, caregiver burden measures the psychosocial strain a caregiver experiences as a result of caring for a person with autism. In addition, this study focuses on the effect of socioeconomic status on caregiver burden. A previous study found an association between lower primary caregiver education level and more sleep problems for children with autism³. Thus, the finding focuses on the child with autism as opposed to the caregiver burden. Other studies focus on elements that affect caregiver burden such as sleep quality, mental health, and cultural aspects. If it is known that socioeconomic status significantly affects …

Overcoming Disparities In The Treatment Of Alzheimer’S Disease, Christian Gamboa, Tribhuvan Lanka, Elaine Flowers, Nayarith Lopez

Rowan-Virtua Research Day

Background: Deaths due to Alzheimer’s have been increasing at an exponential rate for the last 24 years, with an astounding 145% increase between the years 2000-2024. Early detection is key to slowing down the rate of decline. Unfortunately, Latino and African American individuals delay seeking care, which predisposes them to worse outcomes. To date, socioeconomic limitations are the main factors leading to delayed care in Latino and African American communities. A service project was developed with the aim of addressing limitations that result in delays to seeking care within Latino and African American communities.

Methods: A systematic review of available …

Sunscreen Cost And Its Effect On Skin Cancer In Low-Income Communities: A Systemic Review, John Sauer

Rowan-Virtua Research Day

This research examines the pivotal connection between sunscreen affordability and its impact on skin cancer prevalence, especially in low-income communities. Despite universal dermatological recommendations for daily sunscreen use, stringent criteria contribute to elevated prices, averaging around $10 for a 6 oz unit. This financial strain is compounded for families adhering to recommended application rates, leading to significant economic burdens. Outdoor laborers, less likely to follow guidelines, face heightened risks. Government programs' excluding sunscreen costs further exacerbate challenges for low-income communities, contributing to increased skin cancer incidence. This review aims to establish a correlation between sunscreen cost and skin cancer rates, …

Us Adolescent Rest-Activity Patterns: Insights From Functional Principal Component Analysis (Nhanes 2011-2014), Chris Ho Ching Yeung, Jiachen Lu, Erica G Soltero, Cici Bauer, Qian Xiao

Journal Articles

BACKGROUND: Suboptimal rest-activity patterns in adolescence are associated with worse health outcomes in adulthood. Understanding sociodemographic factors associated with rest-activity rhythms may help identify subgroups who may benefit from interventions. This study aimed to investigate the association of rest-activity rhythm with demographic and socioeconomic characteristics in adolescents.

METHODS: Using cross-sectional data from the nationally representative National Health and Nutrition Examination Survey (NHANES) 2011-2014 adolescents (N = 1814), this study derived rest-activity profiles from 7-day 24-hour accelerometer data using functional principal component analysis. Multiple linear regression was used to assess the association between participant characteristics and rest-activity profiles. Weekday and weekend …

Effects Of Income And Language On Health Literacy: A Study Between A Student-Run Free Clinic And A Family Medicine Office, Sahil Parikh, Emily Forester, Alisha Basak, Arpan Bhagat, Leah Cliatt, Usmaan Al-Shehab, Rebecca Moore

Rowan-Virtua Research Day

Background: Over one-third of the US population exhibit limited health literacy, leading to negative health outcomes and lifestyle choices. By employing the NVS assessment, RCHC sought to compare the health literacy levels of uninsured patients at their facility with those of insured patients at the Rowan Family Medicine office in Hammonton, NJ. This study aimed to assess specific factors that may influence health literacy levels.

Methods: This is an IRB-approved study which surveyed patients enrolled at the RCHC and Rowan Family Medicine Office between February 2021 and March 2023. Patients were given a nutrition label and verbally answered the NVS …

Immigration Status And Household Income As Predictors Of Childhood Obesity, Bhaumik Patel, Jeffery Powers

Rowan-Virtua Research Day

Childhood obesity rates have been on a remarkably steep rise in recent years. According to recent literature, the rate in the United States alone has more than doubled compared to other regions in the world such as Australia, Canada and Europe1,2 . Especially in the African immigrant community, there has been speculation of a higher prevalence of childhood obesity in the United States3 . This warranted further investigation into demographic factors impacting childhood obesity rates and their subsequent consequences with other clinical diseases such as diabetes and heart disease. The CDC reports that in 2011-2014, among individuals ages 2 to …

Global Comparison Of Health Policies Focused On Gestational Diabetes: Recognizing Pertinent Gaps, Muskanjot Kaur, Isvita Marfatia, Samarth Gupta, Swetha Sundaram, Anudeep Deevi, Venkat Venkataraman

Rowan-Virtua Research Day

Introduction: Gestational diabetes mellitus (GDM) is a condition that affects 14.7% of women globally and occurs when a mother develops diabetes during the course of her pregnancy.1 Increased insulin resistance in pregnant mothers can lead to further complications, such as a larger baby, increased risk of the baby developing Type II diabetes, having low blood sugar, and even premature birth, which can lead to respiratory issues. The lack of policies in place to address GDM in various countries worldwide highlights the need for this literature. It is necessary to compile policies that are currently in place and to further discuss …

A Systematic Review Of The Barriers Of Opioid Addiction Treatment For Young Adult Males (Ages 18-26) Living In Low Income Areas In The United States Of America, Atish Gandhi, Asim Shafique, Jillian Baker

Rowan-Virtua Research Day

NOTE: This is a broad literature review, not a systematic review.

This systematic review aims to analyze the reasons behind reduced access to opioid addiction treatment for individuals of low socioeconomic standing. Understanding these barriers may allow communities to build a more comprehensive plan to lower addiction rates. In addition, this review will be examining further developments of theopioid crisis due to the recent COVID-19 pandemic. The literature search used publications from the following databases: PubMed, Google Scholar, and NCBI. The keywords searched were “opioid addiction”, “substance abuse”, “low-income area”, “barriers to treatment”, “young male addiction”, “opioid treatment”, “Narcan”. There …

The Effect Of Covid-19 On Depression In Hispanic Vs. Non-Hispanic Populations In South Jersey, Rana Cheikhali, Daniel Casal

Rowan-Virtua Research Day

The COVID-19 pandemic has been challenging for Americans and the world as a whole. It has especially taken a toll on mental health. Studies show that the incidence of depression in the United States was three times greater during the pandemic compared to pre-pandemic times. One specific community in the United States that has been greatly affected by the pandemic is the Hispanic American community. Many Americans across the country have received federal surveys that aim to determine the social and economic impacts of COVID-19. Results revealed that the Hispanic population had the greatest rise in mental illness, with 40% …

Trends In Pediatric Obesity Of School-Aged Children During The Covid-19 Pandemic, Maryanna Schweininger, Amaani Faizal, Suzanna Hosein

Rowan-Virtua Research Day

Since the start of the COVID-19 pandemic, children have been more sedentary due to nationwide school closures resulting in classes being held virtually. Due to restrictions, children could no longer participate in physical education classes and after school activities at the same frequency. The pandemic also placed a disproportionate burden on low-income families thus, potentially amplifying food insecurity. The aim of this study was to identify the impact of the COVID-19 pandemic on childhood obesity.

Real-Time Geospatial Analysis Identifies Gaps In Covid-19 Vaccination In A Minority Population, Cici Bauer, Kehe Zhang, Miryoung Lee, Michelle Jones, Arturo Rodriguez, Isela De La Cerda, Belinda Reininger, Susan P Fisher-Hoch, Joseph B Mccormick

Journal Articles

COVID-19 vaccination is being rapidly rolled out in the US and many other countries, and it is crucial to provide fast and accurate assessment of vaccination coverage and vaccination gaps to make strategic adjustments promoting vaccine coverage. We reported the effective use of real-time geospatial analysis to identify barriers and gaps in COVID-19 vaccination in a minority population living in South Texas on the US-Mexico Border, to inform vaccination campaign strategies. We developed 4 rank-based approaches to evaluate the vaccination gap at the census tract level, which considered both population vulnerability and vaccination priority and eligibility. We identified areas with …

Census Tract Patterns And Contextual Social Determinants Of Health Associated With Covid-19 In A Hispanic Population From South Texas: A Spatiotemporal Perspective, Cici Bauer, Kehe Zhang, Miryoung Lee, Susan Fisher-Hoch, Esmeralda Guajardo, Joseph Mccormick, Isela De La Cerda, Maria E Fernandez, Belinda Reininger

Journal Articles

BACKGROUND: Previous studies have shown that various social determinants of health (SDOH) may have contributed to the disparities in COVID-19 incidence and mortality among minorities and underserved populations at the county or zip code level.

OBJECTIVE: This analysis was carried out at a granular spatial resolution of census tracts to explore the spatial patterns and contextual SDOH associated with COVID-19 incidence from a Hispanic population mostly consisting of a Mexican American population living in Cameron County, Texas on the border of the United States and Mexico. We performed age-stratified analysis to identify different contributing SDOH and quantify their effects by …

Association Of Long-Term Trajectories Of Neighborhood Socioeconomic Status With Weight Change In Older Adults, Dong Zhang, Cici Bauer, Tiffany Powell-Wiley, Qian Xiao

Journal Articles

IMPORTANCE: Studying long-term changes in neighborhood socioeconomic status (SES) may help to better understand the associations between neighborhood exposure and weight outcomes and provide evidence supporting neighborhood interventions. Little previous research has been done to examine associations between neighborhood SES and weight loss, a risk factor associated with poor health outcomes in the older population.

OBJECTIVE: to determine whether improvements in neighborhood SES are associated with reduced likelihoods of excessive weight gain and excessive weight loss and whether declines are associated with increased likelihoods of these weight outcomes.

DESIGN, STUDY, AND PARTICIPANTS: This cohort study was conducted using data from …

Socioemotional Selectivity And Psychological Health In Amyotrophic Lateral Sclerosis Patients And Caregivers: A Longitudinal, Dyadic Analysis, Suzanne C. Segerstrom, Edward J. Kasarskis, David W. Fardo, Philip M. Westgate

Psychology Faculty Publications

Objective: Socioemotional selectivity theory predicts that as the end of life approaches, goals and resources that provide immediate, hedonic reward become more important than those that provide delayed rewards. This study tested whether these goal domains differentially affected psychological health in the context of marital dyads in which one partner had been diagnosed with amyotrophic lateral sclerosis (ALS), a life-limiting disease.

Design: ALS patients (N = 102) being treated in three multidisciplinary clinics and their spouses (N = 100) reported their loneliness, financial worry and psychological health every 3 months for up to 18 months.

Main …

The Art And Skill Of Delivering Culturally Responsive Trauma-Focused Cognitive Behavioral Therapy In Tanzania And Kenya., Briana Woods-Jaeger, Christine M. Kava, Christopher F. Akiba, Leah Lucid, Shannon Dorsey

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: This study explored the facilitators, barriers, and strategies used to deliver a child mental health evidence-based treatment (EBT), trauma-focused cognitive behavioral therapy (TF-CBT), in a culturally responsive manner. In low- and middle-income countries most individuals with mental health problems do not receive treatment due to a shortage of mental health professionals. One approach to addressing this problem is task-sharing, in which lay counselors are trained to deliver mental health treatment. Combining this approach with a focus on EBT provides a strategy for bridging the mental health treatment gap. However, little is known about how western-developed EBTs are delivered in …

Incidence, In-Hospital Case-Fatality Rates, And Management Practices In Puerto Ricans Hospitalized With Acute Myocardial Infarction, Juan C. Zevallos, Jorge L. Yarzebski, Juan A. Gonzalez, Hector L. Banchs, Mario Garcia-Palmieri, Hernando Mattei, Jose Ayala, Marijesmar Gonzalez, Vanessa Torres, Iris N. Ramos, Luis R. Pericchi, David A. Torres, Maria C. Gonzalez, Robert J. Goldberg

Jorge L. Yarzebski

OBJECTIVE: There are extremely limited data on minority populations, especially Hispanics, describing the clinical epidemiology of acute coronary disease. The aim of this study is to examine the incidence rate of acute myocardial infarction (AMI), in-hospital case-fatality rate (CFR), and management practices among residents of greater San Juan (Puerto Rico) who were hospitalized with an initial AMI. METHODS: Our trained study staff reviewed and independently validated the medical records of patients who had been hospitalized with possible AMI at any of the twelve hospitals located in greater San Juan during calendar year 2007. RESULTS: The incidence rate (# per 100,000 …

Perceived Factors Contributing To Coronary Heart Disease In African American Women, Funmilola O. Sholanke

Walden Dissertations and Doctoral Studies

African American women (AAW) suffer from disproportionately high death rates due to coronary heart disease (CHD) compared to Caucasian women. Although there have been a number of studies targeting African American adults with CHD in clinical interventions, very few studies have addressed the social determinants of health and the influence of AAW's perceptions of health factors on health outcomes. The purpose of this phenomenological study was to fill the gap in the existing knowledge base by examining the lived experiences of 10 AAW diagnosed with CHD with a focus on the perceptions of environmental, socioeconomic, and cultural factors related to …

Health Disparities Experienced By People With Disabilities In The Us: A Behavioral Risk Factor Surveillance System Study, Jennifer Renee Pharr, Timothy J. Bungum

Environmental & Occupational Health Faculty Publications

The Americans with Disabilities Act became law in 1990; since then research has shown that people with disabilities continue to experience barriers to health care. The purpose of this study was to compare utilization of preventive services, chronic disease rates, and engagement in health risk behaviors of participants with differing severities of disabilities to those without disabilities. This study was a secondary analysis of 2010 data collected in the Behavioral Risk Factor Surveillance System national survey in the United States. Rao Chi square test and logistic regression were employed. Participants with disabilities had significantly higher adjusted odds ratios for all …

Spina Bifida Subtypes And Sub-Phenotypes By Maternal Race/Ethnicity In The National Birth Defects Prevention Study, A J Agopian, Mark A Canfield, Richard S Olney, Philip J Lupo, Tunu Ramadhani, Laura E Mitchell, Gary M Shaw, Cynthia A Moore

Journal Articles

Spina bifida refers to a collection of neural tube defects, including myelomeningocele, meningocele, and myelocele (SB(M) ), as well as lipomyelomeningocele and lipomeningocele (SB(L) ). Maternal race/ethnicity has been associated with an increased risk for spina bifida among offspring. to better understand this relationship, we evaluated different spina bifida subtypes (SB(M) vs. SB(L) ) and sub-phenotypes (anatomic level or presence of additional malformations) by maternal race/ethnicity using data from the National Birth Defects Prevention Study. This study is a large, multisite, population-based study of nonsyndromic birth defects. Prevalence estimates were obtained using data from spina bifida cases (live births, fetal …

Breast Cancer Survival In Canada And The Usa: Meta-Analytic Evidence Of A Canadian Advantage In Low-Income Areas, Kevin M. Gorey

Social Work Publications

BACKGROUND: This study tested the hypothesis that relatively poor Canadian women with breast cancer have a survival advantage over their counterparts in the USA.

METHODS: Seventy-eight independent retrospective cohort (incidence between 1984 and 2000, followed until 2006) outcomes were synthesized. Fixed effects meta-regression models compared women with breast cancer in low-income areas of Canada and the USA.

RESULTS: Low-income Canadian women were advantaged on survival [rate ratio (RR) = 1.14; 95% confidence interval (CI) 1.13-1.15] and their advantage was even larger among women <65 years of age who are not yet eligible for Medicare coverage in the USA (RR = 1.21, 95% CI 1.18-1.24). Canadian advantages were also larger for node positive breast cancer, which may present with greater clinical and managerial discretion (RR = 1.40, 95% CI 1.30-1.50), and smaller when Hawaii, the state providing the most Canadian-like access, was the US comparator (RR = 1.12, 95% CI 1.01-1.20).

CONCLUSIONS: More inclusive health care insurance coverage in Canada vs the USA, particularly among each country's relatively …

Lower Adherence To Screening Mammography Guidelines Among Ethnic Minority Women In America: A Meta-Analytic Review, Rebecca J. Purc-Stephenson, Kevin M. Gorey

Social Work Publications

OBJECTIVE: This study investigates the association between ethnic minority status and receiving a screening mammogram within the past 2 years among American women over 50.

METHOD: The findings from 33 studies identified from interdisciplinary research databases (1980 to 2006) were synthesized. Separate pooled analyses compared white non-Hispanics to African Americans (28 outcomes), Hispanics (18 outcomes), and Asian/Pacific Islanders (10 outcomes).

RESULTS: Using the random effects model, results showed that African Americans were screened less than white non-Hispanics at a marginal level (OR 0.87, 95% CI 0.75, 1.00). Larger and significant discrepancies were observed for Hispanics (OR 0.65, 95% CI 0.50, …

Cancer Survival In Ontario, 1986-2003: Evidence Of Equitable Advances Across Most Diverse Urban And Rural Places, Kevin M. Gorey

Social Work Publications

OBJECTIVES: This study examined whether place and socio-economic status had differential effects on the survival of women diagnosed with breast cancer in Ontario during the 1980s and the 1990s.

METHODS: The Ontario Cancer Registry provided 29,934 primary malignant breast cancer cases. Successive historical cohorts (1986-1988 and 1995-1997) were, respectively, followed until 1994 and 2003. Diverse places were compared: the greater metropolitan Toronto area, other cities, ranging in size from 50,000 to a million people, smaller towns and villages, and rural and remote areas. Socio-economic data for each woman's residence at the time of diagnosis were taken from population censuses.

RESULTS: …

An International Comparison Of Cancer Survival: Metropolitan Toronto, Ontario, And Honolulu, Hawaii, Kevin M. Gorey

Social Work Publications

OBJECTIVES: Comparisons of cancer survival in Canadian and US metropolitan areas have shown consistent Canadian advantages. This study tests a health insurance hypothesis by comparing cancer survival in Toronto, Ontario, and Honolulu, Hawaii.

METHODS: Ontario and Hawaii registries provided a total of 9190 and 2895 cancer cases (breast and prostate, 1986-1990, followed until 1996). Socioeconomic data for each person's residence at the time of diagnosis were taken from population censuses.

RESULTS: Socioeconomic status and cancer survival were directly associated in the US cohort, but not in the Canadian cohort. Compared with similar patients in Honolulu, residents of low-income areas in …

Gorey, K. Association Between Socioeconomic Status And Cancer Incidence In Toronto, Ontario: Possible Confounding Of Cancer Mortality By Incidence And Survival, Kevin M. Gorey

Social Work Publications

OBJECTIVE: To observe the association between socioeconomic status (SES) and cancer incidence in a cohort of Canadians.

DESIGN: Cases of primary malignant cancer (83,666) that arose in metropolitan Toronto, Ont., from 1986 to 1993 were ascertained by the Ontario Cancer Registry and linked by residence at the time of diagnosis to a census-based measure of SES. Socioeconomic quintile areas were then compared by cancer incidence.

RESULTS: Significant associations between SES and cancer incidence in the hypothesized direction--greater incidence in low-income areas--were observed for 15 of 23 cancer sites.

CONCLUSIONS: These findings, together with the recently observed consistent pattern of significant …

Cancer Differentials Among Us Blacks And Whites: Quantitative Estimates Of Socioeconomic-Related Risks, Kevin M. Gorey

Social Work Publications

This article analyzes 10 studies that assessed the association of socioeconomic status (SES) with cancer occurrence among blacks and whites in the United States. The following summative inferences were made: the associations of SES with cancer are similar among blacks and whites; cancers of organ sites with the most intimate environmental interfaces have the strongest SES-cancer associations (stomach, lung, cervix, and rectum); the prevalence of exposure to low socioeconomic-related risks such as poverty are approximately fourfold greater among blacks; the all-site population attributable risk percent due to low socioeconomic exposure among blacks is estimated to be four times that of …