Medicine and Health Sciences Commons^™

Disparities In Healthcare Coverage And Utilization After Expanded Dependent Coverage, Tina Hernandez-Boussard, Doug E. Morrison, Lu Tian, Sanjay Basu

Journal of Health Disparities Research and Practice

Background. A goal of expanding insurance coverage is reducing racial disparities in healthcare utilization, however the effects of such expansions under the affordable care act (ACA) on disparities remain unclear. The 2010 dependent coverage expansion provided an opportunity to evaluate disparities following a major coverage expansion.

Objectives. We sought to understand changes in emergency department (ED)utilization following a major insurance expansion, the 2010 dependent coverage expansion.

Research Design. We present changes in coverage and utilization among young adults (19-25 years old) before and after the dependent coverage expansion, compared to a control group (26-31 years old) unaffected …

Situating Food Insecurity In A Historic Albuquerque Community: The Whorled Relationship Between Food Insecurity And Place, Janet Page-Reeves, Maurice Moffett, Molly Bleecker, Katharine Linder, Jeannie Romero, Carol Krause

Journal of Health Disparities Research and Practice

This article examines conceptualizations of the relationship between food insecurity and place. We use an ethnographically inspired and community-engaged approach to situate our analysis of fluid dynamics at work in a community with high levels of food insecurity. We propose that the relationship between place and people’s experience of food insecurity is recursive, dialectical, and “whorled.” This relationship reflects complex, interconnected, and multidimensional processes with consequences for the health of residents. Our research demonstrates the key nature of the health-place nexus by exploring how food insecurity articulates with place in unexpected ways that go beyond discussions of food, …

Patient-Provider Race And Sex Concordance: New Insights Into Antibiotic Prescribing For Acute Bronchitis, Jake R. Morgan, Mari-Lynn Drainoni, Cindy Christiansen, Tamar F. Barlam

Journal of Health Disparities Research and Practice

Objective: To examine whether patient and provider concordance by sex or race predicts antibiotic prescribing for acute bronchitis.

Study setting: General Internal Medicine and Family Medicine adult clinics at a large safety-net hospital.

Study design: We used a logistic model of prescribing as a function of race and sex concordance.

Data extraction: Data were extracted from de-identified patient records for those with an acute bronchitis visit between 2008 and 2010.

Principal findings: 71% (95% CI 68%-73%) of visits resulted in an antibiotic prescription. Patients in race-concordant visits were 17% (95% CI 8%-25%) less likely to receive …

Diabetes Disparities In African Americans: A Cry For Help To Primary Care Providers, Pandora Goode

Journal of Health Disparities Research and Practice

Diabetes is a national public health problem. Low socioeconomic status influence access to quality care for African Americans with Diabetes who must rely on government assisted insurance or are uninsured. Inadequate access and poor quality care for African Americans contributes to increased morbidity and negative health outcomes. This manuscript will examine the existence of diabetes disparities in African Americans pertaining to the role of low socioeconomic status, access, and poor quality care, and suggest some practical strategies for reducing diabetes disparities in this population.

Perceptions Of Chronic Disease Among Older African Americans: A Qualitative Analysis, Karon Phillips, Charles Rogers, Adrienne Morgan

Journal of Health Disparities Research and Practice

Research has documented that African Americans suffer disproportionately from chronic diseases when compared to the general population. Yet, limited research examines older African Americans’ perceptions about having chronic diseases. Accordingly, the first aim of the study provided insight into this disparity with the intent of revealing how older African Americans feel about their overall health, and how much they understand about their individual chronic disease(s). The second aim was to gather information about strategies and coping mechanisms older African Americans use to manage their chronic diseases. The purpose of this aim was to determine if any of the strategies they …

Type Of Multimorbidity And Propensity To Seek Care Among Elderly Medicare Beneficiaries, Rahul Garg, Chan Shen, Nethra Sambamoorthi, Usha Sambamoorthi

Journal of Health Disparities Research and Practice

Greater propensity to seek care is critical for improving health of elderly individuals with multimorbidity. We used the Medicare Current Beneficiary Survey (2012) to assess propensity to seek care among community-dwelling elderly Medicare beneficiaries (> 65 yrs.; N=11,270) having (1) no physical or mental illness; (2) single physical or mental condition; (3) multimorbidity with physical conditions only; and (4) multimorbidity with both physical and mental conditions. As compared to multimorbidity with physical conditions, elderly with no multimorbidity were less likely (Adjusted Odds Ratio [95% CI]: 0.50 [0.36, 0.68]) and elderly with both physical and mental conditions were more likely …

Examining The Impact Of Food Environment Changes On County-Level Obesity Prevalence In The Appalachian Region, Jaime Booth, Kai Wei, Allison Little

Journal of Health Disparities Research and Practice

The aim of the present study was to understand the impact of changes in the food environment on county-level obesity prevalence in the Appalachian Region. We examined the food environment in 412 counties across the Appalachian Region using data from the Behavioral Risk Factor Surveillance System, the American Community Survey, and the Food Environment Atlas. We found there was an overall decrease of per capita food stores from 2007 to 2011 in this region. There was also a significant relationship between the decrease of grocery stores per capita from 2007 to 2011 and the increase of county-level obesity in 2012. …

Calidad De Vida: An Exploratory Investigation Of Latino Breast Cancer Survivors And Intimate Partners, Sejal Barden, Daniel Gutierrez, Jessica Gonzalez, Shainna Ali

Journal of Health Disparities Research and Practice

Advances in addressing psychosocial issues related to cancer treatment and prevention are not reaching all survivors equally. Latina breast cancer survivors and intimate partners are underrepresented in psychosocial interventions, and there is a scarcity of research on the influence of cancer on Latino couples’ quality of life. The purpose of this manuscript is to present findings from a trans-linguistic, dyadic qualitative research study aimed at exploring the influence of cancer on quality of life for Latina breast cancer survivors and their intimate partners. Results highlight several areas that are helpful and hindering to supporting survivorship.

Barriers To Addressing Hiv-Associated Neurocognitive Disorder (Hand): Community-Based Service Provider Perspectives, Renato M. Liboro, Francisco Ibanez-Carrasco, Sean B. Rourke, Andrew Easton, Claudia Medina, Daniel Pugh, Allan Rae, Lori E. Ross, Paul A. Shuper

Psychology Faculty Research

HIV-Associated Neurocognitive Disorder (HAND) is an emergent public health issue in developed countries. Consequently, people living with HIV who experience HAND will increasingly require support from community-based HIV service providers. The objective of our qualitative study was to identify barriers service providers face in addressing HAND among people living with HIV. Thirty-three providers from 22 AIDS service organizations across Ontario, Canada, were interviewed. Using thematic analysis, three types of barriers were identified: (a) personal/professional, (b) service access, and (c) systemic. This paper draws attention to HAND-related obstacles that service providers encounter in their work and presents options to overcome them.

Identifying Consumers Who Search For Long-Term Care On The Web: Latent Class Analysis, Darren Liu Mha, Ms, Drph, Takashi Yamashita Mph, Phd, Betty Burston

School of Public Health Faculty Research

Background: Because the internet has become a primary means of communication in the long-term care (LTC) and health care industry, an elevated understanding of market segmentation among LTC consumers is an indispensable step to responding to the informational needs of consumers. Objective: This exploratory study was designed to identify underlying market segments of the LTC consumers who seek Web-based information. Methods: Data on US adult internet users (n=2018) were derived from 2010 Pew Internet and America Life Project. Latent class analysis was employed to identify underlying market segments of LTC Web-based information seekers. Results: Web-based LTC information seekers were classified …

Predicting Risk Factors Of Working Aged Hemorrhagic Stroke Patients In A Tertiary Teaching Hospital In Chiang Mai, Suphannee Triamvisit, Wilaiwan Chongruksut, Wanarak Watcharasaksilp, Rujee Rattanasathien

Asian/Pacific Island Nursing Journal

Stroke is the third leading cause of morbidity and mortality in Thailand accounting for a significant and increasing share of hospital costs. The purpose of this project is to study the epidemiology of the prevalence and its predicting factors of working aged hemorrhagic stroke (HS) patients admitted at a tertiary teaching hospital in Chiang Mai, Thailand.

We conducted a five-year retrospective descriptive study. The subjects in this study were patients diagnosed with HS, between 15-59 years of age, and admitted to a tertiary teaching hospital in Chiang Mai, Thailand from January 2009 to December 2013. A total of …

Randomized Controlled Clinical Trial On Bleaching Sensitivity And Whitening Efficacy Of Hydrogen Peroxide Versus Combinations Of Hydrogen Peroxide And Ozone, Mahmoud K. Al-Omiri, Abdullah A. Al Nazeh, Andrej M. Kielbassa, Edward Lynch

Dental Medicine Faculty Research

The clinical efficacy regarding bleaching sensitivity and tooth shade lightening using a standard hydrogen peroxide (H2O2) bleaching gel was compared with the additional use of ozone either before or after application of H2O2. Using computer-generated tables, 45 participants were randomly allocated into three groups (n = 15 each) in this investigator-driven, single-centre trial. In Group 1, upper anterior teeth were bleached using ozone (produced via a healOzone X4 device) for 60 seconds, then 38% H2O2 for 20 minutes; in Group 2, 38% H2O2 application (20 min) was followed by ozone (60 s); air produced by the healOzone machine (60 s) …

Running Economy While Running In Extreme Cushioning And Normal Cushioning Running Shoes, Miles A. Mercer, Tori M. Stone, John C. Young, John Mercer

Kinesiology and Nutrition Sciences Faculty Research

The purpose of the study was to determine if running economy was influenced by wearing maximal cushioning shoes vs. control (neutral cushioning) shoes. (Please see Abstract in text)

A Model For Investigating Developmental Eye Repair In Xenopus Laevis, Cindy X. Kha, Philip H. Son, Julia Lauper, Kelly Ai-Sun Tseng

Life Sciences Faculty Research

Vertebrate eye development is complex and requires early interactions between neuroectoderm and surface ectoderm during embryogenesis. In the African clawed frog, Xenopus laevis, individual eye tissues such as the retina and lens can undergo regeneration. However, it has been reported that removal of either the specified eye field at the neurula stage or the eye during tadpole stage does not induce replacement. Here we describe a model for investigating Xenopus developmental eye repair. We found that tailbud embryos can readily regrow eyes after surgical removal of over 83% of the specified eye and lens tissues. The regrown eye reached a …

Reliability Of Self-Reported Mobile Phone Ownership In Rural North-Central Nigeria: Cross-Sectional Study, William Nii Ayitey Menson Md, Phd, John Olajide Olawepo Msc, Md, Tamara Bruno Mph, Semiu Olatunde Gbadamosi Md, Mph, Nannim Fazing Nalda Mph, Victor Anyebe Md, Amaka Ogidi Med, Chima Onoka Mph, Phd, Md, John Okpanachi Oko Md, Echezona Edozie Ezeanolue Md, Mph

School of Public Health Faculty Research

Background: Health practitioners seek to leverage the ubiquity of the mobile phone to increase the impact and robustness of their interventions, particularly in resource-limited settings. However, data on the reliability of self-reported mobile phone access is minimal. Objective: We sought to ascertain the reliability of self-reported ownership of and access to mobile phones among a population of rural dwellers in north-central Nigeria. Methods: We contacted participants in a community-based HIV testing program by phone to determine actual as opposed to self-reported mobile phone access. ...(Please see full text for complete abstract)

Perceptions Of Sexual Health Interventions Among Urban, Midwestern Female African American Youth, Melissa Tibbits, Marisa Rosen, Shireen Rajaram

Journal of Health Disparities Research and Practice

Pregnancy and sexually transmitted diseases (STDs) among youth ages 15-24 persist as important public health issues in spite of significant investments in the development and implementation of evidence-based preventive interventions. Further, female African American youth are disproportionately affected by teen pregnancy and STDs. The purpose of this study was to better understand female African American youth’s perceptions of teen pregnancy and STDs, and the characteristics they desire in sexual and reproductive health interventions. Interviews with 19 African American females ages 13-24 were conducted. Results indicated that participants perceived teen pregnancy to be common, but STDs to be rare. Overall, participants …

Two Case Examples Of Reaching The Hard-To-Reach: Low Income Minority And Lgbt Individuals, Tricia K. Gatlin, Michael J. Johnson

Journal of Health Disparities Research and Practice

‘Hard-to-reach’ is a term primarily used by researchers to describe groups of people who have been historically difficult to find or contact. It is important for the public interest to include hard-to-reach groups in research because excluding certain sub-populations diminishes the ability to identify groups that potentially have the highest burden of illness and to develop an understanding of why group differences exist. Thus, the purposes of this paper are to: 1) describe the challenges in recruiting hard-to-reach population in two separate research studies; 2) discuss the strategies that were used to overcome those challenges; and 3) provide recommendations for …

Deconstructing The Model Minority Myth: Exploring Health Risk Behaviors Of American Asian And Pacific Islander Young Adults, Todd M. Sabato

Journal of Health Disparities Research and Practice

The model minority stereotype describes Asian and Pacific Islanders (API) as the epitome of assimilation into U.S. culture using hard work, intelligence, high educational attainment, and economic success to overcome the challenges of discrimination and recent immigration. Adopted model minority pressures assume a life of their own, with origins in childhood that are amplified during adolescence and young adulthood. In response to evidence of increased vulnerability to HIV and other sexually transmitted infection exposure, the present study compared prevalence estimates of health risk behaviors of API and cross-ethnic college students (N = 1,880). Self-reported alcohol use and abuse tendencies, …

An Ambivalent Embrace: Service Needs And Gaps For Asian Immigrants In New Destinations, John J. Chin

Journal of Health Disparities Research and Practice

Asian immigrants to the U.S. are settling in "new destinations," but there has been little research on their health care and social service needs. Our analysis of Census data to identify cities with the fastest Asian immigrant population growth (1990-2000) yielded 33 smaller cities in 13 states. The cities ranged in population from 7,677 to 86,660; were spread across 13 states in the Northeast, South, and Midwest regions of the US; and varied widely demographically. Pilot surveys conducted in 2009 indicated that, although many residents had positive attitudes towards immigrants, many were also concerned about job competition and dilution of …

Addressing Health Disparities And Cultural Competency In Reproductive Health Through Active Learning In The University Of Puerto Rico, School Of Medicine, Ines E. Garcia-Garcia, Kary M. Bouet Md, Lourdes Garcia-Fragoso, Juan Rivera-Gonzalez

Journal of Health Disparities Research and Practice

Introduction: Lesbian, gay, bisexual, transgender and queer (LGBTQ) individuals face health disparities linked to societal stigma, discrimination, and denial of their civil and human rights which impact reproductive health. Previous pregnancy, induced abortion, and hormonal contraceptive use are common among women who report sex with women, regardless of self-identification as lesbian. LGBTQ have higher risk of smoking, use illicit drugs or have alcohol related problems. Methods: A faculty development training addressed methods and skills for teaching cultural competence and eliminate health disparities. Faculty facilitated a small group active learning activity, including a vignette and a reflective self-evaluation, for medical students …

Effectiveness Of A Federal Healthy Start Program In Reducing Infant Mortality, Ronee E. Wilson, Hamisu M. Salihu, Jason L. Salemi, Priyanshi Patel, Rana Daas, Estrellita "Lo" Berry

Journal of Health Disparities Research and Practice

Objective: Infant mortality is an important indicator of the health status of a community. In this analysis, we aimed to evaluate temporal changes in infant mortality rates (IMR) in the Central Hillsborough Healthy Start (CHHS) program service area in Tampa, Florida compared to rates in the rest of Hillsborough County and the state.

Method: We conducted a five-year (2010-2014) trends analysis using birth and infant death data extracted from the Florida Community Health Assessment Resource Tool Set (CHARTS). The number of infant deaths and live births were used to calculate and compare IMRs in the CHHS catchment area to those …

Using Photovoice As A Tool For Community Engagement To Assess The Environment And Explore Environmental Health Disparities, Heather M. Brandt, Venice E. Haynes, Lashanta J. Rice, Dayna Campbell, Edith Williams, *Sacoby Wilson, Saundra H. Glover

Journal of Health Disparities Research and Practice

Photovoice was used as a participatory research method to document perceived local environmental hazards, pollution sources, and potential impact on health among community members to address environmental health disparities. A convenience sample of 16 adults in Orangeburg, South Carolina participated in Photovoice. Photos depicted positive and negative implications of the environment across seven themes: recreation and leisure; food access; hazards and pollution; health, human, and social services; economic issues; beautification; and accommodation and accessibility. Positive and negative photos demonstrated a high level of interest among community members in considering how the environment influences health and health disparities.

Race And “Hotspots” Of Preventable Hospitalizations, Caryn N. Bell, Janice V. Bowie, Roland J. Thorpe Jr.

Journal of Health Disparities Research and Practice

Abstract

Preventable hospitalizations (PHs) are those for ambulatory care-sensitive conditions that indicate insufficiencies in local primary healthcare. PH rates tend to be higher among African Americans, in urban centers, rural areas and areas with more African American residents. The objective of this study is to determine geographic clusters of high PH rates (“spatial clusters”) by race. Data from Maryland hospitals were utilized to determine the rates of PHs in zip code tabulation areas (ZCTAs) by race in 2010. Geographic clusters of ZCTAs with higher than expected PH rates were identified using Scan Statistic and Anselin’s Local Moran’s I. 10 PH …

Disparities In Breast Cancer Stage At Diagnosis: Importance Of Race, Poverty, And Age, Faustine Williams, Emmanuel Thompson

Journal of Health Disparities Research and Practice

This study investigated the association of race, age, and census tract area poverty level on breast cancer stage at diagnosis. The study was limited to women residing in Missouri, aged 18 years and older, diagnosed with breast cancer, and whose cases were reported to the Cancer Registry between 2003 and 2008. The risk, relative risk, and increased risk of late-stage at diagnosis by race, age, and census tract area poverty level were computed. We found that the odds of late-stage breast cancer among African-American women were higher when compared with their white counterpart (OR 1.433; 95% CI, 1.316, 1.560). In …

Persistence With Mammography Screening And Stage At Breast Cancer Diagnosis Among Elderly Appalachia-West Virginia Women, Ami Vyas, Suresh Madhavan, Usha Sambamoorthi

Journal of Health Disparities Research and Practice

The objective of this study is to evaluate the association between persistence with mammography screening and stage at breast cancer diagnosis in elderly Appalachia-West Virginia women diagnosed with first incident breast cancer. The study utilized West Virginia Cancer Registry-Medicare linked database to identify women age 70 and above diagnosed with first incident breast cancer in 2007. Persistence to mammography screening was defined as having had at least three mammography screenings before breast cancer diagnosis. A multiple logistic regression was conducted to assess the association between persistence with mammography screening and stage at breast cancer diagnosis in these women. Of the …

Examining Differences In Hpv Awareness And Knowledge And Hpv Vaccine Awareness And Acceptability Between U.S. Hispanic And Island Puerto Rican Women, Daisy Y. Morales-Campos Phd, Robin Vanderpool

Journal of Health Disparities Research and Practice

Background: In 2015, only 42% of Puerto Rican (PR) girls aged 13-17 and 44% of U.S. Hispanic girls aged 13-17 were vaccinated with all three Human Papillomavirus (HPV) vaccine doses. These percentages were far lower than the Healthy People 2020 goal of 80% of girls aged 13-15 completing the vaccine series. The purpose of this study was to examine potential differences in HPV awareness and knowledge and HPV vaccine awareness and acceptability between a population-based sample of U.S. Hispanic and island Puerto Rican women.

Methods: We restricted our analyses to female respondents from the Health Information National Trends Survey (HINTS) …

Demographics And Cardiovascular Risk Factors In A Bi-Ethnic Church-Based Intervention: Baseline Results Of The Stroke Health And Risk Education (Share) Project, Lesli Skolarus

Journal of Health Disparities Research and Practice

Objectives: Hispanics have a higher incidence of cardiovascular disease (CVD) than non-Hispanic whites (NHWs). Despite proven benefits in other minority populations, few interventions have been conducted in partnership with Churches with substantial Hispanic membership. In this context, we describe the baseline demographics and CVD risk factors among participants of a bi-ethnic Catholic Church-based CVD prevention trial.

Methods: The Stroke Health and Risk Education (SHARE) project was a cluster-randomized, multi-component, faith-based, behavioral intervention that enrolled Mexican Americans (MAs) and NHWs from Catholic Churches in Corpus Christi, Texas. Strategies to ensure MA recruitment included bilingual staff and materials and partnership with Catholic …

Testosterone And The Adult Male, Alex Straftis

Calvert Undergraduate Research Awards

Abstract

In the last 15 years, prescription testosterone sales have increased almost threefold. Testosterone is a powerful hormone, which has both physiological and behavioral effects on the adult male. These effects vary over a man’s life course and social ecology. In a natural setting, testosterone reaches a peak during early adulthood, declines gradually over midlife, and has exponential drops after the age of 70. Increasing testosterone, through testosterone replacement therapy (TRT), past early adulthood, is an evolutionary novel circumstance for an adult male. To gauge these effects, and the motivations that initiated them, this study conducted a preliminary text analysis …

Immigration As A Social Determinant Of Health: Proceedings Of A Workshop, Tiffiany O. Howard, National Academies Of Sciences, Engineering, And Medicine, Numerous Authors, See Full List Below

Political Science Faculty Research

Since 1965 the foreign-born population of the United States has swelled from 9.6 million or 5 percent of the population to 45 million or 14 percent in 2015. Today, about one-quarter of the U.S. population consists of immigrants or the children of immigrants. Given the sizable representation of immigrants in the U.S. population, their health is a major influence on the health of the population as a whole. On average, immigrants are healthier than native-born Americans. Yet, immigrants also are subject to the systematic marginalization and discrimination that often lead to the creation of health disparities. To explore the link …

The Price Of Progress: Funding And Financing Alzheimer's Disease Drug Development, Jeffrey Cummings, Carl Reiber, Parvesh Kumar

School of Medicine Faculty Research

Introduction Advancing research and treatment for Alzheimer's disease (AD) and the search for effective treatments depend on a complex financial ecosystem involving federal, state, industry, advocacy, venture capital, and philanthropy funding approaches. Methods We conducted an expert review of the literature pertaining to funding and financing of translational research and drug development for AD. Results The federal government is the largest public funder of research in AD. The National Institute on Aging, National Institute of Mental Health, National Institute of General Medical Sciences, and National Center for Advancing Translational Science all fund aspects of research in AD drug development. Non-National …