Medicine and Health Sciences Commons^™

The Public Health Exposome: A Population-Based, Exposure Science Approach To Health Disparities Research, Paul D. Juarez, Patricia Matthews-Juarez, Darryl B. Hood, Wansoo Im, Robert S. Levine, Barbara J. Kilbourne, Michael A. Langston, Mohammad Z. Al-Hamdan, William L. Crosson, Maurice G. Estes, Sue M. Estes, Vincent K. Agboto, Paul Robinson, Sacoby Wilson, Maureen Y. Lichtveld

Sociology Faculty Research

The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death. It uses a social-ecological framework that builds on the exposome paradigm for conceptualizing how exogenous exposures “get under the skin”. The public health exposome approach has led our …

The Potentials And Challenges Of Big Data In Public Health, Rena N. Vithiatharan

Australian eHealth Informatics and Security Conference

The potential to use big data sources for public health increases with the broadening availability of data and improved methods of analysis. Whilst there are some well-known examples of the opportunistic use of big data, such as GoogleFlu, public health has not yet realised the full potential of such data sources. A literature review was undertaken to identify the potential of such data collections to impact public health, and to identify what challenges are currently limiting this potential. The potential include improved real-time analysis, research and development and genome studies. However, challenges listed are poor universal standardisation and classification, privacy …

A State And Territorial Survey Regarding Utilization Of Environmental Health Shelter Assessments During Disasters, And A Secondary Analysis Of Available Shelter Assessment Data, Miguel A. Cruz

FIU Electronic Theses and Dissertations

Disasters are complex events characterized by damage to key infrastructure and population displacements into disaster shelters. Assessing the living environment in shelters during disasters is a crucial health security concern. Until now, jurisdictional knowledge and preparedness on those assessment methods, or deficiencies found in shelters is limited. A cross-sectional survey (STUSA survey) ascertained knowledge and preparedness for those assessments in all 50 states, DC, and 5 US territories. Descriptive analysis of overall knowledge and preparedness was performed. Fisher’s exact statistics analyzed differences between two groups: jurisdiction type and population size. Two logistic regression models analyzed earthquakes and hurricane risks as …

Medicaid Expansions & Public Health Spending: Cross-Subsidies, Complementarities, And Crowd-Out, Glen P. Mays

Health Management and Policy Presentations

In this paper we estimate the causal impact of state Medicaid enrollment expansions and expenditures on state and local resources allocated to other public health programs and services. Using a quasi-experimental design with instrumental variables estimation, we find evidence that increased Medicaid spending leads to reduced governmental spending on other public health services, consistent with a crowd-out effect. Over 10 years, such crowd-out has the potential to diminish the health status improvements generated through health insurance coverage expansions.

Geographic Variation In The Delivery Of High-Value Public Health Services: Exploring Causes & Consequences, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: A growing body of evidence indicates that the delivery of public health activities varies widely across states and communities, creating missed opportunities for prevention as well as inequities in health protection. Measures of quality in public health are needed to guide public health improvement initiatives and to support research on the comparative effectiveness of alternative public health strategies. The Multi-network Practices and Outcomes Variation Examination Study (MPROVE), uses the infrastructure of six Public Health Practice-Based Research Networks (PBRNs) across the U.S. to develop and validate a “starter set” of measures and to analyze geographic variation delivery across diverse public …

Annual Report Of The National Coordinating Center For Public Health Services & Systems Research, Year Four, Glen P. Mays, F. Douglas Scutchfield, Anna Goodman Hoover

UKCPHSSR Research Briefs and Reports

The National Coordinating Center for Public Health Services and Systems Research (PHSSR), together with the Public Health Practice-Based Research Networks (PBRN) Program, works to expand the production and application of evidence on how best to organize, finance and deliver public health strategies that improve population health. The Center designs and conducts research studies, provides technical assistance and direction for other researchers across the U.S., develops methodological advances in measurement and analysis, and accelerates the translation and dissemination of research findings for policy and practice stakeholders.

Black Infant Deaths Point To Flaw In U.S. Health Care System, Vanessa Lopez-Littleton

UCF Forum

In a recent interview on The Daily Show, TV host Jon Stewart asked Fox political commentator Bill O’Reilly: “Does white privilege exist?” O’Reilly denied the existence of white privilege but conceded that as a collective, blacks carry more of a burden than whites.

Design And Development Of A Linked Open Data-Based Health Information Representation And Visualization System: Potentials And Preliminary Evaluation, Binyam Tilahun, Tomi Kauppinen, Carsten Keßler, Fleur Fritz

Publications and Research

Background: Healthcare organizations around the world are challenged by pressures to reduce cost, improve coordination and outcome, and provide more with less. This requires effective planning and evidence-based practice by generating important information from available data. Thus, flexible and user-friendly ways to represent, query, and visualize health data becomes increasingly important. International organizations such as the World Health Organization (WHO) regularly publish vital data on priority health topics that can be utilized for public health policy and health service development. However, the data in most portals is displayed in either Excel or PDF formats, which makes information discovery and reuse …

How Can Public Health Economics Help Health Systems Focus Upstream?, Glen P. Mays

Health Management and Policy Presentations

Research on the health and economic impact of public health strategies can help newly evolving health care delivery systems focus on upstream health determinants and make evidence-informed decisions about resource allocation across the prevention-treatment spectrum. Examples from research underway in the U.S. have particular relevance for Canada's evolving regional health authorities and their integrated approaches to medical care and public health delivery.

Tougher Than Rocket Science, Or Just Messier? Using Research To Improve U.S. Public Health Delivery, Glen P. Mays

Health Management and Policy Presentations

Advances in the field of public health services & systems research (PHSSR) are incorporating complexity in theory and methods to derive strong inferences about the health and economic effects attributable to public health strategies. Opportunities for comparative international research in Canada and the U.S. promise to strengthen these avenues of inquiry.

Public Health Services Research: Informing Public Health Practice & Policy, Glen P. Mays

Health Management and Policy Presentations

Heterogeneity in the mechanisms used for organizing and financing public health strategies creates opportunities for comparative effectiveness research (CER) in public health that examine which organization and financing mechanisms work best, for whom, and under what circumstances. Findings from these types of studies have direct utility in shaping public health policy and practice decisions.

Governmental Public Health And The Economics Of Adaptation To Population Health, Glen P. Mays

Health Management and Policy Presentations

Research on the organization and financing of public health strategies offers valuable insight for governmental public health agencies seeking to adapt to a population health improvement perspective under health system reform.

Laboratories And The Value Stream Of Next-Generation Public Health, Glen P. Mays

Health Management and Policy Presentations

Public health laboratories are the information engines for public health agencies and delivery systems. Measuring the value stream that flows from this information can support objective assessments of the health and economic benefits attributable to laboratory infrastructure and information.

Pubh 3231 - Epidemiology And Biostatistics, John Sheahan

Jiann-Ping Hsu College of Public Health Syllabi

This course introduces the student to the principles and practice of epidemiology and vital statistics. Students will be exposed to the historical development of epidemiology, concepts of causality, definitions of health and disease, and sources of community health data. Current principles and practices in the cause, prevention and control of diseases in various community settings will be emphasized.

Using The Minority Stress Model To Understand Depression In Lesbian, Gay, Bisexual, And Transgender Individuals In Nebraska, Molly Mccarthy, Christopher M. Fisher, Jay A. Irwin, Jason D. Coleman, Aja D. Kneip Pelster

Sociology and Anthropology Faculty Publications

Previous studies demonstrated the utility of the minority stress model in understanding health disparities for lesbian, gay, bisexual, and transgender (LGBT) populations. Since most research has considered large metropolitan areas, predominantly in coastal regions of the United States, this research focuses on a midwestern state, Nebraska. This study sought to assess the relationships between depressive symptoms experienced by participants (N = 770) and minority stress variables, including experiences with violence, perceptions of discrimination, and respondents’ degree of self-acceptance of their LGBT identity. Regression analysis revealed that after controlling for demographic variables, self-acceptance, and perceived discrimination were correlated with depressive symptoms. …

Healthcare For Persons With Intellectual And Developmental Disability In The Community, David A. Ervin, Brian Hennen, Joav Merrick, Mohammed Morad

Pediatrics Faculty Publications

INTRODUCTION: While there has been impressive progress in creating and improving community healthcare delivery systems that support people with intellectual and developmental disabilities (IDD), there is much more that can and should be done.

METHODS: This paper offers a review of healthcare delivery concepts on which new models are being developed, while also establishing an historical context. We review the need for creating fully integrated models of healthcare, and at the same time offer practical considerations that range from specific healthcare delivery system components to the need to expand our approach to training healthcare providers. The models and delivery systems, …

Infectious Diseases, Bert Chapman

Libraries Faculty and Staff Scholarship and Research

Provides information about the role of infectious diseases in the early years of U.S. History, with particular emphasis on how they impacted injuries sustained in military conflict.

Primary Care: Mental And Behavioral Health And Persons With Intellectual And Developmental Disabilities, David A. Ervin, Ashley Williams, Joav Merrick

Pediatrics Faculty Publications

INTRODUCTION: There are multiple ways to address the mental and behavioral health needs of people with intellectual and developmental disabilities (IDD).

METHOD: In this paper, we do not argue for a particular approach or set of approaches, but instead review the benefits of integrating mental and behavioral health supports with primary healthcare based primarily on our experience in and understanding of healthcare systems in the United States. It is estimated that between 35 and 40% of people with IDD also live with psychiatric disorders. NADD, an association for persons with developmental disabilities and mental health needs in the US holds …

Social Actors Fight The Rising Tide Of Hiv In U.S. Southern Poor, Courtenay Sprague, Sara E. Simon

Center for Peace, Democracy and Development Publications

The greatest number of persons living with HIV in the United States are now living in the South, and they face poorer health outcomes and increased AIDS-related deaths as compared to the rest of the country. The southern United States has a disproportionate share of low-income individuals, with many lacking access to health care and health insurance. Health facilities are also comparatively fewer and more difficult to reach than in other areas of the United States. The impacts of this already poor health infrastructure on low-income people living with HIV in the South can be life-threatening.

This policy brief summarizes …

Primary Care: Mental And Behavioral Health And Persons With Intellectual And Developmental Disabilities, David A. Ervin, Ashley Williams, Joav Merrick

Public Health Faculty Publications

Introduction: There are multiple ways to address the mental and behavioral health needs of people with intellectual and developmental disabilities (IDD).

Method: In this paper, we do not argue for a particular approach or set of approaches, but instead review the benefits of integrating mental and behavioral health supports with primary healthcare based primarily on our experience in and understanding of healthcare systems in the United States. It is estimated that between 35 and 40% of people with IDD also live with psychiatric disorders. NADD, an association for persons with developmental disabilities and mental health needs in the US holds …

Healthcare For Persons With Intellectual And Developmental Disability In The Community, David A. Ervin, Brian Hennan, Joav Merrick, Mohammed Morad

Public Health Faculty Publications

Introduction: While there has been impressive progress in creating and improving commu- nity healthcare delivery systems that support people with intellectual and developmental disabilities (IDD), there is much more that can and should be done.

Methods: This paper offers a review of healthcare delivery concepts on which new models are being developed, while also establishing an historical context. We review the need for creating fully integrated models of healthcare, and at the same time offer practical consid- erations that range from specific healthcare delivery system components to the need to expand our approach to training healthcare providers. The models and …

A Brief History Of Public Health In Alexandria And Alexandria's Health Department, Krystyn R. Moon

History and American Studies

One of the central tenets of public health is the belief that the practice of medicine serves the broader community; however, the specific meaning of the phrase “public health” is a historically contingent one. Beginning in the late eighteenth century, the public included only white, bourgeois men who met in coffee houses and other such establishments to discuss politics, business ventures, and popular culture. Over the course of the nineteenth and twentieth centuries, the “public” included white working class men, the poor, women, and people of color. Eventually, politicians and medical doctors recognized that children should be included as part …

Does Medicaid Crowd Out Other Public Health Spending? Projecting Aca’S Health & Economic Effects, Glen P. Mays

Health Management and Policy Presentations

Research Objective: Twenty-six states are expanding Medicaid eligibility under the Affordable Care Act (ACA) in 2014, and while federal funds cover most costs for newly eligible recipients, states must share the additional costs of covering previously-eligible state residents who newly enroll in Medicaid in response to ACA’s expanded outreach and enrollment incentives. States, together with their local government counterparts, also provide the vast majority (87%) of public sector funds for public health programs designed to promote health and prevent disease and injury on a population-wide basis. Fiscal constraints and generous federal matching funds create strong budgetary incentives for states to …

Slides: Public Health Research On Near O&G Development: Challenges And Needs, John L. Adgate

Water and Air Quality Issues in Oil and Gas Development: The Evolving Framework of Regulation and Management (Martz Summer Conference, June 5-6)

Presenter: John L. Adgate, PhD, MSPH, Professor and Chair, Department of Environmental and Occupational Health, University of Colorado

19 slides

Reporting Risk, Producing Prejudice How News Reporting On Obesity Shapes Attitudes About Health Risk, Policy, And Prejudice, Abigail C. Saguy, David Frederick, Kjerstin Gruys

Psychology Faculty Articles and Research

News reporting on research studies may influence attitudes about health risk, support for public health policies, or attitudes towards people labeled as unhealthy or at risk for disease. Across five experiments (N = 2123) we examined how different news framings of obesity research influence these attitudes. We exposed participants to either a control condition, a news report on a study portraying obesity as a public health crisis, a news report on a study suggesting that obesity may not be as much of a problem as previously thought, or an article discussing weight-based discrimination. Compared to controls, exposure to the public …

How Will Public Health And Primary Care Come Together In Massachusetts?, Javier Crespo

Public Affairs Capstones Collection

The Patient Protection and Affordable Care Act aims to place public health and prevention practice closer to the clinical care delivery system by mandating basic preventive services and creating a national prevention plan. The Massachusetts health care system has a number of elements that can help foster closer linking of public health practices in the primary care setting. This research set out to examine whether the current healthcare system in Massachusetts will enable public health and primary care integration as intimated upon by the Affordable Care Act. This study will assess the current connection between public health and primary care …

Maximizing Roi: Laboratories And The Value Of Next-Generation Public Health, Glen P. Mays

Health Management and Policy Presentations

Laboratories serve as information engines for the public health enterprise, and their importance to population health improvement is likely to grow considerably under U.S. health reform. This session will examine the changing landscape of public health responsibilities within a reforming U.S. health system, and the current and potential roles for public health laboratories in improving the health and economic value of investments in public health. The session examines key changes in the organization, financing, and delivery of public health services that are occurring through innovations to better integrate public health and medical care delivery, and the current and potential roles …

Public Health Services & Systems Research And The Reforming U.S. Health System, Glen P. Mays

Health Management and Policy Presentations

This session reviews progress in the field of public health services & systems research (PHSSR), with a specific focus on findings that can inform the implementation and impact of health reform strategies on the U.S. public health system.

Increasing Public Awareness Of Venous Thromboembolism Through Social Media, Kathryn A. Lavall

Honors Projects

This paper investigates the problem of public awareness of venous thromboembolism (VTE) from a nursing perspective. VTE encompasses deep vein thrombosis (DVT) and pulmonary embolism (PE). It is a major public health problem as 600,000 people suffer from VTE annually and 100,000 deaths are attributed to it. The aim of this research study was to investigate and attempt to quantify the general public’s knowledge level of VTE. The research study included a survey in which 325 people participated. Of the 242 participants who identified themselves occupationally as nonmedical, less than 30% were familiar with both DVT and PE. Participants who …

Understanding Hiv Care Delays In The Us South And The Role Of The Social-Level In Hiv Care Engagement/Retention: A Qualitative Study, Courtenay Sprague, Sara E. Simon

Center for Peace, Democracy and Development Publications

Introduction: In a significant geographical shift in the distribution of HIV infection, the US South - comprising 17 states - now has the greatest number of adults and adolescents with HIV (PLHIV) in the nation. More than 60% of PLHIV are not in HIV care in Alabama and Mississippi, contrasted with a national figure of 25%. Poorer HIV outcomes raise concerns about HIV-related inequities for southern PLHIV, which warrant further study. This qualitative study sought to understand experiences of low-income PLHIV on the AIDS Drug Assistance Program in engagement and retention in continuous HIV care in two sites in Alabama. …