Medicine and Health Sciences Commons^™

Disparities In Mortality Between Appalachian And Non-Appalachian Regions Of Kentucky, Sonali S. Salunkhe, Sahal Alzahrani, Beatrice Ugiliweneza

Journal of Appalachian Health

Introduction: In the opioid epidemic, the U.S. faces a significant public health crisis, with some areas of the country, such as rural and Appalachian regions, suffering more than others. The differential regional impact of the crisis in Kentucky—a state with both non-metropolitan/metropolitan and Appalachian/Non-Appalachian statuses—has not yet been documented despite such knowledge being essential to the success of overdose prevention efforts.

Purpose: This study compares all-cause, drug- and opioid-related mortality between counties in different regions of Kentucky: Appalachian non-metropolitan, Appalachian metropolitan, non-Appalachian non-metropolitan, and non-Appalachian metropolitan.

Methods: Age-adjusted mortality data from the Centers for Disease Control and Prevention’s Wide-ranging Online …

Strategies To Reduce Chronic Disease: Adding Role To Community Health Workers, Ingrid J. Renwanz Dnp, Pmhfnp-Bc/Aprn, Msn, Rnc

Doctor of Nursing Practice (DNP) Projects

Background: Underserved, rural, immigrant, low-income Latinx communities need to strengthen healthcare access to improve their quality of life (Capitman et al., 2009; McCartney et al., 2019; Save the Children [STC] Organization, 2021). Non-communicable chronic disease of physical and behavioral origin is the leading cause of morbidity for adults and children in Latinx communities (Campbell et al., 2020). Estimates of greater than 30% of the Latinx populations within the United States have these health needs, with projections to reach 28% of the U.S. population by 2060 (Eghaneyan & Murphy, 2019; Ortega et al., 2018).

Local Problem: If poor access to preventive …

Cancer Disparities In Southeast Asia: Intersectionality And A Call To Action, Erin Jay G. Feliciano, Frances Dominique V. Ho, Kaisin Yee, Joseph A. Paguio, Michelle Ann B. Eala, Janine Patricia G. Robredo, Kenrick Ng, Jasmine Lim, Khin Thuzar Pyone, Catherine A. Peralta, Jerickson Abbie Flores, J. Seth Yao, Patricia Mae G. Santos, Christian Daniel U. Ang, Gideon Lasco, Jeffrey Shi Kai Chan, Gary Tse, Enrico D. Tangco, T. Peter Kingham, Imjai Chitapanarux, Nirmala Bhoo-Pathy, Gerardo D. Legaspi, Edward Christopher Dee

Einstein Health Papers

No abstract provided.

The Impact Of Neighborhood Socioeconomic Disadvantage On Operative Outcomes After Single-Level Lumbar Fusion, Grace Y. Ng, Ritesh Karsalia, Ryan S. Gallagher, Austin J. Borja, Jianbo Na, Scott Mcclintock, Neil R. Malhotra

Mathematics Faculty Publications

INTRODUCTION: The relationship between socioeconomic status and neurosurgical outcomes has been investigated with respect to insurance status or median household income, but few studies have considered more comprehensive measures of socioeconomic status. This study examines the relationship between Area Deprivation Index (ADI), a comprehensive measure of neighborhood socioeconomic disadvantage, and short-term postoperative outcomes after lumbar fusion surgery. METHODS: 1861 adult patients undergoing single-level, posterior-only lumbar fusion at a single, multihospital academic medical center were retrospectively enrolled. An ADI matching protocol was used to identify each patient's 9-digit zip code and the zip code-associated ADI data. Primary outcomes included 30- and …

Sociodemographic Factors Influencing Pandemic-Era Ehdi Use And Access, Nicole Perez, David Adkins, Marissa Schuh, Jennifer B. Shinn, Lori Travis, Matthew L. Bush

Journal of Early Hearing Detection and Intervention

Objective: The COVID-19 pandemic impact on Early Hearing Detection and Intervention (EHDI) programs is unknown. This research evaluated sociodemographic factors influencing adherence to EDHI diagnostic testing and the incidence of infant hearing loss during the pandemic.

Method: We evaluated EHDI adherence and incidence of hearing loss in Kentucky before and during the COVID-19 pandemic. Using univariate and multivariate analysis, we evaluated the association of these outcomes to sociodemographic variables.

Results: There were 71,206 births and 1,385 referred infant hearing screening tests during the study period. Infants during the pandemic had a 24% lower odds of hearing testing adherence (OR …

Individual- And Neighborhood-Level Characteristics Of Lung Cancer Screening Participants Undergoing Telemedicine Shared Decision Making, Christine S. Shusted, Hee-Soon Juon, Brooke Ruane, Brian M. Till, Charnita Zeigler-Johnson, Russell K. Mcintire, Tyler Grenda, Olugbenga Okusanya, Nathaniel R. Evans, Gregory C. Kane, Julie Barta

Division of Pulmonary and Critical Care Medicine Faculty Papers

BACKGROUND: Although lung cancer screening (LCS) for high-risk individuals reduces lung cancer mortality in clinical trial settings, many questions remain about how to implement high-quality LCS in real-world programs. With the increasing use of telemedicine in healthcare, studies examining this approach in the context of LCS are urgently needed. We aimed to identify sociodemographic and other factors associated with screening completion among individuals undergoing telemedicine Shared Decision Making (SDM) for LCS.

METHODS: This retrospective study examined patients who completed Shared Decision Making (SDM) via telemedicine between May 4, 2020 - March 18, 2021 in a centralized LCS program. Individuals were …

Examination Of Disparities In Prehospital Encounters For Pediatric Asthma Exacerbations, Lauren Riney, Sam Palmer, Erik Finlay, Andrew Bertrand, Shannon Burcham, Phyllis Hendry, Manish Shah, Kathryn Kothari, David W Ashby, Daniel Ostermayer, Olga Semenova, Benjamin N Abo, Benjamin Abes, Nichole Shimko, Emily Myers, Marshall Frank, Tim Turner, Mac Kemp, Kim Landry, Greg Roland, Jennifer N Fishe

Journal Articles

INTRODUCTION: There are disparities in multiple aspects of pediatric asthma care; however, prehospital care disparities are largely undescribed. This study's objective was to examine racial and geographic disparities in emergency medical services (EMS) medication administration to pediatric patients with asthma.

METHODS: This is a substudy of the Early Administration of Steroids in the Ambulance Setting: An Observational Design Trial, which includes data from pediatric asthma patients ages 2-18 years. We examined rates of EMS administration of systemic corticosteroids and inhaled bronchodilators by patient race. We geocoded EMS scene addresses, characterized the locations' neighborhood-based conditions and resources relevant to children using …

Characterization Of Oral Cavity And Oropharyngeal Cancer In The Texas Rio Grande Valley, Jared A. Sperling, Rachel Giese

Research Symposium

Background: Cancers of the oral cavity (OC) and oropharynx (OP) account for 3% of cancers diagnosed in the United States each year. A primary cause of death among the Hispanic population in the United States is cancer, accounting for 20% of annual mortality. The Rio Grande Valley (RGV) is a medically-underserved area of South Texas with a large Hispanic population facing health disparities. In this study, we examine the incidence and mortality of OC and OP cancer in the RGV.

Methods: CDC population-level incidence and mortality rate per 100,000 of OC/OP cancer among patients in the RGV counties of Hidalgo …

From Awareness To Action: Understanding And Addressing Health Disparities, Aamira Shah

The Cardinal Edge

In the United States, marginalized groups consistently face barriers to healthcare services necessary for maintaining quality of life and achieving positive health outcomes. Health disparities can be defined as “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by populations that have been disadvantaged by their social or economic status, geographic location, or environment” (CDC, 2008). With input from insightful interviews, this article seeks to investigate specific challenges faced by marginalized groups in the healthcare setting and provide potential solutions to reduce health disparities.

Association Between Lgb Status And Levels Of Mental Distress, Florida Brfss 2017-2019, Tammie M. Johnson, Torhonda Lee

Florida Public Health Review

Background: Poor mental health is a significant determinant of health in the US and is associated with several adverse health outcomes. Health-Related Quality of Life (HRQOL) measures help assess the mental distress burden on individuals and populations. This study examines mental distress health disparities at and above the frequent mental distress threshold among Florida adults who identify as lesbian, gay, or bisexual (LGB).

Methods: We used data from the 2017-2019 Florida Behavioral Risk Factor Surveillance System (BRFSS). A total of 39,876 adults aged 18 years and older were included in the analyses. The key dependent variables used for the study …

Developing A National-Scale Exposure Index For Combined Environmental Hazards And Social Stressors And Applications To The Environmental Influences On Child Health Outcomes (Echo) Cohort., Sheena E. Martenies, Mingyu Zhang, Anne E. Corrigan, Anton Kvit, Timothy Shields, William Wheaton, Deana Around Him, Judy Aschner, Maria M. Talavera-Barber, Emily S. Barrett, Theresa M. Bastain, Casper Bendixsen, Carrie V. Breton, Nicole R. Bush, Ferdinand Cacho, Carlos A. Camargo, Kecia N. Carroll, Brian S. Carter, Andrea E. Cassidy-Bushrow, Whitney Cowell, Lisa A. Croen, Dana Dabelea, Cristiane S. Duarte, Anne L. Dunlop, Todd M. Everson, Rima Habre, Tina V. Hartert, Jennifer B. Helderman, Alison E. Hipwell, Margaret R. Karagas, Barry M. Lester, Kaja Z. Lewinn, Sheryl Magzamen, Rachel Morello-Frosch, Thomas G. O'Connor, Amy M. Padula, Michael Petriello, Sheela Sathyanarayana, Joseph B. Stanford, Tracey J. Woodruff, Rosalind J. Wright, Amii M. Kress, Program Collaborators For Environmental Influences On Child Health Outcomes

Manuscripts, Articles, Book Chapters and Other Papers

Tools for assessing multiple exposures across several domains (e.g., physical, chemical, and social) are of growing importance in social and environmental epidemiology because of their value in uncovering disparities and their impact on health outcomes. Here we describe work done within the Environmental influences on Child Health Outcomes (ECHO)-wide Cohort Study to build a combined exposure index. Our index considered both environmental hazards and social stressors simultaneously with national coverage for a 10-year period. Our goal was to build this index and demonstrate its utility for assessing differences in exposure for pregnancies enrolled in the ECHO-wide Cohort Study. Our unitless …

Parabens Promote Protumorigenic Effects In Luminal Breast Cancer Cell Lines With Diverse Genetic Ancestry, Jazma L. Tapia, Jillian C. Mcdonough, Emily L. Cauble, Cesar G. Gonzalez, Dede K. Teteh, Lindsey S. Treviño

Health Sciences and Kinesiology Faculty Articles

Context

One in 8 women will develop breast cancer in their lifetime. Yet, the burden of disease is greater in Black women. Black women have a 40% higher mortality rate than White women, and a higher incidence of breast cancer at age 40 and younger. While the underlying cause of this disparity is multifactorial, exposure to endocrine disrupting chemicals (EDCs) in hair and other personal care products has been associated with an increased risk of breast cancer. Parabens are known EDCs that are commonly used as preservatives in hair and other personal care products, and Black women are disproportionately exposed …

Impact Of Covid-19 On Latinx And Black Communities, Carolina Zuluaga

Dissertations

This critical literature review project explored the impact of COVID-19 on Latinx and Black communities. According to the Centers for Disease Control and Prevention, as of September 28, 2022, around 16% of COVID-19 cases in the United States were among Latinx people, and 14% of cases were among Black people (Centers for Disease Control and Prevention, 2022). Since COVID-19 began, clinicians have become more conscious of the effects of health disparities within racial and ethnic minorities, which has warranted increased advocacy by educating health and mental health providers and creating and providing resources to these communities and clinicians. The review …

Hierarchy Of Life: Whose Lives Do We Value?, Jessica Wiggins

International Journal on Responsibility

COVID-19 has heightened already existing health disparities amongst marginalized communities within the United States. In crisis, whose lives do healthcare systems value most and how are these decisions rooted in ableism and racism? Who is responsible for these inequities and in what ways? This multimedia presentation and companion paper explore these important questions.

Positive Changes In Safety Perception Among Blacks With Hiv And Comorbidities: Assessment Of Social Determinants Of Health During Covid‑19, Marc Fleming, Deidra Lee, Chukwuezugo Oranu, Jon C. Schommer, Jennifer M. Cocohoba, Jennifer Cooper, Crystal K. Hodge, Saharnaz Nedjat, Kathleen Borgmann

Pharmacy Faculty Articles and Research

Purpose

This study aimed to examine the impact of the COVID-19 lockdown on social determinants of health (SDOH) among Blacks with HIV and a comorbid diagnosis of hypertension or type 2 diabetes mellitus (T2DM).

Methods

This was a longitudinal survey study. The inclusion criteria were adults ≥ 18 years and the presence of hypertension and/or diabetes, along with a positive HIV diagnosis. This study enrolled patients in the HIV clinics and chain specialty pharmacies in the Dallas-Fort Worth (DFW) area. A survey of ten questions examining SDOH was conducted before, during, and after the lockdown. A proportional odds mixed effects …

Low Educational Attainment Is Associated With Higher All-Cause And Cardiovascular Mortality In The United States Adult Population, Najah Khan, Zulqarnain Javed, Isaac Acquah, Kobina Hagan, Madiha Khan, Javier Valero-Elizondo, Ryan Chang, Umair Javed, Mohamad B. Taha, Salim S. Virani

Office of the Provost

Introduction: Educational attainment is an important social determinant of health (SDOH) for cardiovascular disease (CVD). However, the association between educational attainment and all-cause and CVD mortality has not been longitudinally evaluated on a population-level in the US, especially in individuals with atherosclerotic cardiovascular disease (ASCVD). In this nationally representative study, we assessed the association between educational attainment and the risk of all-cause and cardiovascular (CVD) mortality in the general adult population and in adults with ASCVD in the US.
Methods: We used data from the 2006-2014 National Death Index-linked National Health Interview Survey for adults ≥ 18 years. We generated …

Opioid Overdose: Rural Georgia Vs. Urban Georgia - Who's Winning The Battle?, Zizah-Wosseni Blair, Justice Dove, Didem Aydin, Stacie Fairley

Research Day

INTRODUCTION: The opioid crisis is a major public health issue affecting communities across the United States, including Georgia. The widespread misuse of prescription and illicit opioids has led to a significant increase in opioid-related overdoses and deaths. The impact on Georgia communities has been devastating, affecting individuals from all walks of life and causing significant harm to families and communities. The Georgia Department of Public Health reported that the number of drug overdose deaths in the state rose by 61.9% from 2019 to 2021. Rural and Urban communities in Georgia face unique challenges in addressing this epidemic. Rural communities often …

Mind The Gap! Advancing Data Equity To Improve Population Health Equity For People With Disabilities, Michelle Fong

Poster Presentations

The Center for Community Inclusion and Disability Studies (CCIDS), Maine’s University Center for Excellence in Developmental Disability (UCEDD), carries out a variety of education and research activities designed to improve the social and health equity of people with disabilities (PWD). CCIDS sought to examine the health equity of Maine’s population with intellectual and neurodevelopmental disabilities (IDD/NDD) regarding Covid-19. However, we encountered a data gap. Therefore, we examined the drivers of data gaps for people with disabilities to make recommendations for improving their health equity by ensuring their representation in public health data, the evidence base for policymaking.

Our Story, Our Song: Assessing And Addressing Black Women's Healthcare Experiences., Jason Deakings

Electronic Theses and Dissertations

Despite advancements in medicine and health sciences, health disparities and declining life expectancy persists among Black women in the United States. Researchers and non-traditional healthcare providers suggest alternative healing (e.g., music and Sister Circles) and research methodologies to achieve a culturally conscious, traumainformed, quality, and holistic care and practice. The intersecting identities and cultural responsibility of Black women highly influences the barriers and facilitators on the uptake of healthcare services. Utilizing a community engaged research approach, this qualitative study assessed the healthcare experiences, as well as the role of music in the lived and retold experiences of Black women navigating …

Strengthening Patient-Family Engagement Amidst A Pandemic: Lessons Learned And Paths Forward, Kyle J. Rehder, Shannon Haney, Jan Freeman, Aaron West

Patient Experience Journal

The COVID-19 pandemic was highly disruptive to healthcare and negatively affected healthcare worker and patient experience on multiple levels. Patient Family Advisors serve an important role in partnering with health systems to improve patient experience, yet the work of many volunteer programs were interrupted by the onset of the pandemic, at a time when integrating patient voice into care delivery was sorely needed. This case study presents one health system’s experience adapting a system-wide Patient Family Advisory program in the setting of the COVID-19 pandemic, including the transition to a virtual format and increased flexibility in how Patient Family Advisors …

Review Of: Appalachian Health: Culture, Challenges, And Capacity, Danielle M. Davidov

Journal of Appalachian Health

The Journal of Appalachian Health is committed to reviewing published media that relates to contemporary concepts affecting the health of Appalachia. This is a review of the text Appalachian Health: Culture, Challenges, and Capacity. This book is an ideal starting point for anyone interested in Appalachian history, public health, and health disparities research.

Racial Differences In Perception And Experiences Of Adverse Treatment By Healthcare Providers: A Cross-Sectional Analysis Of The All Of Us Data, Tanya Funchess, Traci Hayes, Yang Ge, Felix Twum

Journal of Public Health in the Deep South

Health disparities among racial and ethnic groups in the U.S. are well documented. Among the non-medical issues, including discrimination, language barriers, and low health literacy, the patient-provider relationship has been identified as a factor that drives health disparities. Negative interactions with healthcare providers and the healthcare system produce poor health outcomes, exacerbating health inequalities and reducing the likelihood of patients adhering to recommended treatments and therapies. The purpose of this study was to examine racial differences in perceptions and experiences of adverse treatment by healthcare providers. A cross-sectional analysis of select variables from the All of Us research program basic …

Mind The Gap: A White Paper On Maine's Missing Covid-19 Surveillance Data, How They Perpetuate Health Disparities Of Maine's Citizens With Disabilities, And What Can Be Done To Increase Maine's Public Health Data & Service Equity, Michelle Fong

Student and Trainee Scholarship

A white paper by Michelle Fong, a 2023 NH-ME Leadership Education in Neurodevelopmental and Related Disabilities (LEND) trainee and MPH student at the University of New England. Equitable health data represents all populations and can be linked to their common characteristics. Maine’s COVID-19 data can be disaggregated by gender, race, ethnicity, and age, but not by disability status or type. It is an example of inequity in data collection, or a data gap, that prevents analysis of pandemic health outcomes for Mainers with disabilities.

“They’Re Still Trying To Wrap Their Head Around Forever”: An Anatomy Of Hope For Spinal Cord Injury Patients, William A. Lucas

USF Tampa Graduate Theses and Dissertations

This dissertation draws on ethnographic data to investigate the nature of spinal cord injury (SCI) rehabilitation in Central Florida, using participant observation and interview data to understand how people with SCI (pwSCI) conceptualize their own disabilities after experiencing such radical alterations in their subjectivities. Using case studies and ethnographic vignettes, it argues that the extreme double binds in which pwSCI find themselves (where they are personally ordinarily disabled and socially extraordinarily novel; and where they are enabled resources to pursue “hopeful” therapy modalities while being designated as hopelessly disabled) is further polarized by the various legislative regimes of truth in …

Leveraging Digital Technologies For Management Of Peripartum Depression To Mitigate Health Disparities, Alexandra Zingg

Dissertations & Theses (Open Access)

Health disparities are adverse, preventable differences in health outcomes that affect disadvantaged populations. Examples of health disparities can be seen in the condition of peripartum depression (PPD), a mood disorder affecting approximately 10-15% of peripartum women. For example, Hispanic and African-American women are less likely to start or continue PPD treatment. Digital health technologies have emerged as practical solutions for PPD care and self-management. However, existing digital solutions lack an incorporation of behavior theory and distinctive information needs based on women’s personal, social, and clinical profiles. Bridging this gap, I adapt Digilego, an integrative digital health development framework consisting of: …

Comparative Medicaid Policy Analysis Related To Maternal And Infant Birth Outcomes In South Carolina, Cassidy L. Lena

Senior Theses

The United States despite being one of the most industrialized and wealthiest nations in the world, has the worst maternal and child health outcomes of any industrialized nation. The rates of maternal morbidity, mortality, and infant mortality have been increasing within the past decade, when many causes of death for this population are preventable. This study conducted a literature review on Medicaid policies and associated programs between three states (South Carolina, North Carolina, and California) in order to gain background information. Secondly, a comparative Medicaid policy analysis was completed using the Centers for Disease Control and Prevention [CDC] framework, which …

Impact Of A Health Fair On Student Organizations Providing Care To The Detroit Hispanic/Latinx Community And Barriers Affecting Patients Of A Student-Run Clinic Primarily Serving This Population, Amanda Rodriguez Bs, Lucas Edgren Bs, Sanjana Rao Bsph, Diane L. Levine Md, Jennifer Mendez Phd, Joel Appel Do

Medical Student Research Symposium

Current literature shows Hispanic/Latinx populations in the U.S. face health inequities. Amigos Medicos (AM) Clinic, located in Southwest Detroit, is a student-run free clinic that addresses these issues through preventive health screenings. We hosted a health fair in 2022 and invited other student organizations in efforts to connect the community to resources. Our aim is to identify specific barriers faced by our population in receiving health care and to identify the impact of participation in the fair on those organizations. One survey was administered to patients attending clinic that identified health barriers they face. The other survey was administered to …

Advancing Health Equity In The Us Military, James D. Mancuso, John Young, Jennifer Rusiecki, Shauna Stahlman, Natasha Schvey, Toya Randolph, Candy Wilson, Catherine Witkop, Patrick Hyde, Althea Green, Patcho Santiago, Donald Shell, Tracy Sbrocco

Journal of Health Disparities Research and Practice

Eliminating health disparities and achieving health equity are central to US national health objectives and the Military Health System’s “quadruple aim,” which has readiness as its core aim. Because military service members enjoy universal eligibility for health care, it is sometimes assumed that health disparities do not exist in the Department of Defense (DoD). However, while some studies have shown that disparities have been attenuated or eliminated in the DoD, others suggest that significant disparities remain. Reasons these disparities may remain include that universal eligibility for care does not necessarily result in equal to access to care, and that equal …

Health Disparities Experienced By Hispanic Americans With Multiple Myeloma: A Systematic Review, Andrea Anampa-Guzmán, Sara Taveras Alam, Inas Abuali, Samer Al Hadidi

Journal Articles

Health disparities in multiple myeloma (MM) disproportionately affect minorities. Characterization of health disparities encountered by Hispanic Americans with MM is necessary to identify gaps and inform future strategies to eliminate them. We performed a systematic review of publications that described health disparities relevant to Hispanic Americans with MM through December 2021. We included all original studies which compared incidence, treatment, and/or outcomes of Hispanic Americans with other ethnic groups. Eight hundred and sixty-eight articles were identified of which 22 original study articles were included in our systematic review. The number of publications varied over time with the highest number of …

Risk Factor Analysis Of Hospital Readmissions At St. Petersburg General Hospital, Vincent Wu, Sean Quinonez, My Myers, Kyle Borodunovich, Aisha Shamsi, Patrick Stocker, Bryan Fink, Steven Ferreira

HCA Healthcare Journal of Medicine

Background

Decreased readmission rates are largely seen as an indicator of effective care and improved resource management. The case management team at St. Petersburg General Hospital in St. Petersburg, Florida identified chronic obstructive pulmonary disease (COPD) exacerbation, pneumonia, and sepsis as 3 of the leading diagnoses on index admission that later led to 30-day readmissions. By examining patients with these 3 diagnoses on index admission, we decided to investigate potential readmission risk factors including patient age, sex, race, body mass index (BMI), length of stay during the index admission, insurance type during index admission, discharge placement after index admission, coronary …