Mental and Social Health Commons^™

Evaluating The Predictive Value Of Basc-3 Anxiety Scale And Working Memory Index Scores For Clinically Significant Test Anxiety: A Comprehensive Analysis Of Non-Classifiable Cases, Des'tiana S. Williams

Electronic Theses and Dissertations

This dissertation will explore how test anxiety (TA) affects working memory (WM) and whether certain factors can help predict higher levels of test anxiety. Anxiety has been defined as a common experience that can show up in various forms—like general worry, social fears, panic attacks, and specific phobias (APA, 2022). It was described as often triggering our natural “fight-or-flight” response, which can impact our ability to focus, think clearly, and remember things. For students, test anxiety has been especially challenging, affecting how they perform in high-stakes academic settings. Using data from a university based psychological assessment center, this study will …

The Impact Of Household Dysfunction On Dating Violence Perpetration Among Adolescents In The United States: A Scoping Review, Sumaita Choudhury, Melissa F Peskin, Timothy J Walker, Emily T Hébert, Nivedhitha Parthasarathy, Kaitlyn L Zajack-Garcia, Lea Sacca, Christine M Markham

Faculty, Staff and Student Publications

Adverse childhood experiences, such as household dysfunction (HD), play a central role in how adolescents establish, experience, and navigate the challenges of relationship formation, maintenance, and dissolution. HD exposures have been independently associated with dating violence (DV) perpetration in both adolescents and adults. However, research examining the association between the concurrent effect of HD on DV perpetration, especially among adolescents remains scarce. Thus, we conducted a scoping review to accumulate and summarize existing research regarding the impact of HD on DV perpetration among adolescents aged 10 to 17 years in the United States. We used three electronic databases, Medline (Ovid), …

Author Reply, Cyprian Mostert

Population Health, East Africa

No abstract provided.

Understanding Rural Schools’ Capacity To Learn About Evidence-Based Practices That Promote Youth Mental Health: A Comparative Case Study, Savannah Hobbs, Elaine S. Belansky, Nick Cutforth, Cynthia Hazel

The Rural Educator

Amid growing student mental health concerns, numerous evidence-based practices (EBPs) exist to promote student mental health, but most rural schools do not have these practices in place. Little is known about the organizational capacity of rural schools to learn about and select youth mental health EBPs, or the role research intermediaries can play to support these processes. In this study, 11 middle school staff from three rural school districts participated in surveys and semi-structured interviews to provide information on how schools learn about and select mental health EBPs, related barriers and facilitators, and the role of intermediary support. A semi-structured …

Implementation Of A Zen Room And Mindfulness Techniques To Decrease Perceived Burnout, Danika Scott

Doctor of Nursing Practice Final Project Abstract

Purpose: The purpose of this quality improvement (QI) project was to implement a Zen room and mindfulness techniques, aiming to improve job satisfaction by 65% and reduce perceived burnout by 10% among behavioral health staff. The project was conducted at a substance abuse center in Deer Park, TX.

Background: Behavioral health staff face high levels of emotional exhaustion and job-related stress, leading to increased burnout.

Methodology: The Plan-Do-Study-Act model guided the QI methodology using a sample of 23 behavioral health staff. Interventions included an equipped Zen space and wellness resources. Data collection utilized the Maslach Burnout Inventory and a …

Issues That Ministers Identify As Factors Contributing To Anxiety And Depression, Heather Sawtelle

Doctor of Ministry (DMin)

Although mental health is an emerging topic within the church community, the stigmatization of mental illness within ministers’ lives can create a myriad of personal beliefs that can lead to shame and discontent in ministers’ lives. Many ministers have daily stressors that compromise their mental health, and these stressors can contribute to depression or anxiety. This study defined mental health issues and described mental illness’ influence on ministers’ lives and the factors that contribute to mental health issues. This health condition, described as mental illness, involves significant changes in thinking, emotion, behavior, distress, and problems functioning in social, work, or …

Βiv Spectrin Abundancy, Cellular Distribution And Sensitivity To Akt/Gsk3 Regulation In Schizophrenia, Jessica Di Re, Michela Marini, Syed Ibrar Hussain, Aditya K Singh, Akshaya Venkatesh, Musaad A Alshammari, Tahani K Alshammari, Abdul-Rizaq Ali Hamoud, Ali Sajid Imami, Zahra Haghighijoo, Nickolas Fularcyzk, Laura Stertz, Derek Hawes, Angela Mosebarger, Jordan Jernigan, Claire Chaljub, Ralda Nehme, Consuelo Walss-Bass, Anton Schulmann, Marquis P Vawter, Robert Mccullumsmith, Robert D Damoiseaux, Agenor Limon, Demetrio Labate, Michael F Wells, Fernanda Laezza

Faculty, Staff and Student Publications

Schizophrenia (SCZ) is a complex psychiatric disorder with unclear biological mechanisms. Spectrins, cytoskeletal proteins linked to neurodevelopmental disorders, are regulated by the AKT/GSK3 pathway, which is implicated in SCZ. However, the impact of SCZ-related dysregulation of this pathway on spectrin expression and distribution remains unexplored. Here, we show that βIV spectrin protein levels were reduced in neurons of the dorsolateral prefrontal cortex in SCZ postmortem samples compared to healthy control (HC) from the Human Brain Collection Core (HBCC). To investigate potential links between βIV spectrin and the AKT/GSK3 pathway, we analyzed the PsychEncode dataset, revealing elevated SPTBN4 and AKT2 mRNA …

Little Changes, Jessica Wolfe

HCA Healthcare Journal of Medicine

This collage is made of hundreds of small pieces of paper cut from old magazines and junk mail. As I worked on it, I thought about how each tiny piece of paper alters the canvas in a nearly imperceptible way, but the shapes and colors could shift completely in the course of an hour. This concept of making small changes is something I think a lot about in my work as a psychiatric nurse as well. Even though it doesn’t always feel like it, we become wiser each day. By looking for these small opportunities to evolve, we can build …

Breath Of Life, Cynthia Borum, Colleen Dowd, Meg Underwood, Shauna Graham, Terri Schmidt, Linda Myers

HCA Healthcare Journal of Medicine

We meet for friendship, laughter, and spending time together. Each person paints a 6 X 6 inch tile, some more competent than others. Each person comfortably shares their painting without judgment, and we are proud of what our bond produces. The output keeps us going with a refreshing breath of life. You see, we also work together every day in health care.

Unraveling The Threads: A Case Report On Confusional Migraine And The Intricate Dance Between Psychiatry And Neurology, Mabit C. Gonzalez, Manjula Kottapalli

HCA Healthcare Journal of Medicine

Background

Migraine affects about 1 billion people worldwide and is associated with a significant negative impact on personal and occupational functioning. Migraine accompanied by aura is seen in about 15% of migraineurs. Visual aura is the most common type of aura. Much less common though are auras that involve higher mental function, such as confusional state. The confusional state may manifest with a wide variety of cortical dysfunction, such as speech impairment, increased alertness, agitation, and amnesia, often lasting longer than a typical migraine aura.

Case Presentation

The authors present the unique case of a 29-year-old patient with episodic and …

"The Growing Burden: Overweight And Obesity Prevalence And Risk Factors Among Medical College Students In Mysuru: A Cross-Sectional Study", Akansha ., Nayanabai Shabadi, Anchu R Nath, Ravipati Manogna

Digital Journal of Clinical Medicine

ABSTRACT:

Background:

The transition from adolescence to adulthood is often accompanied by significant lifestyle changes, including changes in dietary habits, physical activity levels, and stress, which can contribute to unhealthy weight gain. In India, the prevalence of overweight and obesity among youth has shown an upward trend, raising concerns about early onset of non-communicable diseases. This study aims to assess the prevalence of overweight and obesity among degree college students in Mysuru and to identify the associated socio-demographic and lifestyle factors contributing to these conditions.

Methodology:

A cross-sectional study was conducted over three months, from January to March 2025, among …

Efektivitas Senam Hamil Dalam Mengurangi Tingkat Stres Dan Kecemasan Ibu Hamil Trimester Iii: Literature Review, Suyati Suwito, Dini Nur Alpiah

Jurnal Fisioterapi Terapan Indonesia

According to WHO (2020), around 10% of pregnant women experience depression and this condition is higher in developing countries, reaching 15.6% during pregnancy and 19.8% after giving birth. Anxiety experienced during pregnancy can have negative effects on both the mother and the fetus. These negative impacts are not only during pregnancy but can also affect the labor process and lactation period. There are various types of sports to reduce anxiety, one of which is gymnastics. This study aims to determine the effectiveness of pregnancy gymnastics in reducing stress and anxiety before childbirth. Literature review research was conducted using PICO search …

The Effect Of Computer-Mediated Communication On Occupational Positive Mental Health Mediated By Work-Family Enrichment In Workers In Remote Areas: Analysis Using Structural Equation Modelling, Herlando Junanta, Suryo Wibowo, Herqutanto ., Dewi Yunia Fitriani, Titis Mariyamah, Dewi Sumaryani Soemarko

Occupational and Environmental Medicine Journal of Indonesia

Objective: This study aims to examine the effect of computer-mediated communication (CMC) on occupational positive mental health (OPMH) mediated by work-family enrichment (WFE) in workers in remote areas using the CMC, OPMH-40, and WFE questionnaires. Method: The latent variables in this study are CMC, OPMH, and WFE. The observed variables include all items from CMC, OPMH, and WFE. The sample technique used was total sampling, revealing that 349 workers in the project department of an oil and gas company located in the West Papua Province of Indonesia expressed their willingness to participate as research participants. To test research hypotheses using …

Pengaruh Media Ceramah, Kipas Dan Poster Terhadap Peningkatan Pengetahuan Junk Food Pada Remaja Awal, Lulu' Luthfiya, Mufidatul Khoiriyah, Hafidhotun Nabawiyah, Kartika Pibriyanti, Ladya Mayu Pinasti

Perilaku dan Promosi Kesehatan: Indonesian Journal of Health Promotion and Behavior

Background. Consuming excess junk food lead to degenerative diseases and cause various nutritional problems. This is due to the lack of information regarding the dangers of junk food in teenagers from education media. Fan media and posters as a media intermediari for delivering information related to the dangers of junk food in adolescents.

Aim. This study conducted to determine the effect of educational media of lecturer fan and poster) on knowledge of junk food in adolescents.

Method. The study was conducted by quasi-experimental method with a pre-post test group design. Sample was 174 respondents that divided into …

Transforming Primary Care: Innovative Post Graduate Pa Training For Real-World Solutions, Kenneth Botelho, James Ali

Lynchburg Journal of Medical Science

The ongoing crisis in primary care demands innovative and scalable strategies to prepare and retain advanced practice providers. This article introduces the Primary Care Practitioner (PCP) Program, a conceptual postgraduate training model designed for certified physician associates/assistants (PAs) who aim to serve in underserved and rural communities. The program integrates advanced clinical training, leadership development, telehealth competencies, VR-enhanced simulation, and evidence-based strategies to promote provider resilience. Rooted in systems-based thinking and real-world applicability, the PCP Program culminates in capstone projects that encourage innovation in care delivery and population health.

Aligned with national frameworks such as the HRSA Primary Care Training …

Binge Eating Disorder: A Clinical Review, Michell Mcdiffett Mshs, Pa-C

Lynchburg Journal of Medical Science

Binge eating disorder (BED) is the most common eating disorder (ED) in the United States (U.S.) and is characterized by recurrent episodes of eating a larger than normal amount of food in a discrete period of time and includes a sense of loss of control over food intake. BED is often comorbid with serious somatic and psychiatric disorders and is associated with reduced quality of life and excess mortality. Some consider BED a public health concern due to frequent co-occurrence with obesity and worse outcomes in those populations. The diagnosis is often delayed due to shame and underreporting of symptoms …

Living Heritage, Resilience And Ethically Informed Infrastructures In Malawi, Martha B. Lerski, Frank Puluputu Mwale

Publications and Research

Rooted in a rural community’s needs, this paper explores how historically, and ethically informed infrastructures can support community engagement towards identification, documentation, and dissemination of local, traditional, and indigenous knowledge relating to climate change. The paper examines climate adaptation and sustainability issues through the lenses of community organizing and Library & Information Science best practices. It draws on a growing body of literature identifying a role for expanded epistemological and subject discipline perspectives. While the impacts of climate on material culture are increasingly recognized, intangible, and biocultural heritage have not received as much attention. Living heritage traditions and knowledge systems …

U.S. Young Adults’ Family-Building Intentions In The Event Of Infertility And Knowledge Of Associated Costs, Jean Marie Place, John Horowitz, Minh Nguyen, Maya Guinn, Brennan Peterson

Marriage and Family Therapy Faculty Articles and Research

Introduction: Infertility affects approximately 8.5% of married women in the United States, yet there is limited understanding of how young adults anticipate and prepare for potential barriers to biological parenthood. As reproductive planning increasingly intersects with social, medical, and financial considerations, it is important to examine how emerging adults perceive and approach family-building options. This study aims to explore college students' intentions regarding childbearing, their openness to non-traditional family-building methods, and their awareness of the associated financial costs.

Methods: A cross-sectional survey was administered to undergraduate students (mean age = 20) at a Midwestern public university. Most participants had not …

Senior Health (Age 65+) In The Mountain West, 2024, Taylor Volk, Kristian Thymianos, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet presents senior health care statistics for the Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah. The “2024 Senior Report – State Summaries,” study from America’s Health Rankings, United Foundation provided the data for all fifty states and Washington, D.C.

Gender Differences In Regretted Consensual Sexual Experiences And Problematic Alcohol Use Among First-Year College Students, Shannon Shen, Soyoung Kwon, Sukho Lee

Journal of Social, Behavioral, and Health Sciences

Regretted sexual behaviors and alcohol use often occur in tandem for college students; however, few studies have examined their interrelationships or the variance across gender. This study tested gender differences in how regretting a consensual sexual experience is related to college students’ alcohol use. One hundred and forty first-year students (63% women, 69% Hispanic) surveyed in 2018 and 2019 reported their sexual behavior and alcohol use (following the Rutgers Alcohol Problem Index [RAPI]). Twenty-one percent of men and 16% of women reported a regretted sexual encounter. Interaction effects from regression models revealed that men with sexual regret had a significantly …

Exploring Predictors Of Treatment Response To Glp-1 Receptor Agonists For Smoking Cessation, Luba Yammine, Constanza De Dios, Robert Suchting, Charles E Green, David A Nielsen, Consuelo Walss-Bass, Joy M Schmitz

Faculty, Staff and Student Publications

Introduction: Understanding predictors of smoking cessation medication efficacy facilitates the ability to enhance treatment effectiveness. In our pilot trial, exenatide, a glucagon-like peptide-1 receptor agonist, adjunct to nicotine patch improved smoking abstinence compared to nicotine patch alone. This secondary analysis explores potential baseline characteristics associated with differential treatment response to exenatide.

Aims and methods: The parent trial randomized (1:1) 84 smokers with prediabetes and/or overweight to once-weekly placebo or exenatide, 2 mg, subcutaneously. All participants received nicotine patch (21 mg) and brief smoking cessation counseling, with biologically confirmed 7-day point prevalence abstinence at week 6 (end-of-treatment) deemed the primary outcome. …

Potential Effect Of Statins As Adjuvant Anti‑Tuberculosis Agents: A Short Communication, Mehwish Hanif, Ayesha Tariq, Laiba Zahoor

Digital Journal of Clinical Medicine

Tuberculosis is a chronic pulmonary infectious disease caused by Mycobacterium tuberculosis and can affect other parts of the body such as bones, brain, and lymph nodes (extra pulmonary Tb). Statins, primarily used for hyperlipidemia, have demonstrated anti-inflammatory and immunomodulatory properties that may help prevent and manage TB. They inhibit HMG-CoA reductase, reduce cholesterol synthesis and interfere with phagocytosis crucial for TB infection. Given the rise in resistance to first-line anti-tubercular therapies, Statins have shown promise as adjunctive agents by potentially shortening treatment duration, reducing adverse effects, and improving outcomes, particularly in immunocompromised and diabetic patients. Based on these findings, Statins …

Multi-Ancestry Genome-Wide Association Analyses Incorporating Snp-By-Psychosocial Interactions Identify Novel Loci For Serum Lipids, Amy R Bentley, Michael R Brown, Solomon K Musani, Karen L Schwander, Thomas W Winkler, Mario Sims, Tuomas O Kilpeläinen, Hugues Aschard, Traci M Bartz, Lawrence F Bielak, Jin-Fang Chai, Kumaraswamy Naidu Chitrala, Nora Franceschini, Mariaelisa Graff, Xiuqing Guo, Fernando P Hartwig, Andrea R V R Horimoto, Elise Lim, Yongmei Liu, Alisa K Manning, Ilja M Nolte, Raymond Noordam, Melissa A Richard, Albert V Smith, Yun Ju Sung, Dina Vojinovic, Rujia Wang, Yujie Wang, Mary F Feitosa, Sarah E Harris, Leo-Pekka Lyytikäinen, Giorgio Pistis, Rainer Rauramaa, Peter J Van Der Most, Erin Ware, Stefan Weiss, Wanqing Wen, Lisa R Yanek, Dan E Arking, Donna K Arnett, Christie Ballantyne, Eric Boerwinkle, Yii-Der Ida Chen, Martha L Daviglus, Lisa De Las Fuentes, Paul S De Vries, Joseph A C Delaney, Amanda M Fretts, Lynette Ekunwe, Jessica D Faul, Linda C Gallo, Sami Heikkinen, Georg Homuth, M Arfan Ikram, Carmen R Isasi, Jost Bruno Jonas, Liisa Keltikangas-Järvinen, Pirjo Komulainen, Aldi T Kraja, Jose E Krieger, Lenore Launer, Lifelines Cohort Study, Jianjun Liu, Kurt Lohman, Annemarie I Luik, Ani W Manichaikul, Pedro Marques-Vidal, Yuri Milaneschi, Stanford E Mwasongwe, Jeffrey R O'Connell, Kenneth Rice, Stephen S Rich, Pamela J Schreiner, Lars Schwettmann, James M Shikany, Xiao-Ou Shu, Jennifer A Smith, Harold Snieder, Nona Sotoodehnia, E Shyong Tai, Kent D Taylor, Lesley Tinker, Michael Y Tsai, André G Uitterlinden, Cornelia M Van Duijn, Diana Van Heemst, Melanie Waldenberger, Robert B Wallace, Hwee-Lin Wee, David R Weir, Wen-Bin Wei, Ko Willems Van Dijk, Gregory Wilson, Jie Yao, Kristin L Young, Xiaoyu Zhang, Wei Zhao, Xiaofeng Zhu, Alan B Zonderman, Ian J Deary, Christian Gieger, Hans Jörgen Grabe, Timo A Lakka, Terho Lehtimäki, Albertine J Oldehinkel, Martin Preisig, Ya-Xing Wang, Wei Zheng, Michele K Evans, Michael Province, James Gauderman, Vilmundur Gudnason, Catharina A Hartman, Bernardo L Horta, Sharon L R Kardia, Charles Kooperberg, Ching-Ti Liu, Dennis O Mook-Kanamori, Brenda Wjh Penninx, Alexandre C Pereira, Patricia A Peyser, Bruce M Psaty, Jerome I Rotter, Xueling Sim, Kari E North, Dabeeru C Rao, Laura Bierut, Clint L Miller, Alanna C Morrison, Charles N Rotimi, Myriam Fornage, Ervin R Fox

Faculty, Staff and Student Publications

Serum lipid levels, which are influenced by both genetic and environmental factors, are key determinants of cardiometabolic health and are influenced by both genetic and environmental factors. Improving our understanding of their underlying biological mechanisms can have important public health and therapeutic implications. Although psychosocial factors, including depression, anxiety, and perceived social support, are associated with serum lipid levels, it is unknown if they modify the effect of genetic loci that influence lipids. We conducted a genome-wide gene-by-psychosocial factor interaction (G×Psy) study in up to 133,157 individuals to evaluate if G×Psy influences serum lipid levels. We conducted a two-stage meta-analysis …

Adapting And Evaluating A Positive Psychology Intervention For Children With Cancer And Their Families, Camryn Legra

USF Tampa Graduate Theses and Dissertations

This study utilized a mixed methods approach in two phases. The first phase entailed adapting an evidence-based positive psychology intervention—the Well-Being Promotion Program (WBPP; Suldo, 2016)— for children with pediatric cancer. The WBPP has mostly been provided to students at public schools, and to the researcher’s knowledge, has never been used for children with pediatric cancer. To make it culturally appropriate for this group of students, adaptations were made by collecting input and recommendations from a sample of two caregivers of children with pediatric cancer who participated in a focus group. A micro-interlocutor analysis (Onwuegbuzie et al., 2009) was completed …

Exploring The Association Between Self-Esteem And Blood Pressure: A Cross-Sectional And Longitudinal Investigation, Bijou C. Allard, Julia K. Boehm

Psychology Faculty Articles and Research

High self-esteem is linked to favorable outcomes including better mental health and relationships, however, its impact on cardiovascular health is less understood. This study examined the relationship between self-esteem and blood pressure levels using data from the Midlife in the United States (MIDUS) study (M_age = 54.53; 57% women; 20% non-White). We hypothesized that higher self-esteem would be associated with lower systolic and diastolic blood pressure concurrently and 10 years later. Self-esteem was measured with the Rosenberg Self-Esteem Scale, and blood pressure was clinically assessed. Cross-sectional analyses included 1194 participants; longitudinal analyses included 566 participants. Contrary to expectations, …

The Social Standing Versus The Mind Standing Of Older Adults In Egypt: Cross-Sectional Analysis Of The Relationship Between Social Capital And Cognitive Functions, Shaza H. Shinaishen Dr

Theses and Dissertations

Introduction: Egypt's population, much like that of other countries, is expected to age considerably over the course of the coming decades. Although biological and socioeconomic predictors of cognitive function have been studied widely, personal level social capital remains unexplored, especially in LMICs.

Purpose: This study primarily investigates the relationship between individual social capital and cognitive functioning among older adults aged 65 years and older in Egypt using the structural and cognitive components of social capital, including group membership, civic engagements, and caregiving roles.

Methods: A cross-sectional survey on 363 older individuals in different geographical and demographic segments of Egypt using …

Perceived Neighborhood Crime And Gun Carrying Behavior: Examining The Role Of A History Of Traumatic Brain Injury, Eric J Connolly, Anne C Wingert, Dennis E Reidy, Jarrad D Hodge, Jeff R Temple

Faculty, Staff and Student Publications

Background: Individuals living in high crime neighborhoods are more likely to carry a firearm. Members of these communities are also more likely to experience a traumatic brain injury (TBI) in their lifetime, which is a common correlate of hypervigilance and aggression. The current study evaluates the independent and interactive effects of TBI on perceived levels of neighborhood crime and gun carrying.

Methods: Data from 2015 to 2017 from a longitudinal ethnically diverse sample of adolescents and young adults are analyzed (Ns = 600-734). Multivariate logistic regression models are estimated to evaluate associations between perceived levels of neighborhood crime, TBI, gun …

Increasing Behavior-Specific Praise Use And Variability With Secondary Education Teachers Using Behavioral Skills Training, Tactile Prompts, And Multiple Exemplars, Cecilia Pannone

USF Tampa Graduate Theses and Dissertations

Teachers often receive minimal training in classroom management strategies, leading to punitive-based teacher-student interactions. Negative interactions (e.g., reprimands) may decrease behaviors momentarily but do not yield lasting behavior change. Behavior-specific praise (BSP) is a low-response effort classroom management strategy that positively impacts students’ behaviors and academic performance. However, training does not guarantee that BSP will be used throughout the academic years or across student cohorts, leading teachers to revert to negative interactions to manage classroom behaviors. Limited research has investigated the components of praise that increase effectiveness and saliency. This study aimed to increase teachers’ use of BSP using tactile …

The Role Of Neuroscience In Mental Health Management Within The Adhd Population, Kadi Rae Smith

University Honors Theses

Neuroscience-based educational interventions play a role in the management of Attention Deficit Hyperactive Disorder (ADHD), including the regulation of ADHD-correlated depression and anxiety. Existing research shows that elevated rates of depression correspond to anxiety within the ADHD community; approximately 8.83% of the global population. Social ostracization and isolation are established contributors to depression and anxiety which are commonly comorbid with ADHD. The need exists for further investigation of the beneficial impact that an accurate, biological understanding of how the brain works has on the mental health of the ADHD population, and by extension their families, education systems, and medical industries. …

Urban-Rural Divide In Inequality’S Impact On Substance Abuse, Jonathan E. Flores

Undergraduate Theses, Capstones, and Recitals

This thesis focuses on investigating the relationship between income inequality, measured through the Gini coefficient, and drug addiction, proxied through substance-related mortality. Specifically, this thesis focuses on how these dynamics vary across rural and urban counties in the United States, using population size as a proxy. County-level data from 2016 to 2020 were collected through both the CDC and the Census Bureau and subsequently analyzed using Stata, with crude death rates from drug and alcohol causes serving as a function of the Gini coefficient, labor force participation, racial composition, and other socioeconomic indicators. Through a quadratic version of the model, …