Population Health Commons^™

Race And Ethnicity And Overall Survival In Pediatric Acute Myeloid Leukemia, Daniel J. Zheng, Long Khuong, Catherine Aftandilian, Kira Bona, Emi H. Caywood, Caitlin W. Elgarten, Brian T. Fisher, Cody-Aaron L. Gathers, Taumoha Ghosh, M. Monica Gramatges, Gary Hettinger, Meret R. Henry, Yuan-Shung V Huang, Yimei Li, Kelly Maloney, Amir Mian, Tamara P Miller, Arunkumar Modi, Rajen Mody, Regina M. Myers, Haley Newman, Jose Ortiz, Alix E. Seif, Caroline Smith, Jamie Stokke, Naomi Winick, Jennifer J. Wilkes, Victor Wong, Richard Aplenc, Kelly D. Getz

Department of Pediatrics Faculty Papers

IMPORTANCE: Hispanic and non-Hispanic Black (hereafter, Black) children with acute myeloid leukemia (AML) have historically experienced worse survival outcomes compared with non-Hispanic White (hereafter, White) children. Understanding specific intermediate pathways underlying these outcome disparities is a critical step to directing interventional efforts and resources.

OBJECTIVE: To compare survival outcomes by race and ethnicity in a large contemporary cohort of pediatric patients with AML and to examine presentation acuity, frontline organ toxic effects, and relapse as potential mediators of any observed outcome disparities.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study was analyzed from April 2025 to January 2026 and included …

Rural/Urban Disparities In Utilization Of Diabetes Self-Management Training (Dsmt) To The Fee-For-Service Medicare Population, 2017–2024, Wanying Zhu, Aleksandr Taraskin, Jeffrerey Talbert

Rural & Underserved Health Research Center Publications

Key Report Highlights

• A significant rural DSMT access gap exists. Rural beneficiaries accounted for 20.1% of Medicare beneficiaries with diabetes but only 7.8% of DSMT participants.

• Geographic availability remains limited. Only 16.8% of counties with DSMT utilization were rural.

• Access, not demand, appears to be the primary challenge. Rural counties offering DSMT achieved utilization rates more than twice those observed in urban counties (6.0% vs. 2.5%).

• Expanding rural DSMT capacity may represent a high-impact opportunity to improve diabetes self-management support among underserved Medicare beneficiaries.

Non-Metropolitan Vs. Metropolitan Variations In Alcohol, Illicit Drug, And Prescription Therapeutic Drug Misuse, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Key Findings

Alcohol Use. The prevalence of past year and past 30-day drinking was lower among non-metropolitan (non-metro) than metropolitan (metro) residents. However, non-metro drinkers engaged in more frequent binge drinking than metro drinkers. Drinking 3-5, 6-19, and 20-30 days over the past 30 days were higher among non-metro than metro residents.

Illicit Drug Use. Hallucinogens were the mostly commonly used illicit drugs among non-metro as well as metro residents. Methamphetamine use was significantly higher among non-metro than metro residents.

Prescription Pain Reliever Use. The misuse of prescription pain killers, primarily prescription opioids, was higher among non-metro than …

A Longitudinal Multi‑Proxy Geospatial Classification Of Peri‑Urban Transitions Across Community Health Units In Coastal Kenya, Prissy Makena, Felix Oluoch, Rosebella Iseme, Fredrick Gudda, Alfred Keter, Jai Das, Zulfiqar Bhutta, Anthony Ngugi

Population Health, East Africa

Background Urbanization is spatially heterogeneous in many sub-Saharan African settings. This complicates community health planning when rural and peri-urban labels are applied informally or updated inconsistently. We assessed whether multiple publicly available geospatial proxies could characterize settlement dynamics and support Community Health Unit (CHU) level classification within the Kaloleni Rabai Health and Demographic Surveillance System (KRHDSS) in coastal Kenya.

Methods We conducted a longitudinal ecological analysis across 10 CHUs in Kilifi County with annual observations from 2017 to 2024. Five geospatial proxy indicators of settlement intensity were summarized within CHU boundaries: Visible Infrared Imaging Radiometer Suite (VIIRS) nighttime lights radiance, …

Environmental Exposure Risk Education To Enhance Chronic Kidney Disease Prevention And Screening For Nurse Practitioners, Kelsea J. Carrier

Doctor of Nursing Practice Posters and Presentations

Chronic kidney disease (CKD) affects approximately 36 million adults in the United States, with nearly 90% of individuals unaware of their diagnosis until advanced stages. While diabetes and hypertension remain the primary causes, increasing evidence highlights environmental exposures as significant and underrecognized contributors to CKD onset and progression. Exposures such as heavy metals, per- and polyfluoroalkyl substances (PFAS), air and water pollution, microplastics, and heat exposure have been linked to impaired renal function. Despite this growing body of evidence, environmental health content remains limited in nursing education, resulting in gaps in environmental health literacy (EHL) among nurse practitioners (NPs) and …

Fertility And Birth Rates In The Mountain West, 2024, Sydney Mitchell, Maisoon Faris, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet reports 2024 data on the overall birth rate and birth-related health measures in the five Mountain West states of Arizona, Colorado, New Mexico, Nevada, and Utah using data from the Centers for Disease Control and Prevention (CDC) website. This fact sheet includes information from the National Center for Health Statistics, “Statistics by State” subsection related to birth. This subsection focuses on fertility rates, teen birth rates, infant mortality rates, births to unmarried mothers, cesarean deliveries, pre-term births, and infants with low birth weight.

Leveraging Health Information Exchange (Hie) Data To Demonstrate The Impact On Health Outcomes Of Community Based Organization Interventions: Case Studies Of Housing Placement And Medically Tailored Meal Program, Kevin Kramer, Harm Scherpbier, William Marella

College of Population Health Faculty Papers

Objective

Methods

Community-Based Tuberculosis Screening With Computer-Aided Detection Technology Alone And In Combination With Point-Of-Care C-Reactive Protein Testing: A Paired Screen-Positive Trial, Klaus Reither, Fiona Vanobberghen, Anna Verjans, Harsh Harkare, Bart Jacobs, Alastair Heerden, Shriya Misra, Fabrizio Tedios, Curdin Brugger, Alfred Keter

Population Health, East Africa

Background Active tuberculosis case-finding in communities is crucial for early disease detection and disruption of transmission; however, it is complex and costly. A thorough analysis of tuberculosis screening strategies is essential, particularly because the health systems affected often have limited resources. We aimed to compare two community screening approaches in terms of tuberculosis case yield and cost.

Methods This pragmatic community trial, with a paired screen-positive design (ie, within-person comparison), was conducted in the Butha-Buthe District in Lesotho and the uMgungundlovu District in South Africa. All household members aged at least 18 years were eligible to participate, except those who …

Persistent Gaps In Management And Risk Factor Control Among Patients With Atherosclerotic Cardiovascular Disease: All Of Us Research Program, Yakubu Bene-Alhasan, Soad Al Osta, Yussif Issaka, Isaac Acquah, Ahmad Alkhatib, Leen Othman, Samuel Mensah, Ato Howard, Christie Ballantyne, Salim S. Virani

Population Health, East Africa

Background

Methods

U.S. Cardiovascular Mortality Before And During Covid-19: Cdc Wonder Vs Gbd Comparison, Mirza Ali Baig, Muhammad Umar, Carol Becker, Salim S. Virani, Dmitry Abramov, Xiaoming Jia, Abdul Minhas

Population Health, East Africa

No abstract provided.

New-Onset Cognitive Impairment After Delirium Among Hospitalised Older Ghanaians: A Pilot Study, John-Paul Omuojine, Richard Dei-Asamoa, Caleb Otu-Ansah, Gertrude Aboah, Belinda Opoku, George Amponsah, Stella Afeti, Leah Ratner, Ruth Owusu-Antwi, Cyprian Mostert

Population Health, East Africa

Background Delirium is a potentially modifiable risk factor for dementia. However, post-delirium cognition has hardly been studied in Africa, where the burden of both disorders is rising disproportionately.

Objective We estimated the incidence of new-onset cognitive impairment (NCI) 6 months after hospitalisation with non-stroke delirium among older Ghanaians.

Methods This was a prospective observational pilot study conducted among 60 previously cognitively unimpaired (retrospective proxy assessment) adults aged ≥60 years, hospitalised with non-stroke prevalent delirium in a Tertiary Hospital. Delirium was confirmed and rated using the Confusion Assessment Method (CAM) and Severity Scale (CAM-S) within 24–72 hours of admission and reassessed …

Disability Rates Among South Asian Immigrants In The U.S. Vary By Country Of Origin, Sobia Mushtaq, Marc A. Garcia

Population Health Research Brief Series

South Asian immigrants are often grouped together in U.S. health data, masking significant differences in health outcomes across subgroups. This brief uses data from the American Community Survey (ACS) 5-Year Public Use Microdata Sample (N = 6,643,738; 2020–2024) to describe disability rates among foreign-born adults from India, Pakistan, and Bangladesh residing in the U.S. The authors find that while South Asian immigrants as a group have lower disability rates than U.S.-born adults, this average is driven largely by Indian immigrants, who make up about 79% of South Asians in the U.S. Among adults aged 65 and older, Bangladeshi immigrants have …

When School Culture Excludes: Deficit Discourse, Microaggressions, And The Mental Health Of Marginalized Students – A Conceptual Framework With Implications For School Psychology Practice And Equity Policy, Modupe Mercy Oyewunmi

Publications

Deficit-laden language like ‘behavior problem,’ ‘not college material,’ ‘won’t fit in’, ‘not a cultural fit’, operates as a systemic form of implicit bias and microaggression in school settings. Despite decades of research on school belonging and well-being, school psychology has yet to integrate these exclusionary discursive practices into a coherent health-determinant model that also accounts for the current anti-diversity, equity, and inclusion (DEI) policy environment. This conceptual paper proposes a testable framework linking deficit discourse and school-based microaggressions to student identity suppression, academic impostor phenomenon, and educator moral injury, with downstream effects on school mental health outcomes. We situate these …

Ambulatory Blood Pressure Monitoring Phenotypes And Circadian Blood Pressure Patterns Among Adults Referred For Diagnostic Evaluation At Aga Khan University Hospital, Nairobi, Kenya: A Retrospective Cross-Sectional Study, Nadeem Kassam, Mzee Ngunga, James Orwa, Alisa Bhojani, Mohamed Varwani, Swaffiya Salim, Yvonne Oketch, Salim Surani, Anthony Ochola, Barbara Karau, Jeilan Mohamed, Etienne Amendezo

Internal Medicine, East Africa

Introduction: hypertension represents the primary modifiable risk factor for cardiovascular disease and poses a public health challenge in sub-Saharan regions, with Kenya experiencing particularly low detection and control rates. Traditional office-based blood pressure measurements often fail to detect key phenotypes, such as white-coat and masked hypertension. Ambulatory Blood Pressure Monitoring (ABPM) offers a comprehensive 24-hour profile that excludes white-coat hypertension and allows for the evaluation of circadian patterns, including nocturnal hypertension and non-dipping status, both of which are recognized as high-risk phenotypes strongly linked to adverse cardiovascular events. This study evaluated ABPM data from Aga Khan University Hospital, Nairobi …

Socioeconomic Inequalities In Health-Related Quality Of Life During The Covid-19 Pandemic: A Six-Country Comparison Using The Eq-5d-5 L, Joëlle Eijkens, Joshua M. Bonsel, You-Shan Feng, M. F. Bas Janssen, Erica I. Lubetkin, Juanita A. Haagsma

Publications and Research

Purpose

Despite the growing attention to health inequalities, there is no global consensus on how to measure socio-economic status. This study examined inequalities in health-related quality of life (HRQoL) during the early phase of the COVID-19 pandemic across six countries—China, Italy, the Netherlands, Sweden, the United Kingdom (UK), and the United States (US)—using three SES indicators: education level, income, and work status.

Methods

Between April and June 2020, individuals aged 18–75 years old completed a web-based survey. HRQoL was measured using the EQ-5D-5L Level Sum Score (LSS), where higher scores indicate poorer health. Country-specific differences in LSS across SES groups …

Structured Telehealth Community Health Worker-Clinician Feedback And Diabetes Outcomes: A Randomized Clinical Trial, Elizabeth Vaughan, Xiaoying Yu, Amber Amspoker, Aanand Naik, Ashok Balasubramanyam, Craig Johnston, Christi Ballantyne, Salim S. Virani, Shelton Brown, Kristina Mena

Population Health, East Africa

Importance  Community health workers (CHWs) improve chronic disease management in underserved populations, but scalable integration strategies are limited.

Objective  To evaluate whether a multidimensional intervention incorporating telementored CHWs and a structured participant-CHW-clinician feedback loop can improve diabetes outcomes.

Design, Setting, and Participants  This 12-month randomized clinical trial was conducted at 3 institutionally and geographically diverse community clinics in Texas between September 1, 2023, and April 30, 2025, and included low-income, uninsured White Hispanic adults with type 2 diabetes identified through clinic databases. Data were analyzed between May 1 and July 31, 2025.

Intervention  Individuals were randomized 1:1 to the intervention …

Assessing Aflatoxin Knowledge, Perceptions, And Related Practices, In A Rural Coastal Community: A Population-Based Cross-Sectional Survey, Rosebella Iseme, Joseph Abuodha, Anthony Ngugi, Innocent Abayo, Mansoor Saleh

Population Health, East Africa

Background

Aflatoxin contamination is a significant yet under-addressed food safety challenge in low-resource settings, driven by a complex interplay of environmental, agricultural, and socio-economic factors. Limited access to agricultural inputs, inadequate post-harvest handling and storage, and weak regulatory enforcement alongside food scarcity and climate change heighten the risk of contamination and exposure. Human exposure is associated with serious health consequences, including hepatocellular carcinoma, immune suppression, and childhood stunting. Although aflatoxin is increasingly recognized as a global food safety concern, little is known about community-level knowledge, risk perceptions, and preventive practices. This study examined household heads’ awareness, perceptions, and behaviours related …

Satellite-Derived Longitudinal Evidence Of Flood Effects On Community Water And Sanitation Resilience In Coastal Kenya, Felix Oluoch, Rosebella Iseme, Fredrick Gudda, Alfred Keter, Rachel Odhiambo, Jai Das, Zulfiqar Bhutta, Anthony Ngugi

Population Health, East Africa

Background Flooding can disrupt water, sanitation and hygiene services in low-income rural and peri-urban settings, yet there is limited quantitative evidence on how repeated flood exposure affects safe water and sanitation over time at the level of Community Health Units (CHUs), which are the operational units for primary health care in Kenya.

Methods We analysed repeated CHU-level data from ten Community Health Units in Kilifi County, Kenya, across eleven surveillance rounds from 2017 to 2024. For each round, we calculated the percentage of households with safe drinking water and with access to a functional latrine, and linked these outcomes to …

Feasibility And Acceptability Of A Mobile App And Wearable Device For Collecting Mental Health Survey And Passively Sensed Data Among Health Care Workers In Kenya: Mixed Methods Pilot Study, Linda Khakali, Andrew Aballa, Dorcas G. Mwigereri, Willie Njoroge, Rachel Maina, Amos Bunde, Peris Musitia, Moses Nyongesa, James Orwa, Jasmit Shah, Anthony Ngugi, Lukoye Atwoli, Amina Abubakar, Zul Merali

Brain and Mind Institute

Background: Mobile apps and wearable devices may help to facilitate early detection of mental health conditions by providing objective, real-time data to supplement other forms of feedback and diagnoses. Few studies have investigated the acceptability and feasibility of using a mobile app to track survey- and wearable-based data in mental health research in Sub-Saharan Africa.

Objective: This pilot study evaluated the feasibility and acceptability of using a mobile app and wearables to capture mental health–based survey data and passively sensed data among Kenyan health care workers.

Methods: A mixed methods study was conducted among health care workers …

Extending The Global Impact Of Dnp Education: Integrating Scholarly Dissemination And International Practice Projects, Cynthia Plonien, Pricilla Muisyo, Deborah Behan, Kristine Cope, Cathy Brown

Nursing Faculty Publications & Presentations

The Doctor of Nursing Practice (DNP) Program at the University of Texas at Arlington initiated a global outreach effort in 2024 through two complementary strategies: expansion of a digital repository to support dissemination of DNP scholarly work and implementation of pilot DNP projects in Kenya. Together, these initiatives represent an integrated model for global engagement that combines knowledge dissemination with application of practice-based scholarship. The repository has facilitated international access to DNP projects, demonstrating significant global reach across multiple countries. Concurrently, a pilot project in Kenya was established through a strategic in-country professional partnership, enabling culturally relevant and sustainable implementation …

Internalized Homophobia As An Influence On Participation In Hiv Prevention Among Young Men Who Have Sex With Men (Ymsm), Kasey I. Brazee

Honors Scholar Theses

Stigma is a known barrier to accessing preventative services for human immunodeficiency virus (HIV), however, the types of stigmas involved in this relationship remain not well defined. Homophobia, or negative attitudes directed towards homosexuality, is a particularly important type of stigma considering the disproportionate effect of HIV on men who have sex with men (MSM). Young MSM (YMSM) are especially impacted, making them a key population in the context of HIV prevention research.  Internalized homophobia, which refers to homophobia that one directs towards themselves, is under researched regarding its role in participating in HIV prevention. In this study, we aimed …

Five Corridors: A Community Health Needs Assessment Of Horry County, Stephen Borders, Hayley Bilko, Molly Craig, Olivia Guthrie, Ashley Mcconnell, Emily Mcgowan, Anna Quick, Abigail Rike, Makayla Wilson

Public Health

This report presents a Community Health Needs Assessment (CHNA) of Horry County, South Carolina. Its central analytical contribution is a five-corridor framework derived from k-means cluster analysis of the county's 76 residential census tracts, drawing on social and economic indicators from the American Community Survey and health estimates from the CDC PLACES program. The analysis organizes the county into five distinct community types — Affluent Coastal Retirement, Moderate Coastal Retirement, Inland Rural/Suburban Transitional, Concentrated Disadvantage, and Hispanic Hospitality Worker — each with a characteristic profile of social and health conditions.

Within this framework, the assessment examines a range of social …

Associations Between Father–Mother Food Parenting Practices And Children’S Dietary Intake, Brian K. Lo, Natalie Grafft, Mariane Helen De Oliveira, Sebastien Haneuse, In Young Park, Alejandra Cantu-Aldana, Katherine W. Bauer, Rebekah Levine Coley, Jorge E. Chavarro, Kirsten K. Davison, Jess Haines

Human Genetics Publications

Objective: To examine whether the number of parents using high levels of structure or coercive control food parenting practices is associated with children’s dietary intake.

Design: Cross-sectional analysis of father–mother dyads from the Fathers & Families cohort study. Fathers and mothers independently reported their food parenting practices and child’s dietary intake. Multivariate logistic regression models estimated associations between the number of parents (0, 1 or 2) using high structure or coercive control practices and children’s intake of fruit, vegetables, fast food and sugar-sweetened beverages (SSB), adjusting for demographics and recruitment site.

Setting: United States

Participants: 474 father–mother dyads with a …

Bio 340 Final Project: Rural Population Structure And Food Production Interact To Shape Global Undernourishment, Ava Ripanti

Biology Student Scholarship

Ava Ripanti - Environmental Biology '27

Undernourishment remains a major global public health challenge, reflecting the proportion of a population lacking sufficient dietary energy intake. While food availability is central to food security, undernourishment is also shaped by structural and socioeconomic factors such as population distribution and access to resources. Although rural populations are closely tied to agriculture, they often experience higher food insecurity due to limited infrastructure, market access, and healthcare. Prior research emphasizes that broader determinants, particularly inequality and development, are stronger predictors of undernourishment than agricultural output alone, that food insecurity exists in both rural and urban …

Participant Recruitment, Baseline Characteristics And Burden Of Cardiometabolic Risk Markers Among Adults With Prediabetes In Kenya: Insights From The Fermented Foods And Prediabetes Study, Rosebella Iseme, Alex Muia, Jacob Shabani, Samuel Mucheru, Catherine Gathu, Eliphas Gitonga, Redempta Mutisya, Peter Kioko, Jalal Safipour, Cornelia Witthöft

Population Health, East Africa

Aims

Methods

Results …

Rhode Island Right To Life: Veritas Grant Funded Internship Summer 2025, Ekaterina Rau

Biology Student Scholarship

No abstract provided.

Overcoming Challenges With Rural-Related Health Data: Lessons Learned From Published Studies, Casey P. Balio, Margaret M. Francisco, Nicole Galler, Olivia A. Sullivan, Kate E. Beatty, Michael E. Meit, Chyanne Morrison, Christiana Keinath, Stephanie M. Mathis

ETSU/NORC Rural Health Research Center Policy Briefs

No abstract provided.

Disseminated Tuberculosis Presenting With A Nodo-Colonic Fistula In A Newly Diagnosed Hiv-Positive Patient: A Case Report From Tanzania, Samina Somji, Salim Surani, Joshua Ngimbwa, Tevin Kahwa, Frank Swai, Fatema Tayabali, Bishoy Rofaeil

Population Health, East Africa

We present the case of a 35-year-old male with no known comorbidities who presented with chronic gastrointestinal (GI) and constitutional symptoms and was empirically treated with several antibiotics during multiple clinic visits at different health facilities. The laboratory test sent included a stool GeneXpert, which was positive for Mycobacterium tuberculosis (MTB). CT imaging revealed multiple necrotic abdominal and retroperitoneal lymph nodes, hypoenhancing splenic lesions, a nodo-colonic fistula between the necrotic retroperitoneal lymph nodes and the adjacent colon, and a mild left-sided pleural effusion. Colonoscopy demonstrated caseating discharge from the fistulous tract 40 cm from the anal verge, and histology showed …

Burden Of Cardiovascular Disease In Pakistan – Insight From Global Burden Of Disease Study 2019, Ali Bin Jabbar, Taha Mansoor, Sana Sheikh, Tazeen Jafar, Sawera Hanif, Christian Razo, Mahboob Alam, Jamal Rana, Khurram Nasir, Salim Virani

Population Health, East Africa

Background Pakistan, currently the fifth-largest country by population globally, has experienced a population increase of over 100% since 1990. It is facing an escalating challenge from cardiovascular diseases (CVD). The Global Burden of Disease (GBD) 2019 study provides an in-depth evaluation of Pakistan's health situation since 1990, offering essential insights into the nation's overall health conditions.

Methods The data were obtained from the Global Burden of Disease Study 2019, which provides records for global, regional, and national burden of diseases. Specifically, data regarding CVD and its subtypes, morbidity, and mortality in Pakistan and globally from 1990 to 2019 were used …

Development And Validation Of The Emergency Department Transitions Measure, Sara Beachy, Danielle M. Mccarthy, Julianna Lenoir, Alexzandra Gentsch, Richard W. Hass, Marissa Witmer, Paula Ostroff, Melissa Tupas, Lindsey Shughart, Hailey Shughart, Kristin L. Rising

Jefferson Center for Connected Care Faculty Papers

BACKGROUND: Transitions of care are high-risk periods for patient safety in the emergency department (ED), particularly for patients who are still in the diagnostic process and are discharged with diagnostic uncertainty. Care transitions must be improved for these patients, as one third of discharged ED patients have diagnostic uncertainty. Yet there are no validated measures that assess the quality of care transitions from the ED, limiting the ability to assess the impact of interventions. Thus, we developed and validated the ED Transitions (EDT) measure.

METHODS: This mixed methods study was conducted across a large healthcare system in three phases: item …