Rural Health Commons^™

Environmental Predictors Of Human Lyme Disease Incidence Across Appalachian Counties In Kentucky, Virginia, And West Virginia, 2000-2019, Karlie D. Rennison

Theses and Dissertations--Epidemiology and Biostatistics

This ecological study examined county-level environmental, landscape, and host-related predictors of Lyme disease incidence across Kentucky, Virginia, and West Virginia from 2000-2019. Lyme disease is an emerging public health concern in the Appalachian region, where geographic expansion and shifting ecological conditions may influence disease risk.

Lyme disease case rates (per 10,000 population) were analyzed in relation to climate variables, land cover metrics, host density measures, and rurality using publicly available data sources. Descriptive and regression analyses were conducted to evaluate associations between candidate predictors and disease incidence.

Substantial geographic variation in Lyme disease incidence was observed, with higher case rates …

Facilitating Shared Reading Exposure To Promote Health Outcomes In A Rural Pediatric Primary Care Clinic, Meredith L. Longino

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this scholarly project was to address a gap in early literacy promotion for rural children by incorporating the Reach Out and Read program. This program bolsters foundational literacy by providing a book and anticipatory guidance at every well-child visit from birth through age 5. This project was expected to decrease no-show well-child attendance rates and improve provider morale.

Background

The project was implemented in an established rural pediatric primary care clinic in Northeast Texas. 

Methodology

Process implementation was measured through books distributed and EHR documentation of the intervention. Process objectives were measured by no-show rates for …

Promoting Maternal And Infant Health In Franklin County, Ky: A Community-Based Physical Activity And Education Intervention, Subin Kim

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Maternal and infant health outcomes are key indicators of population health, yet persistent disparities exist in rural communities across the United States. In Kentucky, Franklin County reflects this pattern, with concerning maternal and infant health indicators despite relatively favorable socioeconomic conditions. Identified challenges include elevated rates of poor physical and mental health days, high drug overdose mortality, provider shortages, and ongoing reproductive health concerns such as tobacco use during pregnancy and increased infant mortality associated with elevated maternal body mass index.

To address these gaps, a three-pronged, community-based prenatal and postpartum physical activity and education program is proposed. The program …

The Effect Of The Affordable Care Act Medicaid Expansion On The Risk Of Hospital Closure And Adolescent Hpv Immunization In Rural Counties, Juliette Des Rosiers

Scripps Senior Theses

From 2005 to 2025, over 200 rural hospitals shut their doors, often citing increased operational costs, staffing shortages, low patient volume, regulatory barriers, financial challenges exacerbated by the COVID-19 pandemic, and uncompensated care as common contributors to the closures. Rural patients are often referred by their primary care physician to a hospital for regular immunizations, since smaller clinics have less capacity to provide immunizations due to a shortage of pediatricians and limited vaccine stock. A crucial vaccine that is not required by schools and underutilized in rural areas is that against human papillomavirus (HPV), a virus that infects cutaneous and …

Rurality, Infant Feeding Practices, And Perinatal Cardiovascular Health Behaviors, Elly Marie Marshall

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Cardiovascular diseases are a leading cause of pregnancy-related deaths in the United States, with higher rates in rural areas. While limited healthcare access contributes to this disparity, other factors remain unclear. Breastfeeding provides long-term protection against cardiovascular disease, but modern infant feeding practices are complex and may impact maternal cardiovascular health (CVH) in unexpected ways. Healthy CVH behaviors of sufficient sleep duration, adequate physical activity, a healthy diet, and nicotine avoidance can enhance protection against future cardiovascular disease risk. Therefore, the aims of this dissertation are to 1) assess associations between rurality and first trimester CVH behaviors; 2) synthesize …

Rural Hospital Closure And Medicaid Expansion, Jason White

Theses, Dissertations and Capstones

Introduction: In the United States, hospitals in rural areas have been under financial pressure and have been closing at an increasing rate.  This reduces access to care for rural citizens.  The Affordable Care Act of 2010 was passed in order to increase access to medical care, partially through an optional expansion of Medicaid coverage to a larger percentage of the population.  As some states adopted the expansion and some states did not, an opportunity was created to examine the policy’s effect on rural hospital stability.

Purpose of the Study:  This study was designed to examine the effect of …

Indian Health Service Strategic Plan 2006-2011, Indian Health Service

Native Health Database Full Text

The main health challenges currently faced by American Indian and Alaska Native people are the increasing health conditions and chronic diseases that are related to lifestyles issues such as obesity, physical inactivity, poor diet, substance abuse, and injuries. To help meet these challenges, the Indian Health Service (IHS) has launched a Health Promotion and Disease Prevention (HPj DP) Initiative to develop a coordinated and systematic approach to enhance preventive health approaches at the local, regional, and national levels. This Initiative is aligned with the President's HealthierUS, HHS Steps to a HealthierUS, and Healthy People 2010.

Examining The Structural Covariates Of Methamphetamine Use: A Social Disorganization Perspective, Justin Smith

Masters Theses

There have been many anecdotal accounts describing the characteristics of individuals involved in methamphetamine use, trafficking and production. However, prior to the current study there was yet to be a macro-level analysis of methamphetamine use. The extant macro-level literature on drug use has suggested that areas with high levels of social disorganization experience high rates of drug use. It was expected that school-districts with low SES and high rates of ethnic heterogeneity, residential instability and family disruption will experience high rates of methamphetamine use. In addition, it was expected that rural school districts would show higher rates than urban and …

Cancer In Alaska Natives 1969-2003: 35-Year Report, C. Homan, J. Kelly, A. Lanier, J. Maxwell, T. Mcevoy

Native Health Database Full Text

Cancer incidence rates for all Alaska Natives (Eskimo, Indian, Aleut) were first reported in 1976. Since then numerous publications have documented the unusual cancer patterns in this population. These are the latest statistics for which there is complete data statewide, and provide the best estimates of cancer incidence in the Alaska Native population. Numbers of new (incident) cases and rates are given for all cancers and for specific sites. These numbers are presented by age, sex, ethnicity, geographic region, and service unit. Data have been collected, tabulated, and analyzed in accordance with procedures established by the National Cancer Institute Surveillance, …

Cancer Information Seeking Preferences Among Health Professionals Serving American Indians In Minnesota, North Dakota, And Wisconsin, K. Knutsen, R. Strickland, J. Matloub, P. Remington, J. Kaur

Native Health Database Full Text

This article identifies cancer information resources used by health professionals in tribal health departments or Indian Health Service clinics serving American Indian communities in Wisconsin, Minnesota and North Dakota.

2005 Navajo Middle And High School Youth Risk Behavior Survey Report, Primary Navajo Yrsb Team

Native Health Database Full Text

From 1997 to 2005, the Navajo Youth Risk Behavior Surveilance System (YRBS) was implemented to be used to monitor health-risk behaviors among youth in middle and high schools. Unhealthy risk behaviors can lead to unhealthy health conditions or injuries, and could enventually lead to health or social problems as chronic diseases, disability and drug or alcohol addictions.

People With Disabilities On Tribal Lands: Education, Health Care, Vocational Rehabilitation, And Independent Living, A. Kauffman, M. Whelshula, V. Paternoster, T. Spellman, W. Thompson, A. Walline

Native Health Database Full Text

This project examined research on health, rehabilitation, independent living, and education issues that affect people with disabilities living in Indian Country. The report discusses views and perspectives of American Indialaska Native people with disabilities, tribal leaders, and federal agency representatives identified as productive in meeting the needs of people with disabilities residing in tribal lands. This report also assesses and recommends government-to-government (state to sovereign tribal to U.S. government) improvements in relationships needed for effective coordination across existing federally funded projects/programs. In addition, a Toolkit guide providing resource information was developed for use by consumers, tribal communities, and people at …

Final Report On Evaluation Of Indian Health Service Funded Community Alcohol Service Programs., Indian Health Service

Native Health Database Full Text

The IHS Strategic Plan is the product of a diverse workgroup with expertise in various facets of healthcare from clinical care to facilities construction. The IHS Strategic plan entails four goals: Build Healthy Communities, Achieve Parity in Access by 2010, Provide Compassionate Quality Health Care, and Embrace Innovation. Each of these goals are outlined alongside their respective strategies for accomplishment.

Cancer Mortality Among American Indians And Alaska Natives: Regional Differences, 1994-1998, D.K. Espey, R.E. Paisano, N. Cobb

Native Health Database Full Text

This monograph delineates cancer mortality rates among American Indians and Alaska Native within the different regions served by the Indian Health Service (IHS). The table and charts depict broader geographic regions than in previous IHS cancer mortality monographs. The estimated IHS service population for each region and the cancer mortality rates from 1994 to 1998 are presented. Comparisons are made to the general U.S. population for the same time period. The intention of this publication is to provide detailed information about thew impact of cancer among Native American peoples, with a focus on the regional variability of cancer incidence for …

Trends In Indian Health 1998-99, Division Of Program Statistics, Staff Office Of Planning, Evaluation And Research, Indian Health Service.

Native Health Database Full Text

The IHS Trends in Indian Health attempts to fulfill the basic statistical information requirements of parties that are interested in the IHS. The tables and charts contained in the IHS Trends in Indian Health describe the IHS program and the health status of American Indians and Alaska Natives residing in the IHS service area.

2000 Navajo Middle School Youth Risk Behavior Survey, Navajo Area Indian Health Service

Native Health Database Full Text

The Navajo Area Indian Health Service, Health Promotion Program administered a modified version of the New Mexico 2000 Middle School Youth Risk Behavior Survey in April, 2000. The survey was developed to monitor priority health-risk behaviors that contribute to the leading causes of mortality, morbidity, and social problems, among youth and adults in the United States. These behaviors fall into six categories: (1) behvaiors that result in unintentional and intentional injuries, (2) tobacco use, (3) alcohol and other drug use, (4) sexual behaviors that result in HIV infection, other sexually transmitted diseases (STDs), and unintended pregnancies, (5) dietary behaviors, and …

Racial And Ethnic Disparities In Access To Health Insurance And Health Care, Ucla Center For Health Policy Research, The Henry J. Kaiser Family Foundation

Native Health Database Full Text

Racial and ethnic groups in the United States continue to experience major differences in health status compared to the majority white population. Although many factors affect health status, the lack of health insurance and other barriers to obtaining health services markedly diminish minorities' use of both preventive services and medical treatments. This report, produced in collaboration with the UCLA Center for Health Policy Research, examines health insurance coverage and access to physician services among African Americans, Latinos, Asian Americans and Pacific Islanders, and American Indians and Alaska Natives. By pooling national survey data over two years, information about particular minority …

Regional Differences In Indian Health 1998-1999, Indian Health Service

Native Health Database Full Text

This document contains tables and charts that describe the Indian Health Service (IHS) program and the health status of American Indians and Alaska Natives residing in the IHS area. The information is grouped into five major categories: 1) IHS structures, 2) population statistics, 3) natality and infant/maternal mortality statistics, 4) general mortality statistics, and 5) patient care statistics.

Tribal Environmental & Natural Resource Assistance Handbook, White House Domestic Policy Council, Native American Fish & Wildlife Society

Native Health Database Full Text

This handbook was developed by the Domestic Policy Council Working Group on American Indians and Alaska Natives (Working Group). This handbook is intended to provide a central location for federal sources of both technical and financial assistance available to Tribes for environmental management.

Native Outreach: A Report To American Indian, Alaska Native And Native Hawaiian Communities, C.S. Glover, F.S. Hodge

Native Health Database Full Text

The National Cancer Institute (NCI) is presenting a monograph written specifically for community leaders, health professionals and lay health workers serving Native American communities. Native Americans have higher mortality rates than the general U.S. population for several major cancer sites. This publication focuses on the need to reduce those rates through effective interventions at the grassroots level.

American Indians And Crime, Bureau Of Justice Statistics, U.S. Department Of Justice, L.A. Greenfeld, S. Smith

Native Health Database Full Text

This report represents a compilation and new analysis of data on the effects and consequences of violent crime among American Indians. The report uses data from a wide variety of sources, including statistical series maintained by the Bureau of Justice Statistics (BJS), the FBI, and the Bureau of the Census. Data are reported from American Indian crime victims on how they were affected by the victimization and about who victimized them. The report also includes the first BJS estimates of the total number of American Indians under the custody or supervision of the justice system.

Alaska Native Cancer Survival Report, A.P. Lanier, P. Holck, J. Kelly, B. Smith, T. Mcevoy

Native Health Database Full Text

This report presents Alaska Native cancer survival rates and stage of disease at diagnosis. Data on survival and stage at diagnosis are given for all cancers combined, and for select primary cancer sites (the organ in which the cancer first began). Survival rates are given for only those cancers for which there were enough patients to calculate reliable estimates. The focus is on five-year relative survival rates because these rates are most commonly used in the cancer literature and most appropriate for comparisons between populations.

Editorial: Mental Health Needs Assessments Performed By Four Urban American Indian Organizations, D.K. Novins

Native Health Database Full Text

In 1991, the Indian Health Service funded a nationwide initiative with the goal of determining the need for culturally appropriate mental health services among American Indian people residing in urban areas. In the author's opinion, the assessment method used in this initiative is a valuable, fresh approach that is a significant change from flawed attempts to make these assessments in the past.

Indian Health Service Managed Health Care Strategies Workshop, Indian Health Service

Native Health Database Full Text

During the week of November 5-8, 1990, the Indian Health Service sponsored the Managed Health Care Strategies Workshop for tribal health programs and interested lHS staff. As part of the continuing effort to seek methods to improve health care delivery, this training workshop provided practical management tools to achieve cost savings while ensuring that health care procured from the private sector is appropriate in terms of cost and quality.

Indian Alcoholism Program Evaluation Fiscal Year 1984, G.M. Charleston, J. G. Myers, K. Charleston

Native Health Database Full Text

In fiscal year 1984, the Indian Health Service contracted with various Indian tribes to administer 189 Indian alcoholism programs that provide treatment and prevention services desi gned for the treatment and control of alcoholism among Native Americans, Alaskan Natives, Aleuts, Eskimos, and Native Hawaiians living in the United States. The services provided by the various Indian tribes and organizations vary from tribe to tribe for many diverse reasons. The Indian alcoholism programs offer an array of treatment and prevention services through one or more of the following components: detoxification, primary residential treatment, halfway house, outpatient care, school -based prevention. community-based …

Indian Health Service Phoenix Area Tribal Involvement Evaluation Project., Indian Health Service Phoenix Area

Native Health Database Full Text

Report from the Indian Health Service Phoenix Area Tribal Involvement Evaluation Project.