Public Health Commons^™

Science Tikkun: A Bioscience Pandemic Framework In A Hebrew Tradition Of Global Repair, Peter Hotez

Center for Medical Ethics and Health Policy Staff Publications

Over the past decade we have seen a steady increase in dangerous pandemic threats. They include two major Ebola epidemics and cholera in Africa; dengue, Zika, yellow fever in the Americas; a COVID-19 pandemic; and H5N1 in Texas. This is happening because of a confluence of modern forces including urbanization, deforestation, and climate change. Yet as pandemics emerge on a crowded and warming planet, anti-science disinformation and antisemitism impede our response. Science tikkun is an overarching framework for repair and redress. It honors the legacy of Maimonides, Teilhard de Chardin, and others who have sought reconciliation between science and religion.

Framing The Future: A Community Health Analysis Of The Pee Dee Region, Stephen Borders, Jean Anton, Rian Fontaine, Donielle Phillips, Treyton Ringer, Jessica Robinson, Caitlin Thompkins

Public Health

This report presents a comprehensive, data-driven analysis of community health across South Carolina’s Pee Dee region, encompassing Florence, Darlington, Chesterfield, Marlboro, Marion, and Dillon Counties. Using tract-level data from CDC PLACES, the U.S. Census, and the National Provider Identifier registry, it assesses chronic health conditions, health behaviors, and social determinants of health. The analysis incorporates the South Carolina Healthy Communities Index (SCHCI) and a Suitability Analysis to identify the region’s most disadvantaged communities. The findings highlight persistent disparities, particularly in rural counties, where high rates of poverty, chronic disease, and unmet basic needs intersect with limited access to care. Despite …

Long-Term Care Services And Support In The Mountain West, 2023, Taylor Volk, Ivan Sun, Miguel Soriano Ralston, Kristian Thymianos, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet presents data from the American Association of Retired Persons (AARP) report, “Long-Term Services and Supports 2023 State Scorecard Report,” comparing Long-Term Services and Supports (LTSS) systems across multiple dimensions of performance for older adults, people with physical disabilities, and family caregivers for all 50 states. This fact sheet focuses on state-level LTSS system data for the Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah.

A Pill Too Expensive: A Comprehensive Review For Exploring Medical Non-Adherence In The Age Of Rising Drug Prices, Vidhani Goel, Roberto Sagaribay

Undergraduate Research Symposium Lightning Talks

Prevalence & Health Disparities:

• Medication non-adherence is a major public health issue.
• High prescription drug costs are a significant barrier.
• Affects chronic conditions like diabetes, hypertension, and mental health disorders.

Potential Solutions:

• Patient assistance programs.
• Use of generic drugs.
• Policy reforms to reduce medication costs.

Future Directions & Solutions:

• Address research gaps in long-term outcomes.
• Explore broader policy interventions.
• Improve accessibility and awareness of assistance programs.

Contributing Factors:

• Leads to worse health outcomes.
• Increases hospitalizations and long-term healthcare costs.
• Affects vulnerable populations (i.e., elderly, uninsured, racial minorities)

Analyzing Healthcare As A Right, Instead Of A Privilege, Saidt Gutierrez

Undergraduate Research Symposium Podium Presentations

Healthcare is a fundamental necessity, yet in many countries including the United States, it remains a privilege rather than a right. This research examines the benefits of universal healthcare by analyzing its impact in countries that have successfully implemented healthcare such as Canada, the United Kingdom, and Germany. This study evaluates the healthcare accessibility, cost efficiency, and health outcomes in these countries against the U.S. This finding will suggest that universal health care leads to lower overall healthcare costs, improve public health, and reduce financial burdens on individuals. By ensuring healthcare as a right, rather than a privilege, the U.S …

Costing Care: Unpacking The Drivers Of Medicaid Spending For Nicu Admissions In Nevada, Vidhani Goel, Ana L. Reyes, Bertille Assoumou, Dodds P. Simangan, Farooq Abdulla, Deborah A. Kuhls

Undergraduate Research Symposium Podium Presentations

Overview This study examines how maternal and neonatal factors influence Medicaid spending for NICU admissions in Nevada, with an emphasis on identifying cost-driving health disparities. Approach: A retrospective analysis was conducted using linked data from Nevada’s Birth Registry and Medicaid claims (2015–2021). Infant records were analyzed using univariate and bivariate statistics, and logistic regression models identified associations between maternal/neonatal characteristics and above-median Medicaid spending. Cost trends were assessed using NICU case costs, annual growth rates, and year-to-year fluctuations. Key Objectives: Analyze trends in NICU-related Medicaid spending over a seven-year period. Identify maternal and neonatal characteristics linked to higher NICU costs. …

Heartache In The Heartland: Unraveling The Social Roots Of Deaths Of Despair In Kentucky, Lyndsey K. Blair, Madeline M. Tomlinson, Michele Abee-Biskis, Jessica Hume, Gabri Warren

Journal of Appalachian Health

Introduction: Deaths of despair (DoD), encompassing suicides, drug overdoses, and alcohol-related liver diseases, have emerged as a critical public health crisis in the United States, with their rise particularly pronounced from 1995 to 2013 and exacerbated by the COVID-19 pandemic. Kentucky, grappling with high rates of substance use disorder, poor mental health, and economic hardship, is at the forefront of this issue, particularly in its rural and Appalachian regions.

Purpose: This study explores the social determinants contributing to DoD in Kentucky, focusing on economic and social factors that influence rising rates of suicide, drug overdose, and alcohol-related liver disease. The …

The Repercussions Of Race-Based Egfr On The Morbidity & Mortality Of Black Children With Renal Disease, Angelina Siino

Rowan-Virtua Research Day

This study investigates the implications of race-based adjustments in estimated glomerular filtration rate (eGFR) calculations on the health outcomes of Black children with renal disease. Historically, a race coefficient has been added to eGFR calculations for patients identified as Black, resulting in an artificial inflation of kidney function by approximately 16%. This inflation can delay the classification of chronic kidney disease (CKD), postpone eligibility for essential interventions like preemptive kidney transplantation, and prolong reliance on maintenance dialysis. Through a comprehensive literature review of peer-reviewed U.S. medical journal articles published between 2000 and 2023, this work explores how these clinical delays …

Addressing Gaps In Clinical Trial Access For African Americans, Vanessa Veltre, Michael Acevedo, Alexandra Stone, Lydell Lettsome, Brian Stone

Rowan-Virtua Research Day

Background: Clinical trials are essential for generating evidence on the safety and efficacy of new treatments. However, Black Americans remain underrepresented in clinical research, particularly for conditions that disproportionately affect them. This underrepresentation compromises the generalizability of findings and perpetuates health disparities. This study aimed to identify barriers and facilitators to African American participation in clinical trials and to inform culturally sensitive strategies to improve enrollment of diverse populations.

Methods: We developed a 38-question web-based survey, divided into three domains: (1) cultural affinity, (2) trust, and (3) background information. The survey was administered using Jotform, a HIPAA-compliant platform. Participants—Black adults …

Disparities In Demographics Of Patients Presenting To A Student-Run Free Clinic In South Jersey, Kirsten Carlberg, Sabah Iqbal, Christian Moya Gamboa, Daliza Diaz, Cerena Moreno, Rebecca Moore

Rowan-Virtua Research Day

Medical schools around the country have established free clinics to better serve the underserved patient populations. In this study, we aimed to evaluate demographic characteristics in the patient population at our free clinic, Rowan-Virtua Community Health Clinic (RVCHC), compared to the general population of Camden County. We found a disproportionately higher percentage of black patients at our clinic when compared to the county overall. Addressing these disparities would require targeted outreach to specific patient populations and improved transit access. Future studies should aim to identify RVCHC health outcomes through the management of chronic disease and understanding emergency room utilization.

The Affordable Care Act: Analyzing Rates Of Healthcare Claim Denial, Lauren Sitter

Political Science Theses and Capstones

The United States healthcare industry is an integral aspect of every American’s life. The Affordable Care Act (ACA) in 2010 reformed the healthcare system by expanding coverage to millions of Americans and eliminating claim denials due to pre-existing conditions. It requires participating states to submit transparency data. Despite these reforms, coverage denials continue and vary by plan category, metal level, and among different states. I analyze data from The Kaiser Family Foundation (2023) and The CommonWealth Fund to test the correlation between claim denial and a variety of variables, including state political culture, plan type, metal level, and out-of-pocket costs. …

The Politics Of The Black Womb: How Education And Power Reinforce The U.S. Black Maternal Health Crisis, Foluke Akinkunmi

Honors Scholar Theses

This study investigates the alarming maternal mortality rates among Black women in the U.S. today first by exploring the historical exploitation of Black maternal bodies during enslavement and with the rise of professionalized gynecology. It challenges the narrative that attributes these outcomes to individual choices or supposedly inherent biological factors, arguing instead that the devaluing of Black women’s well-being and authoritative knowledge have been constructed along with the United States itself. To advance a constructive response, the paper analyzes curriculum competencies for obstetric and midwifery healthcare providers, surveys of Black women's birthing experiences in the previous 20 years, and interviews …

The Association Between Economic Outcomes And Abortion: A Scoping Review, Larisa Nicole Stephenson

Capstone Experience: Master of Public Health

Background: Abortion access is not just an issue of autonomy, but an economic issue as well. Evidence of the intersectionality of abortion health care and economics has endured due to the financial cascading effects a denial of an abortion, or the inability to access an abortion, has on one’s personal, professional, and economic upward mobility. A change in recent policies impacting access to abortion warrants an updated synthesis examining the relationships between economic outcomes and abortion access for people of reproductive age in the United States (U.S.).

Aim: This scoping review summarizes evidence pertaining to the association …

The Self-Sustainability Of Federally Qualified Health Centers, Javier Vallejo

MUSC Theses and Dissertations

This exploratory data analysis examines the self-sustainability of Federally Qualified Health Centers (FQHCs) using the 2023 Uniform Data Systems (UDS) dataset, focusing on health centers' reliance on government grants as a revenue source. FQHCs provide high-quality healthcare services to medically underserved populations; today, nearly 1 out of every 11 Americans receives some form of care at an FQHC. There is widespread variability in the delivery of care amongst FQHCs. Additionally, funding and reimbursement methodologies vary across states and geographic regions. FQHCs face challenges maintaining operational efficiency amid federal funding shortfalls, shifting reimbursement methodologies, and the lingering impact of the COVID-19 …

Psychological Treatment Behind The Walls:Insights From The Inside, Rogelio Serrano

Psychology Division Scholarship

Repeated eras of mass incarceration, criminalization of marginalized communities, and substance use policies have created a revolving door of justice involved populations. The ever-increasing prison population has repeatedly become the largest contingency of mental health clientele for an overburdened mental health system. Those who work with formerly incarcerated individuals in the community often don’t know the unique set of challenges faced by practitioners within the system. Increased understanding and coordination of care can offer opportunities for sustained recovery and reduced levels of recidivism. In this presentation participants will learn about the unique insights on mental health treatment that can be …

Behere Nevada: Partnership And Policy, Sara Hunt

Community Engagement Expo Research Posters

Partnership: Nevada ranks 51st in the nation for mental illness prevalence and access to care (Mental Health America). Significant shortages in mental health professions, especially in rural areas. Other states using policy and funding to implement a “grow our own” model for behavioral health workforce development. Proposed a behavioral health workforce development center for Nevada.

Indeterminate Benefit Of Long-Term Beta-Blocker Use After Acute Myocardial Infarction For Some Patients, Logan S. Thayer, Khush Hussain, Nicholas Apostolakis, Gretchen Swift, Arifbillah Sarowar, Mohammad Al-Hadidi, Scott Yaekle

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Yndigegn T, Lindahl B, Mars K, et. al., Beta-blockers after myocardial infarction and preserved ejection fraction. N Engl J Med. April 7 2024;390:1372-1381. https://doi.org/10.1056/NEJMoa2401479

for a patient showing 55% left ventricular ejection fraction after myocardial infarction.

Activity Levels Among Older Adults In A Life Plan Community, Emily D. Winters

OHSU-PSU School of Public Health Annual Conference

This study aimed to analyze resident's knowledge of the health and wellness programs available to them in their facility. It explored activity levels, preferred activity methods, and health and wellness program utilization among older adults residing in a life-plan community. A total of 166 survey respondents, aged 65 and older, were included in the analysis. Data were collected using a self-administered questionnaire designed to assess physical activity patterns, preferences for activity types, and engagement with the facility’s health and wellness offerings. Open-ended questions were assessed qualitatively through thematic analysis to find common themes within data. Results indicated that the most …

Comparing Cpr Ventilation Strategies Within Tualatin Valley Fire And Rescue Using A Retrospective Observational Cohort Study, Jack T. Hindley

OHSU-PSU School of Public Health Annual Conference

Study Objective: This was a registry based retrospective observational cohort study of roughly 1,150 cardiac arrest cases transported by the Tualatin Valley Fire and Rescue emergency medical service (EMS) agency to hospitals in the Portland area from 2018-2019 and from 2022-2023 to compare cardiopulmonary resuscitation (CPR) ventilation policy changes between these two years from continuous chest compressions (CCC) to a compression ventilation ratio of 30:2. Hospital outcomes were linked to EMS records through trauma registries, state discharge and emergency department data. The primary outcome was survival to discharge, and the secondary outcome was positive neurological outcome (Cerebral performance category score …

Academyhealth - 2024 Data Visualization Winners, Chelsea Keating, Emily Boniface, Mina Colon

OHSU-PSU School of Public Health Annual Conference

Social determinants of health, such as income, employment, social contexts, and the built environment, influence the risk of food insecurity. Food insecurity can be defined as uncertain access to food and can lead to negative health outcomes like increased risk for obesity, chronic disease, and adverse effects on a child's development and mental health. Drivers like limited physical access to food, limited transportation options, and the quality and access to food assistance programs within local systems perpetuate health disparities—particularly in those communities with populations who have been systematically marginalized. This descriptive study uses 2022 data from the National Health Interview …

Exploring Health Equity With Culturally Specific Providers Of Permanent Supportive Housing, Judith R. Solomon

OHSU-PSU School of Public Health Annual Conference

Chronic homelessness is an important public health issue. Permanent Supportive Housing (PSH) is a promising opportunity for transitioning people experiencing homelessness into housing, however there remain unaddressed racial inequities in service provision and outcomes. The aim of this study is to better understand the role of culturally specific (CS) providers of PSH in improving health equity. I analyzed interviews with CS PSH providers for themes related to health and healthcare. Providers spoke about the importance of connecting clients to healthcare. Providers stressed the importance of honesty and lived experience, highlighting the strong sense of responsibility to the community. Providers also …

Comparing Acuity Of Patient Care At Student Run Free Medical Clinic Locations, Hana Warmflash, Olivia Krol, Alex Foster

OHSU-PSU School of Public Health Annual Conference

Intro:

Student run free medical clinics (SRFC) are present at roughly 75% of Association of American Medical Colleges member institutions1,2 providing care for underserved populations, such as those experiencing houselessness. 3 Persons experiencing houselessness have a higher burden of illness than housed persons but experience a greater barrier to obtaining care4. Delays in care result in more complex and longer hospitals stays4,5.

Our SRFC, Bridges Collaborative Care Clinic (BCCC), functions to address emergent complaints and monitor chronic health conditions. We aim to demonstrate how relocating from River District Navigation Center (RDNC) to a more accessible location, Resource Center (RC), enabled …

How To Kill A Human: Creating An Immersive Learning Game, Théo Caldwell, Nathan Bonnell

OHSU-PSU School of Public Health Annual Conference

How to Kill a Human is an experiment in teaching through gameplay. The environmental crisis facing the planet, though denied by many, is a collection of well-documented historical environmental catastrophes. The purpose of this project was to design a method of relating the impacts of environmental systems on human health, highlighting the dangers of ill planned human tampering, by presenting hypothetical environmental catastrophes and then relating them to documented historical disasters. In pursuit of this goal, we designed a semi-collaborative game for three to six players with a suggested age rating of 10+, ideal for teaching individuals of middle school …

Differences Between Stem Students And Faculty On Seeing Value In A Classroom Belonging Exercise, Kaisa S. Holt

OHSU-PSU School of Public Health Annual Conference

Efforts to enhance belonging in undergraduate STEM classrooms are believed pivotal for student success. However, we must not only promote belonging interventions but also understand STEM students and faculty perceptions of their value and utility. We gathered perspectives of faculty and undergraduates regarding the implementation and efficacy of a belonging exercise (Our Lives Lived, OLL) used in multiple STEM classes at one university over two years. We hypothesized that students would see more value in the exercise than faculty. We sent a survey instrument with an OLL summary and a series of open-ended responses to faculty. We recruited for focus …

Universal Health Care, Oregon, Jennifer S. Arnold, Bethany Clouse, Alec Martin

OHSU-PSU School of Public Health Annual Conference

Historically, the US has chosen not to fund universal health care at every opportunity, leaving our nation as the only industrialized country without some system of health coverage for our citizens and with the worst health care outcomes of any high-income nation in the world. Health care in Oregon is no exception. Our current health care system is financially unsustainable, harmfully complex, and socially unjust, as well as inequitably delivered. Too many Oregonians, because of their race, age, income, geography, or insurance, endure vastly different health care access, varied health care quality, and wide-ranging health outcomes. In 2019, the Oregon …

Behind The Walls: The Implications Of Assisted Living Building Codes On Resident Safety, Adam Pennavaria, Lindsey Smith, Paula Carder, Cassandra Hua, Eric Jutkowitz, Kali Thomas

OHSU-PSU School of Public Health Annual Conference

As the US population collectively ages, issues related to assisted living (AL) resident safety have become an increasingly pressing issue for the general public, reflected by major media reporting in the last year. The building codes that govern ALs play an important role in mitigating the risks associated with falls, wandering, and other hazards, especially for residents living with Alzheimer’s disease and related dementias. We sought to understand how states vary in their approaches to building code regulations that might impact resident safety. We used search term-based text retrieval to identify areas of text relevant to locks, alarms, and egress …

Expanded Patient Reach At New Student Run Free Medical Clinic Location, Olivia Krol, Hana Warmflash, Alex Foster

OHSU-PSU School of Public Health Annual Conference

Background: Critical to modern medical education, student run free medical clinics (SRFCs) are present at more than 75% of AAMC member institutions. SRFCs educate students while providing low-barrier, free healthcare to underserved populations. SRFCs provide unique leadership and health systems management opportunities not traditionally emphasized in training, including leading logistical and operational changes.

In this project, we highlight the impact of a student-led operational initiative that transitioned our clinic from the River District Navigation Center (RDNC) to the Resource Center (RC), improving accessibility.

Methods:

Deidentified patient data from medical clinics from January 2024 to February 2025 were analyzed using RStudio …

No Vaccine? Why Not: Causes Of Vaccine Hesitancy And How Governments Can Stop It, Alexander (Alec) Mccarty '25

Honor Scholar Theses

Vaccine hesitancy is a term that has entered the spotlight since the beginning of the COVID-19 pandemic. With concerns about efficacy, safety, and individual choice, many people have developed a hesitancy toward receiving any vaccine, creating concerns for public and global health. Through responses from local and state health departments about their actions during the COVID-19 pandemic, and through analysis of state vaccine rates based on political affiliation, this study suggests that vaccine hesitancy is a current issue that is likely politically motivated. States that are Republican affiliated have lower rates of vaccine uptake, and in turn they have higher …

Evaluating The Current State Of Quality Measure Reporting In The Merit-Based Incentive Payment System, Kinan Sawar, Geoffrey Potts Md

Medical Student Research Symposium

The Merit-Based Incentive Payment System (MIPS) requires physicians to report quality measures along with other metrics that are used to determine an annual percentage adjustment to physician Medicare Part B payments. Unfortunately, physicians have been forced to choose from an ineffective, limited set of quality measures. This has led to an overreliance on process measures, which fail to stratify physician performance effectively; it has also led to differences in the number of reporting options across specialties, resulting in unequal opportunity for physicians to succeed in MIPS. Using Centers for Medicare and Medicaid Services (CMS) public use file data from 2021-2024, …

Strengthening Local Health Systems And Governance For Universal Health Coverage: Experiences And Lessons From The Covid-19 Pandemic Response In Quezon City, Philippines, Esperanza Anita Escano-Arias, Ramona Asuncion D.G. Abarquez, Rolando V. Cruz, Rosalie Espeleta, Madeline Mae Ong, Arianna Maever L. Amit, Veincent Christian Pepito, Vida Gomez, Manuel M. Dayrit

Ateneo School of Medicine and Public Health Publications

The COVID-19 pandemic has disrupted the Philippines's transition toward universal health coverage. However, some local government units in the country made use of the pandemic as a catalyst to strengthen their local health system, scale-up the provision of preventive and primary care services, and improve health governance to make it more prepared to face future pandemics and realize the aims of the country's new Universal Healthcare Act. This paper describes the response of the local government of Quezon City, Philippines, to COVID-19 and how it strengthened local health systems. We also discuss enablers such as partnerships, collaborations, and foresight to …