Public Health Commons^™

Assessment Of Implementation And Enforcement Of Smoke-Free Laws And Policies Among Malaysian Smokers: A Mixed Method Approach, Gan Shiz Yee

Student Works (2020-2029)

Smokefree laws (SFL) and policies could deter smoking by strengthening anti-smoking norms, impacting cessation behaviour due to decreased social acceptability of smoking in public spaces. With socioeconomic status (SES) affecting smoking risk factors, disparities in health outcomes post-SFL implementation are likely. Furthermore, regional and international assessments show Malaysia’s poor performance due to ineffective smoking bans and enforcement. Local studies revealed inadequate SFL implementation and enforcement, leading to high secondhand smoke (SHS) exposure. Understanding these challenges and opportunities is crucial for improving policy implementation and enforcement to enhance public health outcomes. This study examined the association between SFL and quit intention …

Seasonal Pollen Increases Traffic Fatalities In The United States, Monica Deza

Population Health Research Brief Series

Traffic fatalities are the among the leading causes of death in the United States. Motor vehicle crash death rates have declined overall in the U.S. in recent decades, but there is substantial variation in rates across the country. Due to climate change, exposure to pollen has increased in various parts of the U.S. The antihistamine response triggered by pollen can result in poor physical and cognitive symptoms, thus impacting an individual’s ability to drive and increasing the risk of motor vehicle fatalities. This brief summarizes findings from a study that used data from the National Allergy Bureau (NAB) Pollen and …

The Challenge Of Regulating Pharmaceutical Clinical Trials In The 21st Century With A Focus On Guatemala, Alejandro Cerón, Antonio Ricafort, Carter Saccocio, Maria Delmonte, Jordan Vasquez, Amarri Bishop, Julia Atwood, Addison Bucsko, Jordan Lewis, Alexandra Welch, Itzael Garcia, Ella Wald, Selena Johnson, Crystal Jin, Talya Riciputi, Lindsey Speer, Vanessa Udo-Obong, Soren Engberg, Tessa Lindstrom

Anthropology: Undergraduate Student Scholarship

This report was prepared by the students and instructor of the "Right to Health in Theory and Practice" class taught in the fall of 2024 at the University of Denver. The report was prepared for the Vice Ministry of Health Regulation, Surveillance and Control of the Ministry of Public Health and Social Assistance of Guatemala. The work used the following guiding question: What can a country like Guatemala do to regulate international pharmaceutical clinical trials in the context of research commercialization? In other words, the work was guided by three important elements. First, the regulatory aspect of clinical trials. Second, …

Building Community Resilience Through Community Participatory Asset Mapping For Emergency Preparedness, Cassandra Y. Davila

2024 Fall Honors Capstone Projects - Archive

A community's capacity to prepare, manage, and recover from a disaster determines its level of resilience. The Federal Emergency Management Agency recommends engaging community members in resilience planning to ensure sustainable strategies are implemented. This project uses community-based asset mapping to identify how community participatory methods influence community resilience to combat emergency events. An asset map documents a community’s existing resources, highlighting its strengths. Focus group discussions in the urban area will be conducted to obtain feedback about existing assets and suggestions for additional resources to include. The expected result of this project is to build a comprehensive map of …

Addressing The Public Health Concern Of Maternal Mortality In Houston, Texas, Lucy Couture

Dissertations and Theses (Open Access)

Maternal mortality remains a pressing public health concern in the United States, with disproportionate consequences for marginalized communities. Despite being a developed nation, the U.S. reports one of the highest maternal mortality rates among its peers, with approximately 80% of maternal deaths deemed preventable. Texas reflects this national crisis, particularly affecting Black women, whose maternal mortality rate is significantly higher than that of other racial and ethnic groups. This thesis explores maternal mortality trends in Houston, Texas, analyzing the roles of systemic inequities, social determinants of health, and disparities in access to quality care. Drawing on data from the Texas …

Obesity: Influencing Behavioral Consumption Through Meal Kit Distribution, Alejandro Hernandez

Capstone Projects and Master's Theses

Founded in 2002, Everyone’s Harvest is a grassroots nonprofit dedicated to providing access to healthy, affordable fruits and vegetables through certified farmers markets and community food programs. Its key initiatives—Fresh Rx, Market Match, Edible Education and Farms Together —focus on alleviating nutrition insecurity and combating diet-related health conditions by providing vulnerable populations the resources to purchase, or receive, fresh produce and gain nutritional knowledge. This study explores a new intervention: the distribution of farmers' market meal kits as a complementary strategy to the current Edible Education program. These meal kits, which feature seasonally available produce and pre-measured ingredients, aim to …

Economic Growth, Poverty Gap, And Health Inequality: Implications Based On Panel Analysis Of Organization For Economic Cooperation And Development Data, Sangik Han

Kesmas

This study investigated the impact of economic growth and income distribution on health inequality using data from the Organization for Economic Cooperation and Development (OECD). Employing a panel analysis, this study amalgamated 21 years of data (spanning from 2000 to 2020) from 37 OECD countries. The dependent variables (life expectancy and avoidable mortality) were scrutinized against independent variables (gross domestic product and poverty gap). Control variables encompassed body mass index, consumption patterns, smoking rates, health workers availability, number of beds in health facilities, national medical expenses, and unemployment rates. This study revealed significant associations between economic growth, poverty gap, and …

Social Determinants Of Neonatal Health Outcomes In Indonesia: A Multilevel Regression Analysis, Rooswanti Soeharno, Amal Chalik Sjaaf

Kesmas

Indonesia’s neonatal mortality rate remains alarmingly high. This study addressed the determinants of neonatal outcomes in Indonesia, including the effects of a decentralized health system, socioeconomic disparities, and geographic variations. The analysis used 2018 national survey data across 34 provinces, 513 cities/districts, and 300,000 households, with a sample of 73,864 women aged 10-54 years who have given birth in the preceding five years. The multilevel regression was used to assess the impact of social determinants and systemic inequalities on neonatal health. Key findings revealed a neonatal mortality rate that, despite being preventable in many cases, remained high with significant disparities. …

Telemedicine Adoption In Developing Economies: A Systematic Review On The Enablers And Barriers, Zaidbren Macabato, Lemuel Clark Velasco, Art Brian Escabarte, Mae-Lanie Ong Poblete, Armando Isla Jr., Rentor Cafino, Sarah Lizette Aquino-Cafino, Frevy Teofilo-Orencia

Kesmas

Telemedicine’s adoption has been effective in certain contexts despite being controversial in certain settings because of its tendency to cause misdiagnosis and concerns about data privacy. This study aimed to synthesize the research findings on the factors leading to the adoption of telemedicine among developing economies. The study utilized Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology to analyze 27 related literature and the Unified Theory of Acceptance and Use of Technology to map out the factors considered enablers and barriers in adopting telemedicine. Results showed that performance expectancy, effort expectancy, social influence, and facilitating conditions were significant predictors. …

Mortalidad Por Cirrosis En Guatemala 2018: Patrones E Inequidades, Cristian Ramírez, Luis Pablo Méndez-Alburez, María Fernanda Piedrasanta, Alejandro Cerón

Anthropology: Faculty Scholarship

El presente estudio busca analizar la mortalidad por cirrosis en Guatemala. El propósito es identificar posibles criterios epidemiológicos que orienten la priorización de acciones de salud pública. El riesgo de morir por cirrosis en Guatemala muestra marcadas desigualdades por departamento, las cuales son mayores al comparar por municipio. El riesgo de morir es también más alto en hombres, en personas mestizas o ladinas, en niveles educativos bajos, y en personas que se dedican a ocupaciones elementales. Las medidas de salud pública orientadas a los municipios y grupos en mayor riesgo son de suma importancia para la prevención de muerte por …

The Meatpacking Industry Needs Stronger Worker Protections And Enhanced Oversight, India Luxton, Laura-Anne Minkoff-Zern

Center for Policy Research

Meatpacking plants are hazardous workplaces with high injury rates and poor working conditions, negatively impacting the health of the industry’s predominately immigrant and refugee workforce. The COVID-19 pandemic illuminated ongoing concerns in the industry, including the problems associated with consolidation and concentration, worker safety, and poor public health outcomes. This brief summarizes findings from a study that used data from 39 interviews with local, state, and federal officials and bureaucrats, worker advocates, and workers to analyze meatpacking policymaking and oversight during COVID-19. The authors find that a lack of industry oversight and decreased regulation contribute to unsafe environments, and injustices …

An Analysis Of The Environmental Account Of Obesity As A Form Of Financial Neo-Imperialism, Zahara Alzubaidi

The Cardinal Edge

Socioeconomic developments of the past half-century have created mass social concern over an “obesity epidemic.” This concern is given a sense of legitimacy by studies that warn of a totally obese America in only a few decades, and children being more likely than ever to be diagnosed with Type 2 Diabetes. The “environmentalist account” of obesity asserts that factors like genetics, food availability, and social or political climate are the major determinants of an “obesogenic environment” – that is, an environment of obese adults likely to raise obese children. Some feminist thinkers argue that the environmentalist account is necessary to …

The Southern Nevada Care Economy: Addressing Child Care And Elder Care Challenges, The Lincy Institute

Lincy Institute Events

This community forum examines the economic and societal impact of the “care economy” in Southern Nevada in collaboration with Tripp Umbach, a nationally recognized consulting firm that provides comprehensive services including research and strategic plans to further the operations and activities of healthcare services.

Central to the care economy is elder care and child care. Having access to elder care and child care services is essential to working age adults, many of whom need one or both types of services to continue participating in the workforce. The delivery of child care and elder care services have far-reaching implications for our …

Political Polarization Harms Public Health, Shana Kushner Gadarian, Jay Van Bavel, Kai Ruggeri, Eric Knowles

Population Health Research Brief Series

Political polarization poses considerable risks to well-being. Both ideological polarization (“extremification” of policy positions and ideological orientations) and affective polarization (out-party hate) have increased over the past several decades with detrimental effects on public health. This brief summarizes the impacts of political polarization on public health in the U.S., highlighting the COVID-19 pandemic as a case study on the health risks of polarization. The authors show that, in the United States, one of the strongest predictors of COVID-19 prevention behaviors, such as social distancing and vaccination, was political partisanship. Gaps in these behaviors between Republicans and Democrats increased over the …

The Southern Nevada Care Economy: Challenges And Opportunities, Tripp Umbach

Policy Briefs and Reports

National policymakers increasingly recognize the care economy as an essential economic driver, contributing $648 billion annually to the U.S. economy and supporting 3.6 million jobs. The care economy is also critical in driving economic development and prosperity in Southern Nevada. Yet, as this Tripp Umbach analysis finds, Southern Nevada’s care economy dramatically underperforms compared to national benchmarks and peer regions. High caregiving costs and limited access to care for children, seniors, and individuals with disabilities in Southern Nevada strain families, businesses, and public resources. This burden reduces workforce participation, productivity, and economic growth. Low pay and high turnover among care …

Impacting Community Well-Being Through Effective Engagement Using The Seed Method, Carlin Rafie, Emily B. Zimmerman, Angelina Hargrove, Theodora Biney Amissah, Samantha Lee

Journal of Extension

Cooperative Extension can make a significant impact on health in the United States through effective community engagement that focuses on the complex socio-ecological factors that impact health. The Stakeholder Engagement in Question Development Method (SEED Method) employs community based participatory research principles to engage communities in research, problem-solving, and action planning. Projects employing the SEED Method engage community members from diverse backgrounds, create community capacity, result in tangible outcomes, and foment inter-organizational trust and networking. A SEED Toolkit is available on the Extension Foundation Campus site and provides implementation instructions, tools and timelines, and potential applications within Extension.

A Pilot Randomized Clinical Trial Of A Smartphone-Based Application To Support At-Home Psa Screening And Culturally Tailored Prostate Cancer Education For African American Men: A Study Protocol, Jordan Neil, Bingjing Mao, Ruosi Shao, E. Ogunsanya Motolani, Summer Frank-Pearce, Michael Businelle, Michael Cookson, Kelly Stratton, Mark Doescher, Stephanie Pharr, Valerie Moise, Brianna Fleshman, Jack Fronheiser, Kimberly Estrada, Iván Flores, David Bradley, Ashley Kendrick, Adam C. Alexander

School of Public Health Faculty Publications

Background: Prostate cancer is the most diagnosed cancer in Black/African American men (AA) and the second‑leading cause of cancer-related deaths. A prostate-specific antigen (PSA) blood test is an early detection screening tool for prostate cancer, but uptake of PSA screening remains low among AA men. Greater PSA screening rates among AA men, coupled with earlier treatment, may reduce disparities in prostate cancer outcomes, including mortality. The current pilot study will test the first-of-its-kind mobile health (mHealth) app to improve prostate cancer knowledge and increase PSA screening uptake among AA men using home-based screening methods. Methods: AA men aged 55 to …

Health Outcomes Reported By Healthcare Providers And Clients Of A Community-Based Medically Tailored Meal Program, Jessica M Sautter, Jule Anne Henstenburg, Adrian Glass Crafford, Ian Rowe-Nicholls, Victor S Diaz, Kaitlyn Ann Bartholomew, Julia S Evans, Maria R Johnson, Jeffrey Zhou, Deeksha Ajeya

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Medically tailored meal (MTM) programs provide home-delivered meals to people living with serious illness and poor nutritional status. Client outcome studies have found evidence of decreased healthcare utilization and cost savings associated with MTM program participation, and inconclusive evidence of change in health measures. The purpose of this study was to use a novel observational framework to describe the client profile and change in health outcomes using routinely collected health and program data from a community-based MTM program at MANNA (Philadelphia, PA).

METHODS: Clients reported their self-rated health and experiences of food insecurity and malnutrition. Healthcare providers reported clients' …

Racial Residential Segregation And Covid-19 Health Outcomes: Evidence From The State Of Georgia, Palak Patel, Simon Medcalfe, Catherine P. Slade

Journal of the Georgia Public Health Association

ABSTRACT

Background:

According to the Georgia Department of Public Health (GDPH), the state of Georgia reported 563,658 cumulative COVID-19 cases and 9,845 total deaths in 2020. Decades of research on racial disparities in health outcomes suggest we should not be surprised with the disproportionate number of cases, hospital visits, and deaths of non-white and Black Georgia residents. Racial disparities in health are often defined by a Social Determinants of Health (SDOH) model. One understudied SDOH is racial residential segregation. In this study we explore the relationship between racial residential segregation and COVID-19 health outcomes. Our paper addresses critical challenges for …

Beyond Assistance: Amplifying The Lived Experiences Of Marginalized Communities Navigating Support Service Systems In Mississippi, Karla Mccullough, Rodney Washington, Angela A. Omondi

Journal of Public Health in the Deep South

Background

Perceived dehumanizing experiences when interacting with social assistance caseworkers and providers can contribute to negative perceptions of the service system that may impede enrollment and retention of families in need thereby contributing to health disparities.

Purpose

This study aimed to use secondary analysis of qualitative data to explore the interaction between social services workers/providers and recipients from the perspectives of families seeking social support services in Mississippi.

Methods

This study analyzed secondary qualitative data from a sample of (n=15) representatives in Mississippi. Data was analyzed using a thematic analysis approach.

Results

Participants reported perceived dehumanized experiences such …

The Jackson Water Crisis Across The Lifespan: Living And Dying For Clean Water, Ashley W. Jones, Antonio J. Gardner

Journal of Public Health in the Deep South

At the height of the COVID-19 pandemic and in the midst of freezing temperatures from a snowstorm, the city of Jackson, MS faced the potential demise of its drinking water infrastructure. Triggered by the freezing of water pipes in the city and a subsequent fire at a local water treatment facility, the lack of clean, accessible water made daily tasks more difficult for the city’s older adult population who had limited mobility, income, and ability to relocate. This commentary examines the effects of ongoing water infrastructure issues in Jackson, MS and its effect on aging in place. Considerations for a …

Non-Partner Sexual Violence Among International College Students In The United States, Kruti S. Chaliawala, Rebecca A. Vidourek, Keith A. King

Dignity: A Journal of Analysis of Exploitation and Violence

The prevalence of non-partner sexual violence among college students is a pressing concern that demands urgent attention. Although an integral part of the education system, international college students are often underrepresented in various studies. This calls attention to understanding the cultural nuances and multiple factors affecting this population. The current research delves into the experiences of sexual abuse among international students within the last 12 months, focusing specifically on incidents where sexual penetration or unwanted sexual touching occurred without consent. The study sheds light on the frequency and demographics associated with these distressing incidents using data from a large-scale survey …

Parallel Electrophysiological Abnormalities Due To Covid-19 Infection And To Alzheimer’S Disease And Related Dementia, Yang Jiang, Jennifer Neal, Pradoldej Sompol, Görsev Yener, Xianghong Arakaki, Christopher M. Norris, Francesca R. Farina, Agustin Ibanez, Susanna Lopez, Abdulhakim Al-Ezzi, Voyko Kavcic, Bahar Güntekin, Claudio Babiloni, Mihály Hajós

Neurology Faculty Publications

Many coronavirus disease 2019 (COVID-19) positive individuals exhibit abnormal electroencephalographic (EEG) activity reflecting “brain fog” and mild cognitive impairments even months after the acute phase of infection. Resting-state EEG abnormalities include EEG slowing (reduced alpha rhythm; increased slow waves) and epileptiform activity. An expert panel conducted a systematic review to present compelling evidence that cognitive deficits due to COVID-19 and to Alzheimer’s disease and related dementia (ADRD) are driven by overlapping pathologies and neurophysiological abnormalities. EEG abnormalities seen in COVID-19 patients resemble those observed in early stages of neurodegenerative diseases, particularly ADRD. It is proposed that similar EEG abnormalities in …

Implementation Of Sugar-Sweetened Beverages Excise Policy And Its Implications In Various Countries: Literature Review, Roissiana Khotami, Vetty Yulianty, Ratih Oktarina

Journal of Indonesian Health Policy and Administration

The prevalence of diabetes in the world is projected to continue to increase to 643 million in 2030. Indonesia is ranked 7th with the highest number of diabetes mellitus sufferers and the only one in Southeast Asia with a total of 10.7 million sufferers. Consumption of sweetened drinks is the most dominant factor in the incidence of diabetes mellitus in Indonesia. Indonesia ranks third highest in Southeast Asia in sweetened drink consumption. Excise on sweetened drinks is an effective intervention to reduce consumption of sweetened drinks, but Indonesia has not yet implemented it. This research aims to determine the implementation …

Providing End-Of-Life Counseling: A Narrative Inquiry, Carol Hecht, Sibyl West

Adultspan Journal

This qualitative study aimed to address the gap in the research related to end-of-life counseling by exploring the experiences of counselors working with clients at end of life. While counseling literature and education are lacking regarding end of life, many counselors will work alongside clients approaching death. The purpose of this study was twofold: (a) to better understand the nuanced experiences of counselors providing end-of-life counseling and (b) to explore the supports and preparations helpful for counselors to provide end-of-life counseling. A narrative approach, using the Listening Guide (Gilligan, 2015), was employed to analyze and present the stories of three …

Considerations Of Medicare Telehealth Services With Older Adults, Sonah Kho, Amanda Dediego

Adultspan Journal

The onset of the COVID-19 pandemic set in motion a rapid expansion of mental health services offered via telehealth. With this rapid expansion came the need to examine how policy and practice should be shaped in a future where telehealth is considered common in counseling practice. For counselors to understand how to support older adult clients in using telehealth services, they must understand telehealth policy. Following the eligibility of licensed counselors to participate in Medicare, counselors need to stay abreast of regulatory changes regarding restrictions and regulations on use of telehealth for mental and behavioral health services, including video and …

Case Title: Uncovering The Truth: The Unexpected Incidental Discovery Of Metastatic Carcinoid Tumor In An Elderly Patient., Kavitha Chittaragi Dr, Shwetha R. Poojary Dr

Radiology Teaching Files

Carcinoid tumors are rare neuroendocrine neoplasms with varied clinical presentations. We report a case of a 70-year-old female patient who presented with history of loose stools, vomiting, and abdominal pain. Imaging revealed a small hyper-enhancing nodule in the small bowel, multiple liver lesions, and a mesenteric mass, all suggestive of metastatic carcinoid disease. Biopsy confirmed a neuroendocrine tumor. As these tumors can remain indolent for years, early detection and treatment are critical for effective management and better prognosis.

Expanding Healthcare Access For The Undocumented Immigrant Community: The Heal For Immigrant Families Act Of 2023, Perla Torres Estrada

The Gettysburg Journal for Public Policy

When it comes to the topic of universal healthcare, most of us will readily agree that healthcare is a human right. Where this agreement usually ends, however, is on the question of who should be granted this right, and if it should be left to the free market to determine access and affordability. Specifically, the political debate on expanding healthcare access to undocumented immigrants in the United States revolve around concerns over costs, legality, and equity. Proponents maintain that it is a human right whereas opponents question the potential burden on taxpayers and the implication for immigration policy. The HEAL …

Pickup: Survey Of People Experiencing Homelessness In New Mexico, Summary Report, Kimberly Page, Christina E. Phillips, Annemarie Madaras, University Of New Mexico Health Sciences Center Department Of Internal Medicine

Epidemiology, Biostatistics, and Preventive Medicine

The PICKUP Project represents a comprehensive effort to ascertain the needs and conditions of unhoused populations in New Mexico, engaging a partnership network that spans academic institutions, community health services, and government bodies. The PICKUP Study aims to provide actionable data to inform targeted interventions by community and public health groups, clinical organizations, and academic institutions.

Project participants included the University of New Mexico Health Sciences Center (Dr. Kimberly Page, PI); Alianza of New Mexico, Roswell, Chavez County, NM; Interfaith Community Shelter, Santa Fe, Santa Fe County, NM; Four Corners Detox Recovery & Santa Fe Recovery Center, Gallup, McKinley County, …

Developing A Stand-Alone Children’S Hospital In Southern Nevada: Improving Pediatric Care And Diversifying The Regional Economy, The Lincy Institute

Lincy Institute Events

Southern Nevada is the largest metropolitan region in the country without a stand-alone children's hospital. The absence of such a facility results in poor health outcomes for children, fragmented and inadequate specialized care, and a shortage of pediatric medical professionals. Currently ranked last in clinical care nationwide, Nevada urgently needs a centralized, academic-based children's hospital to improve health services.

The Lincy Institute hosted a community forum to release the findings of a new report conducted by Tripp Umbach detailing why Southern Nevada needs a stand-alone children’s hospital. Tripp Umbach is a recognized industry leader, with 30 years of successful partnerships …