Public Health Commons^™

Peace Innovation And Healing: A Design Justice Framework To Support Change Processes, Strengthen Relationships, Foster Trust, And Build Community, Michelle Helman

Peace and Conflict Studies Journal Conference

Many organizations aiming to achieve peace and health equity outcomes often focus their design processes and innovation efforts externally without addressing how their organizational culture can unintentionally reproduce the very harms they are trying to address. The purpose of this qualitative design research study is to explore the role of a design justice framework in piloting a Peace Innovation Project aimed at facilitating an organizational culture change process. Specifically, the study focuses on better understanding how integrating a design justice approach could support research collaborators to center equity and justice as core components in building a culture of peace and …

Embodying Design Justice: A Peace Education Framework To Strengthen Relationships, Foster Trust And Build Community, Michelle Helman

Peace and Conflict Studies Journal Conference

BACKGROUND

Groups working toward creating peace and equity often focus on external innovation without addressing internal culture shifts necessary to navigate change and achieve their goals. Michelle’s doctoral research and practice address this challenge through a design research study and peace innovation project focused on organizational culture transformation through a design justice framework. Findings suggest that interweaving the framework with storytelling, arts, and embodiment practices are key to support people in navigating change processes to strengthen relationships, foster trust, and build community.

ABOUT

The workshop offers an applied learning experience for participants to explore the concepts of design and innovation …

Medicaid Expansion And Breast Cancer Care And Outcomes-What Lies Ahead?, Meghan H. Maceyko, Oluwadamilola M. Fayanju

Department of Surgery Faculty Papers

No abstract provided.

Enhancing Military Health System Organizational Efficiency And Quality Of Care Through A Social-Ecological Framework, Eric L. Peipelman

College of Graduate Studies: Theses & Dissertations

Timely and fair adjudication of incivility-related actions within the Department of Defense (DoD) and Military Health System (MHS) is increasingly crucial for maintaining accountability, mission readiness, and quality of care. Ongoing delays in resolving workplace complaints and inefficiencies in resource-heavy adjudications highlight the need to shift from reactive complaint handling toward proactive civility promotion and transparent decision-making. This Integrated Learning Experience (ILE) introduces the Peipelman Civility Discussion and Assessment Toolkit (PCDAT)—a comprehensive, evidence-based framework designed to improve civility, optimize resources, and enhance communication, even in the MHS. Based on the Social-Ecological Model (SEM) and adapted from the Workplace Power and …

Feeding Missoula: Food Insecurity In Rural Children And Youth, Chani Brammer, Braelee Cheeks, Jordin Holland, Rayne Mccollough, Laurel Palmer, Therese Solomon

Undergraduate Theses, Professional Papers, and Capstone Artifacts

In Montana, approximately one in seven children live in a food-insecure household, with rural Montanans in particular facing significant barriers. Existing needs-based food assistance programs, such as SNAP and WIC, have structural weaknesses: SNAP benefits are often not sufficient to last through the month, and those eligible for these programs face a confusing application process, shame and stigma, and logistical hurdles, such as limited transportation.

“Feeding Missoula” began with an evaluation of how current food assistance programs met or failed to meet the needs of rural youth. Our methodology integrated a comprehensive review of existing literature and structured interviews with …

Maternal Healthcare In The United States: An Exploration Of The Organizational And Political Determinants Of Maternal Healthcare Quality And Outcomes, Tamaya S. Browder

College of Graduate Studies: Theses & Dissertations

Despite having an advanced U.S. healthcare system, childbirth remains risky in the US, especially for socially vulnerable populations. Medicaid covers a large portion of births and is equipped to implement large-scale interventions to improve maternity care and patient outcomes. Two studies were conducted to (a) examine the relationship between organizational factors in U.S. hospitals and adverse clinical outcomes among Medicaid-insured maternity patients, and (b) analyze state-level Medicaid bundled payment models for maternity care. Guided by the Donabedian Quality of Care Model, Study One used logistic regression on data from the 2018-2020 National Inpatient Sample to explore how hospital organizational factors …

The Impact Of The 7th October War On Preterm Birth Rates And Neonatal Outcomes: A Retrospective Comparative Study From Northern Israel, Raghda Zidan Sweid, Adi Sharabi Nov, Hana Helfgot, Steven L. Warsof, Inbar Ben-Shachar

Department of Obstetrics & Gynecology Faculty Publications

PURPOSE: Maternal psychological stress is associated with adverse obstetric and neonatal outcomes, including preterm birth and low birthweight. Warfare represents a significant source of acute and chronic stress, yet its impact on pregnancy outcomes remains unclear. This study aimed to evaluate the association between a 6-month period of continuous wartime exposure following October 7, 2023, during the "Iron Swords" conflict and preterm birth, neonatal outcomes, and obstetric management.

METHODS: This retrospective cohort study included all deliveries at ZIV Medical Center during the 6-month conflict period, compared with a pre-war cohort from 2021 until October 6, 2023. The primary outcome was …

Left In The (Road) Dust: Analyzing Advanced Clean Cars Ii In California’S Disadvantaged Communities, Jj Hoffman

Pomona Senior Theses

Across the United States, air pollution disproportionately impacts minority groups. California’s Advanced Clean Cars II (ACC II) waiver was positioned to lead to significant environmental justice impacts, such as reductions in emissions and adverse health outcomes, by establishing stricter regulations for vehicle emissions and ensuring that 100 percent of new passenger vehicle sales are zero-emission by 2035. As the federal government recently nullified ACC II, pollution, and by extension health, could worsen, especially in disadvantaged communities. The thesis established several important relationships, including how disadvantaged communities experienced higher traffic, pollution, and worse health outcomes than non-disadvantaged communities. Though the results …

Racial Disparities In Maternal Mortality: The Role Of Explicit And Implicit Bias In U.S. Healthcare, Lailah Allen

Capstone Showcase

Maternal mortality in the United States remains a critical public health crisis, with disproportionately high rates among Black and other minority women. Despite advances in obstetric medicine, racial disparities in pregnancy-related deaths persist due to structural inequities, implicit bias in healthcare delivery, unequal access to prenatal and postpartum care, and broader social determinants of health. Nationally, Black women are significantly more likely to experience severe maternal morbidity and mortality compared to White women, reflecting longstanding inequities embedded within the healthcare system. This paper examines the relationship between race, healthcare access, and maternal outcomes through a focused case study of and …

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 …

Improving Maternal Health: Investigating The Early Impacts Of Medicaid Coverage Of Doulas In Oregon, Miriam Akhmetshin

Scripps Senior Theses

While the U.S. spends more per-capita than any country on healthcare, we experience the worst maternal health outcomes of high-income nations. In addition to hefty healthcare bills, an overwhelming majority of mothers experience pregnancy-related health issues that decrease productivity and utility. Thus, it is critical to research cost-effective solutions that can improve maternal health and promote equitable outcomes. Doulas are trained non-medical professionals who support mothers and families before, during and after birth. As a growing body of medical literature points to the role of doulas in decreasing costly medical interventions, insurance companies have begun covering their services. In 2014, …

Food Stamp Participation And Health Outcomes In Ca Immigrants, Esther Kang

Scripps Senior Theses

The U.S. social welfare system includes programs aiming to increase access to nutritious food to reduce nutrition insecurity. However, studies suggest that immigrants continue to face disproportionate risks of nutrition insecurity and may face barriers to enrollment due to legal status. This study, using secondary data from the 2023 California Health Interview Survey, examines the associations between food stamp participation, food insecurity, and clinical diagnosis of diabetes among adult U.S.-born, naturalized, and non-citizen adults in California. The findings suggest that those enrolled in food stamps are more likely to report food insecurity than those who are not enrolled, and that …

Neighborhood Socioeconomic Deprivation And Physical Activity Associate With Extracellular Vesicle Size And Cargo In A Community-Based Cohort Of Women, Yvonne Baumer, Elizabeth M. Aquino Peterson, Matthew R. Bavuso, Noel Miller, Cristhian A. Gutierrez-Huerta, Nithya P. Vijayakumar, Sam J. Neally, Kaveri Curlin, Valerie M. Mitchell, Billy S. Collins, Neelam R. Redekar, Subrata Paul, Anca D. Dobrian, Tiffany M. Powell-Wiley

Department of Biomedical and Translational Sciences Faculty Publications

African American (AA) women face disproportionate cardiovascular disease (CVD) risk due to adverse social determinants of health (SDoH), including lower socioeconomic status (SES). Physical activity (PA) and plasma extracellular vesicles (EVs) modulate CVD risk, but their relationships with SDoH remain unclear. This study examines associations between SDoH, PA, and plasma EVs in a Washington, DC-based cohort of at-risk AA women. Participants (N = 24, Age: 57 ± 12, BMI: 35 ± 6, ASCVD: 9 ± 5) joined the Step It Up Community-Engaged, Digital Health Physical Activity Intervention pilot study. EVs were isolated from fasting plasma samples. Multivariable regression, adjusted for …

Technological Interventions For Reducing Climate Change Impacts On Health: An Overview Of Future Possibilities, Sujatha Alla, Vijay Kumar Chattu, Bawa Singh

Engineering Management & Systems Engineering Faculty Publications

Globally, over five million deaths annually are attributed to extreme weather events exacerbated by climate change, such as heatwaves, hurricanes, wildfires, droughts, and floods, which create health crises and economic losses. The 2015 Paris Declaration emphasized climate technology mechanisms, including research and development, to enhance resilience and reduce greenhouse gas emissions. Biotechnological advancements have mitigated about 20% of economic losses since the 1960s, highlighting technology’s potential to address climate-induced health risks.

Edible Cannabis Product Information Captured Within Patient Poison Center Records, G. Fulkerson, B. J. Holstege, R. Farah, A. Zmuda, C. P. Holstege

Department Psychiatry & Behavioral Science Faculty Publications

Introduction

United States poison centers are encountering increasing numbers of calls pertaining to edible cannabis exposed patients following state decriminalization. The emergence of these edible products has led to numerous emergency department visits in both adults and children following exposure. The capturing of specific data associated with the product type is imperative as state government regulators attempt to control cannabis products emerging on the market as a growing public health issue.

Objectives

This study was performed to determine if the exact products involved with edible cannabis exposure were being captured in the electronic medicial records and to delineate those specific …

The Impact Of Substance Abuse Problems And Serious Mental Illness/Serious Emotional Distress On Post-Discharge Residential Status Among Clients With Behavioral And Cognitive Disorders: Evidence From Samhsa Mh-Cld Data, Eden Moges, Norma Rochez, William Peycha, Aditya Chakraborty

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

BACKGROUND: Behavioral and cognitive disorders can undermine housing stability, a key determinant of mental health recovery, with persistent disparities across demographic and socioeconomic groups. This study examined the associations of substance abuse problems (SAP) and serious mental illness/serious emotional distress (SMISED) with residential status at discharge from mental health facilities.

METHODS: This cross-sectional study used the utilized data from the Substance Abuse and Mental Health Services Administration (SAMHSA). Descriptive statistics were used to summarize demographic characteristics, whereas univariate and multivariable logistic regression models were employed to assess associations between the covariates and the residential outcome, adjusting for a variety of …

Air Quality Risks In Public Housing, Brynn Sheehan, Carolyn Caraballo Velez, Vaughan W. Rees, Miasha T. O'Neal, Kristen E. Moore, Katie M. Jones, Jessica Meadows, Sarah Gehlert, Richard Grucza, Andrew Plunk, Kelli J. England

Department Psychiatry & Behavioral Science Faculty Publications

Importance Public housing residents face elevated environmental health risks, yet indoor air quality in these settings remains underexamined. OBJECTIVE: To evaluate indoor air quality in public housing 5 years after implementation of the federal smoke-free housing policy and compare it with outdoor air quality in the same regions.

Design, Setting, and Participants A 1-year cohort study of indoor air quality (particulate matter ≤2.5 μm in diameter [PM2.5]) across 12 multifamily public housing communities in southeastern Virgina for individuals 65 years and older or persons with disability in cities with the highest rated outdoor air quality. Indoor PM2.5 was continuously measured …

From Coverage To Care: Evaluating The Effects Of Aca Medicaid Expansion On Birth Outcomes, Bailey R. Lengfelder

Economics Honors Projects

I examine the impact of the Affordable Care Act’s Medicaid expansion on maternal and fetal health outcomes using National Center for Health Statistics Natality data from 2006 to 2023. I exploit staggered state adoption as a quasi-experiment, and the staggered differences-in-differences estimates indicate an increase in the share of Medicaid births but broadly no impact on maternal prenatal care, maternal health, and fetal health. The absence of statistically significant effects is consistent across heterogeneity groups. These null findings indicate that expanded insurance access through the Affordable Care Act may be insufficient to improve health outcomes. I do find a statistically …

Spectral Frequency And Broadband Noise Analysis Of The Firefighter Environment: Potential Implications For Cardiac Health, James Blando, Catherine Reed, Amya Turner

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Firefighters are well known to have elevated risk of adverse health outcomes across a wide range of diseases and injuries, including cancer, hearing loss, fatal cardiac events, post-traumatic stress disorder (PTSD), sleep disorders, and many other adverse outcomes. It has been speculated that the noise environment is a significant risk factor for several of these diseases. In particular, the impact of noise on cardiac outcomes has recently been identified. An environmental survey of noise that included spectral and broadband analysis was conducted across all 14 firehouses in a southeastern city in the United States as a first step to investigate …

Incorporating New Guidelines Into School-Based Asthma Management, Jessica Michala Jindra, Angela Duff Hogan

Department of Pediatrics Faculty Publications

Purpose of the Review

The aim of this review is to identify barriers and provide solutions to the implementation of inhaled corticosteroid-formoterol as rescue therapy within schools.

Recent findings

GINA guidelines in 2019 and NAEPP in 2020 recommended inhaled corticosteroids combined with formoterol for a rescue inhaler over the traditional short-acting beta-agonist.

Summary

The findings discussed in this article describe the barriers to the implementation of inhaled corticosteroids combined with formoterol for a rescue inhaler in school systems. Traditional asthma action plans, school nursing and parental education, and differences in dosing are some barriers identified. This paper provides solutions for …

A Scoping Review To Conceptualize Social Privilege For Studying Patients' Health Outcomes And Health Disparities, Elizabeth A. Brown, Priyanka Patel, Esther May B. Sarino, Vladimir Markovic, Carles Muntaner

Health Behavior, Policy & Management Faculty Publications

Background

The continued reliance on single-category self-reported demographic data (e.g., race/ethnicity) reflects conceptual limitations that hinder the study and understanding of health outcomes research. There is a pressing need for more precise measures of social privilege that conceptualize privilege and oppression while enabling the examination of their effects on health outcomes in the United States (US) healthcare system.

Objective

The purpose of this scoping review was to review the literature, determine how researchers have measured aspects of privilege and oppression, and develop a conceptual framework to study patients' social privilege in the US healthcare system and public health research.

Methods …

Natural Resource Rents And Energy Poverty Nexus In Next Eleven Economies, Muhammad Salah Uddin, Ayub Ali, Zobayer Ahmed, Md Nasir Uddin Sikdar, Ahsan Habib, Abdullah Elah Al-Mahde

Finance Faculty Publications

Energy poverty (EP) remains a persistent global challenge with important implications for economic development, public health, and social welfare. While natural resources, particularly oil and gas, are often viewed as key sources of energy access, their effectiveness in mitigating EP remains underexplored in emerging economies. This study examines the relationship between natural resource rents (NRR), specifically oil rents (OR) and natural gas rents (NGR), and energy poverty (EP) in the Next Eleven (N-11) countries from 2000 to 2020. The primary objective is to assess how NRR influences EP at various levels of poverty using the Method of Moments Quantile Regression …

Association Between Neighborhood Social Determinants Of Health And Stillbirth, Tetsuya Kawakita, Misa Hayasaka, Ann M. Harper, John Brush, George Saade

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE:

To examine the association between neighborhood-level social determinants of health and stillbirth.

METHODS:

We performed a retrospective cohort study of deliveries that occurred at a gestational age of at least 20 weeks within a five-hospital system (2012-2022). Electronic health record data mapped to the Observational Medical Outcomes Partnership Common Data Model were geocoded using addresses at the time of delivery and linked to neighborhood health indices, which included the Area Deprivation Index (ADI), Maternal Vulnerability Index (MVI), and Social Vulnerability Index (SVI) at the Census tract level. Stillbirths were adjudicated by medical record review. Modified Poisson regression generated relative …

Mediating Effect Of Social Determinants Of Health Between Race And Phthalate Biomarkers In Pregnancy, Tetsuya Kawakita, Misa Hayasaka, Carole Barake, Trinity Soto, Jillian Fleming, Amir Lueth, Stevens Danielle, Alfred Abuhamad, Ann Pryzybylska, Elena Sinkovskaya, Kelly K. Ferguson, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Introduction

Prenatal phthalate exposure is linked to adverse reproductive and developmental outcomes and is consistently higher among non‐Hispanic Black compared to non‐Hispanic White pregnant individuals, yet the factors responsible for these disparities are poorly characterized. We sought to quantify Black–White differences in repeated urinary concentrations of phthalate biomarkers during pregnancy and to estimate the extent to which neighborhood‐level social determinants of health (SDoH) mediate these disparities.

Methods

This secondary analysis used data from the Human Placenta Project Study, a prospective observational cohort study conducted at two academic institutions between 2016 and 2018. Eligible participants had singleton pregnancies, were recruited before …

Diagnosing The Discourse: How The Academy Of Breastfeeding Medicine Constructs And Constrains Treatment Of Tethered Oral Tissues, Mary E. Miller

Antioch University Dissertations & Theses

While breastfeeding is recognized as fundamental to global public health, oral restrictions that can affect infant latch, milk transfer, and feeding efficiency warrant further examination within policy frameworks. This dissertation proposes an expanded conceptualization of tethered oral tissues (TOTs) that encompasses not only anatomical frenal restrictions but also fascial tensions, neuromuscular limitations, and other conditions restricting orofacial function that may be congenital or acquired. The purpose of this study was to critically examine how this clinical guidance document shapes understandings and responses to TOTs. Using Carol Bacchi’s “What’s the Problem Represented to Be?” approach, a critical discourse analysis of the …

The Cost Of Getting To “No”: Cultural Evolution Of Community Psychology In Two Indiana Communities, Catherine Cullen, Megan Peek

The Journal of Purdue Undergraduate Research

No abstract provided.

Addressing Challenges In Accessing Secondary And Tertiary Healthcare Services For Migrants And Refugees In Egypt, Noura Seada, Nehal El-Bakhshawangy, Heba Semary, Fatma Alzahraa Hassan, Ahmed Hammad

Papers, Posters, and Presentations

The growing number of vulnerable migrants and refugees worldwide presents a significant challenge to host countries, particularly in terms of accessing healthcare services. Egypt hosts over 9 million migrants and refugees, with 1.5 million in a vulnerable situation. Despite the country’s efforts in providing adequate healthcare to these vulnerable groups, some challenges persist. This paper addresses the barriers that vulnerable migrants and refugees face when seeking secondary and tertiary healthcare services in Egypt, analyzing the legal, economic, social, and health system factors that contribute to this problem.

In 2018, the Egyptian government began an ambitious journey to reform its healthcare …

Behind The Badge: Effects Of Stress And Trauma In Policing -- Understanding The Importance Of Evidence-Based Prevention, Early Intervention, And Wellness Programs, Jessica Rolshouse

Master of Arts in Human Services

Law enforcement officers are exposed to occupational stress and trauma routinely and at rates that far exceed the general population. This chronic exposure places them at risk for physical and psychological injury and negative outcomes to include mental health disorders including burnout, anxiety, depression, and PTSD. Prolonged exposure to occupational stress and trauma also increases the risk of suicidal ideation and dying by suicide, the most tragic outcome of the stress law enforcement officers face. This literature review focuses on individual risk factors, occupational stress, and trauma, and the development of mental health disorders in law enforcement officers. It also …

Disaster Risk Reduction In Rural Indonesia: Evaluation Of The Japan Red Cross Program In Pujiharjo Village, Meyralda Dara Adisa, Pujo Widodo, Anwar Kurniadi, Wilopo Wilopo

Preventia: The Indonesian Journal of Public Health

Pujiharjo Village in Malang Regency, Indonesia, is highly vulnerable to natural disasters. In 2021, the Indonesian Red Cross (PMI) partnered with the Japanese Red Cross Society (JRCS) to implement a community-based disaster preparedness program. This study evaluates the program's effectiveness in terms of community participation, institutional support, and alignment with the Sendai Framework for Disaster Risk Reduction 2015–2030. Using a qualitative case study, data were collected through document analysis of Vulnerability and Capacity Assessments (VCA), Community Action Plans (CAP), and local SOPs. Thematic analysis explored disaster risk perception, governance, mitigation investment, and emergency preparedness. The program successfully improved risk awareness, …

Asian College Students' Well-Being During A Period Of Rising Anti-Asian Sentiment, Kyuhan Choi, Ying Shi, Maria Zhu

Center for Policy Research

We use a large survey of students in U.S. colleges to study the distinct ways in which the COVID-19 pandemic and accompanying anti-Asian rhetoric shaped the experiences of Asian and Pacific Islanders (APIs). Using a difference-in-differences approach, we find that the pandemic led to Asian students experiencing more discrimination, feeling less safe during the day, and using fewer mental health services compared to White peers. The increase in discrimination and the perceived lower safety are concentrated among East and Southeast Asians, while South Asians were not affected. Despite these effects, we detect no relative deterioration in severe psychological distress or …