Public Health Commons^™

Preface: Experiencing Cancer In Appalachian Kentucky, Michele Ellison, Robin C. Vanderpool

Journal of Appalachian Health

Connected cancer care is of increasing importance in light of the COVID-19 pandemic. The Linking & Amplifying User-Centered Networks through Connected Health (L.A.U.N.C.H.) Collaborative in Appalachian Kentucky has pioneered a new roadmap for equipping communities with the transformative power of broadband to innovate around the future of cancer care and to better scale their ideas. The roadmap involves reaching across disciplines, including public health, anthropology, telecommunications, and user-centered design. The goal is to leverage connectivity and cancer communication research and practice to make a real difference for patients and families.

Geographic Variation In The Structure Of Kentucky’S Population Health Systems: An Urban, Rural, And Appalachian Comparison, Rachel Hogg-Graham, Angela Carman, Glen P. Mays, Pierre Martin Dominique Zephyr

Journal of Appalachian Health

Introduction: Research examining geographic variation in the structure of population health systems is continuing to emerge, and most of the evidence that currently exists divides systems by urban and rural designation. Very little is understood about how being rural and Appalachian impacts population health system structure and strength.

Purpose: This study examines geographic differences in key characteristics of population health systems in urban, rural non-Appalachian, and rural Appalachian regions of Kentucky.

Methods: Data from a 2018 statewide survey of community networks was used to examine population health system characteristics. Descriptive statistics were generated to examine variation across geographic regions in …

Appalachian Regional Commission Recovery Ecosystem Background And Overview, Kostas Skordas, Andrew Howard

Journal of Appalachian Health

The Appalachian Regional Commission (ARC) has long addressed issues of substance abuse through funded community-based interventions, research, and sponsored conferences. Recently, the opioid crisis created a new urgency for cross-sector collaboration among various partners and funders dealing with this issue. This commentary provides an overview of recent efforts by the ARC to convene stakeholders to focus on assisting individuals with substance abuse disorder to access recovery services while pursuing education and training necessary to reenter the workforce and gain employment. Two papers have been prepared to describe this year-long effort. One paper focuses on the participatory methods used to gather …

Perspective On Substance-Abuse Recovery Ecosystem From The Appalachian Regional Commission Federal Co-Chair, Tim Thomas

Journal of Appalachian Health

The Appalachian Regional Commission (ARC) is a local, state, and federal partnership focused on economic development in the communities of the Appalachian Region. ARC Federal Co-Chairman Tim Thomas provides his perspective on how an economic development entity, such as ARC, can support efforts to address the Region’s drug crisis in a way that both saves lives and strengthens economic opportunity in communities throughout Appalachia.

Fiscal Challenges And Anticipated Changes To Kentucky's Population Health System, Jeffrey Howard

Journal of Appalachian Health

The hallmark of public health is population-level intervention. However, current public health funding in Kentucky is largely programmatic or disease-based. As a result, public health leaders are not able to appropriately utilize present resources to pursue population health endeavors. However, a recent transformation of the public health system has emphasized multisector partnerships and efficient funding mechanisms that may increase resources to pursue population-level health interventions based on community health assessments.

Cbt-Informed Interventions For Essential Workers During The Covid-19 Pandemic, Kathy Benhamou, Alexandra Piedra

Student Scholarship

Essential workers during the COVID-19 pandemic face heightened levels of anxiety and depression due to increased work demands, lack of adequate personal protective equipment, fear of contracting the virus, and fear of spreading it to loved ones. This is a time of urgent need for mental health support for workers affected by the pandemic crisis. Clinicians may employ empirically supported interventions derived from cognitive behavioral therapy (CBT) and related therapies. Psychological First Aid, an evidence-based crisis intervention, may be utilized to emphasize basic needs and support, but is intended as an acute disaster intervention. Given that a pandemic is an …

Covid-19 Spread In Europe: The Soccer Connection, Bibodh J. Karki, Raghava S. Ambadapoodi, Zahid Imran, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Introduction: Mass gatherings, such as sports events, are potential causes of the rapid spread of COVID-19 infection. Millions of soccer fans travel across Europe every week. With the world’s most popular leagues continuing play until the second week of March 2020, we hypothesize that a correlation exists between the number of people attending the soccer league games in Spain, Italy, France, Germany, and the UK and the increasing number of cases of COVID-19 in these countries during the ongoing epidemic.

Methods: We calculated the total number of attendees in the five major soccer leagues from the popular sports websites and …

Black Drowning Deaths: An Introductory Analysis, Alena Gadberry, James Gadberry

International Journal of Aquatic Research and Education

Black children between the ages of 5 and 14 are 2.6 times more likely to drown than white children. A systematic exclusion from public pools and other forms of water activities over time has led to a lack of cultural capital involving aquatics among black families. Pierre Bourdieu has provided a theoretical foundation in which to understand this issue. The social fields created by generational socialization have made blacks feel like they have no place in the water. It will take a restructuring of the social institutions to set in motion the socialization (or a re-socialization) of new and more …

Understanding Attitudes Toward Healthcare Reform: The Roles Of Self-Interest, Group Identity And Racial Resentment, Maria Beatrice Livaudais

Political Science ETDs

The Patient Protection and Affordable Care Act (ACA) cemented itself as one of the most controversial pieces of legislation of the decade. Public opinion polls find Americans are often evenly split in support of the ACA. This dissertation explores the roles of self-interest, group identity, and racial resentment on attitudes toward the ACA and healthcare reform. The dissertation centers our attention on variation by race and the impact racial tensions beyond the Black-White paradigm on these attitudes. I find group identity shapes attitudes Blacks’ and Latinos’ attitudes toward the ACA but not Whites’ and racial resentment, directed toward Blacks, Latinos …

Lessons From A Five-Year Research Programme On Fgm/C And Their Relevance For Policy And Programmes In Kenya, Dennis Matanda, Agnes K. Meroka-Mutua, Samuel Kimani

Reproductive Health

The Sustainable Development Goals target the elimination of all forms of harmful practices, including female genital mutilation/cutting (FGM/C) by 2030. Kenya has made progress in addressing the elimination of FGM/C through ratification of global instruments and enactment of the Prohibition of FGM Act in 2011 and other supportive laws. The Act created the foundation for the establishment of the Anti-FGM Board, which provides policy leadership and coordination of anti-FGM/C programs in Kenya. More recently, the President of Kenya issued a decree for accelerated elimination of FGM/C by 2022. This synthesis report highlights how evidence generated over the last five years …

Effects Of Covid-19 On Nutrition In Bihar, Unicef, Population Council Institute

Poverty, Gender, and Youth

An extended nationwide lockdown and stoppage of economic activities resulting from COVID-19 caused substantial loss of income for many families in Bihar, India. One of the significant implications is a food shortage in households and a reduction in food intake. This nutrition shock may hit females harder than males due to the deep-rooted gendered culture prevalent in India. This study's key objectives are to understand the extent of food shortage in households, any changes in food intake, and coverage of government nutrition schemes. Half of the households in Bihar reported food shortages in the past month, causing most to reduce …

Self-Help Groups: A Potential Pivot Of Bihar's Response To Covid-19, Unicef, Population Council Institute

Poverty, Gender, and Youth

More than 10 million women in Bihar, India, are members of women’s self-help groups (SHGs), run by the Bihar Rural Livelihoods Promotion Society, Government of Bihar. The SHGs play a crucial role in the community by providing livelihood support and income-generating activities to their members. The key objectives of this study are to document SHG leaders’ engagement in community awareness and infection-prevention activities and the extent of support they give to their members through different funds and loans for livelihoods and income generation during the COVID-19 pandemic. About half of the SHG leaders were engaged in COVID-19–related community-awareness and prevention …

Covid-19 Times: Study Protocol For Rapid Assessment Of The Situation Of Women And Children In Bihar, Unicef, Population Council Institute

Poverty, Gender, and Youth

India reported its first COVID-19 case on January 30, 2020, and numbers began to rise in late March 2020. The containment measures implemented by the national and state governments, particularly the nationwide lockdown, have helped keep the COVID-19 pandemic at a relatively low level in India. Bihar, being one of the poorest states in India, is at particularly high risk of adverse health and economic effects of COVID-19 and the lockdown. The Population Council Institute, in partnership with UNICEF Bihar, is conducting a rapid longitudinal study that aims to inform the design and development of locally relevant suitable response mechanisms …

Returning Home: Effects Of Covid-19 On Migrant Households In Bihar, Unicef, Population Council Institute

Poverty, Gender, and Youth

Many migrants from metropolitan cities in India began to return to their native homes with the rise in COVID-19 cases in the cities and the extension of the lockdown. With relaxation of travel restrictions, Bihar started receiving migrants who were returning home. The government made arrangements for them to be quarantined before they traveled to their villages and homes. The key objectives of this study are to understand the extent of return migration, the impact of lockdown on migrant household livelihoods, and the opportunities for household economic revival through social protection schemes. Among migrant households, about half may experience return …

Effects Of Covid-19 On Livelihood, Employment, And Financial Resources, Unicef, Population Council Institute

Poverty, Gender, and Youth

COVID-19 and steps to break the chain of viral transmission led to certain economic challenges that triggered loss in livelihoods and income and constraints on financial resources in Bihar, India. Often, these effects were disproportionately experienced among the most marginalized. The key objective of this study is to assess the loss of income, livelihoods, and jobs among households in Bihar to help with program planning and implementation. Data were gathered May 13–22, 2020, from the existing study cohort of households under the UDAYA study. Interviews were conducted with a total of 794 participant households. About four-fifths of respondents said their …

Are More People Adopting Covid-19 Prevention Measures?, Unicef, Population Council Institute

Poverty, Gender, and Youth

Drawing on data from two rounds of COVID-19 knowledge, attitudes, and practices (KAP) telephone surveys conducted in Bihar, India, this research brief sheds light on the socioeconomic differentials and changes over time in the adoption of COVID-19 preventive measures. Though the adoption of preventive measures has increased, around two-fifths of males and one-quarter of females reported that they were currently practicing all four standard preventive measures. The better educated, wealthier, and those belonging to privileged castes were more likely than others to practice these measures, as were those who perceived moderate or high risk of COVID-19 in their neighborhood. Social …

Awareness Of And Receiving Social Protection Measures During Covid-19 Lockdown In Bihar, India, Unicef, Population Council Institute

Poverty, Gender, and Youth

Economic hardships caused by the nationwide lockdown to prevent the spread of COVID-19 have been reported across India. Social protection measures have been announced by the state and central governments to ease these hardships. The key objectives of this research brief are to examine the awareness and the social protection measures received during the COVID-19 lockdown in Bihar, and the socioeconomic differentials in receiving these measures. The majority of respondents (64%) reported a family member losing their job/income-earning opportunity and lacking resources to survive for long. Awareness of social protection schemes was high (88%). Among households, 68% reported having ration …

Demand For And Access To Family Planning Services Among Young Married Women During Covid-19 Crisis, Unicef, Population Council Institute

Poverty, Gender, and Youth

In Bihar, India, as a result of the COVID-19 lockdown and men returning home in large numbers and spending more time at home in high stress conditions, the need for contraceptive services could get greater. March to May are considered the “lean season” when demand is typically low for family planning (FP) programs in states like Bihar. However, higher demand caused by the lockdown and lack of access to health facilities has created a gap between demand and uptake. This could have negative consequences such as high numbers of unintended pregnancies, unsafe abortions, and maternal mortality. Current use of modern …

Disparities In Vulnerability To Severe Complications From Covid-19 In The United States, Emily E. Wiemers, Scott Abrahams, Marwa Alfakhri, V. Joseph Holtz, Robert F. Schoeni, Judith A. Seltzer

Population Health Research Brief Series

Preexisting health conditions increase vulnerability to severe complications from COVID-19. Among middle-aged and older Americans, vulnerability to severe COVID-19 complications based on preexisting conditions is 2-3 times greater for those with low versus high income. Vulnerability is about 40% higher for middle-aged and older adults with a high school degree or less than adults with a four-year college degree. In every age group, Blacks are more vulnerable than Whites, but Hispanics are at lower risk based on fewer preexisting health conditions.

Important Lessons On Fgm/C Abandonment From Four Research Studies In Egypt, Nada Wahba, Nahla G. Abdel-Tawab, Abeer Salem

Reproductive Health

Female genital mutilation/cutting (FGM/C) continues to be a widespread practice in Egypt. According to the 2014 Egypt Demographic and Health Survey, the prevalence of FGM/C was 92 percent among ever-married women aged 15–49. However, Egypt continues to witness a drastic surge in the medicalization of FGM/C, with 74 percent of women aged 19 years and younger circumcised by medical practitioners, compared to 55 percent in 1995. This policy brief provides key results and recommendations of four studies conducted by the Population Council/ Egypt under the Evidence to End FGM/C project, in coordination with Egypt’s National Population Council. The four studies …

Commentary: Using Law More Effectively Towards Abandonment Of Fgm/C In Kenya, Agnes K. Meroka-Mutua

Reproductive Health

Female genital mutilation/cutting (FGM/C) is considered a harmful cultural practice and a form of violence against women. Kenya has an FGM/C prevalence rate of 21 percent, but levels vary by ethnic group. Kenya has adopted a robust legal framework for the prohibition of FGM/C, including passage of the Prohibition of FGM Act in 2011, a detailed law that criminalizes carrying out FGM/C and associated offenses. Kenya relies on the human rights–based approach and criminalization in its legal framework for the prohibition of this practice. Despite extensive legal provisions, Kenya has prosecuted fewer than 100 cases, raising concerns with the law’s …

Insufficient Sun Exposure Has Become A Real Public Health Problem, Lars Alfredsson, Bruce K Armstrong, D. Allan Butterfield, Rajiv Chowdhury, Frank R. De Gruijl, Martin Feelisch, Cedric F. Garland, Prue H. Hart, David G. Hoel, Ramune Jacobsen, Pelle G. Lindqvist, David J. Llewellyn, Henning Tiemeier, Richard B. Weller, Antony R. Young

Chemistry Faculty Publications

This article aims to alert the medical community and public health authorities to accumulating evidence on health benefits from sun exposure, which suggests that insufficient sun exposure is a significant public health problem. Studies in the past decade indicate that insufficient sun exposure may be responsible for 340,000 deaths in the United States and 480,000 deaths in Europe per year, and an increased incidence of breast cancer, colorectal cancer, hypertension, cardiovascular disease, metabolic syndrome, multiple sclerosis, Alzheimer's disease, autism, asthma, type 1 diabetes and myopia. Vitamin D has long been considered the principal mediator of beneficial effects of sun exposure. …

Calculating An Equation To Estimate The Maximum Oxygen Uptake In Lifeguards, Brais Ruibal-Lista, José Palacios-Aguilar, José Antonio Prieto, Sergio López-García, Miguel Santiago-Alonso, José Antonio Cecchini-Estrada, Cristian Abelairas-Gómez

International Journal of Aquatic Research and Education

The aim of this study was to derive an equation that validly and reliably estimates the VO₂ reached in the IPTL, a maximum stress test for lifeguards. From the results obtained in the first part of the research, a multiple linear regression model was identified. A "stepwise" procedure was established as a variable selection method, where the VO_2IPTL was selected as the dependent variable and the maximum time reached in the IPTL (s), the percentage of muscle mass (%) and weight of the participant (kg), as independent variables. This procedure generated a regression model where a high correlation …

What Do Children Need From Playwork In The Time Of Covid-19? A Reflection On Playwork Practice In A Pandemic., Freya H. Howard

International Journal of Playwork Practice

This article explores the child’s need for play especially at the time of the coronavirus (COVID-19) pandemic in terms of the child’s welfare and rights, playfulness and their wellbeing. It reflects on previously learnt lessons with regards to virus outbreaks and the production of activity packs as a means of playwork in the pandemic context.

Portuguese Lifeguards Performance In Aquatic Rescue: An Exploratory Study, Olga G. Marques Ph.D., José Palacios-Aguilar Ph.D, Henrique G. Melo Mcs., Nuno G. Leitão, Lucia P. Castillo Msc., David Szpilman M.D, Luís Rama Ph.D.

International Journal of Aquatic Research and Education

The objective of the study was to compare the performance of Portuguese lifeguards in two trials of simulated rescue at the beach within a regular continuous workday. Additionally, the study aimed to analyse the influence of experience and initial course syllabus on the rescue performance. A total of 86 Portuguese lifeguards (LG) participated in this study, 69 males and 17 females. The two simulated drowning occurrences were planned to occur at 50 meters from the coastline between 9.00h am and 18.00h pm. The weather conditions, the characteristics of the beach, wave amplitude were also controlled. The results were analysed through …

Digital Disinformation Is A Threat To Public Health, Austin Mcneill Brown

Population Health Research Brief Series

In times of public health crises, like COVID-19, a country’s residents must be able to access valid, timely, and evidence-based information that can guide behaviors and prevention strategies. Disinformation undermines these efforts and represents an existential threat to U.S. population health.

Publication Of Data Collection Forms From Nhlbi Funded Sickle Cell Disease Implementation Consortium (Scdic) Registry, Jeffrey Glassberg, Elizabeth A. Linton, Katrina Burson, Tabitha Hendershot, Joseph Telfair, Julie Kanter, Victor R. Gordeuk, Allison A. King, Cathy L. Melvin, Nirmish Shah, Jane S. Hankins, Axel Yannick Epié, Lynne D. Richardson

Health Policy & Community Health: Faculty Publications

Background: Sickle cell disease (SCD) is an autosomal recessive blood disorder affecting approximately 100,000 Americans and 3.1 million people globally. The scarcity of relevant knowledge and experience with rare diseases creates a unique need for cooperation and infrastructure to overcome challenges in translating basic research advances into clinical advances. Despite registry initiatives in SCD, the unavailability of descriptions of the selection process and copies of final data collection tools, coupled with incomplete representation of the SCD population hampers further research progress. This manuscript describes the SCDIC (Sickle Cell Disease Implementation Consortium) Registry development and makes the SCDIC Registry baseline …

Foundational Research And Nih Funding Enabling Emergency Use Authorization Of Remdesivir For Covid-19, Ekaterina Galkina Cleary, Matthew J. Jackson, Zoë Folchman-Wagner, Fred D. Ledley

Natural & Applied Sciences Faculty Publications

Emergency Use Authorization for remdesivir months after discovery of COVID-19 is unprecedented. Typically, decades of research and public-sector funding are required to establish the mature body of foundational research requisite for efficient, targeted drug discovery and development. This work quantifies the body of research related to remdesivir’s biological target, RNA-dependent RNA polymerase (RdRp), or parent chemical structure, nucleoside analogs (NcAn), through 2019, as well as NIH funding for this research 2000–2019. There were 6,567 RdRp-related publications in PubMed, including 1,263 with NIH support, and 11,073 NcAn-related publications, including 2,319 with NIH support. NIH support for RdRp research comprised 2,203 Project …

Immune Function During Pregnancy Varies Between Ecologically Distinct Populations, Carmen Hové, Benjamin C. Trumble, Amy S. Anderson, Jonathan Stieglitz, Hillard Kaplan, Michael Gurven, Aaron Blackwell

ESI Publications

Background and objectives

Among placental mammals, females undergo immunological shifts during pregnancy to accommodate the fetus (i.e. fetal tolerance). Fetal tolerance has primarily been characterized within post-industrial populations experiencing evolutionarily novel conditions (e.g. reduced pathogen exposure), which may shape maternal response to fetal antigens. This study investigates how ecological conditions affect maternal immune status during pregnancy by comparing the direction and magnitude of immunological changes associated with each trimester among the Tsimane (a subsistence population subjected to high pathogen load) and women in the USA.

Methodology

Data from the Tsimane Health and Life History Project (N = 935) and …

High Covid-19 Mortality Risk In Pennsylvania’S Rural Counties, Raeven Faye Chandler, Shannon M. Monnat, Yue Sun

Population Health Research Brief Series

COVID-19 cases in Pennsylvania have been concentrated in eastern urban counties this far. However, the 14-day incident rate has recently begun increasing in several rural counties that have high prevalence of several chronic health conditions that increase risk of severe complications and death from COVID-19.