Public Health Commons^™

Clinician Identified Barriers To Treatment For Individuals In Appalachia With Opioid Use Disorder Following Release From Prison: A Social Ecological Approach, Amanda M. Bunting, Carrie B. Oser, Michele Staton, Katherine S. Eddens, Hannah K. Knudsen

Sociology Faculty Publications

Background: The non-medical use of opioids has reached epidemic levels nationwide, and rural areas have been particularly affected by increasing rates of overdose mortality as well as increases in the prison population. Individuals with opioid use disorder (OUD) are at increased risk for relapse and overdose upon reentry to the community due to decreased tolerance during incarceration. It is crucial to identify barriers to substance use disorder treatment post-release from prison because treatment can be particularly difficult to access in resource-limited rural Appalachia.

Methods: A social ecological framework was utilized to examine barriers to community-based substance use treatment among individuals …

Project Renew Worcester, Danni Yue, Amy Zhang, Jing Han, Omid Ashrafi, Yiming Xu

School of Professional Studies

n The client for this capstone project is RENEW Worcester which is a fledgling solar power project whose main goals are to bring renewable energy in the form of solar power into local, primarily low-income communities and are committed to the mission of making the transition off of fossil fuels to clean, renewable power. Based in Worcester, Massachusetts, they are a local chapter of Co-op Power which is a consumer-owned sustainable energy cooperative (co-op) made up of numerous different local chapters all over the New England area as well as the state of New York. The problem that we will …

Maternal Immune Activation (Mia) In Mice: A Study To Phenotype Asd-Related Communication Behaviors And Analyze Maternal Health Outcomes In The Us, Komalpreet Gulati

Honors Scholar Theses

Core symptoms of Autism Spectrum Disorders (ASD) include deficits in social/communicative behaviors, and repetitive/stereotyped behaviors. Mouse models are a highly established paradigm used to study the phenotypic deficits that result from various inducible genotypic or environmental risk factors for ASD. Previous studies have demonstrated a link between maternal immune activation (MIA) and ASD-like behaviors in mouse models. In this model, the maternal immune system is activated during pregnancy by injecting the viral mimic poly(I:C). The resulting offspring are phenotyped and analyzed with regards to their communicative behaviors.

Previous studies have demonstrated that male pups born to dams with immune activation …

The Critical Need For Mental Health Education To Be Mandated In New Mexico's Public Schools, Bonnie L. Murphy

Shared Knowledge Conference

Based on a review of research and best practices in mental health awareness and skills, this inquiry project argues for state legislative policies that would require mental health awareness and skills in the K-12 curriculum. Mental health affects individual accomplishments in every stage of people’s lives beginning in early childhood and throughout the life cycle. Prevention and treatment of mental illness plays a key role in the ability of an individual to cope with loss and develop resiliency and perseverance in challenging times and to make better decisions that improve the individual’s life and the lives of those around them. …

School‐Level Body Mass Index Shapes Children's Weight Trajectories, Ashley W. Kranjac

Sociology Faculty Articles and Research

BACKGROUND

Embedded within children's weight trajectories are complex environmental contexts that influence obesity risk. As such, the normative environment of body mass index (BMI) within schools may influence children's weight trajectories as they age from kindergarten to fifth grade.

METHODS

I use 5 waves of the ECLS‐K—Kindergarten Class 1998‐1999 data and a series of multilevel growth models to examine whether attending schools with higher overall BMI influences children's weight status over time.

RESULTS

Results show that, net of child, family, and school sociodemographic characteristics, children who attend schools with higher rates of obesity have increased weight compared to children who …

Involuntary Termination From Substance Use Disorder Treatment: Unknown Phantoms, Red Flags, And Unexplained Medical Data, Izaak L. Williams

Journal of Human Services: Training, Research, and Practice

In the United States, all treatment programs receiving public funds are required by law to regularly submit admission and discharge data, inclusive of the forced/involuntary termination or administrative discharge of clients, to their local state authorities. In some states, this requirement even extends to programs not receiving public funds. The aim of collecting discharge data—collected under the auspices of the Substance Abuse and Mental Health Services Association [SAMHSA]—is to assist state and county authorities, funders, and accreditors to monitor recovery-focused program performance. However, investigation here undertaken shows that published discharge data from many state treatment settings are perennially and grossly …

“My Determination Is To Live”: Narratives Of African-American Women Who Have Lived With Hiv For 10 Or More Years, Sabrina Cherry, Kathleen Demarrais, Cheryl Keita, Marsha Davis, Joel Lee

The Qualitative Report

Exploring the experiences of African-American women who have lived with HIV for many years can inform public health practice on how to better serve high-risk populations along the care continuum. To understand the experiences of African-American women who are HIV positive, the researchers used a narrative approach to guide repeat interviews. Under a theoretical framework of Womanism, we interviewed six African-American women ages 48-66 (M=57) who have lived with HIV for 10 years or longer and conducted analyses of narrative to identify key themes. The primary themes were: recollecting early hardships, HIV infection, and diagnosis; embracing social support; surviving and …

Tumor Biology And Racial Disparities In Reconstruction After Mastectomy: A Seer Database Analysis, Sarah J. Ullrich, Michael C. Smith, Paul J. Chung, Sara Y. Kim, Gainosuke Sugiyama

Journal of Health Disparities Research and Practice

Introduction:

Significant disparities in immediate breast reconstruction after mastectomy have persisted, and may even be increasing, despite large-scale efforts to minimize them, such as the Women’s Health and Cancer Rights Act of 1998. Immediate breast reconstruction has been shown to lead to higher rates of surgical satisfaction, minimize delay in post-operative cancer treatment, and improve the quality of life and overall well-being of mastectomy patients. However only 25-40% of eligible women in the United States receive reconstruction. The rate of reconstruction is even lower in African American and Hispanic women compared to White women. To better understand this disparity, …

Racial Disparities In Breast Cancer Survival: The Mediating Effects Of Macro-Social Context And Social Network Factors, Ganga Vijayasiri, Yamile Molina, Ifeanyi B. Chukwudozie, Silvia Tejeda, Heather Pauls, Garth Rauscher, Richard T. Campbell, Richard B. Warnecke

Journal of Health Disparities Research and Practice

ABSTRACT

This study attempts to clarify the associations between macro-social and social network factors and continuing racial disparities in breast cancer survival. The study improves on prior methodologies by using a neighborhood disadvantage measure that assesses both economic and social disadvantage and an ego-network measurement tool that assesses key social network characteristics. Our population-based sample included 786 breast cancer patients (nHWhite=388; nHBlack=398) diagnosed during 2005-2008 in Chicago, IL. The data included census-derived macro-social context, self-reported social network, self-reported demographic and medically abstracted health measures. Mortality data from the National Death Index (NDI) were used to determine 5-year survival.

Based on …

Promoting Community And Population Health In Public Health And Medicine: A Stepwise Guide To Initiating And Conducting Community-Engaged Research, Scott D. Rhodes, Amanda E. Tanner, Lilli Mann-Jackson, Jorge Alonzo, Florence Siman, Eunyoung Y. Song, Jonathan Bell, Megan B. Irby, Aaron T. Vissman, Robert E. Aronson

Journal of Health Disparities Research and Practice

Various methods, approaches, and strategies designed to understand and reduce health disparities, increase health equity, and promote community and population health have emerged within public health and medicine. One such approach is community-engaged research. While the literature describing the theory, principles, and rationale underlying community engagement is broad, few models or frameworks exist to guide its implementation. We abstracted, analyzed, and interpreted data from existing project documentation including proposal documents, project-specific logic models, research team and partnership meeting notes, and other materials from 24 funded community-engaged research projects conducted over the past 17 years. We developed a 15-step process designed …

Discutiendo Desde El Interior: La Marginación De Los Hombres Trans Dentro Del Movimiento Por El Aborto Legal En Argentina / Arguing From Within: The Marginalization Of Trans Men Within The Movement For Legal Abortion In Argentina, Olivia Nichols

Independent Study Project (ISP) Collection

En la actualidad, el color verde lleva con ello una asociación casi indudable al movimiento por el aborto legal en Argentina. A pesar de este alto perfil del movimiento conocido como la marea verde, una recorrida por la historia del movimiento revela una gran brecha en el diálogo en relación con la inclusión de personas que no son mujeres cis, como los hombres trans que también abortan.

Informada por entrevistas con activistas trans argentinos y la observación de un encuentro de la Campaña Nacional por el Derecho al Aborto Legal, Seguro y Gratuito, esta investigación considera la inclusión (o falta …

Older Adults' Health Care Utilization A Year After Experiencing Fear Or Distress From Hurricane Sandy, Laura P Sands, Yimeng Xie, Rachel Pruchno, Allison Heid, Yili Hong

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVE: To determine whether self-reports of disaster-related psychological distress predict older adults' health care utilization during the year after Hurricane Sandy, which hit New Jersey on October 29, 2012.

METHODS: Respondents were from the ORANJ BOWL Study, a random-digit dialed sample from New Jersey recruited from 2006 to 2008. Medicare hospital, emergency department (ED) and outpatient claims data from 2012 and 2013 were matched to 1607 people age 65 and older in 2012 who responded to follow-up surveys conducted from July 2013 to July 2015 to determine their hurricane-related experiences.

RESULTS: In total, 7% (107) of respondents reported they experienced …

The Challenges Of India’S Rising Breast Cancer Epidemic, Brigette Stickney

Independent Study Project (ISP) Collection

India is currently undergoing rapid urbanization, which is greatly impacting Indian citizens’ health. One of the rising concerns due to the drastic lifestyle and environmental changes that are results of urbanization is the issue of breast cancer. Breast cancer diagnosis rates are rising exponentially, and breast cancer has moved its way up to be the most common cancer in India. Breast cancer mortality rates in India are also some of the worst in the world. This paper analyses the social, mental, economic, geographic, and physical challenges that are present for women diagnosed with cancer in India. It assesses how they …

Lifetime Economic Burden Of Intimate Partner Violence Among U.S. Adults, Cora Peterson, Megan C. Kearns, Wendy Likamwa Mcintosh, Lianne Fuino Estefen, Christina Nicolaidis, Kathryn E. Mccollister, Amy Gordon, Curtis Florence

School of Social Work Faculty Publications and Presentations

Introduction: This study estimated the U.S. lifetime per-victim cost and economic burden of intimate partner violence.

Methods: Data from previous studies were combined with 2012 U.S. National Intimate Partner and Sexual Violence Survey data in a mathematical model. Intimate partner violence was defined as contact sexual violence, physical violence, or stalking victimization with related impact (e.g., missed work days). Costs included attributable impaired health, lost productivity, and criminal justice costs from the societal perspective. Mean age at first victimization was assessed as 25 years. Future costs were discounted by 3%. The main outcome measures were the mean per-victim (female and …

Integrated Mental Health Care In Education For Syrian Refugees: An Exploratory Study, Emily Goldstein

Independent Study Project (ISP) Collection

Trauma-inducing experiences during conflict can significantly impede the ability to function and effectively learn in the classroom; thus, it is essential to integrate mental health services into the school setting for refugee populations. This study investigated the state of integrated mental healthcare for Syrian refugees in Jordan by surveying Syrian students on their attitudes towards seeking mental health and interviewing educators on their classroom practices. The scope of the study was extremely limited, as data was collected on only 21 students and 5 educators in one school and a number of biases could have skewed the results. It was found …

Boys’ Sex Education In Rural Maharashtra: Context, Community, And Trust, Sierra Bradshaw-Kreimer

Independent Study Project (ISP) Collection

The primary research question of this study is: do alumni of CRHP’s Adolescent Boy’s Program (ABP) and parents of alumni of the ABP report that the boys have changed after completing the program, and if yes, in what ways? Beyond that, the study is also concerned with examining potential reasons behind the results of the primary research question. The researcher conducted interviews with 3 ABP alumni and 3 parents of ABP alumni, in addition to attending information sessions and observing the workings of CRHP. The primary findings were that yes, the respondents reported a change. The change was described as …

Trust, Access, And Adaptation To Needs: The Role Of Community-Based Promoters In Health Insurance Delivery In Gujarat, India, Lauryn Stafford

Independent Study Project (ISP) Collection

The research question this study addresses is: How do community-based promoters contribute to the delivery and utilization of health insurance among marginalized populations in India? To address this question, the successes and difficulties experienced by VimoSEWA community-based insurance promoters, called aagewans, were investigated through field visits and personal interviews in Ahmedabad and nearby rural districts in Gujarat. VimoSEWA’s insurance delivery model is an appropriate topic of investigation for this study because its beneficiaries are self-employed women with limited prior access to financial protection. Both aagewans and insurance members were interviewed during this study to develop a comprehensive understanding of the …

Poly Cystic Ovarian Syndrome In India: A Socio-Cultural Perspective, Hannah Wickham

Independent Study Project (ISP) Collection

This study examines the ways in which cultural determinants affect the health-seeking, diagnosis and treatment process of women with Poly Cystic Ovarian Syndrome (PCOS) as well as the underlying socio-cultural causes of the illness. Often coined as a “lifestyle disease”, PCOS is becoming a growing concern of physicians and women alike as its prevalence is on the rise with no signs of slowing down. Lifestyle, stigmas/taboos, PCOS’s effect on identity, and quality of life are all areas that are examined throughout this paper. A mixture of patients’ and doctors’ perspectives on PCOS were gathered throughout a three-week time period in …

Justice Served Fresh: Associations Between Food Insecurity, Community Gardening, And Property Value, Micajah Daniels, Courtney Coughenour Ph.D

McNair Poster Presentations

Numerous stakeholders in Nevada have used a variety of efforts to combat the growth of food insecurity facing Nevadans. The purpose of this research project is to understand the association between food insecurity, community gardens, and property value. Following the wealth of scholarship on these topics and data collected from community garden agencies in Southern Nevada, the research questions for this project include: (1) Where are community gardens located in SNV? (2) What efforts community gardens agencies are doing to address food insecurity (most interested in their efforts using community gardens)? (3) What are the perceptions of supports and barriers …

Cardiorespiratory Fitness Is Positively Associated With Waist To Height Ratio And School Socio Economic Status In Irish Primary School Aged Children, M. O'Leary, E. Rush, Seán Lacey, Con Burns, Tara Coppinger

Publications

Background; The purpose of this paper is to examine any association between cardiorespiratory fitness (CRF) and markers of health among 6 and 10 year old Irish children. Methods; A total of 917 children (6 year olds, N=459; 10 year olds, N=458) from 11 primary schools in Cork (Ireland) participated. Body composition, blood pressure (BP), CRF (550-metre distance run) and school socio-economic status (SES) were assessed. Children were classified as low or high fitness based on run-time standard deviation scores (SDS). Physical activity (PA) determined over 1 week by accelerometry was collected from a sub sample of 700 children (76.3%). Results; …

Unequal Hopes, Lives, And Lifespans In The Usa: Lessons From The New Science Of Well-Being, Carol Graham

Center for Policy Research

Given that we have had historic increases in inequality, as well as stagnant poverty levels for several decades, I will tell the story of poverty and inequality in the U.S. from the perspective of the metrics of happiness and well-being. My research—and the book that resulted—found that inequality is part of this story, but not the only part. The story was much more complicated than I anticipated. One of the most interesting parts of the story includes different levels of hope and resilience across races and places. Poverty and inequality play a big role, but there is much more to …

A Land Not Forgotten: Indigenous Food Security & Land-Based Practices In Northern Ontario By Michael A. Robidoux And Courtney W. Mason, Tonia L. Payne Ph.D.

The Goose

Review of Michael A. Robidoux and Courtney W. Mason's (eds.) A Land Not Forgotten: Indigenous Food Security & Land-Based Practices in Northern Ontario.

Queering Sexual Health: The Intersection Of Sexual Health And Lgbtq Identities In Worcester, Ma, Sara Richman Davidow

Sustainability and Social Justice

This research examined what support, services, and programming existed at the intersection of sexual health and LGBTQ identities in Worcester MA. The data analyzed were interviews with professionals in sexual health or LGBTQ related fields as well as the public websites of sexual health or LGBTQ organizations. The researcher examined this data, along with literature on the rise of sexual health and LGBTQ communities, to understand (1) how inclusive sexual health resources in Worcester were and (2) what themes still need to be addressed to make gender and sexuality minorities comfortable seeking sexual health medical aid. The findings indicated that …

Toxic Effects Of Lead Disposal In Water: An Analysis Of Tri Facility Releases, Patrick Koval

Economics Department Working Papers

Using county-level TRI data from 2003 to 2016, I find evidence that lead emissions in water adversely affect birth weights within the emitting county, especially with respect to the percentage of births considered low birth weight within that county (less than 2,500 grams). I find that a one percent increase in lead emissions per square mile increases the proportion of low birth weights by 0.27 percentage points. For a county with an average number of births in a particular year, this one percent increase in lead per square mile translates to an additional $475,000 in hospitalization costs from complications with …

Geographical, Racial And Socio-Economic Variation In Life Expectancy In The Us And Their Impact On Cancer Relative Survival, Angela B. Mariotto, Zhaohui Zou, Christopher J. Johnson, Steve Scoppa, Hannah K. Weir, Bin Huang

Markey Cancer Center Faculty Publications

Purpose

Despite gains in life expectancy between 1992 to 2012, large disparities in life expectancy continue to exist in the United States between subgroups of the population. This study aimed to develop detailed life tables (LT), accounting for mortality differences by race, geography, and socio-economic status (SES), to more accurately measure relative cancer survival and life expectancy patterns in the United States.

Methods

We estimated an extensive set of County SES-LT by fitting Poisson regression models to deaths and population counts for U.S. counties by age, year, gender, race, ethnicity and county-level SES index. We reported life expectancy patterns and …

Wide Educational Disparities In Young Adult Cardiovascular Health, Elizabeth M. Lawrence, Robert A. Hummer, Benjamin W. Domingue, Kathleen Mullan Harris

Sociology Faculty Research

Widening educational differences in overall health and recent stagnation in cardiovascular disease mortality rates highlight the critical need to describe and understand educational disparities in cardiovascular health (CVH) among U.S. young adults. We use two data sets representative of the U.S. population to examine educational disparities in CVH among young adults (24–34) coming of age in the 21st century: the National Health and Nutrition Examination Survey (2005–2010; N= 689) and the National Longitudinal Study of Adolescent to Adult Health (2007–2008; N=11,200). We employ descriptive statistics and regression analysis. The results show that fewer than one in four young adults had …

Depression, Anxiety, Post-Traumatic Stress Disorder And A History Of Pervasive Gender-Based Violence Among Women Asylum Seekers Who Have Undergone Female Genital Mutilation/Cutting: A Retrospective Case Review, Hazel Lever, Deborah Ottenheimer, Jimmitti Teysir, Elizabeth Singer, Holly G. Atkinson

Publications and Research

We sought to evaluate the frequency of anxiety, depression, PTSD, and any experiences of violence in women who had undergone Female Genital Mutilation/Cutting (FGM/C) and were seeking asylum in the United States. We undertook a retrospective qualitative descriptive study of FGM/C cases seen in an asylum clinic over a 2-year period. Standardized questionnaires provided quantitative scores for anxiety, depression and PTSD. Clients’ personal and physician medical affidavits were analyzed for experiences of violence. Of the 13 cases, anxiety and depression were exhibited by 92 and 100% of women, while all seven women screened for PTSD had symptoms. Qualitative analysis revealed …

Adults Using Long Term Services And Supports: Population And Service Use Trends In Maine, Sfy 2016, Kimberly I. Snow Mhsa, Ba, Frances Jimenez Ba, Tina Gressani, Louise Olsen

Disability & Aging

All of us have likely either used, will use, or know someone who uses long term services and support (LTSS). They enable us to live with dignity and as much independence as possible and offer us the opportunity to remain involved and productive in our communities. The need for LTSS can arise suddenly after injury or illness or a life-long condition. But how ever the need arises, the impact is the same—services such as personal care, work support, home health care, and residential care provide not just for individual health and comfort, but also for interaction, inclusion, and engagement with …

The Social Provision Of Healthcare To Migrants In The Us And In China, Van C. Tran, Katharine M. Donato

Publications and Research

This article develops a comparative analysis of healthcare provision to migrants in the US and in China. It proceeds in three parts. First, we begin by describing the growth of the unauthorized population and trace the evolution of social provision of healthcare to immigrants, highlighting the restrictive nature of federal social provisions and greater autonomy of state and local governments in redefining eligibility criteria in the US. Second, we examine the impact of legal status on healthcare access and utilization among Mexicans, using original data from the 2007 Hispanic Healthcare Survey and the Mexican Migration Project. We find that unauthorized …

Measuring Women's Empowerment In Sub-Saharan Africa: Exploratory And Confirmatory Factor Analyses Of The Demographic And Health Surveys, Ibitola O. Asaolu, Halimatou Alaofè, Jayleen K. L. Gunn, Akosua K. Adu, Amanda J. Monroy, John E. Ehiri, Mary H. Hayden, Kacey C. Ernst

Epidemiology and Environmental Health Faculty Publications

Background: Women's status and empowerment influence health, nutrition, and socioeconomic status of women and their children. Despite its benefits, however, research on women's empowerment in Sub-Saharan Africa (SSA) is limited in scope and geography. Empowerment is variably defined and data for comparison across regions is often limited. The objective of the current study was to identify domains of empowerment from a widely available data source, Demographic and Health Surveys, across multiple regions in SSA.

Methods: Demographic and Health Surveys from nineteen countries representing four African regions were used for the analysis. A total of 26 indicators across different dimensions (economic, …