Public Health Commons^™

Developing Countries, Vaccine Access And Influenza Outbreaks: Ethics And Global Health Governance When Facing A Pandemic, Shawn Smallman

International & Global Studies Faculty Publications and Presentations

The threat posed by influenza pandemics raises serious ethical issues, as well as questions of global health governance. In order to create pre-pandemic vaccines, global health authorities need access to virus from regional outbreaks. But because the countries where these outbreaks occur are unlikely to benefit from the vaccine, they are sometimes reluctant to share this seed stock, and may try to make proprietary arrangements with pharmaceutical companies, as briefly occurred in Indonesia. Although these arrangements may increase developing countries' access to vaccine, they hamper the global cooperation necessary to prepare for influenza outbreaks. Developing countries, in contrast, point to …

A Study Of Riders' Noise Exposure On Bay Area Rapid Transit Trains, Alexis Dinno, Cynthia Powell, Margaret Mary King

Community Health Faculty Publications and Presentations

Excessive noise exposure may present a hazard to hearing, cardiovascular and psychosomatic health. Mass transit systems, such as the Bay Area Rapid Transit (BART) system, are potential sources of excessive noise. The purpose of this study was to characterize transit noise and riders' exposure to noise on the BART system using three dosimetry metrics. We made 268 dosimetry measurements on a convenience sample of 51 line segments. Dosimetry measures were modeled using linear and non-linear multiple regression as functions of average velocity, tunnel enclosure, flooring, and wet weather conditions, and presented visually on a map of the BART system. This …

Preliminary Efficacy Of A Computer-Delivered Hiv Prevention Intervention For African American Teenage Females, Charles H. Klein, Josefina J. Card

Anthropology Faculty Publications and Presentations

This study translated SiHLE (Sisters Informing, Healing, Living, and Empowering), a 12-hour Centers for Disease Control and Prevention evidence based group-level intervention for African American females 14-18 years of age, into a 2-hour computer-delivered individual-level intervention. A randomized controlled trial (n = 178) was conducted to examine the efficacy of the new Multimedia SiHLE intervention. Average condom-protected sex acts (proportion of vaginal sex acts with condoms, last 90 days) for sexually active participants receiving Multimedia SiHLE rose from M = 51% at baseline to M = 71% at 3-month follow-up (t = 2.06, p = .05); no statistically significant difference …

Community-Based Approaches To Reduce Toxins In Housing: Lessons Learned From Working With Diverse Communities, Erin Mcnally, Ian Blazina, Stephanie Farquhar

Community Health Faculty Publications and Presentations

This article will review lessons learned from a community-based participatory research project with Latino and Somali residents in Portland, Oregon. The aim of the Healthy Futures Collaborative (HFC) project was to reduce in-home environmental health hazards associated with childhood respiratory illness and asthma through a process that strengthened social support and civic engagement. Using a community-based approach, the HFC trained community residents as community scientists to ensure local leadership and participation. Results suggest an increase in Somali and Latino residents' knowledge of environmental stressors and changes in behavior that may improve indoor environmental quality. Especially when working with historically marginalized …

Interpretations Of Interpretations: Combining Community-Based Participatory Research And Interpretive Inquiry To Improve Health, Jessica Gregg, Lourdes Centurion, Julio Maldonado, Raquel Aguillon, Rosemary Carmela Celaya-Alston, Stephanie Farquhar

Community Health Faculty Publications and Presentations

Background: Latina immigrants from Mexico suffer significantly increased morbidity and mortality from cervical cancer when compared with non-Hispanic White women, largely owing to lack of screening and appropriate treatment. Objectives: To demonstrate that by combining the tools of community-based participatory research (CBPR) with the tools of interpretive inquiry, it is possible to address explicit community concerns surrounding a particular problem such as cervical cancer while also examining what other, perhaps less immediately visible, matters consume the time and attention of community members. Methods: We first briefly discuss and compare CBPR as an approach to research and interpretive inquiry as a …

Anticipated Effects Of The U.S. Mexico City Policy On The Attainability Of The Millennium Development Goals And Future Development Efforts In Sub-Saharan Africa, Katherine Clare Alexander

Anthós

In the low-income countries of sub-Saharan Africa, the performance of pyramidal reproductive health and family planning services with public outreach initiatives has not met the expectations or the needs of the communities they serve. Insufficient case management, limited management capacity and referral and communication failures are challenges faced on the delivery level, while on the policy level these health clinics face insufficient coordination among organizations and weak links between programs (Schneider, 2006). The Mexico City Policy, first introduced by President Reagan in 1984, only exacerbated these challenges for organizations that offer comprehensive contraception and family planning programs by denying any …

Aging-In-Place Research At Orcatech: Making Sense Of The Data, Tamara Hayes

Systems Science Friday Noon Seminar Series

The Oregon Center for Aging and Technology (ORCATECH) seeks to facilitate successful aging and reduce the cost of healthcare by establishing the evidence base for technologies supporting aging-in-place research and care. This is done through pilot studies evaluating the role of the technologies, as well as large longitudinal studies in which sensors are placed in the homes of community-dwelling elders to monitor daily patterns of activity, walking speeds, medication adherence, and other behaviors. These sensors collect continuous data that reflect normal variability in behaviors as well as trends that may indicate problematic changes in cognition or mobility. Because data are …

Book Review Of, The Politics And History Of Aids Treatment In Brazil In Latin American Politics And Society, Shawn Smallman

International & Global Studies Faculty Publications and Presentations

Reviews the book "The Politics and History of AIDS Treatment in Brazil," by Amy Nunn

Indigenous And Mestizo Mexican Migrant Farmworkers: A Comparative Mental Health Analysis, William Donlan, Junghee Lee

School of Social Work Faculty Publications and Presentations

Mexican-origin migrant farmworkers using: (a) lifetime prevalence of culture-bound syndromes, (b) self-rated emotional/mental health, (c) depression measured by PHQ-9, (d) stress level. Demographic and psychosocial variables were examined by ethnicity and gender using Chi square and independent t-tests. Logistic and linear regression models were constructed for mental health variables. Indigenous participants reported significantly higher stress compared to mestizos, and indigenous women reported significantly higher stress compared to all groups. Prevalence of culture-bound syndromes and mean PHQ-9 severity score was highest for indigenous females. Mean self-rated emotional/mental health was lowest among indigenous females. Controlling for main effects and other interactions, (a) …

War And Hiv In Latin America, Shawn Smallman

International & Global Studies Faculty Publications and Presentations

Conflict has shaped the HIV pandemic from its inception, from the spread of HIV-1 in Central Africa, to the diffusion of HIV-2 from Portuguese Africa to the globe. At the same time, the relationship between HIV and conflict has been non-linear and poorly understood. Nancy Mock and her colleagues have been almost the only scholars to propose a model to understand this relationship. Their work suggests that several key variables (such as the time scale of the conflict, the characteristics of the parties involved, and the geographic scale of the fighting) explain wide variations in how warfare appears to have …

Exploring The Sensitivity Of Horn's Parallel Analysis To The Distributional Form Of Random Data, Alexis Dinno

Community Health Faculty Publications and Presentations

Horn's parallel analysis (PA) is the method of consensus in the literature on empirical methods for deciding how many components/factors to retain. Different authors have proposed various implementations of PA. Horn's seminal 1965 article, a 1996 article by Thompson and Daniel, and a 2004 article by Hayton et al., all make assertions about the requisite distributional forms of the random data generated for use in PA. Readily available software is used to test whether the results of PA are sensitive to several distributional prescriptions in the literature regarding the rank, normality, mean, variance, and range of simulated data on a …

Inflammatory Biomarkers And Subclinical Atherosclerosis In African-American Women With Systemic Lupus Erythematosus (Sle), Edith M. Williams, Carlos J. Crespo, Joan Dorn

Community Health Faculty Publications and Presentations

Women with lupus are at increased risk for developing cardiovascular disease (CVD). Previous studies of atherosclerosis in SLE have not been representative of the minority groups most affected by lupus and its complications. Therefore, a study of 41 lupus cases and 83 controls was conducted to investigate the relationship between carotid atherosclerosis and inflammation in African-American women. Participation consisted of a questionnaire, physical examination, fasting blood draw, and ultrasound of the carotid arteries. There were observed differences between cases and controls with regard to carotid intima media thickness (IMT) and traditional cardiovascular risk factors, although few reached statistical significance. Tumor …

Occupational Health And Safety Status Of Indigenous And Latino Farmworkers In Oregon, Stephanie Farquhar, Nancy M. Goff, Nargess Shadbeh, Julie Samples, Santiago Ventura, Valentin Sanchez, Pamela Rao, Shelley Davis

Community Health Faculty Publications and Presentations

Exposure to pesticides poses great risk to agricultural workers and their families. Of the approximately 174,000 agricultural workers in Oregon, studies estimate that up to 40% of the workers in Oregon are indigenous and may be particularly vulnerable to the health risks of working in pesticide treated areas. Surveys conducted with Oregon farmworkers suggest that Latino and indigenous farmworkers differ demographically and may have diverse occupational and health needs. All Latino workers reported Spanish as their native language, while indigenous workers spoke several different native languages. Latino workers were employed mostly in orchards (28%) and nurseries (24%), while indigenous workers …

Tobacco Control Polices Are Egalitarian: A Vulnerabilities Perspective On Clean Indoor Air Laws, Cigarette Prices, And Tobacco Use Disparities, Alexis Dinno, Stanton Glantz

Community Health Faculty Publications and Presentations

This study models independent associations of state or local strong clean indoor air laws and cigarette prices with current smoker status and consumption in a multilevel framework, including interactions with educational attainment, household income and race/ethnicity and the relationships of these policies to vulnerabilities in smoking behavior. Cross sectional survey data are employed from the February 2002 panel of the Tobacco Use Supplement of the Current Population Survey (54,024 individuals representing the US population aged 15 to 80). Nonlinear relationships between both outcome variables and the predictors were modeled. Independent associations of strong clean indoor air laws were found for …

Coffee Intake And Risk Of Incident Diabetes In Puerto Rican Men: Results From The Puerto Rico Heart Health Program, Barbara J. Fuhrman, Ellen Smit, Carlos J. Crespo, Mario R. Garcia-Palmieri

Community Health Faculty Publications and Presentations

Objective: To study prospectively the association of coffee intake with incident diabetes in the Puerto Rico Heart Health Program cohort, comprising 9824 middle-aged men (aged 35-79 years). Methods: Of 9824 men, 3869 did not provide a fasting blood sample at baseline, 1095 had prevalent diabetes and 131 were not given fasting glucose tests at any subsequent study visit. Thus, the present analysis includes 4685 participants. Diabetes was ascertained at baseline and at two study visits between 1968 and 1975 using fasting glucose tests and self-reports of physician-diagnosed diabetes or use of insulin or hypoglycaemic medication. Logistic regression analysis was used …

"Sitting In Different Chairs:" Roles Of The Community Health Workers In The Poder Es Salud/Power For Health Project, Stephanie Farquhar, Noelle Wiggins, Yvonne L. Michael, G. Luhr, Jennifer Jordon, A. Lopez

Community Health Faculty Publications and Presentations

Evaluations of Community Health Worker programs consistently document improvements in health, yet few articles clearly describe the roles of Community Health Workers (CHWs) from the CHWs' perspective. This article presents the CHWs' points of view regarding the various roles they played in a community-based participatory research (CBPR) project, Poder es Salud/Power for Health in Portland, Oregon, including their roles as community organizers and co-researchers. Methods: Authors draw from an analysis of transcript data from in-depth interviews conducted with CHWs to present a description of the strategies employed by the CHWs to build leadership skills and knowledge among community members. CHWs …

Effect Of The California Tobacco Control Program On Personal Health Care Expenditures, James M. Lightwood, Alexis Dinno, Stanton A. Glantz

Community Health Faculty Publications and Presentations

Background: Large state tobacco control programs have been shown to reduce smoking and would be expected to affect health care costs. We investigate the effect of California's large-scale tobacco control program on aggregate personal health care expenditures in the state. Methods and Findings: Cointegrating regressions were used to predict (1) the difference in per capita cigarette consumption between California and 38 control states as a function of the difference in cumulative expenditures of the California and control state tobacco control programs, and (2) the relationship between the difference in cigarette consumption and the difference in per capita personal health expenditures …

Physical Activity And Prostate Cancer Mortality In Puerto Rican Men, Carlos J. Crespo, Mario R. Garcia-Palmieri, Ellen Smit, I-Min Lee, Daniel Lee Mcgee, Paola Muti, Nayda R. Figueroa Valle, Farah A. Ramirez-Marrero, Jo L. Freudenheim, Paul Sorlie

Community Health Faculty Publications and Presentations

Studies on the association between physical activity and fatal prostate cancer have produced inconclusive results. The Puerto Rico Heart Health Program was a cohort study of a randomly selected sample of 9824 men age 35 to 79 years at baseline who were followed for mortality until 2002. Multiple examinations collected information on lifestyle, diet, body composition, exercise, urban-rural residence, and smoking habits. Physical activity status was measured using the Framingham Physical Activity Index, an assessment of occupational, leisure-time, and other physical activities measured as usual activity over the course of a 24-hour day. Physical activity was strati- fied into quartiles. …

Increased Hiv Risk Associated With Criminal Justice Involvement Among Men On Methadone, Matthew Epperson, Nabila El-Bassel, Louisa Gilbert, E. Roberto Orellana, Mingway Chang

School of Social Work Faculty Publications and Presentations

This paper examines the relationship between HIV risk and criminal justice involvement among a random sample of 356 men enrolled in methadone maintenance treatment programs in New York City. Bivariate and logistic regression analyses were performed to estimate the associations between measures of criminal justice involvement and participant HIV risk, controlling for socio-demographic variables. A lifetime history of incarceration was significantly associated with being HIV positive (Adjusted OR = 5.08). Recent arrest was associated with unprotected vaginal sex and having multiple female sexual partners. Sex trading was associated with both arrest and incarceration, and the strongest association was found between …

Where's The Kale? Environmental Availability Of Fruits And Vegetables In Two Racially Dissimilar Communities, Edith M. Williams, Bamidele O. Tayo, Beverly Marie Mclean, Ellen Smit, Christopher T. Sempos, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Minority communities across the United States have limited numbers of stores that offer a variety of fruits and vegetables, creating major barriers to good eating habits and nutritional practices among minority groups such as African Americans. Factors like environmental availability of healthy food options have not been fully investigated as possible sources of current cross-population differences in disease. The present study examined whether a predominantly African American neighborhood had disproportionately less availability of fruits and vegetables than a predominantly non-Hispanic White neighborhood. Availability was judged on the bases of the types of stores available in each community and the specific …

Loop Analysis Of Causal Feedback In Epidemiology: An Illustration Relating To Urban Neighborhoods And Resident Depressive Experiences, Alexis Dinno

Community Health Faculty Publications and Presentations

The causal feedback implied by urban neighborhood conditions that shape human health experiences, that in turn shape neighborhood conditions through a complex causal web, raises a challenge for traditional epidemiological causal analyses. This article introduces the loop analysis method, and builds off of a core loop model linking neighborhood property vacancy rate, resident depressive symptoms, rate of neighborhood death, and rate of neighborhood exit in a feedback network. I justify and apply loop analysis to the specific example of depressive symptoms and abandoned urban residential property to show how inquiries into the behavior of causal systems can answer different kinds …

Building Community Research Capacity: Process Evaluation Of Community Training And Education In A Community-Based Participatory Research Program Serving A Predominately Puerto Rican Community, Laurene M. Tumiel-Berhalter, Victoria Mclaughlin-Diaz, John Vena, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Background: Education and training build community research capacity and have impact on improvements of health outcomes.

Objectives: This manuscript describes the training and educational approaches to building research capacity that were utilized in a community-based participatory research program serving a Puerto Rican population and identifies barriers and strategies for overcoming them.

Methods: A process evaluation identified a multitiered approach to training and education that was critical to reaching the broad community.

Results: This approach included four major categories providing a continuum of education and training opportunities: networking, methods training, on-the-job experience, and community education. Participation in these opportunities supported the …

Beyond Education: Improving The Prospects For Good Health, Stephanie Farquhar

Community Health Faculty Publications and Presentations

In this editorial the author focuses on the historical tension between individual responsibility and social accountability in public health programs.

Measuring The Influence Of Built Neighborhood Environments On Walking In Older Adults, Yvonne L. Michael, Tracey Beard, Dongseok Choi, Stephanie Farquhar, Nichole Carlson

Community Health Faculty Publications and Presentations

Examined the degree of association between perceived and objective characteristics of the neighborhood environment and the relation of each type of measurement to neighborhood walking in older adults. Participants included 105 adults aged 65-92 (mean age 75.1) from 10 neighborhoods in Portland, Oregon, participating in Senior Health and Physical Exercise (SHAPE), a randomized walking intervention. Neighborhoods were stratified by a "walking friendliness" ranking variable. This variable was derived for each neighborhood based on available social and environmental data that were hypothesized to correlate with walking and physical activity: high income, high older adult population density, high proportion of white residents, …

Community-Based Participatory Research: Defining Community Stakeholders, Laurene M. Tumiel-Berhalter, Robert Watkins, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Community-based participatory research requires the participation of community stakeholders to inform the process. The West Side Community Asthma Project, a community-based participatory research program to study the effects of the environment on asthma conducted in Buffalo, N. Y, identified a stakeholders group of community leaders and activists. Creative strategies have been implemented to reach out to other community residents to invite them to participate in the participatory process.

Understanding The Relative Importance Of Positive And Negative Social Exchanges: Examining Specific Domains And Appraisals, Jason T. Newsom, Karen S. Rook, Masami Nishishiba, Dara H. Sorkin, Tyrae Mahan

Community Health Faculty Publications and Presentations

Negative social exchanges have been more reliably related to psychological health than have positive social exchanges. Little research, however, has sought to understand how underlying appraisal processes link such exchanges to psychological health. This study examined the frequencies of occurrence and appraisals of four parallel domains of positive and negative exchanges in relation to positive well-being and psychological distress in a national sample of 916 older adults. Structural equation analyses revealed that negative exchanges were related both to less well-being and greater psychological distress, whereas positive exchanges were related only to positive well-being. Furthermore, results supported a process in which …

Racial Discrepancies In The Association Between Paternal Vs. Maternal Educational Level And Risk Of Low Birthweight In Washington State, Christina Nicolaidis, Cynthia W. Ko, Somnath Saha, Thomas D. Koepsell

School of Social Work Faculty Publications and Presentations

Background: The role of paternal factors in determining the risk of adverse pregnancy outcomes has received less attention than maternal factors. Similarly, the interaction between the effects of race and socioeconomic status (SES) on pregnancy outcomes is not well known. Our objective was to assess the relative importance of paternal vs. maternal education in relation to risk of low birth weight (LBW) across different racial groups.

Methods: We conducted a retrospective population-based cohort study using Washington state birth certificate data from 1992 to 1996 (n = 264,789). We assessed the associations between maternal or paternal education and LBW, adjusting for …

Precautionary Approaches For Health And The Environment: Making The Case For A Toxics Reduction Strategy At Multnomah County And City Of Portland, Stephanie Farquhar, Molly Chidsey, Neha Patel

Community Health Faculty Publications and Presentations

This report summarizes an overview of the problem, local concerns, model policies, and best practices for toxic pollution prevention and provides recommendations for next steps to protect human health and the local environment in Portland and Multnomah County. This report accompanies the Multnomah County and City of Portland resolutions to "Recognize National Pollution Prevention Week and develop a Toxics Reduction Strategy jointly with City of Portland / Multnomah County using the Precautionary Principle."

Next-Of-Kin Perceptions Of Physician Responsiveness To Symptoms Of Hospitalized Patients Near Death, Joel C. Cantor, Jan Blustein, Matthew J. Carlson, David A. Gould

Sociology Faculty Publications and Presentations

Many different medical providers visit critically ill patients during a hospitalization, and patients and family members may not feel any physician is truly in charge of care. This study explores whether perceiving that a physician was clearly in charge is associated with reports by surviving next of kin about the responsiveness of physicians to symptoms in hospitalized patients near the end of life. We conducted telephone interviews with surviving next of kin of adult patients (n = 1107) who died in one of five New York City teaching hospitals between April 1998 and June 1999 after a minimum 3-day inpatient …

A Comparative History Of Aids In Latin America: Brazil And Cuba, Shawn Smallman

International & Global Studies Faculty Publications and Presentations

According to a joint report of the World Health Organization and the Pan American Health Organization in September 2002 there were approximately 1.4 million HIV+ people in Latin America, and a further 420,000 HIV+ people in the Caribbean. The number of infections had increased by nearly 10% from the previous year in Latin America, and 16% in the Caribbean. While striking, these figures may obscure the diversity of the HIV epidemic in the region. Latin America has a varied pattern of infections, which means that the experience of Bolivia, Ecuador and Mexico is quite different from that of Honduras, Haiti …