Public Health Commons^™

Covid-19: Health As A Common Good, Alfredo Morabia

Publications and Research

No abstract provided.

Life Expectancy And Active Life Expectancy By Marital Status Among Older U.S. Adults Results From The U.S. Medicare Health Outcome Survey (Hos), Haomiao Jia, Erica I. Lubetkin

Publications and Research

Background: Previous investigations of the relationship between marital status and life expectancy and healthy life expectancy rely on the assumption that participants will remain in a given marital status until death. This study estimated total life expectancy (TLE) and active life expectancy (ALE) for respondents by their baseline marital status using a large longitudinal sample of the U.S. community-dwelling elderly population.

Methods: Data were from the Medicare Health Outcomes Survey Cohort 15 (2012 baseline, 2014 follow-up). We included respondents aged ≥65 years (n = 164,597). Multi-state models estimated TLE and ALE by marital status to allow participants' marital status to …

Neuroinvasion, Neurotropic, And Neuroinflammatory Events Of Sars-Cov-2: Understanding The Neurological Manifestations In Covid-19 Patients, Yassine Yachou, Abdeslem El Idrissi, Vladimir Belapasov, Said Ait Benali

Publications and Research

Respiratory viruses are opportunistic pathogens that infect the upper respiratory tract in humans and cause severe illnesses, especially in vulnerable populations. Some viruses have neuroinvasive properties and activate the immune response in the brain.These immune events may be neuroprotective or they may cause long-term damage similar to what is seen in some neurodegenerative diseases. The new “Severe Acute Respiratory Syndrome Coronavirus 2” (SARS-CoV-2) is one of the Respiratory viruses causing highly acute lethal pneumonia coronavirus disease 2019 (COVID-19) with clinical similarities to those reported in “Severe Acute Respiratory Syndrome Coronavirus” (SARS-CoV) and the “Middle East Respiratory SyndromeCoronavirus” (MERS-CoV) including neurological …

Proximity To Comprehensive Emergency Obstetric Care And The Utilization Of Facility-Based Delivery Services Across Six Low-And-Middle Income Countries, Chioma T. Amadi

Dissertations and Theses

Background: More than 90% of maternal deaths occur in low-and-middle-income countries (LMICs) and are largely attributed to preventable pregnancy-related causes. Comprehensive emergency obstetric care (EmOC), also known as signal functions, is the most effective life-saving intervention for managing obstetric and newborn emergencies. Health facilities offering delivery services are generally classified as having either comprehensive, basic or less than basic EmOC capacity based on their obstetric resources. Multiple EmOC methods are regularly utilized in characterizing facility obstetric capacity and this introduces inconsistencies that pose significant public health and policy implications for access to delivery care among women within a service environment. …

Awareness Of And Willingness To Use Prep Among Black And Latinx Adolescents Residing In Higher Prevalence Areas In The United States, Tamara Taggart, Yilin Liang, Paolo Pina, Tashuna Albritton

Publications and Research

This mixed-methods study examined awareness of and willingness to use pre-exposure prophylaxis (PrEP) among sexually active Black and Latinx adolescents (13–17 years) residing in five cities in the United States with some of the highest burden of HIV. Data are from adolescents who participated in a cross-sectional survey (n = 208) and one-on-one interviews and focus groups (n = 26) conducted from September 2017—August 2019. Approximately 50% of the sample were recruited through community efforts, and the other half through a panel. Logistic regression with covariates including sexual orientation, relationship status, socioeconomic status, and race/ethnicity were used to assess factors …

The Public Health We Need, Alfredo Morabia

Publications and Research

No abstract provided.

Resuming On-Site Services: Final Report And Recommendations Of The Cuny Libraries Covid-19 Task Force, Kathleen Dreyer, Jeffrey Delgado, Karen Okamoto, Steven Ovadia, Roxanne Shirazi, Michael Waldman, Haruko Yamauchi, Simone Yearwood

Publications and Research

This report was prepared by the CUNY Libraries COVID-19 Task Force, which formed in May 2020 with the following charge:

Authorized by the CUNY Office of Library Services and the Council of Chief Librarians, the task force is charged to survey best practices shared by libraries world-wide and to develop guidelines for CUNY Libraries site management, staff and user safety, circulation and resource sharing, and materials handling as pandemic conditions evolve.

A summary of the draft report was submitted by Interim Dean for Library Services Polly Thistlethwaite to CUNY’s Academic & Student Support Task Force on June 23, 2020. The …

Addressing The Commercial Determinants Of Health Begins With Clearer Definition And Measurement, Kelley Lee, Nicholas Freudenberg

Publications and Research

No abstract provided.

Stress Measured By Allostatic Load Varies By Reason For Immigration, Age At Immigration, And Number Of Children: The Africans In America Study, Thomas Hormenu, Elyssa M. Shoup, Nana H. Osei-Tutu, Arsene F. Hobabagabo, Christopher W. Dubose, Lilian S. Mabundo, Stephanie T. Chung, Margarethe F. . Horlyck-Romanovsky, Anne E. Sumner

Publications and Research

Stress leads to physiologic dysfunction and cardiometabolic disease. Allostatic load score (ALS) measures stress-induced cardiovascular, metabolic, and inflammatory biomarkers. We estimated the odds of high ALS by reason for and age at immigration, duration of American residence, number of children, and socioeconomic status in 193 African immigrants (male: 65%, age 41 ± 10 y (mean ± Standard Deviation (SD)), range 22–65 y). ALS was calculated with High-ALS defined as ALS ≥ 3.0 and Low-ALS defined as ALS < 3.0. Oral glucose tolerance tests (OGTT) were performed, the cardiovascular disease (CVD) risk estimated, and TNF-α, an inflammatory cytokine, measured. Logistic regression was used to estimate odds of High-ALS. In the High- and Low-ALS groups, ALS were 4.0 ± 1.2 vs. 1.3 ± 0.7, diabetes prevalence: 14% vs. 4%, CVD risk: 23% vs. 8%, TNF-α levels: 15 ± 9 vs. 11 ± 6 pg/mL, respectively (all p ≤ 0.01). Immigrants were more likely to be in the High-ALS group if their reason for immigration was work or asylum/refugee (OR 2.18, p = 0.013), their age at immigration was ≥30 y (OR 3.28, p < 0.001), their duration of residence in United States was ≥10 y (OR 3.16, p = 0.001), or their number of children was ≥3 (OR 2.67, p = 0.019). Education, income, health insurance, marital status, and gender did not affect High-ALS odds. Factors adversely influencing allostatic load and cardiometabolic health in African immigrants were age at and reason for immigration, duration of residence in America, and number of children.

Online Grocery Shopping By Nyc Public Housing Residents Using Supplemental Nutrition Assistance Program (Snap) Benefits: A Service Ecosystems Perspective, Nevin Cohen, Katherine Tomaino-Fraser, Chloe Arnow, Michelle Mulcahy, Christophe Hille

Publications and Research

This paper examines adoption of online grocery shopping, and potential cost and time savings compared to brick and mortar food retailers, by New York City public housing residents using Supplemental Nutrition Assistance Program (SNAP) benefits. A mixed methods action research project involving the co-creation of an online shopping club, the Farragut Food Club (FFC), recruited 300 members who registered to shop online using SNAP, and received waivers on delivery minimums and provided technical assistance and centralized food delivery. We conducted a survey (n = 206) and focus groups to understand shopping practices; FFC members collected receipts of groceries over two …

Medical Cannabis In New York State, David Steven Younger

Dissertations and Theses

Background: In July 2014, New York State became the 23rd state to legalize marijuana (“cannabis”) for medical consumption under the New York State Medical Marijuana Program (“Program”). Three years later, during his Executive budget address, the NYS Governor, Honorable Cuomo, directed the Department of Health in consultation with other NYS agencies, to evaluate the experience, consequences and effects of legalized marijuana in neighboring states and territories, and to review the health, criminal justice and economic impacts of regulating marijuana use. That report concluded that the positive effects of a regulated marijuana market outweighed the potential negative impacts.

Objective: This dissertation …

The House We Built In Challenging The Status Quo: House And Ballroom Community Leadership And Health Justice, Jennifer Lee

Dissertations and Theses

Background: The House Ballroom Community (HBC), an underground queer subculture, has been leading actions in large urban cities throughout the Unites States to address health inequities exacerbated by stigma, systemic neglect, and economic disparities, such as the HIV/AIDS epidemic. The HBC is an inventive and dynamic space that posits new leadership paradigms for health equity and health justice, where collective actions and their resulting social impact center the embodied knowledge of their members to create social change.

Methods: Community-based participatory research (CBPR) was a fundamental method and framework for each of the studies (Aims 1, 2, and 3). The meaningful …

The Role Of Agency In Early And Unwanted Adolescent Pregnancy: A Multi Country Analysis, Katharine Mccarthy

Dissertations and Theses

Purpose. The agency to decide one’s reproductive future is paramount, yet an estimated 75 percent of adolescent girls in the United States (U.S.) and 49 percent of those in low and middle-income countries experience mistimed or unwanted pregnancy. This dissertation characterized empirical representations of agency over the course of adolescence and investigated the relationship between agency and early and unwanted pregnancy and childbearing using data from three countries (India, Zambia and the U.S.).

Methods. Using latent class and latent transition analysis, multi-dimensional profiles of adolescent agency were assessed using data from: (1) a state representative cross-sectional cohort study of adolescents …

Agnostic Search For Metabolites Causally Implicated In Alzheimer's Disease, Sal P. Leggio

Dissertations and Theses

This paper uses two sample Mendelian randomizations to conduct an agnostic search of the metabolic GWAS published by Tao Long and co-workers. GWAS for AD from IGAP and from UK Biobank were used for outcomes. The author uses two sample Mendelian randomization (MR) to test for causal relationships between common blood metabolites and Alzheimer’s disease (AD). First, estimates for a set of 22 metabolites which are statistically significant for both outcome GWAS are determined. Egger regression, Mendelian Randomization Pleiotropy Residual Sum and Outlier (MRPRESSO), and weighted median regression are used as sensitivity checks. AD shares risk factors with both heart …

Psychosocial Impacts And Employment Preparedness Of Participating In An Hiv Peer Program: Implications For Tailoring A Vocational Counseling Model For Plwh, Erin R. Mckinney-Prupis

Dissertations and Theses

Background:

Medical advancements in HIV care should have reduced barriers to employment for PLWH, yet in 2017 only 47.7% of PLWH reported being employed, as compared to 62.9% in the general population. Employment is a significant social determinant of health, it impacts a variety of factors related to health, including earned income, access to healthcare, and social connectedness. Quantitative and qualitative studies have identified several concerns PLWH have about entering the workforce; the most pressing being fear of losing benefits. Targeted work readiness programs for PLWH is an important approach to help PLWH overcome their unique barriers to work, such …

Sexual And Reproductive Health Outcomes In Women By Dimensions Of Sexual Orientation: An Examination Of 2011-2017 National Survey Of Family Growth Data, Lauren Porsch

Dissertations and Theses

Background: Sexual minority women experience disparities in sexual and reproductive health outcomes including higher rates of certain STIs, lower engagement in preventive sexual health behaviors, and higher rates of unintended pregnancy compared to their non sexual minority counterparts. Much prior research on sexual minority women’s health has been limited by incomplete or inconsistent definitions of sexual minority status, and has failed to consider sexual orientation branchedness as a risk factor.

Method: Using pooled National Survey of Family Growth data, survey cycles 2011-2013, 2013-2015, and 2015-2017, we performed bivariate and multivariable logistic and multinomial regression analyses to estimate the independent associations …

Investigating The Impact Of The Nursing Practice Environment (Npe) On Central Line-Associated Bloodstream Infections (Clabsi) Among Older Adults In The Intensive Care Unit (Icu), Kristen A. Cribbs

Dissertations and Theses

Background: Health care–associated infections, resulting from treatment received for medical or surgical conditions in a health care setting, represent a critical public health and patient safety issue, exacting substantial medical, social, and economic costs. The costliest among the leading causes of preventable health care-associated infections is central-line associated bloodstream infections (CLABSI), to which older adults (age 65 years and older) are particularly susceptible, especially during intensive care unit (ICU) stays. A rich body of research has empirically linked the quality of the nursing practice environment (NPE) in hospitals to both positive and negative patient outcomes; yet, surprisingly few studies have …

The Social Construction Of Deservedness In Medicaid Eligibility Design: A Qualitative Content Analysis Of State Policy Responses To The Affordable Care Act, Carmina Bernardo

Dissertations and Theses

When the U.S Supreme Court in 2012 ruled that the federal government could not withhold Medicaid funding from states that did not expand Medicaid to low income, non-disabled adults under the Affordable Care Act (ACA), Medicaid expansion became a state option. By the end of 2015, nineteen states had not expanded Medicaid, excluding about 2.5 million individuals from affordable health coverage and access to care. Prior research explored the reasons certain states expanded or did not expand Medicaid, but state decisions did not always result in one of these binary outcomes. There were four policy responses to the ACA’s Medicaid …

Impacts Of Rift Valley Fever Virus: A One Health Approach To Assess Burden And Inform Prevention And Control Options, Catherine Machalaba

Dissertations and Theses

Background: Rift Valley Fever (RVF) is a climate-sensitive emerging zoonotic disease associated with large-scale livestock production losses and human disease burden in Sub-Saharan Africa and the Middle East. While recognized as a key One Health issue based on its transmission dynamics involving human, animal and environmental determinants, there has been poor coordination between sectors to reduce the risk and impact of RVF. Efforts to counter the disease remain largely reactive, presenting an ongoing threat to local and global health security. The intent of this dissertation was to improve understanding of the burden of RVF across society and to identify entry …

An Assessment Of Potential Causal Pathways Between Two Autoimmune Diseases: Mendelian Randomization Studies Of Rheumatoid Arthritis And Crohn’S Disease; And A Phenome-Wide Association Study To Assess Potential New Targets For Tocilizumab, An Interleukin-6 Inhibitor, Staci Abramsky Risman

Dissertations and Theses

Background

Rheumatoid arthritis (RA) and Crohn’s disease (CD) are two among a group of immune-mediated inflammatory diseases (IMIDs). These diseases are common, collectively affecting as many as two million Americans and as many as 28 million people worldwide. They have different clinical presentations but may have a common pathogenesis. An over-expression of tumor necrosis factor (TNF) and interleukin-6 (IL-6) have been proffered as a causal factor for IMIDs. These and other IMIDs may co-occur in patients, and it has been shown that patients with one IMID may have an increased risk of another IMID. What is not clear is whether …

An Evaluation Of Respiratory Exacerbation In New York City Given Current Trends In Climate Variability And Predictive Sociodemographic Factors, Sarah L.R. Kuril

Dissertations and Theses

Background: Within the last century, the massive increase in emissions due to economic growth has made climate variability a major problem for many of the industrialized countries and an emerging problem for the rest of the world. With an increasing number of extreme weather events, such as heat waves, cold fronts, floods, heavy rain, and storms, individuals with Chronic Obstructive Pulmonary Disease (COPD) and asthma remain a vulnerable population, placing them at highest risk of respiratory exacerbation. This dissertation aims to contribute to our understanding of how climate variability, which can influence patterns of rainfall, temperature and other variables on …

An Evaluation Of A Web-Based Tool To Improve Feeding Practices And The Home Environment Among Parents Of Low-Income Minority Preadolescents At-Risk For Childhood Obesity, Katrina F. Mateo

Dissertations and Theses

Background: Web-based/mHealth interventions may be an engaging approach to promote positive dietary-related behaviors among parents of youth at-risk for childhood obesity. Importantly, childhood obesity research highlights the role of parents as a key support mechanism in improving child dietary outcomes. Intervention INC is a childhood obesity intervention that comprises a unique, interactive web-based child nutrition comic aimed at improving dietary behaviors among urban Black/African American (AA) and Latino preadolescents, and also weekly online parent newsletters (with feeding tips, healthy printable recipes, links to coupons to support healthy eating/feeding and health-promoting local/community events, and access to the child nutrition comic) to …

Enhancing Global Health Communication During A Crisis: Lessons From The Covid-19 Pandemic, Scott C. Ratzan, Silvia Sommarivac, Lauren Rauh

Publications and Research

Background/objective: The understanding and practice of public health crisis communication are improved through the study of responses to past crises, but require retooling for present challenges. The ‘Addressing Ebola and other outbreaks’ checklist contains guiding principles built upon maxims developed from a World Health Organization consultation in response to the mad cow (bovine spongiform encephalopathy) crisis that were later adopted for Ebola. The purpose of this article is to adapt the checklist for the health communication challenges and public health practices that have emerged during the coronavirus disease 2019 (COVID-19) pandemic. The communication challenges of promoting vaccine acceptance are used …

What’S For Lunch? Examining The Factors Associated With Food Choices And Food Insecurity Among Cuny College Students- A Mixed Methods Study, Rachel G. Taniey

Dissertations and Theses

Background: The growing rates of food insecurity in college students points to the need to examine food choices within the context of a socio-ecological framework with an emphasis on the contribution of financial constraints and limited food access on food-based decisions.

Methods: A mixed-methods study design using both primary and secondary data analysis was developed for this dissertation. Primary data examining undergraduate college students was collected on three CUNY campuses including: semi-structured in-depth interviews (N=33), computerized 24-hour dietary recalls using the ASA24 program (N=45), three focus groups (N=26) with students who utilize on-campus food assistance programs, and key informant interviews …

The Reproductive Health And Academic Impact Of The New York City School-Based Health Center Reproductive Health Project For Adolescents, Michelle Silverio

Dissertations and Theses

Background: Gaining an understanding of how school reproductive health policies impact adolescent sexual health and academic outcomes is a public health priority in the United States (U.S.) since it has the highest rates of adolescent pregnancy and sexually transmitted infections among developed nations. Adolescence is a critical developmental period and influences in this period affect reproductive health and social well-being over a person’s entire lifespan. Almost all adolescents spend the majority of their time in school settings; therefore local school reproductive health policies may have substantial lifetime impacts. Policies such as providing comprehensive sexual health education and contraceptive access in …

Development Of A Hospital Readmission Reduction Program For Patients Discharged To Skilled Nursing Facilities: An Application Of Artificial Intelligence And Machine Learning Techniques, Anna Stachel

Dissertations and Theses

Background

Hospital readmissions within 30 days after discharge have drawn national policy attention as they are a reflection of suboptimal patient care. Readmissions are costly, accounting for more than $17 billion in potentially avoidable Medicare expenditures - nearly 78% of readmissions may be avoidable. Rich electronic data from medical records, growing computing capacities, and open source machine learning algorithms offer new opportunities to predict patients at high risk for readmission and prevent readmission through focused interventions. Prediction models might also serve to provide a more nuanced context of patient characteristics that lead to variations in readmission rates. Furthermore, transitional care …

Factors Predicting Sustainability: A Correlational Study Of One Multi-Site Program, Meredith L. King Jensen

Dissertations, Theses, and Capstone Projects

Healthcare organizations invest significant economic, physical, and human resources to implement changes and expect sustained benefits for their investments in the long term. Yet, few studies have examined long-term sustainability and factors contributingto sustainability. The primary aim of the study was to gain a better understanding of sustainability and five factors (champions, leadership support, policy, resources, and training and education) that might predict long-term sustainability within the context of one Safe Patient Handling and Mobility (SPHM) program implemented in a large, nationwide system more than 7 years ago. The secondary aim was to examine the number of nursing staff injuries, …

Shadow Standards And The Logic Of Costs: Care, Stewardship, And Data In U.S. Community Health, Margarite J. Whitten

Dissertations, Theses, and Capstone Projects

This dissertation examines the delegation of responsibility for providing health care to particular categories of marginalized populations in the United States in the absence of a uniform and universal health care system. It explores how the U.S. federal government governs patient populations at a distance by mandating that healthcare providers collect, produce, and report on patient data. Drawing from eighteen months of ethnographic research in Massachusetts clinics for the homeless and the frail elderly between 2014-2015, I argue that when marginalized patients are unable to satisfy the neoliberal ideal of self-governance to maintain their health in cost-effective ways, providers are …

Using Short Chain Fatty Acids To Inactivate Pseudomonas Aeruginosa Biofilms, Stephen Lee

Dissertations and Theses

Abstract

Using Short Chain Fatty Acids to Disinfect Pseudomonas Aeruginosa Biofilms

by

Stephen Lee

Background

The study of bacteria typically focuses on the planktonic or free-living single-cell state that is purely cultured in a laboratory for subsequent growth with appropriate media. Although this traditional way of growing bacteria has been paramount to the understanding of bacterial behavior, physiology, and pathogenesis, bacteria rarely exist as pure cultures of planktonic growth forms in the natural habitat. Bacterial contamination of environmental surfaces, in the form of biofilms, is a prime public health problem and causes numerous infections within the general public. Biofilms are …

Racism And The Political Economy Of Covid-19: Will We Continue To Resurrect The Past?, Zinzi D. Bailey, J. Robin Moon

Publications and Research

COVID-19 is not spreading over a level playing field; structural racism is embedded within the fabric of American culture, infrastructure investments, and public policy, and fundamentally drives inequities. The same racism that has driven the systematic dismantling of the American social safety-net has also created the policy recipe for American structural vulnerability to the impacts of this and other pandemics. The Bronx provides an important case study for investigating the historical roots of structural inequities showcased by this pandemic; current lived experiences of Bronx residents are rooted in the racialized dismantling of New York City’s public infrastructure and systematic disinvestment. …