Public Health Commons^™

More Than A Century After Problem Emerged, Manhole Explosions Still Injuring Dozens In New York City, Gaspard Le Dem, Gabriel Sandoval

Capstones

Since the early days of electrification, New York City has been rattled by manhole explosions –– underground blasts that injure residents, damage buildings, force evacuations, cause power outages and traffic disruptions.

Consolidated Edison, the city's largest electric provider, has for decades blamed manhole issues on bad weather and road salt that erodes underground wires. But some experts and former utility workers say lack of maintenance is at the root of the problem.

Meanwhile, city and state officials have failed to rein in the problem through weak laws and loose oversight. As a result, unsuspecting drivers and pedestrians continue to be …

Dirty Water: The Newburgh Water Crisis, Shantal Riley

Capstones

Dirty

Dirty Water: the Newburgh water crisis

Summary

This project covers the ongoing water crisis in the City of Newburgh, New York. It tells the story of the contamination of the city’s drinking water by chemicals known as PFAS – short for perfluoroalkyl and polyfluoroalkyl substances.

Valued for their resistance to water and oil, the chemicals are found in carpets, furniture, clothes, non-stick cookware, food packaging and a range of industrial products. They’re nicknamed “forever chemicals” because they don’t break down in the environment. They’re also found in fire foam, which was used at Stewart Air National Guard Base. Located …

Acceptability Of A Vaginal Ring To Prevent Hiv And Pregnancy: Integrating Multiple Qualitative Methods, Dana Watnick

Dissertations and Theses

Heterosexual vaginal sex can simultaneously put women at risk for unintended pregnancy and sexually transmitted infections, such as HIV, disproportionately impacting poor women around the world. Both unintended pregnancy and HIV are persistent public health concerns associated with negative outcomes for mothers, families and communities. The current mix of prevention tools available to women to protect against unintended pregnancy and HIV is limited. Multipurpose Prevention Technologies (MPTs) are innovative products that simultaneously offer protection against pregnancy and HIV. However, MPTs will only be effective in reducing unintended pregnancy and incident HIV if women are willing to use them. With an …

College Students And Snap: The New Face Of Food Insecurity In The United States, Nicholas Freudenberg, Sara Goldrick-Rab, Janet Poppendieck

Publications and Research

Over the last decade, multiple studies of food insecurity among college students have found rates from 20% to more than 50%, considerably higher than the 12% rate for the entire US population.

Reasons for higher rates of food insecurity among college students include a growing population of low-income college students, high college costs and insufficient financial aid, more financial hardship among many low- and moderate-income families, a weak labor market for part-time workers, declining per capita college resources, and Supplemental Nutritional Assistance Program (SNAP) policies that specifically exclude many college students from participation.

This essay reviews the causes and consequences …

The Importance Of Being A Consequential Public Health Journal, Alfredo Morabia

Publications and Research

No abstract provided.

What Happened To This Child? Identifying Factors That Influence The Identification And Categorization Of Child Maltreatment In The United States, Erika Tullberg

Dissertations and Theses

Background: Research has shown that adverse childhood experiences are strongly linked with health outcomes over the life course, and that child maltreatment – generally defined as physical abuse, sexual abuse, emotional maltreatment and neglect – can have an immediate, negative impact on child health and development and a longer-term impact on adolescent and adult health, including the leading causes of morbidity and mortality in the U.S. With such significant consequences, the accurate identification of child maltreatment is critical.

Child welfare caseworkers are charged with protecting the safety and fostering the well-being of children who have been identified as maltreated or …

Hiv Prevention Via Mobile Messaging For Men Who Have Sex With Men (M-Cubed): Protocol For A Randomized Controlled Trial, Patrick Sean Sullivan, Ryan J. Zahn, Sarah Wiatrek, Cristian J. Chandler, Sabina Hirshfield, Rob Stephenson, Jose A. Bauermeister, Mary Ann Chiasson, Martin J. Downing, Deborah J. Gelaude, Aaron J. Siegler, Keith Horvath, Erin Rogers, Ana Alas, Evelyn J. Olansky, Heather Saul, Eli S. Rosenberg, Gordon Mansergh

Publications and Research

Background:

Men who have sex with men (MSM) continue to be the predominately impacted risk group in the United States HIV epidemic and are a priority group for risk reduction in national strategic goals for HIV prevention. Modeling studies have demonstrated that a comprehensive package of status-tailored HIV prevention and care interventions have the potential to substantially reduce new infections among MSM. However, uptake of basic prevention services, including HIV testing, sexually transmitted infection (STI) testing, condom distribution, condom-compatible lubricant distribution, and preexposure prophylaxis (PrEP), is suboptimal. Further, stronger public health strategies are needed to promote engagement in HIV care …

Public Health Research Priorities To Address Female Genital Mutilation Or Cutting In The United States, Holly G. Atkinson, Deborah Ottenheimer, Ranit Mishori

Publications and Research

Female genital mutilation or cut- ting (FGM/C), an age-old tradition that is still widely practiced around the world, is gaining recognition as an important public health issue in the United States. Increasingly, because of migration, women and girls affected by FGM/C have become members of host communities where the practice is not culturally acceptable.

According to recent conservative estimates, more than 513 000 immigrant women and girls living in the United States have undergone or are at risk for FGM/C, a significant increase from the 1990 estimate of 168 000. The arrests of physicians in Michigan in 2017 for performing …

The Concurrent Decline Of Soil Lead And Children’S Blood Lead In New Orleans, Howard W. Mielke, Christopher R. Gonzales, Eric T. Powell, Mark A. S. Laidlow, Kenneth J. Berry, Paul W. Mielke Jr., Sara Perl Egendorf

Publications and Research

Lead (Pb) is extremely toxic and a major cause of chronic diseases worldwide. Pb is associated with health disparities, particularly within low-income populations. In biological systems, Pb mimics calcium and, among other effects, interrupts cell signaling. Furthermore, Pb exposure results in epigenetic changes that affect multigenerational gene expression. Exposure to Pb has decreased through primary prevention, including removal of Pb solder from canned food, regulating lead-based paint, and especially eliminating Pb additives in gasoline. While researchers observe a continuous decline in children’s blood lead (BPb), reservoirs of exposure persist in topsoil, which stores the legacy dust from leaded gasoline and …

Hypertension And Hiv In An Urban Slum Setting, Port-Au-Prince, Haiti, Olga Tymejczyk

Dissertations and Theses

Background: Rapidly growing urban slum settings increasingly face co-occurring communicable and non-communicable health crises, against the backdrop of extreme poverty, and social and environmental vulnerability. In Haiti, sparse data suggest a growing burden of hypertension and cardiovascular disease (CVD), along with substantial prevalence of HIV, increasingly recognized as a major CVD risk factor. As life-saving antiretroviral treatment (ART) is extended to more people living with HIV (PLWH), their risk of CVD increases with longer life expectancy and possibly cumulative ART exposure. Pregnant HIV-positive women may face additional cardiovascular vulnerability, due to the risk of gestational hypertension and pre-eclampsia. Integration of …

Trends In The Timeliness Of Hiv Diagnosis And Antiretroviral Treatment Initiation Before, During And After The “Treat All” Recommendation – New York City, 2006 - 2015, Mckaylee Robertson

Dissertations and Theses

BACKGROUND: Voluntary HIV testing followed by immediate antiretroviral treatment (ART) initiation (universal testing and treatment) has become an integral part of strategies to eliminate HIV and control the HIV/AIDS epidemic. Minimizing the time from HIV infection to ART initiation is essential for universal test and treatment to be optimally effective. In New York City, an epicenter of the HIV epidemic, the ‘treat all’ recommendation, immediate treatment for all people diagnosed with HIV, was made in late 2011, and efforts to ‘treat all’ were contemporaneous with large scale HIV testing initiatives in NYC. The overarching goal of this dissertation was to …

Extreme Obesity Among Adults In The United States: Spatial Variation And The Association With Mortality, Carrie Mills

Dissertations and Theses

Objectives: The purpose of this dissertation was to create small area estimates to describe and explore the county-level spatial variation of extreme obesity among adults in the United States and to assess the county-level association and spatial variation of extreme obesity and mortality.

Methods: The Behavioral Risk Factor Surveillance System was used in conjunction with data from the Census Bureau to estimate county-level model-predicted prevalence of extreme obesity using multilevel regression and poststratification. Spatial dependence of estimates was assessed using global Moran’s Index, and local Moran’s Indices were used to identify clusters of higher and lower rates of extreme obesity …

Burdern Of Chronic Health Conditions And Healthcare Utilization Among Mobile Populations In Sub-Saharan Africa, Elizabeth M. Ortiz

Dissertations and Theses

Background: Much of public health research in sub-Saharan Africa on mobile occupations, such as truck drivers and sex workers, has focused on HIV risk. However, evidence is emerging to suggest that the HIV epidemic among these groups is coupled with a high prevalence of chronic health conditions (CHC), specifically hypertension, diabetes, and obesity. For people living with HIV, increased risk of CHC may also be linked to HIV-related chronic inflammatory cascade. In Africa, there has been little research on CHC risk factors or patterns of healthcare utilization among mobile populations. Therefore, the objectives of this study are to examine the …

Patient And Provider Perspectives On Sexual History Taking During Gynecological Care: A Pilot Study In An Academic Family Medical Setting In New York City, Ashley M. Chastain

Dissertations and Theses

Background: In the United States (US), women face a number of serious issues concerning sexual health. Current surveillance data indicates that overall rates of bacterial sexually transmitted infections (STIs) are increasing rapidly. While rates of new diagnoses have decreased, the risks of acquiring HIV are still relatively high for some females, specifically Black/African-American women. In New York City (NYC), where this dissertation research was conducted, similar HIV/STI rates exist among females of reproductive age (aged 15-44). Among women in the US, there are also high estimated rates of other sexual health problems, such as sexual anxiety, sexual dysfunction, and intimate …

Does Ethnic Identity, In-Group Preference, And Acculturation Protect Latinas With A History Of Interpersonal Trauma From Developing Symptoms Of Ptsd?, Evelyn M. Ramirez

Dissertations, Theses, and Capstone Projects

Previous research suggests ethnic identity, a sense of belonging to a particular cultural group, may be protective against symptoms of post-traumatic stress disorder (PTSD). However, the role of ethnic identity, in-group preference (i.e., an individual’s preference for interactions with members of their own ethnic group) and acculturation (i.e., the level of comfort with the mainstream culture) have not been investigated as protective factors for Latinas with a history of interpersonal and sexual trauma. In this study, ethnic identity, in-group preference and acculturation were assessed via self-report on the Scale of Ethnic Experience in two samples of undergraduate Latina and non-Latina …

Frontal Alpha Asymmetry And Inhibitory Control Among Individuals With Cannabis Use Disorders, Alina Shevorykin, Lesia M. Ruglass, Robert D. Melara

Publications and Research

To better understand the biopsychosocial mechanisms associated with development and maintenance of cannabis use disorder (CUD), we examined frontal alpha asymmetry (FAA) as a measure of approach bias and inhibitory control in cannabis users versus healthy nonusers. We investigated: (1) whether FAA could distinguish cannabis users from healthy controls; (2) whether there are cue-specific FAA effects in cannabis users versus controls; and (3) the time course of cue-specific approach motivation and inhibitory control processes. EEG data were analyzed from forty participants (CUD (n = 20) and controls (n = 20)) who completed a modified visual attention task. Results showed controls …

Examination Of Human Health Impacts Due To Adverse Climate Events Through The Use Of Vulnerability Mapping: A Scoping Review, Michael T. Schmeltz, Peter J. Marcotullio

Publications and Research

Government officials, health professionals, and other decision makers are tasked with characterizing vulnerability and understanding how populations experience risks associated with exposure to climate-related hazards. Spatial analyses of vulnerable locations have given rise to climate change vulnerability mapping. While not a new concept, the spatial analyses of specific health outcomes remain limited. This review explores different methodologies and data that are used to assess vulnerability and map population health impacts to climate hazards. The review retrieved scholarly articles and governmental reports concerning vulnerability mapping of human health to the impacts of climate change in the United States, published in the …

Choline: Exploring The Growing Science On Its Benefits For Moms And Babies, Hunter W. Korsmo, Xinyin Jiang, Marie A. Caudill

Publications and Research

The importance of ensuring adequate choline intakes during pregnancy is increasingly recognized. Choline is critical for a number of physiological processes during the prenatal period with roles in membrane biosynthesis and tissue expansion, neurotransmission and brain development, and methyl group donation and gene expression. Studies in animals and humans have shown that supplementing the maternal diet with additional choline improves several pregnancy outcomes and protects against certain neural and metabolic insults. Most pregnant women in the U.S. are not achieving choline intake recommendations of 450 mg/day and would likely benefit from boosting their choline intakes through dietary and/or supplemental approaches.

After The Supreme Court Decision Relative To The Citizen Question In The Census: What Are The Options?, Alfredo Morabia

Publications and Research

No abstract provided.

Fighting Independent Risk Assessment Of Talc And Glyphosate: Whose Benefit Is It Anyway?, Alfredo Morabia

Publications and Research

No abstract provided.

A Mendelian Randomization Study Of Coronary Artery Disease And Three Amino Acids: Alanine, Glycine, And Glutamine, Allan Uribe

Dissertations and Theses

Cardiovascular disease is the leading cause of death worldwide. Coronary Artery Disease (CAD) accounts for the majority of those deaths. Observational studies have identified risk factors that have been helpful in lowering the death rate, including hypertension, high cholesterol, diabetes, smoking, physical inactivity and poor diet. The effects of these risk factors on CAD remain unclear. To clarify the effect of three amino acids, alanine, glutamine, and glycine on CAD I applied a two sample Mendelian randomization analysis to extensively genotyped observational data. In a sample with up to 184,000 individuals and approximately 60,000 controls, SNPs that reached genome wide …

Using Marginal Structural Models To Control For Time-Dependent Confounding And Detect Effect Modification In A Randomized Control Trial With A Time-Varying Exposure, Non-Adherence And Missing Data, Elizabeth A. Lancet

Dissertations and Theses

Background: Unlike traditional regression used in the Intention to Treat (ITT) approach, Marginal Structural Models (MSM) can account for joint effects of baseline and subsequent treatments as well as the presence of time-dependent confounding influenced by prior treatment and selection bias due to censoring. In addition, MSMs have been theorized to be able to assist investigators in determining the overall benefit of a drug in the total population as they are able to provide a summary effect size across all strata of an effect modifier which cannot be done via tradition regression techniques. The overall goal of this dissertation is …

Comorbidities And Medication Adherence Among Older Individuals Living With Hiv In The United States, Amanda M. Kong

Dissertations and Theses

The number of people living with HIV (PLWH) ≥65 years old is increasing in the United States (US) as PLWH live longer. In 2015, there were nearly 1 million people living with diagnosed HIV in the US and under 10% were age ≥65. By 2035, the proportion of PLWH in this age group is projected to be 27%. Like the general population of elderly individuals, as they age, PLWH face age-related comorbidities, many of which require routine medical care and daily medications, in addition to daily antiretroviral therapy (ART) for treatment of HIV. Previous research has found that PLWH develop …

Use Of And Access To Abortion Services Among Asian And Immigrant Populations In The United States, Sheila Desai

Dissertations and Theses

Background: Abortion is common in the United States (U.S.) and a critical component of comprehensive reproductive health care. Yet, little research has documented patterns of abortion use among Asian populations or potential barriers to abortion care among immigrants in the U.S., two rapidly growing but understudied populations. In response, this dissertation aims to examine use of and access to abortion services among individuals obtaining abortions in the U.S., focusing specifically on Asians in New York City (NYC), immigrants in the U.S., and individuals living in high immigrant concentration neighborhoods in the U.S.

Methods: Using vital statistics data from …

The Association Of Higher Carbon Dioxide Levels And Teachers’ Perceived Air Quality And Well Being In New York City Elementary Schools, Leon Levine

Dissertations and Theses

Introduction:

Several recent studies have investigated the direct effects of carbon dioxide (CO₂) at concentrations typically found in office buildings on occupant cognitive functioning. These studies have reported a significant association between (impaired) decision making ability and exposure to increased levels of CO₂ (600 ppm versus 1500 ppm). The findings have serious implications in a classroom setting since the objective of schools is to provide an optimal environment for learning. If CO₂ levels in schools are elevated, the teachers’ health and the students’ learning environment will be compromised. Higher CO₂ levels could impact teachers’ and …

Oral Rapid Hiv Testing In The Dental Setting: Experiences From Three Dental Hygiene Clinics, Anthony J. Santella, Petal Leuwaisee, Susan H. Davide, Hanna Horowitz, Bhuma Krishnamachari

Publications and Research

Background: Oral rapid HIV testing (ORHT) is implemented in the dental setting to make individuals aware of their possibly undiagnosed HIV infection. The testing process and characteristics of clients willing to receive ORHT has yet, however, to be systematically collected. Case description: Three dental hygiene clinics located in academic institutions implemented ORHT from March 2016 to April 2017. Results: 231 persons received ORHT; all had non-reactive results. Most had seen a primary care provider in the past year (n = 130), had had a previous ORHT (n = 111), and described themselves as extremely likely or likely to accept a …

Exploring The Main Effects Of Patient Activation And Provider Support For Patient Self-Management On Patient Portal Use, Linda Anne Greenspan

Dissertations and Theses

Objectives:

This dissertation was designed to: (1) explore variations in clinicians’ views about patient self-management, (2) explore variation in patient activation and (3) explore variation in patients’ and their primary care physicians’ characteristics in the use of a patient portal and the main effects of patient activation and primary care physician support for patient self-management on portal use in an understudied closed multi-specialty ambulatory center. The main hypothesis is that primary care physician support for patient self-management will be an effect modifier on the association between patient activation and patient portal use.

Setting:

The New York Hotel Trades Council and …

Making Public Health History: 1969–2019, Alfredo Morabia

Publications and Research

No abstract provided.

Factors That Predict Lien Payouts, Viktoria Chudsky

Theses and Dissertations

The purpose of this research is to find ways to increase Medicaid collections in order to promote citizens’ access to government sponsored programs. This research paper is written to observe which variables increase reimbursement funds that will be reinjected into Medicaid and Public Assistance programs. The study looks at client and law firm characteristics such as the settlement amount, the client’s age, how long the case has been open in the MAESTRO system for, the client’s borough of residence, and the defending law firm’s location to identify if any of these characteristics influence the amount of recoupment. The firms’ names …

Illness And The American Workplace: Issues And Implications For Employers And Employees, Victoria R. Dolan

Student Theses and Dissertations

This project aims to identify American employee experiences and existing workplace policies and cultures surrounding illness, disability, and sick leave. This approach was taken in order to closely examine what looks to be working well for companies and workers, and what could benefit from a more human centric approach in regards to workplace policy and employee support programs. The study of employee experiences in particular represents a gap in the current scholarly literature regarding illness and illness policy in the American workplace, and more accurately represents the experiences for both employees and employers. Furthermore, it assists with distinguishing the types …