Public Health Commons^™

(Un)Weighted Assumptions: Anti-Fatness & Health, Kieran Chase, Nell Carpenter, Madysen Schreiber

OHSU-PSU School of Public Health Annual Conference

This lecture/discussion session aims to expand and add nuance to public health students’, professors’, and practitioners’ understanding of the interplay between body size and health. We will begin by naming and challenging common assumptions about the relationship between bodyweight and health outcomes. We will then argue for the consideration of weight-related stigma as a Fundamental Cause of Disease as defined by Phelan and Link, and for institutionally embedded anti-fat bias at the policy level (e.g., insurance policy, medical equipment) as a cause of population health inequity as defined in Whitehead’s Health Equity Framework. We offer these frameworks in contrast to, …

Does Sph Curricula Promote ‘Health Equity’, Reproduce Injustice, Or Both?, Jesse Yarnold

OHSU-PSU School of Public Health Annual Conference

Does SPH Curricula Promote ‘Health Equity’, Reproduce Injustice, or both?

The social justice movements of recent years (preceded by [generations of] insurmountable suffering) have facilitated a collective recognition of the systemic effects of racism and epistemic violence. Despite the ambitious and well-intentioned vision of “health equity” as defined by epidemiologic scholarship - progress is slow and injustices prevail.

Students, scholars, and researchers of ‘Public Health’ are uniquely positioned to imagine and create innovative ways of understanding and addressing the harmful inequities and injustices perpetuated by white settler colonialism. I argue that Academic institutions delivering Public Health education are uniquely positioned …

Determinants Of Modern Contraceptive Use Among Young Women In Ghana: A Mixed-Methods Study Design, Adjoa N. Manu

OHSU-PSU School of Public Health Annual Conference

Background: Only 20% of sexually active women aged 15-24 in Ghana used contraception during their last sexual intercourse. Young women are highly exposed to the risks associated with having unprotected sexual intercourse, such as unintended pregnancy and sexually transmitted infections.

Objective: To use an explanatory sequential mixed-methods design to examine the determinants of modern contraceptive use among young women in Ghana using population-based data and identify the types of contraceptive methods the population know and use.

QUAN Design: Analysis of the 2017 Ghana Maternal Health Survey data, a nationally representative cross-sectional survey.

QUAN Findings: The male …

Investing In Family Planning, Education, And Empowering Of Women And Girls To Mitigate The Impact Of Climate Change: An Exemplary Case Of Rwanda., Adjoa N. Manu

OHSU-PSU School of Public Health Annual Conference

Countries where population growth is high are often highly impacted by the climate crisis despite not being a significant contributor to historical greenhouse gas emissions. This has created a global inequality in that countries with poorly developed infrastructure are 15 times more likely to have deaths due to climate related disasters such as floods, droughts, and storms compared to wealthy countries that can better protect against similar events. While the climate crisis impacts everyone, women and girls are at a higher risk because of their unique health needs and roles in the community. The effects of climate change can be …

Map The System: Presence And Impact Of Ppcps In Water, Emma Vandermeulen, Ruby Mitchell

OHSU-PSU School of Public Health Annual Conference

In a changing climate, there is growing emphasis on protecting our water sources and developing systems for conserving and reusing water. While many contaminants of concern are monitored and addressed by water treatment systems, pharmaceuticals and personal care products (PPCPs) are generally not accounted for. PPCPs in water systems have been an increasing concern as detection of these products has increased over the last few decades. Studies have been exploring the impact of antibiotics, antidepressants, contraceptives, and other anthropogenic products on our water system and how these substances interact with local ecosystems. Our main research questions are to understand what …

Impact Of Industrial Disasters On The Mental Health Of Vietnamese Americans On The Gulf Coast, Vivian L. Duong

OHSU-PSU School of Public Health Annual Conference

An explosion on the Deepwater Horizon oil rig caused 200 million gallons of crude oil to spill on the Gulf Coast over a five-month span. About 16,000 miles of coastline, ecosystem and marine life along Alabama, Florida, Louisiana, Mississippi, and Texas were contaminated. This disaster and the recovery process caused social, financial, and ecological shocks, resulting in adverse psychosocial and physical health outcomes, health disparities, and socioeconomic inequality. Among the oil spill's most affected and vulnerable populations are the Vietnamese American communities that settled on the Gulf Coast after the end of the Vietnam War in 1975. The plight of …

History Of Hypertension And Urinary Incontinence Among Adults Aged 40 And Older: A Cross-Sectional Study From The National Health And Nutrition Examination Survey, Puthyda Keath, Karla Cordova Nicolas

OHSU-PSU School of Public Health Annual Conference

Introduction: Urinary incontinence (UI) impacts over 200 million individuals world-wide, though little is known about the causes of this condition. The aim of this cross-sectional study was to examine prevalence of UI and the association between a history of hypertension and UI in older adults. A secondary aim was to determine if sex modified the association between history of hypertension and UI.

Methods: This study utilized data from the U.S. National Health and Nutrition Examination Survey (NHANES) 2011-2016 cycles. We included 9,717 U.S adults (≥40 years) with complete information on history of hypertension, UI and other independent variables. Participants with …

Qualitative Evaluation Of Medical Student Perceptions Of Chronic Disease, Mallory A. Decampos-Stairiker, Viviane Cahen, Sarah Dzubay, Saffron Evergreen, Rachel Shore

OHSU-PSU School of Public Health Annual Conference

Background:
Chronic disease is becoming increasingly common around the world. Students in different US medical training programs are exposed to varying amounts of chronic disease education and are taught unique ways of approaching chronic disease management. The purpose of this study is to investigate allopathic and naturopathic medical students’ attitudes, understandings, and perceptions of chronic diseases and their management.

Methods:
This study was conducted as a class project for UNI 504: Qualitative Methods for Health Professionals. We conducted virtual interviews during February 2023 with five allopathic and five naturopathic medical students from around the United States. Demographic information on …

Housing Quality In Philadelphia, Pa: An Urban Health Equity Indicators Approach, Jennifer Piacentini

OHSU-PSU School of Public Health Annual Conference

Philadelphia is also the poorest large city in the country, and many residents live in substandard housing. Poor housing quality is associated with poor physical health outcomes as well as mental health issues (Schilling et al., 2022). Many homes in Philadelphia are of poor quality partially due to the median house age being 93 years, and the fact that 75% of homes are more than 50 years old (Jay, 2017). It has also been found that Black households are disproportionately impacted by housing quality issues. The Habitat for Humanity Philadelphia’s Home Repair programs are invaluable, and work with homeowners to …

The Prevalence Of Osteoporosis And Low Femoral Neck Bone Density Among Never-Smoking U.S. Adults With Exposure To Secondhand Smoke: A Cross-Sectional Study Using The National Health And Nutrition Examination Survey (Nhanes), Felicia Zhou, Mikaela Haglund

OHSU-PSU School of Public Health Annual Conference

Objective

Epidemiologic studies have observed an association between exposure to secondhand smoke (SHS) and low bone mineral density (BMD) among current and past smokers. However, there is a knowledge gap in elucidating this association among never-smoking adults. The objective of this study is to examine the association between SHS exposure, measured by serum cotinine levels, and BMD for never-smoking U.S. adults.

Methods

This cross-sectional analysis included 3,224 never-smoking U.S. adults aged 50 years and older from the National Health and Nutrition Examination Survey cycles 2007-2008, 2009-2010, and 2013-2014. Serum cotinine, a biomarker for tobacco exposure, was the exposure variable while …

Consensus Panel For Assessing Usability And Acceptability Of Mobile Health Autism Screeners, Gabriella Tangkilisan, Luis Andres Rivas Vazquez, Sarabeth Broder-Fingert, Plyce Fuchu, Benjamin Sanders, Katharine Zuckerman

OHSU-PSU School of Public Health Annual Conference

Abstract:

Background:

Parents go online to assess whether their child has symptoms of autism. Though early autism identification is important, language, cultural, and technological barriers may impede equitable access to online autism screening tools.

Objective:

To create consensus recommendations for equitable design of autism screening apps and websites using an online panel of parents, autistic self-advocates, health and educational providers, autism researchers, and online screening tool developers.

Methods:

We invited 6 parents (4 of autistic and 2 of typically-developing children), 2 autistic adults, 3 early intervention providers, 3 pediatric primary care providers, and 3 autism online screening app/website developers to …

Client-Reported Quality Of In-Facility Medication Abortion Compared With Pharmacy-Based Self-Managed Abortion In Bangladesh, Laura E. Jacobson Mph, Sarah E. Baum, Erin Pearson, Rezwana Chowdhury, Nirali M. Chakraborty, Julia Goodman, Caitlin Gerdts, Blair Darney

OHSU-PSU School of Public Health Annual Conference

Objective: We used the newly developed Abortion Care Quality (ACQ) Tool to compare client-reported quality of medication abortion care by modality (facility-based versus pharmacy-based self-managed abortion (SMA)) in Bangladesh.

Study Design: We used the abortion client ACQTool exit and 30-day follow-up surveys and bivariate statistics to compare 18 client-reported quality indicators grouped in six domains and eight abortion outcomes, by service modality. We used multivariable logistic regression to identify factors associated with selected quality indicators and outcomes (abortion affordability, information provision, and knowing what to do for an adverse event), controlling for client socio-demographic characteristics.

Results: Of 550 abortion clients, …

Telehealth Family Navigation For Early Autism Services Access: The Autism Alert Project, Mohadeseh Solgi, Avneet Sidhu, Annie Hoang, Alicia Feryn, Joseline Raja-Vora, Patricia Cavanaugh, Michelle Tae, Eric Fombonne, Katharine Zuckerman

OHSU-PSU School of Public Health Annual Conference

Background: Delays in access to educational services for autism are common and more likely among children from families of color and/or with low income. In-person family navigation accelerates autism diagnosis; however, the effectiveness of telehealth autism diagnostic navigation is unknown.

Objectives: To test preliminary feasibility and efficacy of a telehealth autism navigation program.

Method: This was a site-randomized pilot trial of autism family navigation for Oregon children in 2021-2022. The intervention used layperson family resource specialists based at Oregon’s Help Me Grow program as navigators for families of children with autism symptoms. Pediatric clinics with >30% Medicaid, located in 5 …

Homelessness, Water Access, And Environmental Justice In An Urban Environment, Alicia Gamble

Environmental Science and Management Professional Master's Project Reports

Only in recent years has houselessness been viewed as an environmental justice issue, and little is understood about the environmental injustices of water insecurity among unhoused individuals, especially during the COVID-19 pandemic. In order to understand the environmental injustices (i.e., distributive, procedural, and recognition) of the water insecurity process using the cause-response-effect theoretical model, unhoused participants living near services were interviewed in Portland, Oregon about their lived experiences gaining access to water, the barriers they encounter when trying to access water, and the impacts that result from these barriers. Results revealed that COVID-19 was a barrier to water access and …

Relationship Between Chinese Herbal Medicine Use And Risk Of Sjögren’S Syndrome In Patients With Rheumatoid Arthritis: A Retrospective, Population-Based, Nested Case-Control Study, Hou-Hsun Liao, Hanoch Livneh, Miao-Chiu Lin, Ming-Chi Lu, Ning-Sheng Lai, Hung-Rong Yen, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Background and Objectives: Sjögren’s Syndrome (SS) is a common extra-articular feature among subjects with rheumatoid arthritis (RA). While Chinese herbal medicine (CHM) has been used to treat symptoms of RA for many years, few studies have examined its efficacy in guarding against the SS onset. This study aimed to compare risk of SS for RA patients with and without use of CHM. Materials and Methods: Data obtained for this nested case-control study were retrieved from Taiwanese nationwide insurance database from 2000–2013. Cases with SS claims were defined and matched to two randomly selected controls without SS from the recruited RA …

The People’S Social Epi Project: Pdx With Ryan Petteway, Ryan J. Petteway

PDXPLORES Podcast

In this episode of PDXPLORES, Ryan J. Petteway, Associate Professor at the Oregon Health & Science University-Portland State University School of Public Health, discusses the research behind The People's Social Epi Project: PDX. Providing a counternarrative to the settler-colonial and racial capitalist practices of traditional epidemiological research on health inequities, Petteway's PSEP: PDX initiative is a portfolio of three projects centering around youth-led participatory research, music, and poetry. PSEP: PDX seeks to "center the margins'' to advance health and epistemic justice.

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Paid Sick Leave, Chronic Disease, And Systemic Racism: A Systematic Review, Lauren Yee

University Honors Theses

The purpose of this systematic review is to assess the impact of paid sick leave (PSL) availability on chronic disease prevention, treatment, and recovery. Furthermore, this study aims to investigate the role of race on this relationship as a possible source of systemic racism. The findings of this review show a growing body of evidence that affirms the statistically significant association between PSL and chronic disease-related outcomes. The availability of PSL has the potential to remove financial barriers allowing employees to access preventative services for chronic diseases. Access to PSL also increases work resumption by improving financial stability after being …

Building The Foundation For A Community Generated National Research Blueprint For Inherited Bleeding Disorders: Research Priorities In Health Services; Diversity, Equity, And Inclusion; And Implementation Science, Vanessa R. Byams, Judith Baker, Cindy Bailey, Alexis Dinno, Multiple Additonal Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: The National Hemophilia Foundation (NHF) conducted extensive all-stakeholder inherited bleeding disorder (BD) community consultations to inform a blueprint for future research. Sustaining and expanding the specialized and comprehensive Hemophilia Treatment Center care model, to better serve all people with inherited BDs (PWIBD), and increasing equitable access to optimal health emerged as top priorities. Research Design and Methods: NHF, with the American Thrombosis and Hemostasis Network (ATHN), convened multidisciplinary expert working groups (WG) to distill priority research initiatives from consultation findings. WG5 was charged with prioritizing health services research (HSR); diversity, equity, and inclusion (DEI); and implementation science (IS) research …

Conspiracy Theories And Ebola: Lessons Learned Important For Future Pandemics, Shawn C. Smallman

International & Global Studies Faculty Publications and Presentations

The public health campaign against Ebola in the Democratic Republic of the Congo faced serious challenges, some due to conspiracy theories and denial. These beliefs were so powerful that they even caused repeated attacks upon health care providers and medical centers. These conspiracy theories were nothing new, as they are a common feature of all frightening epidemics, such as HIV and COVID-19. These narratives also circulated during the 2015 West African Ebola outbreak. Addressing conspiracy theories during an epidemic requires a coordinated campaign involving not only local leaders but also the cooperation of social media organizations

“I Don’T Have A Pile Of Money To Take Care Of Things”: Financial Stress And Housing Insecurity Among Low-Income Hispanic/Latinx Immigrant Families During Covid-19, Marisa Westbrook

OHSU-PSU School of Public Health Faculty Publications and Presentations

Housing, the single largest expense for low-income individuals, is inherently tied to economic security. During the COVID-19 pandemic, Hispanic/Latinx and Black communities experienced the highest rates of income loss, basic needs insecurity, and COVID-19 hospitalization and mortality. As part of an ethnographic case study, I conducted serial interviews over two years with 35 predominantly low-income Hispanic/Latinx immigrant families in one Denver, Colorado neighborhood during the COVID-19 pandemic. These interviews revealed that very few of these individuals were able to access governmental financial support as a result of limited dissemination despite facing unemployment, underemployment and rising rents. Although governmental financial support …

Association Of Maternal Age 35 Years And Over And Prenatal Care Utilization, Preterm Birth, And Low Birth Weight, Mexico 2008–2019, Laura Jacobson, Evelyn Fuentes-Rivera, Raffaela Schiavon, Blair Darney

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective:

We compared prenatal care utilization, preterm birth, and low birth weight neonates among women 35 years and older compared to women 20-34 years old in Mexico, 2008-2019.

Methods:

We used birth certificate data and conducted a historical cohort study of all singleton live births in Mexico from 2008-2019. Study outcomes were inadequate prenatal care (timing of initiation of care and number of visits), preterm birth, and low birth weight. We compared outcomes among women 35-39, 40-44, and 45-49 with births to women 20-34. We used logistic regression to account for individual and contextual confounders.

Results:

We included a total …

Evaluating The Effect Of San Francisco’S Paid Parental Leave Ordinance On Birth Outcomesf, Deborah Karasek, Sarah Raifman, Rita Hamad, William H. Dow, Julia M. Goodman

OHSU-PSU School of Public Health Faculty Publications and Presentations

Since 2017, San Francisco’s Paid Parental Leave Ordinance (PPLO) has allowed parents who work for private-sector employers to take 6 weeks of fully paid postnatal parental leave. Previous studies have linked paid parental leave with health improvements for birthing people and babies, although evidence for birth outcomes is limited. We hypothesized that the PPLO may have improved birth outcomes via reduced stress during pregnancy due to anticipation of increased financial security and postnatal leave. We used linked California birth certificate and hospital discharge records from January 2013 to December 2018 (n = 1,420,781). We used quasi-experimental difference-in-difference (DD) models to …

On Epidemiology As Racial-Capitalist (Re)Colonization And Epistemic Violence, Ryan J. Petteway

OHSU-PSU School of Public Health Faculty Publications and Presentations

This commentary reflects upon power-knowledge dynamics and matters of epistemic, procedural, and distributive justice that undergird epidemiological knowledge production related to racial health inequities in the U.S. Grounded in Foucault’s power-knowledge concepts—“objects”, “ritual”, and “the privileged”—and guided by Black feminist philosopher Kristie Dotson’s conceptualization of epistemic violence, it critiques the dominant positivist, reductionist, and extractivist paradigm of epidemiology, interrogating the settler-colonial and racial-capitalist nature of the knowledge production/curation enterprise. The commentary challenges epidemiology’s affinity for epistemological, procedural, and methodological norms that effectively silence/erase community knowledge(s) and nuance in favor of reductionist empirical representations/re-presentations produced by researchers who, often, have never …

3 Selections From "Upon The Body: Poems Of/To A Black Social Epi, Pt.Ii--Love//Resistance In The Time Of Covid", R. J. Petteway

Amplify: A Journal of Writing-as-Activism

The 3 poems included here are from a collection written between January and August 2020. The full collection—27 poems total—examines intersections of structural racism, racialized police violence, and COVID-19, drawing from generations of creative resistance produced and embodied by Black artists, activists, and scholars like Nina Simone, Langston Hughes, Paul Laurence Dunbar, Audre Lorde, Ida B. Wells, James Baldwin, and W.E.B. DuBois. The collection as a whole is crafted as counternarrative to public health’s ahistoric, apolitical, racist, and homophobic proclivities in times of crisis. The 3 poems here are from Part II, "LOVE//Resistance in the Time of COVID.” These selections …

The Passive Approach: How Academically Motivated Students Approach Their Mental Health., Megan E. Mccoy

Anthós

The research utilizes qualitative interviews and focus groups to understand how academically motivated students approach their mental health. Mental health is defined as “emotional, psychological, and social well-being,” by the Center for Disease Control and Prevention and is becoming a more significant concern in collegiate student populations. At Portland State University, the effects of mental health concerns on students are nearly double that of students around the U.S (Community Commons, n.d.). Academically motivated students are a group who seemingly strive for success and likely experience high levels of stress daily. The study found that students often take a passive approach …

Preliminary (Year 1) Report To Oha On Pediatric Sogi: Executive Summary. Report To The Oregon Health Authority, Office Of Equity And Inclusion, Martin Arrigotti, Kieran Chase, Alexis Dinno

OHSU-PSU School of Public Health Faculty Publications and Presentations

Overview: The enclosed report is the result of collaboration between the authors and the Oregon Health Authority. The report synthesizes the thinking and recommendations of the authors about routine data collection of SOGI data in minors for clinical and demographic purposes. Primary motivations to routinely collect SOGI data include: (1) inclusive practice in order to welcome and make space for people from historically excluded genders, sexes, and sexual orientations, (2) to promote health equity between minority and majority SOGI identities, and (3) to direct group-specific services towards those who need them.

Investigation and Findings: These recommendations are informed …

Disrupted Course Delivery In The Covid-19 Landscape: Consequences For University Student Stress And Mental Health, Madison M. Eki

University Honors Theses

University students have experienced a massive disruption in the path to their academic goals. The Covid-19 pandemic has negatively impacted populations of students internationally. They have incurred physical and psychological distress. In this paper, the literature and data collected about how the pandemic affected the stress levels of students at universities will be analyzed and a recommendation for future research will be made. The purpose of this literature review is to analyze data and publications pertaining to the mental health and perceived stress of students resulting from Covid-19. There is an emphasis on the severity of the ways that their …

Maternal Socioeconomic Status And Infant Low Birth Weight: Interactions Across Generations, Kira M. Anderson

University Honors Theses

This article examines the interplay between low birth weight (LBW) and socioeconomic status (SES) across generations. Transgenerational research of LBW and SES is limited and poses certain challenges and nuances. A literature review was conducted which gathered studies that analyze both LBW and SES for two or more generations. Results of these studies are mixed, but the body of research is suggestive of patterns in which LBW and low SES may mutually exacerbate each other across generations. Furthermore, the research suggests that these patterns may be more severe among Black women. This paper calls into question the consequences that these …

Investigating The Efficacy & Implications Of Abstinence-Based Drug Education, Sophia Hanken

University Honors Theses

The United States has a long and complex history surrounding substance use. Drug education programs have become widely implemented in American schools and the media. Policy, rhetoric, and ideology have directly affected the curriculum of drug education programs. Drug education in the United States centers around substance abstinence. While well-intended, abstinence-based drug education is not a pragmatic solution for reducing substance-related harm or promoting health. The purpose of this thesis is to critique two of the most widely used abstinence-based drug education programs; Drug Abuse Resistance Education (D.A.R.E) and Project ALERT. These programs often emphasize the dangers of substance use …

Reflecting On Resilience: Insight Into Resiliency Development And Utilization In Oregon's Older Adults From 2020 To 2022, Riley A. Wilton

University Honors Theses

The events of the last 2 years have complicated the lives of older adults throughout the world. For many, their survival can be traced back to one key trait: resilience. In the state of Oregon, the years 2020-2022 came with a host of issues that expanded past the COVID-19 pandemic. These events provide context for the world our storytellers discuss.

Using a snowball recruitment strategy through the efforts of community organizations and senior centers, 4 storytellers sat down to describe their resilience in different ways. They were asked to reflect on their own life experiences, how it influenced their resilience, …