Public Health Commons^™

Centering Communities Of Color In The Modernization Of A Public Health Survey System: Lessons From Oregon, Daniel F. López-Cevallos, Kusuma Madamala, Mira Mohsini, Andres Lopez, Roberta Hunte, Ryan Petteway, Tim Holbert

School of Social Work Faculty Publications and Presentations

Context: Public health survey systems are tools for informing public health programming and policy at the national, state, and local levels. Among the challenges states face with these kinds of surveys include concerns about the representativeness of communities of color and lack of community engagement in survey design, analysis, and interpretation of results or dissemination, which raises questions about their integrity and relevance.

Approach: Using a data equity framework (rooted in antiracism and intersectionality), the purpose of this project was to describe a formative participatory assessment approach to address challenges in Oregon Behavioral Risk Factor Surveillance System (BRFSS) and Student …

"We Just Have To Trust The People In White Lab Coats": Analyzing Distrust In Vaccine Hesitant Comments On The Hhs Nondiscrimination In Health Programs And Activities Proposed Rule, Hima Bindu Lakshmi Vedantham

Dissertations and Theses

Vaccine attitudes provide a valuable site for analyzing trust relations on both interpersonal and institutional levels. This study is a content analysis of public comments submitted from August through October 2022 in response to a proposed rule issued by the U.S. Department of Health and Human Services, which sought to strengthen non-discrimination protections in healthcare programs. Specifically, it examines the role of distrust in shaping and reinforcing vaccine hesitant beliefs, experiences, and healthcare decisions. The five themes identified in the study illustrate a breakdown in trust in pharmaceutical companies, government actors, and healthcare providers, reflecting broader social patterns. In the …

Examining Factors Impacting The Service Needs Of Unhoused Women, Holly Brott

Dissertations and Theses

Women account for a sizeable proportion of the unhoused population in the U.S. Over one-third (38.7%) of unhoused individuals are women, which is a 17% increase from 2016 (United States Department of Housing and Urban Development, 2019). The increased prevalence of women experiencing homelessness calls for a renewed examination of their service needs. This dissertation presents three studies examining factors impacting the service needs of unhoused women. The first manuscript examined factors contributing to unhoused mothers’ successful completion of transitional housing; highlighted participant-identified programmatic strengths; and investigated differences in facilitators to success across two geographic contexts: one rural and one …

The Past, Present, And Future Of The Latino Paradox, Sheila Flores

University Honors Theses

The Latino/Hispanic paradox has left scholars and researchers puzzled as to how Latinos, despite facing socioeconomic challenges, show better health outcomes when compared to other racial/ethnic groups. The emergence of this phenomenon can be traced back to the 1980s/1990s when researchers first noticed Latinos in the United States having characteristics of lower mortality rates and improved health compared with non-Hispanic whites despite having a better socioeconomic status. Performing a literature review of scholars analyzing the past, present, and future of the Latino Paradox will thus allow for an understanding of its origin, current state, and the possible potential trajectories that …

The Impact Of Sars-Cov-2 On The Consolidated Meatpacking System In The United States, Judith R. Solomon

Anthós

The Sars-Cov-2 virus has had a particularly intense impact on the meatpacking industry in the United States. In this paper I provide a brief introduction to the social, economic, and political realities that lead to mass deaths of meatpacking workers from COVID, and the impact of a consolidated meatpacking system on disease mitigation. These workers are considered expendable due to a lack of power.

Let Kids Sleep: The Role Of Interdisciplinary Neuroscience Outreach In Stimulating Brains And Developing Research-Informed Approaches To Community Concerns, Marc Chenard

University Honors Theses

Northwest Noggin (NW Noggin), an all-volunteer neuroscience education outreach non-profit, serves its community by bringing students, artists, scientists and other participants together for artistic collaboration and learning. The outreach takes place in K-12 schools and other institutions (such as museums, coffee shops and correctional facilities) all over the Pacific Northwest. Neuroscience education outreach generates discourse surrounding community concerns through illuminating the brain-centric qualities of issues and by drawing on neuroscience research to create solutions. The neuroscience research-informed perspectives on these concerns stimulate awareness, create momentum towards evidence-based reform, and can result in policy interventions. This thesis details how NW Noggin …

The Association Of Patient-Provider Language Concordance With Healthcare Comprehension Among Latino/As In Oregon, Grace Parra

University Honors Theses

Background: The purpose of this study is to describe the need and preferences among Mexican-origin Latinos in Oregon for language-concordant healthcare providers. We hypothesize that the presence of a language concordant provider is associated with greater health care comprehension.

Methods: This is a cross sectional study in collaboration with the General Consulate of Mexico. We developed a 20-item survey that includes questions about socio-demographics, a validated language-based acculturation scale, and questions regarding language concordant care experience and preferences used in previous studies. We are recruiting at the Mexican Consulate 500 Latino/as ages 18 or older who had a healthcare visit …

The Impact Of Period Poverty On Low-Income Adolescents In The United States, Makayla Olson

University Honors Theses

Period poverty is an issue that impacts menstruators globally. This creates a significant health disparity for menstruators, including difficulties accessing menstrual products, inadequate menstrual and puberty health education, and shame and stigma that come from societal misunderstandings and misinformation regarding menstruation. This paper examines the effects of period poverty on low-income adolescents in the United States. It looks at the current literature that addresses how the financial and accessibility barriers that cause period poverty, as well as how these causes impact school-aged menstruators. It aims to address the role that schools play in creating safe environments for menstruators, including staff …

The Evolution Of Leadership During The Covid-19 Pandemic: An Analysis Of The Research, Luca Patrick Thierry Gregston

University Honors Theses

This paper's research question, "How has the COVID-19 pandemic changed the concept and practice of leadership? In the end much of the empirical evidence for what COVID-19 did or didn't change in leadership practices is still relatively ambiguous. So it is too early to say that "business as usual" is gone for good. And COVID furthered and deepened long term trends, accelerating the great resignation and a dramatic revaluation of intangible assets like reputation, intellectual property and human capital. In response, there is a clear need for a new leadership mindset for the 21st century after the COVID pandemic.

Final (Year 2) Report To Oha On Sogi Demographic Standards For Minors, Martin Arrigotti, Nell Carpenter, Kieran Chase, Alysia Cox, Itai Jeffries, Alexis Dinno

OHSU-PSU School of Public Health Faculty Publications and Presentations

Executive Summary

The report synthesizes thoughtful recommendations of the authors to the Oregon Health Authority (OHA) about routine data collection of SOGI† (sex, sexual orientation, and gender) demographic data in minors for clinical and reporting purposes. We see five primary motivations to routinely collect SOGI data, including to:

1. create an inclusive practice in order to welcome and make space for people from historically excluded genders, sexes, and sexual orientations,
2. promote health equity between minority and majority SOGI identities,
3. direct group-specific services towards those who need them,
4. represent the actual diversity of Oregon, and its communities, and
5. shift normative expectations about …

Investigating Interpersonal And Community Drivers Of Taenia Solium Prevention To Reduce Acquired Seizure Disorders In Northern Peru: An Analysis Of Social Networks, Social Capital, And Community-Identified Barriers And Facilitators, Angela Gayle Spencer

Dissertations and Theses

Background: In Northern Peru and other low- and middle-income countries (LMICs) worldwide, the Taenia solium parasite causes an estimated 30% of acquired epilepsy -- an entirely preventable disease burden. Sanitation development and pork production regulation would reduce infection risk in endemic communities, but large-scale systemic improvements are not likely to occur in the near future. In the meantime, communities can reduce infection risk by adopting protective behaviors. Social networks can provide role modeling and support for health-promoting behaviors, and deliver social capital in the form of trusting relationships, norms of reciprocity, and information exchange in support of T. solium control. …

Humanity In Trauma, Alyssa K. Thompson

University Honors Theses

The main objective of the literature review is to use the trauma-informed care paradigm to argue that the current implementation of trauma-informed care reinforces hierarchies of harm, leading to feelings of moral obligation and moral injury while perpetuating othering. This literature review criticizes trauma-informed care, emphasizing lived experiences against the characteristics trauma-informed care aspires to reflect. The review centers on the broad themes of understanding, universality, and acceptance of the present trauma-informed care paradigm. The critique comes from the silently excluded group of healthcare workers, with a personal perspective from a professional who worked in an urban hospital emergency department …

Paperwork, Paradox, And Prn: Psychotropic Medication Deficiencies In Assisted Living, Sarah Dys, Paula Carder

Institute on Aging Publications

Individual state approaches to assisted living/residential care (AL/RC) licensing and oversight in the United States result in different practice standards and requirements, including psychotropic medication use. We examined 170 psychotropic medication deficiency citations issued to 152 Oregon AL/RC settings from 2015 to 2019. Applied thematic analysis resulted in the following themes: (1) documentation issues are primarily responsible for noncompliance, (2) unclear parameters place direct care workers in a role paradox, and (3) there is a persistent disconnect about when to seek qualified expertise before requesting psychotropic medications. AL/RC-specific mechanisms for medication prescription and administration are necessary to improve the structure …

Sex Education In American Public Schools: Policy And Outcomes, Alexandra Mattingly

University Honors Theses

Sexual Education in American public schools is the subject of a long-standing debate between educators, parents, and policy makers. From the beginning of public schooling in the United States, the role that public schools ought to serve in educating students about sexual health has been unclear. This remains a topic of debate despite the fact that since the 1980s studies have shown consistently that comprehensive sexual education unequivocally leads to lower rates of pregnancy and sexually transmitted infection spread among students. Comprehensive sexual education is sexual education that includes information on safer sexual activity practices as well as information about …

Connection Between Migraine Physiology And Modifiable Lifestyle Factors And Behaviors: A Literature Review, Sophia A. Kogan

University Honors Theses

Migraine headache is a physiologically complex disorder that presents as an intense headache with other symptoms. Globally, more than one billion people suffer from migraine, and it is the second leading cause of disability worldwide. At present, migraines are targeted with many pharmaceutical interventions; however, there are no well-studied ways to combat migraines through lifestyle modifications alone. One of the molecules involved in migraine physiology is the calcitonin gene-related peptide (CGRP), which causes vasodilation and the sensation of pain. The focus of this thesis is to find connections between CGRP physiology and modifiable factors that individuals have the power and …

International Comparison Of Literature On Home Health: Taiwan And The United States, Jaden Gloden

University Honors Theses

Taiwan is one of the world's fastest-aging societies and in 1994 implemented its universal National Health Insurance program which would later include a comprehensive long-term care system. The United States is also an aging society and a growing number of Americans are in need of long-term care services that the government has yet to provide or finance. Aging in place, the desire of older adults to stay in their homes as they age has consistently remained popular among Americans 50+ resulting in the popularity of home-based medical care. Taiwan society also values aging in place and an emphasis on Confucian …

The Sanitary Lens: A Study Of 19th Century Public Health In British Colonial India And Australia, Josephine Cannistra

University Honors Theses

Specific colonial processes informed highly distinct policies of public health and sanitation in colonial India and Australia. Their distinctions and lasting legacies are obscured when they are uncritically lumped together within the British Empire. The 19th century was a period of great change throughout India and Australia. It was also a period of dramatic change in general understandings of sanitation and health. This paper examines colonial India and Australia through the lens of sanitation and medicine as it was understood and practiced in British spheres of influence. A comparative approach to these histories and this past sheds light on how …

The Influence Of Microorganisms On Human Health, Tiffany Bui

University Honors Theses

The purpose of this thesis is to explore the interplay between the environment, lifestyle, and composition of human microbiomes across different communities, with a specific focus on immune and digestive health. This literature review investigates three distinct types of communities: isolated/traditional, transitional, and urban/industrialized communities, each characterized by unique environments, societal structures, and interactions. These factors contribute to the distinct microbial populations and compositions within each community. It is impossible to avoid contact with microorganisms as they are present in every aspect of our lives, from the air we breathe, the water we drink, the soil we walk on, the …

"I'M Clean And Sober, But Not Necessarily Free": Perceptions Of Buprenorphine Among Patients In Long-Term Treatment, Jessica J. Wyse, Travis I. Lovejoy, Adam J. Gordon, Katherine Mackey, Anders Herreid-O'Neill, Benjamin J. Morasco

OHSU-PSU School of Public Health Faculty Publications and Presentations

Patients receiving buprenorphine for the treatment of opioid use disorder (OUD) experience a roughly 50% reduction in mortality risk relative to those not receiving medication. Longer periods of treatment are also associated with improved clinical outcomes. Despite this, patients often express desires to discontinue treatment and some view taper as treatment success. Little is known about the beliefs and medication perspectives of patients engaged in long-term buprenorphine treatment that may underlie motivations to discontinue.

Increasing Access To Doulas In Oregon: A Delphi Study, Courtney Elizabeth Crane

Dissertations and Theses

Doulas are trained, nonmedical support professionals that provide continuous emotional, informational, physical, and practical support before, during, and after childbirth. Doula care has been shown to reduce the cost of birth-related healthcare, reduce adverse birth outcomes, and increase patient satisfaction and positive birth experience. In 2011 Oregon became the first state to authorize payment expenditures of doula care through Medicaid as a strategy to reduce birth-related health disparities and increase culturally and linguistically appropriate healthcare delivery. The intention of the set of policies and administrative rules was to mandate access to doulas and other types of Traditional Health Workers (THWs) …

Beyond The Bmi: Expanding Quantitative Methods To Study Health For All Bodies, Kieran Chase, Daniel Oron

OHSU-PSU School of Public Health Annual Conference

The public health field is beginning to reckon with its role in perpetuating and reinforcing systemic anti-fatness. Emerging evidence for the devastating health impacts of stigma call into question decades of research and policy that labels the size of people’s bodies as diseased. However, even as we acknowledge the harmful effects of stigma, the field is materially and institutionally invested in a health paradigm that centers weight loss and size-related proxies for health, such as the BMI. Public health scholars interested in questions related to nutrition, chronic disease, and exercise must begin to expand their research focus to imagine non-stigmatizing …

Serotonin And Migraine, Sophia A. Kogan

OHSU-PSU School of Public Health Annual Conference

Migraine, experienced by more than 1 billion people, is the second leading cause of disability worldwide. It is a physiologically complex disorder with nervous, vascular, and inflammatory components, and is associated with genetic factors and environmental influences. Migraine triggers are poorly understood, and sufferers have little control in preventing migraines from occurring. The aim of this review is to bridge the physiological migraine processes with lifestyle behaviors that can be modified by individuals, focusing on serotonin.

Migraines can be initiated when an external event triggers the release of vasodilators such as calcitonin gene-related peptide (CGRP), leading to cranial vasodilation, headache, …

(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 …

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 …

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 …

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 …

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 …