Public Health Commons^™

Prehypertensive Risk Among African-American Undergraduates: Do The Extra Pounds Really Matter?, Cecile N. Yancu, Amber Debono, Anna K. Lee, Correll Mcrae, Daphne Witherspoon

Journal of Health Disparities Research and Practice

The objective of this study is to examine prehypertension among young African American adults and evaluate the predictive value of easily obtained standard measures of adiposity. Data for this study of 155 primarily African-American undergraduates was collected between April 2010-11. Participants provided family health history and anthropometric measures, including body weight, body mass index (BMI), and waist to hip (WHR) ratio. Percentages were calculated for demographics. The average systolic blood pressure measured over two time periods within a single semester generated prehypertension rates. Univariate and multivariate logistic regression examined the impact of BMI, WHR, weight, and family medical history on …

Disparities In Access To Primary Care And Emergency Department Utilization In A Large Medicaid Program, Natasha Parekh, Marian Jarlenski, David Kelley

Journal of Health Disparities Research and Practice

Identifying and eliminating disparities are priorities for State Medicaid programs, especially in the context of increased enrollment through Medicaid expansion. We assessed racial, ethnic, regional, and managed care organization (MCO) differences, as well as time trends before and after Medicaid expansion, in primary care and emergency department (ED) utilization in a large Medicaid program. We performed a cross-sectional evaluation of data from Pennsylvania Medicaid from 2011-2015. Three primary care outcomes included: 1) adult access to primary care; 2) adolescent access to primary care; and 3) pediatric access to dental care. Our fourth outcome reflected ED utilization. We observed significant racial …

Racial Variations Of The Injection Route Of Administration Among Injection Drug Users In The United States: A Comparative Trend Analysis, Philip Danquah

Graduate & Professional Student Association Research Forum

The objective of this research is to address the variations in the injection route of administration among racial groups who are injection drug users in the United States and how that contributes to their vulnerability to HIV/AIDS behaviors and hospital admissions.

Associations Between Opioid-Related Hospitalizations And Intravenous Drug Users, Jacklynn De Leon

UNLV Theses, Dissertations, Professional Papers, and Capstones

The opioid epidemic has led to a chain reaction of public health concerns, including an increase in heroin usage, injection drug abuse, incidence of hepatitis C virus (HCV), and HIV transmission. There have been few population-based studies investigating the clinical and socio- demographic data associated with opioid use in Nevada (Feng et al., 2016; Frank, 2000) and few studies investigating the intravenous drug user (IDU) population in Clark County. On February 2017, Clark County’s first syringe exchange program (SEP) opened its doors to the IDU population. This study provides an updated analysis of opioid-related injuries within Nevada and provides a …

Examining Environmental Hazards In Rental Homes And Habitability Laws In Clark County, Nevada, Jorge Luis Bertran

UNLV Theses, Dissertations, Professional Papers, and Capstones

It is well established that home conditions are linked to the health outcomes of occupants. There are over 880,000 housing units in Clark County, Nevada; nearly half of those are renter-occupied units (ROUs). Currently, there is limited research on the characteristics of environmental hazards found in Clark County ROUs and the strength of habitability statutes created to protect tenants from substandard housing. Understanding how renters in Clark County are affected by environmental hazards in ROUs and the processes by which landlords and tenants resolve grievances related to those hazards would benefit public health. It would enhance the ability to quickly …

Telelactation And Breastfeeding Outcomes Among Low-Income Mothers In Mississippi: A Retrospective Cohort Study, Aaron Thomas Hunt

UNLV Theses, Dissertations, Professional Papers, and Capstones

New mothers are recommended to exclusively breastfeed their infants for the first six months to provide optimal health for infant and mother. However, only 13.0% of mothers in Mississippi reached this milestone among infants born in 2015, which was far below the Healthy People 2020 objective of 25.5%. One factor that impacts breastfeeding success is access to certified lactation consultants, but low-income women may lack access due to an inadequate number of providers, unreliable transportation, rural location, or cost. The use of “telelactation” programs, which provide access to lactation consultants via video conferencing on internet connected devices, has been suggested …

Air Pollution Related Asthma Inpatient Hospital Admission In The Las Vegas Valley, Joshua Allen Jensen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Asthma is a chronic respiratory condition characterized by inflammation in the lungs that causes airflow to be restricted. In Southern Nevada’s Las Vegas Valley, the natural basin geography causes air pollutants to accumulate. Research has linked air pollution with worsening asthma symptoms. The goal of this study was to determine the non-linear lagged relationship between Asthma Related Inpatient Hospital Admissions (ARIHA) and the Environmental Protection Agency’s (EPA) criteria air pollutants in the Las Vegas Valley using hospital and pollution monitoring station data. Overall, a statistically significant increased RR of ARIHA between 7 and 13 days after exposure to PM2.5 24-hour …

Healthy Food Options At Dollar Discount Stores Are Equivalent In Quality And Lower In Price Compared To Grocery Stores: An Examination In Las Vegas, Nv, Courtney Coughenour, Timothy J. Bungum, M. Nikki Regalado

School of Public Health Faculty Research

Food deserts indicate limited access to and affordability of healthy foods. One potential mediator is the availability of healthy food in non-traditional outlets such as dollar-discount stores, stores selling produce at the fixed $1 price. The purpose of this study was to compare availability, quality, price differences in ‘healthier’ versus ‘regular’ food choices, price per each food item, and summary score in dollar-discount stores to grocery stores in Las Vegas using the NEMS-S; a protocol consisting of three subscores—availability, quality, price of healthier versus regular food, and a summary score. [...] see article for full abstract

The Life She Deserves: Medical Marijuana In The United States, John Hudak, George Burroughs, Maritza Bermudez

Brookings Scholar Lecture Series

Brookings Mountain West offered an event titled, "The Life She Deserves: Medical Marijuana in the United States on Monday, November 5, 2018. This event featured a viewing of the film, and was followed by a panel discussion with John Hudak, George Burroughs, and Maritza Bermudez. “The Life She Deserves” is an intimate portrait of Jennifer Collins and her family’s struggle to find a treatment to control her debilitating epilepsy. Because her legal pharmaceutical treatments cause severe side effects, Jennifer and her mother move across the country to access medical marijuana. The therapy provides Jennifer and her family with the relief …

Unlv School Of Medicine: Rethinking Governance, Planning, And Economic Impact, The Lincy Institute

Brookings Scholar Lecture Series

The launch of the UNLV School of Medicine presented a unique opportunity for Southern Nevada to address two critical issues: the absence of adequate healthcare services for a region of more than 2.2 million people, and the economic impact of a new medical school resulting in an expanded regional health care economy. A collaborative process that engages local, state, and private sector interests is essential to the development of the UNLV School of Medicine and the expansion of an effective, efficient, and profitable healthcare economy.

In this colloquium The Lincy Institute released new health policy publications prepared with the support …

The Privilege Of Healthy Eating: A Qualitative Study Exploring The Local Food Choices Of Low-Income Families From Appalachia, Iryna Sharaievska Dr., Stephanie West Dr., Melissa Weddell Dr.

Journal of Health Disparities Research and Practice

Using qualitative semi-structured interviews, 15 low-income women of different ages were asked to discuss their perceptions of healthy eating, local farmers’ markets, as well as their visitation of farmers’ markets. The participants were also asked to share what features of farmers’ markets they found appealing. The results showed that most of the participants had either a deep or moderate understanding of what it means to eat healthy. However, many of them also believed they could improve their own patterns of eating. The data also showed that the low-income women who took part in the study had positive attitudes overall toward …

Tumor Biology And Racial Disparities In Reconstruction After Mastectomy: A Seer Database Analysis, Sarah J. Ullrich, Michael C. Smith, Paul J. Chung, Sara Y. Kim, Gainosuke Sugiyama

Journal of Health Disparities Research and Practice

Introduction:

Significant disparities in immediate breast reconstruction after mastectomy have persisted, and may even be increasing, despite large-scale efforts to minimize them, such as the Women’s Health and Cancer Rights Act of 1998. Immediate breast reconstruction has been shown to lead to higher rates of surgical satisfaction, minimize delay in post-operative cancer treatment, and improve the quality of life and overall well-being of mastectomy patients. However only 25-40% of eligible women in the United States receive reconstruction. The rate of reconstruction is even lower in African American and Hispanic women compared to White women. To better understand this disparity, …

Children As Agents Of Change: Parent Perceptions Of Child-Driven Environmental Health Communication In The Apsáalooke (Crow Indian) Community, Jessica Milakovich, Vanessa W. Simonds, Frances L. Kim, Deborah Laveaux, Velma Pickett, Suzanne Held, Christine Martin, Jason Cummins, Lynn Kelting-Gibson

Journal of Health Disparities Research and Practice

While previous research suggests children have successfully acted as health change agents, no studies have examined the role of children in promoting environmental health knowledge and awareness. This study describes parent perceptions of the impact of a five-day water-focused environmental health summer camp on elementary school children in an American Indian community. We interviewed parents about their perception of changes in their child's environmental health knowledge, attitudes, and behaviors. Parents in this study confirmed that their child had shared information related to the camp activities. In addition, parents perceived that their children had increased knowledge and positive changes in attitudes …

An Examination Of Active Commuting By Race/Ethnicity, Income And Location, Dangaia Sims, Melissa Bopp

Journal of Health Disparities Research and Practice

Introduction

Active commuting (AC; walking and biking to work) is associated with a number of positive health outcomes, low participation remains low in the USA. Our objective was to examine the multi-level influences on AC considering social determinants of health: race/ethnicity, income level and location.

Methods

We conducted a cross-sectional survey examining correlates of AC in the Mid-Atlantic region of the United States. The sample consisted of 1,310 adults over the age of 18 who were employed part- or full-time outside of the home and physically able to walk and bike. One-way ANOVAs, t-tests, and Pearson correlation analyses were run …

Racial Disparities In Breast Cancer Survival: The Mediating Effects Of Macro-Social Context And Social Network Factors, Ganga Vijayasiri, Yamile Molina, Ifeanyi B. Chukwudozie, Silvia Tejeda, Heather Pauls, Garth Rauscher, Richard T. Campbell, Richard B. Warnecke

Journal of Health Disparities Research and Practice

ABSTRACT

This study attempts to clarify the associations between macro-social and social network factors and continuing racial disparities in breast cancer survival. The study improves on prior methodologies by using a neighborhood disadvantage measure that assesses both economic and social disadvantage and an ego-network measurement tool that assesses key social network characteristics. Our population-based sample included 786 breast cancer patients (nHWhite=388; nHBlack=398) diagnosed during 2005-2008 in Chicago, IL. The data included census-derived macro-social context, self-reported social network, self-reported demographic and medically abstracted health measures. Mortality data from the National Death Index (NDI) were used to determine 5-year survival.

Based on …

Promoting Community And Population Health In Public Health And Medicine: A Stepwise Guide To Initiating And Conducting Community-Engaged Research, Scott D. Rhodes, Amanda E. Tanner, Lilli Mann-Jackson, Jorge Alonzo, Florence Siman, Eunyoung Y. Song, Jonathan Bell, Megan B. Irby, Aaron T. Vissman, Robert E. Aronson

Journal of Health Disparities Research and Practice

Various methods, approaches, and strategies designed to understand and reduce health disparities, increase health equity, and promote community and population health have emerged within public health and medicine. One such approach is community-engaged research. While the literature describing the theory, principles, and rationale underlying community engagement is broad, few models or frameworks exist to guide its implementation. We abstracted, analyzed, and interpreted data from existing project documentation including proposal documents, project-specific logic models, research team and partnership meeting notes, and other materials from 24 funded community-engaged research projects conducted over the past 17 years. We developed a 15-step process designed …

Estimates Of Female Breast Cancer Mortality-To-Incidence Ratio (Mir) Of The Counties And The Senatorial Districts Grouped To County Boundaries (Sdgcs) In Missouri 2008 - 2012, Awatef A. Ben Ramadan, Jeannette Jackson-Thompson, Chester L. Schmaltz

Journal of Health Disparities Research and Practice

Purpose: To measure Mortality-to-Incidence Ratios (MIRs) on Senatorial Districts Grouped to County Boundaries (SDGCs) to explore the female breast cancer (FBC) racial and age disparities in Missouri.

Methods: The MIRs and their 95% CI by age and race were calculated for the 20 SDGCs for the period from 2008-2012.

Results: For the 65+ years old FBC cases, the MIRs for whole Missouri and the 20 SDGCs were typically twice the MIR for thewhites.

Conclusions: FBC MIRs can be used as a measure of cancer inequalities in Missouri. These measures might be informative for policy makers to assess the existing policies …

Justice Served Fresh: Associations Between Food Insecurity, Community Gardening, And Property Value, Micajah Daniels, Courtney Coughenour Ph.D

McNair Poster Presentations

Numerous stakeholders in Nevada have used a variety of efforts to combat the growth of food insecurity facing Nevadans. The purpose of this research project is to understand the association between food insecurity, community gardens, and property value. Following the wealth of scholarship on these topics and data collected from community garden agencies in Southern Nevada, the research questions for this project include: (1) Where are community gardens located in SNV? (2) What efforts community gardens agencies are doing to address food insecurity (most interested in their efforts using community gardens)? (3) What are the perceptions of supports and barriers …

Limited Contribution Of Health Behaviours To Expanding Income-Related Chronic Disease Disparities Based On A Nationwide Cross-Sectional Study In China, Qing Wang, Jay J, Shen, Kaitlyn Frakes

School of Public Health Faculty Research

This study estimated the association of income and prevalence of cardiovascular diseases (CVD) and hypertension, and then quantified the contribution of health behaviors to the association in China. Using the 2013 survey of the China Health and Retirement Longitudinal Study (CHARLS), a logit model was applied to examine income-related health disparities in relation to CVD and hypertension. A four-step regression method was then constructed to measure the role of health behaviors in income-related health disparities. Using indirect effects, mediation by health behaviors was examined. Income-related health disparities in chronic diseases were found to exist in China. Specifically, individuals in the …

Measuring Inequity: A Systematic Review Of Methods Used To Quantify Structural Racism, Maya Groos, Maeve Wallace, Rachel Hardeman, Katherine P. Theall

Journal of Health Disparities Research and Practice

Abstract

Objective: To summarize the ways in which researchers have quantified measures of structural racism for the purposes of empirical, quantitative investigation of its associations with physical and mental health outcomes.

Methods: Systematic review of literature published January 1, 2007-June 30, 2017. We searched PubMed and EMBASE databases for studies including at least one of the following search terms in the title or abstract: “structural racism”, “systemic racism”, “institutional racism”, “institutionalized racism”. Excluded studies were not original research, not US based, did not quantify an explicitly named indicator of structural racism, or were qualitative designs. Data from full …

Impact Of Race And Insurance On Door-To-Appendectomy Time Among Pediatric Patients, Carla M. Lopez, Emily R. Christison-Lagay, Daniel Solomon

Journal of Health Disparities Research and Practice

Racial and ethnic disparities in the rate of appendiceal rupture have been widely reported among the pediatric population. The main reasons for this remain largely unknown given that previous explanations pointing to signs of poor health care access have recently been shown to account for only a small percentage of the difference in perforation rates between white and minority children. Because the risk of perforation increases with time, racial disparities in time delay from emergency department presentation to OR appendectomy may help account for the higher appendiceal perforation rates observed among minority children. This is the first study dedicated to …

Effectiveness Of Community Health Workers In Healthcare Delivery: Evidence From The Field, Mohammad Shahbazi Professor, Mukesh Kumar, Anthony Mawson, Donna Antoine Lavigine, Cassandra Dove

Journal of Health Disparities Research and Practice

Evidence suggests that health care in the United States could benefit from including the services of Community Health Workers (CHW), provided through Community Health Houses, in the delivery of care. This research project evaluated the impact of three newly-established Health Houses and the services provided to patients by Community Health Workers at three locations in the Mississippi Delta. The patients were current enrollees in the Medicare administered by United Healthcare. The program began in February 2014 and continued through September 2015. After analyzing data for payments made for each enrollee, emergency room visits and hospital admissions for the years of …

Exploring H.Pylori Seropositivity As A Risk Factor For Type 2 Diabetes, Virginia Chaidez, Yumou Qiu

Journal of Health Disparities Research and Practice

Background: In the US, the percentage of adults with diagnosed diabetes are higher in members of racial and ethnic minority groups compared to non-Latino Whites. Understanding why such disparities exist has been less forthcoming.

Methods: Secondary data analysis was conducted using the National Health and Nutrition Examination Survey (NHANES) 1999-2000 cross-sectional data.

Results: H.pylori seropositivity was highest in Mexican Americans (43.7%), lowest in non-Hispanic Whites (18.1%). Diabetes was highest in non-Hispanic Blacks (5.9%); lowest in non-Hispanic whites (4.3%). H.pylori seropositivity was associated with greater likelihood of having type 2 diabetes (1.927, 95% CI 1.142, 3.257) compared to H.pylori negative in …

Alternative Financial Services And Health Status In U.S. Metropolitan Statistical Areas, Courtney Hundley, Richard W. Wilson 8520196, John Chenault

Journal of Health Disparities Research and Practice

Abstract

Alternative financial services (AFS) such as, payday lenders, pawn brokers, tax refund loans, and check cashers are more prevalent in minority and lower income neighborhoods. These are neighborhoods also found to have disparities in health, compared to more affluent neighborhoods and communities. The focus of this paper is to determine if any relationship exists between use of AFS and health disparities.

Using data from a survey performed by the Federal Deposit Insurance Corporation (FDIC), we compared four banking variables to several measures of health for 85 metropolitan statistical areas (MSA) across the nation. The four banking variables all related …

Implementing A Pre-Exposure Prophylaxis Intervention For Safer Conception Among Hiv Serodiscordant Couples: Recommendations For Health Care Providers, Mari-Lynn Drainoni, Dea L. Biancarelli, Ashley A. Leech, Meg Sullivan, Angela R. Bazzi

Journal of Health Disparities Research and Practice

Couples in HIV serodiscordant relationships frequently desire children. Although partners who are virally suppressed pose almost no risk of transmitting HIV to their partners, partners who are inconsistently on therapy may transmit HIV to their partners when attempting to conceive. Pre-exposure prophylaxis (PrEP) is an available safer conception strategy for these couples but is not consistently offered. We sought to better understand barriers to PrEP implementation for couples seeking conception and patient perceptions on what providers could do to encourage use. We conducted in-depth, qualitative interviews with 11 participants representing six couples taking PrEP for safer conception in a safety-net …

Human Papillomavirus Infections In The Southern And Other United States Regions, Dudith Pierre-Victor, Mary Jo Trepka, Dionne Stephens, Tan Li, Timothy Page, Purnima Madhivanan

Journal of Health Disparities Research and Practice

Human papillomavirus (HPV) infection is the most common sexually transmitted infection worldwide and has been linked to several cancers, including cervical cancer. In the United States, the Southern region has a disproportionate burden of cervical cancer, and research about the epidemiology of HPV in the region is scarce. This study estimates the prevalence and correlates of HPV infection among 14–59 year-old females.

Data from 4,250 females aged 14–59 years collected during the 2007–2010 National Health and Nutrition Examination Survey (NHANES) were used. We estimated the prevalence of HPV infection for the South and the rest of the country. We performed …

Bibliometric Analysis Of Gaps In Research On Asbestos-Related Diseases: Declining Emphasis On Public Health Over 26 Years, Ro-Ting Lin, Matthew John Soeberg, Lung-Chang Chien, Scott Fisher, Jukka Takala, Richard Lemen, Tim Driscoll, Ken Takahashi

School of Public Health Faculty Research

Objectives The global burden of asbestos-related diseases (ARDs) is significant, and most of the world’s population live in countries where asbestos use continues. We examined the gaps between ARD research and suggestions of WHO and the International Labour Organization on prevention. Methods From the Web of Science, we collected data on all articles published during 1991–2016 and identified a subset of ARD-related articles. We classified articles into three research areas—laboratory, clinical and public health—and examined their time trends. For all and the top 11 countries publishing ARD-related articles, we calculated the proportions of all ARD-related articles that were in each …

Wide Educational Disparities In Young Adult Cardiovascular Health, Elizabeth M. Lawrence, Robert A. Hummer, Benjamin W. Domingue, Kathleen Mullan Harris

Sociology Faculty Research

Widening educational differences in overall health and recent stagnation in cardiovascular disease mortality rates highlight the critical need to describe and understand educational disparities in cardiovascular health (CVH) among U.S. young adults. We use two data sets representative of the U.S. population to examine educational disparities in CVH among young adults (24–34) coming of age in the 21st century: the National Health and Nutrition Examination Survey (2005–2010; N= 689) and the National Longitudinal Study of Adolescent to Adult Health (2007–2008; N=11,200). We employ descriptive statistics and regression analysis. The results show that fewer than one in four young adults had …

Provider Perspectives On Demand Creation For Maternal Vaccines In Kenya, Irina Bergenfeld, Stacy W. Nganga, Courtni A. Andrews, Vincent L. Fenimore, Nancy A. Otieno, Sandra S. Chaves, Jennifer R. Verani, Marc-Alain Widdowson, Winnie N. Wairimu, Susan N. Wandera, Raphael O. Atito, Maxwell O. Adero, Paula M. Frew

Environmental & Global Health Faculty Research

Background. Expansion of maternal immunization, which offers some of the most effective protection against morbidity and mortality in pregnant women and neonates, requires broad acceptance by healthcare providers and their patients. We aimed to describe issues surrounding acceptance and demand creation for maternal vaccines in Kenya from a provider perspective. Methods. Nurses and clinical officers were recruited for semi-structured interviews covering resources for vaccine delivery, patient education, knowledge and attitudes surrounding maternal vaccines, and opportunities for demand creation for new vaccines. Interviews were conducted in English and Swahili, transcribed verbatim from audio recordings, and analyzed using codes developed from interview …

Nonlinear Associations Between Working Hours And Overwork-Related Cerebrovascular And Cardiovascular Diseases (Ccvd), Ro-Ting Lin, Lung-Chang Chien, Ichiro Kawachi

School of Public Health Faculty Research

Long working hours are recognized as a risk factor for cerebrovascular and cardiovascular diseases (CCVD). We investigated the relationship between working hours and different CCVD severity outcomes—death, disability, and illness—across industries in Taiwan from 2006 to 2016. We applied a generalized additive mixed model to estimate the association between working hours and the rate of each severity outcome, adjusted for salary, unemployment rate, time, and a random intercept. Industry-average working hours were significantly associated with each outcome level of overwork-related CCVD, especially when monthly working hours increased from 169 (relative risk [RR] = 1.46, 95% confidence interval [CI] 1.002–2.12) to …