Public Health Commons^™

Trends In Nonresident Abortion Rates In New York City From 2005 To 2015: A Time Series Analysis, Emily White Johansson, Erica Lee Argov, Aileen Langston, Alison Yager, Hannah Searing, Sze Yan Liu

Department of Public Health Scholarship and Creative Works

Abstract

OBJECTIVES:

To examine trends and utilization patterns of NYC abortion services by nonresidents since growing abortion restrictions across many states could drive women to seek care in less restrictive jurisdictions including NYC.

STUDY DESIGN:

We used data from Induced Termination of Pregnancy certificates filed with the NYC Department of Health and Mental Hygiene in 2005-2015. An autoregressive integrated moving average (ARIMA) model was fit to the monthly nonresident abortion rate time series. Pearson's χ² tests determined associations between women's residence and other variables.

RESULTS:

During 2005-2015, 885,816 abortions were reported in NYC, with 76,990 (8.7%) among nonresidents; 50,211 …

Challenges To Diabetes Self-Management For Adults With Type 2 Diabetes In Low-Resource Settings In Mexico City: A Qualitative Descriptive Study, Robin Whittemore, Mireya Vilar-Compte, Selene De La Cerda, Denise Marron, Rosabelle Conover, Roberta Delvy, Annel Lozano-Marrufo, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

Background: The prevalence of type 2 diabetes (T2D) in Mexico is one of the highest in the world, with high morbidity and mortality, and difficulty meeting glycemic targets. The purpose of this study was to identify the challenges for T2D self-management as perceived by both adults with T2D and health care providers in primary health clinics from Seguro Popular in Mexico City.

Methods: This was a qualitative descriptive study conducted in three Seguro Popular primary care clinics in Mexico City using convenience sampling. Semi-structured interviews were conducted with participants and data were analyzed using a content analysis approach.

Results: The …

Structural Racism And Odds For Infant Mortality Among Infants Born In The United States 2010, Roman Pabayo, Amy Ehntholt, Kara L. Davis, Sze Yan Liu, Peter Muening, Daniel Cook

Department of Public Health Scholarship and Creative Works

Abstract

OBJECTIVES:

While ecological studies indicate that high levels of structural racism within US states are associated with elevated infant mortality rates, studies using individual-level data are needed. To determine whether indicators of structural racism are associated with the individual odds for infant mortality among white and black infants in the US.

METHODS:

We used data on 2,163,096 white and 590,081 black infants from the 2010 US Cohort Linked Birth/Infant Death Data Files. Structural racism indicators were ratios of relative proportions of blacks to whites for these domains: electoral (registered to vote and voted; state legislature representation), employment (civilian labor …

Short Relative Leg Length Is Associated With Overweight And Obesity In Mexican Immigrant Women, Mireya Vilar-Compte, James Macinko, Beth C. Weitzman, Carlos M. Avendaño-Villela

Department of Public Health Scholarship and Creative Works

Background: Prior research suggests that undernutrition and enteric infections predispose children to stunted growth. Undernutrition and infections have been associated with limited access to healthy diets, lack of sanitation, and access barriers to healthcare - all associated with human rights. Stunting has also been documented to be a major determinant of subsequent obesity and non-communicable diseases. Short leg length relative to stature during adulthood seems to be a good proxy indicator tracking such barriers, and has been reported to be associated with adverse health effects during adulthood. Our objective was to examine the association between relative leg length (as measured …

Structural Racism And Severe Maternal Morbidity In New York State, Sze Yan Liu, Christina Fiorentini, Zinzi Bailey, Mary Huynh, Katherine Mcveigh, Deborah Kaplan

Department of Public Health Scholarship and Creative Works

ABSTRACT

Objective: We examined the association between county-level structural racism indicators and the odds of severe maternal morbidity (SMM) in New York State.

Design: We merged individual-level hospitalization data from the New York State Department of Health Statewide Planning and Research Cooperative System (SPARCS) with county-level data from the American Community Survey and the Vera Institute of Justice from 2011 to 2013 (n = 244 854). Structural racism in each county included in our sample was constructed as the racial inequity (ratio of black to white population) in female educational attainment, female employment, and incarceration.ReSulT S: Multilevel logistic regression analysis …

Costing A Maternity Leave Cash Transfer To Support Breastfeeding Among Informally Employed Mexican Women, Mireya Vilar-Compte, Graciela Teruel, Diana Flores, Grace J. Carroll, Gabriela S. Buccini, Rafael Pe ́Rez-Escamilla

Department of Public Health Scholarship and Creative Works

Background: Investing in maternity protection for working women is an important social equity mechanism. Addressing the maternity leave needs of women employed in the informal sector economy should be a priority as more than half of women in Latin America, South Asia, and sub-Saharan Africa are employed in this sector.

Objective: To develop a costing methodology framework to assess the financial feasibility, at the national level, of implementing a maternity cash transfer for informally employed women.

Methods: A World Bank costing methodology was adapted for estimating the financial need to establish a maternity cash transfer benefit. The methodology estimates the …

An Iterative Process For Training Design And Implementation Increased Health Workers' Knowledge For Taking Nutrition Behavior Change To Scale, Wendy Gonzalez, Anabelle Bonvecchio Arenas, Armando García-Guerra, Mireya Vilar-Compte, Alejandría Villa De La Vega, Laura Quezada, Cynthia Rosas, Ana Lilia Lozada-Tequeanes, Amira Hernández

Department of Public Health Scholarship and Creative Works

The shortage of skilled, motivated, and well-supported health workers is a major barrier to scaling up nutrition interventions and services. Objective: The objective of this study is to describe the process for developing and implementing a training of health personnel for the delivery of the Integrated Strategy for Attention to Nutrition (EsIAN), an evidence-based strategy for promoting infant and young child feeding through primary health care in Mexico. The specific objective is to provide a case study and highlight challenges, as well as elements to successfully mitigate these, and discuss potential applications of findings beyond the Mexican context. Methods: The …

Determinants Of Severe Maternal Morbidity And Its Racial/Ethnic Disparities In New York City, 2008–2012, Renata E. Howland, Meghan Angley, Sang Hee Won, Wendy Wilcox, Hannah Searing, Sze Yan Liu, Emily White Johansson

Department of Public Health Scholarship and Creative Works

Objectives Severe maternal morbidity (SMM) is an important indicator for identifying and monitoring efforts to improve maternal health. Studies have identified independent risk factors, including race/ethnicity; however, there has been limited investigation of the modifying effect of socioeconomic factors. The study aims were to quantify SMM risk factors and to determine if socioeconomic status modifies the effect of race/ethnicity on SMM risk. Methods We used 2008–2012 NYC birth certificates matched with hospital discharge records for maternal deliveries. SMM was defined using an algorithm developed by the Centers for Disease Control and Prevention. Mixed-effects logistic regression models estimated SMM risk by …

Syndemics Of Severity And Frequency Of Elder Abuse: A Cross-Sectional Study In Mexican Older Females, Mireya Vilar-Compte, Pablo Gaitán-Rossi

Department of Public Health Scholarship and Creative Works

Background: Elder abuse is a common phenomenon with important effects on the health and well-being of older adults. There are important gaps in elder abuse measurement, as it is usually reported as the absence or presence of elder abuse, disregarding its severity and frequency.

Objectives: Identify different ways of measuring severity and frequency of elder abuse and assess whether different experiences of severity and frequency suggest syndemic relationships.

Methods: Through a sample of 534 non-institutionalized Mexican older women, we assessed how severity (i.e., number of abusive experiences and number of types of abuses) and frequency (i.e., if abusive experiences had …

Syndemics Of Severity And Frequency Of Elder Abuse: A Cross-Sectional Study In Mexican Older Females, Mireya Vilar-Compte, Pablo Gaitán-Rossi

Department of Public Health Scholarship and Creative Works

Background: Elder abuse is a common phenomenon with important effects on the health and well-being of older adults. There are important gaps in elder abuse measurement, as it is usually reported as the absence or presence of elder abuse, disregarding its severity and frequency.

Objectives: Identify different ways of measuring severity and frequency of elder abuse and assess whether different experiences of severity and frequency suggest syndemic relationships.

Methods: Through a sample of 534 non-institutionalized Mexican older women, we assessed how severity (i.e., number of abusive experiences and number of types of abuses) and frequency (i.e., if abusive experiences had …

“Are You Accepting New Patients?” A Pilot Field Experiment On Telephone-Based Gatekeeping And Black Patients’ Access To Pediatric Care, Tamara Leech, Amy Irby-Shasanmi, Anne L. Mitchell

Department of Public Health Scholarship and Creative Works

Study Objectives

To determine whether the name and accent cues that the caller is Black shape physician offices’ responses to telephone‐based requests for well‐child visits.

Method and Data

In this pilot study, we employed a quasi‐experimental audit design and examined a stratified national sample of pediatric and family practice offices. Our final data include information from 205 audits (410 completed phone calls). Qualitative data were blind‐coded into binary variables. Our case‐control comparisons using McNemar's tests focused on acceptance of patients, withholding information, shaping conversations, and misattributions.

Findings

Compared to the control group, “Black” auditors were less likely to be told …

The Legalization Of Medical/Recreational Marijuana: Implications For School Health Drug Education Programs, Joseph Donnelly, Michael Young

Department of Public Health Scholarship and Creative Works

BACKGROUND

More than half of US states have legalized medical marijuana. Several states have also legalized it for recreational use. In spite of states' actions, marijuana remains illegal under federal law. It remains to be seen, however, if the Trump administration will enforce federal law in states that have legalized marijuana. For now, it appears the move toward state legalization of marijuana will increase. Because of its legal status, research concerning the medical benefits of marijuana has been limited.

METHODS

We reviewed the literature pertaining to medical use and legalization of marijuana.

RESULTS

Available research shows that marijuana can benefit …

Unconditional Cash Transfers For Reducing Poverty And Vulnerabilities: Effect On Use Of Health Services And Health Outcomes In Low-And Middle-Income Countries, Frank Pega, Sze Yan Liu, Stefan Walter, Roman Pabayo, Ruhi Saith, S L. Lhachimi

Department of Public Health Scholarship and Creative Works

Background

Unconditional cash transfers (UCTs; provided without obligation) for reducing poverty and vulnerabilities (e.g. orphanhood, old age or HIV infection) are a type of social protection intervention that addresses a key social determinant of health (income) in low‐ and middle‐income countries (LMICs). The relative effectiveness of UCTs compared with conditional cash transfers (CCTs; provided so long as the recipient engages in prescribed behaviours such as using a health service or attending school) is unknown.

Objectives

To assess the effects of UCTs for improving health services use and health outcomes in vulnerable children and adults in LMICs. Secondary objectives are to …

Does First Sex Really “Just Happen?” A Retrospective Exploratory Study Of Sexual Debut Among American Adolescents, Lisa D. Lieberman, Eva S. Goldfarb, Samantha Kwiatkowski, Paul Santos

Department of Public Health Scholarship and Creative Works

First sex marks a significant transition for most adolescents, yet teens often report that it was unplanned. Seventy-four college students participated in exploratory focus groups about their first sex. Although initially asked whether their first sex was spontaneous or planned, many participants revealed evidence of forethought or anticipation, signifying a third option, anticipation. This study suggests that the development and timing of sexual health messages should build on the apparent, albeit often unacknowledged, planning and thought that accompany the transition to first sex. Specifically, during the time immediately preceding first sex, young people might be particularly open to such messages.

Discrimination And Telomere Length Among Older Adults In The United States, Sze Yan Liu, Ichiro Kawachi

Department of Public Health Scholarship and Creative Works

Abstract

Objectives:

Chronic stress from experiencing discrimination can lead to long-term changes in psychological and physiologic responses, including shorter leukocyte telomere length. We examined the association between leukocyte telomere length and variations in the association by race or type of discrimination.

Methods:

Our study consisted of 3868 US-born non-Hispanic black (hereinafter, black) and non-Hispanic white (hereinafter, white) adult participants from the 2008 Health and Retirement Study biomarker sample with complete sociodemographic and discrimination information. We examined major lifetime unfair treatment and everyday discrimination. Coarsened exact matching matched exposed and unexposed participants on several sociodemographic factors. Coarsened exact matching creates analytic …

The Scoping Review Method: Mapping The Literature In “Structural Change” Public Health Interventions, Rosie Hanneke, Yuka Asada, Lisa D. Lieberman, Leah Christina Neubauer, Michael C. Fagan

Department of Public Health Scholarship and Creative Works

This case discusses how we used scoping review methodology to map the literature in an emergent area of research, “structural change” public health interventions. Scoping reviews are similar to systematic reviews in both scale and rigor; both of these literature review methodologies are comprehensive approaches to reviewing the literature on a topic. However, while a systematic review attempts to answer a specific, targeted research question, a scoping review is designed to map and categorize all of the literature on a broad topic. For this reason, it is an excellent method to employ in emergent research areas, in which researchers have …

Perspectives On Conceptualizing Developmentally Appropriate Sexuality Education, Sara Silverio Marques, Eva Goldfarb, Julianna Deardoff, Norman A. Constantine

Department of Public Health Scholarship and Creative Works

Despite recognition of the importance of a developmentally appropriate approach to sexuality education, there is little direct guidance on how to do this. This study employed in-depth interviews with experienced sexuality educators and developers of sexuality education materials to identify how this concept is understood and applied in the field. Developmentally appropriate sexuality education was conceptualized consistently across interviews to include (a) addressing developmentally relevant topics, (b) adapting content to cognitive development, (c) accommodating developmental diversity, and (d) facilitating the internalization of sexual health messages. However, these views fell short of incorporating the breadth of knowledge offered by adolescent development …

Perceptions Of Peer Sexual Behavior: Do Adolescents Believe In A Sexual Double Standard?, Michael Young, Susan Cardenas, Joseph Donnelly, Mark J. Kittleson

Department of Public Health Scholarship and Creative Works

BACKGROUND

The purpose of the study was to (1) examine attitudes of adolescents toward peer models having sex or choosing abstinence, and (2) determine whether a “double standard” in perception existed concerning adolescent abstinence and sexual behavior.

METHODS

Adolescents (N = 173) completed questionnaires that included 1 of 6 randomly assigned vignettes that described male and female peer models 3 ways: (1) no information about model's sexual behavior, (2) model in love but choosing abstinence, and (3) model in love and having sex. Participants read the vignette to which they had been assigned and responded to statements about the peer …

‘Because I Don’T Know’: Uncertainty And Ambiguity In Closed-Ended Reports Of Perceived Discrimination In Us Health Care, Chih-Yuan Lee, Amy Irby-Shasanmi

Department of Public Health Scholarship and Creative Works

Objective

Surveys often ask respondents to assess discrimination in health care. Yet, patients’ responses to one type of widely used measure of discrimination (single-item, personally mediated) tend to reveal prevalence rates lower than observational studies would suggest. This study examines the meaning behind respondents’ closed-ended self-reports on this specific type of measure, paying special attention to the frameworks and references used within the medical setting.

Design

Twenty-nine respondents participated in this study. They were asked the widely used question: ‘Within the past 12 months when seeking health care do you feel your experiences were worse than, the same as, or …

The Effects Of The Yes You Can! Curriculum On The Sexual Knowledge And Intent Of Middle School Students, Joseph Donnelly, Robert Horn, Michael Young, Andrada E. Ivanescu

Department of Public Health Scholarship and Creative Works

BACKGROUND

The purpose of the study was to examine the effects of the “Yes You Can!” (YYC) curriculum on sexual knowledge and behavioral intent of program participants.

METHODS

Participants included students ages 10‐14 from schools in a northeast US urban area. Yes You Can! program lessons were designed to support healthy relationships. The curriculum was taught by trained instructors. The testing instrument was a 30‐item questionnaire, which included sexual knowledge and intent items. Students completed the questionnaire before program implementation, immediately following intervention, and a third time at follow‐up. Data were analyzed using analysis of covariance. …

Inequitable Chronic Lead Exposure: A Dual Legacy Of Social And Environmental Injustice, Tamara Leech, Elizabeth A. Adams, Tess D. Weathers, Lisa K. Staten, Gabriel M. Filippelli

Department of Public Health Scholarship and Creative Works

Both historic and contemporary factors contribute to the current unequal distribution of lead in urban environments and the disproportionate impact lead exposure has on the health and well-being of low-income minority communities. We consider the enduring impact of lead through the lens of environmental justice, taking into account well-documented geographic concentrations of lead, legacy sources that produce chronic exposures, and intergenerational transfers of risk. We discuss the most promising type of public health action to address inequitable lead exposure and uptake: primordial prevention efforts that address the most fundamental causes of diseases by intervening in structural and systemic inequalities.

Instrumental Variable Approaches To Identifying The Causal Effect Of Educational Attainment On Dementia Risk, Thu T. Nguyen, Eric Tchetgen Tchetgen, Ichiro Kawachi, Stephen E. Gilman, Stefan Walter, Sze Yan Liu, M Maria Glymour

Department of Public Health Scholarship and Creative Works

PURPOSE:

Education is an established correlate of cognitive status in older adulthood, but whether expanding educational opportunities would improve cognitive functioning remains unclear given limitations of prior studies for causal inference. Therefore, we conducted instrumental variable (IV) analyses of the association between education and dementia risk, using for the first time in this area, genetic variants as instruments as well as state-level school policies.

METHODS:

IV analyses in the Health and Retirement Study cohort (1998-2010) used two sets of instruments: (1) a genetic risk score constructed from three single-nucleotide polymorphisms (SNPs; n = 7981); and (2) compulsory schooling laws (CSLs) …

The Impact Of The 2008 Financial Crisis On Food Security And Food Expenditures In Mexico: A Disproportionate Effect On The Vulnerable, Mireya Vilar-Compte, Sebastian Sandoval-Olascoaga, Ana Bernal-Stuart, Sandhya Shimoga, Arturo Vargas-Bustamante

Department of Public Health Scholarship and Creative Works

Objective The present paper investigated the impact of the 2008 financial crisis on food security in Mexico and how it disproportionally affected vulnerable households. Design A generalized ordered logistic regression was estimated to assess the impact of the crisis on households' food security status. An ordinary least squares and a quantile regression were estimated to evaluate the effect of the financial crisis on a continuous proxy measure of food security defined as the share of a household's current income devoted to food expenditures. Setting Both analyses were performed using pooled cross-sectional data from the Mexican National Household Income and Expenditure …

The Role Of Place In Explaining Racial Heterogeneity In Cognitive Outcomes Among Older Adults, Sze Yan Liu, M Maria Glymou, Laura B. Zahodne, Christopher Weiss, Jennifer J. Manly

Department of Public Health Scholarship and Creative Works

Racially patterned disadvantage in Southern states, especially during the formative years of primary school, may contribute to enduring disparities in adult cognitive outcomes. Drawing on a lifecourse perspective, we examine whether state of school attendance affects cognitive outcomes in older adults and partially contributes to persistent racial disparities. Using data from older African American and white participants in the national Health and Retirement Study (HRS) and the New York based Washington Heights Inwood Cognitive Aging Project (WHICAP), we estimated age-and gender-adjusted multilevel models with random effects for states predicting years of education and cognitive outcomes (e.g., memory and vocabulary). We …

Work/ Family Demands And Cardiometabolic Risk And Sleep Duration In Extended Care Employees: Multilevel Findings From The Work, Family And Health Network, Lisa Berkman, Sze Yan Liu, Leslie Hammer, Phyllis Moen, Laura Cousino Klein, Erin Kelly, Martha Fay, Kelly Davis, Mary Durham, Georgia Karuntzos, Orfeu M. Buxton

Department of Public Health Scholarship and Creative Works

The study investigates the associations of work-family conflict and other work and family conditions with objectively-measured outcomes cardiometabolic risk and sleep duration in a study of employees in nursing homes. Multilevel analyses are used to assess cross-sectional associations between employee and job characteristics and health in analyses of 1,524 employees in 30 extended care facilities in a single company. We examine work and family conditions in relation to two major study health outcomes: 1) a validated, Framingham cardiometabolic risk score based on measured blood pressure, cholesterol, glycosylated hemoglobin (HbA1c), body mass index (BMI), and self-reported tobacco consumption, and 2) wrist …

Unconditional Cash Transfers For Assistance In Humanitarian Disasters: Effects On The Use Of Health Services And Health Outcomes In Low- And Middle-Income Countries, Frank Pega, Sze Yan Liu, Stefan Walter, S K. Lhachimi

Department of Public Health Scholarship and Creative Works

BACKGROUND:

Unconditional cash transfers (UCTs) are a common social protection intervention that increases income, a key social determinant of health, in disaster contexts in low- and middle-income countries (LMICs).

OBJECTIVES:

To assess the effects of UCTs in improving health services use, health outcomes, social determinants of health, health care expenditure, and local markets and infrastructure in LMICs. We also compared the relative effectiveness of UCTs delivered in-hand with in-kind transfers, conditional cash transfers, and UCTs paid through other mechanisms.

SEARCH METHODS:

We searched 17 academic databases, including the Cochrane Public Health Group Specialised Register, the Cochrane Database of Systematic Reviews …

Sexuality Education Websites For Adolescents: A Framework-Based Content Analysis, Sara Silverio Marques, Jessica S. Lin, Summer Starling, Aubrey G. Daquiz, Eva Goldfarb, Kimberly Garcia, Norman A. Constantine

Department of Public Health Scholarship and Creative Works

The web has unique potential for adolescents seeking comprehensive sexual health information. As such, it is important to understand the nature, scope, and readability of the content and messaging provided by sexuality educational websites. We conducted a content analysis of 14 sexuality education websites for adolescents, based on the 7 essential components (sexual and reproductive health and HIV, relationships, sexual rights and sexual citizenship, pleasure, violence, diversity, and gender) of the International Planned Parenthood Framework for Comprehensive Sexuality Education. A majority of content across all sites focused on sexual and reproductive health and HIV, particularly pregnancy and STI prevention, and …

Know Your Value: Negotiation Skill Development For Junior Investigators In The Academic Environment—A Report From The American Society Of Preventive Oncology's Junior Members Interest Group, Allison B. Burton-Chase, Maria C. Swartz, Stephanie A. Navarro Silvera, Karen Basen-Engquist, Faith E. Fletcher, Peter G. Shields

Department of Public Health Scholarship and Creative Works

The American Society of Preventive Oncology (ASPO) is a professional society for multidisciplinary investigators in cancer prevention and control. One of the aims of ASPO is to enable investigators at all levels to create new opportunities and maximize their success. One strategy adopted by ASPO was to develop the Junior Members Interest Group in 1999. The Interest Group membership includes predoctoral fellows, postdoctoral fellows, and junior faculty members who are provided career development and training opportunities (1). Responsibilities of the members of the Junior Members Interest Group include serving on the ASPO Executive Committee and the Program Planning …

Historical Differences In School Term Length And Measured Blood Pressure: Contributions To Persistent Racial Disparities Among Us-Born Adults, Sze Yan Liu, Jennifer M. Manly, Benjamin Capistrant, M Maria Glymour

Department of Public Health Scholarship and Creative Works

Abstract

Introduction

Legally mandated segregation policies dictated significant differences in the educational experiences of black and white Americans through the first half of the 20^th century, with markedly lower quality in schools attended by black children. We determined whether school term length, a common marker of school quality, was associated with blood pressure and hypertension among a cohort of older Americans who attended school during the de jure segregation era.

Methods

National Health and Nutrition Examination Survey I and II data were linked to state level historical information on school term length. We used race and gender-stratified linear regression …

Historical Differences In School Term Length And Measured Blood Pressure: Contributions To Persistent Racial Disparities Among Us- Born Adults, Sze Yan Liu, Jennifer J. Manly, Benjamin D. Capistrant, M. Maria Glymour

Department of Public Health Scholarship and Creative Works

Introduction
Legally mandated segregation policies dictated significant differences in the educational experiences of black and white Americans through the first half of the 20th century, with markedly lower quality in schools attended by black children. We determined whether school term length, a common marker of school quality, was associated with blood pressure and hypertension among a cohort of older Americans who attended school during the de jure segregation era.
Methods
National Health and Nutrition Examination Survey I and II data were linked to state-level historical information on school term length. We used race and gender-stratified linear regression models adjusted for …