Public Health Commons^™

Addressing Structural Racism In The Health Workforce, Randl B. Dent, Anushree Vichare, Jaileessa Casimir

Publications and Research

One of the greatest challenges facing the United States are health inequities among racial/ethnic and other marginalized populations. The deep-rooted structural racism embedded in our social systems, including our health care system and health workforce, is a core cause of racial health inequities. 1 Among many definitions of institutionalized or structural racism, Dr Jones 2 best defines it as: “Differential access to goods, services and opportunities of society by race ... It is structural, having been codified in our institutions of custom, practice, and law, so there need not be an identifiable perpetrator.” Dr Jones further explains that to set …

Who Needs To Be “Burned-Out”? Time For A New Approach To Job-Related Distress, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

Burnout is a popular indicator of job-related distress, notably in research on the ill-being of medical professionals. The burnout construct is, however, plagued by definitional and measurement problems. Often unnoticed, these problems undermine findings and conclusions emanating from burnout research. The definitional and measurement problems affecting the burnout construct hamper knowledge growth, waste resources, and impede our ability to make informed decisions and take effective action to support personnel. It is time for occupational health specialists to abandon the idea of burnout and focus on occupational depression.

Urgent Need For Integrated Pandemic Policies On Pathogen Spillover, Pallavi A. Kache, Sonila Cook, Nigel Sizer, Lee Hannah, Neil M. Vora

Publications and Research

No abstract provided.

Factors Influencing The Relationship Between Work-Related Stress And Posttraumatic Stress Disorder Among Working Black Adults In The United States, Paul C. Archibald

Publications and Research

Introduction: Work-related stress (WRS) and posttraumatic disorder (PTSD) is higher among Black adults relative to their White counterparts. Trauma exposure is not the only connection to increased risk for PTSD as WRS is highly associated with risk for PTSD. However, the factors that link WRS and PTSD among working Black adults is not well understood. Materials and Methods: Cross-sectional data from the National Survey of American Life was used to examine the relationship between WRS and PTSD among 2,139 working Black adults and to determine whether there are influencing factors. Results: Logistic regression analyses revealed that working …

Intergenerational Differences In Dietary Acculturation Among Ghanaian Immigrants Living In New York City: A Qualitative Study, Margrethe F. Horlyck-Romanovsky, Terry T.-K Huang, Ramatu Ahmed, Sandra E. Echeverria, Katarzyna Wyka, May May Leung, Anne E. Sumner, Melissa Fuster

Publications and Research

Dietary acculturation may explain the increasing risk of diet-related diseases among African immigrants in the United States (US). We interviewed twenty-five Ghanaian immigrants (Youth n 13, Age (Mean ± SD) 20 y±5⋅4, Parents (n 6) and Grandparents (n 6) age 58⋅7± 9⋅7) living in New York City (NYC) to (a) understand how cultural practices and the acculturation experience influence dietary patterns of Ghanaian immigrants and (b) identify intergenerational differences in dietary acculturation among Ghanaian youth, parents and grandparents. Dietary acculturation began in Ghana, continued in NYC and was perceived as a positive process. At the interpersonal level, parents encouraged youth …

Health-Related Quality Of Life And Mental Well-Being Of Healthy And Diseased Persons In 8 Countries: Does Stringency Of Government Response Against Early Covid-19 Matter?, Di Long, Juanita A. Haagsma, Mathieu F. Janssen, John N. Yfantopoulos, Erica I. Lubetkin, Gouke J. Bonsel

Publications and Research

Objectives

Our study aimed to (1) assess health-related quality of life (HRQoL) and mental well-being of healthy and diseased persons in the general population during the early stage of the COVID-19 pandemic and (2) examine the relationship between HRQoL and mental well-being and individual characteristics and government response against COVID-19, as measured by the stringency index.

Methods

A web-based survey was administered to a cohort of persons from the general population of eight countries: Greece, Italy, the Netherlands, Russia, South Africa, Sweden, the United Kingdom (UK) and the United States of America (US) from April 22 to May 5 and …

Association Of X-Ray Absorptiometry Body Composition Measurements With Basic Anthropometrics And Mortality Hazard, Nir Y. Krakauer, Jesse C. Krakauer

Publications and Research

Dual-energy X-ray absorptiometry (DEXA) is a non-invasive imaging modality that can estimate whole-body and regional composition in terms of fat, lean, and bone mass. We examined the ability of DEXA body composition measures (whole-body, trunk, and limb fat mass and fat-free mass) to predict mortality in conjunction with basic body measures (anthropometrics), expressed using body mass index (BMI) and a body shape index (ABSI). We used data from the 1999–2006 United States National Health and Nutrition Examination Survey (NHANES), with mortality follow-up to 2015. We found that all DEXA-measured masses were highly correlated with each other and with ABSI and …

Increasing Obesity Odds Among Foreignborn New Yorkers Are Not Explained By Eating Out, Age At Arrival, Or Duration Of Residence: Results From Nyc Hanes 2004 And 2013/2014, Margrethe F. Horlyck-Romanovsky, Sean J. Haley

Publications and Research

Background: Among the foreign-born in the United States (US) dietary acculturation and eating out may increase obesity risk. Using the 2004 (N = 1952) and 2013/14 (N = 1481) New York City (NYC) Health and Nutrition Examination Surveys, we compared for the foreign-born and US-born by survey year: 1) odds of obesity; 2) association between eating out and obesity and 3) effect of age at arrival and duration of residence among the foreign-born. Weighted logistic regression estimated odds of obesity.

Results: Compared to the US-born, the foreign-born had lower odds of obesity in 2004, (aOR = 0.51 (95%CI 0.37– 0.70), …

Pattern Of Use Of Electronic Health Record (Ehr) Among The Chronically Ill: A Health Information National Trend Survey (Hints) Analysis, Rose Calixte, Sumaiya Islam, Zainab Toteh Osakwe, Argelis Rivera, Marlene Camacho-Rivera

Publications and Research

Effective patient–provider communication is a cornerstone of patient-centered care. Patient portals provide an effective method for secure communication between patients or their proxies and their health care providers. With greater acceptability of patient portals in private practices, patients have a unique opportunity to manage their health care needs. However, studies have shown that less than 50% of patients reported accessing the electronic health record (EHR) in a 12-month period. We used HINTS 5 cycle 1 and cycle 2 to assess disparities among US residents 18 and older with any chronic condition regarding the use of EHR for secure direct messaging …

The Magnetic Couples Study: Protocol For A Mixed Methods Prospective Cohort Study Of Hiv-Serodifferent Heterosexual Couples’ Perspectives And Use Of Pre-Exposure Prophylaxis (Prep), James M. Mcmahon, Janie Simmons, Jessica E. Haberer, Sharon Mannheimer, Natalie M. Leblanc, Leilani Torres, Robert Quiles, Guillermo Aedo, Anabel Javier, Amy Braksmajer, Graham Harriman, Nicole Trabold, Enrique R. Pouget, Ann Kurth, Martez D. R Smith, Judith Brasch, Eric J. Podsiadly, Peter L. Anderson

Publications and Research

Introduction HIV transmission within serodifferent heterosexual couples plays a key role in sustaining the global HIV pandemic. In the USA, transmission within established mixed-status couples accounts for up to half of all new HIV infections among heterosexuals. Oral HIV pre-exposure prophylaxis (PrEP) is a highly effective prevention method, although underutilised among serodifferent couples. Moreover, there is a dearth of research on US HIV-serodifferent couples’ perspectives and use of PrEP, alone or in combination with other prevention methods. In this paper, we describe the study protocol for the Magnetic Couples Study, designed to fill critical knowledge gaps regarding HIV-serodifferent heterosexual couples’ …

Using Economic Evaluation To Hasten Health Equity, Maria-Isabel Roldos, Nancy Breen

Publications and Research

Achieving health equity has proven elusive for two reasons. First, most research has focused on changing the behavior of individuals; however, policies that address socioeconomic factors or change the context to facilitate healthy decisions tend to be more effective. Second, health disparity science and evidence are not consistently used to guide policymakers, even those seeking health equity. In this perspective, we discuss economic evaluation tools that researchers can use to assist decision-makers in conducting research or evaluating policy: self-reported health-related quality-of-life surveys and cost–benefit analysis evaluations informed with the willingness to pay for research and analyses.

Examining Inequities In Rates Of Undiagnosed Hiv And Rectal Stis In A Large Nationwide Cohort Study Of Sexual Minority Men, H Jonathon Rendina, Ali Talan, K Marie Sizemore, Nicola F. Tavella, Brian Salfas, Ore Shalhav, Drew Westmoreland, Brian Mustanski, Carlos E. Rodríguez- Díaz

Publications and Research

Objective Sexual minority men (SMM) of colour are disproportionately impacted by HIV and bacterial STIs (bSTIs). To better understand within-group heterogeneity and differential risk factors by race and ethnicity, we sought to examine rates of undiagnosed HIV and rectal bSTI at the intersection of racial and ethnic identity with other sociodemographic factors.

Methods We examined data from 8105 SMM conducting home-based self-testing at enrollment in a nationwide cohort study collected from November 2017 to August 2018. We conducted analyses stratified by racial and ethnic groups to examine within- group (ie, subgroup) unadjusted rates of HIV and rectal bSTI infection across …

Area Characteristics And Consumer Nutrition Environments In Restaurants: An Examination Of Hispanic Caribbean Restaurants In New York City, Melissa Fuster, Hanish Kodali, Krishnendu Ray, Brian Elbel, Margaret A. Handley, Terry T. Huang, Glen Johnson

Publications and Research

Hispanics in the USA, particularly those of Caribbean descent, experience high levels of diet-related diseases and dietary risk factors. Restaurants are an increasingly important yet understudied source of food and may present opportunities to positively influence urban food environments. We sought to explore food environments further, by examining the association between neighborhood characteristics and restaurant consumer nutrition environments within New York City’s Hispanic Caribbean (HC) restaurant environments. We applied an adapted version of the Nutrition Environment Measurements Survey for Restaurants (NEMS-R) to evaluate a random sample of HC restaurants (n=89). NEMS-HCR scores (continuous and categorized as low, medium, and high …

At What Cost: Modern Capitalism And The Future Of Health (Preface), Nicholas Freudenberg

Publications and Research

Freedom of choice lies at the heart of American society. Every day, individuals decide what to eat, which doctors to see, who to connect with online, and where to educate their children. Yet, many Americans don't realize that these choices are illusory at best. By the start of the 21st century, every major industrial sector in the global economy was controlled by no more than five transnational corporations, and in about a third of these sectors, a single company accounted for more than 40 percent of global sales. The available options in food, healthcare, education, transportation, and even online presence …

Chemical Exposure From Manufactured Gas Plants: Public Health Risks?, Aneeza Hussain

Publications and Research

This project aims at identifying the chemicals and their risk factors to public health, which were found underneath Public Place, a brownfield next to the Gowanus Canal. The site is heavily contaminated with coal tar — a toxic chemical by-product of gas manufacturing, which happened at the site for 100 years until the gas plant closed down in the 1960s and the land was seized by the city. Recently, the city has planned to develop Public Place into “Gowanus Green” and which will be comprised of a school and low-income housing units on this site. The aim of this research …

Chemical Exposure From Manufactured Gas Plants: Demographic & Governmental Research, Aneeza Hussain

Publications and Research

There are thousands of brownfields in New York on former Manufactured Gas Plants (MGP) similar to the Public Place site in Gowanus, Brooklyn. Public Place is an active brownfield abutting an EPA Superfund site currently undergoing remediation. After consulting recent literature finding that populations living on and near superfund sites have lower life expectancy that also correlate with “sociodemographic factors” like income and race, we used American Community Survey data to conduct a demographic analysis of census districts within the rezone area. Assessment of current demographic data shows that Gowanus residents living within census districts overlapping with the rezone area …

Understanding Of Aerosol Transmission Of Covid 19 In Indoor Environment - Part 2: Approaches To Mitigation, Adama Barro, Cathal O'Toole, Jacob S. Lopez, Matthew Quinones, Sherene Moore

Publications and Research

The challenge we face in implementing solutions for new HVAC ventilation and filtration design, is to effectively improve air quality for virus mitigation without losing performance efficiency. The purpose of this improvement is to decontaminate the occupied enclosed areas, reducing the transmission of the corona virus aerosol transmission. Our research seeks reliable approaches to mitigate the further spread of aerosol transmission in indoor spaces. The methodology is to examine innovative HVAC engineering solutions that combat epidemiological problems of Covid-19 for the post-pandemic era, by researching scholarly articles and ASHRAE journals. We are achieving the goal of finding highly efficient resolutions …

Hispanic Acculturation: Associations With Family Planning Behaviors And Attitudes, Rachel Chamberlain, Mary Fatehi, Joshua Fogel, Jacob Kulyn

Publications and Research

Introduction. The purpose of this study was to investigate the association of Hispanic acculturation in the U.S. with family planning behaviors and attitudes.

Methods. Surveys of 225 Hispanic women were collected that used acculturation measures of number of years lived in the U.S. and the Short Acculturation Scale for Hispanics (SASH), along with questions about family planning behaviors, including birth control use, sterilization, and abortion.

Results. SASH-Language statistically differed (p = 0.03) where those with ‘yes birth control’ had significantly lower English acculturation (M = 6.10, SD = 1.77) than those with ‘no birth control’ (M = 7.00, SD = …

Resuming On-Site Services: Final Report And Recommendations Of The Cuny Libraries Covid-19 Task Force (April 2021), Kathleen M. Dreyer, Jeffrey Delgago, Karen Okamoto, Steven Ovadia, Roxanne Shirazi, Michael Waldman, Haruko Yamauchi, Simone Yearwood

Publications and Research

This report was prepared by the CUNY Libraries COVID-19 Task Force, which formed in May 2020 with the following charge:

Authorized by the CUNY Office of Library Services and the Council of Chief Librarians, the task force is charged to survey best practices shared by libraries world-wide and to develop guidelines for CUNY Libraries site management, staff and user safety, circulation and resource sharing, and materials handling as pandemic conditions evolve.

A summary of the draft report was submitted by Interim Dean for Library Services Polly Thistlethwaite to CUNY’s Academic & Student Support Task Force on June 23, 2020. The …

Implementing A Peer Advocate Mental Health Digital Intervention Program For Ohio Youth: Descriptive Pilot Study, Tashuna Albritton, Kelsey Lynett Ford, Kira Elsbernd, Melodie Santodomingo, Ivan Juzang, Pam Weddington, Sheana Bull

Publications and Research

In the United States, millions of adolescents report poor mental health, where 1 in 5 teenagers considers suicide. Reducing stigma and fostering peer support remains critical for positive mental health interventions and programs. Increasingly, digital mental health tools have emerged with great promise, leveraging social networks. Despite the potential, limited understanding of such comprehensive programs and their implementation exist.

Slowing The Spread Of Covid-19: Review Of “Social Distancing” Interventions Deployed By Public Transit In The United States And Canada, Camille Kamga, Penny Eickemeyer

Publications and Research

This paper presents a review of social distancing measures deployed by transit agencies in the United States and Canada during the COVID-19 pandemic and discusses how specific operators across the two countries have implemented changes. Challenges and impacts on their operations are also provided.

Social distancing is one of the community mitigation measures traditionally implemented during influenza pandemics and the novel coronavirus pandemic. Research has shown that social distancing is effective in containing the spread of disease. This is applicable to the current situation with the novel coronavirus, given the lack of effective vaccines and treatments in the United States …

Hba1c Performance In African Descent Populations In The United States With Normal Glucose Tolerance, Prediabetes, Or Diabetes: A Scoping Review, Lakshay Khosla, Sonali Bhat, Lee Ann Fullington, Margrethe F. Horlyck-Romanovsky

Publications and Research

IntroductionAfrican descent populations in the United States have high rates of type 2 diabetes and are incorrectly represented as a single group. Current glycated hemoglobin A1c (HbA1c) cutoffs (5.7% to

Methods A PubMed, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) search (January 2020) yielded 3,238 articles published from January 2000 through January 2020. After review of titles, abstracts, and full texts, 12 met our criteria. HbA1c results were compared with other ethnic groups or validated against the oral glucose tolerance test (OGTT), fasting plasma glucose (FPG), or previous diagnosis. We classified study results by the …

Detection Of Mutations Associated With Variants Of Concern Via High Throughput 2 Sequencing Of Sars-Cov-2 Isolated From Nyc Wastewater, Davida S. Smyth, Monica Trujillo, Kristen Cheung, Anna Gao, Irene Hoxie, Sherin Kannoly, Nanami Kubota, Michelle Markman, Kaung Myat San, Geena Sompanya, John J. Dennehy

Publications and Research

Monitoring SARS-CoV-2 genetic diversity is strongly indicated because diversifying selection may lead to the emergence of novel variants resistant to naturally acquired or vaccine-induced immunity. To date, most data on SARS-CoV-2 genetic diversity has come from the sequencing of clinical samples, but such studies may suffer limitations due to costs and throughput. Wastewater-based epidemiology may provide an alternative and complementary approach for monitoring communities for novel variants. Given that SARS-CoV-2 can infect the cells of the human gut and is found in high concentrations in feces, wastewater may be a valuable source of SARS-CoV-2 RNA, which can be deep sequenced …

Facilitating Healthier Eating At Restaurants: A Multidisciplinary Scoping Review Comparing Strategies, Barriers, Motivators, And Outcomes By Restaurant Type And Initiator, Melissa Fuster, Margaret A. Handley, Tamara Alam, Lee Ann Fullington, Brian Elbel, Krishnendu Ray, Terry T-K Huang

Publications and Research

Restaurants are understudied yet increasingly important food environment institutions for tackling diet-related diseases. This scoping review analyzes research and gray literature (n = 171 records) to assess which healthy eating promotion strategies have been implemented in restaurants and the associated motivations, barriers, and outcomes, compared by restaurant type (corporate/chain vs. independently owned restaurants) and initiator (restaurant-initiated vs. investigator-initiated). We found that the most commonly reported strategy was the increase of generally healthy offerings and the promotion of such offerings. Changes in food availability were more common among corporate restaurants and initiated by restaurants, while environmental facilitators were more commonly initiated …

A Solution For Breaking The Impasse Of Burnout Measurement, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

In view of the profound problems affecting burnout’s conceptualization and measurement and because there is now robust evidence that burnout is a depressive condition, we recommend that occupational health specialists shift their focus from burnout to depression. A measure of job-related depressive symptoms, the Occupational Depression Inventory (ODI), has recently been developed. Advantageously, the ODI resolves many of the persistent problems linked to burnout while being consistent with burnout researchers’ original aim of assessing a work-attributed form of distress. The ODI includes a diagnostic algorithm that allows investigators to estimate the prevalence of depressive disorders that individuals specifically ascribe to …

The Occupational Depression Inventory—A Solution For Estimating The Prevalence Of Job-Related Distress, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

We are concerned about researchers’ reliance on the burnout construct and the MBI-GS to estimate the prevalence of job-related distress. In this paper, we first describe some of the problems plaguing the burnout construct and its measures. Then, we present the Occupational Depression Inventory, a new instrument designed to help occupational health specialists get a clearer view of the mental health status of the workforce (Bianchi and Schonfeld, 2020).

Barriers And Facilitators To Pre-Exposure Prophylaxis Uptake Among Black Women: A Qualitative Analysis Guided By A Socioecological Model, Alexa B. D'Angelo, Leah N. Davis Ewart, Juline Koken, David Bimbi, Justin Brown, Christian Grov

Publications and Research

Background This study included Community Health Workers and their supervisors from HIV clinical care teams who participated in the Healthy Choices intervention program. Healthy Choices is a Motivational Interviewing-based intervention aimed at improving medication adherence and reducing alcohol use for adolescents and emerging adults ages 16—24 living with HIV. In this study, the intervention was “scaled up” for delivery by local HIV care providers in real-world clinic settings. Methods Providers (N = 21) completed semi-structured interviews (N = 29) about their experiences with intervention scale-up. Rigorous thematic analyses were conducted within discussions of barriers and facilitators of intervention implementation. Results …

Are Covid-19 Vaccine Boosters Needed? The Science Behind Boosters, Rachel M. Burckhardt, John J. Dennehy, Leo L. M. Poon, Linda J. Saif, Lynn W. Enquist

Publications and Research

Waning vaccine-induced immunity coupled with the emergence of SARS-CoV-2 variants has led to increases in breakthrough infections, prompting consideration for vaccine booster doses. Boosters have been reported to be safe and increase SARS-CoV-2-specific neutralizing antibody levels, but how these doses impact the trajectory of the global pandemic and herd immunity is unknown. Information on immunology, epidemiology and equitable vaccine distribution should be considered when deciding the timing and eligibility for COVID-19 vaccine boosters.

Protocol For Safe, Affordable, And Reproducible 1 Isolation And Quantitation 2 Of Sars-Cov-2 Rna From Wastewater, Monica Trujillo, Kristen Cheung, Anna Gao, Irene Hoxie, Sherin Kannoly, Nanami Kubota, Kaung Myat San, Davida S. Smyth, John J. Dennehy

Publications and Research

The following protocol describes our workflow for processing wastewater with the goal of detecting the genetic signal of SARS-CoV-2. The steps include pasteurization, virus concentration, RNA extraction, and quantification by RT-qPCR. We include auxiliary steps that provide new users with tools and strategies that will help troubleshoot key steps in the process. This protocol is one of the safest, cheapest, and most reproducible approaches for the detection of SARS-CoV-2 RNA in wastewater. Furthermore, the RNA obtained using this protocol, minus the pasteurization step, can be sequenced both using a targeted approach sequencing specific regions or the whole genome. The protocol …

Online Or In-Person? Examining College Decisions To Reopen During The Covid-19 Pandemic In Fall 2020, Jacob Felson, Amy Adamczyk

Publications and Research

When coronavirus disease 2019 (COVID-19) became a major impediment to face-to-face college instruction in spring 2020, most teaching went online. Over the summer, colleges had to make difficult decisions about whether to return to in-person instruction. Although opening campuses could pose a major health risk, keeping instruction online could dissuade students from enrolling. Taking an ecological approach, the authors use mixed modeling techniques and data from 87 percent of two- and four-year public and four-year private U.S. colleges to assess the factors that shaped decisions about fall 2020 instructional modality. Most notably, the authors find that reopening decisions about whether …