Public Health Commons^™

The Intergenerational Effects Of Adverse Childhood Experiences On Children’S Emergency Department Utilization And Depression And Anxiety In South Carolina, Eboni E. Haynes

Theses and Dissertations

Adult exposure to adverse childhood experiences (ACEs) is common in the U.S., with over half of adults reporting exposure to at least one ACE. Childhood trauma is associated with risk factors for premature death, disability, poor physical and mental health, and lower quality of life in adults. Traumatic experiences also influence parenting behaviors later in life, placing offspring at an increased risk of ACE exposure. Few studies have explored the intergenerational effects of ACEs on the health and well-being of offspring. This study sought to identify whether associations existed between caregiver ACE exposures and emergency department (ED) utilization for sick …

Hiv Care Location: An Evaluation Of Single Versus Multi Facility Utilization Of Hiv/Aids Care Services And Patient Health Outcomes And Clinical Indicators In South Carolina, Melanie Gwynn

Theses and Dissertations

Background: On the HIV/AIDS care continuum, the “retention in care” metric does not distinguish between single-facility (SF) or multi-clinic utilization (MC), also described as HIV care location (or type). SF utilization is vital as it has been linked optimal clinical outcomes among People Living with HIV/AIDS (PLWH). Published research detailing the prevalence of HIV care type and its association with health outcomes/clinical indicators, has been studied only in limited urban settings. Additionally, coinfections such as sexually transmitted infections (STIs), have yet to be evaluated as potential predictive factors for HIV care type.

Methods: A cross-sectional design was used …

Disparities In Colorectal Cancer: Measuring Spatial Accessibility, Screening, And Surveillance Outcomes In South Carolina, Michele J. Josey

Theses and Dissertations

The purpose of this dissertation project is to add to the growing literature about the multi-faceted aspects of colorectal cancer (CRC) prevention and related disparities. We focused on the spatial distribution of facilities performing screening services to identify areas that underutilize colonoscopy screening. Next, we examined how the food and physical activity environment affects precursors of CRC by considering plausible pathways. Finally, we explored if access to health insurance reduced the racial disparity of receiving a timely surveillance colonoscopy after a CRC diagnosis.

We utilized the SC Ambulatory Surgery Discharge Database, an all-payer, population-based outpatient dataset with colonoscopy records from …