Public Health Commons^™

Machine Learning Models For Pancreatic Cancer Survival Prediction: A Multi-Model Analysis Across Stages And Treatments Using The Surveillance, Epidemiology, And End Results (Seer) Database, Aditya Chakraborty, Mohan D. Pant

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background: Pancreatic cancer is among the most lethal malignancies, with poor prognosis and limited survival despite treatment advances. Accurate survival modeling is critical for prognostication and clinical decision-making. This study had three primary aims: (1) to determine the best-fitting survival distribution among patients diagnosed and deceased from pancreatic cancer across stages and treatment types; (2) to construct and compare predictive risk classification models; and (3) to evaluate survival probabilities using parametric, semi-parametric, non-parametric, machine learning, and deep learning methods for Stage IV patients receiving both chemotherapy and radiation. Methods: Using data from the SEER database, parametric models (Generalized Extreme Value, …

Enhancing Wellbeing Through Caregiver Support: Improving Quality Of Life For Individuals With Special Needs And Complex Medical Diagnoses In Nicaragua, Jenna K. Devchand

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Individuals with disabilities living all over the world are constantly faced with additional barriers. In low-income countries, such as Nicaragua, there is often a gap in access to resources and education, for both individuals living with disabilities and their caregivers. Access is essential to provide high quality care to meet unique needs. This occupational therapy doctoral capstone project was created to support individuals providing care to children with special needs and complex medical diagnoses in Nicaragua by providing community-based education and sustainable resources to caregivers to enhance wellbeing in daily life. The deliverable was presented in country in Nicaragua to …

An Evaluation Of The Association Between Female Reproductive Health Policy And Children's Health Outcomes, Kira Markowski, Rachel Bobko

Scholarship in Medicine - All Papers

Background: As policy pertaining to female reproductive health and education continues to be a central issue concerning Americans and a divisive focus of political campaigns, it is important to fully understand the ramifications of female reproductive health legislation not only on women’s health outcomes but also the health outcomes of children and adolescents.
Objective: We set out to identify how legislation and policy related to female reproductive health and education impacts the health and well-being of children and adolescents. By evaluating this relationship, we aim to show whether variations in policy correlate with variations in a child’s well-being as lawmakers …

Awake And Affected: Cultural And Socioeconomic Impacts On Sleep Insufficiency In Modern-Day Ohio, Nehal Mittal, Marina Shenouda

Scholarship in Medicine - All Papers

Background: Previous literature explores factors such as urban environments, screen use and stress negatively impact sleep quality in American adults. However, there is a lack of demographic focus on non-white, low-income populations specifically related to sleep. There is a growing need for targeted interventions to address increasingly prevalent disparities.
Objective: Our study aims to look deeper into race, age, and socioeconomic status and other demographic factors that may affect sleep health.
Results: Our analysis revealed a strong positive correlation between insufficient sleep and selfreported poor or fair health (r = .728) and a moderate positive correlation with unemployment (r = …

Prevention Of Substance Related Deaths Through Mental Health Counseling, Lindsey Tout, Camille Zonfa

Scholarship in Medicine - All Papers

Background: Substance abuse, particularly alcohol and drug use, remains a critical public safety issue in Ohio. Those suffering with abuse disorders are likely to often have accompanying mental health disorders, however, there lies a significant gap in treatment.
Objective: This study examines trends in alcohol-related driving deaths, drug overdose deaths, excessive drinking, and mental health provider availability from 2016 to 2023 in rural and urban counties of Ohio.
Methods: Data collected from the public source, County Health Rankings and Roadmaps, was analyzed using statistical methods to assess changes between 2016 to 2023 for the 88 counties of Ohio. Urban versus …

Factors Driving Potentially Preventable Hospitalizations In Ohio And Surrounding States, Ann Walter, Andy Russell

Scholarship in Medicine - All Papers

No abstract provided.

An Analysis Of Alcohol, Mental Health, And Suicide, Motassem Bayyoud, Megan Galluch

Scholarship in Medicine - All Papers

Suicide rates in Montana, Iowa, Ohio, and New Jersey vary strongly and encompass the wide range seen across all fifty states in America. Previous research has told us that there is a significant relationship between Alcohol Use Disorder and the ideation, attempt, and completion of suicide. Additionally, most people who are victims of suicide suffer from mental disorders. People use alcohol to cope with mental health and alcohol leads to deteriorating and adverse outcomes in a person’s life. To attempt to better understand the relationship between these variables and why suicide rates differ so widely, an analysis of binge drinking, …

Examining Low Mammogram Rates In Native American Populations In Arizona And New Mexico, Mason Berges, Ayesha Ahmad

Scholarship in Medicine - All Papers

Introduction: Despite improvements in technology over the last several decades, breast cancer incidence and mortality rates have remained steady among the Native American population. This is in direct contrast to the general United States population which has seen substantial decreases in these incidence and mortality rates. A key factor in eliminating breast cancer and saving lives is undergoing mammogram screenings. While mammogram screenings are of crucial importance, many Native American women lack equitable access to healthcare resources and as a result face unnecessary health challenges. Several social determinants of health could be playing a key role in these mammogram screening …

Impact Of Abortion Restrictions On Childhood Health Outcomes, Rico Carter, Griffin Suppa

Scholarship in Medicine - All Papers

Abortion has been a topic for debate in the U.S. for decades. With the Supreme Court’s recent overturning of Roe v. Wade, many pro-abortion advocates fear for the looming effects this policy change will have on healthcare. In this study we aim to study how abortion access or lack thereof influences childhood healthcare outcomes. Past research has shown a negative impact of abortion restrictions on infant survival, future socioeconomic success, and the U.S. foster care system. Using data collected from County Health Rankings & Roadmaps and three abortion restriction levels created from Guttmacher, we found that states with restrictions had …

Food Insecurity Rates And Its Related Factors In The State Of Ohio, Sophia Danchine, Maia Sethi

Scholarship in Medicine - All Papers

Food insecurity is an ongoing issue across Ohio counties, influenced by socioeconomic factors, geographical location, and age and ethnic demographics. This study explores food insecurity rates from 2016 to 2023, comparing urban and rural counties, various social determinants of health, such as income, education, and age, and exploring correlations with racial and ethnic demographics. Using data from the County Health Rankings and Roadmaps database, statistical analyses revealed key findings that food insecurity was not significantly different when comparing rural versus urban counties in Ohio. The most significant predictor to food insecurity in 2023 was median household income, followed by percent …

Social And Structural Determinants Of Mammography Screening Rates Among Female Medicare Beneficiaries: A Retrospective Analysis, Stephen Fuglsang, Rakhsha Khatri

Scholarship in Medicine - All Papers

Introduction: Despite Medicare fully covering annual mammogram costs, less than one half of female Ohio residents aged 65-74 sought yearly mammograms. As such, our analyses explore which social and structural determinants of health predict the likelihood that a woman aged 65-74 on Medicare will receive an annual mammogram.
Methods: This retrospective analysis utilized data from the County Health Rankings database, focusing on female Medicare enrollees aged 65-74. Mammography screening rates were compared across counties within Ohio, Michigan, and Missouri. Pearson and Spearman correlation tests were employed to examine relationships between English non-proficiency, high school graduation rates, residential segregation, primary care …

Income, Education, And Family Structure: Drivers Of Teen Pregnancy In Rural And Urban Ohio, Adam Klauck, Maggie Stiefel, Catherine Wilson

Scholarship in Medicine - All Papers

Teen birth rates in Ohio have been declining; however, due to the potential adverse ramifications of any teen birth, for either the mother or the child, understanding the strongest predictors of teen birth rates in Ohio will allow physicians to preventatively care for their young female population. Our objective was to identify some qualitative factors that best indicate the environment in which a teenage pregnancy is most likely to occur, giving special attention to the difference between rural and urban environments. Relevant data was obtained from County Health Rankings and Roadmaps. This study used qualitative methods and SPSS to analyze …

The Effect Of Socioeconomic Factors On Childhood Mortality, Sathvika Madisetty, Benjamin Curl

Scholarship in Medicine - All Papers

Objective: This study investigates the impact of socioeconomic factors specifically childhood poverty, uninsurance, and severe housing problems on childhood mortality rates in Ohio in 2016 and 2023.
Methods: The study analyzes county-level data from Ohio in 2016 and 2023, focusing on childhood mortality, childhood poverty, uninsurance, and severe housing problems using data from County Health Rankings and Roadmaps1. Statistical analyses, including paired t-tests, Spearman correlations, and linear regression, were performed to examine associations and predictive relationships.
Results: Childhood poverty was found to have a moderate, statistically significant correlation with childhood mortality in Ohio for 2023, emerging as the strongest predictor …

Exploring The Socioeconomic Drivers Of Type 2 Diabetes Mellitus Prevalence And Their Implications For Treatment In The Midwest, Kendall Locascio, Anirudha Koppaka

Scholarship in Medicine - All Papers

Type 2 Diabetes Mellitus (T2DM) is a leading chronic disease globally with its prevalence steadily rising and significantly impacting public health systems. Previous research has indicated correlations between resource scarcity, low income, and limited education completion and T2DM prevalence. However, the degree of influence of these factors on incidence and progression remains unclear. This study aims to identify the most significant socioeconomic determinants of T2DM prevalence and progression in the Midwest to aid healthcare providers in creating maximally effective T2DM treatment plans. Methods include using data from County Health Rankings & Roadmaps (CHR&R) for Ohio, Illinois, Indiana, and Michigan. We …

From Judgment To Support: Advocating For Mothers Of Children With Behavioral Disorders, Alisha Riggins, Jessica Guerrette, Nazish Masud, Tobi Oloyede, Sarah Sejoro, Joanne Chopak-Foss, Logan Cowan

Eagles Talking About the Public’s Health

No abstract provided.

The Role Of Horizontal Gene Transfer In Antibiotic Resistance Amidst Prevalent Community And Healthcare-Associated Mrsa Rates, Gabrielle Nascimento

Honors College Theses

In recent decades, cases of community-acquired MRSA (CA-MRSA) and healthcare-associated MRSA (HA-MRSA) have been on the rise. The ability of antibiotic resistance to transfer between microorganisms greatly expands its threat to the effective treatment and containment of bacterial infections. The mecA gene is found on a mobile cassette within the Staphylococcal cell and encodes for PBP2a, an alternate version of penicillin-binding protein (PBP) with less binding affinity for β-lactam antibiotics, increasing resistance to the effects of antibiotics. The goal of this research is to investigate the horizontal transfer of the mecA gene between various Staphylococcus species as well as to …

The Relationship Between Socioeconomic Factors And Low Birth Rates In Ohio, Ryan Gora, Hannah Amin

Scholarship in Medicine - All Papers

Background: The incidence of low birth weight (LBW) has not substantially fallen over time despite advances in medical interventions. LBW has been linked to several chronic diseases in adulthood including type 2 diabetes (T2DM) and cardiovascular disease (CVD), making it a particularly salient public health issue.
Objective: To examine socioeconomic factors and diseases associated with LBW in Ohio between 2016-2022.
Methods: Using data from County Health Rankings, we identified socioeconomic factors predictive of LBW in Ohio between 2016-2022. We also examined the relationship between LBW and incidence of T2DM as well as food insecurity (FI). In addition, we investigated how …

Food And Mood, Angelina Gentilin, Patrick Tawil

Scholarship in Medicine - All Papers

Depression and mental illnesses are on the rise in the United States alongside other chronic illnesses like obesity. Preliminary research indicates that diets of individuals and obesity can have profound roles in mental health status. Alongside the consummatory behavior of eating, drinking alcohol is associated with mental illnesses like depression and could potentially play a role in mental health and poor diet. The authors analyzed the public health county data in Ohio of adults between the years of 2016 and 2022 to investigate any differences in the population’s health rates. This study found that diet plays an influencing role in …

Texans In Transition: Exploring Socioeconomic Effects On Health From 2016 To 2023, Dylan Timperman, Nowshin Islam, Akshey Suresh

Scholarship in Medicine - All Papers

Background: Although it has been shown that low socioeconomic status (SES) negatively impacts many health outcomes, very little is known about this relationship in the second largest U.S. state, Texas. Over the past decade, Texas has experienced crises such as Hurricane Harvey, the COVID 19 pandemic, and other environmental disasters that have worsened disparities in health and financial stability. With the highest uninsured rate in the nation and a rapidly growing Hispanic population, understanding financial health disparities is important in influencing public policy and resource allocation.
Objective: By analyzing The University of Wisconsin’s Public Health Institute County Health Rankings & …

Examining Intersectional Factors In Infant Mortality: The Role Of Race, Geography, And Socioeconomic Status In Ohio, Catherine Tran, Rebekah Murray

Scholarship in Medicine - All Papers

Background: Aspects of a mother’s identity such as race, socioeconomic status, and geographical location can impact healthcare access and outcomes, especially infant mortality.
Objective: The aim of this study is to identify how different variables relating to a mother’s identity intersect with one another to impact infant mortality rate in Ohio.
Methods: Data for infant mortality rate, racial residential segregation index, patient race by percentage, and median household income was collected from County Health Rankings, and data was analyzed using IBM SPSS Statistics.
Results: A linear regression found that the best fitting model including median household income and percent Black …

The Opioid Crisis: Analyzing Access To Resources, Mental Health And The Influence On Overdose Deaths In Urban And Rural Communities, Katharina Johnson, Maggie Obourn

Scholarship in Medicine - All Papers

Background: Opioid use contributes significantly to deaths throughout the United States. Opioid overdose deaths have increased in recent years and the opioid crisis has far reaching effects on many communities. There are several factors that contribute to opioid overuse and death, including access to resources and social factors.
Objective: In this study we aimed to assess how social factors affect overdoses by examining the differences between rural and urban communities over time.
Methods: We utilized data from County Health Rankings and conducted a retrospective review of data from 2016 and 2023 to compare several factors that we hypothesized affected opioid …

Access To Exercise Opportunities And Food Security: Mediators In The Prevalence Of Chronic Diseases In Ohio, Anidya Soni, Lisa Victor

Scholarship in Medicine - All Papers

Background: Obesity remains a leading public health issue in the United States, with 40.3% of adults classified as overweight, underscoring the need to understanding the environmental and social determinants of health1. The neighborhood food environment, including access to healthy food and recreational spaces in one's community, plays a critical role in shaping dietary behaviors and physical activity levels.

Objective: This study examines the relationship between neighborhood food environments including access to healthy food and exercise opportunities, socioeconomic factors, and health outcomes like obesity, and diabetes in Ohio from two-time points: 2016 to 2023 using data from the County Health Rankings …

A Program Evaluation Case Study, Madelyne G. Culbertson

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This case study presents a program evaluation of a physical activity intervention implemented in Bourbon County, Kentucky, guided by the Centers for Disease Control and Prevention’s Framework for Program Evaluation in Public Health.

A Case Study In Program Evaluation, Alexis Strottman

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This paper presents a comprehensive evaluation plan for the Bourbon County Physical Activity Improvement Program, as prompted in the University of Kentucky's 2025 MPH-Health Management and Policy Capstone Case Study. The case study outlines a program developed in response to high obesity and inactivity rates in Bourbon County, Kentucky. Utilizing the CDC's 6-step program evaluation framework, the plan outlines engagement of a diverse group of stakeholders to assess the program's effectiveness in increasing physical activity among residents. The evaluation focuses on both process and outcome measures, examining the implementation of exercise facilities, community events, and an app designed to track …

A Case Study In Program Evaluation: Evaluation Of A Program Designed To Increase Activity Levels In Bourbon County Residents, Brooke M. Woodburn

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This paper provides recommendations to eliminate possible barriers in a program developed to reduce inactive levels across Bourbon County.

Increasing Hpv Vaccination Adherence In Floyd County, Ky: Give Teens Vaccines, Taylor M. Stumbo

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Cervical cancer remains a pressing public health issue, particularly in underserved and rural areas where access to preventive care is limited. This capstone addresses the urgent need to increase human papillomavirus (HPV) vaccination adherence in Floyd County, Kentucky—part of the central Appalachian region that experiences disproportionately high cervical cancer incidence and mortality. Despite the proven effectiveness of HPV vaccines in preventing the virus strains most responsible for cervical cancer, uptake in this region remains below national targets due to socioeconomic barriers, limited healthcare access, and lack of awareness. Give Teens Vaccines is a two component intervention leveraging existing healthcare systems …

A Case Study In Program Evaluation Evaluation Of A Physical Inactivity Program In Bourbon County, Kentucky, Carine N. Malekera

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This paper evaluates a physical activity program by the Bourbon County Health Department aimed at increasing physical activity among local residents. Using the CDC’s Framework for Program Evaluation, the study includes both process and outcome evaluations to assess program implementation and impact on health outcomes. Key findings indicate success in urban areas but challenges in rural regions due to limited access to resources. Recommendations include improving access to exercise opportunities in rural areas and offering virtual classes. This evaluation emphasizes the importance of continuous assessment for effective public health interventions.

A Case Study In Program Evaluation, Kaitlyn E. Lee

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This capstone project evaluates a fictious online MRSA education program developed by the Lexington-Fayette County Health Department and Fayette County Public Schools after a suspected outbreak among student athletes. Using the CDC’s 6-Step Framework for Program Evaluation, the project focuses on how stakeholders were engaged, how the program was described and mapped, how the evaluation questions were developed, what evidence was collected, and how conclusions were formed. The goal of the evaluation is to understand whether the program’s structure, delivery, and implementation support clear infection-control education for the different school personnel who use it. This project emphasizes the overall evaluation …

Customary Corruption, Ani B. Satz, Liza Vertinsky

Faculty Articles

For over a hundred years, it has been well-accepted among tort scholars that physicians—as one of the legally recognized professions— determine their own customary practices. Within tort law, and medical malpractice more specifically, customary practice establishes whether physicians breach or uphold the required standard of care toward their patients. The results of our hand-coded examination of decided cases and statutes show a more complex picture. While some states have endeavored to shift the standard away from professional custom, it continues to play a critical, and in many cases a determinative, role in establishing physician liability in most states.

Using illustrative …

Tort Liability For Failure To Age Gate: A Promising Regulatory Response To Digital Public Health Hazards, Matthew B. Lawrence, Brett Frischmann, Avi Sholkoff

Faculty Articles

Tort liability for failure to “age gate” is a promising legal response to the public health hazards of AI, social media, sports gambling, and other digital spaces. Tort liability for failure to “age gate” hinges liability for harms to minors on an app’s failure to take reasonable steps to prevent minors from gaining access or otherwise to apply appropriate governance rules, such as privacy-protective default settings or ensuring genuine parental consent. While no one legal response is a panacea, tort liability for failure to age gate carries several distinctive advantages that make it a particularly promising option at this stage …