Public Health Commons^™

Describing Trends In Virginia's Dentist And Dental Hygienist Workforce: Challenges And Opportunities, Shillpa Naavaal, Yetty Shobo, Barbara Hodgdon

Virginia Journal of Public Health

Purpose: Regular assessment of the dental workforce is essential to improve the population's oral health. This analysis aimed to understand the trends in the distribution of dentists and dental hygienists (DHs) in Virginia.

Methods: Annual survey data (2013-2022) of dentists and DHs from the Virginia Department of Health Professions Healthcare Workforce Data Center was used to examine the trends in provider distribution by age, gender, race/ethnicity, and geography across Virginia.

Results: In 2022, there were 5,720 dentists and 5,290 DH licensees in Virginia. In the dentist workforce, there was a high representation of those aged ≥60 years (23%), males (58%), …

County-Level Trends And Potential Disparities In The Suicide Rates In Virginia, 2020 – 2022, Sharon A. Olowoyo, Oluwatosin M. Oduneye, Glodi B. Bokanya, Ayooluwa G. Olowoyo, Coralie E. Mugenga, Yuhan Yan, Robyn L. Anderson

Montview Journal of Research & Scholarship

Abstract

Objectives

This study aims to investigate the influence of social determinants of health (SDH) on suicide patterns in the state of Virginia.

Methods

A secondary statistical analysis was conducted using publicly accessible data from the County Health Rankings & Roadmaps database for Virginia. Data from 2020 to 2022 were analyzed, focusing on age-adjusted suicide rates and SDH factors, including % rural, mental health provider rate, median household income, high school completion, and unemployment rates. Multiple regression analysis and visualizations were employed for data interpretation.

Results

The analysis revealed that SDH factors significantly predicted suicide rates across the study period. …

Assessing And Addressing The Determinants Of Appalachian Population Health: A Scoping Review, David L. Driscoll, Hannah O'Donnell, Maitri Patel, David C. Cattell-Gordon

Journal of Appalachian Health

Introduction: Residents of Appalachia experience elevated rates of morbidity and mortality compared to national averages, and these disparities are associated with inequitable exposures to various determinants of population health. Social and environmental determinants of health are a useful lens through which to develop and evaluate programs to mitigate regional health disparities.

Methods: This 2023 scoping review was conducted of studies linking determinants of Appalachian health with leading causes of regional mortality and morbidity. The search strategy employed a keyword search that included geographic terms for the Appalachian Region and the primary adverse health outcomes in that region. Studies meeting the …

Predictors Of Lung Cancer Screening Recommendation In Virginia Using The Community Health Assessment Survey, Aashish Batheja, Carrie Miller, Sunny Jung Kim, Bernard Fuemmeler F., Rajsh Balkrishnan

Virginia Journal of Public Health

Purpose: The purpose of this analysis was to determine the factors that may influence the probability of being recommended a lung cancer screening by a health professional in Virginia.

Methods: Data were obtained from the Community Health Assessment Survey conducted by the University of Virginia (UVA) Health System and Cancer System in collaboration with Virginia Commonwealth University (VCU) Cancer Center. SAS software was used to conduct a logistic regression with the following variables: age, sex, race, current smoking status, cancer history, education level, income level, insurance, and rurality.

Results: Statistically significant positive predictors included being a current smoker (OR: 3.504, …

Ballad Health: Understanding Appalachia’S Regional Healthcare Monopoly, Meredith A. Bailey

Baker Scholar Projects

The Ballad Health merger of 2018, which combined the now 21 hospitals in the region under one organization, has impacted the healthcare landscape in Northeast Tennessee and Southwest Virginia. Historically, Appalachia has had to persevere through primary physician shortages, a lack of specialty care, geographic obstacles to accessing healthcare, challenges related to substance abuse, and much more. Since the merger of Mountain States Health Alliance and Wellmont Health System, little research has been done to assess the perceived impact the aggregation of providers has had on the population it serves. This study utilizes an online survey to better understand the …

A Mixed Methods Investigation Of How Young Adults In Virginia Received, Evaluated, And Responded To Covid-19 Public Health Messaging, Natalie Cook, Sophie G. Wenzel, Rachel Silverman, Danielle Short, Kristina Jiles, Teace Markwalter, Mary Ann Friesen

Virginia Journal of Public Health

The purpose of this study was to investigate how young adults in Virginia received, evaluated, and responded to messages related to the coronavirus/COVID-19, a major disruptor of our time, and to understand how and when these messages influenced behavior. This was a sequential explanatory mixed methods study, including an online survey (quantitative) and virtual focus groups (qualitative). We surveyed a convenience sample of 3,694 Virginia residents by distributing a link to complete the survey online. Only data from18-24 year old adults (n=207) were included in the analysis for this study. Focus group participants were recruited from the survey participants as …

Hpv Vaccination In The Virginia Context: Demographic Disparities, Patient-Provider Gender Concordance And The Impact Of Changing Recommendations, Isha Patel, Norma M. Benitez, George L. Maxwell, Fabian T. Camacho, Rajesh Balkrishnan

Virginia Journal of Public Health

Objective: Despite its effectiveness in preventing several cancers, there are marked disparities in HPV vaccination initiation and series completion. The present study sought to understand disparities in HPV vaccinations among patients in northern Virginia (ages 9-26) and the impact of patient and provider gender concordance, in lieu of CDC’s vaccine recommendation changes in 2016, which reduced the recommended doses from three to two, in this population. Design: Analyses of electronic medical records collected from 2012 to 2017. Setting: A large health care system in Northern Virginia. Participants: A total of 37,427 patients, ages 9 to 26, were included in analyses. …

Knowledge Of The Human Papillomavirus Vaccine: An Analysis Using Together For Health Virginia Population Health Survey, Mythili Vigneshwar, Sunny Jung Kim, Carrie A. Miller, Bernard Fuemmeler, Rajesh Balkrishnan

Virginia Journal of Public Health

Purpose: The purpose of this analysis was to identify key predictors which impact knowledge of the Human Papillomavirus vaccine in adults aged 21 to 45 in Virginia.

Methods: Data was collected from the Together for Health Virginia Population Surveys administered by Virginia Commonwealth University and the University of Virginia. Logistic regression was performed on data using the variables sex, age, rurality, race, education, income, occupation, and type of health insurance coverage.

Results: There was a statistically significant positive relationship between knowledge of the HPV vaccine and part-time occupation (OR: 4.288, CI: 1.492-13.325), younger age (OR: 2.31, CI: 1.088-4.905), and …

Spatial Analysis Of Health Care Utilization Among Medicare Beneficiaries With Coal Workers’ Pneumoconiosis And Other Related Pneumoconiosis, Ahmed A. Arif, Claudio Owusu, Rajib Paul, Christopher M. Blanchette, Ripsi P. Patel, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• The states with the highest number of Medicare beneficiaries with coal workers’ pneumoconiosis (CWP) were Kentucky, West Virginia, Virginia, and Pennsylvania.
• Significant clustering of health care utilization rates for Medicare beneficiaries with CWP was observed in the central Appalachian states of Kentucky, West Virginia, and Virginia.
• Significant clustering of health care utilization rates for Medicare beneficiaries with Other Related Pneumoconiosis was observed in Appalachia and the southeast parts of Texas and Louisiana. This clustering merits additional research to understand underlying disease etiology.

Covid-19 Evacuation And Sheltering Risk Perception Study, Joshua G. Behr, Rafael Diaz, Wie Yusuf, Bridget Giles, Kaleen Lawsure, George Mcleod

Presentations, Lectures, Posters, Reports

First two paragraphs from the Executive Overview:

This report, COVID-19 Evacuation and Sheltering Risk Perception Study, is one of several key science-based research efforts produced for the State reflecting the most current knowledge related to evacuation and sheltering behavior. The primary data source for this report are interviews with 2,200 households across ten localities in Hampton Roads, including the Eastern Shore. The findings – and recommendations – within this report are intended to inform and advance state and local evacuation and public shelter planning.

This report contains 31 specific recommendations (Action Items) that broadly advance coastal resilience and protect the …

Impact Of Different Factors On Premature Deaths In Rural And Urban Virginian Counties, Christian Randazzo

Scholarship in Medicine - All Papers

The goal of this investigation is to analyze data that influences premature death rates in Virginian counties. Specifically, I am looking at how the rates compare between rural and urban Virginian counties in 2020. In addition, I am analyzing how the premature death rates correlates with low birthweights, with air pollution, with preventable hospital stays, and with children in poverty and see how these variables predict the variance in premature death rates by county. I am using data from the County Health Rankings website. They gathered their data via surveys, the National Vital Statistics System, the CDC health tracking network, …

A Virginia Mountain City Responds To The Challenge Of Improving Health Outcomes, Robert S. Cowell Jr.

Journal of Appalachian Health

In 2012, Roanoke Virginia was becoming a city of haves and have-nots, a place where many were benefitting from revitalization underway but too many were seeing their situation grow worse and becoming even more entrenched. Poverty with levels as high as 50% in some neighborhoods; life expectancy sometimes 14 years shorter than those living just one or two neighborhoods over; and lack of access to fresh food, medical care, and economic opportunities—all within view of the largest hospital in the region was unacceptable.

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It Takes A Village To Uplift A Population: Addressing The Homeless In District 16 Of Virginia, Chloe Allen

Student Writing

Homelessness is a community issue which affects every country. My research group and I decided to look into the causes of homelessness in our community. We interviewed the Fredericksburg Regional Continuum of Care (FRCoC), The Brisben Center (TBC), and Micah Ecumenical Ministries (MEM) to better understand the situation in District 16 of Virginia. This paper discusses the actions already in place in the district as well as our proposed solutions to help the homeless population. We propose acting on minimum wage, petitioning and revising a budget proposed by the FRCoC, and opening a new shelter to serve the chronically homeless. …

Effect Of Socioeconomic And Neighborhood Factors On Stroke Hospitalization Rate In Virginia, Esther Musu Stephens

Walden Dissertations and Doctoral Studies

The stroke rate in Virginia is above the national rate. Stroke results in poor quality health, morbidity, and mortality. This quantitative epidemiological study was conducted to investigate whether a significant association exists between stroke and (a) socioeconomic and (b) neighborhood factors among people who were admitted to Virginia hospitals between 2010 and 2015. An ecological design, including ecosocial theory, was used to examine associations between environmental factors and stroke. Data (746 census output areas) were acquired using patients' billing zip codes from the Virginia Health Information System in combination with socioeconomic and neighborhood data by Zip Code Tabulation Area from …

Health Care Service Disparity: Factors Associated With The Distribution Of Primary Care Physicians, Robert L. Morgan

Senior Honors Projects, 2010-2019

Primary care physicians operate on the front lines of health care. Although primary care physicians play a critical role in improving health outcomes, workforce trends in the United States show a growing shortage of primary care physicians as demand for primary care rises. In conveying the importance of primary care physicians, the worsening physician shortage, the inequitable distribution of providers, and the lackluster institutional response thus far, this paper calls into question the effectiveness of current indicators used to identify underserved areas and provide appropriate government assistance. Through the use of data from the 2010 census and American Medical Association …

Virginia Air Quality: Trends, Exposure, And Respiratory Health Impacts, James Blando, My Ngoc Nguyen, Manasi Sheth-Chandra, Muge Akpinar-Elci

Virginia Journal of Science

Air quality is an important determinant of public health and quality of life. A secondary data analysis was carried out to investigate trends and air quality in Virginia. The analysis included an evaluation of two major air pollution source categories, emission of criteria and hazardous air pollutants, ambient concentrations of criteria pollutants, ozone standard violations and associated meteorology, and hospital admissions for asthma and chronic obstructive pulmonary disease in Virginia. Comparisons were also made to national trends and statistics. Data was gathered from many open reputable on-line sources available through various state and federal agencies. Virginia routinely meets 5 of …

Economic Evaluation Of Fungal Meningitis Outbreak Response In New River Valley: Local Health Department Perspective, Kaja M. Abbas, Nargesalsadat Dorratoltaj, Margaret L. O’Dell, Paige Bordwine, Thomas M. Kerkering, Kerry J. Redican

Frontiers in Public Health Services and Systems Research

Background: The multi-state fungal meningitis outbreak started in September 2012 in Tennessee. The cause of the outbreak was injection of contaminated lots of methylprednisolone acetate used in epidural spinal injections. Roanoke and New River Valley were the epicenter of this outbreak in Virginia, with two clinical centers having administered the contaminated injections to their patients. New River Health District, in coordination with hospitals, and state and federal agencies, deployed its resources to control the local impact of the outbreak.

Purpose: The objective of this study was to conduct an economic evaluation of the fungal meningitis outbreak response in New River …

A Brief History Of Public Health In Alexandria And Alexandria's Health Department, Krystyn R. Moon

History and American Studies

One of the central tenets of public health is the belief that the practice of medicine serves the broader community; however, the specific meaning of the phrase “public health” is a historically contingent one. Beginning in the late eighteenth century, the public included only white, bourgeois men who met in coffee houses and other such establishments to discuss politics, business ventures, and popular culture. Over the course of the nineteenth and twentieth centuries, the “public” included white working class men, the poor, women, and people of color. Eventually, politicians and medical doctors recognized that children should be included as part …

Developing A Comprehensive Youth Obesity Initiative For The State Of Virginia, Jennifer Thompson

Theses and Dissertations

The 2009 Virginia General Assembly Session unanimously voted to change the legislation governing the Virginia Tobacco Settlement Foundation to create the Virginia Foundation for Healthy Youth (VFHY) and incorporate childhood overweight and obesity prevention and reduction in its mission. In order to successfully meet the requirements of this legislation, VFHY needed assistance developing a strategic plan for the obesity initiative and a knowledge base to draw from. A comprehensive assessment of the status of Virginia’s childhood obesity problem was conducted, including the prevalence of the illness, the barriers existing to and the benefits to obesity prevention programs, the need for …

A Comparison Of Different Methods For Predicting Cancer Mortality Counts At The State Level, Corinne Wilson

Virginia Journal of Science

Cancer is a major health issue in the United States. Reliable estimates of yearly cancer mortality counts are essential for resourcing and planning. The American Cancer Society has used several methods of forecasting to estimate the future cancer burden and researchers are continually working to develop new methods with improved performance. There have been studies comparing different models for predicting the US cancer mortality counts. This study explores and compares several different models for cancer mortality count predictions at the state level, principally for the state of Virginia. Results of the comparisons appear to show the final improved model to …

The Association Between Adult Self-Reported Asthma & Potential Exposures To Asthma Triggers In Virginia Workplaces: An Ecological Study, Jeanette R. Bowman

Theses and Dissertations

Introduction: Work-related asthma (WRA) is thought to be the most common occupational lung disease in the U.S., but there is no standard case definition of WRA. Most states, including Virginia, do not require WRA diagnoses to be reported to health departments. At present, there is too little epidemiological data on WRA in Virginia to direct public health planning efforts. Objectives: The first objective of this study was to estimate potential exposure to workplace asthma triggers in each of Virginia's 35 health districts. The second objective was to examine associations at the health district level between workplace asthma triggers, other asthma …

Trend Analysis Of Automobile Collision Amongst 15-19 Year Olds In Virginia, 2000-2004, Imo F. Ndem

Theses and Dissertations

Purpose. This research study on automobile collision in Virginia amongst fifteen to nineteen (15-19) year olds looked into the trend analysis over a five (5) year period of 2000 to 2004. Trend analysis is usually done for aggregates of all injuries—either intentional or unintentional injuries, or both. The primary objective of this research study was to examine the trend in hospitalization rates and mortality rates for males and females independently. It further looked into the trend, if any, in hospitalization rates, mortality rates, and case-fatality rates, for both males and females combined. The different Tables illustrate the extent and the …

Examination Of Birth Outcomes With Mode Of Delivery For Breech Presentation, Kelly Marie Arey

Theses and Dissertations

Introduction: Approximately 3% to 4% of all pregnancies at term will have a fetus with a breech presentation. Studies have shown that the US has almost completely abandoned vaginal delivery for breech presentation through the influence of the "Term Breech Trial" (TBT) which concluded that a policy of planned caesarian section would reduce perinatal mortality, late neonatal mortality, and serious neonatal morbidity by approximately two-thirds for term fetuses. However, the recommendations are still being challenged by others.Objectives: The purpose of the study was to describe who in Virginia is having a vaginal delivery for a breech presentation and to determine …

Has Richmond, Virginia Become Safer In The Past Five Years (2002-2006)?: An Analysis Of Ambulance Data Regarding Penetrating Trauma Incidents, Ashleigh K. Mccabe

Theses and Dissertations

Introduction: The World Health Assembly declared violence as a worldwide public health problem. Homicides have been identified as a leading cause of death in the United States across all age groups. The national homicide rate for 2004 and 2005 are 5.5 and 5.6 per 100,000 population, respectively. The reported rates for Virginia are 5.2 (2004) and 5.6 (2005) per 100,000 population, showing a 16.9% increase. Richmond has been ranked as high as the sixth most dangerous among similar cities in the United States. This study examines penetrating trauma injuries identified through 9-1-1 calls as an indicator of the incidence of …

Oral Cancer Prevalence In Virginia, Karin C. Loftin, Michele Darby, Stacey Plichta, Sophie Thompson, Shreeram Kumar, Louis Abbey

Dental Hygiene Faculty Publications

Purpose. Oral and pharyngeal cancer affects 30,000 Americans a year and kills one fourth of those diagnosed. The primary risk factors for oral cancer are past or present cigarette and tobacco usage, and alcohol consumption in conjunction with tobacco use. Even though the prevalence of oral cancer is relatively low in the younger age groups, this group is most likely to benefit from intervention programs designed to change risky behavior such as smoking, and to prevent oral cancer in the later years. The goal of the study was to identify high-risk target areas for an oral cancer prevention program in …

A Needs Assessment For Annual Physical Examination For Selected Richmond Public School Children, Aimee Gibbs

Theses and Dissertations

Introduction: The following risk factors have found to be associated with inadequate health care and have been found to affect the well-being of children: racial or ethnic minority, poverty status, median family income, family structure of household, maternal education level, and parental employment status. Also, there has found to be health indicators including, teen pregnancy, asthma hospitalization, and lead poisoning cases that affect the well-being of a child and are associated with the presence of these risk factors in a population. Objectives: The objectives of this study is to (1) compare the presence of risk factors and health indicators in …

Predictors Of Primary Elective Cesarean Delivery Among Apparently Healthy Pregnant Women In Virginia, Brooke W. Rossheim

Theses and Dissertations

Objectives. The purpose of this cross-sectional study was to evaluate whether certain maternal variables were associated with the performance of a primary cesarean delivery rather than a spontaneous vaginal delivery among apparently healthy pregnant women in the Commonwealth of Virginia.Methods. This study utilized the 2004 Virginia Statistics File for Live Births which contained 103,830 records. From this dataset, the following groups of women were excluded: multiparous women, women who had had a previous delivery by any method, women with medical and obstetric problems, women with any labor and delivery complications, women with premature births and women with multiple gestations. The …

The Great Pestilence: Yellow Fever In Portsmouth, Virginia, 1855, Burden Susan Lundgren

Health Services Research Dissertations

In 1855, the town of Portsmouth, Virginia was devastated by an epidemic of yellow fever. Most citizens fled. Of those who remained, most became infected and a thousand died. The municipal government collapsed. In their place, a small organization known as the Portsmouth Relief Association assumed responsibility for ensuring the survival of the town. This organization managed the care of the sick, the burial of the dead, and the care of orphans. It was the sole agent receiving and allocating the funds and resources that poured into the community. Scarce food, drugs and other supplies were available only through the …

Trends In Canine Lyme Disease On The Eastern Shore Of Virginia, 2000-2005, Ellen Garrett Hillyer

Theses and Dissertations

Introduction: Lyme disease is caused by the tick-borne spirochete Borrelia burgdorferi. Research has shown that dogs can be used as sentinels for human infection of Lyme disease. The purpose of this 5-year, retrospective study was to determine if there was any evidence that the incidence of canine Lyme disease has increased between 2000 and 2005 in Accomack and Northampton counties. An increased incidence in Lyme disease in dogs may indicate an increased present or future risk of Lyme disease in humans.Methods: Cases of canine Lyme disease were identified via practice invoicing systems and dogs that received doxycycline were entered into …

Pressure Ulcer Development And Prevention In Long-Term Care Facilities In Virginia: A Descriptive Survey, Audrey D. Arthur

Community & Environmental Health Theses & Dissertations

The development of pressure ulcers is a common occurrence among older persons who may be temporarily immobilized or confined to a bed. An estimated 60,000 deaths annually can be attributed to complications from pressure ulcers. Guidelines recommended by the Agency for Health Care Policy and Research have been disseminated nationally and continue to be recommended as the standard of care for pressure ulcer prevention. In spite of the use of the recommended guidelines, pressure ulcer rates persist, suggesting there are other factors contributing to pressure ulcer development in long-term care facilities.

A survey was conducted to investigate which provider related …