Community Health and Preventive Medicine Commons^™

Five Corridors: A Community Health Needs Assessment Of Horry County, Stephen Borders, Hayley Bilko, Molly Craig, Olivia Guthrie, Ashley Mcconnell, Emily Mcgowan, Anna Quick, Abigail Rike, Makayla Wilson

Public Health

This report presents a Community Health Needs Assessment (CHNA) of Horry County, South Carolina. Its central analytical contribution is a five-corridor framework derived from k-means cluster analysis of the county's 76 residential census tracts, drawing on social and economic indicators from the American Community Survey and health estimates from the CDC PLACES program. The analysis organizes the county into five distinct community types — Affluent Coastal Retirement, Moderate Coastal Retirement, Inland Rural/Suburban Transitional, Concentrated Disadvantage, and Hispanic Hospitality Worker — each with a characteristic profile of social and health conditions.

Within this framework, the assessment examines a range of social …

Assessment Of Health Disparities Among Community Clinic Patients In Southern New Jersey, Hetasvi Saraiya, Priyal Gajera, Mahhum Naqvi, Nils Brolis

Rowan-Virtua Research Day

Introduction:

The Rowan Community Health Center (RCHC) is a student-run free clinic that provides primary care services to uninsured and underserved populations in southern New Jersey. Access to quality healthcare remains a persistent challenge for these communities due to social and economic barriers1 . This study aims to identify and analyze the most common health disparities and barriers to care. The primary outcome of this study was to assess health disparities and barriers to care, secondary outcomes included characterizing chief complaints and identifying alternative care options patients would pursue if not seen at the clinic

Methods:

This survey-based study was …

Addressing Diabetes Risk Through Preventative Education In Multicultural And Economically Underserved South Jersey Communities, Bavly Nagy Halaka, Janet Jimenez-Merino, Izayah Diaz

Rowan-Virtua Research Day

BACKGROUND: Diabetes and prediabetes affect a substantial and growing portion of the U.S. population, with adolescent prediabetes rates more than doubling from 11% in 1999 to 28% in 2018. In multicultural and economically underserved South Jersey communities, structural barriers including food insecurity, limited access to preventive healthcare, and language gaps make early detection and prevention particularly difficult. We aimed to assess diabetes risk, management behaviors, and preferred education formats among a Camden-area bilingual community, and to identify culturally responsive intervention strategies.

METHODS: We conducted a literature review utilizing data from the CDC, NJ Department of Health, NJSHAD, and the U.S. …

Barriers To Asthma Management And Specialty Care Among Low-Income Families In South Jersey, Sally Park, Courtney Ray-Fofana, Christal Onwuegbule

Rowan-Virtua Research Day

Asthma is a chronic respiratory condition that remains a significant public health concern, particularly among low-income and underserved populations. This poster presents a focused review of existing literature and publicly available data to examine barriers to asthma management and access to specialty care in South Jersey, with emphasis on counties such as Camden, Atlantic, and Cumberland.

Data were synthesized from sources including PubMed, the New Jersey Department of Health, and the National Institutes of Health to evaluate asthma prevalence, disease burden, and the impact of social determinants of health. Current estimates suggest that approximately 8.8%–9.0% of adults in New Jersey …

Exploring Systemic Challenges In The Western North Carolina Dental Safety Net: A Qualitative Analysis, Blaire Mirmow, Bill Milner, Nadia Laniado

Journal of Appalachian Health

Introduction: Despite statewide growth, rural communities in Western North Carolina (WNC) face persistent barriers to oral health care driven by chronic dental workforce shortages and systemic geographic disparities. Within this Appalachian region, the dental safety net serves as a vital yet strained support system, struggling with limited financial resources and a lack of provider participation that leaves many underserved populations without essential oral health services.

Purpose: This study aims to explore the experiences of individuals working within the WNC dental safety net to identify barriers and strategies required to strengthen the delivery of oral health care in high-need rural settings. …

A Qualitative Analysis Of Progress, Successes, And Challenges Among Indiana Recipients As Part Of A National Initiative To Reduce Covid-19–Related Health Disparities, Marla Winters, Lily Darbishire

Purdue Journal of Service-Learning and International Engagement

In light of the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) provided funding to states as part of the CDC Disparities Grant initiative. The aim of the funding was to reduce chronic disease and COVID-19–related health disparities among vulnerable communities through four unique strategies. Funding was awarded to the Indiana Department of Health (IDOH) to begin an Indiana chapter of this initiative, called Indiana Healthy Opportunities for People Everywhere (I-HOPE). From 2021 to 2023, the IDOH provided I-HOPE funding to local communities (subgrantees) to support the design and implementation of programs to improve community health. For example, …

Overview Of Aboriginal And Torres Strait Islander Health Status 2025, Australian Indigenous Healthinfonet

Research outputs 2022 to 2026

This Overview provides a summary of the most recent indicators of the health and wellbeing of Aboriginal and Torres Strait Islander people (of all ages, where data are available). The topics included in the Overview cover chronic health conditions which are featured on the HealthInfoNet website. Over the years as additional funding has been obtained and in consultation with HealthInfoNet networks, more topics have been covered on the website and are now included in the Overview. The topics aim to reflect the status of Aboriginal and Torres Strait Islander health over this period and going forward.

Long-Lasting Impact Of Public Health Dentistry, Michal Herman Dds, Facd

Journal of the American College of Dentists

This article reflects on the enduring impact of public health dentistry through the author’s 25-year professional journey serving underserved and marginalized communities. It examines persistent barriers to equitable oral health care, including workforce shortages, inadequate insurance coverage, racial disparities, and limited access in rural and low-income populations. Drawing on experiences in nonprofit and community dentistry, the article highlights the importance of mentorship, advocacy, leadership, and community engagement in addressing oral health inequities. It argues that public health dentistry represents a form of professional altruism grounded in service and social responsibility, and calls on dental professionals to expand access, support workforce …

Examining The Barriers To Healthcare Among Native Hawaiian And Pacific Islander Populations Living In Hawaii, Gracie L. Kaye

Honors Undergraduate Theses

The state of Hawaii was annexed by the United States in 1898, and served as a starting point from which the U.S. influenced Hawaii's socioeconomic conditions and healthcare access. The literature review examines healthcare views and outcomes among Native Hawaiian and Pacific Islander residents, utilizing various tools and resources to investigate how these factors have impacted overall health statistics and the reasons behind these trends. Results found that the western colonization of the island and the disease outbreaks led to an initial mistrust of “western ideas.” Additionally, due to long-standing cultural beliefs, there is a natural preference for traditional cultural …

Geospatial Analysis Of Breast Cancer Incidence, Mortality, And Access To Screening In Rural And Appalachian Virginia, Jennifer Osher, Caleb Brown, Phillip Nichols, Tariq Ayubi, Jeremy Powers

Journal of Appalachian Health

Introduction: Breast cancer is the most common malignancy among women in the United States (U.S.), despite recent survival rates improving nationally. However, rural and Appalachian regions have experienced slower mortality declines. These communities face unique health care-related challenges that may contribute to observed disparities.

Purpose: The purpose of this study is to assess differences in breast cancer incidence, mortality, and mortality-to-incidence ratio (MIR) between Appalachian and non-Appalachian counties, as well as rural and non-rural counties in Virginia (VA). Furthermore, we aim to evaluate whether availability of mammography is associated with these differences.

Methods: County-level breast cancer incidence and mortality data …

Impact Of Community Health Needs Assessments As Barriers To Chronic Disease Prevention: A Comparative Study, Marissa E. Woelm Ms.

Honors Thesis

Community health needs assessments (CHNAs) are vital tools for identifying population health priorities through monitoring chronic diseases and conditions; however, their effectiveness in preventing chronic diseases remains debated. This comparative study examines CHNAs from sixteen South Dakota hospitals across Avera, Sanford, Monument Health, and independent systems to evaluate their role in preventing chronic diseases. Analysis reveals significant challenges, including biased data sampling, limited community engagement, small survey samples, and inconsistent implementation strategies. While CHNAs effectively identify mental health, cancer, and obesity as the top community concerns alongside several other diseases like diabetes and kidney disease, most reports lack specific timelines …

Public Perception About Covid-19 Vaccine Hesitancy In South Central Nebraska, Rita Nnenne Oparaocha

Biology Theses, Dissertations, and Student Creative Activity

The COVID-19 pandemic created a shift in the trajectory of vaccination hesitancy, altering risk perceptions and vaccination attitudes among individuals in rural communities. The 5C framework highlights confidence, complacency, constraints, calculation, and collective responsibility as influencing factors of vaccine hesitancy. This study assessed the proportion of adults who refused COVID-19 vaccination and identified the individual reasons for hesitancy among those who refused the COVID -19 vaccines in South Central Nebraska. Data was analyzed from a local cross-sectional public health survey administered to 2,034 adult participants over a six-month period (March-August 2024), including 91 respondents who were from outside the seven-county …

Development And Applications Of A Health Equity Summary Score Using The Medical Expenditure Panel Survey, Ronald R. Sanchez

Dissertations and Theses

Despite sustained national efforts, disparities in healthcare delivery persist among racial and ethnic minorities, low-income individuals, and socially at-risk populations. Monitoring modifiable aspects of care delivery, such as the structures and processes that health systems can directly improve, is a key strategy for addressing these gaps. However, most measures evaluate modifiable aspects of care delivery separately, limiting understanding of how improvements in one domain reinforce the other and how their combined effect influences equitable care.

This dissertation addresses this gap by combining patient experience and clinical quality, two modifiable aspects of care that captures how patients interact with the health …

21st-Century Dental Public Health: Revisiting The Role Of Community Water Fluoridation, Larry Williams, Preetha Kanjirath

Journal of the American College of Dentists

Community water fluoridation (CWF) has been celebrated as a major public health achievement, significantly reducing dental caries and narrowing oral health disparities. While historically effective, today’s fluoride exposure landscape has shifted, with multiple sources contributing to cumulative intake. This article reviews the scientific foundation, mechanisms of action, public health benefits, and ethical considerations surrounding CWF, alongside real-world outcomes from policy reversals. It examines contemporary concerns, including potential neurodevelopmental risks and vulnerable populations, and calls for recalibrated policies that maintain caries prevention benefits while monitoring total fluoride exposure to ensure safety in modern contexts.

Understanding Rural Health Through Rae Garringer's Country Queers: A Love Letter, Bradley A. Firchow

Journal of Appalachian Health

Rae Garringer’s Country Queers: A Love Letter examines the experiences of queer individuals in rural America, emphasizing the relationship between place and identity. Through oral histories, the book presents perspectives on community, resilience, and healthcare access. While not centered on medical care, it highlights challenges in obtaining affirming services in rural areas. Garringer’s experience as a standardized patient provides additional context on healthcare gaps. For public health professionals, Country Queers offers insight into the structural and social factors affecting rural LGBTQ2+ populations, contributing to a broader understanding of community health and identity in Appalachia and similar regions.

2024 Health Equity Impact Report, Children's Health, Stormee Williams

Publications

The Health Equity Impact Report from Children’s Health outlines the organization’s strategy and progress in advancing equitable pediatric care. The report highlights efforts to identify and address social determinants of health—such as food insecurity, housing instability, and access to transportation—through systemwide screening and targeted interventions.

Patient-Clinician Communication In The Appalachian Region: A Scoping Review, Kawther Al Ksir, Hadii M. Mamudu, Chidiebube J. Ugwu, Emily K. Flores, Tracy Fasolino, Holly Wei, Rick L. Wallace, Florence M. Weierbach

Journal of Appalachian Health

Introduction: Effective communication between patients and clinicians is a critical component of quality health care, influencing disease prevention, management, and outcomes. In regions with unique socioeconomic and geographic challenges, communication barriers can further exacerbate health disparities. Understanding the factors that facilitate or hinder patient-clinician communication is essential for developing targeted interventions that improve health care delivery.

Purpose: This review explores the existing literature on patient-clinician communication concerning cardiovascular disease (CVD) in the Appalachian Region with the aim to understand existing gaps and interventions.

Methods: PubMed and Web of Science databases were utilized to conduct a systematic search. The Population, Concept, …

Heart To Heart: Exploring Why Cardiovascular Risk Is Higher In South Asians, Jasjeet Kaur Dhaliwal

Rowan-Virtua Research Day

Cardiovascular disease (CVD) is a leading global cause of mortality, but South Asians experience a disproportionately high burden of disease, often developing CVD at younger ages and with lower body mass indices compared to other populations. This project explores the underlying genetic and lifestyle factors contributing to elevated cardiovascular risk in South Asians, aiming to highlight the need for targeted prevention strategies and policy reforms.

A literature review was conducted using peer-reviewed studies, meta-analyses, and reviews published between 2007 and 2024. After screening 47 initial articles, 18 were selected for analysis based on their relevance to genetic and lifestyle risk …

Differences In Self-Reported Cancer Measures Persist Despite Covid-Era Improved Insurance Access, Ismail Mustafa Aijazuddin, Ammar M. Sukari

Medical Student Research Symposium

Background:

The Covid-19 pandemic has challenged healthcare access, jeopardizing cancer-related health measures. However, pandemic-era health policies led to increased health insurance coverage across most counties in the United States. This study aims to explore relationships between uninsured rates and cancer prevalence and screening behaviors.

Methods:

Data were collected from the CDC’s PLACES datasets for the 2021 (collected 2018-2019) and 2024 (collected 2022) release years and merged at the county level. For both 2021 and 2024 releases, Pearson’s correlation and student’s t-test were performed between uninsured rates and the age-standardized rates of the following at the county level: cancer prevalence, colorectal …

Socioeconomic And Demographic Factors In Genetic Testing Utilization Among Advanced Prostate Cancer Patients: A Retrospective Single-Institution Study, Alexandra T. Skowron Ms, Karen Childers, Courtney M. Rose Ms, Kyle C. Mcelyea Md, Avery K. Supernois Bs, Yousuf Hussain, Mohammed Baseer Ms, Sunita Ghosh Phd, Clara Hwang Md

Medical Student Research Symposium

Introduction

Germline genetic testing in patients with advanced prostate cancer (PCa) is underutilized. Socioeconomic and demographic factors are hypothesized to affect low rates of testing, but causality has not been established. This single institution, retrospective study aimed to understand what barriers may affect germline genetic testing for PCa patients.

Methods

The Henry Ford Health (HFH) tumor registry was queried for new diagnoses of stage 3, 4A and 4B PCa from 2017-2022. Census tract levels were assigned using patient addresses and neighborhood-based geocoding was completed for Median household income (gMHI) and Social vulnerability index (SVI). gMHI and SVI were divided into …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Changes In The Perceptions Of The Neighborhood Environment And Physical Activity Patterns Among Mexican Americans On The Texas-Mexico Border, Natalia I Heredia, Soo Kyung Park, Minjae Lee, Lisa Mitchell-Bennett, Paul Yeh, Rose Gowen, Arturo Rodriguez, Miryoung Lee, Belinda M Reininger

Faculty, Staff and Student Publications

INTRODUCTION: Little research on the association of neighborhood environment with physical activity in resource-poor communities has been done. This study assessed changes in perceptions of the neighborhood environment and the association between those perceptions and physical activity in Mexican Americans on the Texas-Mexico border in an area where there would be community efforts to enhance pedestrian and cycling infrastructure and programming.

METHODS: We analyzed data from a population-based cohort of Mexican American individuals on the Texas-Mexico border. From 2008 to 2018, interviewer-administered questionnaires were used to collect perceptions of neighborhood environment and physical activity at baseline, 5- and 10-year follow-ups, …

Feasibility Of Fit24, A Digital Diabetes Prevention Program For Hispanic Adolescents: Qualitative Evaluation Study, Erica G Soltero, Salma M Musaad, Teresia M O'Connor, Debbe Thompson, Keith Norris, Bettina M Beech

Faculty, Staff and Students Publications

BACKGROUND: Digital health interventions are promising for reaching and engaging high-risk youth in disease prevention opportunities; however, few digital prevention interventions have been developed for Hispanic youth, limiting our knowledge of these strategies among this population.

OBJECTIVE: This study qualitatively assessed the feasibility and acceptability of Fit24, a 12-week goal-setting intervention that uses a Fitbit watch (Fitbit Inc) and theoretically grounded SMS text messages to promote physical activity and sleep among Hispanic adolescents (aged between 14 and 16 years) with obesity.

METHODS: After completing the intervention, a subsample of youth (N=15) participated in an in-depth interview. We categorized the themes …

Unveiling The Impact: Structural Racism And Childhood Lead Exposure's Health Consequences In Philadelphia, Mahhum Naqvi, Mahrukh Naqvi, Justin Stout, Colton Spencer

Rowan-Virtua Research Day

Childhood lead exposure poses a significant risk to health and well-being, adversely affecting brain function, nervous system development, and behavioral patterns. This study examines the health disparities and inequities associated with childhood lead exposure in Philadelphia, focusing on structural racism and residential segregation as crucial lenses for analysis. By delving into the sociocultural context of lead exposure, this study underscores the imperative of collaborative efforts among stakeholders to safeguard Philadelphia's most vulnerable populations. Healthcare professionals and policymakers play pivotal roles in enhancing funding and prevention strategies. Addressing this issue through the prism of structural racism allows for the identification and …

Diabetes Health Education For South Jersey Communities, Heaven Chu, Sarah Tamous, Ashhabal Kavvi, Amin Khan

Rowan-Virtua Research Day

Diabetes is a chronic health condition that hinders the body’s metabolic process using insulin to maintain glycemic homeostasis. It is prevalent worldwide, with about 10% of the global adult population affected. Socio-economic and cultural factors and determinants make diabetes and diabetes management more of a health risk for certain populations rather than others. The prevalence of diabetes in the United States is higher than the global average and the risk factors disproportionately affect disadvantaged communities.

This study was designed to investigate health disparities in diabetes among a diverse population sample. The study included researching the disparities of diabetes patients in …

Health Disparities Among Adults With Disabilities, Kirsten Carlberg, Madison Plone, Chrismely Castro, Nayarith Lopez

Rowan-Virtua Research Day

Background: According to the Centers for Disease Control (CDC), 27% of adults in the United States (US) live with a disability. These disabilities are often accompanied by poorer health outcomes with adults with disabilities reporting higher rates of obesity, diabetes, and cardiovascular disease. This review aims to characterize rates of disability among young adults in Camden County, New Jersey.

Methods: Data was collected from the CDC and United States Census and analyzed using Microsoft Excel 365.

Results: In 2022, 9.7% of residents of Camden County aged 18-34 were reported as disabled while the rate was 8.3% of US residents nationwide. …

Barriers In Health Care Leading To High Maternal Mortality Rates In Southern New Jersey, Katarina Rusinak, Muznah Khan, Ava Dinardo, Nayarith Lopez

Rowan-Virtua Research Day

Maternal mortality remains a significant issue in New Jersey, particularly in the Southern counties where rates are alarmingly high. This study investigates barriers faced by mothers in these areas, utilizing data from state health departments, as well as the CDC. Findings reveal clear disparities in healthcare access and resources, exacerbated by high poverty and rural settings. Proposed interventions include educational posters and community workshops to empower expecting mothers and families. However, challenges such as low attendance and limited effectiveness of interventions underscore the need for comprehensive, sustainable solutions to tackle maternal mortality in Southern New Jersey.

Ensuring Equitable Application Of Interventions To Vulnerable Subpopulations In The Kentucky Consortium For Accountable Health Communities (Kc-Ahc), Jing Li, Jessica M. Clouser, Akosua Adu, Aiko Weverka, Nikita Vundi, Terry D. Stratton, Mark V. Williams

Journal of Appalachian Health

Introduction: The Centers for Medicare and Medicaid Services (CMS) has funded the Accountable Health Communities (AHC) model to test whether systematically identifying and addressing the health-related social needs (HRSNs) of individuals would impact healthcare utilization and total cost of care for Medicare and Medicaid beneficiaries. Toward this effort, AHCs implement screening, referral, and community navigation services in their local areas. There are 28 CMS-funded AHCs nationwide, including the Kentucky Consortium for Accountable Health Communities (KC-AHC).

Purpsoe: This study aims to assess the equity of KC-AHC model activities in three vulnerable sub-populations: dual enrollees, disabled individuals, and women.

Methods: Twenty-eight primary …

Assessing Lung Cancer Screening Protocols And Outcomes: A Comparative Analysis Between Indonesia And The United States, Priscilla Sitorus

Nursing | Student Research Posters

After losing a loved one to lung cancer, it can be difficult to process, especially when the diagnosis could have been made earlier. However, some may struggle to trust a healthcare system when screening protocols and care vary significantly, to the extent that it may seem unclear. Amongst both men and women, lung cancer is the worldwide leading cause of cancer-related mortality (World Health Organization, 2023), thus further creating a considerable amount of challenges that not only takes part in communities, but the overall healthcare system. Despite the increasing rate of lung cancer, Indonesia has limited screening programs available for …

Physical Activity Barriers And Facilitators In African American Women: A Social Ecological Models Perspective, Leah Ann Carter

LSU Doctoral Dissertations

African American (AA) women experience poor health outcomes that can be addressed by increasing PA engagement. Understanding how PA barriers and facilitators occur at multiple levels of influence may help tailor PA interventions for AA women. Although prior work has established barriers to PA that are unique to African American women, few studies identify the sociocultural norms associated with these impediments. Little is known about the cultural implications of barriers such as haircare maintenance, and public policy.

The primary aim of this dissertation was to capture AA women’s voice about PA barriers and facilitators using the social ecological model framework. …