Community Health and Preventive Medicine Commons^™

Understanding And Promoting Racial Diversity In Healthcare Settings To Address Disparities In Pandemic Crisis Management, Azza Sarfraz, Zouina Sarfraz, Alanna Barrios, Kuchalambal Agadi, Sindhu Thevuthasan, Krunal Pandav, Manish Kc, Muzna Sarfraz, Pedram Rad, George Michel

Department of Paediatrics and Child Health

Background: Health disparities have become apparent since the beginning of the COVID-19 pandemic. When observing racial discrimination in healthcare, self-reported incidences, and perceptions among minority groups in the United States suggest that, the most socioeconomically underrepresented groups will suffer disproportionately in COVID-19 due to synergistic mechanisms. This study reports racially-stratified data regarding the experiences and impacts of different groups availing the healthcare system to identify disparities in outcomes of minority and majority groups in the United States.
Methods: Studies were identified utilizing PubMed, Embase, CINAHL Plus, and PsycINFO search engines without date and language restrictions. The following keywords were used: …

Discordance In Perceptions Of Barriers To Breast Cancer Treatment Between Hispanic Women And Their Providers, Swapna Reddy, Mary Saxon, Nina Patel, Matthew Speer, Tiffany Ziegler, Nirali Patel, Madison Ziegler, Stephany Esquivel, Andrea Daniella Mata, Asha Devineni, Pooja Paode, Nitika Thawani, Subhakar Mutyala

Journal of Patient-Centered Research and Reviews

Despite comparable screening and incidence rates that are 26% below that of non-Hispanic Whites, Hispanic women present with breast cancer at more advanced stages of disease, representing a continuing and troubling health disparity for this population. Reducing these disparities warrant more innovative research approaches to better understand perspectives of Hispanic patients regarding barriers to treatment and how these perspectives compare to those of their providers. A pilot qualitative study was conducted at a major urban cancer center in Arizona that measured both patient and provider perspectives regarding barriers to treatment. Through a multimethod qualitative analysis, researchers surveyed patients and providers …

Covid-19 Treatment Resource Disparities And Social Disadvantage In New York City, Jason A. Douglas, Andrew M. Subica

Health Sciences and Kinesiology Faculty Articles

Black and Hispanic communities in the U.S. have endured a disproportionate burden of COVID-19-related morbidity and mortality. Racial and ethnic health disparities such as these are frequently aggravated by inequitable access to healthcare resources in disadvantaged communities. Yet, no known studies have investigated disadvantaged communities' access to COVID-19-related healthcare resources. The current study accordingly examined racial and ethnic differences in (1) April 2020 COVID-19 total and positive viral test rates across 177 New York City (NYC) ZIP Code Tabulation Areas (ZCTA); and (2) November 2019–April 2020 licensed and intensive care unit (ICU) hospital bed access across 194 NYC ZCTAs. Pairwise …

Disparities In Health Behavior Risks Among Employed And Unemployed Black And White Older Adults, M. Courtney Hughes, Tamara A. Baker, Hansol Kim

Journal of Health Disparities Research and Practice

Objective: Examine health behavior risk rates and disparities in health behavior risks related to race and employment among older adults. Methods: A cross-sectional analysis of a representative sample of noninstitutionalized adults aged 65 and older (150,669 in 2015 and 168,011 in 2016) from the Behavioral Risk Factor Surveillance System. Self-reported health behavior risks were measured as well as multiple logistic regression analyses assessing the independent effects of demographic variables on health behavior risks. Results: Employed older adults have greater health behavior risks than unemployed older adults. Black employed older adults have greater health behavior risks than Black unemployed older adults …

A Lung Cancer Screening Personalized Decision-Aid Improves Knowledge And Reduces Decisional Conflict Among A Diverse Population Of Smokers At An Urban Academic Medical Center, Madeline Kaufman, Nilan Schnure, Andrea Nicholson, Frank Leone, Carmen Guerra

Journal of Health Disparities Research and Practice

Introduction: Few lung cancer screening decision aids have been tested in diverse populations. The study objective was to determine whether the online decision aid www.shouldiscreen.com impacts knowledge of and decisional conflict around lung cancer screening in a diverse population.

Methods: Eligible patients had significant smoking histories, were at increased risk for lung cancer (ages 45-80, >20 pack-years, smoking within last 15 years) and had no history of prior lung cancer or screening. Data was collected and analyzed in 2017.

Results: 40 patients were enrolled: 80% were female, 62.5% black, 33% white, and 48% had a high school …

Hs-4100 - Global Health Issues, Jose Nanin

Open Educational Resources

This syllabus includes OER materials and college policies for a fully online course that takes a comprehensive look at global health issues. In this course, the assessment of health issues are analyzed from various perspectives including geographic, ethnic, religious, human rights, socioeconomic, social, cultural, and political influences. Students learn about global environmental causes and consequences of infectious diseases, major diseases, mental illness, natural disasters, malnutrition, drug and alcohol addiction, violence and injuries.

Coh-2000 - Community Health Interventions, Jose Nanin

Open Educational Resources

This syllabus includes OER materials and college policies for a fully online course that exposes students to a range of health promotion and disease prevention and management strategies used by health specialists to address community health challenges. Through readings and videos, as well as online course assignments and discussions, students learn about planning and designing interventions to improve the health of specific priority populations and communities-at-large.

Black Women Survive Breast Cancer With Community-Based Care, Shelley I. White-Means, Jill Dapremont, Barbara D. Davis, Tronlyn Thompson

Faculty Presentations

PURPOSE Community-based breast cancer support agencies who address non-medical, social determinants of health needs that serve as barriers to maximizing breast health outcomes may play a vital role in mitigating breast cancer mortality. They share a common emphasis on addressing social, economic, and psychological needs of breast cancer survivors and those at risk of breast cancer. This paper is third in a series of papers exploring why the rate of breast cancer mortality is two times higher for African American women than white women in Memphis. We sought insights from community-based breast cancer support agencies because they have a close-up …

Examining The History Of Racial Groups To Understand Health Disparities In Monterey County, Virginia Murillo

Capstone Projects and Master's Theses

The Monterey County Health Department’s Health Equity Scholars Academy aspires to train health workforce leaders to prioritize equity into services. Health inequities occur when there are systematic differences in the health statuses of different populations. These disparities perpetuate negative health outcomes for minority groups. In Monterey County, too few public employees are aware of the types and pervasiveness of health inequities experienced by a significant proportion of the population. A timeline was developed to provide a more accessible way to educate public employees about significant events and policies affecting Monterey County resident’s health. Content from the timeline has been incorporated …

¡Sí, Yo Puedo Vivir Sano Con Diabetes! A Self-Management Randomized Controlled Pilot Trial For Low-Income Adults With Type 2 Diabetes In Mexico City, Robin Whittemore, Mireya Vilar-Compte, Selene De La Cerda, Roberta Delvy, Sangchoon Jeon, Soraya Burrola-Méndez, Mariana Pardo-Carrillo, Annel Lozano-Marrufo, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

Background: Type 2 diabetes (T2D) is a worldwide epidemic and a leading cause of death in Mexico, with a prevalence of 15.9%, and >70% of diagnosed adults have poor glycemic control [glycated hemoglobin (HbA1c) >7.5%]. We developed a diabetes self-management education program contextualized to the study population, including dietary preferences, health literacy, and health system.

Objectives: We aimed to evaluate the efficacy of a self-management + text message program (¡Sí, Yo Puedo Vivir Sano con Diabetes!) on primary (HbA1c), and secondary behavioral (self-management), clinical, and psychosocial outcomes in adults with T2D in Mexico City.

Methods: Participants were recruited at public …

Assets And Unmet Needs Of Diverse Older Adults: Perspectives Of Community-Based Service Providers In Minnesota, Hayley R. Mccarron, Alana Wright, Rajean P. Moone, Traci Toomey, Theresa L. Osypuk, Tetyana Shippee

Journal of Health Disparities Research and Practice

This paper examines assets and unmet needs of diverse older adults and highlights the need for programs and policies that address the social determinants of health. The United States is undergoing an unprecedented demographic shift, becoming increasingly diverse and aging rapidly. Given these changing demographics, it is important to understand the strengths and needs of our diverse population of older adults. This study captures perspectives of diverse service providers who work with older adults in communities, to identify existing assets as well as unmet needs and challenges facing diverse older adults in Minnesota. Qualitative data were collected using key informant …

Evaluation Of A Drowning Prevention Campaign In A Vietnamese American Community, Linda Quan Md, Elena Shephard Md, Elizabeth Bennett Ches, Mph

International Journal of Aquatic Research and Education

To address Washington State’s high pediatric fatal drowning rates in Asian children, especially Vietnamese, we conducted and evaluated a community water safety campaign for Vietnamese American families. Working with community groups, parks departments and public health, we disseminated three messages (learn to swim, swim with a lifeguard, and wear a life jacket) in Vietnamese media and at events, increased access to free/low cost swim lessons and availability of lifeguarded settings and life jackets in the community. Parents completed 168 pre- and 230 post-intervention self-administered, bilingual surveys. Significantly more post-intervention compared to pre-intervention respondents had heard water safety advice …

Understanding Facilitators And Barriers To Dietary Management Of Type 2 Diabetes Among Hispanic Men: Perceptions Of Health Professionals, Leah Galitzdorfer, Melissa Fuster Phd, Pamela Koch Edd, Rd

Publications and Research

Objectives: Hispanic Americans have a higher prevalence of Type 2 Diabetes (T2DM) compared to non-Hispanic whites, and are at greater risk for developing diabetes-related complications. Barriers and facilitators to dietary managment of T2DM among this population may be particularly influenced by culture and gender, where traditional gender roles and values prevent Hispanic men from engaging in healthy dietary self-management behaviors. Despite this, research focusing on dietary management of T2DM among Hispanic men is scant. This study aimed to assess perceived barriers and facilitators, as well as perceived influences of culture and gender on the dietary management of T2DM among Hispanic …

Improving Community Advisory Board Engagement In Precision Medicine Research To Reduce Health Disparities, Erin Connors, Rebecca Selove, Juan Canedo, Maureen Sanderson, Pamela Hull, Marilyn Adams, Ila Mcdermott, Calvin Barlow, Denice Johns-Porter, Caree Mcafee, Karen Gilliam, Oscar Miller, Nora Cox, Mary Kay Fadden, Stephen King, Hilary Tindle

Journal of Health Disparities Research and Practice

Community Advisory Boards (CABs) are used in efforts to reduce health disparities; however, there is little documentation in the literature regarding their use in precision medicine research. In this case study, an academic-CAB partnership developed a questionnaire and patient educational materials for two precision smoking cessation interventions that involved use of genetic information. The community-engaged research (CEnR) literature provided a framework for enhancing benefits to CAB members involved in developing research documents for use with a low-income, ethnically diverse population of smokers. The academic partners integrated three CEnR strategies: 1) in-meeting statements acknowledging their desire to learn from community partners, …

The Right To Vote, The Right To Health: Voter Suppression As A Determinant Of Racial Health Disparities, Anna K. Hing

Journal of Health Disparities Research and Practice

Civic participation is beneficial to one’s health. Conversely, being unable to participate, such as being unable to vote, may be detrimental for health. Barriers that prevent voting and civic participation, which constitute voter suppression, disproportionately impact people of color. Therefore, voter suppression may explain intractable racial health disparities. However, few studies have examined the connection between voter suppression and health. In consideration of the frequent, and increasing, reports of voter suppression in recent elections, including the rise in voter identification laws, the reduction in early voting opportunities, and the closing of polling places, the field of public health should address …

Covid-19’S Effects On New York City’S Food System: Lessons For Public Health Responses, Nevin Cohen, Nicholas Freudenberg

Publications and Research

The COVID-19 pandemic disrupted food availability and affordability and changed the daily food practices of New Yorkers. Eleven surveys of samples of 1,000 New York City adults from March 13 through June 28 illustrate three effects on food access and food insecurity: (1) closing restaurants, schools, and other sources of prepared foods reduced access and changed shopping patterns, food expenditures, and diets; (2) economic disruption exacerbated food insecurity and increased demand for food assistance; and (3) altered food practices affected diets and health. These impacts were disproportionately borne by vulnerable populations. This paper reports survey responses illustrating the effects of …

Disparities In Health Behavior Risks Among Employed And Disparities In Health Behavior Risks Among Employed And Unemployed Black And White Older Adults, M. Courtney Hughes, Tamara A. Baker, Hansol Kim

Faculty Articles, Papers, and Other Scholarship

Objective: Examine health behavior risk rates and disparities in health behavior risks related to race and employment among older adults.

Methods: A cross-sectional analysis of a representative sample of noninstitutionalized adults aged 65 and older (150,669 in 2015 and 168,011 in 2016) from the Behavioral Risk Factor Surveillance System. Self-reported health behavior risks were measured as well as multiple logistic regression analyses assessing the independent effects of demographic variables on health behavior risks.

Results: Employed older adults have greater health behavior risks than unemployed older adults. Black employed older adults have greater health behavior risks than Black unemployed older adults …

Examining Racial & Ethnic Disparities In The Reach Of The Medicare Shared Savings Program, Lindsey Arneson

Capstone Experience: Master of Public Health

It is important to understand the quality of health care for racial and ethnic minorities covered under the largest U.S. government-run insurance program, Medicare, because the demographics of the U.S. are becoming older and more diverse. A new value-based program under Medicare is the Shared Savings Program (MSSP), which creates incentives to improve care quality and health outcomes for Medicare beneficiaries with a specific focus on increasing the provision of preventive care services. This capstone project aims to understand the representation of racial/ethnic minority Medicare beneficiaries, namely African Americans/Blacks and Hispanics/Latinxs, that receive care from providers or facilities (i.e., Accountable …

Challenges To Diabetes Self-Management For Adults With Type 2 Diabetes In Low-Resource Settings In Mexico City: A Qualitative Descriptive Study, Robin Whittemore, Mireya Vilar-Compte, Selene De La Cerda, Denise Marron, Rosabelle Conover, Roberta Delvy, Annel Lozano-Marrufo, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

Background: The prevalence of type 2 diabetes (T2D) in Mexico is one of the highest in the world, with high morbidity and mortality, and difficulty meeting glycemic targets. The purpose of this study was to identify the challenges for T2D self-management as perceived by both adults with T2D and health care providers in primary health clinics from Seguro Popular in Mexico City.

Methods: This was a qualitative descriptive study conducted in three Seguro Popular primary care clinics in Mexico City using convenience sampling. Semi-structured interviews were conducted with participants and data were analyzed using a content analysis approach.

Results: The …

Building Health Equity One Institution At A Time: The Research Infrastructure In Minority Institutions Project, Laura H. D'Anna, Dennis G. Fisher, Lyka Eunice F. Trinidad, Carol Canjura, Jefferson L. Wood

Journal of Health Disparities Research and Practice

Developing a well-trained workforce interested in, and prepared for, conducting health equity research is an important national priority. Scientists from Minority-Serving Institutions (MSIs) bring unique perspectives and experiences with racial, ethnic and social inequities in health and health status but often lack access to training and mentoring opportunities, which is crucial for increasing the diverse pool of investigators who are adequately prepared to conduct health disparities research and to compete for National Institutes of Health research funding. The focus of the California State University, Long Beach (CSULB) Research Infrastructure in Minority Institutions (RIMI) Project was to: (a) enhance CSULB’s infrastructure …

“You Come Back To The Same Ole Shit:” A Qualitative Study Of Smoking Cessation Barriers Among Women Living With Hiv: Implications For Intervention Development, Faith E. Fletcher, Damon J. Vidrine, Meredith K. Buchberg Trejo, Yamile' Molina, Beverly E. Sha, Brenikki R. Floyd, Noreen Sarhene, Jamesetta Mator, Alicia K. Matthews

Journal of Health Disparities Research and Practice

Although tobacco use among women living with HIV (WLWH) is decreasing, the prevalence is more than double that of women in the general population and remains an important health behavior to target among WLWH. Few smoking cessation interventions specifically focus on the unique social and medical needs of women living with HIV (WLWH). Thus, the investigative team engaged WLWH (N=18) in qualitative focus groups to: 1) understand barriers and facilitators to smoking cessation; and 2) inform intervention structure and content priorities. Participants identified salient reasons for smoking and barriers to smoking cessation, which included coping mechanisms for life stressors, HIV-related …

Ecological Determinants Of Respiratory Health: Examining Associations Between Asthma Emergency Department Visits, Diesel Particulate Matter, And Public Parks And Open Space In Los Angeles, California, Jason A. Douglas, Reginald S. Archer, Serena E. Alexander

Health Sciences and Kinesiology Faculty Articles

Los Angeles County (LAC) low-income communities of color experience uneven asthma rates, evidenced by asthma emergency department visits (AEDV). This has partly been attributed to inequitable exposure to diesel particulate matter (DPM). Promisingly, public parks and open space (PPOS) contribute to DPM mitigation. However, low-income communities of color with limited access to PPOS may be deprived of associated public health benefits. Therefore, this novel study investigates the AEDV, DPM, PPOS nexus to address this public health dilemma and inform public policy in at-risk communities. Optimized Hotspot Analysis was used to examine geographic clustering of AEDVs, DPM, and PPOS at the …

Racial Variations Of The Injection Route Of Administration Among Injection Drug Users In The United States: A Comparative Trend Analysis, Philip Danquah

Graduate & Professional Student Association Research Forum

The objective of this research is to address the variations in the injection route of administration among racial groups who are injection drug users in the United States and how that contributes to their vulnerability to HIV/AIDS behaviors and hospital admissions.

Water And Life. A Cross-Sectional Study On Determinants Of Beverage Consumption And Water Access In One Tribal Community, Christina White

All Master's Theses

Increasingly, poor diet has been shown to be one of the most crucial factors associated with cause of death, even more critical than smoking. Research in the past two decades has consistently linked increased consumption of sugar-sweetened beverages (SSB) to the obesity epidemic contributing to a public health crisis all over the United States. Native Americans, among other minority groups, suffer obesity disproportionately from the rest of the US population, yet they continually fail to be included in research on the subject. Traditional research methods, sparse care coverage on reservations, consolidation of unique tribes into one classification, and failure to …

Alternative Financial Services And Health Status In U.S. Metropolitan Statistical Areas, Courtney Hundley, Richard W. Wilson 8520196, John Chenault

Journal of Health Disparities Research and Practice

Abstract

Alternative financial services (AFS) such as, payday lenders, pawn brokers, tax refund loans, and check cashers are more prevalent in minority and lower income neighborhoods. These are neighborhoods also found to have disparities in health, compared to more affluent neighborhoods and communities. The focus of this paper is to determine if any relationship exists between use of AFS and health disparities.

Using data from a survey performed by the Federal Deposit Insurance Corporation (FDIC), we compared four banking variables to several measures of health for 85 metropolitan statistical areas (MSA) across the nation. The four banking variables all related …

An Assessment Of Students' Knowledge Of Health Disparities Through Participation In A Clinic-Based Project, Haley Dewitt, Lea Pounds

UCARE: Research Products

No abstract provided.

Improving Health And Well-Being: Connecting Research And Practice. The 24th Annual Conference Of The Health Care Systems Research Network, Karen L. Margolis, Nico Pronk, Jane E. Duncan, Sarah M. Greene

Journal of Patient-Centered Research and Reviews

The 24th annual conference of the Health Care Systems Research Network (HCSRN, formerly the HMO Research Network), held April 11–13, 2018, in Minneapolis, Minnesota, attracted 357 attendees. The HCSRN is a consortium of 18 community-based research organizations embedded in or affiliated with large health care delivery systems. Its annual research conference, held since 1994, is a unique venue that brings diverse stakeholders (eg, research teams, clinicians, patients, funders) together to explore a range of health research topics and scientific findings, with a unifying goal of connecting applied research to real-world care delivery for the betterment of individual and community health. …

Graduating Into Lower Risk: Chlamydia And Trichomonas Prevalance Among Community College Students And Graduates, Janet E. Rosenbaum

Journal of Health Disparities Research and Practice

Background: Community colleges enable youth from economically disadvantaged and minority populations to access college and may enable social mobility including improved health outcomes. However, educational health disparities studies rarely assess the health outcomes for community college graduates.

Methods: Chlamydia and trichomonas prevalence were assessed with nucleic acid based tests in a nationally representative sample of 6233 high school graduates (ages 18–25) from five educational levels: young adults without post-secondary credentials who were not enrolled in college, community college students, 4-year college students, associate’s degree, and bachelor’s degree. To reduce confounding between educational attainment and STI status, we used full matching …

Identifying Health Conditions, Priorities, And Relevant Multilevel Health Promotion Intervention Strategies In African American Churches: A Faith Community Health Needs Assessment., Jannette Berkley-Patton, Carole Bowe Thompson, Andrea Bradley-Ewing, Marcie Berman, Alexandria Bauer, Delwyn Catley, Kathy Goggin, Eric Williams, Cassandra Wainright, Therese Petty, Natasha Aduloju-Ajijola

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Primary Care-Related Emergency Department Use, Tiffany Wetz

Theses & Dissertations

Primary care-related emergency department use has become a focal point in the United States considering health reform and changes made to the delivery model and reimbursement mechanisms. Emergency departments serve as critical access points within the United States delivery system because important medical resources are made available for all members within the community. However, a gap in the literature exists due to a lack of consensus regarding factors that influence emergency department use for primary care-related health needs. The purpose of this study was to understand the relationship between demographic, social, economic, geographic, and need factors that influenced use of …