Community Health and Preventive Medicine Commons^™

Barriers To Accessing Primary Dental Care For The Uninsured/ Underinsured Population In The City Of Cincinnati, Kiana R. Trabue

Master of Public Health Program Student Publications

Despite federal, state and local efforts to provide access to dental services to vulnerable populations such as the uninsured and underinsured, many people still do not receive adequate dental care. This study seeks to identify barriers to primary dental care in the City of Cincinnati. The Cincinnati Health Department (CHD) operates five safety net health centers which provide dental care for the citizens of the Cincinnati service area. Surveys conducted in these centers found that cost was the main reason individuals do not see the dentist regularly. Even in those with dental insurance cost was a major barrier, although most …

The Relationship Of Maternal Age, Trimester Of Entry Into Prenatal Care, Maternal Postpartum Depression, And Race With Birth Weight Of Infants Born In Cincinnati, Ohio, Kelli Kohake

Master of Public Health Program Student Publications

Healthcare, resources, and technology in the United States (U.S.) has improved, yet the U.S. ranks 29th in the world for the highest infant mortality rates – behind other less developed countries. Within the U.S., Ohio (and Hamilton County in particular) has high rates of infant mortality. Low birth weight and preterm births are a major cause of infant mortality. Data analysis was done consisting of descriptive statistics and Analysis of Variance of the prenatal patients served at the Cincinnati Health Department health centers who delivered in 2009, with dependent variables of birth weight and postpartum depression. Independent variables included maternal …

Hospital Evacuations: Historical Precedence And Modern Preparedness, Nicholas Squillace

Master of Public Health Program Student Publications

Objectives: The purpose of this research was to identify common problems encountered during hospital evacuations and how those problems are or should be addressed when creating a hospital evacuation plan.

Methods: Articles relating to hospital evacuations were retrieved from PubMed and CINAHL in addition to government websites and the Joint Commission on Accreditation of Healthcare Organizations. The articles collected were limited to within the last 20 years, from 1990 to 2010. Hospital plans were collected from search engines including Google and Yahoo. Moreover, a plan was obtained from a Dayton area hospital.

Results: Numerous instances of hospital evacuations that were …

The Relationship Between Body Image And Body Mass Index In Attendees At A Health Fair, Millie S. Olds

Master of Public Health Program Student Publications

The purpose of this study was to examine the relationship between body image and body mass index (BMI) in attendees at a health fair. BMI and body image was also compared between races, ages and genders. It was hypothesized that there would be discrepancies between perceived body image and weight status, as measured by BMI. Sixty-two participants at a health fair in Cincinnati completed a survey about perceived body image and had their height and weight measured and BMI calculated later. Results suggested a positive relationship between BMI and body image. Participants with a higher BMI identified themselves with a …

Unmet Medical Need Of Underserved Population In A Safety-Net Organization, Leslie Clem

Master of Public Health Program Student Publications

Background: Safety net providers serve a large proportion of America’s uninsured and low income population. The purpose of this study is to determine if differences in unmet medical needs exist between the provisional and clinic populations, age groups, and sex and race categories. This research study provides information about the population that receives services from Good Neighbor House, a non-profit social service organization in Dayton, Ohio.

Methods: GNH created a survey to assess the unmet medical need of their clients. The instrument contains questions about routine medical care, unmet medical care in the last 12 months, medical bills, and demographic …

Socioeconomic And Environmental Causes For Respiratory Infection Death In Alaska Native Villages, Sarah Mcbeth

Master of Public Health Program Student Publications

Objectives. This ecological study evaluates the association between community characteristics and death rates from pneumonia/influenza, tuberculosis, and infectious diseases in 196 Alaska Native villages.

Methods. Ecological variables studied included percentage of Natives in the population, age distribution, latitude, average household size, socioeconomic status, percentage of homes with complete plumbing and/or kitchens, type of heating fuel used, community alcohol restrictions, level of healthcare access, and residence in specific regions of Alaska. These data come from the 2000 U.S. Census, the Alaska Alcohol Beverage Control Board, and the Alaska Native Tribal Health Consortium. A stepwise analysis of variance using the Proc GLM …

Safe Choices: An Examination Of Contraceptive Choices Of The Patient Population Of Planned Parenthood Of Central Ohio, Chloe Williams

Master of Public Health Program Student Publications

Objective: This study sought to evaluate the variation between racial groups and contraceptive methods chosen by women served by Planned Parenthood of Central Ohio (PPCO) in 2009 in order to better understand the issue of unintended pregnancy.

Methods: This two part study used administrative records provided by PPCO that included raw data for all women who were scheduled for an appointment to receive, or be consulted on contraception from January 1, 2009 through December 31, 2009 which included three PPCO clinic locations in Franklin County, Ohio. A chi-square analysis was performed with java-based mathematical software from the Math Beans Project …

Zoonotic Disease In Ohio: Surveillance, Preparation, And Response, Erik B. Balster

Master of Public Health Program Student Publications

This paper examines the state of public health preparation and response capacity to zoonotic infectious disease in the state of Ohio. A comprehensive literature review of zoonotic disease emergence and re-emergence, the National Veterinary Stockpile (NVS), the One Health Initiative, emergency response, and Ohio policy was performed in conjunction with telephone interviews. This study shows that responsibilities and systems integral to disease preparedness, such as sentinel surveillance and reporting, vary significantly between two key departments: the Ohio Department of Health (ODH) and the Ohio Department of Agriculture (ODA). Consistency and standardization of agency, mirroring the One Health Initiative, must be …

Detecting, Preventing, And Treating Sexually Transmitted Diseases Among Adolescent Arrestees: An Unmet Public Health Need, Steven Belenko, Richard Dembo, Matthew Rollie, Kristina Childs, Christopher Salvatore

Department of Justice Studies Faculty Scholarship and Creative Works

Studies of detained and incarcerated adolescent offenders in the United States indicate that these juveniles have an elevated risk of sexually transmitted diseases (STDs). However, many more arrestees enter the “front end” of the juvenile justice system that is detained or incarcerated, and research into the STD risk profiles and service needs of this larger group is lacking. An expansion of STD testing (including of asymptomatic youths), prevention, and treatment is needed, as is improved knowledge about gender- and race-specific services. A pilot program in Florida has shown that juvenile justice and public health systems can collaborate to implement STD …

Benefit Design Of Medicare Drug Plans: An Analysis Of Ohio And The National Landscape From 2006 Through 2009, Brad Haverkos

Master of Public Health Program Student Publications

Objectives: Since previous research was fragmented and incomplete, I described changes in the benefit designs of stand-alone PDPs in the United States from 2006 through 2009. In addition, I identified trends in the PDP market of Ohio and compared them to the national data. The intent was to discover changes that might only be observed during the examination of a smaller market. I then presented the enrollment data of stand-alone PDPs in Ohio and discussed the benefit designs of popular plans to help further understand the PDP market dynamics.

Methods: Each year, CMS collected and released information on benefit characteristics …

Preterm Birth Rates In Pregnant Women With Sexually Transmitted Infections: Cincinnati Public Health Centers 2005 And 2006 Deliveries, Elizabeth Singhoffer

Master of Public Health Program Student Publications

Objective: To evaluate the differences in prenatal maternal infections in women served by the City of Cincinnati health centers that have or have not had a preterm birth.

Methods: A retrospective and observational study of medical records of 738 patients seen at the City of Cincinnati health centers, who delivered in the years of 2005 and 2006. The usable data resulted in 668 total subjects. Data collected included types of health care visits prior to index pregnancy, if preconception/ reproductive health care was discussed, demographics, gestational age at first prenatal visit and at delivery, insurance at first prenatal visit and …

Evaluating Patient Compliance: Effect Of Appointment Reminder Systems On Attendance, Jacquelyn D. Phillips

Master of Public Health Program Student Publications

Currently, rising health care cost is an important topic on many agendas and platforms. In 2007, health care spending in the United States reached $2.3 trillion, and was projected to reach $3 trillion in 2011 (NCHC, 2007). Increasing health care cost is in direct relationship with the rise in the ageing population, chronic illness, and the uninsured lower socioeconomic population as well. The research on medical compliance and attendance (missed/kept appointment) behavior is an important area to explore because it is critical for all aspects of successful treatment, disease prevention, and health promotions that have direct correlation with health care …

Soda: Seniors For Organ Donation Awareness “Increasing The Enrollment Of Senior Citizens (Age 65 Years And Older) In The Ohio Donor Registry”, Laurie L. Phillips

Master of Public Health Program Student Publications

Research Hypothesis: A targeted informational awareness program about organ and tissue donation to senior citizens (age >65 years) in Montgomery County, Ohio will produce an increase in the number of registered organ donors in the Ohio Donor Registry, hence, allowing more available organs for transplant for aging patients (50 years of age or older) in need across the region. Subsequently, another research objective is to identify and address underlying factors causing senior citizens to be the lowest number of registered donors in Montgomery County, Ohio, in fact, across the state. This information will assist in future public education efforts of …

Water System Preparedness For Pandemic Influenza, Phil Van Atta

Master of Public Health Program Student Publications

This project involved an investigation of water utility preparedness and best practices for pandemic influenza. A pandemic could cause serious disruptions to the operations of critical infrastructure, including drinking water systems. These disruptions could be caused by staffing shortages, power disruptions, and shortages of chemicals and other supplies. Ensuring continuity of operations for drinking water systems is crucial to protect public health and safety, and to the economy of all communities. Literature searches, interviews, and a survey of Ohio water systems indicated that water systems in Ohio and across the United States are preparing for pandemic influenza. Pandemic influenza preparation …

The Public Health Implications Of Trafficking, Tami Ashbridge

Master of Public Health Program Student Publications

Trafficking in human beings is a serious and complex human rights issue. Trafficking for the purpose of sexual exploitation has grave public health implications. The vulnerability of women and children increases their risk of becoming victims of trafficking for the purposes of sexual exploitation. Review of the literature on this subject demonstrates a direct link between the trafficking of women and children for sexual exploitation and the prevalence of HIV/AIDS, STIs and Reproductive/Gynecological Issues, Mental Health, Violence, Abuse and Social Issues. This review supports the concept of human trafficking as a serious public health issue and the need for improved …

Emerging Trends In Cigarette Sales In Ohio During First Year Implementation Of The Smoking Ban, Megan Luse

Master of Public Health Program Student Publications

Objective: The Ohio smoking ban was passed by Ohio voters on November 7, 2006 and took effect on December 7, 2006. The reporting of violations to the Ohio smoking ban began on May 3, 2007 with the implementation of the civil penalties for the violations. The purpose of this study is to look at emerging trends in cigarette sales change from 2006 to 2007 for the 88 counties in Ohio following implementation of the smoking ban on December 7, 2006 based on geographical location, violation level, and tobacco production.

Methods: Data was obtained from Claritas for the 2006 aggregate expenditure …

Concurrent Panel Session 2: Health Challenges Facing Las Vegas, Carlos Brandenburg, Shawn Gerstenberger, Zaven Khachaturian, John Mcdonald, Dennis Pirages, Thom Reilly, Kathy Silver, Bonnie Sorenson, Carolyn B. Yucha, Maurizio Trevisan

Shaping the Future of Southern Nevada: Economic, Environmental, and Social Sustainability

Moderator: Marcia Turner, NSHE Health Science System Scribe: Candace Griffith, UNLV Department of Sociology Conference white paper & Full summary of panel session, 8 pages

Mrsa Prevention And Control In County Correctional Facilities In The Greater Dayton Area, Jeffrey Allen Webb

Master of Public Health Program Student Publications

Recently there has been an increasing number of methicillin-resistant Staphylococcus aureus (MRSA) cases in correctional facilities around the country, including the Greater Dayton area. Considering the potential health impact of MRSA on correctional facilities it is important that facilities have prevention and control protocols in place. This study summarizes the prevention and control preparedness activities of county correctional facilities in the Greater Dayton area. The positive response rates for the control measures were 88.4% for screening, 83.6% for treatment, 80.6% for personal hygiene, 95.4% for environmental control, 80.4% for education and 84.3% for standard precautions. The study also compared rural …

Environmental Health Information Systems: More Than Just Gigabytes, Christopher R. Cook

Master of Public Health Program Student Publications

Environmental health professionals are concerned about bites. Animal bites, mosquito bites, and tick bites to name a few. But what about bytes of data? Environmental health information systems (EHIS) are often the "silent partners" in an environmental health (EH) department's daily protection of public health. By Webster's dictionary definition, a silent partner is a cohort that does not have the right to participate in an organization's management process. The purpose of this study was to encourage public health officials to make EHIS full partners in their EH departments. Through the use of five surveys, this study was designed to increase …

A Quality Assurance Initiative For Emergency Medical Services, Melissa Anne Howell

Master of Public Health Program Student Publications

Ohio Revised Code 4765.12 mandates the implementation of ongoing peer review and quality assurance (QA) programs for all emergency medical service (EMS) organizations in the State of Ohio. The purpose of implementing QA programs for EMS is to ensure delivery of quality care to the public. Public health core strategies are to assess systems and assure the implementation of policies and processes that improve community health. Involving public health in the development of a QA program provides technical assistance in developing valid methods that can be used to measure the performance of an EMS system. This study will use a …

Planning An Integrated Disease Surveillance And Response System: A Matrix Of Skills And Activities, Helen N. Perry, Sharon M. Mcdonnell, Wondimagegnehu Alemu, Peter Nsubuga

Dartmouth Scholarship

The threat of a global influenza pandemic and the adoption of the World Health Organization (WHO) International Health Regulations (2005) highlight the value of well-coordinated, functional disease surveillance systems. The resulting demand for timely information challenges public health leaders to design, develop and implement efficient, flexible and comprehensive systems that integrate staff, resources, and information systems to conduct infectious disease surveillance and response. To understand what resources an integrated disease surveillance and response system would require, we analyzed surveillance requirements for 19 priority infectious diseases targeted for an integrated disease surveillance and response strategy in the WHO African region.

Obesity, Physical Activity, And Mortality In A Prospective Chinese Elderly Cohort, Mary Schooling, Tai Hing Lam, Zhi Bin Li, Sai Yin Ho, Wai Man Chan, Kin Sang Ho, May Ked Tham, Benjamin J. Cowling, Gabriel M. Leung

Publications and Research

Background
In older people, it is unclear whether obesity relates to mortality, which calls into question its etiologic role in disease and its public health relevance. This apparent lack of relationship in older people could be an artifactual result of their diverse health states.

Methods
We used Cox regression analysis to determine whether the effect of body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) or physical activity on mortality varied with health status in a prospective cohort study of Chinese people 65 years or older enrolled from 1998 to 2000 at …

Feasibility Of Gdaha Hospitals Meeting The Surge Capacity And Capability Requirements Of An Avian Flu Pandemic In The Miami Valley, Raymond P. Ten Eyck

Master of Public Health Program Student Publications

Hospital surge capacity is a crucial portion of disaster preparedness planning within a community. The demands generated by a disaster require additional capacity, in the form of beds, equipment, personnel, and special capabilities. The scope and urgency of these requirements must be balanced with a practical approach addressing cost and space concerns. The advent of new infectious disease threats, particularly an avian flu pandemic, have reinforced the need to be prepared for a prolonged surge, lasting six to eight weeks, in addition to the shorter duration surges required for industrial accidents, tornados, chemical disasters and terrorists. Using a standardized data …

Retrospective Comparative Analysis Of The Socio-Demographic Characteristics Of Pregnant Abortion-Minded Clients Versus Pregnant Non-Abortion-Minded Clients In A Crisis Pregnancy Center In Montgomery County, Ohio, Betsy Liliana Cote

Master of Public Health Program Student Publications

Purpose: The purpose of this study is to compare socio-demographic characteristics of pregnant abortion-minded women versus pregnant non-abortion minded women who had consulted a crisis pregnancy center in Montgomery County, Ohio. The findings will be used to help develop public health prevention programs for unintended pregnancies.

Methods: A database sample of 581 records collected by a crisis pregnancy center in t Montgomery County was used for this study. Criteria for inclusion were women obtaining a positive pregnancy test, whose pregnancy intentions were assessed as being either abortion-minded or non-abortion-minded. Socio-demographic characteristics such as age, marital status, household income, education, religious …

Attention-Deficit Hyperactivity Disorder And Substance Use Disorders: Prevalence And Treatment Outcomes, Carole J. Huddleston

Master of Public Health Program Student Publications

Attempts to improve substance use disorder (SUDs) treatment outcomes have been made by identifying subgroups of clients with psychoactive comorbidities and tailoring treatment approaches accordingly. This study sought to determine the prevalence of Attention-deficit Hyperactivity Disorder (ADHD) among admittees to a 28-day, residential program. It was hypothesized that ADHD screening and assessment would result in a higher prevalence rate when compared to the clinical record. It was further hypothesized that clients with ADHD would have higher, earlier unsuccessful terminations and higher overall unsuccessful terminations than non-ADHD clients. The differences in the prevalence rates (3.44% clinical record and 43.68% study psychologist) …

How Should Health Departments Manage Prenatal Care?, Julianne Nesbit

Master of Public Health Program Student Publications

Objective: To compare how health departments in the southwest district of Ohio manage prenatal care, defined as preventative care provided immediately preceding, during, and following pregnancy, to determine if there is a better management technique based on cost and/or characteristics of jurisdictions.

Design: Qualitative descriptive analysis of prenatal services at local health departments in the southwest district of Ohio for 2004.

Setting and Participants: Health Departments in the southwest district of Ohio.

Main Outcome Measures: Comparison of the types of services currently being used to provide prenatal care services (i.e., direct, contracted, combination, or no service) including budgeting and cost …

Is Public Health Paternalism Really Never Justified? A Response To Joel Feinberg, Thaddeus Mason Pope

Faculty Scholarship

n the preeminent scholarly legal treatise on paternalism, The Moral Limits of the Criminal Law: Harm to Self, Joel Feinberg argues that hard paternalism is never justified because it is superfluous; all reasonable restriction of self-regarding conduct can be justified on (more palatable) soft paternalistic grounds.

In this article, I argue that Feinberg's strategy seems to work only because he "stretches" soft paternalism to justify liberty limitation that is properly described as hard paternalism. I expose Feinberg's strained appeals, and argue for honesty and transparency regarding the bases for paternalistic liberty limitation. If the rationale for public health restrictions on …

Nevada "Nurselessness": An Acute Or Chronic Condition? An Examination Of The Etiology And Possible Treatment Alternatives, Jeanine Warren-Newmon

UNLV Theses, Dissertations, Professional Papers, and Capstones

Data released by the Department of Health and Human Services in February, 2001, revealed that Nevada has the lowest number of registered nurses per 100,000 population in the nation. The state’s population is growing faster than the nursing programs are currently able to produce new graduates. Current predictions are that the existing nursing shortage will become more severe and have a longer duration than has ever before been experienced. While there may not be one single identifiable causative factor, the aging nursing workforce, low unemployment, and the universal nature of the shortage magnify the problem. This paper focuses on the …

Balancing Public Health Against Individual Liberty: The Ethics Of Smoking Regulations, Thaddeus Mason Pope

Faculty Scholarship

Ten years ago, philosopher Robert E. Goodin published "No Smoking: The Ethical Issues." Goodin argued that the liberty of smokers can be justifiably limited for two reasons: to prevent harm to third persons and to prevent harm to smokers themselves under circumstances which make their decision to smoke substantially non-autonomous. In this article Thaddeus Pope reexamines the harm principle and the soft paternalism principle in light of more recent legal developments, gives them additional content, and carefully demarcates the justificatory scope of each. Pope also defines and defends a third liberty-limiting principle, hard paternalism, arguing that the liberty of smokers …

Condom Availability In New York City Public High Schools: Relationships To Condom Use And Sexual Behavior, Sally Guttmacher, Lisa D. Lieberman, David Ward, Nick Freudenberg, Alice Radosh, Don Des Jarlais

Department of Public Health Scholarship and Creative Works

OBJECTIVES: This study examines the impact of the condom availability program in New York City public high schools by comparing rates of sexual activity and condom use for New York students and similar students in Chicago. METHODS: A total of 7119 students from 12 randomly selected New York schools and 5738 students from 10 Chicago schools participated in a cross-sectional survey. RESULTS: New York students, compared with Chicago students, reported equal rates of sexual activity but higher rates of condom use at last intercourse (odds ratio [OR] = 1.36). For higher-risk students (those with three or more sexual partners in …