Environmental Public Health Commons^™

Program Evaluation: Utilizing Health Department’S Community Health Needs Assessment Data To Improve Emergency Preparedness Plans, Kathleen Gottschalk

Capstone Experience: Master of Public Health

Public health officials conducting emergency response plans must know how to easily identify the vulnerable populations in their community or jurisdiction. It is beneficial for access and functional needs appendices to include information and resources directed at the identified vulnerable groups before an emergency event to improve health outcomes. Community Health Needs Assessments (CHNA) can provide population-level statistics and information needed to easily identify vulnerable or at-risk groups. This report aims to evaluate the use of the CHNA data to guide the development of inclusive emergency response plans that account for vulnerable populations in local health department jurisdictions. The 2021 …

Environmental And Social Factors Associated With High Chronic Kidney Disease Mortality Rates In Municipalities Of Guatemala: An Ecological Study Of Municipal-Level Mortality Data, Alejandro Cerón

Anthropology: Faculty Scholarship

The purpose of this study was to determine the association between social and environmental indicators and high mortality rates from chronic kidney disease (CKD) in municipalities of Guatemala. An ecological study of municipal-level factors associated with CKD mortality in Guatemala was conducted. Crude mortality rates were calculated for the 2009–2019 period for each of the country’s 340 municipalities, by gender and age groups. Municipal-level social and environmental indicators were used as independent variables. Linear regression was used for bivariate and multivariate analysis. A total of 28,723 deaths from CKD were documented for the 2009–2019 period. Average crude mortality rate for …

Environmental Enrichment Devices Are Safe And Effective At Reducing Undesirable Behaviors In California Sea Lions And Northern Elephant Seals During Rehabilitation, Kirsten Donald, Amanda Benedetti, Vinícius Donisete Lima Rodrigues Goulart, Alissa Deming, Hendrik Nollens, Grey Stafford, Sabrina Brando

Faculty, Staff and Student Publications

Environmental enrichment devices (EEDs) have been proven to promote positive wellbeing in zoos and aquariums, and support animals' reintroduction success; however, their use in rehabilitation centers is still limited. This pilot study investigated the safety and efficacy of three EEDs, Artificial Kelp, Horse KONG™ and Wubba Kong™, and their ability to decrease and/or eliminate undesired stereotypic behaviors or looking at staff/staff areas in seven wild California sea lions (CSLs) and eight northern elephant seals (NESs) undergoing rehabilitation in Southern California. Observers conducted instantaneous sampling once a minute during a 30-min baseline, followed by a 30-min EED implementation on one focal …

Adult Asthma Associated With Roadway Density And Housing In Rural Appalachia: The Mountain Air Project (Map)., W Jay Christian, John Flunker, Beverly May, Susan Westneat, Wayne T Sanderson, Nancy Schoenberg, Steven R Browning

UK CARES Faculty Publications

BACKGROUND: Appalachian Kentucky is a rural area with a high prevalence of asthma among adults. The relative contribution of environmental exposures in the etiology of adult asthma in these populations has been understudied.

OBJECTIVE: This manuscript describes the aims, study design, methods, and characteristics of participants for the Mountain Air Project (MAP), and focuses on associations between small area environmental exposures, including roadways and mining operations, and lifetime and current asthma in adults.

METHODS: A cohort of residents, aged 21 and older, in two Kentucky counties, was enrolled in a community-based, cross-sectional study. Stratified cluster sampling was used to select …

Information-Motivation-Behavioral Skill In Diabetes Self-Management Using Structural Equation Modeling Analysis, Dien Kurtanty, Adang Bachtiar, Cicilya Candi, Alya Pramesti, Almira Fanny Rahmasari

Kesmas

Diabetes is the “mother” of various diseases increasing the risk of morbidity and mortality. Diabetes self-management, an effort made by patients to control blood sugar levels, is an important part of the management strategy. Therefore, this study analyzed information, motivation, and behavioral skills associated with diabetes self-management. Data were collected in the Special Capital Region of Jakarta, with 277 diabetic patients selected using a questionnaire by a systematic random sampling method. The analyzed variables were information (with indicator variables of information on physical activity, nutritional intake, drug consumption, and blood sugar monitoring); sociodemographic (age, sex, occupation, education level, and duration …

Job Satisfaction Model Of Primary Health Care Midwives Based On Indonesian Workforce Research In The Health Sector, Mieska Despitasari, Adang Bachtiar, Harimat Hendarwan, Besral Besral, Yuyun Yuniar

Kesmas

Promotive, preventive, curative, and rehabilitative efforts that are comprehensive, integrated, and sustainable are employed to enhance the health state of the global population. Within this context, however, the quality of primary health care depends on job satisfaction, which leads to the happiness of human resources in the health sector. Therefore, this study aimed to analyze and formulate a job satisfaction model among primary health care midwives in Indonesia. This study was an advanced secondary data analysis of a cross-sectional study conducted in 2017 by the National Institute of Health Research and Development, Ministry of Health of the Republic of Indonesia. …

Obesity And Asthma Risk In Indonesian Adults: Findings From The 2018 Indonesia Basic Health Research, Hoirun Nisa

Kesmas

Obesity and asthma are both global public health challenges. Mounting evidence suggests that obesity may increase asthma risk in adults; however, the association by sex remains uncertain. This study examined the association of obesity with asthma risk in Indonesian adult men and women. Data were obtained from the 2018 Indonesia Basic Health Research. The analysis included 299,837 men and 333,218 women aged ≥18 years. Asthma was identified by the self-report of a doctor’s diagnosis. Obesity was defined as a body mass index ≥30 kg/m2. A logistic regression was used for data analysis. Asthma prevalence was 2.7% (2.5% in men and …

Presidential Vote Share And Covid-19 Vaccination Rate In Indonesia: A District-Level Cross-Sectional Ecological Study, Gede Benny Setia Wirawan, Ni Luh Zallila Gustina, Ivy Cerelia Valerie, I Gusti Ayu Indah Pradnyani Rs, Muchamad Zaenal Arifin, Pande Putu Januraga

Kesmas

Political affiliation has been reported as a determinant of COVID-19 vaccine acceptance in some countries, although few studies have examined the Asian context. This study aims to fill this gap by employing an ecological study design using Indonesian regions as data points. Political affiliation was represented by incumbent President Jokowi’s vote share in the 2019 presidential election. Potential confounders included population density, human development index, availability of hospitals and primary health care, 2019–2020 economic growth, COVID-19 mortality rate, and proportion of Muslims in the population. The final analysis included 201 out of 501 districts and cities in Indonesia. Controlling for …

Oxidative Stress Levels Of Fine Particulate Matter (Pm2.5) And Urinary Glutathione Of Microbus Drivers, Purnama Sidebang, Agustin Kusumayati, Budi Haryanto

Kesmas

Urinary glutathione levels are known to be an early indicator of oxidative stress in travelers. This study analyzed the association between particulate matter (PM2.5) exposure on the road and urine glutathione levels in Jakarta’s microbus drivers. This cross-sectional study involved 96 microbuses (one of Jakarta’s public transportations) drivers of nine routes in Kampung Melayu Bus Station, Jakarta, Indonesia. An anthropometric assessment and a structured questionnaire were employed. Along with the participants driving on the road, real-time personal equipment measuring PM2.5 exposure concentrations was used. Total glutathione levels were measured using a colorimetric method. A correlation test and linear regression analysis …

The Determinants Of Stunting In The Under-Five In Three Municipalities In The Special Capital Region Of Jakarta, Tria Astika Endah Permatasari, Chairunnisa Chairunnisa, Hernani Djarir, Lily Herlina, Munaya Fauziah, Andriyani Andriyani, Yudi Chadirin

Kesmas

The COVID-19 pandemic has impacted the global decline in public health status. This study aimed to analyze the determinants of stunting in the under-five in three municipalities in the Special Capital Region of Jakarta, Indonesia. A cross-sectional study was conducted in August-December 2020 with 460 pairs of mothers and children selected by simple random sampling. Stunting was measured using a conventional anthropometric index (length/height-for-age), and anthropometric failure was measured using the Composite Index of Anthropometric Failure. The prevalence of stunting, underweight, and wasting was 41.5%,35%, and 19.8%, respectively, and 62% of the under-five experienced anthropometric failure. The dominant factor associated …

The Effect Of Covid-19-Related Occupational Stress And Burnout In Referral Hospital Nurses, Yulastri Arif, Masyithah Fadhani

Kesmas

Nurses' continuous contribution to patient health makes them prone to occupational stress, which has been exacerbated during the COVID-19 pandemic. Occupational stress that lasts for a long time and is not resolved may cause burnout. Burnout experienced by nurses can impact patients, hospital services, and themselves. This study aimed to determine the effect of occupational stress on the incidence of nurse burnout during the COVID-19 pandemic. It used a quantitative approach with a cross-sectional design. The study sample was 235 nurses in six COVID-19 referral hospitals in West Sumatra from a proportional random sampling technique. Data were collected using a …

Developing A New Tool For Early Detection Of The Nutritional And Health Risk Factors Of Urban Workers’ Productivity, Hildagardis Meliyani Erista Nai, Arimbi Karunia Estri, Christina Ririn Widianti

Kesmas

Nutrition and health play vital roles in work productivity. This study aimed to develop a risk self-assessment tool called Early Detection of the Nutritional and Health Risk Factors on the productivity of urban workers. This study was conducted in two stages: 1) the development of the tool to determine the nutritional and health risk factors that affect productivity based on literature reviews and scoring systems and 2) the testing of validity and reliability. Finally, the tool contained 63 items, including 28 items on nutritional risk factors and 35 on health risk factors. The validity of the tool was assessed using …

Maternal And Child Health Handbook Utilization, Quantity And Quality Of Antenatal Services, And Maternal Emergency Rates In Padang City In 2022, Rena Afri Ningsih, Yusrawati Yusrawati, Joserizal Serudji

Kesmas

This study analyzed the relationship between the utilization of the Indonesian Ministry of Health’s Maternal and Child Health Handbook and the quantity and quality of antenatal care to maternal emergency levels. This study applied mixed methods with a consecutive sampling technique and included 108 mothers undergoing maternal emergencies at a central general hospital (quantitative) and eight mothers, seven midwives, and five cadres at primary health cares (qualitative) as informants. The result showed a relationship between the utilization of the Maternal and Child Health Care Handbook (p-value = 0.043), the quantity of antenatal care (p-value

Association Between E-Cigarette Use Behaviors And Anxiety/Depression Among Black/African American Adults Based On Sexual Identity, David Adzrago, Melissa B Harrell, Kayo Fujimoto, Antwan Jones, J Michael Wilkerson

Faculty, Staff and Student Publications

Limited studies have examined disparities in e-cigarette use among Black/African American adults by sexual identity and whether the relationship between symptoms of anxiety/depression and e-cigarette use varies by sexual identity. We examined the association between e-cigarette use behaviors (never, former, and current use) and anxiety/depression among a nationally representative sample of Black/African American adults who identified as a sexual minority (lesbian/gay, bisexual, and others) or heterosexual individuals. We combined cross-sectional data from the 2011 to 2020 Health Information National Trends Survey (n = 6267), which is a nationally representative data set. We computed weighted e-cigarette use prevalence and multinomial logistic …

Preparing For The Next Disaster: Lessons Learned From The Early Experiences Of Autistic Adults During The Covid-19 Pandemic, Amber Pomponio Davidson, Cecilia Feeley, Beth Pfeiffer, Mark Salzer

Internet Journal of Allied Health Sciences and Practice

Purpose: Disasters, such as the worldwide COVID-19 pandemic, create significant disruptions for individuals and their communities. Understanding these disruptions is a first step towards planning for future events and disaster recovery. This research aims to explore how the initial COVID-19 restrictions, including lockdowns, impacted adults with Autism (ASD). Method: Using semi-structured interviews to understand how individuals with ASD experienced the early months of the COVID-19 pandemic, twelve participants were interviewed: six individuals with ASD (ages 20-38), three parents of individuals with ASD, and three support staff for individuals with ASD. Analysis: Grounded theory methods were used to analyze the impacts …

Epigenetics And Social Inequalities In Asthma And Allergy, Elizabeth S. Clausing, Cassidy J. Tomlinson, Amy L. Non

School of Global Integrative Studies: Faculty Publications

Respiratory illnesses, such as asthma and allergy disorders, are disproportionately more common among minority racial/ethnic groups and those of low socioeconomic status. In the United States, asthma prevalence and severity are highest among Puerto Ricans (19.2%), American Indians/Alaska Natives (13%), and Black Americans (12.7%) and higher in families living below the poverty threshold than among those living above it (11% vs 8%–9%).¹ Many studies of asthma/allergy inequalities assume that genetic differences underlie racial/ethnic differences in these disorders, pointing to genetic ancestry differences between races, but most genetic variants fail to explain racial/ethnic differences and are usually studied only in …

Examining The Utility Of A Kentucky Fcs Cooperative Extension Curriculum On Community Members’ Healthy And Sustainable Diet-Related Behaviors, Catharine Pickford

Theses and Dissertations--Nutrition and Food Systems

Experts recommend individuals adopt healthy and sustainable dietary behaviors to improve human and environmental health. The objective of this study was to pilot a sustainable eating Family and Consumer Sciences (FCS) Cooperative Extension curriculum and evaluate the effectiveness of the lesson series by measuring participants’ changes in knowledge, perceptions, and intentions towards healthy and sustainable dietary behaviors as well as overall satisfaction with lessons. A five-lesson sustainable eating curriculum was developed with topics focused on: reducing food waste; eating more seasonal, local plant-based foods; varying protein sources; maintaining energy balance; and consuming fewer highly processed and packaged foods. To assess …

Barriers To Outdoor Recreation For Marginalized Groups At The University Of Montana, Sabine R. Englert, Beatrix Frissell, Adrienne Liebert, Sophia Rodriquez, Margaret Jensen, Rachana Harris, Abby Doss

Undergraduate Theses, Professional Papers, and Capstone Artifacts

Exclusion from outdoor recreation reflects legacies of oppression of marginalized communities and makes access to the outdoors not equally available. In the United States, approximately 38% of Black Americans and 48% of Hispanic Americans participated in outdoor recreation in 2020. This is compared to 55% participation among Caucasian Americans. Many other intersecting identities are actively excluded, including people with disabilities, fat populations, and members of the LGBTQIA2S+ community; furthermore, class-based hierarchies are shown through the restricted outdoor access of low-income populations.

While numerous studies show a lack of diversity in outdoor recreation, little to no research has been conducted on …

‘A Healthy Mtu’ A Mixed Methods Baseline Programme Of Research To Empirically Inform A Campus Health Promotion Initiative Within An Irish Higher Education Setting, Andrea Bickerdike

Theses

Higher Education Institutions (HEIs) have been called to lead global health promotion actions, yet there remains a dearth of empirically informed ‘Healthy University’ (HU) initiatives. This thesis constituted a baseline mixed methods needs assessment to inform a settings-based health promotion (HP) initiative (‘A Healthy MTU’) within a multi-campus ‘case’ HEI in Ireland (Cork campuses of MTU, formerly CIT). Specific aims were to (i) investigate student and staff health metrics, and (ii) identify the cultural and environmental determinants of health and wellbeing within the case HEI setting. Using a phased, mixed methodology (QUAN-QUAL), five sequential empirical studies were undertaken. Quantitative data …

Coh 1700: Health Care Coordination Syllabus, Sasha Harry

Open Educational Resources

This is the syllabus for a Health Care Coordination course.

The goal of health care coordination is to improve patient outcomes with better health care services. Care coordinators play a critical role in improving patient care. Students will learn how to effectively advocate for patients and interact with members of the healthcare team in finding solutions to provide high quality, value-based, and efficient care. Effective communication styles, assessing patient’s needs and goals, and helping with patients’ transitions of care are among many topics covered in this course. Upon course completion, students will have acquired basic knowledge and skills to educate, …

An Analysis Of Water Quality At Orange County, California Beaches, Naomi Meurice

Pomona Senior Theses

Beaches in Southern California are highly recreated by residents and visitors, making beaches socially and economically important. Public health departments in coastal communities are in charge of measuring water quality and ensuring it is safe for users. Research in the past has indicated that beach water quality gets worse after storms, with bacteria levels jumping on the day of a storm and staying high for up to five days. Studies have shown these spikes in bacteria to be associated with storm runoff, with beaches closer to runoff discharge locations experiencing more impact. However, prior research has not considered the period …

Diagnosing Neurocysticercosis In Skeletonized Human Remains Of Forensic Importance, John O. Obafunwa, Karl Reinhard

Karl Reinhard Publications

Neurocysticercosis is endemic in many parts of the underdeveloped and developing countries, with continuous presence in developed countries due to the influx of migrants from regions where the diseases are endemic. Neuroimaging, anatomic pathological techniques, immunodiagnostic tests, clinical examination and epidemiologic considerations will easily provide the diagnosis. However, physicians in developed countries are perhaps progressively missing the diagnosis, and need to re-acquaint themselves with the condition and acquire a high suspicion index. The authors present a medicolegal case where the forensic team made a conclusion of neurocysticercosis (among other diagnoses), following post mortem examination of a largely skeletonized and mummified …

Exploring The Evolution Of Trypanosoma Cruzi And The Emergence Of Chagas Disease In The Context Of Environmental Change: Applying The Stockholm Paradigm To Archaeoparasitology, Part I, Aida Romera Barbera, Daniel R. Brooks, T. Michael Fink, Karl J. Reinhard

Karl Reinhard Publications

The Stockholm Paradigm is an evolutionary synthesis that explains the emergence of novel pathogens in the context of environmental disturbances. Considering the urgent climate change situation, anticipation stands as key to prevent and mitigate the effects that climate change can have in the emergence of pathogens. However, the success of preventive measures is hindered by a limited knowledge of the interplaying dynamics between biology, environment, and culture leading to emerging infectious diseases. For many decades, bioarchaeologists have been gathering data on past human-environment interactions, therefore contributing to the conversation. Archaeoparasitology, at the intersection between pathology, bioarchaeology, and biology, is uniquely …

Documenting The Presence Of Chagas Disease In Prehistoric North America: Applying The Stockholm Paradigm To Archaeoparasitology, Part Ii, Karl J. Reinhard, Daniel R. Brooks, Aida Romera Barbera, T. Michael Fink

Karl Reinhard Publications

The DAMA protocol (Document, Assess, Monitor, Act) is the applied aspect of the Stockholm Paradigm. Evidence from archaeology and history of medicine has a demonstrated value in documenting infection risk for specific study areas. Bioarchaeological remains and historical documents show vivid examples of pathology related to the Chagas disease life cycle. The science of archaeology defines the lifestyles that created risk of triatomine kissing bug infestations and trypanosome protozoa infections. Paleogenetics, in the form of molecular analyses of Trypanosoma cruzi, elucidate the temporal origins of genetic variants and adaptation to human environments. We illustrate how these fields reveal the risk …

Assessment Of Spatio-Temporal Variations In Pm2.5 And Associated Long-Range Air Mass Transport And Mortality In South Asia, Md Sariful Islam, Shimul Roy, Tanmoy Roy Tusher, Mizanur Rahman, Ryley C. Harris

Political Science & Geography Faculty Publications

Fine particulate matter (PM_2.5) is associated with adverse impacts on ambient air quality and human mortality; the situation is especially dire in developing countries experiencing rapid industrialization and urban development. This study assessed the spatio-temporal variations of PM_2.5 and its health impacts in the South Asian region. Both satellite and station-based data were used to monitor the variations in PM_2.5 over time. Additionally, mortality data associated with ambient particulate matter were used to depict the overall impacts of air pollution in this region. We applied the Mann–Kendall and Sen’s slope trend analysis tool to investigate the …

Forest Bathing Increases Adolescent Mental Well-Being And Connection To Nature: A Transformative Mixed Methods Study, Jennifer Keller

Antioch University Dissertations & Theses

Previous research has demonstrated that practicing forest bathing has significant positive effects on well-being. However, few studies have investigated whether forest bathing increases adolescent well-being despite the growing adolescent mental health crisis in the United States. Similarly, few studies have explored forest bathing’s impacts on connectedness to nature. Considering the ongoing environmental crisis, determining if forest bathing increases connectedness to nature is a critical expansion of forest bathing research, as connectedness to nature is linked to environmental care and concern. This study investigated the possibility that forest bathing, a nature-based mindfulness practice, could increase adolescent mental well-being and connectedness to …

Risk Factors For Emergency Medical Care Or Hospitalization Due To Heat-Related Illness Or Injury: A Systematic Review, Blair Litwiller, Amber N. Barnes

Florida Public Health Review

Background: Temperatures globally have been predicted to increase due to changes in the climate. As the earth gets warmer, it is expected that heat-related illness will also increase worldwide. An effective and appropriate public health response will be critical. Purpose: The aim of this review was to identify risk factors associated with heat-related illness and injury to provide target areas for future interventions. Methods: A review of existing literature was analyzed for risk factors that may increase the likelihood of being admitted to an emergency department for a heat related illness or injury. Results: Of the …

Association Of Gulf War Illness With Characteristics In Deployed Vs Non-Deployed Gulf War Era Veterans In The Cooperative Studies Program 2006/Million Veteran Program 029 Cohort: A Cross-Sectional Analysis, Linh M Duong, Alice B S Nono Djotsa, Jacqueline Vahey, Lea Steele, Rachel Quaden, Kelly M Harrington, Sarah T Ahmed, Renato Polimanti, Elani Streja, John Michael Gaziano, John Concato, Hongyu Zhao, Krishnan Radhakrishnan, Elizabeth R Hauser, Drew A Helmer, Mihaela Aslan, Elizabeth J Gifford

Center for Medical Ethics and Health Policy Staff Publications

Gulf War Illness (GWI), a chronic multisymptom illness with a complex and uncertain etiology and pathophysiology, is highly prevalent among veterans deployed to the 1990-1991 GW. We examined how GWI phenotypes varied by demographic and military characteristics among GW-era veterans. Data were from the VA's Cooperative Studies Program 2006/Million Veteran Program (MVP) 029 cohort, Genomics of GWI. From June 2018 to March 2019, 109,976 MVP enrollees (out of a total of over 676,000) were contacted to participate in the 1990-1991 GW-era Survey. Of 109,976 eligible participants, 45,169 (41.1%) responded to the 2018-2019 survey, 35,902 respondents met study inclusion criteria, 13,107 …

The Relationship Between Urban Green Space Perception And Use Within The Adolescent Population: A Focused Ethnography, Rachel Lyons

Electronic Theses and Dissertations

Introduction: Greenspace is beneficial for improving adolescent mental health, yet we still do not understand the connection between the built environment and subjective mental wellbeing. We also lack understanding of how this population uses greenspace and how they feel when in it. Purpose: The purpose of this qualitative study was threefold: to understand why adolescents use greenspace, to identify how they use greenspace, and to explore how they feel when they are in greenspace. Methods: participated in a focused ethnography that utilized auto photography for photo elicitation. Braun and Clark's (2006), six phases of thematic analysis were used to guide …

Crisisready's Novel Framework For Transdisciplinary Translation: Case-Studies In Wildfire And Hurricane Response, Andrew Schroeder, Caleb Dresser, Akash Yadav, Jennifer Chan, Shenyue Jia, Caroline Buckee, Satchit Balsari

Institute for ECHO Articles and Research

Extreme weather events including wildfires and hurricanes are becoming increasingly hazardous due to climate change, and often result in transient or permanent population displacements. Disaster-related disruptions in infrastructure, workforce, wages, and social networks can combine with population displacements to result in interruptions in health care access and prolonged impacts on morbidity and mortality. The data needed to make health systems and emergency management approaches more resilient to these hazards, and more responsive to the needs of affected populations, are sequestered in silos across private corporations and public agencies. In two case studies, we describe how our research team at CrisisReady …