Other Public Health 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 …

Examining The Rural Workforce: Comparing Admissions Strategies And Training Pathways In U.S. Medical And Dental Education, Charolyn A. Harris

Honors Theses

Access to healthcare in rural and underserved communities remains a significant challenge in the United States, particularly in dental care, where workforce shortages are more pronounced. This study examines how medical and dental education programs develop rural healthcare providers, focusing on admissions strategies and training pathways. Using a structured scoping review and secondary data analysis, this research compares how each field incorporates known predictors of rural practice, such as rural background and training experiences, into workforce pipeline development. Findings indicate that while both medical and dental education recognize rural background as a strong predictor of rural practice, medical education more …

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 …

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 …

Leveraging The Science Of Early Life Predictability To Inform Policies Promoting Child Health, Laura M. Glynn, Sabrina R. Liu, Candice Taylor Lucas, Elysia Poggi Davis

Psychology Faculty Articles and Research

Addressing the tremendous burden of early-life adversity requires constructive dialogues between scientists and policy makers to improve population health. Whereas dialogues focused on several aspects of early-life adversity have been initiated, discussion of an underrecognized form of adversity that has been observed across multiple contexts and cultures is only now emerging. Here we provide evidence for “why unpredictability?”, including: 1. Evidence that exposures to unpredictability affect child neurodevelopment, with influences that persist into adulthood. 2. The existence of a translational non-human animal model of exposure to early life unpredictability that can be capitalized upon to causally probe neurobiological mechanisms. 3. …

Improving Patient Care: Expansion Of Access To Free Clinics, Anahis H. Davidian, Gail M. Bloom

Patient Experience Journal

Free clinics provide free or reduced-fee healthcare services for uninsured, underserved, and marginalized populations. Free clinics may be the only source of primary care for socioeconomically disadvantaged individuals lacking health insurance. However, consistently understaffed and underfunded free clinics are struggling to meet growing needs. The demand for services results in long waitlists with long wait times. Most free clinics rely on volunteer providers and staff due to limited financial resources. This case study proposes recommendations that can address the challenges of funding limitations while improving free clinics' ability to offer more accessible and equitable care to serve a greater proportion …

The Impact Of Covid-19 In The Latinx Community, Laura Pedraza, Ricardo Villela, Vikki Kamatgi, Kaitlyn Cocuzzo, Ricardo Correa, Miriam Zylberglait Lisigurski

HCA Healthcare Journal of Medicine

The COVID-19 pandemic has intensified the existing health and social disparities that affect minority groups in the United States (US), including the Latinx community. This situation has been reflected in many aspects of health, including increased morbi-mortality and reduced adherence to medical and scientific recommendations. Limited access to health care, financial challenges, migrant status, and health literacy, or lack thereof, have all hampered the Latinx community's ability to seek aid quickly and to be tested or treated effectively for this disease. This pandemic has shown that the Latinx community's socioeconomic status correlates with greater mortality rates when compared to other …

Citizenship Matters: Non-Citizen Covid-19 Mortality Disparities In New York And Los Angeles, Jason A. Douglas, Georgiana Bostean, Angel Miles Nash, Emmanuel B. John, Lawrence M. Brown, Andrew M. Subica

Health Sciences and Kinesiology Faculty Articles

U.S. non-citizen residents are burdened by inequitable access to socioeconomic resources, potentially placing them at heightened risk of COVID-19-related disparities. However, COVID-19 impacts on non-citizens are not well understood. Accordingly, the current study investigated COVID-19 mortality disparities within New York (NYC) and Los Angeles (LAC) to test our hypothesis that areas with large proportions of non-citizens will have disproportionately high COVID-19 mortality rates. We examined ecological associations between March 2020–January 2021 COVID-19 mortality rates (per 100,000 residents) and percent non-citizens (using ZIP Code Tabulation Areas (ZCTA) for NYC and City/Community units of analysis for LAC) while controlling for sociodemographic factors. …

Health Disparities In Afro-Latinx Populations: Chronic Health Diseases, Linguistic And Cultural Competency, And Inequities And Barriers In Richmond, Virginia, Roma A. Kankaria, Avani Hariprashad, Henzee Machado, Teerth Patel, Anubhav Thapaliya

UROP Posters

Afro-Latinx individuals face health disparities that differ from those faced by white Latinx individuals. This literature review was conducted by the Collective Corazón—a VCU student organization, mentored by Dr. Indira Sultanić, that addresses Latinx health equity through service and advocacy—in order to examine the underlying causes of Afro-Latinx health disparities. Skin color is a predictor of health, life expectancy, and quality of life for many Latinx individuals. On average, Afro-Latinx individuals in particular have less access to education, fewer financial freedoms, and poorer health outcomes. The Afro-Latinx community also describes higher rates of discrimination compared to white Latinx individuals. As …

Perception Of Health Care Access In Rural Georgia: Findings From A Community Health Needs Assessment Survey, Elisa M. Childs, Tiffany R. Washington

Journal of the Georgia Public Health Association

Background: Limited access to health care services has been cited as a barrier to care for individuals who live in rural areas, contributing to significant health disparities in this population. While perception of services has been cited as a determinant of utilization of health services, it is unknown how perception of services influences health care access in rural areas. The paucity of studies specific to areas in the United States that are medically underserved, necessitated this study and its quantification of the issues that are relevant to individuals living in rural Georgia.

Methods: This study examined the perception of health …

Access To Health Care In Appalachia: Perception And Reality, Michele Morrone, Cory E. Cronin, Kristin Schuller, Shannon E. Nicks

Journal of Appalachian Health

Introduction: Health disparities such as cancer and diabetes are well documented in Appalachia. These disparities contribute to health status, and by many indicators, Appalachian people are less healthy than those who live in other parts of the country. Access to health care is one factor that contributes to health disparities. Access to care is complex and involves both intrinsic and extrinsic aspects, including satisfaction with quality of care. This research sought to compare Appalachian to non-Appalachian communities in terms of perceptions of access to care.

Methods: We implemented a statewide survey to quantify perceptions of multiple components of …

Black And White Health Disparities: Racial Bias In American Healthcare, Yasmeen Almomani

Bridges: An Undergraduate Journal of Contemporary Connections

This paper explores the historical implications of race in American society that have led to implicit racism in the healthcare system. Racial bias in healthcare against Black people is a factor in the health disparities between Black and white people in America, such as the gap in life expectancy, infant death, and maternal mortality. Black people are more likely to report racial discrimination from healthcare providers, which is a reason for the decreased quality of care received. The past justifications of slavery, the Tuskegee syphilis study, and the medical experimentations on Black women are horrifying but were considered acceptable in …

Fundamental Causes Of Racial And Ethnic Covid-19-Related Health Disparities, Hana Neutz

Student Scholar Symposium Abstracts and Posters

Underserved low-income communities of color in the U.S. have endured an unequal burden of COVID-19 morbidity and mortality. This pattern of pandemic-related health disparities has been pervasive throughout history. However, no known studies have simultaneously examined social and biological factors that contribute to these concerning health disparities. Therefore, this paper aims to bridge the gap by employing a scoping literature review of (1) the deleterious impacts of systemic racism on COVID-19-related outcomes; and (2) the cellular and molecular mechanisms connecting COVID-19 and hypertension (a comorbidity known to exacerbate COVID-19 severity). My findings indicate that systemic racism manifests in inequitable access …

Addressing Hidden Barriers To Follow Up Healthcare: A Community Referral Pilot Project, Amber Williams

Doctor of Nursing Practice Projects

Objective: The project was aimed to reduce the number of participants lost to primary care follow-up following a mobile health unit screening event.

Design: A pilot study program screening tool implementation was utilized to address the hidden barriers of the Social Determinants of Health (SDoH) during a Winter 2021 event.

Sample: A group of 12 participants were screened during a mobile health unit event. Eight of the participants opted to be a part of the pilot study.

Measurements: A comparison ratio of Primary Care follow up was compared from the Winter of 2020 with Winter of 2021, where the screening …

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 …

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 …

¡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 …

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 …

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 …

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 …

Knowledge Disparities In Diabetes Mellitus Among Undergradute College Students: An Exploratory Study, Caroline Duffy

Honors College Theses

The primary goal of this research study is to examine the knowledge disparities in diabetes mellitus of health related and non- health related undergraduate majors at Georgia Southern University. The Newest Vital Sign tool is used to assess health literacy between majors. Health related majors will have a higher health literacy score. The research questions to be investigated are (a). do non-health related majors lack an understanding of diabetes mellitus and (b). do all college students have adequate health literacy. With the findings, health education and promotion programs can be established and directed towards the appropriate population.

Reducing Stigma-Driven Health Disparities In People Living With Hiv (Plwh): A Literature Review, Stephanie P. Dizon

McNair Research Journal SJSU

Introduction: Research has found that HIV-related stigma has numerous negative impacts on the lives of people living with HIV (PLWH). Although there are more resources than ever dedicated to HIV/AIDS efforts, stigma continues to be a major factor challenging the prevention and treatment of HIV today. Understanding the impacts of stigma on health outcomes and quality of life in PLWH is essential to address the global HIV epidemic and reduce health disparities.

Search Strategy: We conducted a secondary meta-analysis of existing research that discussed and evaluated the impacts of HIV-related stigma and discrimination on PLWH. We searched the following databases …

Social Ecological Constraints To Park Use In Communities With Proximate Park Access, J. Aaron Hipp, Deepti Adlakha, Ravikumar Chockalingam

Brown School Faculty Publications

Evidence correlates physical activity, psychological restoration, and social health to proximity to parks and sites of recreation. The purpose of this study was to identify perceived constraints to park use in low-income communities facing significant health disparities, but with proximate access to underutilized parks. The authors used a series of focus groups with families, teens, and older adults in neighborhoods with similar demographic distribution and parks over 125 acres in size. Constraints to park use varied across age groups as well as across social ecological levels, with perceived constraints to individuals, user groups, communities, and society. Policies and interventions aimed …

Individualized Healthcare And Health Disparities: An Examination Of Health Disparities Related To Short-Term Response To Food Insecurity In Low-Income, Urban Communities, Valen R. Diaz

Honors Scholar Theses

The U.S. has seen a spike in chronic diseases along with worsening health outcomes. There are many factors at play to create these circumstances, especially regarding the social determinants of health, like socioeconomic status, access to food, and geographic location. Another concern is health disparities, particularly regarding obesity, and the fact that food access and neighborhood food environments contribute to these disparities. This paper gives a broad overview of American food culture and then focuses on the local food environment in urban, low-income communities, regarding both food deserts and food swamps. There is also a discussion about the response of …

Changing Corporate Practices To Reduce Cancer Disparities, Nicholas Freudenberg, Sandro Galea, Marianne Fahs

Publications and Research

While reducing racial/ethnic and socioeconomic disparities in cancer mortality has been identified as a national goal, current policies are unlikely to achieve it. In order to advance the development of policies for the primary prevention of cancer and cancer disparities, we propose that the practices of the tobacco, alcohol, and food industries be considered as modifiable social determinants of health. We review evidence that the practices of these industries in product design, marketing, retail distribution, and pricing contribute to cancer risk behavior, incidence, and disparities, then examine public health strategies designed to reduce health-damaging practices of these industries and encourage …

Constructing Whiteness In Health Disparities Research, Jessie Daniels, Amy J. Schulz

Publications and Research

There is a long tradition within the United States of constructing whiteness (the racial subject) against racialized others (the racial object) and in the process displacing the focus of critical analysis. Here we turn our lens to the often invisible--or at least underinterrogated--concept of whiteness within the context of the literature on racial disparities in health. Specifically, we examine how whiteness is constructed in the active literature documenting and interpreting racial disparities in health and the implications of these constructions for efforts to eradicate inequalities in health. We draw on the concepts of racial formation and "racial projects" that emphasize …