Public Health Education and Promotion Commons^™

Reduced Vascular Function, Ventilatory Efficiency And Exercise Capacity In Young Adult Electronic Cigarette Users, Azmy Faisal, Agata Giles, Sarah Jones, Christopher I. Morse, Hans Degens, Caroline J. Jolley, Steven K. Rogers, Rashid Ahmed, Amany F. Elbehairy, Rehan T. Junejo

Department of Public Health Scholarship and Creative Works

Background: Acute electronic cigarette (E-cigarette) use has shown adverse cardiorespiratory impacts similar to conventional cigarette (C-cigarette) smoking; however, its early effects remain unclear. We aimed to examine the early effects of E-cigarette use on systemic vascular function, cardiorespiratory responses to exercise and exertional symptoms in young adults.

Methods: 75 healthy active young adults (18–30 years), divided into three age- and sex-matched groups (E-cigarette users, C-cigarette smokers and never-smoker controls; n=25 each, E-cigarette use or smoking duration ≥18 months), underwent an incremental cycle exercise test with standard metabolic, cardiorespiratory, blood lactate and sensory measurements. Brachial artery flow-mediated dilatation (FMD) was assessed …

The Health Communications Assessment Checklist: A Teaching Tool For Uncovering Bias In The Age Of Ai, Rebecca H. Ofrane, Taliah Canada, Amanda S. Birnbaum

Department of Public Health Scholarship and Creative Works

Introduction: The COVID-19 pandemic highlighted significant failures in United States public health communications, which were often perceived as unclear and biased, particularly among racialized and marginalized groups. As generative artificial intelligence (genAI) becomes integrated into public health practice, there is an urgent need to train the workforce to recognize and mitigate the societal biases these tools can reproduce. This study describes the development and classroom testing of a tool designed to teach these critical evaluation skills.

Methods: We developed the “Health Communications Assessment Checklist,” a 14-question pedagogical tool based on the CommunicateHealth Framework for Equity-Centered Health Communication and the CDC’s …

Depressive Symptoms, Campus Connectedness, And Campus Climate Related To Sexual Violence And Misconduct, Stephanie A. Navarro Silvera, Amanda S. Birnbaum, Eva S. Goldfarb, Ranju Mainali, Lisa D. Lieberman

Department of Public Health Scholarship and Creative Works

Depression, although a consequence of sexual violence, has not been studied in the context of college students’ views of campus sexual violence climate. Depression is one of the most prevalent and impairing mental health concerns among college students and has well-established links to sexual violence victimization; therefore, it serves as a theoretically and clinically meaningful focal outcome. Therefore, we assessed perceptions of institutional climate in the context of self-reported depression. Undergraduates (n = 716) reported perceptions and experiences of campus sexual violence and misconduct, connectedness, attitude, and depressive symptoms in an online survey. More than a third of participants reported …

Dual Challenges, Shared Wins: Unlocking Climate Financing For Nutrition, Chiara Dell’Aira, Natalia Rovelo-Velazquez, Sarah Lahaye, Xiu Xin Catherine Lok, Stella Nordhagen, Stephen Dorey, Mireya Vilar-Compte

Department of Public Health Scholarship and Creative Works

Background

The intertwined challenges of climate change and malnutrition amplify each other, with climate change exacerbating malnutrition, particularly in vulnerable populations; and food systems significantly contributing to emissions and environmental degradation. Addressing these issues together offers opportunities for shared gains, yet funding streams for these sectors remain siloed and misaligned.

Objective

This study developed a scoring methodology to assess the compatibility of climate funds with financing nutrition-related actions where synergies align with climate funds’ primary goals, referred to as the “scope for nutrition integration”.

Methods

Using the Climate Funds Update database, 18 active climate funds were systematically reviewed …

Is It Rape Or Consent? College Men Just Don’T Know, Stephanie A. Navarro Silvera, Eva S. S. Goldfarb, Amanda S. Birnbaum, Lisa D. Lieberman

Department of Public Health Scholarship and Creative Works

Introduction: Women and LGBTQ+ undergraduates face higher rates of sexual assault and rape compared to cisgender male peers—the overwhelming majority of perpetrators. Federal policies have aimed to curb campus sexual violence, yet questions remain about the efficacy of consent education, particularly among cisgender heterosexual men. Methods: This study surveyed 1567 undergraduate students at a large Northeastern public university in 2017 and 2022. Responses to a nine-item consent scale were analyzed by gender, sexuality, and demographic factors. Results: Cisgender heterosexual (cis-het) men had poorer understanding of consent compared to women and LGBTQ+ students, both in 2017 and 2022. Cis-het men’s consent …

Geographic Disparities In Birth Outcomes: County-Level Investigation On Pm2.5 And Low Birth Weight In The United States, Eunice Y. Park, Ranju Mainali

Department of Public Health Scholarship and Creative Works

Exposure to air pollution adversely affects health and is highly associated with birth outcomes. This study analyzes the relationship between air pollution and low birth weight (LBW; less than 2,500 g at birth) at the county level in the United States. Using the latest publicly available data from the County Health Rankings and Roadmaps across 3,027 counties and equivalents, simple and quantile regression analyses were conducted to test the association between the average daily density of fine particulate matter (PM2.5) and LBW. The LBW data were from 2016 to 2022 from the National Center for Health Statistics and PM2.5 data …

Is Universal Health Coverage Really Better? Unintended Consequences Of The 2019 Amendment Of The National Health Insurance Act For Humanitarian Sojourners In South Korea, Minji Ju, Minah Kang, Eunice Y. Park

Department of Public Health Scholarship and Creative Works

Background

South Korea achieved universal health coverage (UHC) through the National Health Insurance (NHI). However, humanitarian sojourners under temporary stay permits were initially excluded. Alongside recommendations from the National Human Rights Commission of Korea (NHRCK), the 2019 Amendment of the NHI Act expanded eligibility of the NHI. While this marked significant progress toward greater universality in health care, it also led to unintended consequences for humanitarian sojourners.

Methods

This study employed a two-fold approach aligned with the trajectory of the Amendment. First, we conducted semi-structured in-depth interviews to analyze diverse perspectives on the universality of health coverage, the benefits of …

Menopause And Autism: Towards A Public Health Framework, Amanda Birnbaum, Alicia Broderick, Caprice Benoit, Bhumi Patel

Department of Public Health Scholarship and Creative Works

Despite volumes of autism publications, there are enormous gaps in what we know about autism in adults and women. Yet, a large UK study reported that recent surges in autism diagnoses have been greatest in these populations. As the understanding of who is autistic expands, so too must our understanding of autism across the lifecourse.

Menopause is one (of many) underexplored aspects of the autistic lifecourse. Based on the sparse literature on autism and menstruation, there is reason to believe the hormonal changes of menopause may create more challenges for autistic than neurotypical adults. Some qualitative research suggests that …

Enhancing Health Education: The Role Of Social Emotional Learning In Prek-12 Students' Well-Being, Elena Saldutti, Joseph Donnelly, Judy Lobianco, Mary Connolly

Department of Public Health Scholarship and Creative Works

Purpose: This commentary delves into the profound impact of Social Emotional Learning (SEL), particularly through the lens of the Collaborative for Academic, Social, and Emotional Learning (CASEL), on Health Education, elucidating its potential to nurture the well-being of PreK-12 students. Results: Students experiencing comprehensive skills-based health/SEL education gain knowledge, skills, and competencies that are used within and beyond the classroom, fostering the development of healthier decision-making, bolstering self-esteem, and enriching the emotional and mental wellness of students. Health educators have the opportunity to utilize CASEL's SEL Competencies in conjunction with the National Health Education Standards, as both are mutually aligned …

Voting Restrictions And Increased Odds Of Adverse Birth Outcomes In The Us, Sze Yan Liu, Erin Grinshteyn, Daniel Cook, Roman Pabayo

Department of Public Health Scholarship and Creative Works

Background: Disparities persist in adverse birth outcomes — preterm birth and small-for-gestational age (SGA) among racialized populations. Previous studies have indicated that voting restrictions are associated with health outcomes, such as access to health insurance and teenage birth rates. This paper examines whether the association between voting restrictions and adverse birth outcomes varies according to birthing individuals’ race/ethnicity. Methods: These analyses merged individual-level 2019–2020 Pregnancy Risk Assessment Monitoring System (PRAMS, 8th edition) data with state-level exposure information. The exposure, the Cost of Voting Index (COVI), is a 2020 state-level measure of voting restrictions, and the outcomes were preterm birth and …

Public Health Implications Of Social Media On Adolescent Health Behaviors: Upstream Approaches To Prevention Strategies, Joseph Donnelly, Elena Saldutti

Department of Public Health Scholarship and Creative Works

This commentary provides a comprehensive overview of the influence of social media on the health and well-being of adolescents, focusing on emotional/mental health, self-esteem, alcohol and drug use, peer pressure, and both negative and positive influences. It highlights concerns about the potential negative impact of social media, including increased levels of anxiety, depression, and loneliness, as well as the impact on self- esteem through seeking validation and unrealistic comparisons. Furthermore, it discusses how social media exposes adolescents to content promoting alcohol and drug use and amplifies peer pressure, leading to potential substance abuse and negative decision-making. Despite these drawbacks, the …

Official Multidimensional Measurement Of Poverty In Mexico: Scope And Limitations, Miguel Reyes, Graciela Teruel, Mireya Vilar, Oliver López, Vanessa Pérez

Department of Public Health Scholarship and Creative Works

The aim of this study is to identify the achievements and limitations of the official multidimensional measurement of poverty in Mexico, identify some opportunities for improvement, and propose a series of modifications that would enhance its technical robustness and increase its relevance for the design, analysis, and evaluation of public policies. After a critical analysis of its conceptual and methodological foundations, it is argued that the proposed modifications, particularly the inclusion of new dimensions, would improve the measurement of poverty and make it more relevant for diagnosing the country’s social situation.

Adaptation Of A Community Health Outreach Model During The Covid-19 Pandemic: The Case Of The Mexican Consulates In The United States Of America, Pablo Gaitán-Rossi, Mireya Vilar-Compte, Arturo Vargas Bustamante

Department of Public Health Scholarship and Creative Works

The Ventanillas de Salud (VDS – “Health Windows”) are a culturally sensitive outreach program within the 49 Mexican Consulates in the United States that provides information and health care navigation support to underserved and uninsured Mexican immigrants. During the COVID-19 pandemic the VDS rapidly transitioned to remote operations adding new services. Based on the EquIR implementation framework, this qualitative study investigates how adaptations to improve emergency preparedness were performed. We conducted motivational interviews with three actors – six VDS coordinators, eight partner organizations, and ten VDS users– in two VDS, Los Angeles and New York, to document specific needs of …

Can Changing Neighborhoods Influence Mental Health? An Ecological Analysis Of Gentrification And Neighborhood-Level Serious Psychological Distress—New York City, 2002–2015, Karen A. Alroy, Haleigh Cavalier, Aldo Crossa, Shu Meir Wang, Sze Yan Liu, Christina Norman, Michael Sanderson, L. Hannah Gould, Sung Woo Lim

Department of Public Health Scholarship and Creative Works

Neighborhood conditions influence people’s health; sustaining healthy neighborhoods is a New York City (NYC) Health Department priority. Gentrification is characterized by rapid development in historically disinvested neighborhoods. The gentrification burden, including increased living expenses, and disrupted social networks, disproportionally impacts certain residents. To ultimately target health promotion interventions, we examined serious psychological distress time trends in gentrifying NYC neighborhoods to describe the association of gentrification and mental health overall and stratified by race and ethnicity. We categorized NYC neighborhoods as hypergentrifying, gentrifying, and not-gentrifying using a modified New York University Furman Center index. Neighborhoods with ≥100% rent growth were hypergentrifying; …

Public Health Implications: A Scoping Review Of Opioid Prevention Programs Among Adolescents, Joseph Donnelly, Elena Saldutti, Lisa Ellis Gavin, Michael Hecht

Department of Public Health Scholarship and Creative Works

This article presents a comprehensive review of the pressing issue of adolescent opioid and fentanyl deaths and overdoses, highlighting the urgent need for effective prevention strategies and educational interventions. The escalating crisis of opioid abuse among adolescents necessitates immediate attention from drug educators, concerned parents, and society as a whole. We examine the alarming rise in adolescent opioid and fentanyl-related fatalities, emphasizing the unique challenges posed by fentanyl's potency and the dangerous allure it holds for young individuals. By analyzing existing harm reduction strategies, we underscore the crucial role they play in mitigating the devastating consequences of opioid use. Moreover, …

Sleepless In Inequality: Findings From The 2018 Behavioral Risk Factor Surveillance System, A Cross-Sectional Study, Roman Pabayo, Priya Patel, Sze Yan Liu, Beth E. Molnar

Department of Public Health Scholarship and Creative Works

Despite the large body of research on the adverse effects of income inequality, to date, few studies have examined its impact on sleep. The objective of this investigation is to examine the association between US state income inequality and the odds for regularly obtaining inadequate (<  7 h) and very inadequate (<  5 h) of sleep in the last 24 h. We analysed data from 350,929 adults participating in the US 2018 Behavioral Risk Factor Surveillance System (BRFSS). Multilevel modeling was used to determine the association between state-level income inequality, as measured by the Gini coefficient, and the odds for obtaining inadequate and very inadequate sleep. We also determined if associations were heterogeneous across gender. A standard deviation increase in the Gini coefficient was associated with increased odds for inadequate (OR = 1.06, 95% CI: 1.00, 1.13) and very inadequate sleep (OR = 1.11, 95% CI: 1.03,1.20). Also, a cross-level Gini Coefficient X Gender interaction term was significant (OR = 1.07, 95% CI:1.01,1.13), indicating that increasing income inequality was more detrimental to women’s sleep behavior. Future work should be conducted to determine whether decreasing the wide gap between incomes can alleviate the burden of income inequality on inadequate sleep in the United States.

Financial Barriers To Mental Healthcare Services And Depressive Symptoms Among Residents Of Washington Heights, New York City, Roman Pabayo, Claire Benny, Sze Yan Liu, Erin Grinshteyn, Peter Muennig

Department of Public Health Scholarship and Creative Works

Objectives: In the United States, Hispanics are more likely to experience financial barriers to mental health care than non-Hispanics. We used a unique survey to study the effect of these financial barriers on the severity of depressive symptoms among Hispanics who had previously been diagnosed as having depression. Methods: This cross-sectional study used data from the 2015 Washington Heights Community Survey, administered to 2,489 households in Manhattan, New York City. Multiple regression models and propensity score matching were used to estimate the association between financial barriers to mental health care and depressive symptoms and the likelihood of being clinically depressed. …

The Relationship Between Voting Restrictions And Covid-19 Case And Mortality Rates Between Us Counties, Roman Pabayo, Erin Grinshteyn, Brian Steele, Peter Muennig, Sze Yan Liu

Department of Public Health Scholarship and Creative Works

Background

Since the 2010 election, the number of laws in the U.S. that create barriers to voting has increased dramatically. These laws may have spillover effects on population health by creating a disconnect between voter preferences and political representation, thereby limiting protective public health policies and funding. We examine whether voting restrictions are associated with county-level COVID-19 case and mortality rates.

Methods

To obtain information on restricted access to voting, we used the Cost of Voting Index (COVI), a state-level measure of barriers to voting during a U.S. election from 1996 to 2016. COVID-19 case and mortality rates were obtained …

The Bidirectional Relationship Between Posttraumatic Stress Symptoms And Social Support In A 9/11-Exposed Cohort: A Longitudinal Cross-Lagged Analysis, Sze Yan Liu, Jiehui Li, Lydia F. Leon, Ralf Schwarzer, James E. Cone

Department of Public Health Scholarship and Creative Works

Research on the longitudinal relationship between posttraumatic stress disorder (PTSD) and social support among survivors of large-scale trauma is limited. This study assessed bidirectional relationships between PTSD and perceived social support in a large sample of the 9/11-exposed cohort over a 14-year follow-up. We used data from 23,165 World Trade Center Health Registry (WTCHR) enrollees who were exposed to the 9/11 attacks and participated in the first four WTCHR surveys (Wave 1 (2003–2004) to Wave 4 (2015–2016)). PTSD symptoms were measured using the 17-item PTSD Checklist. Perceived social support was measured using the five-item version of the Modified Social Support …

Assessing Sexual Assault And Harassment At Montclair State University: Research Abstracts, Amanda Birnbaum, Eva Goldfarb, Lisa Lieberman, Stephanie A. Navarro Silvera

Department of Public Health Scholarship and Creative Works

No abstract provided.

Public Health Implications Of Cannabis Legalization: An Exploration Of Adolescent Use And Evidence-Based Interventions, Joseph Donnelly, Michael Young, Brenda Marshall, Michael L. Hecht, Elena Saldutti

Department of Public Health Scholarship and Creative Works

Abstract: This article examines the relaxation of state marijuana laws, changes in adolescent use of marijuana, and implications for drug education. Under federal law, use of marijuana remains illegal. In spite of this federal legislation, as of 1 June 2021, 36 states, four territories and the District of Columbia have enacted medical marijuana laws. There are 17 states, two territories and the District of Columbia that have also passed recreational marijuana laws. One of the concerns regarding the enactment of legislation that has increased access to marijuana is the possibility of increased adolescent use of marijuana. While there are documented …

Aproximación Al Consumo De Alimentos Recomendables Y No Recomendables En La Primera Ola De La Pandemia Por Covid-19 En México, Erika Lozano-Hidalgo, Mauricio Hernández-Fernández, Pablo Gaitán-Rossi, Mireya Vilar-Compte

Department of Public Health Scholarship and Creative Works

Objective. To estimate the frequency of consumption of some recommended and non-recommended food groups during the Covid-19 pandemic in Mexico, and their association with sociodemographic characteristics and food security. Materials and methods. We used the Survey on the Effects of Covid-19 on the wellbeing of Mexican households (Encovid-19). We identified four groups with information about the frequency of their consumption, and estimated logistic regression models adjusted for sociodemographic characteristics and food security. Results. Higher socioeconomic levels A/B and C were associated with higher frequency of consumption of recommended and non-recommended food groups. Mild food insecurity was associated with lower consumption …

Reply To The Commentary Of The Article "Monthly Prevalence Of Generalized Anxiety Disorder During The Covid-19 Pandemic In Mexico", Pablo Gaitán-Rossi, Víctor Pérez-Hernández, Mireya Vilar-Compte, Graciela Teruel-Belismelis

Department of Public Health Scholarship and Creative Works

No abstract provided.

The Yearly Financing Need Of Providing Paid Maternity Leave In The Informal Sector In Indonesia, Adiatma Y. M. Siregar, Pipit Pitriyan, Donny Hardiawan, Paul Zambrano, Mireya Vilar-Compte, Graciela Ma Teruel Belismelis, Meztli Moncada, David Tamayo, Grace Carroll, Rafael Perez-Escamilla, Roger Mathisen

Department of Public Health Scholarship and Creative Works

Background: The economic cost of not breastfeeding in Indonesia is estimated at US$1.5–9.4 billion annually, the highest in South East Asia. Half of the 33.6 million working women of reproductive age (WRA) in Indonesia (15–49 years) are informal employees, meaning they are working as casual workers or they are self-employed (small scale business) and assisted by unpaid/family worker(s). No specific maternity protection entitlements are currently available for WRA working informally in Indonesia. This study aims to estimate the financing need of providing maternity leave cash transfer (MCT) for WRA working in the informal sector in Indonesia. Method: The costing methodology …

Breastfeeding Media Coverage And Beliefs During The Covid-19 Pandemic In Mexico: Implications For Breastfeeding Equity, Mireya Vilar-Compte, P. Gaitán‐Rossi, E. C. Rhodes, V. Cruz‐Villalba, R. Pérez‐Escamilla

Department of Public Health Scholarship and Creative Works

Background: Because breastfeeding offers short- and long- term health benefits to mothers and children, breastfeeding promotion and support is a public health priority. Evidence shows that SARS-CoV-2 is not likely to be transmitted via breastmilk. Moreover, antibodies against SARS-CoV-2 are thought to be contained in breastmilk of mothers with history of COVID-19 infection or vaccination. WHO recommends direct breastfeeding as the preferred infant feeding option during the COVID-19 pandemic, even among women with COVID-19; but conflicting practices have been adopted, which could widen existing inequities in breastfeeding. This study aims to describe how information about breastfeeding was communicated in Mexican …

Impact Of The Covid-19 Pandemic On Loneliness And Social Isolation: A Multi-Country Study, Roger O’Sullivan, Annette Burns, Gerard Leavey, Iracema Leroi, Vanessa Burholt, James Lubben, Julianne Holt-Lunstad, Christina Victor, Brian Lawlor, Mireya Vilar-Compte, Carla M. Perissinotto, Mark A. Tully, Mary Pat Sullivan, Michael Rosato, Joanna Mchugh Power, Elisa Tiilikainen, Thomas R. Prohaska

Department of Public Health Scholarship and Creative Works

The COVID-19 global pandemic and subsequent public health social measures have challenged our social and economic life, with increasing concerns around potentially rising levels of social isolation and loneliness. This paper is based on cross-sectional online survey data (available in 10 languages, from 2 June to 16 November 2020) with 20,398 respondents from 101 different countries. It aims to help increase our understanding of the global risk factors that are associated with social isolation and loneliness, irrespective of culture or country, to support evidence-based policy, services and public health interventions. We found the prevalence of severe loneliness was 21% during …

La Migración Como Determinante De La Obesidad Infantil En Estados Unidos Y Latinoamérica, Mireya Vilar-Compte, Arturo V. Bustamante, Nancy López-Olmedo, Pablo Gaitán-Ross, Jaqueline Torres, Karen E. Peterson, Graciela Teruel, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

La migración internacional tiene consecuencias económicas y en la salud. El proceso de aculturación en el país de acogida puede estar relacionado con la obesidad infan-til. Utilizamos el marco conceptual del balance energético comunitario (CEB, por sus siglas en inglés) para analizar la relación entre migración y obesidad infantil en los hogares mexicanos con migrantes internacionales. Utilizando datos longitudinales de la Encuesta Nacional de Niveles de Vida de los Hogares de México (ENNViH), exami-namos cómo influyen las redes de migrantes sobre la obesidad infantil en las comuni-dades de origen. También revisamos programas de salud binacionales que podrían ser eficaces para …

Barriers To Voting And Access To Health Insurance Among Us Adults: A Cross-Sectional Study, Roman Pabayo, Sze Yan Liu, Erin Grinshteyn, Daniel M. Cook, Peter Muennig

Department of Public Health Scholarship and Creative Works

Background: Many states in the United States (US) have introduced barriers to impede voting among individuals from socio-economically disadvantaged groups. This may reduce representation thereby decreasing access to lifesaving goods, such as health insurance. Methods: We used cross-sectional data from 242,727 adults in the 50 states and District of Columbia participating in the US 2017 Behavioral Risk Factor Surveillance System (BRFSS). To quantify access to voting, the Cost of Voting Index (COVI), a global measure of barriers to voting within a state during a US election was used. Multilevel modeling was used to determine whether barriers to voting were associated …

Prevalencia Mensual De Trastorno De Ansiedad Generalizada Durante La Pandemia Por Covid-19 En México, Pablo Gaitán-Rossi, Víctor Pérez-Hernández, Mireya Vilar-Compte, Graciela Teruel-Belismelis

Department of Public Health Scholarship and Creative Works

Objective. Estimate the prevalence of generalized anxiety disorder (GAD) from April to June 2020. Materials and methods. Repeated cross-sections design based in the Encovid-19, a series of monthly mobile surveys with represen- tative samples of Mexico (N= 833-1 674).The questionnaire includes the GAD-2 scale, and, in July, the GAD-7 scale was added; we examined its internal validity with confirmatory factor analysis and its concurrent validity with sociodemo- graphic variables. Using GAD-7 as criterion, we analyzed the predictive validity of the GAD-2.We estimated the monthly prevalence with the GAD-2. Results. The GAD-7 and the GAD-2 are reliable and valid.The GAD-2 has …

Migration As A Determinant Of Childhood Obesity In The United States And Latin America, Mireya Vilar-Compte, Arturo V. Bustamante, Nancy López-Olmedo, Pablo Gaitán-Rossi, Jaqueline Torres, Karen E. Peterson, Graciela Teruel, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

International migration has economic and health implications. The acculturation process to the host country may be linked to childhood obesity. We use the Community Energy Balance (CEB) framework to analyze the relationship between migration and childhood obesity in Mexican households with international migrants. Using longitudinal data from the Mexican Family Life Survey (MxFLS), we examine how migrant networks affect childhood obesity in origin communities. We also review binational health programs that could be effective at tackling childhood obesity in migrant households from Mexico. Children embedded in migrant networks are at greater risk of developing overweight or obesity, suggesting a significant …