Geographic Information Sciences Commons^™

Interrogating Race And Place-Based Inequities In Hiv And Covid-19, Rohan Khazanchi

MD Honors Theses

Over the last four years, I have developed a research focus examining the intersections of race, place, and health. My M.D. Honors Thesis reflects a snapshot of these efforts. In this collection of brief research reports, I leverage area-based measures to investigate structural inequities in three contexts: the HIV epidemic in our hyperlocal community, the early stages of the COVID-19 pandemic, and clinical trials for novel COVID-19 therapeutics. I apply novel social epidemiologic tools to measure and explore disparate outcomes. And, in reflecting upon my findings, I discuss concrete implications for clinicians, researchers, and policymakers alike.

Chapter 1: Neighborhood-Level Deprivation …

Using Geospatial Analysis To Evaluate Relationships Between Cancer Incidence And Social Factors In Brooklyn, Ny, Sheena Philogene

Theses and Dissertations

This study explored the spatial distribution of cancer incidence in Brooklyn, NY. Using publicly available data, the relationships between cancer incidence and factors linked to cancer were investigated. Furthermore, the study explored the value of using large amounts of data with GIS techniques to quickly analyze geographic trends for cancer.

Geography Of Covid-19 Waves In Georgia, Walker Tompkins

Symposium of Student Scholars

Geography of COVID-19 Waves in Georgia

Over the past 2 years everyone on the globe’s lives have been changed drastically after the COVID-19 virus spread across the world. This united and divided us more than any other event in most of our lifetimes. The pandemic everyone and now that there are two years of data, it is important to examine impacts at various geographic scales. As such, focusing on the state of Georgia, this project explores how the different variants, public policy, and vaccination of our population has changed the trajectory of the virus and how many deaths it has …

Interrogating Race And Place-Based Inequities In Hiv And Covid-19, Rohan Khazanchi

EMET Projects

Over the last four years, I have developed a research focus examining the intersections of race, place, and health. My M.D. Honors Thesis reflects a snapshot of these efforts. In this collection of brief research reports, I leverage area-based measures to investigate structural inequities in three contexts: the HIV epidemic in our hyperlocal community, the early stages of the COVID-19 pandemic, and clinical trials for novel COVID-19 therapeutics. I apply novel social epidemiologic tools to measure and explore disparate outcomes. And, in reflecting upon my findings, I discuss concrete implications for clinicians, researchers, and policymakers alike.

Chapter 1: Neighborhood-Level Deprivation …

Environmental Racism In Baltimore: A Geographical Study Into The Connections Between Environmental Toxins And Public Health, Genevieve Block

Honors Theses

An investigation into the relationship between environmental toxins and environmental racism in Baltimore City, Maryland.

Examining The Spatial Relationship Between Maternal Morbidity, Access To Health Care, And Community Characteristics In West Virginia, Sarah E. Woolard

Graduate Theses, Dissertations, and Problem Reports (ETD)

Maternal-related morbidity rates in the United States have risen almost three fold since the early 1990’s. Issues related to rurality, socioeconomic disparities, and pre-existing health conditions increase the risk of poor pregnancy outcomes and introduce barriers to accessing advanced maternal health care. West Virginia (WV) has higher maternal morbidity rates than many other states in the United States (US), and is considered to be driven by all 55 counties being classified as Appalachian, possessing the highest prenatal smoking rate in the US, and having disparities in access to health care. Despite this, no previous studies have evaluated maternal morbidity in …

Synthesis Of A Multimodal Ecological Model For Scalable, High-Resolution Arboviral Risk Prediction In Florida, Sean P. Beeman

USF Tampa Graduate Theses and Dissertations

West Nile virus (WNV) and Eastern Equine Encephalitis virus (EEEV) represent the two greatest endemic arboviral risks to the state of Florida. Currently, no approved human vaccine exists for the prevention of either virus. In the absence of a vaccine, effective disease surveillance is paramount for public health. In Florida, WNV and EEEV sentinel chicken surveillance is conducted by mosquito control programs operated at the county, municipality, or special taxing district level. This program was implemented in 1978 following human outbreaks of St. Louis Encephalitis virus (SLEV) that occurred between 1959 and 1977, with initial sentinel coops placed in proximity …

Mapping The Suitability Of Cal Poly's Insulated Solar Electric Cookers (Isec) In Ghana, Togo, And Jamaica, Julia G. Kraatz

Social Sciences

The World Health Organization estimates that 3 billion people depend on biomass fuels for cooking, heating, and other day-to-day activities, which causes approximately 4.3 million people annually to die from illnesses attributable to indoor air pollution. The issue is especially pressing for women and children in developing countries, because women care for the home and are consequently responsible for attaining household fuels and cooking. In 2015, ISECs (Insulated Solar Electric Cookers) were developed at California Polytechnic State University, San Luis Obispo, as a technology that utilizes solar electricity to directly cook food in a well-insulated chamber. They are capable of …

Evaluating Urban Parks Accessibility And Equity: A Case Study Of Hartford, Ct And New Haven, Ct, Natalie Roach, Mara Tu

Honors Scholar Theses

Public parks provide cities with environmental benefits, positive health effects, recreational opportunities, community building, educational spaces, and public amenities. However, certain populations have been systematically denied their fair share of these benefits because of unjust practices in the creation and maintenance of urban parks. With a lens of environmental justice, the goal of this research was to assess park quality and accessibility of two Connecticut cities, Hartford and New Haven, by gathering publicly available information as well as using GIS tools.

The Trust for Public Land (TPL) has an existing ParkScore rating system that evaluates the quality of a city’s …

Mapping Nevada's Dental Workforce, Kelvin Chen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Access to care is a concern at the forefront of public health. Due to socioeconomic and geopolitical pressures, the distribution of healthcare providers across a population often does not coincide with the demand for healthcare in a specific geographic area. Rural areas typically do not have enough providers and urban areas typically have too many. This stark reality underscores an inherent inefficiency in the allocation of healthcare resources and is a discrepancy that must be addressed by state-sponsored institutions and programs. From a public health perspective, the problem of insufficient or lack of access to care is the greater of …

Predictive Modeling Of Fmol Health System Utilization Using Machine Learning Algorithms And Retrospective Study Of Covid Tested Patients, Ramyakrishna Tummala

LSU Master's Theses

Overutilization of Emergency Departments (ED) is a major problem among the health care providers in the United States. In this research, a machine learning-based predictive model for predicting ED high utilizers will be designed based on a set of existing and proposed facilities and the population and social determinant of health (SDOH) factors influencing utilization. The purpose of the model will be to alert the healthcare systems and government organizations by identifying the reasons for overutilization of the medical services among the people in a particular community. Also, the novel coronavirus disease 2019 (COVID-19) developed in Whunan city, China has …

Substance Use Disorder Program Facilities In Detroit: A Geographic Analysis, Oksana Doubrovski

Medical Student Research Symposium

Background: Over 630,000 Michiganders have a substance use disorder (SUD) and about 80% are not receiving care (1). The rate of unmet need for SUD care in the Detroit-Dearborn-Livonia area is 81% (1). Geographic placement of facilities may serve as a barrier in patient access to SUD program services. This geographic analysis investigates current Detroit SUD program facility locations and their community demographics.

Methods: ArcGIS Pro was used to visualize and analyze data by creating 2D maps and tables. Data on SUD programs, medically underserved areas, and zip codes were retrieved from government data portals. Census tract data …

Maternal Proximity To Mountaintop Removal Mining And Birth Defects In Appalachian Kentucky, 1997-2003, Daniel B. Cooper

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Extraction of coal through mountaintop removal mining (MTR) alters many dimensions of the landscape, and explosive blasts, exposed rock, and coal washing have the potential to pollute air and water with substances known to increase risk of developmental and birth anomalies. Previous research suggests that infants born to mothers living in MTR coal mining counties have higher prevalence of most types of birth defects.

Objectives: This study seeks to examine further the relationship between MTR activity and birth defects by employing individual level exposure estimation through precise satellite data of MTR activity in the Appalachian region and maternal residence …

Assessing The Vulnerability Of Monterey Bay Area Seniors To Covid-19, Ethan A. Quaranta, Gerhard L. Gross

Culture, Society, and Praxis

This paper assesses the vulnerability of seniors residing in the Monterey Bay Tri-County Region to the COVID-19 pandemic. Due to weakened immune systems, seniors are the most at-risk members of our community to COVID-19, and have a death rate that is three times higher than the overall death rate to COVID-19. Using standard ambulance response times from each hospital throughout the area, our objective is to determine what proportion of Tri-County seniors aged 65 and over, including those who are in nursing homes, are living independently, and cannot afford health care, were within an adequate travel time to the hospital. …

Improving Access To Treatment For Opioid Use Disorder In High-Need Areas: The Role Of Hrsa Health Centers, Michael Topmiller, Jennifer Rankin, Jessica L. Mccann, Jene Grandmont, David Grolling, Mark Carrozza, Hank Hoang, Josh Bolton, Alek Sripipatana

Journal of Appalachian Health

Introduction: Despite the opioid epidemic adversely affecting areas across the U.S. for more than two decades and increasing evidence that medication-assisted treatment (MAT) is effective for patients with opioid use disorder (OUD), access to treatment is still limited. The limited access to treatment holds true in the Appalachia region despite being disproportionately affected by the crisis, particularly in rural, central Appalachia.

Purpose: This research identifies opportunities for health centers located in high-need areas based on drug poisoning mortality to better meet MAT care gaps. We also provide an in-depth look at health center MAT capacity relative to need …

On The Importance Of Context: Examining The Applicability Of Infertility Insurance Mandates In The United States Using A Mixed-Methods Study Design, Nathanael B. Stanley

USF Tampa Graduate Theses and Dissertations

Accessibility of infertility services is disproportionately experienced in the United States. Although there exist state-based health insurance mandates for infertility services, these mandates contain language that disqualify people from using them. In order to better understand why these mandates are not able to reduce the financial burden and bridge the income disparity for using infertility services, the purpose of this study is to add context to the applicability of these insurance mandates through qualitative and quantitative inquiry. Using the Glass and McAtee model of risk regulators as an operational paradigm, this research explores the role of environmental context, or “place”, …

Cluster Analysis Of Opioid Accessibility In The Carolinas Using Data From The Arcos Database And An Enhanced Two-Step Floating Catchment Area Method, Michael T. Bunker

Electronic Theses and Dissertations

This study takes advantage of transaction level data from the U.S. Drug Enforcement Administration's (DEA) Automation of Reports and Consolidated Orders System (ARCOS) database made newly available under court order by The Washington Post in July 2019. This data details individual shipments of pharmaceutical opioid analgesics from wholesalers to retail distributors. Using the Enhanced 2-Step Floating Catchment Area (E2SFCA) method, this study calculated access to opioid morphine milligram equivalents (MME) per capita for census tracts in North Carolina and South Carolina during the year 2009. This study demonstrated that outlier volumes of opioid analgesics at individual pharmacies are not always …

Malaria Risk On Ancient Roman Roads: A Study And Application To Assessing Travel Decisions In Asia Minor By The Apostle Paul, Daniel C. Browning Jr

Master's Theses

This study models malaria risks for travelers on ancient Roman roads with the goal of providing a tool for historical assessment of travel accounts from antiquity. The project includes: identification of malaria risk factors and associated spatial datasets, malaria risk model construction, verification and validation against available pre-eradication data, overlay of ancient Roman road data, and an initial case-study application to the journeys of the Apostle Paul, as narrated in the New Testament book, Acts of the Apostles (Acts). The project is intentionally cross-disciplinary in bringing the technical capabilities of GIS to the task of evaluating nuanced textual sources for …

Landscapes Of Danger: A Geospatial Analysis Of Perceived And Realistic Risk In Bryce Canyon National Park, Tia Francis

Graduate Theses and Dissertations

The quantification of risk has inspired a wide breath of literature from the physical sciences, social sciences, and interdisciplinary disciplines like geography. Many attempts to estimate risk via natural hazards either focus on quantifying realistic risk or perceived risk of lay persons, with very little overlap between these paradigms. Due to this, a considerable knowledge gap exists within perceived risk and natural hazards research. This study aims to provide a comprehensive, risk estimation and assessment strategy through a multi-hazard risk assessment of Bryce Canyon National Park (BRCA). This case study analyzed knowledge of risk among visitors with perception surveys and …

280— Exploring The Geographic Distribution Of Childbed Fever Deaths In Mid-19th Century Rochester, Ny, Meaghan Parks

GREAT Day Posters

Childbed fever, formally called puerperal fever or puerperal septicemia, is an infection typically contracted by women after childbirth. Historically, childbed fever was a serious threat to maternal health. Childbed fever is caused by exposure of open wounds or abrasions, which are common after giving birth, to group A and B Streptococcal bacteria. Ignaz Semmelweis discovered that hand washing using a chlorinated solution reduced cases of childbed fever in 1847. This project reviews the instances of death from childbed fever in Rochester, New York from 1837-1860 and later from 1907-1919 and attempts to determine which areas of the city had the …

Accessibility Of Hiv Testing In Baton Rouge Metropolitan Statistical Area, Alina Prigozhina

LSU Master's Theses

This study examines HIV testing accessibility in the Baton Rouge Metropolitan Statistical Area (BR MSA) using the two-step floating catchment area (2SFCA) method to calculate accessibility scores for free, low-cost and all other HIV testing facilities. The two goals of this research are to apply accessibility estimation methods to HIV testing facilities, and to examine the accessibility of HIV testing facilities in the BR MSA. To achieve these goals, this study uses several research methods. The data about HIV testing providers and their locations were collected through Internet searches. By means of a fieldwork, the data were checked, revealing that …

Comparing Individual Perceptions Of Food Desert With Quantitative Measures In Omaha, Nebraska., Hector N. Samani, Bradley Bereitschaft

UNO Student Research and Creative Activity Fair

Food deserts have been linked to an increase in chronic diseases such as obesity and diabetes, due to lower access to affordable and healthy foods. The United States Department of Agriculture (USDA) outlines various methods and variables for defining food deserts, in attempts to standardize what constitutes a food desert or their characteristics. The USDA identifies the state of Nebraska as having both rural and urban food deserts, with an increase of food insecurity from 1.1% – 3.0% between 2007 and 2012 and warns of further increase of food deserts and its impact if measures are not taken. However, there …

State Park Selection As Determined By User Health, Connor Phelan

Master's Theses or Doctor of Nursing Practice

The purpose of this study was to determine whether state park difficulty affected location of travel. This study was conducted at three state park locations within the United States. Surveys and on-site examinations were made at the following locations; Wilson State Park, Kansas, Petit Jean State Park, Arkansas, and Kiholo State Park, Hawaii. Park locations were chosen by varying levels of terrain difficulty, as well as a rating from the Recreation Opportunity Spectrum. Participants were asked to report data via iPads on exercise habits, mobility limiting impairments, and frequency of exercise so a ranking of the healthiest participants could be …

An Analysis Of The Economic Barriers To Oral Healthcare Access In Omaha, Nebraska, Elias Witte

Theses/Capstones/Creative Projects

Existing research regarding the analysis of the distribution of oral healthcare practitioners has been conducted across large metropolitan areas within the United States in order to determine the magnitude of healthcare resource deficits. Such research has demonstrated significant deficits in access to oral healthcare predominantly in lower-income urban areas. Consequently, patients in these socioeconomically disadvantaged areas have less access to routine oral care, which impacts their overall health and well-being. While there is an abundance of studies examining this issue in other localities across the country, there is a lack of information regarding the distribution of oral healthcare practitioners in …

A Hybrid Gis/In Situ Analysis Of Aed Coverage On The Unm Central Campus, Ian T. Hill

Geography ETDs

Automated External Defibrillators (AED’s) are lifesaving devices that can greatly improve the survival rates of cardiac arrest when used quickly. There are publicly accessible AED’s on the UNM campus, and each device has an effective range based on how quickly a responder can retrieve the AED and return it to the site of the cardiac emergency. The ranges of the AED’s on UNM central campus are analyzed using GIS, interior building measurements, and various retrieval speeds. This helps evaluate the current placement of AED’s on campus and helps reveal where future coverage is needed. This focus on the combined navigation …

Satellite Monitoring Of Harmful Algal Blooms In The Western Basin Of Lake Erie: A 20-Year Time-Series, Michael Sayers, Amanda Grimm, Robert Shuchman, Karl Bosse, Gary L. Fahnenstiel, Steven A. Ruberg, George A. Leshkevich

Michigan Tech Publications, Part 1

Blooms of harmful cyanobacteria (cyanoHABs) have occurred on an annual basis in western Lake Erie for more than a decade. Previously, we developed and validated an algorithm to map the extent of the submerged and surface scum components of cyanoHABs using MODIS ocean-color satellite data. The algorithm maps submerged cyanoHABs by identifying high chlorophyll concentrations (>18 mg/m3) combined with water temperature >20 °C, while cyanoHABs surface scums are mapped using near-infrared reflectance values. Here, we adapted this algorithm for the SeaWiFS sensor to map the annual areal extents of cyanoHABs in the Western Basin of Lake Erie for the …

The Use Of Geospatial Modeling And Novel Diagnostics To Detect And Map Risk Factors Of Soil-Transmitted Helminths In Feira De Santana, Brazil, Ryan Harry Avery

LSU Doctoral Dissertations

Soil-transmitted helminth (STH) infections impact billions of people worldwide. The traditional STH control approach is a morbidity control strategy implementing mass drug administration (MDA) programs targeting school-aged children (SAC). In Brazil, this control strategy has decreased STH prevalence to less than 20% in most of the country and providing an opportunity to transition from the morbidity control program and towards a surveillance and response system geared towards STH elimination. Surveillance and response systems geared towards elimination require the implementation higher accuracy diagnostics to detect infection in low-transmission communities, surveillance of entire households, high-resolution modeling at the household-habitat scale, and targeted …

An Evaluation Of The Impact Of Leading Pedestrian Interval Signals In Nyc, Jeremy J. Sze

Theses and Dissertations

I evaluated the impact of the phased introduction of Leading Pedestrian Interval Signals (LPIs) on collision and injury outcomes at 12,987 signalized traffic intersections in New York City over the course of 25 quarters from 2012 to 2018. An intersection is treated when a LPIs is installed to give pedestrians lead time to cross the street before vehicles are allowed to move. Outcomes from NYPD’s Motor Vehicle Collisions data were matched to signalized intersections. I hypothesize that LPIs would reduce collisions and reduce injuries for pedestrians at intersections. A difference in difference fixed effects panel regression was used to identify …

Analyzing Trends And Patterns In Adverse Birth Outcomes In Massachusetts From 2000-2014, Madeleine Haynes

Sustainability and Social Justice

This study explores spatio-temporal trends and patterns in adverse birth outcomes (ABO) in the state of Massachusetts from 2000-2014. ABO include low birth weight (< 2500 g) and preterm deliveries (gestational age < 37 weeks). This research evaluates if there are areas in Massachusetts that have experienced statistically significant increases or decreases in ABO throughout the study period. Birth data was obtained from the Massachusetts Department of Public Health and only singleton, live births were included for the analysis. The data were aggregated to census tracts, and the total number of births and the number of ABOs were calculated for each census tract for each year. In total, 1478 census tracts were included in this analysis. Births to non-Hispanic black mothers and births to non-Hispanic white mothers were separated to evaluate if trends in ABO are similar regardless of race as previous literature has identified a much higher rate of ABO in births to non-Hispanic black women. Trends and patterns of ABO were evaluated using the Space Time Cube and the Mann-Kendall statistic and a multivariate regression was conducted to identify potential correlations between socioeconomic factors and prevalence of ABO. Results of this study can be used to identify areas that are experiencing an increase in ABO to potentially allow for more effective, targeted intervention methods.

Identifying Priority And “Bright-Spot” Counties For Diabetes Preventive Care In Appalachia: An Exploratory Analysis, Peter J. Mallow, Michael Topmiller, Jennifer Rankin, Jene Grandmont, David Grolling, Jessica L. Mccann, Mark Carrozza

Journal of Appalachian Health

Introduction: Type 2 diabetes mellitus (T2DM) prevalence and mortality in Appalachian counties is substantially higher when compared to non-Appalachian counties, although there is significant variation within Appalachia.

Purpose: The objectives of this research were to identify low-performing (priority) and high-performing (bright spot) counties with respect to improving T2DM preventive care.

Methods: Using data from the Centers for Medicare and Medicaid (CMS), the Dartmouth Atlas of Health Care, and the Appalachia Regional Commission, conditional maps were created using county-level estimates for T2DM prevalence, mortality, and annual hemoglobin A1c (HbA1c) testing rates. Priority counties were identified using the following criteria: top 33rd …