Inequality and Stratification Commons^™

Factors Associated With Voluntary Refusal Of Emergency Medical System Transport For Emergency Care In Detroit During The Early Phase Of The Covid-19 Pandemic, Nicholas E. Harrison, Robert R. Ehrman, Andrea Curtin, Damon Gorelick, Alex B. Hill, Erin Brennan, Robert Dunne

Urban Studies and Planning Faculty Research Publications

Importance
Emergency department (ED) and emergency medical services (EMS) volumes decreased during the COVID-19 pandemic, but the amount attributable to voluntary refusal vs effects of the pandemic and public health restrictions is unknown.

Objective
To examine the factors associated with EMS refusal in relation to COVID-19 cases, public health interventions, EMS responses, and prehospital deaths.

Design, Setting, and Participants
A retrospective cohort study was conducted in Detroit, Michigan, from March 1 to June 30, 2020. Emergency medical services responses geocoded to Census tracts were analyzed by individuals’ age, sex, date, and community resilience using the Centers for Disease Control and …

Review Of: Appalachians For Medicaid Website, Kendra Barker Dnp

Journal of Appalachian Health

The Journal of Appalachian Health is committed to reviewing published media that relates to contemporary concepts affecting the health of Appalachia. Access to care and the health disparities we face have a direct effect on our experience of illness. Dr. Kendra Barker reviews the website: Appalachians for Medicaid.

Geospatial Analysis Of Rurality And Food Banks In Appalachian Ohio, Cooper T. Johnson, Rebecca Fischbein, Kristin Baughman

Journal of Appalachian Health

Introduction: Food insecurity is a problem for individuals across Ohio, including those living in Appalachia. Adequate access to resources that help combat food insecurity is important for these populations.

Purpose: To examine how rurality relates to food insecurity and need for food resources, as well as availability of those resources including food pantries and soup kitchens, in 15 northern Ohio Appalachian counties.

Methods: A cross-sectional study with a geographical analysis was conducted using data from the American Community Survey census data, County Health Rankings data, and regional foodbank websites.

Results: Rural counties had a higher ratio of potential clients per …

Triple Negative Breast Cancer In An Appalachian Region: Exponential Tumor Grade Increase With Age Of Diagnosis, Gina Sizemore, Toni Marie Rudisill

Journal of Appalachian Health

Introduction: Triple negative breast cancer is an aggressive breast cancer with decreased five-year survival, increased risk for recurrence, and higher risk for metastases. Unlike other breast cancers, it has no targeted treatment and has heterogeneous genetics which make classification and treatment difficult.

Purpose: The purpose of our research was to compare triple negative breast cancer to non-triple negative breast cancer to identify key epidemiologic factors that might lead to improved basic science directives for biomarkers, treatments, and classification.

Methods: The state cancer registry was used to provide the first West Virginia state-wide population evaluation of triple negative breast cancer.

Results: …

Addressing Diabetes Distress In Self-Management Programs: Results Of A Randomized Feasibility Study, Ranjita Misra, Samantha Shawley-Brzoska, Raihan Khan, Brenna O. Kirk, Sijin Wen, Usha Sambamoorthi

Journal of Appalachian Health

Background: West Virginia ranks 1st nationally in the prevalence of hypertension (HTN; 43.8%) and diabetes (16.2%). Patients with type 2 diabetes mellitus (T2DM) are distressed over physical and psychological burden of disease self-management.

Methods: This study investigated the effectiveness of an intervention to reduce diabetes distress and outcomes [glycemic control, blood pressure (BP)] among T2DM adults with comorbid HTN. Participants were randomized to a 12-week diabetes and hypertension self-management program versus a 3-month wait-listed control group. Trained health coaches and experts implemented the lifestyle program in a faith-based setting using an adapted evidence-based curriculum. Twenty adults with T2DM and HTN …

Longitudinal Pre-Exposure Prophylaxis (Prep) Acceptability, Initiation And Adherence Among Criminal Justice-Involved Adults In The Usa: The Southern Prep Cohort Study (Specs) Protocol, Katherine Lemasters, Carrie B. Oser, Mariah Cowell, Katie Mollan, Kathryn Nowotny, Lauren Brinkley-Rubinstein

Sociology Faculty Publications

INTRODUCTION: HIV prevalence among criminal justice (CJ)-involved adults is five times higher than the general population. Following incarceration, CJ-involved individuals experience multilevel barriers to HIV prevention. Pre-exposure prophylaxis (PrEP) is a widely available, daily medication efficacious in preventing HIV. Little is known about PrEP knowledge, acceptability, initiation and sustained use among CJ-involved persons or about how these outcomes vary by multilevel factors. The Southern Pre-Exposure Prophylaxis Study (SPECS) will investigate barriers and facilitators for PrEP initiation and sustained use among CJ-involved adults, building a foundation for PrEP interventions for this underserved population.

METHODS AND ANALYSIS: SPECS uses a mixed-methods sequential …

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 …

Racial And Ethnic Disparities In Opioid Use For Adolescents At Us Emergency Departments, Michael T. Phan, Daniel M. Tomaszewski, Cody Arbuckle, Sun Yang, Candice D. Donaldson, Michelle A. Fortier, Brooke Jenkins, Erik Linstead, Zeev N. Kain

Pharmacy Faculty Articles and Research

Background

Racial/ethnic disparities in the use of opioids to treat pain disorders have been previously reported in the emergency department (ED). Further research is needed to better evaluate the impact race/ethnicity may have on the use of opioids in adolescents for the management of pain disorders in the ED.

Methods

This was a cross-sectional study using data from the National Hospital Ambulatory Medical Care Survey from 2006 to 2016. Multivariate models were used to evaluate the role of race/ethnicity in the receipt of opioid agonists while in the ED. All ED visits with patients aged 11–21 years old were analyzed. …

Contemporary Brazilian Catholicism And Healing Practices: Notes On Environmentalism And Medicalization, Juliano F. Almeida

Journal of Global Catholicism

Anthropological studies on Brazilian Catholicism traditionally focused on popular variants of this religious practice and their relationship with the official Catholicism. Encouraged by recent anthropological perspectives, which highlight the relevance of devoting researches not only on the margins, but also on the center of social practices, this paper analyzes contemporary practices of Brazilian Catholic friars and priests on health promotion. The analysis of their publications (books that include practices and tips on health and that became best sellers etc.), as well as interviews, allows us to perceive a process of environmentalization on the contemporary Brazilian Catholicism. This process seems to …

Editor's Introduction, Marc Roscoe Loustau

Journal of Global Catholicism

No abstract provided.

Reporting Of Eating Disorder Deaths, Katherine Mobley, Amy Hord

Symposium of Student Scholars

Those affected by eating disorders experience disturbances in eating behaviors which are often related to underlying psychiatric disorders such as anxiety, depression, or obsessive-compulsive disorder (Parekh, 2017, Drieberg et al., 1998 p.53). The duplicitous nature of the disorder makes it difficult to diagnose, and the tole it takes on an individual’s physical health makes its mortality rate the second highest among psychiatric disorders (Guinhut et al., 2021 p.130). Even if the correct education and resources are accessible to certain individuals, negative stigmatization about the disorder can make sufferers unlikely to seek help (Becker et al., 2010). Findings from analysis of …

Intangible Cultural Heritage: A Benefit To Climate-Displaced And Host Communities, Gül Aktürk, Martha B. Lerski

Publications and Research

Climate change is borderless, and its impacts are not shared equally by all communities. It causes an imbalance between people by creating a more desirable living environment for some societies while erasing settlements and shelters of some others. Due to floods, sea level rise, destructive storms, drought, and slow-onset factors such as salinization of water and soil, people lose their lands, homes, and natural resources. Catastrophic events force people to move voluntarily or involuntarily. The relocation of communities is a debatable climate adaptation measure which requires utmost care with human rights, ethics, and psychological well-being of individuals upon the issues …

County-Level Factors That Influenced The Trajectory Of Covid-19 Incidence In The New York City Area, Ashley Wendell Kranjac, Dinko Kranjac

Sociology Faculty Articles and Research

More than a century of research has shown that sociodemographic conditions affect infectious disease transmission. In the late spring and early summer of 2020, reports of the effects of sociodemographic variables on the spread of COVID- 19 were used in the media with minimal scientific proof attached. With new cases of COVID-19 surging in the United States at that time, it became essential to better understand how the spread of COVID-19 was varying across all segments of the population. We used hierarchical exponential growth curve modeling techniques to examine whether community socioeconomic characteristics uniquely influence the incidence of reported COVID-19 …

Tracking The Impact Of Diseases Of Despair In Appalachia—2015 To 2018, Megan Heffernan, Michael Meit, Margaret Cherney, Victoria A. Hallman

Journal of Appalachian Health

Introduction: This study provides an update on mortality due to diseases of despair within the Appalachian Region, comparing 2015 to 2018.

Methods: Diseases of despair include: alcohol, prescription drug and illegal drug overdose, suicide, and alcoholic liver disease/cirrhosis of the liver. Analyses are based on National Vital Statistics System (NVSS) mortality data for individuals aged 15-64.

Results: Between 2015 and 2017, the diseases of despair mortality rate increased in both Appalachia and the non-Appalachian U.S., and the disparity grew between Appalachia and the rest of the county. In 2018, the disease of despair mortality rate declined by …

Effects Of Sleep Duration On Falls In A West Virginia Population-Based Study, Brfss, 2018, R. Constance Wiener, Christopher Waters

Journal of Appalachian Health

Introduction: West Virginia is a state in which most counties are rural, as well as a state with multiple health disparities among its population. The purpose of this study was to determine the association of sleep duration and falls for non-institutionalized West Virginia adults, aged 40 years and above, using the National Sleep Foundation’s definition of “may be appropriate” and “not recommended” sleep durations for specific ages.

Methods: Behavior Risk Factor Surveillance System (BRFSS) 2018 data concerning West Virginia residents were extracted for sleep duration and number of falls within the previous year. Data were analyzed with Chi square and …

Diseases Of Despair: A Commentary, Andrew Howard

Journal of Appalachian Health

Across the nation, and within Appalachia, communities that struggle economically experience greater health challenges, with disparities observed across leading causes of death. Within our region, these disparities are particularly notable across diseases of despair.

The Relationship Between Perceived Neighborhood Disorder And Type 2 Diabetes Risk Across Different Racial/Ethnic Groups, Min Yu, Jennifer N. Robinette

Student Scholar Symposium Abstracts and Posters

Approximately 32 million Americans have Type 2 Diabetes and that number is growing rapidly. Type 2 Diabetes is sensitive to environmental factors, and higher prevalence rates are often observed in disordered neighborhoods (i.e., those with more trash and vandalism). Through discriminatory practices such as redlining, racially restrictive covenants, urban renewal, and gentrification, marginalized racial/ethnic groups are more likely to live in disordered neighborhoods compared to non-Hispanic Whites. These disparities may also contribute to similar disparities in Type 2 Diabetes rates. Yet, research indicates that there may be racial/ethnic differences in the interpretation of neighborhood disorder as a threat to health …

Recovering From Substance Abuse In Arkansas: The Accessibility And Affordability Of Drug Treatment Programs, Whitney King

Graduate Theses and Dissertations

This thesis is going to examine how people recover from drug addiction and see if there are any similarities due to their socioeconomic statuses at the time of recovery. This research addresses the following questions: How accessible and affordable are drug addiction recovery programs and rehabilitation facilities in Arkansas for mid- to low-income individuals? What are the social costs for people who can’t obtain drug rehabilitation services? The goal of this research is to explore whether there is a lack of affordable recovery programs in the state of Arkansas. This project utilizes survey responses as well as in-depth interviews with …

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 …

“In This Industry, You're No Longer Human”: An Exploratory Study Of Women’S Experiences In Pornography Production In Sweden, Meghan Donevan

Dignity: A Journal of Analysis of Exploitation and Violence

Despite being a global, billion-dollar industry, very little is known about the conditions women face within the pornography industry. The aim of this study was to explore women’s experiences in pornography production, with a particular focus on structural antecedents to entrance, coercion, and violence within the industry, as well as current needs and any barriers to exiting the industry. Semi-structured, in-depth interviews were conducted with nine women with experiences in pornography production in Sweden. Participants identified young age, financial insecurity, earlier exposure to sexualized violence, and poor mental health as typical antecedents to entering the pornography industry. Once in the …

Dental Disparities: A Quantitative & Regional Analysis Of Male Oral Health In The United States, Hannah Merritt, Gordon Rakita

Showcase of Osprey Advancements in Research and Scholarship (SOARS)

Project of Merit Winner

Multiple factors contribute to the oral health of male individuals in the United States, including economic, regional, and gender disparities. My study compares health care coverage and poverty rates to indicators of oral health status and dental care access such as percentage of tooth lost, number of dental visits, and oral health services at federally qualified health centers. This oral health data is drawn from the Center for Disease Control and Prevention across all fifty states in the year 2018 and from the United States Census. By examining this data, I will be able to answer …

Kesejahteraan Dan Ekologi Anak Angkat Warga Negara Indonesia Dalam Pengangkatan Anak Antarnegara (Intercountry Adoption) Menghadapi Negara Baru, Monica Sundawati Susanto, Johanna Debora Imelda

Jurnal Ilmu Kesejahteraan Sosial

Adoption is currently one of the efforts chosen by several couples to have children. Adoption of children currently being processed in Indonesia is not only for prospective adoptive parents who are Indonesian citizens, but can also be processed for foreign citizens who wish to adopt Indonesian citizens (intercountry adoption) which has been regulated in the Government through Government Regulation Number 54 of 2007 concerning the Implementation of Child Adoption. In these regulations, children who can be adopted are neglected or neglected children. Therefore, adoption is carried out with the aim of protecting and improving the welfare of the child. The …

Examining The Impact Of Socioeconomic Variables On Covid-19 Death Rates At The State Level, James L. Doti

Economics Faculty Articles and Research

This study uses a step-wise regression model to identify the socioeconomic variables most significant in explaining COVID-19 death rates on a state-level basis. The regression tests cover the 1/1/2020 to 12/1/2020 period as well as the first and second halves of 2020. This study also uses the Oxford stringency index to measure more precisely the efficacy of governmental mandates at the state level. The results in this study rigorously showed that while the density variables were the most significant explanatory variables during the first half of the year, their significance fell during the second half. Use of the Oxford stringency …

Mortalidad Por Infarto Agudo De Miocardio En Guatemala 2018: Patrones E Inequidades, Alejandro Cerón, Gila Goldstein

Anthropology: Faculty Scholarship

El presente estudio busca analizar la mortalidad por infarto agudo de miocardio (IAM) en Guatemala con el propósito de identificar posibles criterios epidemiológicos que orienten la priorización de acciones de salud pública. El riesgo de morir de IAM en Guatemala muestra marcadas desigualdades por departamento, las que son aún más marcadas al comparar por municipio. El riesgo de morir es también más alto en personas mestizas o ladinas, en niveles educativos bajos, y en personas que se dedican a ocupaciones elementales. Deberían implementarse medidas de salud pública orientadas a los municipios y grupos en mayor riesgo de morir de IAM. …

Child Obesity Moderates The Association Between Poverty And Academic Achievement, Ashley W. Kranjac, Dinko Kranjac

Sociology Faculty Articles and Research

Childhood overweight and obesity are major public health problems in the United States. Children who experience poverty are 1.5 times more likely to suffer with overweight and 1.6 times more likely to have obesity. The extent to which overweight or obesity exacerbates the negative influence of socioeconomic inequality on child academic outcomes has not yet been examined. We estimated the effect of poverty on math and reading achievement trajectories using the Early Childhood Longitudinal Study (ECLS) Kindergarten class of 1998−1999 survey data and multilevel growth curve modeling techniques. Our findings indicate that the impact of obesity status is more pronounced …

Environmentally Marginalized Populations: The "Perfect Storm" For Infectious Disease Pandemics, Including Covid-19, Gabriella Y. Meltzer, Oyemwenosa Avenbuan, Christina Awada, Oluwakemi B. Oyetade, Tricia Blackman, Simona Kwon Drph, Mph, Esther Erdei Phd, Judith T. Zelikoff Phd

Journal of Health Disparities Research and Practice

COVID-19 has exacted a severe toll on the United States population’s physical and mental health and its effects have been felt most severely among people of color and low socioeconomic status. Using illustrative case studies, this commentary argues that in addition to COVID-19 health disparities created by psychosocial stressors such as the inability to socially distance and access quality healthcare, environmental justice communities have the additional burden of disproportionate exposure to toxic contaminants that contribute to their higher risk of COVID-19. Environmental contaminants including heavy metals and persistent organic pollutants found contaminating their nearby environments can alter the immune response, …

Executive Summary- Social Protection In Egypt: Mitigating The Socio-Economic Effects Of The Covid-19 Pandemic On Vulnerable Employment, Dina Makram-Ebeid, Amr Adly, Nadine Sika, Hania M Sholkamy, Samer Atallah

Faculty Journal Articles

This is the executive summary of an interdisciplinary project between the fields of development economics, political economy, labor sociology, development anthropology and public health. It reviews the social protection available to vulnerable employees and their households in Egypt and suggests ways to adapt them in light of the COVID 19 pandemic. The research focuses on four areas a) employment security b) social assistance c) health insurance d) gendered mitigations. The project will map the impact of the crisis on vulnerable employees and their households and propose policy interventions to alleviate the socio-economic effects of the pandemic through the publication of …

Employment Security In Egypt In Light Of The Covid-19 Pandemic: Rethinking Policies And Practices, Heba M. Khalil, Kareem Megahed

Faculty Journal Articles

Crises such as COVID-19’s have inequitable impacts on different countries, various population groups and diverse sectors of society and the economy. Areas of work and employment were met with a lot of challenges worldwide, and in particular in countries like Egypt with a large sector of vulnerable and precarious workers. This policy paper addresses the question of employment security both in response to crises such as COVID-19, and on the long term. To do so, the research maps ‘vulnerable work’, including informal labor, labor in the gig economy, self-employed and other types of precarious work. It then assesses Egypt’s policy …

Poll Finds Rural Residents More Hesitant To Get Vaccinated, Tim Marema

Journal of Appalachian Health

Rural residents are more hesitant than their metropolitan counterparts to get a Covid-19 vaccination, even though rural areas have higher rates of infections and deaths from the coronavirus.

Review Of: Ailing In Place: Environmental Inequities And Health Disparities In Appalachia, Jerome A. Paulson Md, Faap, Jennifer A. Mallow Phd

Journal of Appalachian Health

The Journal of Appalachian Health is committed to reviewing published media that relate to contemporary concepts affecting the health of Appalachia. The Appalachian environmental inequities and the health disparities we face have a direct effect on our experience of illness. Dr. Jerome Paulson reviews the book Ailing in Place: Environmental Inequities and Health Disparities in Appalachia.