Medicine and Health Commons^™

The Contribution Of Racism-Related Stress And Adversity To Disparities In Birth Outcomes: Evidence And Research Recommendations, Sabrina R. Liu, Laura M. Glynn

Psychology Faculty Articles and Research

Currently, racial and ethnic differences in adverse birth outcomes and infant mortality are some of the largest and most persistent health disparities in the United States. This narrative review article synthesizes existing literature to present a conceptual model of how racism-related stress and adversity are critical determinants of such disparities. We describe how historical and ongoing racism has created conditions wherein women of color are disproportionately exposed to chronic, multilayered stress and adversity and how the biological consequences of exposure to these stressors confers risk for adverse birth outcomes. Next, we identify important priorities and considerations for future research, including …

Deconstructing Sex Differences In C-Reactive Protein Trends Over Time, Ashley W. Kranjac, Dinko Kranjac, Olivia Lounsbury

Sociology Faculty Articles and Research

Objectives

Heightened inflammatory state, as measured by circulating C-reactive protein (CRP) levels, can promote inflammation-mediated disease risk. It is important to account for population fluctuation and sex variation in serum CRP concentrations on overall time trends.

Methods

Using the National Health and Nutrition Examination Survey data, we specify linear and algebraic decomposition models separately by sex to identify the drivers of the changing trends in the distribution of CRP values in the population.

Results

We found a nonsignificant overall increase in CRP, but a significant decrease among women and increase among men, over a 10-year period. We then used linear …

Consumer Representative Experiences Of Partnership With Health Workers In Australia, Coralie R. Wales, Judith A. Lababedi, Alison Coles, Philip Lee, Emma Clarke

Patient Experience Journal

We examine the experiences of Consumer Representatives participating in consumer engagement activities across a public health service in NSW, Australia. A team of Consumer Representatives and staff members use a participatory, constructivist paradigm and a hermeneutic phenomenological approach to analyse ten interviews with Consumer Representatives over three years 2017-2019, and three focus groups in 2020. We explore these experiences and identify the linked contextual factors from their points of view. Consumer Representatives were prepared to invest their time, but they needed respect. “Respect” from a consumer perspective was being meaningfully included, supported and heard, and activities needed to be purposeful …

Spatiotemporal Variation And Socioeconomic Factors Of Financial Hardships Of Out-Of-Pocket Health Expenditure In Pakistan, Muhammad Ashar Malik, Iqbal Azam Syed, Amir Khan, Faisal Rifaq, Kinza Chaudhary

Community Health Sciences

Background: Financial hardships of out-of-pocket health expenditure (OPHE) is a growing concern for health policy makers in many low and middle-income countries. Spatiotemporal variation between Pakistan's four provinces over 2001-2015 is discussed, which would help comparing existing health services delivery and financial risk protection plans.
Aims: In this paper, we estimate financial hardship of OPHE in Pakistan.
Methods: We use the data sets of the household integrated economic surveys 2001-02, 2005-06, 2010-11 and 2015-16. We estimate OPHE share in household total and non-subsistence expenditure, catastrophic headcount at the threshold of OPHE ≥ 10% of total expenditure or OPHE ≥ 25% …

Policing And Health: Police Encounters As A Fundamental Cause Of Racial Health Disparities, Richard S. Carbonaro

Doctoral Dissertations

Structural racism has taken many forms throughout American history and to this day continues to drive social, economic, and health inequalities. Mass incarceration is a modern tool of social marginalization with well documented and deep-rooted racial inequalities. Research has continually shown that mass incarceration negatively impacts the health of disadvantaged communities. Even police stops, the most common and mundane form of criminal justice contact has been linked with deleterious health outcomes at the individual and community level. In this dissertation, I identify specific social and biological mechanisms connecting encounters with the police and health outcomes. In the first chapter, I …

Implementing Strategies For Strengthening Australia’S Rural Allied Health Workforce, Catherine Cosgrave

Internet Journal of Allied Health Sciences and Practice

Purpose: In many rural places, health services struggle to maintain an adequate health workforce to meet their communities’ health care needs. Shortages of allied health professionals are of particular and growing concern. To address this challenge, a two-year Whole-of-Person Retention Improvement Project was developed involving a research partnership with two rural public health services in Victoria, Australia. This project was informed by the author’s Whole-of-Person Retention Improvement Framework (WoP-RIF), aimed to produce new knowledge for rural health services to attract, recruit, and improve the retention of allied health professionals. A set of evidence-informed and contextually relevant recommendations were made in …

Lessons Learned From The Hiv/Aids Pandemic And Access To Medicines For Covid-19 Treatment, Thalia Le

Independent Study Project (ISP) Collection

There is an imminent need to address the healthcare disparities in accessing all COVID-19 medicinal products in developing countries. While logistical issues like inadequate production facilities such as the lack of vaccines administration capacity, storage issues, gap between supply and demand as well as vaccine hesitancy can certainly play a part in impeding COVID19 medicines distribution, patent monopolies and intellectual property protection laws further exacerbated the problem, especially when vaccines were at its early stages of authorization. Historical and contemporary case studies of efforts to challenge patents on HIV AVRs treatment provide a useful lens through which we may glean …

Analysis Of The Moroccan Government & Ngos Responses To Migrant Health Crisis, Jepchirchir Mutwol

Independent Study Project (ISP) Collection

Healthcare access in Morocco for migrants has been a topic of growing interest. With the implementation of migration reforms in response to Morocco becoming a destination for migrants, it is important to assess the effectiveness of government policies in aiding migrant health. Additionally, assessing other political actors' influence in government policies is equally important. Through research of existing scholarship, I theorize that the biggest issue impacting migrant access to health is the illegalization of migrants. Without being a legal resident, let alone in asylum or a refugee, migrants cannot access public health services without the fear of deportation. Local and …

Assessing The Need For And Access To Migrant-Sensitive Rehabilitative Healthcare: An Analysis Of Current Swiss And German Practices, Lauren Cuppy

Independent Study Project (ISP) Collection

In recent years, the noticeable increase in migration has placed scrutiny on the migrant-sensitive services provided in healthcare settings globally. Migrants, in general, experience different health issues and worse health outcomes than non-migrants. In response to this, healthcare systems around the world have begun implementing migrant-sensitive healthcare (MSHC) systems; yet, although nearly a third of the world’s population experiences some health condition that would benefit from rehabilitation, the implementation of MSHC rehabilitation services have been critically understudied. This paper seeks to investigate the geographic and MSHC accessibility of rehabilitation in Geneva, Switzerland to fill the current gap of literature and …

Covid-19 Vaccine Diplomacy In West Africa: Empathetic Soft-Power Or Neocolonial Intentions?, Mary Sperrazza

Independent Study Project (ISP) Collection

With the impending roll-out of COVID-19 vaccines, many questions have been raised concerning the roll-out of the vaccines beyond the Global North. While some countries across the Global South have been able to purchase limited numbers of vaccines; many countries in the Global South remain highly or entirely dependent on various programs for the distribution of vaccines, such as the COVID-19 Vaccines Global Access (COVAX) program. Another means of distribution is of individual countries of the Global North that have either higher purchasing power or are producers of one or more vaccines that have begun donating an allocated amount of …

Palliative Care And Improving Quality Of Life With End Stage Renal Disease: An Integrative Review, Natoya Bender

Doctoral Dissertations and Projects

End-stage renal disease is a rising health care problem effecting greater than 10% of the US population. there are 700,000 patients in dialysis in the U.S who are characterized by multiple comorbidities and increasing, distressing symptom burden. The need for palliative care for patient with end-stage renal disease is becoming standard of care due to their complex medical needs and high symptom burden. The aim of this integrative review investigated the incorporation of palliative care will improve the quality-of-life of patients with end-stage renal disease once introduced in their care. While palliative care provides an ideal opportunity to assess the …

Disability And Healthcare Access In Morocco: Social And Cultural Influences, Christa Shipman

Independent Study Project (ISP) Collection

I stepped into the SIT Multiculturalism and Human Rights program as a pre-physical therapy student with experience working and volunteering in the disability rights arena. Striking personal encounters with Moroccans combined with these past experiences drew me to investigate how social and cultural factors influence access to healthcare for people with disabilities. I hypothesized that access to medical care is limited by social or cultural mindsets, perceptions, or beliefs for those in my target population. This subject is relevant to Morocco as a developing country and as a society with, in some cases, fixed social dynamics, while in other areas …

Comparación Entre Las Percepciones Médicas Y Psicológicas De La Diabetes Tipo 2 Y La Tuberculosis En El Ecuador, Héctor Ortiz

Independent Study Project (ISP) Collection

Research Question: What are the differences and similarities between the perceptions of the medical and psychological management of both type 2 diabetes and tuberculosis? Objectives: The principal objective of this study is to understand the perceptions behind DM2 and TB as well as how these perceptions affect the care of these diseases. Secondary objectives are to define the epidemiological transition, describe the medical and psychological management and care of DM2 and TB, analyze how the people perceive the management and psychological care of DM2 and TB, and analyze the comparison of the perceptions of both diseases. Background: The epidemiological transition …

What Predicts How Safe People Feel In Their Neighborhoods And Does It Depend On Functional Status?, Alfredo J. Velasquez, Jason A. Douglas, Fangqi Guo, Jennifer W. Robinette

Health Sciences and Kinesiology Faculty Articles

Feeling unsafe in one's neighborhood is related to poor health. Features of the neighborhood environment have been suggested to inform perceptions of neighborhood safety. Yet, the relative contribution of these features (e.g., uneven sidewalks, crime, perceived neighborhood physical disorder) on perceived neighborhood safety, particularly among people with disabilities who may view themselves as more vulnerable, is not well understood. We examined whether sidewalk quality assessed by third party raters, county-level crime rates, and perceived neighborhood disorder would relate to neighborhood safety concerns, and whether functional limitations would exacerbate these links. Using data from the 2012/2014 waves of the Health and …

Food-As-Medicine: An Everyday Strategy Of Health, Rachel Rebecca Bogan

Dissertations, Theses, and Capstone Projects

Using food-as-medicine, a valuable strategy of health, as its focus, this dissertation examines why and how New Yorkers use food to negotiate their health. I argue that while using food medicinally is a common health practice, food-as-medicine operates unequally among different groups of New Yorkers. I attribute this inequity, in part, to how those in power, including public health experts, biomedical doctors, and the food industry, operationalize food-as-medicine as a health remedy and to a neoliberal, healthist context that ties people’s morally “correct” uses of food-as-medicine to their abilities to access “good” citizenship and optimal health.

I chose to write …

Make Your Wishes Known: Understanding The Challenges And Barriers For Providing Effective Ethics Consults To Low-Income African American Men, Ruth Nwefo

Symposium of Student Scholars

The distrust of the U.S. health care system is prevalent, especially within the African American (AA) community. This distrust is largely based on infamous cases such as the Tuskegee Syphilis Experiment and experiments conducted by James Marion Sims on slave women without anesthesia. While these experiments along with many others further advanced medicine, they severed trust between health care institutions and the African American community, bringing upon repercussions still felt today. Although many steps have been taken to rebuild trust in the health care system by establishing effective ethical guidelines, more needs to be done in terms of rebuilding the …

The Emergence Of The Legitimacy Of Religious Healing Knowledge In Taiwan, Wei-Cheng Chiu

LSU Doctoral Dissertations

This dissertation investigates how religious healing knowledge has been defined and used by scholars, physicians, and New Agers and how religious healing knowledge emerged as a legitimate area of knowledge in Taiwan. The key position of religious healing knowledge within the entanglement between religion and spirituality is also examined. After the martial law was lifted in 1987, Taiwan’s society had rapidly diversified, and its religions were at the transition point between the old and the new. Meanwhile, the new spirituality culture was introduced into Taiwan in the 1980s and got popular in the 1990s, and it inherited the trend of …

The Experiences Of Healthcare Workers And Lawyers Engaging In Remote Work, Desha Puri, Tracey L. Adams Dr.

Undergraduate Student Research Internships Conference

This study aims to compare the experiences of healthcare workers and lawyers engaging in remote work during the Covid-19 pandemic. The research poster presents a content analysis of the current research on the experiences of professions in the two fields mentioned above. In engaging in content analysis, the study advances a select number of thematic value codes that effectively characterize the similarities and differences between the two professions. With these thematic values codes, it has been found that the healthcare profession and law profession have had a similar experience working from home. With these similarities and differences, one can propose …

Associations Of Hair Dye And Relaxer Use With Breast Tumor Clinicopathologic Features: Findings From The Women’S Circle Of Health Study, Rohan Rao, Jasmine A. Mcdonald, Emily Barrett, Patricia Greenberg, Dede K. Teteh, Susanne B. Montgomery, Bo Qin, Yong Lin, Chi-Chen Hong, Christine B. Ambrosone, Kitaw Demissie, Elisa V. Bandera, Adana A.M. Llanos

Health Sciences and Kinesiology Faculty Articles

Background

Building upon our earlier findings of significant associations between hair dye and relaxer use with increased breast cancer risk, we evaluated associations of select characteristics of use with breast tumor clinicopathology.

Methods

Using multivariable-adjusted models we examined the associations of interest in a case-only study of 2998 women with breast cancer, overall and stratified by race and estrogen receptor (ER) status, addressing multiple comparisons using Bonferroni correction.

Results

Compared to salon application of permanent hair dye, home kit and combination application (both salon and home kit application) were associated with increased odds of poorly differentiated tumors in the overall …

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 …

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 …

An Intersectional Approach To Time Poverty: A Pilot Study Of Time Poverty And Black Women’S Perceived Health Based On Semi-Structured Interviews, Lauriane Ngaya Fonkou

McNair Scholars Program

The term “time poor” describes people disproportionately burdened by responsibilities and inflexible work schedules resulting in little to no discretionary time. Time poverty was brought to my attention via the social media app TikTok where Black women creators expressed how time poverty affects them. Given that Black women are an especially vulnerable population in terms of health, I became curious about the relationship between time poverty and Black women’s health. However, the existing sociomedical science literature on time poverty does NOT adequately account for Black women’s subjectivity because the research considers mediators of class OR gender OR race but does …

Vulnerability To And Protection Against Covid-19 Fear, Threat, And Worry, Marsha Kim Huh

Graduate Theses and Dissertations

Drawing from a sample of 10,368 adults living in the U.S., the current study examines the role of social and psychological resources in lowering COVID-related fear, threat, and worry, controlling for a number of social vulnerabilities (e.g. gender, race/ethnicity, and presence of children). The impact of social location, particularly in regards to race, and how one accesses and/or utilizes social and psychological resources is also examined through disaggregated regression models. Results demonstrate that some social and psychological resources impact COVID-specific distress (fear/threat/worry), but depending on the resource, relationships vary in direction and significance. The strength of social ties and mastery …

Special Report On Covid-19 Vaccination Trends Among Older Adults In Singapore, Micah Tan, Paulin T. Straughan, Wensi Lim, Grace Cheong

ROSA Research Briefs

This report examines trends in vaccination among older adults in Singapore to better understand why segments of older adults continue to resist vaccination against COVID-19. We find that individuals who were most likely to still be waiting to vaccinate or to not want to be vaccinated as of June 2021; are relatively older (aged 71-75), are of lower socioeconomic status (lower education levels and living in 1-3 room HDB flats), were the least likely to rely on Newspapers and Government Sources as sources of information for COVID-19 related news in November 2020, were least trusting of all sources of information, …

Plotting The Literature On Precautionary Measures Of Covid-19: A Scientometric Analysis Of Web Of Science, Muhammad Shoaib, Nusrat Ali, Abeel Naseer

Library Philosophy and Practice (e-journal)

This study attempted to evaluate the scholarly publications on COVID-19, social distance, physical distance, social isolation, and self-isolation employing the scientometric analysis technique from 2020 to 2021. The main purpose was to consolidate the published scholarship on the COVID-19 in the Web of Science indexed documents. A total of 635 publications were found. The results indicated that social distance and COVID-19 was the top topic along with the article as a type of document, and the majority were published in the English language in 2021. The name of Gimenez-Llort L was at top of the list of authors, along with …

Research Visualization Of Different Treatment Modalities To Treat Covid-19 Infection: Bibliometric Analysis Of Pubmed Database, Abeel Naseer, Muhammad Shoaib, Nusrat Ali, Imtiaz Ahmad

Library Philosophy and Practice (e-journal)

This paper designed to examine research published in PubMed indexed journals of different treatment modalities to treat COVID -19 infection employing bibliometric analysis technique from 2020 to 2021. The purpose was to consolidate the published scholarly work in the PubMed database on different treatment modalities including vaccine, oxygen supplementation, dexamethasone or steroids, aspirin, heparin, remdesivir, zinc, vitamin c or ascorbic acid, oxygen, anti-malarial like chloroquine and hydroxychloroquine, and azithromycin or macrolides. We employed a bibliometric analysis technique and found a total of 3043 published documents. The study findings depicted that vaccine and COVID-19 top was at the top of the …

The Embodiment Of Discovery: An Adapted Framework For Qualitative Analysis Of Lived Experiences, Helen B. Hernandez, Laurie P. Dringus

The Qualitative Report

We reflect on our process of working with an adapted framework as an effective strategy for analyzing and interpreting the results of our qualitative study on the lived experiences of insulin pump trainers. Interpretative Phenomenological Analysis (IPA) was applied as the overarching research methodology and was encapsulated into a framework adapted from Bonello and Meehan (2019) and from Chong (2019). We describe this framework as the “embodiment of discovery” to posit the researcher’s tangible experience of discovering the meaning of data that also brought transparency to the researcher’s process for data analysis and interpretation. We present challenges the doctoral student …

Female Infertility In The United States And India: An Analysis Of Treatment Barriers And Coping Strategies, Devneet Singh

Honors Theses

This research studies barriers to accessing fertility treatment in the United States (U.S.) and India, as well as the coping strategies infertile women use. Barriers include reproductive health knowledge, cost, and politics, while coping is affected by cultural stigma, family, and religion. These two countries were chosen for their different cultural contexts, healthcare systems, and political infrastructure. Ten fertility specialists across both countries were interviewed as expert informants. Reproductive health knowledge was the most important barrier to accessing care in both countries, with similar gaps in understanding when and what type of care to utilize, though social media can educate …

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. …

"It's The Way You Sing It": Translating Music Therapy For Isolated Older Adults Affected By Covid-19 To The Television Screen, Eunice Wong

Expressive Therapies Capstone Theses

The current Covid-19 pandemic has increased the likelihood of loneliness and social isolation among older adults due to the restrictions on movement and visitations in care facilities. Loneliness and social isolation have consistently been identified as risk factors for poor mental and physical health in older people. Meanwhile, a growing number of older adults are utilizing technological resources to enhance their interpersonal relationships and overall quality of life. In the winter of 2020/2021, an innovative music therapy-informed television program was designed and produced for isolated older adults in need of mental and emotional support. This project, produced jointly by a …