Medicine and Health Commons^™

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. …

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 …

Racial/Ethnic Differences In The Benefit Of Social Networks On Anxiety Symptoms, Melissa Vargas Calderon, Jennifer Robinette

Student Scholar Symposium Abstracts and Posters

Anxiety is a pressing health concern, affecting 40 million adults in the United States every year. Interestingly, communities of color have lower rates of anxiety disorders relative to Non-Hispanic Whites, despite on average experiencing more lifetime adversity characteristic of members of marginalized groups, such as low socioeconomic status and discrimination. Research indicates that contact with one’s social network, particularly large, closely knit ones among Hispanics, are protective factors against anxiety. However, empirical investigations of racial/ethnic differences in the benefits of social networks on anxiety are lacking. Data from the Health and Retirement Study (HRS), a nationally representative sample of adults …

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 …

Race, Ethnicity, And Insurance: The Association With Opioid Use In A Pediatric Hospital Setting, Vivian Luong

Student Scholar Symposium Abstracts and Posters

Pediatric opioid-related poisoning and deaths have increased by 268% between 1999 and 2016. One risk factor for these poisonings may be receiving an opioid prescription at a young age. Given the established link between legitimate opioid prescriptions and later misuse in young adulthood, research focused on identifying relationships between sociodemographic factors with opioid and non-opioid prescribing is needed to understand opioid prescribing inconsistencies and promote safe pain management. Of interest, this study examined the association between race/ethnicity and health insurance payer type with pediatric opioid and non-opioid ordering in an inpatient hospital setting. Statistical analyses were performed with cross-sectional inpatient …

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 …

Neighborhoods Matter; But For Whom? Heterogeneity Of Neighborhood Disadvantage On Child Obesity By Sex, Ashley W. Kranjac, Catherine Boyd, Rachel T. Kimbro, Brady S. Moffett, Keila N. Lopez

Sociology Faculty Articles and Research

Although evidence suggests that neighborhood context, particularly socioeconomic context, influences child obesity, little is known about how these neighborhood factors may be heterogeneous rather than monolithic. Using a novel dataset comprised of the electronic medical records for over 250,000 children aged 2–17 nested within 992 neighborhoods in the greater Houston area, we assessed whether neighborhoods influenced the obesity of children differently based on sex. Results indicated that neighborhood disadvantage, assessed using a comprehensive, multidimensional, latent profile analysis-generated measure, had a strong, positive association with the odds of obesity for both boys and girls. Interactions revealed that the relationship between disadvantage …

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 …

Surgical Patients’ Hospital Experience Scores: Neighborhood Context Conceptual Framework, Ashley Wendell Kranjac, Dinko Kranjac, Michelle A. Fortier, Pat Patton, Brad Giafaglione, Zeev N. Kain

Sociology Faculty Articles and Research

Objective:

Through geocoding the physical residential address included in the electronic medical record to the census tract level, we present a novel model for concomitant examination of individual patient-related and residential context-related factors that are associated with patient-reported experience scores.

Summary Background Data:

When assessing patient experience in the surgical setting, researchers need to examine the potential influence of neighborhood-level characteristics on patient experience-of-care ratings.

Methods:

We geocoded the residential address included in the electronic medical record (EMR) from a tertiary care facility to the census tract level of Orange County, CA. We then linked each individual record to the …

Sars-Cov-2 And The (Dark) Future Of Society: A Machiavellian Approach To The End Of Body Sovereignty And The Beginning Of Bio-Feudalism, Andrea Molle

Political Science Faculty Articles and Research

As much as the event following 9/11 triggered massive changes in our understanding of privacy rights and increased our level of acceptance of government infringement on individuals’ freedom, the pandemic of the SARS-COV-2 is threatening to change our understanding of societal hierarchy and democratic process. In this essay, we imagine a society where two classes, defined by their susceptibility to infection, emerge, and a neo-feudal system is established. We suggest that it is possible to evaluate how likely a dystopian outcome is by using Machiavelli’s understanding of the impact of the Plague on medieval Florence. We also recommend following his …

Global Cultural Shifts Induced By Covid-19, Wenshan Jia

Communication Faculty Articles and Research

"While COVID-19 has reportedly been bringing about numerous changes in geopolitics, economy, health, and security around the world, little has been written about changes in cultural practices it has been bringing about. I hereby unravel such emerging changes in the hope that readers could adapt to such changes."

Healthcare Of Indigenous Amazonian Peoples In Response To Covid-19: Marginality, Discrimination And Revaluation Of Ancestral Knowledge In Ucayali, Peru, Doreen Montag, Marco Barboza, Lizardo Cauper, Ivan Brehaut, Isaac Alva, Aoife Bennett, José Sanchez-Choy, Juan Pablo Sarmiento Barletti, Pilar Valenzuela, José Manuyama, Italo García Murayari, Miguel Guimaraes Vásquez, Celso Aguirre Panduro, Angela Giattino, Edwin Julio Palomino Cadenas, Rodrigo Lazo, Carlos A. Delgado, Alfonso Nino, Elaine C. Flores, Maria Amalia Pesantes, Juan Pablo Murillo, Luisa Elvira Belaunde, Sergio Recuenco, Robert Chuquimbalqui, Carol Zavaleta-Cortijo

World Languages and Cultures Faculty Articles and Research

"Systematic and persistent discrimination against Indigenous Peoples translates into differential health outcomes when analysed through ethnicity and/or mother tongue.1 In Peru, morbidity and mortality rates among Indigenous Peoples for COVID-19 appear to confirm this.2 The COVID-19 pandemic has highlighted the historical structural violence against Indigenous Peoples that currently takes a disproportionate toll in the Peruvian Amazon. This equally applies to Indigenous Andean Peoples and Afro Peruvians. Indigenous Peoples in voluntary isolation and those in initial contact are at highest health risk in this pandemic as they have no previous immunity against common infectious diseases, and lack access to public healthcare …

Decomposing Differences In Coronavirus Disease 2019-Related Case-Fatality Rates Across Seventeen Nations, Ashley Wendell Kranjac, Dinko Kranjac

Sociology Faculty Articles and Research

As of 1 November 2020, estimated case-fatality rates associated with coronavirus disease 2019 are not uniformly patterned across the world and differ substantially in magnitude. Given the global spatial heterogeneity in case-fatality rates, we applied the Blinder-Oaxaca regression decomposition technique to identify how putative sociodemographic, structural, and environmental sources influence variation in case-fatality rates. We show that compositional and associational differences in country-level risk factors explain a substantial proportion of the coronavirus disease 2019-related case-fatality rate gap across nations. Asian countries fair better vis-à-vis case-fatality rate differences mainly due to variation in returns to sociodemographic, structural, and environmental sources among …

Seroprevalence Of Novel Coronavirus Sars-Cov-2 At A Community Hospital Emergency Department And Outpatient Laboratory In Northern Orange County, California, Jason Yamaki, Harry Peled, Sajen Mathews, David Park, Mina Firoozi, Kim Smith, Lee Nguyen

Pharmacy Faculty Articles and Research

Introduction

The severe acute respiratory syndrome related coronavirus 2 (SARS-CoV-2) has infected more than 20 million people worldwide, and the spread is most prevalent in the USA, where California had accounted over 240,000 cases in the initial 5 months of the pandemic. To estimate the number of infected persons in our community, we conducted a cross-sectional study to estimate seroprevalence of SARS-CoV-2 infection.

Methods

This cross-sectional study evaluated the presence of immunoglobulin G, antibody for SARS-CoV-2 during the time period of July 15, 2020, to July 27, 2020. Testing was done on serum samples from patients who had visited affiliated …

Covid-19 Treatment Resource Disparities And Social Disadvantage In New York City, Jason A. Douglas, Andrew M. Subica

Health Sciences and Kinesiology Faculty Articles

Black and Hispanic communities in the U.S. have endured a disproportionate burden of COVID-19-related morbidity and mortality. Racial and ethnic health disparities such as these are frequently aggravated by inequitable access to healthcare resources in disadvantaged communities. Yet, no known studies have investigated disadvantaged communities' access to COVID-19-related healthcare resources. The current study accordingly examined racial and ethnic differences in (1) April 2020 COVID-19 total and positive viral test rates across 177 New York City (NYC) ZIP Code Tabulation Areas (ZCTA); and (2) November 2019–April 2020 licensed and intensive care unit (ICU) hospital bed access across 194 NYC ZCTAs. Pairwise …

Race, Ethnicity, And Insurance: The Association With Opioid Use In A Pediatric Hospital Setting, Louis Ehwerhemuepha, Candice D. Donaldson, Zeev N. Kain, Vivian Luong, Michelle A. Fortier, William Feaster, Michael Weiss, Daniel Tomaszewski, Sun Yang, Michael Phan, Brooke N. Jenkins

Psychology Faculty Articles and Research

Background

This study examined the association between race/ethnicity and health insurance payer type with pediatric opioid and non-opioid ordering in an inpatient hospital setting.

Methods

Cross-sectional inpatient encounter data from June 2013 to June 2018 was retrieved from a pediatric children’s hospital in Southern California (N = 55,944), and statistical analyses were performed to determine associations with opioid ordering.

Results

There was a significant main effect of race/ethnicity on opioid and non-opioid orders. Physicians ordered significantly fewer opioid medications, but a greater number of non-opioid medications, for non-Hispanic African American children than non-Hispanic Asian, Hispanic/Latinx, and non-Hispanic White pediatric …

Parent Responses To Pediatric Pain: The Differential Effects Of Ethnicity On Opioid Consumption, Candice D. Donaldson, Brooke N. Jenkins, Michelle A. Fortier, Michael T. Phan, Daniel M. Tomaszewski, Sun Yang, Zeev N. Kain

Psychology Faculty Articles and Research

Objective

Within the context of the United States opioid epidemic, some parents often fear the use of opioids to help manage their children's postoperative pain. As a possible consequence, parents often do not dispense optimal analgesic medications to their children after surgery, putting their children at risk of suffering from postsurgical pain. The objective of this research was to assess ethnicity as a predictor of both pain and opioid consumption, and to examine how Hispanic/Latinx and Non-Hispanic White parents alter their child's opioid consumption in response to significant postsurgical pain.

Methods

Participants were 254 children undergoing outpatient tonsillectomy and/or adenoidectomy …

Mechanisms Study: Using Game Theory To Assess The Effects Of Social Norms And Social Networks On Adolescent Smoking In Schools—Study Protocol, Ruth F. Hunter, Felipe Montes, Jennifer M. Murray, Sharon C. Sanchez-Franco, Shannon C. Montgomery, Joaquín Jaramillo, Christopher Tate, Rajnish Kumar, Laura Dunne, Abhijit Ramalingam, Erik O. Kimbrough, Erin Krupka, Huiyu Zhou, Laurence Moore, Linda Bauld, Blanca Llorente, Olga L. Sarmiento, Frank Kee

Economics Faculty Articles and Research

This proof of concept study harnesses novel transdisciplinary insights to contrast two school-based smoking prevention interventions among adolescents in the UK and Colombia. We compare schools in these locations because smoking rates and norms are different, in order to better understand social norms based mechanisms of action related to smoking. We aim to: (1) improve the measurement of social norms for smoking behaviors in adolescents and reveal how they spread in schools; (2) to better characterize the mechanisms of action of smoking prevention interventions in schools, learning lessons for future intervention research. The A Stop Smoking in Schools Trial (ASSIST) …

Boyd And Blaser: An Uneven Covid-19 Toll In Orange County And Elsewhere — Orange County Isn’T The World, But Is Part Of It, Art Blaser, Louanne Boyd

Political Science Faculty Articles and Research

"Although the crisis is making many issues about humanity, disability, and normality more vivid, for the most part it is a new manifestation of thorny issues that were present before, and will continue in the future. But things won’t be the same. We hope for awareness of the uneven toll of coronavirus in Orange County. We offer three overlapping points of reflection, relevant specifically to Orange County, as part of California, the United States, and the world."

Carty And Barraza: The Hidden Victims Of Covid-19, Victoria Carty, Greg Barraza

Sociology Faculty Articles and Research

"At the Chino Institute for Men (CIM) state prison, notorious for overcrowding conditions, the local authorities are moving toward an illogical pivot from 'containment' to 'encounter' in dealing with the health of both prisoners and staff in terms of the looming threat that Covid-19 poses. Soon, CIM officials intend to transfer inmates who have been living among other inmates who have tested positive for the virus into one of the dormitories where everyone thus far has tested negative and had been quarantined for two weeks. On May 10^th the facility halted the movement of all prisoners to isolate those …

Religious Nationalism And The Coronavirus Pandemic: Soul-Sucking Evangelicals And Branch Covidians Make America Sick Again, Peter Mclaren

Education Faculty Articles and Research

This article investigates the response to the coronavirus crisis by Evangelical Christian nationalists in the USA. The article outlines the curious mediaverse of religious nationalism—its post-truth and fake news aspects in particular—links religious nationalism to American exceptionalism, and analyzes conflicts between secular and religious authorities. Drawing upon some lessons from the past, the article addresses the wider implications of Christian nationalism on American politics, and capitalist ideology, as it has been played out virally in the corporate media. The article shows that the ideological underpinnings of evangelical Christianity prevent its proponents from understanding the virus in an historical and materialist …

Myocardial Infarction And Treatment Adherence Rates Across Sociodemographic & Health Indicators, Deborah Shim, Ashley Wendell Kranjac

Student Scholar Symposium Abstracts and Posters

Trends on first myocardial infarction and rates of adherence to treatment across age were estimated. Data sourced from the National Health and Nutrition Examination Survey (NHANES), 1999-2016, were used to determine the patterned age trends of patients’ first myocardial infarction as well as their subsequent willingness to comply with treatments, such as weight loss. Demographic characteristics and socioeconomic status were taken into account and integrated as they play a key role in contextualizing and understanding these health trends. Preliminary historical trend analyses across 9 waves of data spanning 17 years indicate that patients are increasingly presenting with myocardial infarction earlier …

Pediatric Postoperative Pain Medication: Demographic Predictors And Parent Medication Attitudes, Vivian Luong

Student Scholar Symposium Abstracts and Posters

Over 85% of children experience significant pain after surgery. Despite this presence of pain, research suggests that a quarter of these children receive very little pain medication at home. Such poor pain management in children can have harmful long-term consequences. Previous research indicates that the amount of pain medication administered to children in the home may be significantly impacted by the attitudes parents have regarding analgesics. Given this, the purpose of the present study is to identify how demographic factors such as child sex and ethnicity predict certain parent analgesic attitudes and, in turn, the amount of pain medication their …

Decomposing Trends In Child Obesity, Ashley Wendell Kranjac, Robert L. Wagmiller

Sociology Faculty Articles and Research

We unravel the absolute level and relative prominence of two demographic processes that are relevant for childhood obesity, and that will ultimately determine the long-term course and pace of change in child obesity rates. We leverage data from the National Health and Nutrition Examination Survey to decompose change in child obesity from 1971 to 2012. We partition change into that attributable to (1) healthier, more nutritionally and economically advantaged cohorts in the population being replaced by cohorts of children who are less advantaged (between-cohort change), and (2) the health habits, nutrition, and social and economic circumstances of all cohorts of …

Rationale, Design, And Baseline Characteristics Of Walkit Arizona: A Factorial Randomized Trial Testing Adaptive Goals And Financial Reinforcement To Increase Walking Across Higher And Lower Walkable Neighborhoods, Marc A. Adams, Jane Hurley, Christine Phillips, Michael Todd, Siddhartha Angadi, Vincent Berardi, Melbourne F. Hovell, Steven Hooker

Psychology Faculty Articles and Research

Little change over the decades has been seen in adults meeting moderate-to-vigorous physical activity (MVPA) guidelines. Numerous individual-level interventions to increase MVPA have been designed, mostly static interventions without consideration for neighborhood context. Recent technologies make adaptive interventions for MVPA feasible. Unlike static interventions, adaptive intervention components (e.g., goal setting) adjust frequently to an individual's performance. Such technologies also allow for more precise delivery of “smaller, sooner incentives” that may result in greater MVPA than “larger, later incentives”. Combined, these factors could enhance MVPA adoption. Additionally, a central tenet of ecological models is that MVPA is sensitive to neighborhood environment …

Ecological Determinants Of Respiratory Health: Examining Associations Between Asthma Emergency Department Visits, Diesel Particulate Matter, And Public Parks And Open Space In Los Angeles, California, Jason A. Douglas, Reginald S. Archer, Serena E. Alexander

Health Sciences and Kinesiology Faculty Articles

Los Angeles County (LAC) low-income communities of color experience uneven asthma rates, evidenced by asthma emergency department visits (AEDV). This has partly been attributed to inequitable exposure to diesel particulate matter (DPM). Promisingly, public parks and open space (PPOS) contribute to DPM mitigation. However, low-income communities of color with limited access to PPOS may be deprived of associated public health benefits. Therefore, this novel study investigates the AEDV, DPM, PPOS nexus to address this public health dilemma and inform public policy in at-risk communities. Optimized Hotspot Analysis was used to examine geographic clustering of AEDVs, DPM, and PPOS at the …

Child Obesity And The Interaction Of Family And Neighborhood Socioeconomic Context, Ashley W. Kranjac, Justin T. Denney, Rachel T. Kimbro, Brady S. Moffett, Keila N. Lopez

Sociology Faculty Articles and Research

The literature on neighborhoods and child obesity links contextual conditions to risk, assuming that if place matters, it matters in a similar way for everyone in those places. We explore the extent to which distinctive neighborhood types give rise to social patterning that produces variation in the odds of child obesity. We leverage geocoded electronic medical records for a diverse sample of over 135,000 children aged 2 to 12 and latent profile modeling to characterize places into distinctive neighborhood contexts. Multilevel models with cross-level interactions between neighborhood type and family socioeconomic standing (SES) reveal that children with different SES, but …

School‐Level Body Mass Index Shapes Children's Weight Trajectories, Ashley W. Kranjac

Sociology Faculty Articles and Research

BACKGROUND

Embedded within children's weight trajectories are complex environmental contexts that influence obesity risk. As such, the normative environment of body mass index (BMI) within schools may influence children's weight trajectories as they age from kindergarten to fifth grade.

METHODS

I use 5 waves of the ECLS‐K—Kindergarten Class 1998‐1999 data and a series of multilevel growth models to examine whether attending schools with higher overall BMI influences children's weight status over time.

RESULTS

Results show that, net of child, family, and school sociodemographic characteristics, children who attend schools with higher rates of obesity have increased weight compared to children who …

Neighborhood And Social Environmental Influences On Child Chronic Disease Prevalence, Ashley Wendell Kranjac, Justin T. Denney, Rachel T. Kimbro, Brady S. Moffett, Keila N. Lopez

Sociology Faculty Articles and Research

We investigate how distinct residential environments uniquely influence chronic child disease. Aggregating over 200,000 pediatric geocoded medical records to the census tract of residence and linking them to neighborhood-level measures, we use multiple data analysis techniques to assess how heterogeneous exposures of social and environmental neighborhood conditions influence an index of child chronic disease (CCD) prevalence for the neighborhood. We find there is a graded relationship between degree of overall neighborhood disadvantage and children’s chronic disease such that the highest neighborhood CCD scores reside in communities with the highest concentrated disadvantage. Finally, results show that higher levels of neighborhood concentrated …

Trends And Disparities In Leave Use Under California's Paid Family Leave Program: New Evidence From Administrative Data, Sarah H. Bana, Kelly Bedard, Maya Rossin-Slater

Economics Faculty Articles and Research

We use novel administrative data to study trends and disparities in usage of California's first-in-the-nation paid family leave (PFL) program. We show that take-up for both bonding with a new child and caring for an ill family member increased over 2005–2014. Most women combine PFL with maternity leave from the State Disability Insurance system, resulting in leaves longer than 6 weeks. Most men take less than the full 6 weeks of PFL. Individuals in the lowest earnings quartile and in small firms are the least likely to take leave. There are important differences in take-up across industries, especially for men.