Medicine and Health Commons^™

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.

Discrimination And Anger Control As Pathways Linking Socioeconomic Disadvantage To Allostatic Load In Midlife, Samuele Zilioli, Ledina Imami, Anthony D. Ong, Mark A. Lumley, Tara Gruenewald

Psychology Faculty Articles and Research

Objective

Recent evidence suggests that experiences of discrimination contribute to socioeconomic status health disparities. The current study examined if the experience and regulation of anger—an expected emotional response to discrimination—serves as an explanatory factor for the previously documented links between socioeconomic disadvantage (SED), discrimination, and allostatic load.

Methods

Data were drawn from the second wave of the Midlife Development in the U.S. study and included 909 adults who participated in the biomarkers subproject.

Results

Results revealed that perceived discrimination was associated with higher levels of allostatic load. Furthermore, we found evidence that perceived discrimination and anger control sequentially explained the …

Passing It Along: Experiments On Creating The Negative Externalities Of Climate Change, Alessandro Del Ponte, Andrew W. Delton, Reuben Kline, Nicholas A. Seltzer

Political Science Faculty Articles and Research

Climate change is a global social dilemma. Mitigating it is partly a political problem created by inequitable distributions of the benefits of carbon emissions and the costs of climate change; that is, the people who benefit the most are not the same set of people who pay the most costs. Here we use an experimental economic approach to political science to study these inequities. In two experiments, we show that people willingly create climate problems when those problems are passed along to others. Surprisingly, this is not further exacerbated if those others are from another country. We also show that, …

Smoking Trends Among U.S. Latinos, 1998–2013: The Impact Of Immigrant Arrival Cohort, Georgiana Bostean, Annie Ro, Nancy L. Fleischer

Sociology Faculty Articles and Research

Few studies examine nativity disparities in smoking in the U.S., thus a major gap remains in understanding whether immigrant Latinos’ smoking prevalence is stable, converging, or diverging, compared with U.S.-born Latinos. This study aimed to disentangle the roles of period changes, duration of U.S. residence, and immigrant arrival cohort in explaining the gap in smoking prevalence between foreign-born and U.S.-born Latinos. Using repeated cross-sectional data spanning 1998–2013 (U.S. National Health Interview Survey), regressions predicted current smoking among foreign-born and U.S.-born Latino men and women (n = 12,492). We contrasted findings from conventional regression analyses that simply include period and duration …

Comprehensive Neighborhood Portraits And Child Asthma Disparities Introduction, Ashley W. Kranjac, Rachel T. Kimbro, Justin T. Denney, Kristin M. Osiecki, Brady S. Moffett, Keila N. Lopez

Sociology Faculty Articles and Research

Objectives Previous research has established links between child, family, and neighborhood disadvantages and child asthma. We add to this literature by first characterizing neighborhoods in Houston, TX by demographic, economic, and air quality characteristics to establish differences in pediatric asthma diagnoses across neighborhoods. Second, we identify the relative risk of social, economic, and environmental risk factors for child asthma diagnoses. Methods We geocoded and linked electronic pediatric medical records to neighborhood-level social and economic indicators. Using latent profile modeling techniques, we identified Advantaged, Middle-class, and Disadvantaged neighborhoods. We then used a modified version of the Blinder-Oaxaca regression decomposition method to …

Smoking Selectivity Among Mexican Immigrants To The United States Using Binational Data, 1999–2012, Nancy L. Fleischer, Annie Ro, Georgiana Bostean

Sociology Faculty Articles and Research

Mexican immigrants have lower smoking rates than US-born Mexicans, which some scholars attribute to health selection—that individuals who migrate are healthier and have better health behaviors than their non-migrant counterparts. Few studies have examined smoking selectivity using binational data and none have assessed whether selectivity remains constant over time. This study combined binational data from the US and Mexico to examine: 1) the extent to which recent Mexican immigrants (< 10 years) in the US are selected with regard to cigarette smoking compared to non-migrants in Mexico, and 2) whether smoking selectivity varied between 2000 and 2012—a period of declining tobacco use in Mexico and the US. We combined repeated cross-sectional US data (n = 10.901) on adult (ages 20–64) Mexican immigrants and US-born Mexicans from the 1999/2000 and 2011/2012 National Health Interview Survey, and repeated cross-sectional Mexican data on non-migrants (n …

E-Cigarette Specialty Retailers: Data To Assess The Association Between Retail Environment And Student E-Cigarette Use, Georgiana Bostean, Catherine M. Crespi, Patsornkarn Vorapharuek, William J. Mccarthy

Sociology Faculty Articles and Research

The retail environment is a major social determinant of health, yet little is known about the e-cigarette specialty retailer environment. The e-cigarette specialty retail environment may be associated with e-cigarette use by middle and high school students, an issue that was addressed in a recent article entitled, “E-cigarette use among students and e-cigarette specialty retailer presence near schools,” by Bostean and colleagues (G. Bostean, C.M. Crespi, P. Vorapharuek, W.J. McCarthy, 2016). We present data relating to e-cigarette specialty retailers in Orange County, California. We describe the data collection method (including the search methodology to identify e-cigarette specialty retailers), present descriptive …

The Costs Of Cancer, Jamie Mosely

Honors Papers and Posters

This poster explores the relationship between more advanced cancer-fighting technologies and the increase in healthcare costs over the last several decades, and the socioeconomic impact this has for patients with less disposable income or no health insurance.

Decomposing Trends In Adult Body Mass Index, Obesity, And Morbid Obesity, 1971-2012, Ashley Wendell Kranjac, Robert L. Wagmiller

Sociology Faculty Articles and Research

Trends in adult obesity have been used to motivate key public health policies in the United States. While these analyses provide important insights into the broad historical contours of the obesity epidemic in the U.S., they shed less light on the proximate mechanisms that have generated these changes and that will ultimately determine the long-term course and pace of change in obesity rates. We used data from the National Health and Nutrition Examination Survey (NHANES), Glenn Firebaugh's linear decomposition technique, and Kitagawa's algebraic decomposition method to decompose change in body mass index (BMI), obesity, and morbid obesity from 1971 through …

The Relation Between Discrimination, Sense Of Coherence And Health Varies According To Ethnicity; A Study Among Three Distinct Population Groups Living In Israel, Orna Baron-Epel, Vincent Berardi, John Belletierre, Waleed Shalata

Psychology Faculty Articles and Research

Self-reported experiences of discrimination and sense of coherence (SOC) have been found to be associated with health. A face-to-face survey of Long Term Jewish Residents (LTJR), Arabs and former Soviet Union (fSU) immigrants in Israel was performed. Respondents reported their physical and mental health, self-reported experiences of discrimination, SOC and socioeconomic status. Multivariable logistic regressions and bootstrapping path analyses were performed. Discrimination was associated with health after adjusting for all other variables. SOC was also associated with health. SOC did not mediate the strong association between discrimination and health among Israeli LTJR, but was a significant mediator among Arabs and …

Depression And Body Mass Index, Differences By Education: Evidence From A Population-Based Study Of Adult Women In The U.S. Buffalo-Niagara Region, Ashley Wendell Kranjac, Jing Nie, Maurizio Trevisan, Jo L. Freudenheim

Sociology Faculty Articles and Research

The relationship between obesity and depression is well described. However, the evidence linking depression and body mass index (BMI) across the broad range of body size is less consistent. We examined the association between depressive symptoms and BMI in a sample of adult women in the Buffalo-Niagara region between 1997 and 2001. Using logistic regression, we investigated whether increased weight status beyond normal-weight was associated with a higher prevalence of depressive symptoms, and if educational attainment modified the association between obesity and depression. There was a trend for increased weight status to be associated with higher depressive symptoms (obese II/III, …

Postoperative Pain Management In Children Of Hispanic Origin: A Descriptive Cohort Study, Rebecca Brown, Michelle A. Fortier, Sheeva Zolghadr, Padma Gulur, Brooke N. Jenkins, Zeev N. Kain

Psychology Faculty Articles and Research

BACKGROUND:

It has been established that pain is frequently undertreated in children following outpatient surgery. Very few studies, however, have investigated this phenomenon in ethnically diverse populations.

METHODS:

This study included 105 families of children aged 2 to 15 years of Hispanic origin and low income undergoing outpatient tonsillectomy and adenoidectomy surgery. Participating parents completed baseline and demographic packets. Recorded postoperative pain ratings and administration of analgesics at home for 1 week were collected during home visits.

RESULTS:

Despite the high (70%; 99% confidence interval [CI], 57%–82%) incidence of significant pain in the first 24 hours home, 32% (95% CI, …

The Disease Burden And The Extent Of Drug Therapy Problems In An Underserved Minority Population Receiving Medication Therapy Management At An Ambulatory Care Free Clinic, D. N. Ombengi, F. A. Ndemo, Ayman M. Noreddin, W. T. Harris

Pharmacy Faculty Articles and Research

Objective: To determine the common medical conditions, medications, and associated drug therapy problems in an underserved minority population receiving medication therapy management services at a large Community Free Clinic compared to the findings of the Minnesota Pharmaceutical Care Project.

Methods: Retrospective cohort study of a random sample of 60 minority patients referred for medication therapy management service at a Community Free Clinic from January 2012 to January 2014. Patient data including demographics, medication experience, past medical and medication history, medical conditions, active medications, allergies, immunization history and drug therapy was systematically evaluated to determine the most common conditions, …

First Report Of The National Evaluation Of Rsvp Volunteers, Annie Georges, Susan Gabbard, Ashley Wendell Kranjac

Sociology Faculty Articles and Research

"In 2013, the Corporation for National and Community Service (CNCS) initiated a national evaluation of the Retired and Senior Volunteer Program (RSVP). The national evaluation was intended to collect the necessary information to better guide the RSVP program and to address three objectives: 1) describe the characteristics of RSVP volunteers, including how volunteers are distributed across CNCS’s performance measure categories, and how volunteers allocated their time to different service activities across the performance measure categories; 2) measure the relationship between volunteer characteristics, service activities, and volunteers’ psychosocial health; and 3) measure the impact of RSVP national service participation on volunteers’ …

Duration Of U.S. Stay And Body Mass Index Among Latino And Asian Immigrants: A Test Of Theoretical Pathways, Annie Ro, Georgiana Bostean

Sociology Faculty Articles and Research

Studies find that longer-term immigrants have higher body mass index (BMI) than their more recently-arrived counterparts. Most interpretations of these health patterns by duration of U.S. residence rely on theories of immigrant integration; they posit that with increasing time in the United States, immigrants incorporate economically, socially, and culturally into aspects of U.S. society, and that these changes impact health. Few studies empirically examine whether these aspects of integration are indeed mediators of the association between duration of U.S. stay and BMI, and if their patterns differ across immigrant subgroups. This study examines data from the National Latino and Asian …

The Moderating Effect Of Self-Efficacy On Normal-Weight, Overweight, And Obese Children's Math Achievement: A Longitudinal Analysis, Ashley Wendell Kranjac

Sociology Faculty Articles and Research

Increased body weight is associated with decreased cognitive function in school-aged children. The role of self-efficacy in shaping the connection between children's educational achievement and obesity-related comorbidities has not been examined to date. Evidence of the predictive ability of self-efficacy in children is demonstrated in cognitive tasks, including math achievement scores. This study examined the relationship between self-efficacy and math achievement in normal weight, overweight, and obese children. I hypothesized that overweight and obese children with higher self-efficacy will be less affected in math achievement than otherwise comparable children with lower self-efficacy. I tested this prediction with multilevel growth modeling …

Unequally Distributed Psychological Assets: Are There Social Disparities In Optimism, Life Satisfaction, And Positive Affect?, Julia K. Boehm, Ying Chen, David R. Williams, Carol Ryff, Laura D. Kubzansky

Psychology Faculty Articles and Research

Socioeconomic status is associated with health disparities, but underlying psychosocial mechanisms have not been fully identified. Dispositional optimism may be a psychosocial process linking socioeconomic status with health. We hypothesized that lower optimism would be associated with greater social disadvantage and poorer social mobility. We also investigated whether life satisfaction and positive affect showed similar patterns. Participants from the Midlife in the United States study self-reported their optimism, satisfaction, positive affect, and socioeconomic status (gender, race/ethnicity, education, occupational class and prestige, income). Social disparities in optimism were evident. Optimistic individuals tended to be white and highly educated, had an educated …

Mind+Body: An Ethnodrama About Adolescent And Young Adult Oncology, Jake Russell Thompson

Student Scholar Symposium Abstracts and Posters

The first thing many people think of as a “cancer patient” tends to be an elderly person, or perhaps a child too young to understand what’s happening — pink ribbons and fundraising walks, weak and feeble bodies too sick and delicate to function. These notions of a “quintessential cancer patient” are both limiting in their scope of what the disease actually is, and isolating to younger people going through it. For people who don’t fit this predetermined idea of the psychological, physical, and emotional development of a cancer patient (specifically, the seventeen to thirty-five age range), isolation becomes another side …

Reporting Risk, Producing Prejudice How News Reporting On Obesity Shapes Attitudes About Health Risk, Policy, And Prejudice, Abigail C. Saguy, David Frederick, Kjerstin Gruys

Psychology Faculty Articles and Research

News reporting on research studies may influence attitudes about health risk, support for public health policies, or attitudes towards people labeled as unhealthy or at risk for disease. Across five experiments (N = 2123) we examined how different news framings of obesity research influence these attitudes. We exposed participants to either a control condition, a news report on a study portraying obesity as a public health crisis, a news report on a study suggesting that obesity may not be as much of a problem as previously thought, or an article discussing weight-based discrimination. Compared to controls, exposure to the public …

Lifetime Racism And Blood Pressure Changes During Pregnancy: Implications For Fetal Growth, Clayton J. Hilmert, Tyan Parker Dominguez, Christine Dunkel Schetter, Sindhu K. Srinivas, Laura M. Glynn, Calvin J. Hobel, Curt A. Sandman

Psychology Faculty Articles and Research

Objective: Research suggests that exposure to racism partially explains why African American women are 2 to 3 times more likely to deliver low birth weight and preterm infants. However, the physiological pathways by which racism exerts these effects are unclear. This study examined how lifetime exposure to racism, in combination with maternal blood pressure changes during pregnancy, was associated with fetal growth. Methods: African American pregnant women (n = 39) reported exposure to childhood and adulthood racism in several life domains (e.g., at school, at work), which were experienced directly or indirectly, meaning vicariously experienced when someone …

Cardiovascular Health: Associations With Race-Ethnicity, Nativity, And Education In A Diverse, Population-Based Sample Of Californians, Georgiana Bostean, Christian K. Roberts, Catherine M. Crespi, Michael Prelip, Anne Peters, Thomas R. Belin, William J. Mccarthy

Sociology Faculty Articles and Research

Purpose—This study examined how race-ethnicity, nativity, and education interact to influence disparities in cardiovascular (CV) health, a new concept defined by the American Heart Association (AHA). We assessed whether race-ethnicity and nativity disparities in CV health vary by education, and whether the foreign-born differ in CV health from their US-born race-ethnic counterparts with comparable education.

Methods—We used data from the 2009 California Health Interview Survey to determine the prevalence of optimal CV health metrics (based on selected AHA guidelines) among adults ages 25 and over (n = 42,014). We examined the interaction between education and ethnicity-nativity, comparing predicted …

Does Selective Migration Explain The Hispanic Paradox?: A Comparative Analysis Of Mexicans In The U.S. And Mexico, Georgiana Bostean

Sociology Faculty Articles and Research

Latino immigrants, particularly Mexican, have some health advantages over U.S.-born Mexicans and Whites. Because of their lower socioeconomic status, this phenomenon has been called the epidemiologic “Hispanic Paradox.” While cultural theories have dominated explanations for the Paradox, the role of selective migration has been inadequately addressed. This study is among the few to combine Mexican and U.S. data to examine health selectivity in activity limitation, self-rated health, and chronic conditions among Mexican immigrants, ages 18 and over. Drawing on theories of selective migration, this study tested the “healthy migrant” and “salmon-bias” hypotheses by comparing the health of Mexican immigrants in …

Random Assignment Of Schools To Groups In The Drug Resistance Strategies Rural Project: Some New Methodological Twists, John W. Graham, Jonathan Pettigrew, Michelle Miller-Day, Janice L. Krieger, Jiangxiu Zhou, Michael L. Hecht

Communication Faculty Articles and Research

Random assignment to groups is the foundation for scientifically rigorous clinical trials. But assignment is challenging in group randomized trials when only a few units (schools) are assigned to each condition. In the DRSR project, we assigned 39 rural Pennsylvania and Ohio schools to three conditions (rural, classic, control). But even with 13 schools per condition, achieving pretest equivalence on important variables is not guaranteed. We collected data on six important school-level variables: rurality, number of grades in the school, enrollment per grade, percent white, percent receiving free/assisted lunch, and test scores. Key to our procedure was the inclusion of …