Medicine and Health Commons^™

Colonial Geographies Of Gendered Violence And Mental Health In The United States And Puerto Rico, Lorraine Lizbeth L. Torres Colon

Dissertations, Theses, and Capstone Projects

As of January 2021, after years of community organizing and protests, the Puerto Rican island government announced a state of emergency due to the high rates of gendered violence on the island. At the same time, within the field of psychiatric epidemiology, consistent findings have indicated higher frequencies of mood disorders and substance abuse disorders among Puerto Ricans both on and off the island, relative to all other US Latinx ethnic groups. This dissertation frames Puerto Ricans experiences with psychological distress and gendered violence as public health issues nested within differing geographies of colonial divestment. I explore the relationships between …

"I Stayed There The Whole Night": Exploring Caregivers' Experiences With The Healthcare System When Caring For A Parent At The End Of Life, Lillian Mehran

Dissertations and Theses

Background: In the United States, there are nearly 53 million individuals serving as caregivers to a loved one. Half of all caregivers are caring for a parent or parent-in-law, and 79% of caregivers are caring for a person aged 50 or older. In New York State, there are an estimated 4.1 million caregivers who collectively provide over 2.6 billion hours of unpaid care, with those caring for a person at the end of life providing twice as many hours of caregiving per week compared to other caregivers. The number of individuals requiring caregiving is expected to increase as a significant …

Immigration Status As A Social Determinant Of Health: Provider Perspectives, Elisabeth Brodbeck

Dissertations, Theses, and Capstone Projects

This project examines how immigration is understood as a social determinant of health through the perspective of medical providers and social workers. Through the bridging of immigration studies in sociology and social epidemiology and public health, I demonstrate the need to bring these disciplines together to understand how immigration and legal status are encountered in clinical settings. I conducted a qualitative research study, specifically open-ended interviews with medical providers and social workers, to understand how providers currently screen for complex social determinants of health, and more specifically, how they engage with immigration as a factor influencing health during their patient …

Artificial Intelligence And The Situational Rationality Of Diagnosis: Human Problem-Solving And The Artifacts Of Health And Medicine, Michael W. Raphael

Publications and Research

What is the problem-solving capacity of artificial intelligence (AI) for health and medicine? This paper draws out the cognitive sociological context of diagnostic problem-solving for medical sociology regarding the limits of automation for decision-based medical tasks. Specifically, it presents a practical way of evaluating the artificiality of symptoms and signs in medical encounters, with an emphasis on the visualization of the problem-solving process in doctor-patient relationships. In doing so, the paper details the logical differences underlying diagnostic task performance between man and machine problem-solving: its principle of rationality, the priorities of its means of adaptation to abstraction, and the effects …

Where Gunshots Turn Fatal: A Geographic Examination Of The Spatial Patterning Of Gun Violence, David Hatten

Dissertations, Theses, and Capstone Projects

This dissertation contributes fundamental work to the examination of gun violence through an investigation of prevalence, trends, and likely place-based dynamics that explain the spatial patterning of gun violence in Kansas City, MO over a 5-year period (2015-2019). Specifically, this dissertation assesses 1) the degree to which separate shooting typologies (fatal and non-fatal) concentrate in micro-places, 2) whether they co-locate at micro-places, and 3) the likely community characteristics and place-based dynamics that explain these observed patterns. Importantly, the role of place-based dynamics related to the post-incident operational response to gun violence is tested (e.g., a street segment’s proximity to trauma …

Lactating Justice: Constructing A Society Economically Focused On Optimizing Health Through Human Lactation, Shadley Hobour

Dissertations, Theses, and Capstone Projects

This paper uses a qualitative research method to answer if a Universal Base Income would be a good economic policy to adopt to optimize Black chestfeeding. The key idea this thesis aims to clarify is how anti Blackness is killing Black people and how one economic policy could improve health. In this essay, I will break down the significance and importance of human lactation for lifelong better health, and investment in a UBI would especially work as a preventative measure for several health issues Black people experiences.

Four Corners: A Values Clarification Exercise, Montsine Nshom

Open Educational Resources

Four Corners is a values clarification activity that asks participants to stand/show whether they strongly agree to strongly disagree with a specific statement, and reflect on their position during and after the activity. This four corners activity is designed to help students think about and discuss topics that are pertinent to urban community health and public health.

No prior reading or coursework is required; it is a good option for the first day of class to introduce key themes that will be covered during the course as well as practice ground rules and class discussion norms.

Maternal Wellness: Self, Matrescence, Obstetric Violence, And Self-Care, Vanessa V. Vales-Lewis

Dissertations, Theses, and Capstone Projects

In this dissertation, I engage in a self-study through an examination of my experience of matrescence (i.e., the transition to motherhood). I discuss my praxis in the development of a self-study on maternal wellness as it applies to my well-being as both a researcher and the researched. In Chapter 1, I preface this study by highlighting critical scholars and the bricoleurs who have been foundational in my undertaking of this work on a narrative study on maternal wellness. Using bricolage as part of a research methodological framework that involved key scholarly methodologies of authentic inquiry, emergence and contingence, and narratology, …

"It Was Handed To Them": The Origins Of Targeted Delivery And The Spirit Of Nanomedicine, Marzena Woinska

Dissertations, Theses, and Capstone Projects

Nanotechnology is widely recognized as an important field. Since the 2000s, nano-based targeting has been a cutting-edge approach in cancer research. To specify what nanomedicine means and describe its significance at the cultural level, this study harnesses data from peer-reviewed articles published in leading scientific journals.

Balancing precariously between sociological theory and science and technology studies, this project turns to nanomedicine’s origins to address broader questions regarding the relationship between science and society and the causes of scientific discovery and technological innovation. It tells the story of nanotechnology's discursive formations taking on a life of their own and congealing into …

Should I Stay Or Should I Go? Mexican Return Migration Across The Life Course, Mara G. Sheftel

Dissertations, Theses, and Capstone Projects

Foreign-born individuals make up a growing share of older adults in the US. Older immigrants offer an important vantage point from which to investigate integration because outcomes at older ages can be considered “final” measures providing empirical evidence for theoretical understandings of the forces impacting immigrant trajectories. However, considering the non-negligible portion of immigrants that ultimately return to their country of origin it is impossible to get the full range of immigrant outcomes without considering returnees. Further, patterns of return may differ across the life course with distinct economic, social, and health considerations at older ages. However, the impact of …

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 …

"Divide, Divert, & Conquer” Deconstructing The Presidential Framing Of White Supremacy In The Covid-19 Era, Vivian Louie, Anahi Viladrich

Publications and Research

Based on the analysis of President Donald J. Trump’s social media, along with excerpts from his speeches and press releases, this study sheds light on the framing of white supremacy during the first months of the COVID-19 pandemic in the United States. Our findings reveal that the triad of divide, divert, and conquer was crucial to Trump’s communications strategy. We argue that racist nativism—or racialized national threats to American security—is key to comprehending the external divisiveness in this strategy. When Trump bitterly cast China as the cause of America’s pandemic fallout and Mexico as the source of other key American …

Exploring Social Determinants Of Covid-19 Related Sickness And Suffering In The Bronx, Hamida Chumpa

Student Theses and Dissertations

Through a positivistic and phenomenological approach, the study examines social determinants of COVID-19 related sickness and suffering in the Bronx, New York City, New York, ZIP codes 10462, 10472, 10467, 10458, 10474, and 10464. I utilize a violence paradigm (structural and everyday violence) to describe the social determinants of risk and sickness-related suffering and deploy an assemblage framework to shed light on how these determinants create negative synergies that undermine wellbeing and render certain communities vulnerable to extreme suffering. The mixed methods include 64 surveys and eight interviews. Analysis methods include a descriptive analysis of survey results and a thematic …

Hips That Harm: When Medical Devices Fail Women, Sophie N. Putka

Capstones

Medical devices that save the lives of thousands of Americans each year advance at a rapid pace - but some of them consistently leave women behind. When it comes to joint replacements and even heart devices, women have worse health outcomes. Behind this preventable problem is a system that overlooks women from start to finish. Female bodies are different from male bodies, but women are often underrepresented in medical trials for device approval. Women’s participation in clinical testing for devices has increased, but there’s rarely a detailed analysis of performance by sex, and even less information on women by race …

Is Exposure To Epidemic Associated With Older Adults’ Health Behavior? Evidence From China’S 2002-2004 Sars Outbreak, Hong Zou, Sha Wen, Hongwei Xu

Publications and Research

Objectives: To determine whether exposure to an epidemic is associated with better health behaviors.

Methods: Using nationally representative survey data collected in 2011 and 2014, we identified middle-aged and older Chinese adults whose communities experienced an outbreak of the 2002–2004 severe acute respiratory syndrome (SARS). We estimated logistic models of health behaviors in the years after the SARS epidemic.

Results: Compared to those who lived in communities not hit by the epidemic, respondents who lived in communities with a SARS outbreak in 2002–2004 were more likely to get a physical examination in 2010–2011 and have their blood pressure checked and …

Does Subjective Social Status Predict Self-Rated Health In Chinese Adults And Why?, Hong Zou, Qianqian Xiong, Hongwei Xu

Publications and Research

No abstract provided.

Shadow Standards And The Logic Of Costs: Care, Stewardship, And Data In U.S. Community Health, Margarite J. Whitten

Dissertations, Theses, and Capstone Projects

This dissertation examines the delegation of responsibility for providing health care to particular categories of marginalized populations in the United States in the absence of a uniform and universal health care system. It explores how the U.S. federal government governs patient populations at a distance by mandating that healthcare providers collect, produce, and report on patient data. Drawing from eighteen months of ethnographic research in Massachusetts clinics for the homeless and the frail elderly between 2014-2015, I argue that when marginalized patients are unable to satisfy the neoliberal ideal of self-governance to maintain their health in cost-effective ways, providers are …

Breast Dressing: A Critical Review Of Post-Surgical Bras, Adi Sieradzki

Dissertations, Theses, and Capstone Projects

Breast cancer is acknowledged in the United States as a phenomenon. With more than 3 million women either diagnosed or treated for it as of 2019, it is a seminal part of the American healthcare map. However, the market for the kinds of bras and bandages patients have to wear after surgery remains mostly overlooked and outdated. This thesis aims to explore what it means to bandage or dress a breast that has been altered either in combative or cosmetic procedures. Why post-surgical wound care for breasts still mostly looks like a sports bra? How do breast cancer patients rehabilitate …

Leveraging Technology To Blend Large-Scale Epidemiologic Surveillance With Social And Behavioral Science Methods: Successes, Challenges, And Lessons Learned Implementing The Unite Longitudinal Cohort Study Of Hiv Risk Factors Among Sexual Minority Men In The United States, H. Jonathon Rendina, Ali J. Talan, Nicola F. Tavella, Jonathan Lopez Matos, Ruben H. Jimenez, S. Scott Jones, Brian Salfas, Drew Westmoreland

Publications and Research

The use of digital technologies to conduct large-scale research with limited interaction (i.e., no in-person contact) and objective endpoints (i.e., biological testing) has significant potential for the field of epidemiology, but limited research to date has been published on the successes and challenges of such approaches. We analyzed data from a cohort study of sexual minority men across the United States, collected using digital strategies during a 10-month period from 2017 to 2018. Overall, 113,874 individuals were screened, of whom 26,000 were invited to the study, 10,691 joined the study, and 7,957 completed all enrollment steps, including return of a …

Illicit Psychoactive Medication Use: Experiences Of Medicalization And Normalization, Mark Pawson

Dissertations, Theses, and Capstone Projects

This dissertation explores illicit psychoactive medication use among young adults. Overwhelmingly, the literature on this drug trend, particularly among this population, is grounded in a study of pathology. However, my research demonstrates that this obscures a significant portion of how youth practice and make meaning of their consumption of these controversial medications. The following phenomenologically based dissertation presents and unpacks the experiences, practices, and perspectives of young adults who illicitly consume psychoactive medications. Through analyzing 162 interviews of 18-29 year olds who report recent misuse of a prescription stimulant, tranquilizer, sedative, and/or opioid, I present the ways youth medicalize and …

Illness And The American Workplace: Issues And Implications For Employers And Employees, Victoria R. Dolan

Student Theses and Dissertations

This project aims to identify American employee experiences and existing workplace policies and cultures surrounding illness, disability, and sick leave. This approach was taken in order to closely examine what looks to be working well for companies and workers, and what could benefit from a more human centric approach in regards to workplace policy and employee support programs. The study of employee experiences in particular represents a gap in the current scholarly literature regarding illness and illness policy in the American workplace, and more accurately represents the experiences for both employees and employers. Furthermore, it assists with distinguishing the types …

La Comunicación Lingüística En Español Y Sus Barreras En El Sistema De Salud De Los Estados Unidos, David Sánchez-Jiménez

Publications and Research

La enseñanza del español con fines médicos en los Estados Unidos ha experimentado un crecimiento exponencial en las dos últimas décadas. Sin embargo, los pacientes de origen hispano se encuentran desprotegidos ante las barreras lingüísticas que impone el sistema de salud estadounidense en muchos contextos monolingües y bilingües. Esta investigación descriptiva muestra como, por un lado, los malentendidos producidos por la comunicación ineficiente desarrollada por intérpretes e intermediarios (familiares, enfermeras con conocimientos de español, facultativos con una preparación lingüística deficiente, etc.) tienen serias repercusiones para la salud en el tratamiento de los casos. Por otro lado, el estudio da cuenta …

Doctors As Migration Brokers In The Mandatory Medical Screenings Of Immigrants To The United States, Sofya Aptekar

Publications and Research

Applicants for legal permanent residency in the United States are required to pass a medical screening. Most of these applicants are already living in the United States on non-immigrant and temporary visas and are screened by civil surgeons, physicians designated by the government to look for infectious diseases, incomplete immunization records, and signs that the immigrant will pose a threat or become a public charge. Little is known about the work of these 4000+ physicians, who play a key role as migration brokers in a context where migration control has devolved to non-state actors. I present quantitative analysis of a …

The Social Provision Of Healthcare To Migrants In The Us And In China, Van C. Tran, Katharine M. Donato

Publications and Research

This article develops a comparative analysis of healthcare provision to migrants in the US and in China. It proceeds in three parts. First, we begin by describing the growth of the unauthorized population and trace the evolution of social provision of healthcare to immigrants, highlighting the restrictive nature of federal social provisions and greater autonomy of state and local governments in redefining eligibility criteria in the US. Second, we examine the impact of legal status on healthcare access and utilization among Mexicans, using original data from the 2007 Hispanic Healthcare Survey and the Mexican Migration Project. We find that unauthorized …

Facebook As A Social Outreach And Advocacy Tool In Intersex/Dsd Groups, Emelie J. Ali Ms

Publications and Research

My project includes a netnography of a Facebook intersex group called Families and Friends of Intersex People. I observed the group’s forms of communication within the group and which topics they discussed. It appears one of the major concerns the group has is the use of nonconsensual, sex assignment surgery on infants to “correct” their body to match a gender identity. I have also discovered a link between being intersex and affiliated with the LGBT+ community. Since the 20th century, intersex people have been stigmatized due to their assumed ability to engage in sexual, same-sex relations. I have concluded that …

"I Was Not Sick And I Didn't Need To Recover": Methadone Maintenance Treatment (Mmt) As A Refuge From Criminalization, David Frank

Dissertations, Theses, and Capstone Projects

Methadone Maintenance Treatment (MMT) has been undergoing a cultural and epistemological shift away from an approach that emphasized client stabilization and a reduction of social harms towards one grounded in values associated with the recovery movement. These changes include promoting a view of addiction grounded in the disease model as well as efforts to make abstinence and ancillary services such as recovery coaching/counseling, programs emphasizing proper citizenship, and concern for clients’ spirituality necessary parts of the program. As such, the increasing use of recovery as the dominant conceptual framework for MMT represents a change in how methadone, MMT, and those …

Healthcare Coverage In The United States And New York Metropolitan Area, 2009 - 2015, Andrew S. Alger

Center for Latin American, Caribbean, and Latino Studies

Introduction: This study examines trends regarding health insurance coverage in the United States along lines of sex, race/ethnicity, place of birth, and poverty status between 2009 and 2015.

Methods: This study uses the American Community Survey PUMS (Public User Microdata Series) for the years 2009, 2011, 2013, and 2015. These datasets were downloaded from the IPUMS USA website hosted by the University of Minnesota. The variables used in the study describe these populations in terms of sex, the four major race/ethnic groups (non-Hispanic white, non-Hispanic black, Latino, and Asian), being born either within the United States or abroad, and being …

Medical Transnationalism: Korean Immigrants’ Medical Tourism To The Home Country, Sou Hyun Jang

Dissertations, Theses, and Capstone Projects

This dissertation examines Korean immigrants’ barriers to formal U.S. healthcare, three distinctive types of healthcare behaviors that they exhibit, contributing factors to their medical tourism, and their experiences and evaluations of medical tourism. Analyzing survey data with 507 Korean immigrants and in-depth interviews with 120 Korean immigrants in the New York-New Jersey area, the study finds that more than half of Korean immigrants have barriers to healthcare in the U.S., the two biggest being the language barrier and not having health insurance. The study also finds that there are three distinctive types of healthcare behavior that Korean immigrants employ to …

Older Adults And Mobile Technology: Factors That Enhance And Inhibit Utilization In The Context Of Behavioral Health, Alexis Kuerbis, Adina Mulliken, Frederick Muench, Alison A. Moore, Daniel Gardner

Publications and Research

While numbers and proportions of older adults with behavioral health issues are expected to substantially increase, there is also a widening gap in available services for older adults. Mobile health interventions (mhealth) are a way to address existing barriers to treatment, provide frontline assessment and increase access to services for older adults. Due to perpetuated stereotypes, many assume that older adults do not utilize mobile technology nor will they accept a mHealth intervention. The purpose of this paper is to synthesize contemporary literature from information technology and healthcare regarding: (1) current mobile technology utilization by older adults, particularly in regards …

Warmth And Competence Traits: Perceptions Of Female And Male Nurse Stereotypes, Randolph E. Gross

Dissertations, Theses, and Capstone Projects

A nursing shortage looms ahead; 1.03 million new nurses will be needed by 2022 to meet society's healthcare needs. A major barrier to recruitment of women and men are nurse stereotypes. The literature suggests four female and four male stereotypes exist; however, no quantitative research exists that explores perceptions of non-nursing undergraduate students. Approximately, 90% of college students do not consider nursing as a career option, and 72% have misconceptions of what nurses do in reality.

According to social cognitive theory's Stereotype Content Model (SCM), perceptions are viewed through a combination of two dimensions: warmth and competence. The author devised …