Medicine and Health Commons^™

Hepatitis C And The Social Hierarchy: How Stigma Is Built In Rural Communities, Charley D. Henderson, Atsuko Kawakami

The Qualitative Report

Although Hepatitis C has profound impacts on individuals living in communities, most research has been conducted in a hospital or laboratory setting. Additionally, there is a lack of research exploring the social effects of Hepatitis C in rural communities. In this qualitative study, we focus on perceptions on Hepatitis C within a rural community, describe how the local residents perceive social hierarchy within their community, and explore the process of stigma building. Informed by a grounded theory approach, we employed a snowball sampling strategy in a southern rural area to conduct in-depth, open-ended interviews. In our findings we describe how …

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 …

Clinician Identified Barriers To Treatment For Individuals In Appalachia With Opioid Use Disorder Following Release From Prison: A Social Ecological Approach, Amanda M. Bunting, Carrie B. Oser, Michele Staton, Katherine S. Eddens, Hannah K. Knudsen

Sociology Faculty Publications

Background: The non-medical use of opioids has reached epidemic levels nationwide, and rural areas have been particularly affected by increasing rates of overdose mortality as well as increases in the prison population. Individuals with opioid use disorder (OUD) are at increased risk for relapse and overdose upon reentry to the community due to decreased tolerance during incarceration. It is crucial to identify barriers to substance use disorder treatment post-release from prison because treatment can be particularly difficult to access in resource-limited rural Appalachia.

Methods: A social ecological framework was utilized to examine barriers to community-based substance use treatment among individuals …

Effects Of An Educational Intervention On Exclusive Breastfeeding Rates In Marshallese Mothers Residing In The U.S., Connor K. Otto

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: The largest population of Marshallese immigrants in the Contiguous U.S. resides in Northwest Arkansas. Despite adequate access to healthcare, the Marshallese face many health disparities, perhaps partly due to the language barrier they face in healthcare settings and education. Regarding breastfeeding rates, women in the Marshall Islands have a significantly higher rate of exclusive breastfeeding than in Marshallese women residing in the U.S. who face cultural barriers. Breastfeeding is positively correlated to many benefits for infants and is recommended exclusively for at least 6 months by pediatric policy organizations.

Objective: The purpose of this research is to examine breastfeeding …

Anderson's "The Sense Of Humor: Let Humor Fast Track You To Healthier, Happier Living" (Book Review), Cynthia Hammell

The Christian Librarian

No abstract provided.

Maternal Immune Activation (Mia) In Mice: A Study To Phenotype Asd-Related Communication Behaviors And Analyze Maternal Health Outcomes In The Us, Komalpreet Gulati

Honors Scholar Theses

Core symptoms of Autism Spectrum Disorders (ASD) include deficits in social/communicative behaviors, and repetitive/stereotyped behaviors. Mouse models are a highly established paradigm used to study the phenotypic deficits that result from various inducible genotypic or environmental risk factors for ASD. Previous studies have demonstrated a link between maternal immune activation (MIA) and ASD-like behaviors in mouse models. In this model, the maternal immune system is activated during pregnancy by injecting the viral mimic poly(I:C). The resulting offspring are phenotyped and analyzed with regards to their communicative behaviors.

Previous studies have demonstrated that male pups born to dams with immune activation …

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 …

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 …

Health Behavior Among Men Occupying Multiple Family Roles And The Moderating Effects Of Perceived Partner Relationship Quality, Nicole Depasquale, Courtney A. Polenick, Jesse Hinde, Jeremy Bray, Steven H. Zarit, Phyllis Moen, Leslie B. Hammer, David M. Almeida

Psychology Faculty Publications and Presentations

Men in the U.S. are increasingly involved in their children’s lives and currently represent 40% of informal caregivers to dependent relatives or friends aged 18 years or older. Yet, much more is known about the health effects of varying family role occupancies for women relative to men. The present research sought to fill this empirical gap by first comparing the health behavior (sleep duration, cigarette smoking, alcohol consumption, exercise, fast food consumption) of men who only occupy partner roles and partnered men who also fill father, informal caregiver, or both father and informal caregiver (i.e., sandwiched) roles. The moderating effects …

Racial Disparities In Breast Cancer Survival: The Mediating Effects Of Macro-Social Context And Social Network Factors, Ganga Vijayasiri, Yamile Molina, Ifeanyi B. Chukwudozie, Silvia Tejeda, Heather Pauls, Garth Rauscher, Richard T. Campbell, Richard B. Warnecke

Journal of Health Disparities Research and Practice

ABSTRACT

This study attempts to clarify the associations between macro-social and social network factors and continuing racial disparities in breast cancer survival. The study improves on prior methodologies by using a neighborhood disadvantage measure that assesses both economic and social disadvantage and an ego-network measurement tool that assesses key social network characteristics. Our population-based sample included 786 breast cancer patients (nHWhite=388; nHBlack=398) diagnosed during 2005-2008 in Chicago, IL. The data included census-derived macro-social context, self-reported social network, self-reported demographic and medically abstracted health measures. Mortality data from the National Death Index (NDI) were used to determine 5-year survival.

Based on …

Disentangling The Effects Of Acculturation And Duration In The United States On Latina Immigrant Maternal Overweight And Macrosomia, Miguel Ceballos, Andrea Cantarero, Shanell Sanchez

Journal of Health Disparities Research and Practice

A significant body of research on minority health shows that while Latina immigrants experience unexpectedly favorable outcomes in maternal and infant health in the United States, this advantage deteriorates with increased duration of residency. This study assesses the relationship between excessively high birth weight (macrosomia), maternal weight, and length of residency in the United States. A sample of Mexican immigrant women living in two Midwestern communities in the United States is used to analyze the effects of duration in the United States, acculturation on birth outcomes, and maternal overweight once controlling for social, behavioral, and environmental mediators of health status. …

Exposure To Community Violence And Substance Use Among Black Men Who Have Sex With Men: Examining The Role Of Psychological Distress And Criminal Justice Involvement, Dexter R. Voisin

Faculty Scholarship

Young Black MSM (YBMSM) are disproportionately affected by violence, criminal justice involvement, and other structural factors that also increase vulnerability to HIV. This study examined associations between exposure to community violence (ECV) and substance use, psychological distress, and criminal justice involvement (CJI) among YBMSM in Chicago, IL. Respondent driven sampling was used to recruit a sample of 618 YBMSM (aged 16–29) from the South Side of Chicago between June 2013 and July 2014. Weighted logistic regression assessed the direct effects of ECV, CJI, and psychological distress on substance use outcomes. Indirect effects were assessed via path analysis with mean and …

The Challenges Of India’S Rising Breast Cancer Epidemic, Brigette Stickney

Independent Study Project (ISP) Collection

India is currently undergoing rapid urbanization, which is greatly impacting Indian citizens’ health. One of the rising concerns due to the drastic lifestyle and environmental changes that are results of urbanization is the issue of breast cancer. Breast cancer diagnosis rates are rising exponentially, and breast cancer has moved its way up to be the most common cancer in India. Breast cancer mortality rates in India are also some of the worst in the world. This paper analyses the social, mental, economic, geographic, and physical challenges that are present for women diagnosed with cancer in India. It assesses how they …

A Look At Female Genital Mutilation, Norhan H. Gomaa

Student Publications

Female Genital Mutilation is deeply rooted in misogyny and sexism. This paper looks at current and past efforts of NGOs and other organizations that have tried to eradicate the practice in many countries, mainly in Africa. The strategies and techniques of these organizations have failed for many reasons, this paper highlights those that have worked and those that have failed. The next possible steps to reduce the practice have been proposed in the paper.

Faith C. S. Ho, Western Medicine For Chinese: How The Hong Kong College Of Medicine Achieved A Breakthrough, Jack Greatrex

Research Collection College of Integrative Studies

The Hong Kong College of Medicine for Chinese was founded in 1887 with expansive ambitions: the adoption of western medicine and science by the Chinese population of colonial Hong Kong and China more broadly.

Trust, Access, And Adaptation To Needs: The Role Of Community-Based Promoters In Health Insurance Delivery In Gujarat, India, Lauryn Stafford

Independent Study Project (ISP) Collection

The research question this study addresses is: How do community-based promoters contribute to the delivery and utilization of health insurance among marginalized populations in India? To address this question, the successes and difficulties experienced by VimoSEWA community-based insurance promoters, called aagewans, were investigated through field visits and personal interviews in Ahmedabad and nearby rural districts in Gujarat. VimoSEWA’s insurance delivery model is an appropriate topic of investigation for this study because its beneficiaries are self-employed women with limited prior access to financial protection. Both aagewans and insurance members were interviewed during this study to develop a comprehensive understanding of the …

Poly Cystic Ovarian Syndrome In India: A Socio-Cultural Perspective, Hannah Wickham

Independent Study Project (ISP) Collection

This study examines the ways in which cultural determinants affect the health-seeking, diagnosis and treatment process of women with Poly Cystic Ovarian Syndrome (PCOS) as well as the underlying socio-cultural causes of the illness. Often coined as a “lifestyle disease”, PCOS is becoming a growing concern of physicians and women alike as its prevalence is on the rise with no signs of slowing down. Lifestyle, stigmas/taboos, PCOS’s effect on identity, and quality of life are all areas that are examined throughout this paper. A mixture of patients’ and doctors’ perspectives on PCOS were gathered throughout a three-week time period in …

Exploring The Space Between Healers: A Narrative Approach To Understanding The Relationship Between Traditional Healers And Biomedical Practitioners In Kwazulu-Natal, Marisa Delsignore

Independent Study Project (ISP) Collection

Despite playing essential and parallel roles in the lives of patients, there exists a frictional, imbalanced relationship between traditional healers and Western doctors in South Africa. While national policy encourages a seamless system rooted in both Western science and indigenous knowledge, biomedical institutions are hesitant to accept traditional medical practices, which are based on less tangible and more spiritually-oriented elements. This research project turns to these two ideologically different entities to assess their perspectives on the roles of themselves and the other within the context of the South African health system.

Responses from semi-structured interviews with seven health practitioners from …

Government Roles In Regulating Medical Tourism: Evidence From Guatemala, Ronald Labonté, Valorie A. Crooks, Alejandro Cerón, Vivien Runnels, Jeremy Snyder

Anthropology: Faculty Scholarship

Background: Regulation of the medical tourism and public health sectors overlap in many instances, raising questions of how patient safety, economic growth, and health equity can be protected. The case of Guatemala is used to explore how the regulatory challenges posed by medical tourism should be dealt with in countries seeking to grow this sector.

Methods: We conducted a qualitative case study of the medical tourism sector in Guatemala, through reviews and analyses of policy documents and media reports, key informant interviews (n = 50), and facility site-visits.

Results: Key informants were critical of the absence of effective public regulation …

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 …

Neighbourhood Deprivation And Lung Cancer Risk: A Nested Case–Control Study In The Usa, Maureen Sanderson, Melinda C. Aldrich, Robert S. Levine, Barbara J. Kilbourne, Qiuyin Cai, William J. Blot

Sociology Faculty Research

Objectives To examine the association between neighbourhood deprivation and lung cancer risk.

Design Nested case–control study.

Setting Southern Community Cohort Study of persons residing in 12 states in the southeastern USA.

Participants 1334 cases of lung cancer and 5315 controls.

Primary outcome measure Risk of lung cancer.

Results After adjustment for smoking status and other confounders, and additional adjustment for individual-level measures of socioeconomic status (SES), there was no monotonic increase in risk with worsening deprivation score overall or within sex and race groups. There was an increase among current and shorter term former smokers (p=0.04) but not among never …

Cardiorespiratory Fitness Is Positively Associated With Waist To Height Ratio And School Socio Economic Status In Irish Primary School Aged Children, M. O'Leary, E. Rush, Seán Lacey, Con Burns, Tara Coppinger

Publications

Background; The purpose of this paper is to examine any association between cardiorespiratory fitness (CRF) and markers of health among 6 and 10 year old Irish children. Methods; A total of 917 children (6 year olds, N=459; 10 year olds, N=458) from 11 primary schools in Cork (Ireland) participated. Body composition, blood pressure (BP), CRF (550-metre distance run) and school socio-economic status (SES) were assessed. Children were classified as low or high fitness based on run-time standard deviation scores (SDS). Physical activity (PA) determined over 1 week by accelerometry was collected from a sub sample of 700 children (76.3%). Results; …

The Micro-Politics Of A New Mental Condition: Legitimization In Maladaptive Daydreamers' Discourse, Orit Bershtling Ph.D., Eli Somer Ph.D.

The Qualitative Report

This study illuminates legitimization efforts in the discourse of individuals who suffer from excessive, uncontrolled daydreaming: a contested mental condition that has not yet been recognized by the medical establishment. It aims to explore the rhetorical maneuvers employed by these “Maladaptive Daydreamers” in 35 email exchanges with the second author and two petitions, submitted to the American Psychiatric Association and to the UK Parliament, with a demand for recognition. Our analysis, anchored theoretically and methodologically in Critical Discourse Analysis, identified several verbal strategies employed by the participants to persuade their interlocutors about the realness of their suffering. The main strategies …

A Longitudinal Examination Of Factors Associated With Network Bridging Among Ymsm: Implications For Hiv Prevention, Dexter R. Voisin

Faculty Scholarship

Social-environmental factors may be associated with social network stability, which has implications for HIV acquisition. However, the link between social-environmental factors, network composition and HIV risk has not been examined previously among a city-population based sample of young Black men who have sex with Men (YBMSM). Respondent driven sampling was used to recruit a cohort of 618 YMBSM. Respondents were evaluated at baseline, 9 and 18 months beginning June 2013. A logistic regression model was used to assess the relationship between bridging (i.e. having non-redundant contacts in one’s network, indicating network instability) and social-environmental factors and HIV risk factors between …

Higher Quality At Lower Cost: Community Health Worker Interventions In The Health Care Innovation Awards, Caitlin Cross-Barnet, Sarah Ruiz, Megan Skillman, Rina Dhopeshwarkar, Rachel Singer, Rachel Carpenter, Suzanne Campanella, Maysoun Freij, Lynne Snyder, Erin Colligan

Journal of Health Disparities Research and Practice

Background: Published evidence regarding cost savings, reduced utilization, and improved quality associated with employing community health workers (CHWs) is largely lacking. This paper presents findings from the Centers for Medicare & Medicaid Services Health Care Innovation Awards (HCIA), with a focus on six diverse programs that employ CHWs. We examine outcomes associated with programs incorporating CHWs into care teams for a broad age range of patients with various health issues such as cancer, asthma, and complex conditions.

Methods: This mixed-methods study used data from claims and site visits to assess the effectiveness of CHW programs. In difference-in-differences analyses of Medicare …

A Modern Plague: U.S. Racial And Ethnic Vaccination Disparities During The 2009 H1n1 Influenza Pandemic, Andrew E. Burger

All Graduate Theses and Dissertations, Spring 1920 to Summer 2023

On June 11, 2009 the World Health Organization announced that a novel strain of H1N1 influenza was being classified a Phase 6 pandemic, the highest level of alarm indicating that the disease was present worldwide and its spread was inevitable. While seasonal influenza epidemics occur annually, the 2009 H1N1 strain was the first novel pandemic influenza since the 1968 Hong Kong flu. The 2009 H1N1 pandemic provides a case study of how the U.S. population responded to an emergent and potentially lethal infectious disease. The richness and variety of public health data presents an opportunity to examine predictors of vaccination …

Influence Of Physicians’ Beliefs On Propensity To Include Religion/Spirituality In Patient Interactions, Aaron B. Franzen

Faculty Publications

This study examines physicians’ beliefs, their perceptions of whether religion impacts health outcomes, and their propensity to discuss religion/spirituality with patients. It is not uncommon for patients to want religious/spiritual conversations, but the occurrence is infrequent. This study adds to knowledge regarding which physicians include these topics. Using a nationally representative sample of physicians and a mediated bi-factor structural equation model, the author finds that “religious and spiritual” physicians connect religion and patient health more than other religious/spiritual orientations. As a result, “religious and spiritual” physicians include religion/spirituality most often (indirect path). After this variation is accounted for, “spiritual but …

A Military Chronic Pain Interdisciplinary Outpatient Program’S (Iop) Approach To Reducing Pain And Disability And Increasing Functional Ability, Paris N. Mcdonald

USC Aiken Psychology Theses

The present study employed self-report measures to assess pain intensity, self-report perception of disability, and patient activation, and objective functional measures to explore the outcomes of a military interdisciplinary chronic pain intensive outpatient program. Seventy-three Active Duty Service Members (SM) with chronic pain completed baseline measures (pre-IOP) and graduation day measures, 60 SMs completed one-month follow-up measures, and 28 completed three-month follow-up measures. Results indicated that self-report pain levels decreased from pre-IOP to graduation day. The decrease was maintained; however, no additional significant decrease in pain occurred following program completion. Further, participant’s self-reported perception of disability due to back pain …

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 …