Population Health Commons^™

Socioeconomic Inequalities In Health-Related Quality Of Life During The Covid-19 Pandemic: A Six-Country Comparison Using The Eq-5d-5 L, Joëlle Eijkens, Joshua M. Bonsel, You-Shan Feng, M. F. Bas Janssen, Erica I. Lubetkin, Juanita A. Haagsma

Publications and Research

Purpose

Despite the growing attention to health inequalities, there is no global consensus on how to measure socio-economic status. This study examined inequalities in health-related quality of life (HRQoL) during the early phase of the COVID-19 pandemic across six countries—China, Italy, the Netherlands, Sweden, the United Kingdom (UK), and the United States (US)—using three SES indicators: education level, income, and work status.

Methods

Between April and June 2020, individuals aged 18–75 years old completed a web-based survey. HRQoL was measured using the EQ-5D-5L Level Sum Score (LSS), where higher scores indicate poorer health. Country-specific differences in LSS across SES groups …

Structured Telehealth Community Health Worker-Clinician Feedback And Diabetes Outcomes: A Randomized Clinical Trial, Elizabeth Vaughan, Xiaoying Yu, Amber Amspoker, Aanand Naik, Ashok Balasubramanyam, Craig Johnston, Christi Ballantyne, Salim S. Virani, Shelton Brown, Kristina Mena

Population Health, East Africa

Importance  Community health workers (CHWs) improve chronic disease management in underserved populations, but scalable integration strategies are limited.

Objective  To evaluate whether a multidimensional intervention incorporating telementored CHWs and a structured participant-CHW-clinician feedback loop can improve diabetes outcomes.

Design, Setting, and Participants  This 12-month randomized clinical trial was conducted at 3 institutionally and geographically diverse community clinics in Texas between September 1, 2023, and April 30, 2025, and included low-income, uninsured White Hispanic adults with type 2 diabetes identified through clinic databases. Data were analyzed between May 1 and July 31, 2025.

Intervention  Individuals were randomized 1:1 to the intervention …

Ambulatory Blood Pressure Monitoring Phenotypes And Circadian Blood Pressure Patterns Among Adults Referred For Diagnostic Evaluation At Aga Khan University Hospital, Nairobi, Kenya: A Retrospective Cross-Sectional Study, Nadeem Kassam, Mzee Ngunga, James Orwa, Alisa Bhojani, Mohamed Varwani, Swaffiya Salim, Yvonne Oketch, Salim Surani, Anthony Ochola, Barbara Karau, Jeilan Mohamed, Etienne Amendezo

Internal Medicine, East Africa

Introduction: hypertension represents the primary modifiable risk factor for cardiovascular disease and poses a public health challenge in sub-Saharan regions, with Kenya experiencing particularly low detection and control rates. Traditional office-based blood pressure measurements often fail to detect key phenotypes, such as white-coat and masked hypertension. Ambulatory Blood Pressure Monitoring (ABPM) offers a comprehensive 24-hour profile that excludes white-coat hypertension and allows for the evaluation of circadian patterns, including nocturnal hypertension and non-dipping status, both of which are recognized as high-risk phenotypes strongly linked to adverse cardiovascular events. This study evaluated ABPM data from Aga Khan University Hospital, Nairobi …

Social Determinants As A Predictor For Heart Disease Mortality: Oregon Regional Study, Jewel Jones

University Honors Theses

The study examined the association between selected social determinants of health and heart disease mortality across geographic regions in Oregon. Using a regional analysis design, county-level population and mortality data were grouped into nine geographic regions to evaluate patterns of cardiovascular disease burden across the state. Social determinant variables were obtained from publicly available U.S. Census Bureau datasets and included poverty, crowding among households, single-parent households, lack of broadband internet subscription, housing cost burden, high school diploma attainment, and unemployment.

Heart disease mortality counts per 100,000 population were derived from official birth and death certificate records. Statistical analyses were conducted …

Geographic And Systemic Disparities In Maternal Health: A Systems Analysis Of Prenatal Care Access Across Rural Oregon, Cecelia Petrik

University Honors Theses

Objectives: In Oregon, 51% of hospitals providing labor and delivery services are located in rural areas. Consolidation of these hospitals and provider shortages has created severe geographic and systemic disparities in maternal healthcare. This thesis explores how geographic isolation and inadequate prenatal care access contribute to widening disparities in severe maternal morbidity (SMM) and mortality across Oregon's rural and frontier counties.

Methods: This study utilizes data from the Oregon Health Authority (OHA) Center for Health Statistics (2024) and analyzes spatial correlations across all 36 Oregon counties. A bivariate choropleth map was constructed to examine the structural intersection between health infrastructure …

Assessing Aflatoxin Knowledge, Perceptions, And Related Practices, In A Rural Coastal Community: A Population-Based Cross-Sectional Survey, Rosebella Iseme, Joseph Abuodha, Anthony Ngugi, Innocent Abayo, Mansoor Saleh

Population Health, East Africa

Background

Aflatoxin contamination is a significant yet under-addressed food safety challenge in low-resource settings, driven by a complex interplay of environmental, agricultural, and socio-economic factors. Limited access to agricultural inputs, inadequate post-harvest handling and storage, and weak regulatory enforcement alongside food scarcity and climate change heighten the risk of contamination and exposure. Human exposure is associated with serious health consequences, including hepatocellular carcinoma, immune suppression, and childhood stunting. Although aflatoxin is increasingly recognized as a global food safety concern, little is known about community-level knowledge, risk perceptions, and preventive practices. This study examined household heads’ awareness, perceptions, and behaviours related …

Satellite-Derived Longitudinal Evidence Of Flood Effects On Community Water And Sanitation Resilience In Coastal Kenya, Felix Oluoch, Rosebella Iseme, Fredrick Gudda, Alfred Keter, Rachel Odhiambo, Jai Das, Zulfiqar Bhutta, Anthony Ngugi

Population Health, East Africa

Background Flooding can disrupt water, sanitation and hygiene services in low-income rural and peri-urban settings, yet there is limited quantitative evidence on how repeated flood exposure affects safe water and sanitation over time at the level of Community Health Units (CHUs), which are the operational units for primary health care in Kenya.

Methods We analysed repeated CHU-level data from ten Community Health Units in Kilifi County, Kenya, across eleven surveillance rounds from 2017 to 2024. For each round, we calculated the percentage of households with safe drinking water and with access to a functional latrine, and linked these outcomes to …

Feasibility And Acceptability Of A Mobile App And Wearable Device For Collecting Mental Health Survey And Passively Sensed Data Among Health Care Workers In Kenya: Mixed Methods Pilot Study, Linda Khakali, Andrew Aballa, Dorcas G. Mwigereri, Willie Njoroge, Rachel Maina, Amos Bunde, Peris Musitia, Moses Nyongesa, James Orwa, Jasmit Shah, Anthony Ngugi, Lukoye Atwoli, Amina Abubakar, Zul Merali

Brain and Mind Institute

Background: Mobile apps and wearable devices may help to facilitate early detection of mental health conditions by providing objective, real-time data to supplement other forms of feedback and diagnoses. Few studies have investigated the acceptability and feasibility of using a mobile app to track survey- and wearable-based data in mental health research in Sub-Saharan Africa.

Objective: This pilot study evaluated the feasibility and acceptability of using a mobile app and wearables to capture mental health–based survey data and passively sensed data among Kenyan health care workers.

Methods: A mixed methods study was conducted among health care workers …

Extending The Global Impact Of Dnp Education: Integrating Scholarly Dissemination And International Practice Projects, Cynthia Plonien, Pricilla Muisyo, Deborah Behan, Kristine Cope, Cathy Brown

Nursing Faculty Publications & Presentations

The Doctor of Nursing Practice (DNP) Program at the University of Texas at Arlington initiated a global outreach effort in 2024 through two complementary strategies: expansion of a digital repository to support dissemination of DNP scholarly work and implementation of pilot DNP projects in Kenya. Together, these initiatives represent an integrated model for global engagement that combines knowledge dissemination with application of practice-based scholarship. The repository has facilitated international access to DNP projects, demonstrating significant global reach across multiple countries. Concurrently, a pilot project in Kenya was established through a strategic in-country professional partnership, enabling culturally relevant and sustainable implementation …

The Cannabis Motivation Spectrum: Comparing Medical, Recreational And Dual Intent Users, Addyson Domian, Jacob Borodovsky

Wetterhahn Science Symposium Posters

There is a lack of a standardized definition of “medical” cannabis use in the healthcare industry, which has led to an informal, user-reported definition of medical use. Consequently, individuals who use cannabis for both medical and recreational reasons (dual intent) are not always differentiated from pure medical or pure recreational users. This study compares self-defined medical only and dual intent motivational groups relative to recreational only users to better understand how these groups differ by analyzing sociodemographic and use patterns, clinically relevant factors, and claimed cannabis-related benefits. Using data from the Qualtrics Cannabis Exposure Index survey instrument of 8836 adult …

Internalized Homophobia As An Influence On Participation In Hiv Prevention Among Young Men Who Have Sex With Men (Ymsm), Kasey I. Brazee

Honors Scholar Theses

Stigma is a known barrier to accessing preventative services for human immunodeficiency virus (HIV), however, the types of stigmas involved in this relationship remain not well defined. Homophobia, or negative attitudes directed towards homosexuality, is a particularly important type of stigma considering the disproportionate effect of HIV on men who have sex with men (MSM). Young MSM (YMSM) are especially impacted, making them a key population in the context of HIV prevention research.  Internalized homophobia, which refers to homophobia that one directs towards themselves, is under researched regarding its role in participating in HIV prevention. In this study, we aimed …

Five Corridors: A Community Health Needs Assessment Of Horry County, Stephen Borders, Hayley Bilko, Molly Craig, Olivia Guthrie, Ashley Mcconnell, Emily Mcgowan, Anna Quick, Abigail Rike, Makayla Wilson

Public Health

This report presents a Community Health Needs Assessment (CHNA) of Horry County, South Carolina. Its central analytical contribution is a five-corridor framework derived from k-means cluster analysis of the county's 76 residential census tracts, drawing on social and economic indicators from the American Community Survey and health estimates from the CDC PLACES program. The analysis organizes the county into five distinct community types — Affluent Coastal Retirement, Moderate Coastal Retirement, Inland Rural/Suburban Transitional, Concentrated Disadvantage, and Hispanic Hospitality Worker — each with a characteristic profile of social and health conditions.

Within this framework, the assessment examines a range of social …

Beyond Stabilization: Biological Healing, Structural Exclusion, And The Recovery Gap After Border-Fall Trauma At The U.S.-Mexico Border, Julia Robinson

Undergraduate Honors Theses

This honors thesis examines the biochemical, ethical, and public health consequences of insufficient post-operative follow-up care for undocumented immigrants injured in border falls. Discussing pathways of inflammation resolution, wound healing, and bone remodeling, this thesis argues that recovery depends on tightly regulated molecular and cellular processes that are highly vulnerable to disruption without continued monitoring and rehabilitation (Loi et al., 2016; Maruyama et al., 2020). When follow-up care is absent, these processes can be predicted to derail, leading to infection, impaired healing, and permanent disability (Chung & Sohn, 2025; Howard et al., 2020; Kruidenier et al., 2018). Framed through principles …

Prenatal Care, Pregnancy Risk, Birth Outcomes And The Role Of Neighborhood Characteristics, Monica Garcia-Perez Phd, Randy Huard Phd, Christopher Thoms Phd, David Tilstra Md

InnovateHER Meeting 2026

This study links 2024 CentraCare Health birth records with neighborhood census tract conditions from the National Neighborhood Data Archive (NaNDA, 2020/2021) to examine how place, prenatal care, and clinical risks influence birth outcomes in Central Minnesota. Neighborhood factors are standardized and paired with measures of prenatal-care adequacy and pregnancy-risk indicators in a series of multivariate linear models to explore their effect on birth outcomes. Analyses adjust for maternal demographics and clinical risks to identify independent neighborhood effects. A privacy-preserving, tract-linked dataset is also created to help local partners target high-need prevention areas.

Utilizing Remote Patient Monitoring With Dnp Students To Provide Pre-Natal Care, Sara Mccumber

InnovateHER Meeting 2026

This educational project introduced Nurse Practitioners to the use of RPM during pre-natal care for a patient with pre-natal hypertension. Hypertension is a risk factor in 16% of pregnancies and 5-8% of US births are impacted by hypertensive disorders and preeclampsia (CDC, 2023).

Identification and effective management of hypertension in pregnancy recently was an initiative of the Minnesota Perinatal Quality Collaborative (MPQC, 2022).

Awareness And Attitudes Toward Female Genital Mutilation At A Mid-Sized Midwestern University, Kaafiya Salad

InnovateHER Meeting 2026

This study utilized a confidential survey to examine awareness, knowledge, and attitudes toward Female Genital Mutilation (FGM) among the Saint Cloud State University community. Participants were recruited through campus outreach methods, and responses were collected voluntarily. The survey included questions assessing familiarity with FGM, sources of information, knowledge of associated health risks, and perceptions of the importance of awareness and public education.

Global Health Financing Of Diagonal Interventions: Building Resilient And Sustainable Health Systems In Sub-Saharan Africa, Lucy Kim

Master in Public Policy Theses

Background: Global health financing has historically prioritized disease-specific “vertical” programs over broader “horizontal” strengthening of general health systems. Vertical programs in HIV have led to unprecedented reductions in mortality worldwide, but HIV remains a significant public health threat in sub-Saharan Africa, where vertical strategies have long been criticized for creating fragmented health systems. In response, global health strategies have shifted towards combining vertical investments with broader horizontal activities, commonly referred to as “diagonal” programming. While evidence suggests that diagonal programming has the potential to create more resilient and sustainable health systems, evaluating its value for money is challenging due to …

Exploring Health Insurance’S Role In Chronic Disease Management Among Hispanics, Romelyn Dones

Seton Hall University Dissertations and Theses (ETDs)

This qualitative study examined how insured non-English- and English-speaking Hispanic adults perceive the role of health insurance in the management of chronic disease. Chronic conditions remain a leading cause of morbidity in the United States, and although prior research suggests that insurance coverage improves access to care, it does not always enhance how individuals understand or utilize support for chronic disease management. Limited research has explored how individuals with chronic conditions interpret the role of insurance in their daily self-management practices, particularly among Hispanic populations. Guided by Andersen’s Behavioral Model of Health Services Use, this study explored how contextual, enabling, …

Associations Between Father–Mother Food Parenting Practices And Children’S Dietary Intake, Brian K. Lo, Natalie Grafft, Mariane Helen De Oliveira, Sebastien Haneuse, In Young Park, Alejandra Cantu-Aldana, Katherine W. Bauer, Rebekah Levine Coley, Jorge E. Chavarro, Kirsten K. Davison, Jess Haines

Human Genetics Publications

Objective: To examine whether the number of parents using high levels of structure or coercive control food parenting practices is associated with children’s dietary intake.

Design: Cross-sectional analysis of father–mother dyads from the Fathers & Families cohort study. Fathers and mothers independently reported their food parenting practices and child’s dietary intake. Multivariate logistic regression models estimated associations between the number of parents (0, 1 or 2) using high structure or coercive control practices and children’s intake of fruit, vegetables, fast food and sugar-sweetened beverages (SSB), adjusting for demographics and recruitment site.

Setting: United States

Participants: 474 father–mother dyads with a …

A Quality Improvement Project To Increase Identification And Treatment Of Obstructive Sleep Apnea In Patients With Type 2 Diabetes In A Rural Clinic, Paige Spence

Evidence-Based Practice Project Reports

No abstract provided.