Population Health Commons^™

The Ethical Imperative Of Public Health Institutions To Protect The Reproductive Autonomy Of Vulnerable Populations, Kennethea Wilson

Electronic Theses and Dissertations

This dissertation establishes the ethical responsibility of public health institutions to safeguard reproductive autonomy, especially among vulnerable populations. While reproductive decision-making is traditionally framed within individual clinical encounters, this work contends that reproductive autonomy is fundamentally a matter of public health ethics. Socioecological determinants, including social, legal, environmental, and structural factors, often constrain individuals’ ability to make meaningful reproductive choices, leading to preventable harm.

Reproductive autonomy is defined as the capacity to make informed decisions about whether and when to conceive, as well as how to parent. The dissertation critiques the sufficiency of clinical ethics frameworks, such as informed consent …

The Impact Of Hearts For The Homeless On Students At The University Of Mississippi, Ellie Menszer

Honors Theses

Hearts for Homeless (H4H) is an international organization that works to help one of the most vulnerable populations for cardiac disease, the homeless, due to the lack of access to health care and information. At the University of Mississippi, H4H is a registered student organization that volunteers weekly at the Oxford Community Market (OXCM) to provide free blood pressure screenings and heart health information. H4H helps the community while also providing students with hands-on patient care experience. The goal of this research is to determine how volunteering with H4H impacts students at the University of Mississippi. A literature review informed …

Demographic Disparities In Contraceptive Use: Insights From Female Nsfg Respondents, 2015–2023, Adira Brenner

Rowan-Virtua Research Day

Disparities in contraceptive use persist in the United States despite expanded access to family planning services. Historical policies and ongoing social determinants of health (SDOH) are significant drivers of the continued inequality in reproductive healthcare access and utilization. This study examines demographic trends in contraceptive use using data from the National Survey of Family Growth (NSFG) between 2015 and 2023.

Data were obtained from the NSFG and the National Center for Health Statistics (NCHS) datasets. A cross-comparison was conducted, focusing on variables such as age, race/ethnicity, and educational attainment.

The consensus was that contraceptive use increased to approximately 65% in …

Evaluating The 4mm Endometrial Thickness Threshold: Racial Disparities In Ultrasound Sensitivity And Diagnostic Delay, Ngozi Ikpeama, Sophia Vogiatzidakis, Xuezhi Jiang, Elizabeth Hertz, Vitoria Chaves, Peter Schnatz

Rowan-Virtua Research Day

Title: Evaluating the 4mm Endometrial Thickness Threshold: Racial Disparities in Ultrasound Sensitivity and Diagnostic Delay

Background: Current ACOG guidelines utilize a 4mm endometrial thickness (ET) threshold via transvaginal ultrasound (TVUS) to exclude malignancy in postmenopausal women. However, recent evidence suggests these standardized thresholds may not be equally effective across all racial cohorts. This systematic review evaluates the diagnostic performance of the 4mm threshold specifically in Black patients.

Methods: A systematic search of peer-reviewed literature was conducted to identify studies comparing TVUS sensitivity and clinical outcomes between racial groups. Data were extracted focusing on the diagnostic sensitivity of the 4mm threshold, …

Training Vs. Reality: The Challenges Of Preventing Heat-Related Illness In Migrant Farmworkers, Sonya Homami

Rowan-Virtua Research Day

Background: Heat‑Related Illness (HRI) is a major occupational hazard for migrant farmworkers, who are 35 times more likely to die from HRI than workers in other industries. Although HRI training aims to improve prevention knowledge, its effect on actual HRI outcomes is unclear.

Methods: Following PRISMA guidelines, a systematic review of PubMed, Embase, and Web of Science identified studies evaluating HRI training and reporting HRI prevalence or related symptoms. Fifteen studies met inclusion criteria.

Results: HRI training did not reduce HRI prevalence or provide protective effects. Training increased reporting of workplace injuries and concern about HRI. Despite high training uptake—over …

Medical Providers’ Perspective On Barriers Faced By Intellectual And Developmental Disabled (Idd) Patients From Medically Underserved Backgrounds, Mayra A. Flores

Rowan-Virtua Research Day

•Complexities of obtaining healthcare access can be difficult for all patients across the board, so much so that it’s viewed as a maze. Studies have shown that these challenges are added on for medically underserved communities.2-3 Some of these challenges include insurance, language barriers, appointment availability, stigma, financial limitations and lack of transportation.2 •Identify the barriers that patients with intellectual and developmental disabilities (IDD) from medically underserved backgrounds face in healthcare access. •Intellectually and developmentally disabled patients from medically underserved communities face exacerbated barriers in healthcare access. •Participating medical providers from the Regional Integrated Special Needs Center (RISN) – Sewell …

Left Waiting: Pediatric Primary Care Access For Hispanic Children In Mixed Status Households In South Jersey, Renzovic Francisco Escobedo, Andrea Trifundo, Ayair Hernandez

Rowan-Virtua Research Day

BACKGROUND: High-quality primary care is essential to a strong health system, yet many Hispanic children in mixed-status households face barriers that limit consistent access to pediatric care. In New Jersey, many immigrant families remain uninsured or under-enrolled in public insurance programs despite eligibility. These barriers are shaped not only by insurance and clinic availability, but also by language discordance, fear related to immigration status, and limited trust in the health care system. This project examines the intersecting barriers that affect pediatric primary care access for Hispanic children in mixed-status households in South Jersey.

METHODS: We conducted a literature review using …

Comparing Community-Based And Social Media Interventions To Improve Vaccine Uptake In Low-Income U.S. Populations, Tanisha Shah, Nico Santorelli, Maureen Kennedy, Aastha Lele, Syed Ahmad Bilal, Megan Chien, Judith Anne Lightfoot

Rowan-Virtua Research Day

Background:

In recent years, vaccination has become a highly politicized topic, contributing to decreased trust in medical professionals. Exposure to medical misinformation, distrust in government and research, and concerns about vaccine safety have all led to increased vaccine hesitancy and decreased vaccine uptake. These trends are more widely seen in low socioeconomic status (SES) and certain racial populations, posing a significant public health concern despite the effectiveness of vaccines.

Objective: This literature review aims to compare the effectiveness of community-based interventions led by clinicians and community health leaders with social media campaigns in increasing vaccine uptake among low-income populations in …

Tuberculosis In Long-Term Asian American Immigrant Residents: Trends And Risk Factors In Cases Diagnosed ≥10 Years After U.S. Arrival, Katherine Xie, Kai Mon Lee, Todd Schachter

Rowan-Virtua Research Day

Tuberculosis in Long-Term Asian American Immigrant Residents: Trends and Risk Factors in Cases Diagnosed ≥10 Years After U.S. Arrival

Katherine Xie, MSc¹, Kai Mon Lee, PhD¹, Todd Schachter, DO¹

¹Rowan-Virtua School of Osteopathic Medicine, 1 Medical Center Dr, Stratford, NJ 08084

Background

In the U.S., TB cases are largely due to reactivation of latent TB infections (LTBI) of immigrants from high-burden countries. The CDC and U.S. Preventive Services Task Force currently recommend screening newer immigrant populations, especially those born in highly-burdened areas with TB. This guideline mostly targets newly immigrated populations, defined as those …

Vitamin K And The Vaccine Cascade: Pediatric Patterns In Southern Nj, Kianna Bruzzo, Clare Stephens, Nicole Streeks-Wooden

Rowan-Virtua Research Day

Background:

Intramuscular (IM) vitamin K is recommended at birth to prevent vitamin K deficiency bleeding (VKDB), a potentially life-threatening condition that can result in intracranial hemorrhage or death. Prior research suggests a relationship between refusal of vitamin K prophylaxis at birth and subsequent vaccination patterns, with refusal potentially extending to other neonatal preventive services. In New Jersey, vaccination trends from 2017–2025 demonstrate a decline in the proportion of pre-kindergarten children meeting school vaccination requirements. This study aims to explore whether vitamin K administration at birth is associated with subsequent vaccination patterns in South Jersey.

Methods:

A retrospective cohort study was …

Impact Of Spanish-Speaking Medical Interpreters On Healthcare Access, Outcomes, And Equity In Patients With Limited English Proficiency, Emily Fried, Catherine Awad, Rebecca Moore

Rowan-Virtua Research Day

Impact of Spanish-Speaking Medical Interpreters on Healthcare Access, Outcomes, and Equity in Patients with Limited English Proficiency

Background

Limited English proficiency (LEP) is a significant barrier to equitable healthcare in the United States and is associated with reduced access to care, poorer clinical outcomes, and increased healthcare disparities. The Spanish-speaking population represents the largest proportion of LEP patients, making language access a crucial component of high-quality care. Language discordance between patients and providers contributes to impaired communication, increased medical errors, and decreased utilization of preventative services1-4.

Objectives

The objective of this study was to evaluate the impact of Spanish-speaking professional …

Seasonal Variation And Size Distribution Of Particulate Matter In The Mississippi Delta: Implications For Source Attribution, Abigail E. Barnett

Honors Theses

This study examines seasonal patterns of particulate matter in the Mississippi Delta using data from PurpleAir sensors, with a focus on particle size distributions across PM₁.₀, PM₂.₅, and PM₁₀. The purpose of this research is to evaluate whether particulate trends in the region reflect signatures consistent with wildfire smoke or are better explained by local environmental and agricultural factors.

Daily average concentrations were analyzed and grouped by season to compare spring and summer conditions. Results show that all particle size fractions increased from spring to summer. However, PM₁₀ concentrations remained consistently higher than PM₂.₅ in both seasons. The PM₂.₅/PM₁₀ ratio …

Racial Inequities In Maternal Health And Birth Outcomes In South Jersey, Yariza Orellana, Amenata Dukuray, Christine Ortiz

Rowan-Virtua Research Day

Racial disparities in maternal morbidity and mortality remain a persistent public health issue in the United States, with Black non-hispanic women experiencing a 2.4 to 3.3 greater risk of pregnancy-related complications compared to their white counterparts. In New Jersey, these disparities are similarly pronounced, with severe maternal morbidity occurring at more than twice the rate among non-Hispanic Black mothers. These inequities extend beyond maternal outcomes and contribute to adverse infant health outcomes, including stillbirth, preterm birth, and low birth weight. This study was conducted using databases such as PubMed and Google Scholar, as well as public health sources including the …

Barriers To Accessing Mental Healthcare Among Refugee Populations In Southern New Jersey, Paul Cardillo, Hijab Zaidi, Jacob Trainer, Alison Mancuso Do, Facofp

Rowan-Virtua Research Day

This project examines barriers to accessing mental healthcare among refugee populations in Southern New Jersey, with a focus on individuals with limited English proficiency (LEP). Using a narrative review of peer reviewed studies and government reports, key challenges were identified, including language barriers, cultural stigma, and limited familiarity with the U.S. healthcare system. Findings show that refugee populations experience significantly higher rates of mental health disorders, including PTSD and depression, driven by trauma, structural inequities, and social disadvantage. Effective interventions emphasize culturally competent care, integration of bicultural staff, and community based approaches. Addressing these barriers is essential to improving equitable …

Assessing The Utilization Of Emergency Departments For Primary Care Services In Southern New Jersey, Joshua James Novello, Sheila Joazile, Mohammad Isa

Rowan-Virtua Research Day

Background: Primary care (PC) is essential to proactive, comprehensive, and preventative care that can improve patient outcomes. One-third of emergency department (ED) visits are for non-emergency care that can be appropriately treated by a PC provider. In New Jersey, more than $400 million is spent annually on avoidable ED visits. Decreasing the total PC treatable ED visits per year will improve the quality of care and decrease costs. New Jersey’s PC spending, based on total health spending, is one of the lowest in the country. Demographic and socioeconomic factors in the Social Vulnerability Index (SVI) examine potentially preventable ED …

Metabolic And Bariatric Outcomes In Transgender Patients Receiving Gender Affirming Hormone Therapy: A Literature Review, Emily Sarett, Heather Dixon

Rowan-Virtua Research Day

Title: Metabolic and Bariatric Outcomes in Transgender Patients Receiving Gender Affirming Hormone Therapy: A Literature Review

Authors/Institutions: Emily Sarett, OMS-II1; Heather Dixon, PharmD2

Abstract:

Introduction: Obesity is a growing concern among transgender individuals, influenced by gender-affirming hormone therapy (GAHT) and social determinants of health. Bariatric surgery is effective, but metabolic outcomes and access to care remain understudied. Methods: A literature review was conducted using PubMed, Embase, and StatPearls databases (2020–2025). Studies evaluating bariatric outcomes, pharmacologic therapies, and metabolic effects of GAHT were included. Following screening and deduplication, 22 studies were analyzed. Results: GAHT is associated with increased fat mass and …

Challenges For Older Veterans In Disaster-Prone Rural Areas, Umayma Saifuddin, Joshua Ehrenberg, Elizabeth Tran Phung

Rowan-Virtua Research Day

Purpose: To describe a case in which an elderly veteran was unable to receive necessary health services due to environmental factors and routine natural disaster in his rural coastal town. Methods: A case report is presented. Results: A 95 year-old WWII veteran with a complex medical history and numerous disabilities including hearing impairment, visual impairment, and chronic pain struggles to receive proper care as he lives in a small coastal town. The patient’s son lives an hour away and this area is prone to flooding, making accessing health services extremely challenging. In order to respect the patient’s wishes to remain …

Assessing Risk Of Modern Energy Product Consumption Among Adolescents And Young Adults, Darshak Rana, Jeffery C. Powers

Rowan-Virtua Research Day

Background: Caffeine consumption among adolescents and young adults has increased significantly with the popularity of energy drinks, pre-workout supplements, and high-caffeine beverages. Excessive intake is associated with cardiovascular risk, yet awareness of safe limits remains low. This study evaluated caffeine use patterns, knowledge of guidelines, and self-reported cardiovascular effects among youth.

Methods: A cross-sectional survey was administered to individuals aged 15–25 years (n=27) in clinical settings. Respondents reported frequency of caffeine intake, product types consumed, knowledge of recommended daily limits, and cardiovascular symptoms experienced while caffeinated.

Results: Most participants (70%) consumed caffeine regularly, with coffee, soda, and energy drinks as …

Barriers To Palliative Care Access In Rural South Dakota: A Policy And System-Level Analysis, Harshavardhan Kadarkaraisamy

Honors Thesis

Palliative care improves the quality of life for people living with serious illness. It helps by addressing symptoms, improving communication, and providing mental, physical, and spiritual support. However, in South Dakota access to palliative care is limited in rural areas. These challenges include geographic isolation, workforce shortages, healthcare infrastructure, reimbursement, and misunderstandings about palliative care. This thesis examines the key policy barriers that limit access to palliative care in rural South Dakota. This work involves engaging with South Dakota-specific literature, rural health research, policy sources, community education, telehealth expansion, and policy reform. By focusing on the rural context of South …

Determinants Of Hypertension Awareness And Control In Kenya: A Secondary Analysis Of National Survey Data, Alexander K. Davis

Poster Presentations

No abstract provided.