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Coughenour C, Chien LC, Gakh M, Labus B, McDonough IK, Grigsby TJ, Usufzy P. Food and Housing Insecurity in Nevada During the COVID-19 Pandemic. J Community Health 2024; 49:296-313. [PMID: 37932626 DOI: 10.1007/s10900-023-01284-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 11/08/2023]
Abstract
The COVID-19 pandemic intensified concerns regarding food and housing insecurity in the United States, particularly among vulnerable populations. After the pandemic prompted a shutdown of nonessential businesses in Nevada, unemployment rose dramatically as the gaming, tourism, and hospitality industries struggled. This study analyzed the results of two telephone surveys of Nevada adults' experiences in 2020 (n = 1000) and 2021 (n = 1002). The results demonstrate between 2020 and 2021 an 8.24 percentage point decline in food insecurity (FI) from 30.2% to 21.96% and a 12.58 percentage point increase in housing insecurity (HI) from 12.27% to 24.85%. Age, disability status, and certain categories of race/ethnicity and income were associated with both HI and FI in 2020, but disability was no longer significant in 2021. Instead, spouse/partner-status, living with children ≤ 18-years-old and receipt of SNAP benefits were significantly associated with FI in 2021. In particular, health status became a significant factor of both HI and FI. People of color experienced FI disparities compared to Whites. Asians/Hawaiians/Pacific Islanders were 3.22 times (95% CI 1.51, 6.86) more likely to experience FI in 2021 than Whites. A matched, longitudinal analysis also revealed that Whites experienced a significant 9.1 percentage point estimated decline in the probability of FI between 2020 and 2021. However, the reduction among non-White participants was statistically insignificant at 2.5 percentage points. Results indicate the importance of supporting the food and housing needs of people of color and individuals with disabilities. Further research should especially investigate the comparative FI rate among Asians/Hawaiians/Pacific Islanders in 2021 and offer solutions to the soaring prevalence of housing insecurity.
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Affiliation(s)
- Courtney Coughenour
- School of Public Health, University of Nevada Las Vegas, 4700 S. Maryland Parkway, Suite 335, Mailstop #3063, Las Vegas, NV, 89119, USA.
| | - Lung-Chang Chien
- School of Public Health, University of Nevada Las Vegas, 4700 S. Maryland Parkway, Suite 335, Mailstop #3063, Las Vegas, NV, 89119, USA
| | - Maxim Gakh
- School of Public Health, University of Nevada Las Vegas, 4700 S. Maryland Parkway, Suite 335, Mailstop #3063, Las Vegas, NV, 89119, USA
| | - Brian Labus
- School of Public Health, University of Nevada Las Vegas, 4700 S. Maryland Parkway, Suite 335, Mailstop #3063, Las Vegas, NV, 89119, USA
| | - Ian K McDonough
- Department of Economics, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Timothy J Grigsby
- School of Public Health, University of Nevada Las Vegas, 4700 S. Maryland Parkway, Suite 335, Mailstop #3063, Las Vegas, NV, 89119, USA
| | - Pashtana Usufzy
- School of Public Health, University of Nevada Las Vegas, 4700 S. Maryland Parkway, Suite 335, Mailstop #3063, Las Vegas, NV, 89119, USA
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Pharr JR, Chien LC, Gakh M, Flatt JD, Kittle K, Terry E. Moderated Mediation Analysis of Structural Stigma and Suicidal Ideation and Behaviors Among Sexual and Gender Minority Adults. LGBT Health 2024; 11:239-248. [PMID: 38285526 DOI: 10.1089/lgbt.2022.0349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024] Open
Abstract
Purpose: This study aimed to conduct a moderated mediation analysis to understand further the complex pathways through which structural stigma in the form of transgender sports bans was associated with suicidal ideation and behaviors among sexual and gender minority (SGM) adults. Methods: A cross-sectional survey of 1033 adults who identified as SGM from across the 50 U.S. states and Washington, DC was conducted between January 28 and February 7, 2022. Distal discrimination distress was the mediation variable; individual resilience and social resources were the moderation variables. Familiarity with transgender sports bans represented structural stigma. The conditional process analysis was applied to build a moderated mediation model. Both conditional direct and indirect effects were computed by estimated coefficients. All models were based on linear regression. Results: Our final model explained nearly half (46%) of the variation in suicidal ideation and behaviors between those SGM adults familiar and those not familiar with transgender sports bans. Social resources significantly moderated the conditional indirect effect of distal discrimination distress (adjusted estimate = -0.23; 95% confidence interval = -0.37 to -0.08). Conclusion: Both discrimination distress and social resources influenced the association between structural stigma as measured by familiarity with transgender sports bans and suicidal ideation and behaviors among SGM adults. Findings support the need for future research examining the pathway between structural stigma and suicidal ideation and behaviors among SGM adults and how minority stress, social safety, and other constructs shape this pathway.
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Affiliation(s)
- Jennifer R Pharr
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Lung-Chang Chien
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Maxim Gakh
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Jason D Flatt
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Krystal Kittle
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Emylia Terry
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
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Bungum TJ, Pharr JR, Coughenour CA, Gakh M. An assessment of the move your way program among hispanic adults in Las Vegas, Nevada. Arch Public Health 2023; 81:192. [PMID: 37915087 PMCID: PMC10621095 DOI: 10.1186/s13690-023-01201-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/12/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Physical activity (PA) is important because of its associated health benefits. However, many Americans remain inactive. The 2018 guidelines recognize that PA bouts of less than 10 min are beneficial. The U.S. Department of Health and Human Services' Office of Disease Prevention and Health Promotion created the Move Your Way® (MYW) campaign to provide PA resources for communities and healthcare providers. This study aims to describe the reach of the MYW campaign, and assess whether having seen, heard, or read (SHR) about MYW, or having seen the MYW logo, was associated with PA knowledge, self-efficacy, and behavior among Hispanics residing in the Las Vegas, Nevada area. METHODS Hispanics, aged 18-74, were surveyed at community events (n = 481) or via an online survey (n = 123). Respondents were asked if they had SHR of MYW, were aware of 2018 PA recommendations, and to report their personal PA behavior, PA knowledge, PA intentions, and demographics. RESULTS Respondents (71% female) completed a 38-42-item survey. Approximately (12.4%) had SHR of the MYW campaign and 16.1% had seen the MYW logo. Only 3.4% and 15% identified, "150 minutes per week" and "75 minutes per week" as the 2018 guidelines for moderate physical activity (MPA) and vigorous physical activity (VPA), respectively. Those who had SHR of the MYW campaign were more likely to correctly identify 150 min per week as the MPA guideline and had greater confidence in overcoming selected PA barriers. Regression analysis showed that those who had seen the MYW logo were more likely to meet strength guidelines, and that those who had SHR of MYW or saw the logo were more likely to know the recommended minutes of MPA. CONCLUSIONS Knowledge of the MYW program positively associates with some PA behaviors and PA correlates.
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Affiliation(s)
- Timothy J Bungum
- School of Public Health, Department of Environmental and Occupational Health, University of Nevada - Las Vegas, 4700 S. Maryland Parkway, Box 3063, Las Vegas, NV, USA.
| | - Jennifer R Pharr
- School of Public Health, Department of Environmental and Occupational Health, University of Nevada - Las Vegas, 4700 S. Maryland Parkway, Box 3063, Las Vegas, NV, USA
| | - Courtney A Coughenour
- School of Public Health, Department of Environmental and Occupational Health, University of Nevada - Las Vegas, 4700 S. Maryland Parkway, Box 3063, Las Vegas, NV, USA
| | - Maxim Gakh
- School of Public Health, Department of Environmental and Occupational Health, University of Nevada - Las Vegas, 4700 S. Maryland Parkway, Box 3063, Las Vegas, NV, USA
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Gakh M, Grigsby T, Coughenour C, Ahlo M, Washburn K, Gerstenberger S. Facilitators of a Campus Tobacco-free Policy: Navigating the Politics. Health Behav Policy Rev 2023. [DOI: 10.14485/hbpr.10.1.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Objective: In this paper, we discuss prioritization, formulation, and adoption of a comprehensive campus tobacco-free policy on a large, diverse campus at a public university in the United States. Methods: We examined the comprehensive campus tobacco-free policy experience through Kindgon’s Multiple Streams Framework, which stipulates that policy change can happen when problem, policy, and politics align. We focus on the factors that led the political stream to align with the problem and policy streams to create a “window of opportunity” for adopting this policy. Results: The campus experience with COVID-19 helped spur policy adoption. Support from leadership, a committed faculty-administration team, engagement with stakeholders and community partners, knowledge of the policy adoption process, and sustained advocacy all contributed to policy adoption. Conclusions: Campus tobacco-free policy advocates can navigate the politics of prioritizing, formulating, and adopting a campus smoke-free policy by knowing the context and process, being comfortable with policy work, engaging with tobacco prevention stakeholders, sustaining their efforts and advocating in multiple ways, and considering implementation and evaluation early.
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Pharr JR, Chien LC, Gakh M, Flatt JD, Kittle K, Terry E. Moderating Effect of Community and Individual Resilience on Structural Stigma and Suicidal Ideation among Sexual and Gender Minority Adults in the United States. Int J Environ Res Public Health 2022; 19:14526. [PMID: 36361405 PMCID: PMC9656182 DOI: 10.3390/ijerph192114526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Structural stigma in the form of discriminatory laws and policies impacts the mental health of sexual and gender minorities, especially with regard to suicidality. However, this relationship could be moderated by resilience. The past two years has brought anti-SGM legislation, particularly transgender sports bans, at the state level in the United States into focus. This study aims to understand if the relationship between familiarity with transgender sports bans (proposed or enacted) and suicidality was moderated by individual or community resilience. METHODS This was a cross-sectional study of survey data collected from a national sample of 1033 SGM adults in the United States between 28 January and 7 February 2022. Univariate and multivariate moderation analyses were used. RESULTS In the univariate analyses and the final model, community resilience moderated the relationship between structural stigma and suicidality (p = 0.0002); however, individual resilience did not (p = 0.0664). CONCLUSION Interventions to bolster community resilience may attenuate the negative mental health impacts of structural stigma and are warranted, along with concerted efforts to minimize structural stigma in the form of discriminatory laws and policies targeting people who are SGM.
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Affiliation(s)
- Jennifer R. Pharr
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Lung-Chang Chien
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Maxim Gakh
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Jason D. Flatt
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Krystal Kittle
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Emylia Terry
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
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Dunphy C, Joo H, Sapiano MRP, Howard-Williams M, McCord R, Sunshine G, Kao SY, Guy GP, Weber R, Gakh M, Ekwueme DU. The Association Between State-Issued Mask Mandates and County COVID-19 Hospitalization Rates. J Public Health Manag Pract 2022; 28:712-719. [PMID: 36194816 PMCID: PMC9560902 DOI: 10.1097/phh.0000000000001602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
CONTEXT Mask mandates are one form of nonpharmaceutical intervention that has been utilized to combat the spread of SARS-CoV2, the virus that causes COVID-19. OBJECTIVE This study examines the association between state-issued mask mandates and changes in county-level and hospital referral region (HRR)-level COVID-19 hospitalizations across the United States. DESIGN Difference-in-difference and event study models were estimated to examine the association between state-issued mask mandates and COVID-19 hospitalization outcomes. PARTICIPANTS All analyses were conducted with US county-level data. INTERVENTIONS State-issued mask mandates. County-level data on the mandates were collected from executive orders identified on state government Web sites from April 1, 2020, to December 31, 2020. MAIN OUTCOME MEASURES Daily county-level (and HRR-level) estimates of inpatient beds occupied by patients with confirmed or suspected COVID-19 were collected by the US Department of Health and Human Services. RESULTS The state issuing of mask mandates was associated with an average of 3.6 fewer daily COVID-19 hospitalizations per 100 000 people (P < .05) and a 1.2-percentage-point decrease in the percentage of county beds occupied with COVID-19 patients (P < .05) within 70 days of taking effect. Event study results suggest that this association increased the longer mask mandates were in effect. In addition, the results were robust to analyses conducted at the HRR level. CONCLUSIONS This study demonstrated that state-issued mask mandates were associated with reduction in COVID-19 hospitalizations across the United States during the earlier portion of the pandemic. As new variants of the virus cause spikes in COVID-19 cases, reimposing mask mandates in indoor and congested public areas, as part of a layered approach to community mitigation, may reduce the spread of COVID-19 and lessen the burden on our health care system.
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Affiliation(s)
- Christopher Dunphy
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Heesoo Joo
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Mathew R. P. Sapiano
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Mara Howard-Williams
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Russell McCord
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Gregory Sunshine
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Szu-Yu Kao
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Gery P. Guy
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Regen Weber
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Maxim Gakh
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
| | - Donatus U. Ekwueme
- COVID-19 Response (Drs Dunphy, Joo, Howard-Williams, McCord, Sunshine, Kao, Guy, Weber, and Ekwueme) and Division of Healthcare Quality Promotion (Dr Sapiano), Centers for Disease Control and Prevention, Atlanta, Georgia; Lantana Consulting Group, Thetford, Vermont (Dr Sapiano); and School of Public Health, University of Nevada, Las Vegas, Nevada (Dr Gakh)
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Chien LC, Holloway A, Gakh M, Coughenour C. A novel gun law strength index and influential state gun laws for firearm homicide in the United States, 1999–2018. Public Health 2022; 210:91-98. [DOI: 10.1016/j.puhe.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 05/01/2022] [Accepted: 06/13/2022] [Indexed: 10/16/2022]
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Pharr JR, Chien LC, Gakh M, Flatt J, Kittle K, Terry E. Serial Mediation Analysis of the Association of Familiarity with Transgender Sports Bans and Suicidality among Sexual and Gender Minority Adults in the United States. Int J Environ Res Public Health 2022; 19:ijerph191710641. [PMID: 36078355 PMCID: PMC9518152 DOI: 10.3390/ijerph191710641] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 05/14/2023]
Abstract
BACKGROUND Discriminatory laws and policies are a form of structural stigma that is associated with increased suicidality among sexual and gender minority (SGM) people. Unfortunately, in the United States, there has been an increase in state-level discriminatory laws and policies targeting SGM people in 2021 and 2022, particularly, transgender sports bans. The purpose of this study was to (1) determine if familiarity with transgender sports bans was associated with suicidality among SGM adults; and (2) determine if interpersonal stigma and/or individual stigma mediated this association. METHODS This was a cross-sectional study of data collected from a national sample of 1033 SGM adults in the United States between 28 January and 7 February 2022. Univariate and serial mediator models were used in this analysis. RESULTS The increased suicidality was associated with familiarity with state-level transgender sports bans among SGM adults (p-value = 0.0150). Even after interpersonal and individual stigma mediated this relationship, the association between suicidality and familiarity with state-level transgender sports bans remained (p-value = 0.0106). CONCLUSION State-level transgender sports bans appear to exacerbate existing disparities in mental health, especially for individuals who are familiar with the bans. They directly discriminate against people who are transgender and indirectly stigmatize the broader SGM community.
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Affiliation(s)
- Jennifer R. Pharr
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
- Correspondence: ; Tel.: +1-(702)-895-2006
| | - Lung-Chang Chien
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Maxim Gakh
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Jason Flatt
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Krystal Kittle
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Emylia Terry
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
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Marquez E, Coughenour C, Gakh M, Tu T, Usufzy P, Gerstenberger S. A Mixed-Methods Assessment of Residential Housing Tenants’ Concerns about Property Habitability and the Implementation of Habitability Laws in Southern Nevada. IJERPH 2022; 19:ijerph19148537. [PMID: 35886389 PMCID: PMC9317624 DOI: 10.3390/ijerph19148537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 11/16/2022]
Abstract
Housing is a key health determinant. Habitability laws set minimum standards for adequate housing. However, accessing them to ensure adequate housing may be a challenge for many tenants. This paper explores the need for rental housing policy that would better support adequate and safe housing, particularly for low-income renters. A mixed-methods approach assessed residential tenant habitability concerns in Clark County, Nevada, through calls relayed to the Clark County Landlord–Tenant Hotline (CCLTH). Of the 2865 calls, 74.3% were from ZIP codes that were 80% of the median income and below. There was a significant relationship between the ZIP code-level income and the reporting of at least one essential habitability concern. Of the 266 participants that responded to a follow-up call, 34.6% reported that their complaint was resolved and there was no association between resolution and income. Qualitative data analysis from phone interviews revealed two central themes: (1) resources to navigate landlord–tenant laws are limiting and (2) housing policies need to be strengthened to help tenants and keep people housed. Understanding tenant concerns regarding substandard housing and related inequities can help inform rental housing policy and its implementation to promote healthy homes and improve health outcomes for communities burdened by poor rental housing conditions.
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Pharr JR, Coughenour C, Gakh M, Bungum T, Jalene S, Whitehead M, Sharma M. Predictors of Depression among College Students in the Early Stages of the COVID-19 Pandemic. Glob J Health Sci 2022. [DOI: 10.5539/gjhs.v14n6p9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
College students are disproportionately impacted by depression compared to the general population. The purpose of this study was to determine the predictors of depression among college students during the COVID-19 pandemic to inform interventions. This cross-sectional study surveyed students at a large, diverse university in the southwest United States. Students provided information regarding the severity of their depression symptoms over the past two weeks (dependent variable) along with independent demographic and educational variables (age, sex, sexual orientation, grade point average, number of credits taken, first-generation college student status, race/ethnicity, and employment status), perceived stress, hours of sleep, physical fitness, and minutes of physical activity. Univariate and multivariate linear regression analyses were conducted. Variables that were significantly associated with depression in the multiple linear regression included stress, identifying as Asian, hours of sleep, and age. There is a need for stress management and mental health promotion interventions targeting college students. Additional interventionals should also focus on those more at risk, including those who identified as Asian (almost three times more likely to report depression compared with White students) and younger college students. We also found a need to promote sleep hygiene.
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Gakh M, Ha J, Won Yoo J, Han DH. Preparing for the Next Pandemic: Learning Lessons from the Republic of Korea to Bolster Public Health Disease Surveillance in the United States. Health Secur 2022; 20:177-181. [PMID: 35319262 DOI: 10.1089/hs.2021.0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Maxim Gakh
- Maxim Gakh, JD, MPH, is an Associate Professor and Associate Director, UNLV Health Law Program, School of Public Health
| | - Jane Ha
- Jane Ha, MD, is a Research Associate, Korea University College of Medicine, University of Nevada, Las Vegas, NV
| | - Ji Won Yoo
- Ji Won Yoo, MD, is an Assistant Professor, Department of Internal Medicine, Kirk Kerkorian School of Medicine, University of Nevada, Las Vegas, NV
| | - Dong Hun Han
- Dong Hun Han, DDS, PhD, is a Professor, Department of Preventive and Public Health Dentistry, School of Dentistry, Seoul National University; both in Seoul, Korea
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Abstract
In December 2020, we conducted a telephone survey to determine what factors are connected to COVID-19 vaccine hesitancy among adults in Nevada. The survey was based on factors identified in other studies, such as demographic variables (age, race, ethnicity, gender, household income, urbanicity, educational attainment), health status, previous COVID-19 infections, social media engagement, adherence to social distancing guidelines, beliefs about COVID-19, and political ideology identifications. Using a proportional odds model, we compared vaccine hesitancy levels to determine the odds of being more likely versus unlikely to get the COVID-19 vaccine. Of 1,000 people surveyed, 30.4% exhibited vaccine hesitancy. Findings showed that adults with significantly lower odds of vaccine hesitancy included those who were male, older, worried about COVID-19 infection or its community effects, adhered to social distancing, and reported higher incomes. Adults who identified as African American or Black or as multiple or "other" races exhibited significantly higher odds of vaccine hesitancy than White adults. Adults self-identifying as conservative had significantly higher odds of vaccine hesitancy than others. Vaccine hesitancy levels suggest possible hurdles to addressing the COVID-19 pandemic in a state with high visitor volumes and demographics that resemble the country's future as minority White, highlighting possible lessons for future pandemics. Most measures of COVID-19 worry were not significantly associated with vaccine hesitancy, suggesting that vaccination efforts should focus on other motivators. COVID-19 vaccination efforts should also directly encourage uptake by younger and middle-aged adults who are female, African American, have lower incomes, and identify as conservative.
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Affiliation(s)
- Courtney Coughenour
- Courtney Coughenour, PhD, and Maxim Gakh, MPH, JD, are Associate Professors and Manoj Sharma, PhD, is a Professor, Department of Social and Behavioral Health; Brian Labus, PhD, and Lung-Chang Chien, DrPH, are Assistant Professors, Department of Epidemiology and Biostatistics; all at the University of Nevada, Las Vegas School of Public Health, Las Vegas, NV
| | - Maxim Gakh
- Courtney Coughenour, PhD, and Maxim Gakh, MPH, JD, are Associate Professors and Manoj Sharma, PhD, is a Professor, Department of Social and Behavioral Health; Brian Labus, PhD, and Lung-Chang Chien, DrPH, are Assistant Professors, Department of Epidemiology and Biostatistics; all at the University of Nevada, Las Vegas School of Public Health, Las Vegas, NV
| | - Manoj Sharma
- Courtney Coughenour, PhD, and Maxim Gakh, MPH, JD, are Associate Professors and Manoj Sharma, PhD, is a Professor, Department of Social and Behavioral Health; Brian Labus, PhD, and Lung-Chang Chien, DrPH, are Assistant Professors, Department of Epidemiology and Biostatistics; all at the University of Nevada, Las Vegas School of Public Health, Las Vegas, NV
| | - Brian Labus
- Courtney Coughenour, PhD, and Maxim Gakh, MPH, JD, are Associate Professors and Manoj Sharma, PhD, is a Professor, Department of Social and Behavioral Health; Brian Labus, PhD, and Lung-Chang Chien, DrPH, are Assistant Professors, Department of Epidemiology and Biostatistics; all at the University of Nevada, Las Vegas School of Public Health, Las Vegas, NV
| | - Lung-Chang Chien
- Courtney Coughenour, PhD, and Maxim Gakh, MPH, JD, are Associate Professors and Manoj Sharma, PhD, is a Professor, Department of Social and Behavioral Health; Brian Labus, PhD, and Lung-Chang Chien, DrPH, are Assistant Professors, Department of Epidemiology and Biostatistics; all at the University of Nevada, Las Vegas School of Public Health, Las Vegas, NV
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Guy GP, Lee FC, Sunshine G, McCord R, Howard-Williams M, Kompaniyets L, Dunphy C, Gakh M, Weber R, Sauber-Schatz E, Omura JD, Massetti GM. Association of State-Issued Mask Mandates and Allowing On-Premises Restaurant Dining with County-Level COVID-19 Case and Death Growth Rates - United States, March 1-December 31, 2020. MMWR Morb Mortal Wkly Rep 2021; 70:350-354. [PMID: 33705364 PMCID: PMC7951820 DOI: 10.15585/mmwr.mm7010e3] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Dasgupta S, Kassem AM, Sunshine G, Liu T, Rose C, Kang GJ, Silver R, Maddox BLP, Watson C, Howard-Williams M, Gakh M, McCord R, Weber R, Fletcher K, Musial T, Tynan MA, Hulkower R, Moreland A, Pepin D, Landsman L, Brown A, Gilchrist S, Clodfelter C, Williams M, Cramer R, Limeres A, Popoola A, Dugmeoglu S, Shelburne J, Jeong G, Rao CY. Differences in rapid increases in county-level COVID-19 incidence by implementation of statewide closures and mask mandates - United States, June 1-September 30, 2020. Ann Epidemiol 2021; 57:46-53. [PMID: 33596446 PMCID: PMC7882220 DOI: 10.1016/j.annepidem.2021.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/06/2021] [Accepted: 02/09/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND OBJECTIVE Community mitigation strategies could help reduce COVID-19 incidence, but there are few studies that explore associations nationally and by urbanicity. In a national county-level analysis, we examined the probability of being identified as a county with rapidly increasing COVID-19 incidence (rapid riser identification) during the summer of 2020 by implementation of mitigation policies prior to the summer, overall and by urbanicity. METHODS We analyzed county-level data on rapid riser identification during June 1-September 30, 2020 and statewide closures and statewide mask mandates starting March 19 (obtained from state government websites). Poisson regression models with robust standard error estimation were used to examine differences in the probability of rapid riser identification by implementation of mitigation policies (P-value< .05); associations were adjusted for county population size. RESULTS Counties in states that closed for 0-59 days were more likely to become a rapid riser county than those that closed for >59 days, particularly in nonmetropolitan areas. The probability of becoming a rapid riser county was 43% lower among counties that had statewide mask mandates at reopening (adjusted prevalence ratio = 0.57; 95% confidence intervals = 0.51-0.63); when stratified by urbanicity, associations were more pronounced in nonmetropolitan areas. CONCLUSIONS These results underscore the potential value of community mitigation strategies in limiting the COVID-19 spread, especially in nonmetropolitan areas.
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Affiliation(s)
- Sharoda Dasgupta
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Ahmed M Kassem
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Gregory Sunshine
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA; Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Tiebin Liu
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Charles Rose
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Gloria J Kang
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Rachel Silver
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Christina Watson
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Mara Howard-Williams
- Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Maxim Gakh
- University of Nevada, Las Vegas, Las Vegas, NV
| | - Russell McCord
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA; Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Regen Weber
- Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kelly Fletcher
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Trieste Musial
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Michael A Tynan
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Rachel Hulkower
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA; Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Amanda Moreland
- Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Dawn Pepin
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Lisa Landsman
- Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Amanda Brown
- Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Siobhan Gilchrist
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Catherine Clodfelter
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Michael Williams
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Ryan Cramer
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Alexa Limeres
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Adebola Popoola
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sebnem Dugmeoglu
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA
| | - Julia Shelburne
- Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Gi Jeong
- Public Health Law Program, Centers for Disease Control and Prevention, Atlanta, GA
| | - Carol Y Rao
- CDC COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, GA.
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Joo H, Miller GF, Sunshine G, Gakh M, Pike J, Havers FP, Kim L, Weber R, Dugmeoglu S, Watson C, Coronado F. Decline in COVID-19 Hospitalization Growth Rates Associated with Statewide Mask Mandates - 10 States, March-October 2020. MMWR Morb Mortal Wkly Rep 2021; 70:212-216. [PMID: 33571176 PMCID: PMC7877582 DOI: 10.15585/mmwr.mm7006e2] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Gakh M, Sunshine G, Limeres A, Rutkow L. Governors' Use of Executive Orders and Proclamations in Hurricane Response, 2006-2018. Health Secur 2020; 18:489-495. [PMID: 33326332 DOI: 10.1089/hs.2020.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Hurricanes can destroy or overwhelm communities and cause or exacerbate health conditions. Legal mechanisms and practices may aid or impede hurricane response. In the United States, where states have primary public health responsibility, state governors possess legal powers to address hurricanes. They often exercise these powers using executive orders and proclamations-legal mechanisms that direct public and private parties. Although executive orders and proclamations are critical for hurricane preparedness and response, how governors use them to respond to hurricanes is not fully understood. Using legal epidemiology, we systematically identified and analyzed hurricane-related executive orders and proclamations issued in the United States from January 1, 2006, through December 31, 2018. We found 468 relevant executive orders and proclamations, 14% of which were issued, at least in part, to benefit a jurisdiction other than the issuer's state. We observed variations in when and where such orders and proclamations were issued. Executive orders and proclamations were most commonly used to direct government response or recovery (32%), handle and administer government resources (31%), and suspend legal requirements perceived to inhibit response (27%). Fewer orders and proclamations regulated private parties (10%). Understanding how governors use executive orders and proclamations to respond to hurricanes can bolster future preparedness and response efforts.
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Affiliation(s)
- Maxim Gakh
- Maxim Gakh, JD, MPH, is an Assistant Professor, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV. Gregory Sunshine, JD, is a Public Health Analyst, Public Health Law Program, Center for State, Tribal, Local, and Territorial Support; and Alexa Limeres, JD, is a Public Health Analyst, Office of Science, Office of Scientific Integrity; both at the US Centers for Disease Control and Prevention. Lainie Rutkow, JD, PhD, MPH, is a Professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Gregory Sunshine
- Maxim Gakh, JD, MPH, is an Assistant Professor, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV. Gregory Sunshine, JD, is a Public Health Analyst, Public Health Law Program, Center for State, Tribal, Local, and Territorial Support; and Alexa Limeres, JD, is a Public Health Analyst, Office of Science, Office of Scientific Integrity; both at the US Centers for Disease Control and Prevention. Lainie Rutkow, JD, PhD, MPH, is a Professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Alexa Limeres
- Maxim Gakh, JD, MPH, is an Assistant Professor, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV. Gregory Sunshine, JD, is a Public Health Analyst, Public Health Law Program, Center for State, Tribal, Local, and Territorial Support; and Alexa Limeres, JD, is a Public Health Analyst, Office of Science, Office of Scientific Integrity; both at the US Centers for Disease Control and Prevention. Lainie Rutkow, JD, PhD, MPH, is a Professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Lainie Rutkow
- Maxim Gakh, JD, MPH, is an Assistant Professor, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV. Gregory Sunshine, JD, is a Public Health Analyst, Public Health Law Program, Center for State, Tribal, Local, and Territorial Support; and Alexa Limeres, JD, is a Public Health Analyst, Office of Science, Office of Scientific Integrity; both at the US Centers for Disease Control and Prevention. Lainie Rutkow, JD, PhD, MPH, is a Professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Chien LC, Gakh M. The lagged effect of state gun laws on the reduction of state-level firearm homicide mortality in the United States from 1999 to 2017. Public Health 2020; 189:73-80. [PMID: 33181432 DOI: 10.1016/j.puhe.2020.08.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 07/15/2020] [Accepted: 08/27/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Gun violence is a pressing concern in the United States, where many laws targeting gun violence vary across states and localities. Studies have investigated the association between gun laws and gun violence, but not many focus on the role of time, which is critical for implementation. This study aims to determine the lagged association of gun laws with firearm homicide mortality to better understand the impacts of state gun laws over time. STUDY DESIGN The design of this study is a longitudinal study. METHODS This study applied the distributed lag non-linear model to assess the lagged association between firearm homicide mortality and the number of gun law provisions at the state level from 1999 to 2017. State gun law provisions were analyzed in aggregate and also across five groups of regulations. All estimates were transformed into relative risks (RRs). RESULTS Regarding all state gun laws, regardless of how many gun law provisions were on the books in any year, a significantly reduced RR of firearm homicide mortality was not observed until 7 years later. Among the five regulation groups, a significant RR less than 1 was more likely to happen in longer lags ≥5. The lowest significant RR = 0.24 (95% confidence interval = 0.15, 0.39) was observed in the gun types, components, and trafficking group at lag 8. All regulation groups had an overall impact to reduce significantly the RR of firearm homicide mortality with more gun law provisions, except for the dealer regulation group. CONCLUSIONS State gun law provisions appear to impact firearm homicide mortality differently over time. This emphasizes the centrality of enforcement. Firearm policy researchers need to consider how specific gun laws are implemented over time to help inform law-based interventions.
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Affiliation(s)
- L-C Chien
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, United States
| | - M Gakh
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, United States.
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18
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Chien LC, Gakh M, Coughenour C, Lin RT. Correction to: Temporal trend of research related to gun violence from 1981 to 2018 in the United States: a bibliometric analysis. Inj Epidemiol 2020; 7:43. [PMID: 32660538 PMCID: PMC7359559 DOI: 10.1186/s40621-020-00266-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Lung-Chang Chien
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, 4700 S. Maryland Pkwy, Suite 335, Las Vegas, Nevada, 89119, USA.
| | - Maxim Gakh
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, 4700 S. Maryland Pkwy, Suite 335, Las Vegas, Nevada, 89119, USA
| | - Courtney Coughenour
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, 4700 S. Maryland Pkwy, Suite 335, Las Vegas, Nevada, 89119, USA
| | - Ro-Ting Lin
- Department of Occupational Safety and Health, College of Public Health, China Medical University, No. 91, Xueshi Road, North District, Taichung City, 404, Taiwan
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Chien LC, Gakh M, Coughenour C, Lin RT. Temporal trend of research related to gun violence from 1981 to 2018 in the United States: a bibliometric analysis. Inj Epidemiol 2020; 7:9. [PMID: 32200761 PMCID: PMC7087386 DOI: 10.1186/s40621-020-0235-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 02/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We aimed to evaluate the variation in gun violence-related research in the US over time to determine if there are meaningful changes in frequency of research at certain time points. Related publications were searched from the Web of Science. METHODS We searched articles from Web of Science to collect publication data of gun violence research in three disciplines (clinical sciences, life sciences, and social behavior sciences) from 1981 to 2018. The joinpoint regression approach was applied to evaluate the trend of publication ratio. We also adopted the generalized additive mixed model to compare the publication ratio among the three research disciplines. RESULTS During the study period, each research discipline had a significant decrease in publication ratios, especially social behavioral sciences from 2001 to 2011, with an annual percentage change = - 9.77% (95% CI = - 13.45, - 5.93; p-value < .0001). After combining the three research disciplines, the average change of the publication ratio was significantly increased 9.18% (95% CI = 6.42, 12.01; p-value < .0001) per year from 1981 to 2018. Compared to social behavioral sciences, both clinical sciences and life sciences had a significantly smaller publication ratio. CONCLUSIONS Gun violence research exhibited a significant downward trend in publications in the early 2000s, which may be attributed at least in part to limited federal funding, but the publication ratio increased since the 2010s. To enhance the amount of peer-reviewed gun violence research so that research-informed gun violence interventions are more likely to succeed, decision-makers should keep supporting quality research.
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Affiliation(s)
- Lung-Chang Chien
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, 4700 S. Maryland Pkwy, Suite 335, Las Vegas, Nevada, 89119, USA.
| | - Maxim Gakh
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, 4700 S. Maryland Pkwy, Suite 335, Las Vegas, Nevada, 89119, USA
| | - Courtney Coughenour
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, 4700 S. Maryland Pkwy, Suite 335, Las Vegas, Nevada, 89119, USA
| | - Ro-Ting Lin
- Department of Occupational Safety and Health, College of Public Health, China Medical University, No. 91, Xueshi Road, North District, Taichung City, 404, Taiwan
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Abstract
Background: Chronic school absenteeism is prevalent among high school students in the United States. Its impacts on academic success and health are cause for concern. One specific area of concern is its relationship to youth substance use; chronic absenteeism is associated with using alcohol, marijuana, tobacco, and other drugs. Despite important findings, absent from the literature is a recent and systematic synthesis of related research. Objective: We aimed to examine the literature to provide a better understanding of the relationship between chronic school absenteeism and the use of alcohol, tobacco, marijuana and other drugs among U.S. high school students. Methods: We conducted an integrative review of existing peer-reviewed literature using key terms in five databases from the education and health sectors. We included English-language, quantitative and qualitative studies published between 1992 and October 2017 and focused on U.S. students in grades 9 through 12 and between ages 13 and 21. We extracted data and study quality measures for included studies. Results: After screening 3,130 articles using titles and abstracts and reviewing 99 full-text articles, 37 met inclusion criteria. Most were cross-sectional, used local-level data, widely varied in sampling, were of limited generalizability, and simultaneously considered school absenteeism and the use of multiple substances. Due to methodological issues, the relationship between chronic absenteeism and substance use is difficult to fully understand. Conclusions: We confirm the connection between school absenteeism and substance use among U.S. youth, highlight a limited understanding of how and why this relationship manifests, and call for absenteeism research that uses longitudinal methods, national data, and clearly articulated methodologies and self-appraised limitations.
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Affiliation(s)
- Maxim Gakh
- School of Public Health, University of Nevada Las Vegas, Las Vegas, Nevada USA
| | - Courtney Coughenour
- School of Public Health, University of Nevada Las Vegas, Las Vegas, Nevada USA
| | | | - Melissa Vanderstelt
- School of Public Health, University of Nevada Las Vegas, Las Vegas, Nevada USA
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21
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Gakh M, Cris C, Cheong P, Coughenour C. A State of Uncertainty: An Analysis of Recent State Legislative Proposals to Regulate Preventive Services in the United States. Inquiry 2019; 56:46958019841514. [PMID: 31018737 PMCID: PMC6484240 DOI: 10.1177/0046958019841514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This policy brief examines preventive services state legislation trends in the United States during uncertainty regarding the Affordable Care Act (ACA), which requires certain coverage of 4 evidence-based preventive services categories without additional patient costs under §2713. We used a legal mapping approach to search for and analyze state legislation related to preventive services proposed or enacted over a 25-month period of ACA uncertainty. We screened 1231 bills and coded the 76 screened-in bills. Next, we determined their characteristics and examined trends. Bills originated in 28 states, and 69.7% were not enacted. Only 3.9% contained requirements contingent on ACA modifications. About 56.6% referenced services covered by §2713, but usually not entire §2713 categories. Bills also mentioned preventive services in general (53.9%) and services outside §2713’s scope (21.1%). About 55.3% applied to private insurance, and 75.0% only to one patient group. Bills generally promoted access, and 51.3% specifically prohibited cost-sharing. But 26.3% of the bills limited access to preventive services. State-level legislation targets preventive services, usually expanding, but sometimes limiting, access. Most bills single out specific services without fully incorporating evidence-based recommendations. State legislation may therefore promote access to preventive services but can favor certain services, deviate from experts’ recommendations, and increase nationwide variability. State legislation can function as an important lever for access to preventive services across patient groups. This may be especially important during uncertainty about federal policy. However, the design of state-level proposals is critical for maximizing access to preventive services.
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Affiliation(s)
| | - Cody Cris
- 1 University of Nevada, Las Vegas, USA
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Upadhyay S, Lord J, Gakh M. Health-Information Seeking and Intention to Quit Smoking: Do Health Beliefs Have a Mediating Role? Tob Use Insights 2019; 12:1179173X19871310. [PMID: 31488954 PMCID: PMC6712759 DOI: 10.1177/1179173x19871310] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 07/31/2019] [Indexed: 11/26/2022] Open
Abstract
Background: Smoking is a leading cause of preventable deaths. Smoking cessation can reduce the risk of smoking-associated disease and death. But smoking cessation involves behaviour change. Existing research indicates that health-information seeking and health-promoting behaviours can be positively associated. However, in the context of smoking, the relationship between seeking health information and intending to quit smoking remains only partially understood. Aim: This study aimed to examine the relationship between seeking health information and intending to quit smoking and to determine whether this relationship is mediated by health beliefs. Methods: We used data from the fourth cycle of the US National Cancer Institute’s Health Information National Trends Survey (HINTS). Logistic regression was used to assess the independent variable (ie, health-information seeking) and dependent variable (ie, intention to quit smoking) as mediated by health belief. Results: Our findings suggest that smokers who seek health information have a 2.67 times higher odds of intending to quit smoking than smokers who do not seek health information. However, health beliefs do not have an intervening effect between seeking health information and intending to quit smoking. Discussion: Seeking health information is important in predicting attempts to quit smoking, regardless of the smokers’ pre-existing health beliefs. Our findings support cessation efforts that encourage smokers to seek health information. Determining optimal ways to encourage smokers to seek smoking-related information could support achieving and maintaining smoking cessation. Conclusion: Cessation programmes and policies should encourage smokers to seek health information. Additional research should further examine smokers’ motivators and cues for health-information seeking and should further probe smokers’ beliefs about the risks of smoking.
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Affiliation(s)
- Soumya Upadhyay
- Department of Healthcare Administration and Policy, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Justin Lord
- James K. Elrod Department of Health Administration and Department of Accounting, School of Business, Louisiana State University at Shreveport, Shreveport, LA, USA
| | - Maxim Gakh
- School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, USA
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Abstract
This integrative review examines extant literature assessing the burden and management of noncommunicable diseases 6 months or more after earthquakes and tsunamis. We conducted an integrative review to identify and characterize the strength of published studies about noncommunicable disease-specific outcomes and interventions at least 6 months after an earthquake and/or tsunami. We included disasters that occurred from 2004 to 2016. We focused primarily on the World Health Organization noncommunicable disease designations to define chronic disease, but we also included chronic renal disease, risk factors for noncommunicable diseases, and other chronic diseases or symptoms. After removing duplicates, our search yielded 6,188 articles. Twenty-five articles met our inclusion criteria, some discussing multiple noncommunicable diseases. Results demonstrate that existing medical conditions may worsen and subsequently improve, new diseases may develop, and risk factors, such as weight and cholesterol levels, may increase for several years after an earthquake and/or tsunami. We make 3 recommendations for practitioners and researchers: (1) plan for noncommunicable disease management further into the recovery period of disaster; (2) increase research on the burden of noncommunicable diseases, the treatment modalities employed, resulting population-level outcomes in the postdisaster setting, and existing models to improve stakeholder coordination and action regarding noncommunicable diseases after disasters; and (3) coordinate with preexisting provision networks, especially primary care.
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Gase LN, DeFosset AR, Gakh M, Harris C, Weisman SR, Dannenberg AL. Review of Education-Focused Health Impact Assessments Conducted in the United States. J Sch Health 2017; 87:911-922. [PMID: 29096410 PMCID: PMC7539659 DOI: 10.1111/josh.12566] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 02/24/2017] [Accepted: 02/24/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Health impact assessment (HIA) provides a structured process for examining the potential health impacts of proposed policies, plans, programs, and projects. This study systematically reviewed HIAs conducted in the United States on prekindergarten, primary, and secondary education-focused decisions. METHODS Relevant HIA reports were identified from web sources in late 2015. Key data elements were abstracted from each report. Four case studies were selected to highlight diversity of topics, methods, and impacts of the assessment process. RESULTS Twenty HIAs completed in 2003-2015 from 8 states on issues related to prekindergarten through secondary education were identified. The types of decisions examined included school structure and funding, transportation to and from school, physical modifications to school facilities, in-school physical activity and nutrition, and school discipline and climate. Assessments employed a range of methods to characterize the nature, magnitude, and severity of potential health impacts. Assessments fostered stakeholder engagement and provided health-promoting recommendations, some of which were subsequently incorporated into school policies. CONCLUSIONS Health impact assessment is a promising tool that education, health, and other stakeholders can use to maximize the health and well-being of students, families, and communities.
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Affiliation(s)
- Lauren N Gase
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, 3530 Wilshire Boulevard, 8th Floor, Los Angeles, CA 90010
| | - Amelia R DeFosset
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, 3530 Wilshire Boulevard, 8th Floor, Los Angeles, CA 90010
| | - Maxim Gakh
- Health Law Program, School of Community Health Sciences, University of Nevada, Las Vegas, Box 453064, 4505 South Maryland Parkway, Las Vegas, NV 89154
| | - Celia Harris
- Human Impact Partners, 304 12th Street, Suite 2B, Oakland, CA 94607
| | - Susan R Weisman
- Public Health Law Center, Mitchell Hamline School of Law, 875 Summit Avenue, St. Paul, MN 55105
| | - Andrew L Dannenberg
- Department of Environmental and Occupational Health Sciences, School of Public Health, Department of Urban Design and Planning, College of Built Environments, University of Washington, Box 357234, Seattle, WA 98195
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Affiliation(s)
- Maxim Gakh
- Maxim Gakh is a Scholar in Residence at the University of Nevada, Las Vegas, School of Community Health Sciences in Las Vegas, Nevada
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Polsky C, Stagg K, Gakh M, Bozlak CT. The Health in All Policies (HiAP) approach and the law: preliminary lessons from California and Chicago. J Law Med Ethics 2015; 43 Suppl 1:52-55. [PMID: 25846165 DOI: 10.1111/jlme.12216] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
“Health in All Policies” (HiAP) is the latest manifestation of an ecological approach to public health enhancement — one that recognizes connections between health and other sectors, and that socioeconomic determinants of health are significant. HiAP is related to other holistic, prevention-oriented approaches to collective health, such as the use of Health Impact Assessments to evaluate the health externalities of pending government decisions. Yet HiAP is unique. It goes beyond evaluation of specific projects and policies, and embodies a distinct approach to cross-sectoral public health work.
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Affiliation(s)
- Claudia Polsky
- Deputy Attorney General at the California Department of Justice, and serves as that agency's representative on the California Health in All Policies Task Force
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Rutkow L, Vernick JS, Gakh M, Siegel J, Thompson CB, Barnett DJ. The Public Health Workforce and Willingness to Respond to Emergencies: A 50-State Analysis of Potentially Influential Laws. J Law Med Ethics 2014; 42:64-71. [PMID: 26767477 DOI: 10.1111/jlme.12119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Law plays a critical role in all stages of a public health emergency, providing an infrastructure for planning, response, and recovery efforts. A growing body of research has underscored the potential for certain types of state laws, such as those granting liability protections to responders, to influence the public health workforce's participation in emergency responses. It is therefore especially important to focus on particular state-level laws that may be associated with individuals' increased or decreased willingness to respond. We conducted a systematic identification and analysis of specific state emergency preparedness laws that may affect individuals' willingness to respond and offer recommendations for policymakers seeking to promote more effective responses to public health emergencies.
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Affiliation(s)
- Lainie Rutkow
- Assistant Professor in the Department of Health Policy and Management at Johns Hopkins Bloomberg School of Public Health
| | - Jon S Vernick
- Associate Professor in the Department of Health Policy and Management at Johns Hopkins Bloomberg School of Public Health
| | - Maxim Gakh
- Research Assistant in the Department of Health Policy and Management at Johns Hopkins Bloomberg School of Public Health
| | - Jennifer Siegel
- Research Assistant in the Department of Health Policy and Management at Johns Hopkins Bloomberg School of Public Health
| | - Carol B Thompson
- Assistant Scientist in the Department of Biostatistics at Johns Hopkins Bloomberg School of Public Health
| | - Daniel J Barnett
- Assistant Professor in the Department of Environmental Health Sciences at Johns Hopkins Bloomberg School of Public Health
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Affiliation(s)
- Maxim Gakh
- At the time of this research, Maxim Gakh was a Research Assistant at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland. Jon Vernick is an Associate Professor and Co-Director of the Johns Hopkins Center for Law and the Public's Health at the Johns Hopkins Bloomberg School of Public Health. Lainie Rutkow is an Assistant Professor and Assistant Director of the Johns Hopkins Center for Law and the Public's Health at the Johns Hopkins Bloomberg School of Public Health
| | - Jon S. Vernick
- At the time of this research, Maxim Gakh was a Research Assistant at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland. Jon Vernick is an Associate Professor and Co-Director of the Johns Hopkins Center for Law and the Public's Health at the Johns Hopkins Bloomberg School of Public Health. Lainie Rutkow is an Assistant Professor and Assistant Director of the Johns Hopkins Center for Law and the Public's Health at the Johns Hopkins Bloomberg School of Public Health
| | - Lainie Rutkow
- At the time of this research, Maxim Gakh was a Research Assistant at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland. Jon Vernick is an Associate Professor and Co-Director of the Johns Hopkins Center for Law and the Public's Health at the Johns Hopkins Bloomberg School of Public Health. Lainie Rutkow is an Assistant Professor and Assistant Director of the Johns Hopkins Center for Law and the Public's Health at the Johns Hopkins Bloomberg School of Public Health
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Vernick JS, Gakh M, Rutkow L. Emergency detention of persons with certain mental disorders during public health disasters: legal and policy issues. Am J Disaster Med 2012; 7:295-302. [PMID: 23264277 DOI: 10.5055/ajdm.2012.0102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Public health emergencies (disasters) are associated with mental health conditions ranging from mild to severe. When persons pose a danger to themselves or others, a brief emergency detention allows a mental health assessment to determine if a lengthier involuntary civil commitment is needed. Involuntary commitment requires participation of the civil justice system to provide constitutionally mandated due process protections. However, disasters may incapacitate the judicial system, forcing emergency detainees to be prematurely released if courts are unavailable. The authors review state laws regarding emergency detention of persons deemed a potential mental health-related danger. Although some states are well prepared for the dual impact of disasters on mental health and the court system, important gaps exist. The authors recommend that state laws anticipate the need for brief extensions of emergency detention periods without court participation. States should also include mental health considerations in their disaster preparedness plans for the court system.
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Affiliation(s)
- Jon S Vernick
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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