Accessing Health: Examining Racial and Geographic Disparities in Diabetes Prevalence as a Result of the Built Environment

Diabetes is a leading cause of premature death and disability in the United States and vulnerable populations may be at increased risk. Racial residential segregation, population density, and other factors influence the built environment, which in turn affects access to health-related facilities. Using the theory of fundamental causes, this study aims to determine whether neighborhood-level sociodemographic factors, the built environment, and subsequent access to health-related facilities are associated with diabetes prevalence in Georgia’s population. A built environment assessment of all health facilities located in the state of Georgia was conducted using health data from the 2014 Behavioral Risk Factor Surveillance System and demographic data from the 2010 US Census. Geospatial techniques, including hot-spot analyses and the two-step floating catchment area method were used to determine the effect of racial concentration, socioeconomic status, and population density on access to health-related facilities and thus on diabetes prevalence. Linear and spatial regression analyses were conducted to determine the significance of the association between access to facilities and diabetes prevalence. The results of the geospatial and regression analyses show that socioeconomic factors significantly affect the built environment, which in turn significantly influence diabetes prevalence. This interdisciplinary study contributes to the literature by providing a comprehensive analysis of the relationship between sociodemographic factors, the built environment, and diabetes prevalence in a southeastern state. Keywords: Diabetes, Disparities, Access, Racial Segregation, Urban/Rural, Built Environment Diabetes is a leading cause of premature death and disability in the United States and vulnerable populations may be at increased risk. Racial residential segregation, population density, and other factors influence the built environment, which in turn affects access to health-related facilities. Using the theory of fundamental causes, this study aims to determine whether neighborhood-level sociodemographic factors, the built environment, and subsequent access to health-related facilities are associated with diabetes prevalence in Georgia’s population. A built environment assessment of all health facilities located in the state of Georgia was conducted using health data from the 2014 Behavioral Risk Factor Surveillance System and demographic data from the 2010 US Census. Geospatial techniques, including hot-spot analyses and the two-step floating catchment area method were used to determine the effect of racial concentration, socioeconomic status, and population density on access to health-related facilities and thus on diabetes prevalence. Linear and spatial regression analyses were conducted to determine the significance of the association between access to facilities and diabetes prevalence. The results of the geospatial and regression analyses show that socioeconomic factors significantly affect the built environment, which in turn significantly influence diabetes prevalence. This interdisciplinary study contributes to the literature by providing a comprehensive analysis of the relationship between sociodemographic factors, the built environment, and diabetes prevalence in a southeastern state

Peering into a House of Pain: La pérdida es mía by José Miguel Curet

This collection of nine poems highlights the highly-charged political landscape of Puerto Rico through pointed criticism and poignant nostalgic imagery. Curet follows in the vein of decades of Puerto Rican resistance poetry, and the reality and scope of the nation's struggle seethes through each line and stanza. These poems are replete with repetition, utilized effectively to illustrate the ongoing instability of the nation across generations

Poverty Levels and Dual Enrollment Demographics and their Effect on Mississippi High School Graduation Rates

Despite the fact that education plays a vital role in the success of an individual and society as a whole, it is estimated that 1 of every 4 students will not receive a high school diploma four years after starting ninth grade. In an effort to decrease dropout rates and increase graduation rates of high school students, educators are searching for nontraditional methods to increase student achievement. One such method, dual enrollment, involves community colleges in the role as facilitators. While preliminary research indicates a relationship between dually enrolled students and high school graduation, additional data is needed on student demographics and achievement. To build and improve upon the dual enrollment programs of Mississippi’s community colleges, it will be important to know the participation levels and their effect on graduation rates. The purpose of this study was twoold: 1)To examine the proportions of students participating in Mississippi Community College Dual Enrollment Programs based on various demographics. 2)To determine the degree to which Mississippi Community College Dual Enrollment demographics and poverty levels of Mississippi public schools affect high school graduation rates of Mississippi’s Community College Districts. Data were obtained from the State Board of Community and Junior Colleges and the Mississippi Department of Education. Demographic variables chosen for the study included gender, race, curriculum and poverty level. Data from each public school was grouped according to the corresponding community college district, allowing the researcher to better establish the proportions of students participating in dual enrollment and the poverty level of public school students within the district. These proportions were then analyzed to find correlation between demographics and graduation rates of the community college district. Results indicate a low overall percentage of students participating in dual enrollment and disproportioned percentages between community college districts. Regression analyses indicate that race, gender and curriculum did not contribute significantly to the prediction of graduation rate. However, high poverty levels did show a significant relationship to lower graduation rates. Additionally, in every district females were dually enrolled at rates higher than males, and students were enrolled in academic courses notably more than technical/vocational courses

Can Changing Your Environment Change Your Health? Examining Public Housing Relocation and Cardiovascular Disease Risk

Cardiovascular disease is the leading cause of premature death in the United States today, and vulnerable populations may be more susceptible to this disease risk. Relocating into a new neighborhood may affect one’s cardiovascular disease risk. Through a socio-ecological framework, this study sought to determine whether changes in one’s interior and exterior built environment had a significant effect on cardiovascular disease risk in Atlanta’s relocated public housing population. Using pre- and post-relocation data from a questionnaire delivered to public housing residents, and built environment assessments from before and after demolition neighborhoods, the results showed residents were significantly more satisfied with their new neighborhoods and residences. However, while the interior built environment improved significantly after relocation, the exterior built environment declined significantly. Further, neither overall health nor cardiovascular disease risk improved significantly after relocation. These results corroborate findings in other public housing research that shows that many former public housing residents do not perceive an improvement in their health after relocation

Evaluation of the Indiana Child Care Financing Initiative

A research report evaluating the results of the Indiana Child Care Financing Initiative, a statewide effort to improve child care in Indiana. The report summarizes results in the areas of improving capacity, quality, and community awareness of child care issues, as well as the role of 69 local projects in initiating or expanding local partnerships focused on child care

The Impact and Benefits of USDA Research and Grant Programs to Enhance Mid-size Farm Profitability and Rural Community Success

An analysis of four mainstay USDA research and rural development grant programs found that only five percent of the nearly $500 million provided direct benefits to, or were relevant for, small and mid-sized farms and ranches or beginning farmers and ranchers in the United States. The project was funded in part by a grant from the Leopold Center\u27s Policy Initiative (P2003-13)

Response of Baldcypress (Taxodium distichum) at Different Life Stages to Flooding and Salinity

Baldcypress are dominant trees in forested coastal wetlands. As sea levels rise, it is important to increase our understanding of how increased salinity and flooding will affect forested coastal wetlands. This study combined field observations and a greenhouse experiment to examine the effects of salinity and flooding on baldcypress growth at different life stages: seedlings, young trees, and mature trees. 1) I conducted a greenhouse experiment with flooded and drought conditions and different salinity treatments looking at the growth of seedlings. 2) To assess the response of young trees I examined the diameter at breast height (DBH) and height of >9 year old trees that were planted in a restored wetland across salinity and flooding gradients. 3) I also conducted a regional survey of adult baldcypress growth using increment tree ring cores along a salinity gradient in the Albemarle Sound, North Carolina.   In the greenhouse experiment, I found that drought, saltwater, and sulfate had significant negative effects on height over an exposure period of 26 weeks, while drought and saltwater had a significant negative effect on root collar growth. Overall, I found that the presence of saltwater decreased height of baldcypress seedlings by 15% and decreased the diameter at root collar by 21% compared to the control, regardless of hydrology. Seedlings watered with saltwater showed a decrease in biomass of leaves (55%), stems (50%), and roots (71%) compared to seedlings in the control. For the young trees in a wetland restoration site, DBH and tree height were not significantly correlated with water depth. However, DBH and height were negatively correlated with chloride concentrations in soil solution. Height was also negatively correlated with ammonium and total dissolved nitrogen concentration in soil solution, which are known to increase due to increases with salinity. The increment tree ring cores showed that the average tree age for five sites ranged between 94 to 118 years old. I found a trend towards declining growth of adult trees with increasing salinity, but the lack of long-term environmental data and multiple possible stressors on adults trees (droughts, hurricanes, and fires to name a few) make it difficult to isolate the effects of salinity and flooding on adults tree growth. My results suggest that baldcypress trees in this region of North Carolina are more sensitive to increased salinity than to increase flooding. I found lines of evidence for decreased growth of baldcypress trees in response to salinity at the seedling, young adult, and adult stage. I did not find such support for the effects of flooding on growth at the young adult and adult stage. My results suggest that increases in saltwater incursion and sea level rise could lead to decreased growth and/or death of baldcypress trees, which are foundational species in forested coastal wetlands.  M.S

Politics, hospital behaviour and health care spending

This paper examines the link between legislative politics, hospital behaviour, and health care spending. When trying to pass sweeping legislation, congressional leaders can attract votes by adding targeted provisions that steer money toward the districts of reluctant legislators. This targeted spending provides tangible local benefits that legislators can highlight when fundraising or running for re-election. We study a provision - Section 508 – that was added to the 2003 Medicare Modernization Act (MMA). Section 508 created a pathway for hospitals to apply to get their Medicare payment rates increased. We find that hospitals represented by members of the House of Representatives who voted ‘Yea’ on the MMA were significantly more likely to receive a 508 waiver than hospitals represented by members who voted ‘Nay.’ Following the payment increase generated by the 508 program, recipient hospitals treated more patients, increased payroll, hired nurses, added new technology, raised CEO pay, and ultimately increased their spending by over $100 million annually. Section 508 recipient hospitals formed the Section 508 Hospital Coalition, which spent millions of dollars lobbying Congress to extend the program. After the vote on the MMA and before the vote to reauthorize the 508 program, members of Congress with a 508 hospital in their district received a 22% increase in total campaign contributions and a 65% increase in contributions from individuals working in the health care industry in the members’ home states. Our work demonstrates a pathway through which the link between politics and Medicare policy can dramatically affect US health spending

Politics, Hospital Behavior, and Health Care Spending

This paper examines the link between legislative politics, hospital behavior, and health care spending. When trying to pass sweeping legislation, congressional leaders can attract votes by adding targeted provisions that steer money toward the districts of reluctant legislators. This targeted spending provides tangible local benefits that legislators can highlight when fundraising or running for reelection. We study a provision - Section 508 – that was added to the 2003 Medicare Modernization Act (MMA). Section 508 created a pathway for hospitals to apply to get their Medicare payment rates increased. We find that hospitals represented by members of the House of Representatives who voted ‘Yea’ on the MMA were significantly more likely to receive a 508 waiver than hospitals represented by members who voted ‘Nay.’ Following the payment increase generated by the 508 program, recipient hospitals treated more patients, increased payroll, hired nurses, added new technology, raised CEO pay, and ultimately increased their spending by over $100 million annually. Section 508 recipient hospitals formed the Section 508 Hospital Coalition, which spent millions of dollars lobbying Congress to extend the program. After the vote on the MMA and before the vote to reauthorize the 508 program, members of Congress with a 508 hospital in their district received a 22% increase in total campaign contributions and a 65% increase in contributions from individuals working in the health care industry in the members’ home states. Our work demonstrates a pathway through which the link between politics and Medicare policy can dramatically affect US health spending