Examining the Relationship Between Social Cohesion and Health in Kensington

This quantitative cross-sectional survey study was conducted in collaboration with the New Kensington Community Development Corporation (NKCDC) to improve our understanding of the role of social cohesion in the Somerset neighborhood. Its aims were to help guide future efforts to improve the health of this community by considering whether social factors might contribute to overall health. In previous studies, social cohesion has been hypothesized to be related to overall self-reported health. In this study we examined the nature and strength of this relationship in a low socio-economic status population in Kensington. We used linear regression to evaluate cross-sectional survey data collected from 328 neighborhood residents. Data was collected on health information, social cohesion, demographic factors, health behaviors, and financial stability. Variables that were significantly associated with self-reported health were included in a multiple regression model to examine the relationship between social cohesion and self-reported health. Our findings were that social cohesion and overall health were related. We also found that stress was significantly associated with social cohesion as well as overall health; while the reach of this study stops short of being able to identify the causality of these relationships, organizations such as NKCDC could combine the strength of the relationships with their expertise in the relevant population to better inform their future programming. This study also revealed a number of areas that could be worthy of future study, including the importance of collective efficacy in improving population health and the effect of social cohesion on people’s health over the course of a longitudinal study

The Correlation Between Perceptions of Safety and Perceived Stress Among Residents of the Somerset Neighborhood of Kensington, Philadelphia

Background: The Somerset neighborhood of Kensington, Philadelphia is affected by economic, environmental, and social issues that come with disinvestment. The average median income for Somerset is $26,015 per year which is much lower than Philadelphia’s city-wide income of$36, 957. This study evaluated the connection between perceptions of safety and perceived stress among residents of the Somerset neighborhood. Methods: This study was a secondary data analysis from a cross-sectional study in the Somerset neighborhood. The data included self-reported surveys from Somerset residents that were completed at their homes. The surveys were completed using an electronic (tablet) format which took approximately 20 to 30 minutes to complete. Trained members of the neighborhood collected the data from July to December 2017. We used SPSS to quantify relationships between perceptions of safety and perceived stress using Spearman’s Rank Order Correlation for each of our 12 perceptions of safety variables and stress. Our final model was created using a multivariable linear regression model. Results: We had 328 adults with an average age of 48 years old in our study sample. We found that most of the residents were female, 35.3% were Latino, predominantly single, and mainly employed full-time. Additionally, over half of the residents owned their home and 16 years was the average amount of time lived in the neighborhood. We found that the average score on the stress scale was a 5.18 (range 0-16). In our final model, we found 4 variables to be statistically significant (α= .10) age, years lived in the community, police should spend more time working with community members and groups to solve problems, and members of my community are interested in crime prevention activities. Discussion: Overall, the mean stress levels were lower than we expected. We found associations between demographics and perceptions of safety variables specifically, as age increased, stress decreased and as the years lived in the community increased, stress increased. Our results also indicated as police spent more time working with community members and as crime prevention activities increased in the community, stress decreased. The strongest predictor of stress was the variable: “police should spend more time working with community members and groups to solve problems.” Collaborations between police officers and community members have the potential to improve health and may also help residents feel safer and less stressed in the neighborhood

Purchase of Loose Cigarettes by Adult Smokers in Philadelphia: Individual-level Correlates and Neighborhood Characteristics

Background • Philadelphia has the highest adult smoking rate1 and the highest rate of tobacco retailers2 among the 10 largest U.S. cities. • Governmental reports have identified high rates of illegal sale of cigarettes in Philadelphia2. • Studies have found that a main source of cigarette use in low income communities is single (loose) cigarettes purchased at tobacco retailers or from unregulated street vendors3,4. • While studies have shown that loose cigarette use is a problem among urban youth who reside in disadvantaged neighborhoods, less research has been performed among adults on this topic5,6, and no studies focus on Philadelphia. • In order to efficiently target tobacco control efforts towards reducing smoking rates in Philadelphia, demographic, geographic, and behavioral factors affecting the purchase of loose cigarettes need to be determined. Research Questions: 1. What are the demographic and smoking-related correlates of having purchased loose cigarettes among adult smokers in Philadelphia? 2. Are smokers who purchased loose cigarettes more likely to reside in Philadelphia neighborhoods with high poverty rates, compared to smokers who did not? 3. Are smokers who purchased loose cigarettes more likely to reside in Philadelphia neighborhoods with high tobacco retail density, compared to smokers who did not? Poster presented at APHA in Chicago, Illinois.https://jdc.jefferson.edu/jcphposters/1000/thumbnail.jp

Borders and Blood Pressure: Understanding the Role of Acculturation in a Hypertension Diagnosis Among Hispanic Americans: 2014 California Health Interview Survey

Background: In the U.S. Hispanic population overall, heart disease is the leading cause of death. The prevalence of hypertension among Mexican American immigrants is lower than the general population, yet it is on the rise. Health risks among Hispanics vary depending on their length of stay in the US (as proxy measure of acculturation). The purpose of this study was to examine the association between acculturation and the individual\u27s likelihood of being diagnosed with hypertension among Hispanic Americans. Methods: We used data from the 2014 California Health Interview Survey (CHIS) and performed univariate analysis to examine racial differences in prevalence of hypertension. We also performed a multivariate logistic regression to identify if acculturation was significantly related to hypertension diagnoses, after controlling for sociodemographic characteristics (e.g., age, gender, level of education, marital status), access to care, and health status (e.g., self-reported health status, BMI), among Mexican Americans and all Hispanics, respectively. Results: Of 3,793 Hispanic American participating in the survey, 81.8% were Mexican Americans and 18.2% were other Hispanics. The prevalence of hypertension among Hispanic was 24.0% (95% CI: 21.5%. 26.7%) which was lower than that of African Americans (39.2%, 95% CI 33.7%, 44.9%) and White (30.2%, 95% CI: 28.5%, 31.9%). In multivariate analyses, acculturation was associated with hypertension among Mexican Americans, but not all Hispanics. For both Mexican Americans and Hispanics, age, health status and BMI were associated with having hypertension: Older people, those with poor health status, and overweight and obese people were more likely than their comparison groups to have hypertension. Those without health insurance were less likely to have hypertension. Conclusion: The results show a positive association between length of time in the United States for longer periods of time, and a diagnosis of hypertension. These results, along with others conducted around Hispanic American immigration, acculturation and chronic disease prevalence, help medical providers, to understand the effects of acculturation on specific health care needs among immigrants, and offer suggestions to patients which are culturally sensitive and relevant. Poster presented at AHPA conference in Atlanta Georgia.https://jdc.jefferson.edu/jcphposters/1014/thumbnail.jp

The Association Between Opioid-Related Industry Payments and Opioid Prescribing at the Individual and Ecological Level in Pennsylvania

Objective: to understand how industry payments related to opioid products are associated with opioid prescribing in Pennsylvania. Methods: we merged the Open Payments data, Medicare Part D public use file, and Dartmouth Hospital Atlas of Health Care Hospital Service Areas from 2015 to analyze relationships between opioid related payments and opioid prescribing. We used a binomial regression model to investigate individual-level trends and a log-linear model to investigate Hospital Service Area-level trends. We mapped the distribution of opioid-related payments in Pennsylvania using GIS software. Results: One additional payment to a physician was associated with 4.2% higher opioid-prescribing rate (OR = 1.0418, 95% CI 1.0416-1.0420, Chi-Square(1) = 122678, p Conclusions: We found a positive association between opioid-related payments to physicians and opioid prescribing. Policy makers and administrators should consider revising rules related to pharmaceutical company marketing tactics and promote judicious opioid prescribing

Comparison of Maximal Treadmill Test Using Open-Circuit Spirometry and Maximal Effort Two-Mile Run Test Performance

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Productivity and profitability of cattle stall-fed for beef on smallholder farms in Malawi

Presents the results of biological and financial analyses performed on the productivity and profitability of cattle stall-fed for beef on smallholder farms in Malawi

Do Employees From Less-Healthy Communities Use More Care and Cost More? Seeking to Establish a Business Case for Investment in Community Health.

INTRODUCTION: Few studies have examined the impact of community health on employers. We explored whether employed adults and their adult dependents living in less-healthy communities in the greater Philadelphia region used more care and incurred higher costs to employers than employees from healthier communities. METHODS: We used a multi-employer database to identify adult employees and dependents with continuous employment and mapped them to 31 zip code regions. We calculated community health scores at the regional level, by using metrics similar to the Robert Wood Johnson Foundation (RWJF) County Health Rankings but with local data. We used descriptive analyses and multilevel linear modeling to explore relationships between community health and 3 outcome variables: emergency department (ED) use, hospital use, and paid claims. Business leaders reviewed findings and offered insights on preparedness to invest in community health improvement. RESULTS: Poorer community health was associated with high use of ED services, after controlling for age and sex. After including a summary measure of racial composition at the zip code region level, the relationship between community health and ED use became nonsignificant. No significant relationships between community health and hospitalizations or paid claims were identified. Business leaders expressed interest in further understanding health needs of communities where their employees live. CONCLUSION: The health of communities in which adult employees and dependents live was associated with ED use, but similar relationships were not seen for hospitalizations or paid claims. This finding suggests a need for more primary care access. Despite limited quantitative evidence, business leaders expressed interest in guidance on investing in community health improvement

Using a Smartphone App to Teach Students Practical Epidemiological Skills

Background: Despite the evidence that shows the pedagogical benefits of experiential education, epidemiology instructors rarely utlize experiential activities to teach epidemiological concepts and skills. Poster presented at 8th annual 2016 Thomas Jefferson University Faculty Days

IMMUNOGLOBULIN AND OTHER SURFACE ANTIGENS OF CELLS OF THE IMMUNE SYSTEM

Immunoglobulins (Ig) on cells of the immune system: The cytotoxicity test, with class-specific and type-specific anti-Ig sera, identifies κ and µ determinants on mouse lymphocytes. The proportion of κ+ cells is characteristic for each source of cells: 30% of bone marrow cells, 40% of cells from peripheral lymph nodes, 45% of lymphocytes from peripheral blood or peritoneal cavity, and 50% of spleen cells. No Ig was demonstrable on thymocytes or on leukemia cells (most of which arise from thymus-derived [T] cells). Cytotoxicity tests were performed on various myelomas secreting different Ig; the only positive reactions were given by κγ1 myelomas (all four κγ1 myelomas tested were sensitive to both anti-κ and anti-γ1). Hemolytic plaque-forming cells (PFC) of IgG type had no demonstrable surface Ig, but a proportion of IgM PFC were κ+µ+. Virtually all rosette-forming cells (RFC) have surface Ig, more than 90% of them being inhibited by anti-κ, 50% by anti-µ, and 10–30% by antisera to other heavy chains. Anti-λ sera gave no positive reactions with any cell type, which is in keeping with the low level of this light chain in mouse serum. Ig and other differentiation antigens as markers for T and B cells: Thymocytes are hallmarked by the alloantigens TL, θ, and the Ly series, and it is generally held that extrathymic lymphoid cells that bear them are derived from thymocytes. There is one alloantigen marker for the thymus-independent (B) cell, and that is PC, which appears late in differentiation. (The mouse-specific lymphocyte (MSLA) and mouse-specific bone marrow-derived lymphocyte (MBLA) antigens recognized by heteroantisera, not used in the present study, are other candidates for T and B cell markers.) Making use of antisera to these surface antigens to inhibit the function of cells that carry them, we find the following: Approximately 30% of RFC, 60% of IgM PFC, and 90% of IgG are PC+ and so are identified as B cells. No T markers were demonstrable on these cell populations. Thus if T cells do become RFC or PFC they presumably lose their T surface markers in the process (cf. the quantitative reduction of T markers accompanying the thymocyte → lymphocyte transition). Cells that have the potential to initiate graft-versus-host (GVH) reactions have the T cell surface phenotype θ+Ig-. Adoptive transfer of thymus-dependent antibody-forming capacity (response to sheep erythrocytes) required θ+ cells but transfer of a thymus-independent immune response to Brucella antigen did not. Cells with surface Ig were involved in both types of adoptive transfers. Thus the presently available T markers do not provide evidence for T cells carrying surface Ig. Suppression of the Ig phenotype by antibody: antigenic modulation? A phenotypic change from Ig+ to Ig- occurs when Ig+ lymphocytes or myeloma cells are incubated with anti-Ig sera in vitro in the absence of complement (C). As with antigenic modulation in the TL system, which it resembles, this phenomenon is temperature dependent and in the case of lymph node cells (LNC) can be inhibited by high doses of actinomycin D