Latest estimates show that roughly 188 individuals in the United States die everyday due to an opioid-related overdose. This dissertation explores three avenues for
mitigating opioid use disorder (OUD) and the opioid epidemic in the United States (1.)
How can researchers and…
Latest estimates show that roughly 188 individuals in the United States die everyday due to an opioid-related overdose. This dissertation explores three avenues for
mitigating opioid use disorder (OUD) and the opioid epidemic in the United States (1.)
How can researchers and public health professionals identify areas most in need of
treatment for OUD in an easy-to-use and publicly accessible interface?; (2.) What do
practitioners see as opportunities for reducing barriers to treatment?; and (3.) Why do
differences in opioid mortality exist between demographic groups? To address question
one, I developed an interactive web-based to assist in identifying those counties with the
greatest unmet need of medically assisted treatment (MAT). To answer question two, I
conducted a study of stakeholders (medical providers, peer support specialists, public
health practitioners, etc.) in four New Mexico counties with high unmet need of MAT. to
identify cultural and structural barriers to MAT provision in underserved areas as well as
opportunities for improving access. To answer the third question. I conducted a
systematic review of peer-reviewed literature and government reports to identify how
previous research accounts for race/ethnic and sex disparities in opioid-related
mortality. While many opioid mortality studies show demographic differences, little is
known about why they exist. According to the findings of this systematic review, research
needs to go beyond identifying demographic differences in opioid-related mortality to
understand the reasons for those differences to reduce these inequities.
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The term “Iraqi American” defines any person of Iraqi origin who is residing in the United States. From 1960 until 2014, Iraq experienced numerous armed conflicts and international sanctions. As a result, a great surge of Iraqis migrated out of…
The term “Iraqi American” defines any person of Iraqi origin who is residing in the United States. From 1960 until 2014, Iraq experienced numerous armed conflicts and international sanctions. As a result, a great surge of Iraqis migrated out of the country to seek refuge elsewhere. The United States alone currently houses about 400,000+ persons of Iraqi descent, many of whom identify as its citizens. Despite that, Iraqi Americans remain severely understudied. Therefore, this study aims to understand the cultural barriers Iraqi American women face while seeking healthcare in the United States, and how these barriers can impact their behaviors. I collected data via semi-structured interviews with eight Iraqi American women. In this study, I identified five major themes that contributed to women’s healthcare seeking behaviors: societal/familial pressures, staying “pure,” shame associated with performing medical procedures, taboo surrounding discussions of female health conditions, and issues regarding being in the presence of male doctors. Many of these themes involved cultural stigmas and pointed to potential pathways to destigmatize women’s healthcare in the community. This study acts as an initiative to understanding Iraqi Americans better and lays groundwork for further research.
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Existing research has shown that both ethnic discrimination and household wealth can shape child well-being and development. However, little work examines ethnic discrimination and its relation to income in predicting childhood health globally. This study explores two possible explanations for…
Existing research has shown that both ethnic discrimination and household wealth can shape child well-being and development. However, little work examines ethnic discrimination and its relation to income in predicting childhood health globally. This study explores two possible explanations for disparities in infant mortality between ethnic groups across countries worldwide. The first is an explanation based on wealth differentials across ethnic groups. The second is the impact of forms of ethnic discrimination such as past lethal violence or forced labor experienced by the group. This study examines the correlation between ethnic discrimination and infant mortality using household wealth as a covariate. Analyses focused on 266 ethnicities in 40 low- and middle-income countries globally, drawing on infant mortality data from Demographic and Health Surveys and data on ethnic discrimination compiled by the Inclusive Human Learning Lab at Arizona State University. Findings without the inclusion of household wealth show that ethnic groups that predominantly spoke the state language had significantly lower rates of infant mortality. However, this trend disappears when income is added as a covariate. No other measures of discrimination or privilege were associated with infant mortality. Across all analyses, the wealth of the ethnic group was a significant predictor of infant mortality. Future studies should examine whether these trends persist in high-income countries, and whether the general lack of association of discrimination and privilege variables with infant mortality is influenced by how the variables were coded.
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Opioid use disorder (OUD) has been a growing problem in the United States since the start of the 20th century, but a new wave of the “Opioid Epidemic” began in the mid-1990s when the use of opioid analgesics became the…
Opioid use disorder (OUD) has been a growing problem in the United States since the start of the 20th century, but a new wave of the “Opioid Epidemic” began in the mid-1990s when the use of opioid analgesics became the premier method for treating acute pain. In response to the increasing rates of OUD, in 2002 the Federal Drug Administration (FDA) approved a treatment course known as medication-assisted treatment (MAT), which is a combination therapy that uses buprenorphine, a partial opioid analgesic, and behavioral therapy to treat OUD. However, the use of buprenorphine to treat OUD is relatively controversial and as a result, is not widespread in primary care settings. New Mexico is an area that has seen some of the highest rates of OUD, with patient populations that suffer from the disorder prevalent in both rural and urban areas. This paper seeks to identify the barriers that urban and rural medical providers face when it comes to successfully establishing medication-assisted treatment options for opioid use disorder patients. To answer this question, 20 medical practitioners across the state of New Mexico shared their opinions on the subject in semi-structured interviews. A qualitative analysis of the information gathered from these interviews concluded that there are 3 main barriers (patient-related, provider-related, and medical system-related) that contribute to the inconsistent spread of MAT services in New Mexico. These barriers are relatively consistent across both rural and urban communities, however, in specific instances, they manifest differently. The preliminary findings from this study highlight multiple methods for reducing barriers to the implementation of MAT including starting provider education about OUD and MAT earlier (i.e. in residency) and improving the infrastructure and support systems available to vulnerable patient groups (including those in rural areas and homeless individuals).
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This paper explores the impacts of dam-induced displacement on the health of populations. By the start of the 21st century, an estimated 40-80 million people worldwide were forced to resettle due to the construction of large dams. The process of…
This paper explores the impacts of dam-induced displacement on the health of populations. By the start of the 21st century, an estimated 40-80 million people worldwide were forced to resettle due to the construction of large dams. The process of displacement and resettlement is connected to numerous social impacts on communities such as decreases in household income, natural resources, and social connectivity, but less seems to be known about specific health impacts. Analyzing literature in a formal review allowed for increased understanding about what information already exists in published research regarding the connections between dams, displacement, and health. Some negative health impacts as a result of forced displacement were identified, including increases in infectious disease transmission, depression, and mortality rates as well as losses of food and water sources. However, the small amount of cases found in the literature review when compared to the massive scale of dam development worldwide indicates a gap in knowledge in the dam industry and research field specifically about the health of the vast majority of populations forcibly displaced by dams. Health impacts must be considered and systematically studied in dam projects involving displacement to fully understand the needs of resettled populations and move towards equitable processes in development projects worldwide.
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