General Public Health
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/21737
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Browsing General Public Health by Author "Fulda, Kimberly"
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Item Geographic Disparity in Health Insurance(2015-03) Master, Hiral; Fulda, KimberlyPurpose: The purpose of this study is to identify factors associated with having adequate health insurance for children with special health care needs (CSHCN) differ by geographic region. Methods: The proposed analysis was conducted on the 2009-2010 databases of the NS-CSHCN using SAS which accounted for complex survey weighting and sampling design. The analysis included examining the overall distributions of variables using means and frequencies. Distributions of variables were examined for those who had any kind of health insurance and those who did not. Differences in whether having health insurance or not by region were analyzed using chi-square test and logistic regressions were performed. Odds ratios and 95% CIs were examined. Results: Out of total population, 10110 were insured for entire year while 919 were insured at some point during the year. Education level, family structure and financial condition of the family have significant effect on the insurance status of CSHCN. Based on chi square analysis, education level of the household had significant effect on insurance status of CSHCN in northeast and south and west region while family structure, number of missed school days of CSHCN, Family financial burden was significant for all region. Odds ratio obtained from logistic regression where individuals who were uninsured was used as reference. Thus, odds of having insurance were higher in individuals with higher education in all the regions. Odds of CSHCN being insured was significantly lesser in northeast, south for Hispanics while was significantly higher in west for blacks compared to white non- Hispanics. Odds of CSHCN being insured was significantly lesser in midwest, south in family consisted of only mother and was significantly lesser in northeast in family consisted of parent stepfamily when compared to either biological or adopted parents. Odds of CSHCN being insured was significantly higher in midwest if child’s problems never affected ability to do compared to those where their ability was usually affected. Odds of CSHCN being insured was significantly higher in midwest, northeast, south in family with no financial burden compared to who had financial burden. Conclusion: Policies should be directed to increase the educational awareness, focus on Hispanic groups for insurance, expand the insurance plans that will accommodate the families having financial burden.Item Health Behavior Changes Among First Year Medical Students a Pre- and Post- Analysis(2015-03) Kalra, Kyle; Sori, Ermias; Castillo, Marisa; Stone, Chelsea; Trammell, Randall; Fulda, Kimberly; Smith, Michael L.Background: Entering medical students begin their journey into medicine with the desire of being a healthcare professional whose healthy habits serve as a model for their patients. In truth, the high stress of the academic environment of medical training makes students vulnerable to poor health behaviors. Research has shown that there is a correlation between high stress environments and poor health behaviors. This study is a follow-up to that research. Hypothesis: We hypothesized that first year medical students consumption of energy drinks is associated with less positive health behaviors upon reassessment during medical school. Methods: The study involved the administration via Qualtrics of two surveys to the Texas College of Osteopathic Medicine Class of 2018. The pre-survey, was distributed during the 3rd week of class which was completed by 135 students when there were no impending exams. The participation in the survey was voluntary, and the subjects were recruited by the following methods: announcement in class, announcement on social media, and announcement via email to the Class of 2018. The survey was re-administered during the last 2 weeks of the semester, and it was completed by 99 students. Data analyses of the two surveys only included the students who completed both surveys (n=49). To compare pre- and post- variables of typical hours per sleep in a 24-hour day, days per week exercised (≤2 days or ≥3 days), changes in reported GI symptoms, and whether the subject consumed energy drinks in the past month (yes or no), the nonparametric McNemar’s test was used. An alpha level of less than .05 was considered significant. The Perceived Stress Scale between pre- and post-measurement surveys were compared with a dependent sample T-test. Results: 63% of the students were male and 37% were females ranging from ages 22-41 with a mean age of 25.3+3.6. General trends included an increase in energy drink consumption, reported headaches/palpitations and GI symptoms, and decrease in sleep hours per day. Statistically, there was a significant increase in energy drink consumption (from 26.5% at pre-test to 42.9%, p=0.008), and an increase in gastrointestinal symptoms (from 16.3% at pre-test to 34.7%, p=0.012). Conclusion: An increase in energy drink consumption and gastrointestinal symptoms supports our hypothesis that first year medical students consumption of energy drinks is associated with less positive health behaviors.