Browsing by Subject "Public Health"
Now showing 1 - 20 of 246
- Results Per Page
- Sort Options
Item 2011 Bibliography of Publications(2012-06-13) Mason, Tim; Lindsey, MarylouiseItem A Comparative Breast Cancer Study: Stage & Mortality in El Paso County's non-Hispanic white and Hispanic population(2003-05-01) Aravind, Raven; Russel HovermanAravind, Raven, A Comparative Breast Cancer Study: Stage & Mortality in El PasoCounty's non-Hispanic white and Hispanic population, 1990-2000. Master of Public Health (Epidemiology), May 2003, 17pp., 1 table, 3 figures, bibliography, 43 titles. This retrospective breast cancer study compares the stage of breast cancer diagnosis and mortality between Hispanic (HS) and non-Hispanic white women (NHW). The study includes 874 Hispanic women and 802 non-Hispanic white women diagnosed with breast cancer between January 1990 and December 2000 at the El Paso Cancer Treatment Center, El Paso Texas. The objectives of the study were: 1) to determine if this population of Hispanic women is being diagnosed at a later stage of breast cancer 2) to ascertain the relative survival of non-Hispanic white and Hispanic women 3) to verify if Hispanic women were being diagnosed at a younger age; and 4) to examine tumor size at diagnosis to determine if there is a need for more assertive screening measures in this population of women.Item A Comparison of Medicare Prospective Payment Systems on P.T.C.A. and Stent Outcomes in an Urban Hospital(2001-05-01) Compton, Ben H.; Doug A. Mains; P. E. HilsenrathCompton, Ben H., A Comparison of Medicare Prospective Systems on P.T.C.A. and STENT Outcomes in an Urban Hospital. Master of Public Health (Health Services Administration), May 2001, 57 pp., 10 tables, 1 graph, bibliography, 51 titles. To determine if differences in outcomes exist between Medicare prospective payment systems when doing percutaneous transluminal coronary angioplasty (PTCA) or STENT surgeries. From January 1999 and December 2000, 146 Medicare patients were identified with 35 being outpatient and 111 inpatient. A separate group of 1-day inpatients was used as a comparison for the outpatient group. Results from the comparison reveal that in the three groups, the majority of patients were white, non-Hispanic males who were about 70 years of age. The 1-day inpatient group had the highest profit of all three with about $3,000 while the inpatient group broke even. The outpatient group had no in-hospital deaths or complications while all three had equal amounts of comorbidities. The conclusion is that losses will probably occur if PTCA and STENTs are done outpatient. Possible solutions are moving to an inpatient setting or determining which costs can be reduced in the outpatient setting.Item A Cost Analysis of Tuberculosis and its Prevention in Tarrant County, Texas(2007-05-01) Miller, Thaddeus L.; Scott McNabb; Peter Hilsenrath; Jotam PasipanodyaMiller, Thaddeus L. A Cost Analysis of Tuberculosis and its Prevention in Tarrant County, Texas. Doctor of Public Health (Health Management and Policy), May 2007, 232 pp., 29 tables, 2 illustrations, bibliography, 274 titles. Tuberculosis cost has been incompletely described as the cost arising from acute illness and treatment. The societal cost of tuberculosis arises from infection, suspicion of infection, acute and preventive responses, the sequalae of illness (including acute morbidity, drug induced hepatitis, mortality, and disability), and the compounding effects of transmission. This societal cost in unknown however the variable portion of this cost is equivalent to the savings made possible by averting tuberculosis, This study measured the societal cost of tuberculosis in Tarrant County, Texas, for the year 2002. Societal costs were estimated as the sum of known or estimated expenditures and health losses related to tuberculosis and discounted at 3%. Current and future costs will accrue to an estimated net $33.9 2002 USD million for the year 2002 in Tarrant County, Texas. An average of 1.4 QALYs net of 3% social discount were lost per incident case. The greatest burdens of tuberculosis, when analyzed by either cost or health quality, can be averted only by case prevention. Forty-three and 44% of societal cost was generate by secondary transmission and chronic impairment associated with pulmonary tuberculosis. Neither factor is routinely considered in discussions of tuberculosis cost. Acute treatment, hospitalization and direct medical care account for only 2.4% of societal cost. Any intervention that prevents one tuberculosis case will prevent at least a net $295,182 (2002 USD) and individual health quality losses averaging 1.4 net QALYs.Item A Critical Review of the One Hour and the Eight Hour Standards for Ozone with an Overview of the Proceedings that Led to the Implementation of The New Standard for Ozone(2004-05-01) Palla, Amruth A.Palla, Amruth R., A Critical Review of the One Hour and the Eight Hour Standards for Ozone with an Overview of the Proceedings that Led to the Implementation of The New Standard for Ozone; Master of Public Health (Environmental and Occupational Health), May 2004, 58 pp, 3 tables, 2 illustrations, 35 titles. With the increasing concern for human health and the recognition of the major role played by environment in the multi-factorial disease etiology, the various parameters established for maintaining the environmental constituents in the proportions desired for achieving a normal health status are taking an important position in the present day world. In 1997, during its review process the EPA found the exiting one-hour standards, for ozone to be insufficient to achieve the health friendly concentrations, and therefore proposed a new eight hour standard for this pollutant. The new standards proposed by the EPA were challenged by various other organizations and several proceedings have happened since then. The purpose of my thesis is to do a critical analysis of the advantages and the drawbacks of the two standards and to do an overview of the proceedings that have led to the implementation of the new standards.Item A Descriptive Analysis of Adolescent Pregnancy and Birth Outcomes in Tarrant County, Texas(1999-08-01) Omoloh, Wilfred J.; Gilbert Ramirez; Antonio ReneOmoloh, Wilfred, J., A Descriptive Analysis of Adolescent Pregnancy and Birth Outcomes in Tarrant County, Texas. Master of Public Health, August 14, 1999, 110 pp, 19 tables, reference list, 68 titles. A descriptive study of adolescent pregnancy and birth outcomes in Tarrant county, Texas between 1991 and 1995 was conducted to evaluate the effect of maternal age on infant birthweight and mortality among White, African American, and Hispanic adolescent mothers nineteen years and older. The age of the mother was not a significant predictor of infant birthweight and mortality, but mother’s ethnicity, weight gain, and gestational age were found to be strong predictors of infant birthweight and mortality. The Hispanic ethnic group came out much better than White and Black mothers but no difference between White and Black mothers regarding birthweight was found. The results from the data analysis demonstrated that teenage pregnancy may not be a serious problem in Tarrant County, Texas as was previously though.Item A Faith Based Approached to Cervical Cancer Screening in Latina and Vietnamese Women: Outcome Analysis(2005-05-01) Perez, Robin Z.; Gonzalez, Adela; Lykens, Kristine; Galvan, RobertPerez, Robin Z., A Faith Based Approach to Cervical Cancer Screening in Latina and Vietnamese Women: Outcome Analysis. Master of Public Health (Health Management and Policy), May 2005, 34pp., 4 tables, 3 illustrations, bibliography, 6 titles. A secondary data analysis study of the cervical cancer screening collaboration hosted by the St. Joseph Health Care Trust through six area Catholic churches was conducted to describe a program that has been recognized as a best practice for serving minority communities in Texas. The objectives of the study were to list demographic characteristics associated with the screening participants; to review culturally sensitive programming and approaches to serving both Latina and Vietnamese women. The results of this study will assist in implementation of similar interventions. The conclusions demonstrate that interventions that are tailored to specific communities may influence program participants and increase screening turnout.Item A Health Assessment of Refugee Children From Former Yugoslovia in Tarrant County(2001-12-01) Podgore, John K.; Marshall, Murial; Rene, Antonio; Sandhu, RaghbirThis study was conducted to provide an assessment of the health status and health care utilization of children from former Yugoslavia living in Tarrant County. Additionally an assessment of barriers and problems encountered by these families in obtaining health care for their children was presented. One hundred thirteen households of refugee families arriving in Tarrant County from 1998 through 2000 participated by answering a 79 item health information questionnaire. The results revealed that most of the refugee families had no regular health care provider to assure continuity of medical care. Lack of access to dental care and inappropriate utilization of hospital emergency facilities were also identified as problems. Insufficient understanding of health insurance issues and inability to access health information were additional problems. Addressing these problems by local and state health care agencies may help to improve health care delivery for these and future refugee children.Item A Look at Diabetes Mellitus and the Effects of a Study Drug on Diabetic Nephropathy(2002-08-01) Schlueter, Cynthia K.; Debbie Lewis; Clifton Cage; Rustin ReevesDuring my internship, I assisted with a twenty-four week, phase 2, double blinded, placebo controlled trial for a drug being developed to slow, if not prevent, the development of ESRD from overt neuropathy in patients with both type 1 and type 2 diabetes. This drug is a naturally occurring component of vitamin B6 and is an AGE-inhibitor. The AGE-inhibitory effect of the study drug was discovered by isolating Amadori products in the pathway to AGE formation. Once the intermediates were isolated, the sponsor’s scientists searched for compounds that could specifically block the conversion of these Amadori products into AGEs. The study drug was found to be a strong inhibitor of this pathway. In comparison, the common AGE inhibitor, aminoguanidine was found to be ineffective in blocking the post-Amadori foundation AGEs. Therefore, it must block AGE formation at one of the less clinically relevant pathways, and should be less effective in treating nephropathy according to the sponsor’s scientists. This study included type 1 and type 2 patients with clinically diagnosed diabetic retinopathy and a urinary albumin excretion rate (UAE) of greater than 300 mg/24h. Other inclusion and exclusion criteria were applied for the safety of the subjects and greater viability of the data.Item A Mixed Methods Approach to the Definition of Family Health Promotion Practices for Mexican Sonoran Mothers(2006-12-01) Montiel-Carbajal, Maria Martha; Sue LurieMontiel-Carbajal, Maria M., A Mixed Methods Approach to the Definition of Family Health Promotion Practices for Mexican Sonoran Mothers. Doctor of Public Health (Social and Behavioral Sciences), December 2006, 143 pp., 14 tables, 1 illustration, bibliography, 55 titles. The purpose of this research was to study the family health promotion practices of a sample of Mexican mothers living in the state of Sonora Mexico through a concurrent mixed method approach that included (1) a qualitative component with face to face and in-depth interviews, investigator observations, and analysis of content; (2) a quantitative component consisting of statistical analysis of data from selected selections of the National Survey for the Evaluation of Health Services 2002-2003. For the qualitative component 15 mothers, with mean age of 40 years, mean years of education of 10 years, living with their families were selected to form a purposive sample, and assigned to one of three groups: married working mothers, non-married working mothers, or married non-working mothers. The qualitative component was naturalistic and descriptive using semi-structured interviews with the mothers, and individual questionnaires to collect demographic and housing information. The quantitative component used the survey responses provided by the database of the National Survey for the Evaluation of Health Services 2002-2003, from 404 female adults age 18 and older, living in the urban zone of Sonora. The qualitative component showed that mothers conceptualize the health status of the family as a priority. The specific practices they use depend on the set of external resources and internal strengths of the family in order to overcome the physical, environmental, relational, or economic barriers they found to the promotion of health practices. The participants also reported being unsatisfied with the access and quality of the social health care system. The data from the quantitative component showed that Mexican Sonoran women living in the urban area reported having good health and felt satisfied with their health status; their satisfaction with the social health care system was fair. The group of non-married working mothers was detected to be more at risk for cardiovascular diseases due to a greater proportion of smokers and drinking paired with low amount of exercise. The results provided valuable information to formulate health promotion programs and future policies to be implemented with the target population.Item A Path Analysis of Body Mass Index, Body Image, and Unhealthy Dietary Behavior as Contributors to Suicidal Behavior in Female Adolescents(2004-05-01) Rorie, Michele Taylor; Balcazar, Hector; Lurie, Sue; ReneRorie, Michele Taylor, A Path Analysis of Body Mass Index, Body Image and Unhealthy Dietary Behavior as Contributors to Suicidal Behavior in Female Adolescents. Doctor of Public Health (Social and Behavioral Sciences), May 2004, 120 pp., 17 tables, 6 illustrations, references, 106 titles. Objectives- This study examined the pattern and magnitude of relationships between body mass index, body image, unhealthy dietary behaviors, and suicidal behavior among a sample of White, African American, and Hispanic adolescent females. Methods-This study employed secondary analysis of the 2001 Youth Risk Behavior Survey public-use dataset to provide quantitative estimates of the causal connections between body mass index, body image, dietary behaviors, and suicidal behavior. A sample (n=5,218) of White, African American, and Hispanic adolescent females aged 14-17 were selected for analysis. This cross-sectional study involved public high school students in grades 9-12. The variables/constructs BMI, Body Image, and Dietary Behavior were examined using a path analysis to determine the magnitude of effects on Suicidal Behavior in adolescent females. Results- The path coefficients were obtained for the path model using multiple regression equations, which took direct and indirect effects into account. The Female Adolescent Model (n= 5,218) yielded an R2 = .27. This meant that 27% of the variance in Suicidal Behavior was explained by BMI, Body Image, and Dietary Behavior. When race/ethnicity was analyzed separately, different values were observed. The White Adolescent Female Model (n=2,768) had an R2=.32. The Black or African American Model (n=1,206) had an R2=.23, and the Hispanic or Latino Model (n=1,224) had an R2=.27. Conclusion- The basic state of what is an actual fact about a person (i.e. weight) does not cause an increase of harmful or destructive behavior. The person’s beliefs drive intention as it was demonstrated through the immergence of significant indirect pathways from BMI through Body Image and Dietary Behavior to Suicidal Behavior. The path analyses for the three racial groups suggest that there are varying degrees of influence among BMI, Body Image, Dietary Behaviors, and Suicidal Behaviors.Item A Review of Dendritic Cell Vaccines in Cancer Treatment and a Managerial Focus on Issues Related to Subject Recruitment(2006-12-01) McFarlin, Tory; Arredondo, LaChelle; Gwirtz, Patricia A.; Oglesby, MichaelMcFarlin, Tory. A Review of Dendritic Cell Vaccines in Cancer Treatment and a Managerial Focus on Issues Related to Subject Recruitment. Master of Science (Clinical Research Management), December 2006, 97 pp., 5 tables, bibliography, 24 titles. Melanoma is form of skin cancer that can become deadly if the cancer progresses to a stage of metastasis. Five year survival rates as low as 10% may be noted in such patients. Decarbazine and Proleukin have been approved by the FDA for the treatment of metastatic melanoma; however both have response rates of approximately 20% or less. New treatment modalities including dendritic cell (DC) vaccines are currently being tested for treating metastatic melanoma with greater safety and efficacy profiles. DC vaccines are made by obtaining a subject’s DCs, priming them with melanoma antigen ex vivo and then injecting them into the patient to initiate an immune response against melanoma tumor cells in vivo. Investigational new treatments such has the DC vaccine must first be tested in clinical trials on research subjects. Subject enrollment issues regarding such a trial can cause delays in advances of the treatment. As an intern with a DC vaccine clinical trial, the author assisted in screening 45 patients and observed many hindrances involving enrollment of subjects. Such hindrances include: low rates of study personnel retention, small patient pools, and competing trials. Recommendations to improve enrollment include: more effective advertisement strategies and increased patient education.Item A Review of the Literature on Faith-Based Organization's HIV/AIDs Care and Prevention Efforts in Sub-Saharan Africa(2005-05-01) Rojas, Zeida G.; Lurie, Sue; Urrutia-Rojas, XimenaRojas, Zeida G., A Review of the Literature on Faith-Based Organization’s HIV/AIDS Care and Prevention in Sub-Saharan Africa. Master of Public Health (Community Health), May 2005, 83 pp., 20 diagrams, bibliography, 10 titles. The thesis assesses the role of faith-based organizations (FBOs) involved in HIV/AIDS related care and prevention activities in Sub-Saharan Africa. Do FBOs have the ability to address the multi-faceted syndrome that HIV/AIDS brings to an individual, their family and community? Can FBOs be effective partners to carry out prevention and care initiatives? Faith-based organizations are generally overlooked as potential partners and leaders in the fight against HIV/AIDS. FBOs are often the only genuine nongovernmental organizations in many rural parts of poor countries, or at a minimum, they are the strongest and most influential. Due to their organizational networks, FBOs are able to mobilize people and resources, and to reach rural or isolated areas. Evidence of current FBO efforts demonstrates that FBOs have the ability to address the multifaceted effects of HIV/AIDS and can become indispensable partners for government health agencies and NGOs.Item A Six-Year Analysis of the Distribution of Time to Death Among Colorectal Cancer Patients in the State of Texas(2000-05-01) Williams, Vanessa P.; Antonio A. Rene; Thomas J. Fairchild; Sally BlakleyWilliams, Vanessa P., A Six-Year Analysis of the Distribution of Time to Death Among Colorectal Cancer Patients in the State of Texas. Master of Public Health (Epidemiology), May 2000, 55 pp., 11 tables, 9 figures, references, 52 titles. The cancer experience of Texans differs substantially by race/ethnicity. Among Caucasian, African American, and Hispanic men and women, colon cancer is either the second or third leading type of cancers among Texans. The distribution of time to death over a six-year period were assessed from a cohort of African American, Hispanic, and Caucasian men and women diagnosed with colon cancer in 1992. The purpose of this study is to determine if there is a difference in the overall death time distribution and tumor histology among African Americans, Hispanics, and Caucasian men and women who were diagnosed with colon cancer in 1992 in the state of Texas. Analysis results indicated that Hispanic females (65.59%) and Caucasian males (65.52%) had higher survival times among the race/ethnic groups. African American males (53.85%) and females (56.40%) experienced lower survival time for the cohort. For overall distribution of time to death among deceased subjects, African American males and Hispanic females experienced the lowest distribution times among the subjects. The overall distribution of time to death for all histology types were the same for each type.Item A Study of Disparities in the Receipt of Anti-Retroviral Drugs, Health Status, and Insurance Coverage Among a Sample of HIV-Positive Adults(2006-12-01) Wittenmyer, Brian F.; Kristine Lykens; Jeffrey Talbert; Tim StrawdermanWittenmyer, Brian F., A Study of Disparities in the Receipt of Anti-Retroviral Drugs, Health Status, and Insurance Coverage among a Sample of HIV-Positive Adults. Master of Public Health (Health Management and Policy), December 2006, 88 pp., 8 tables, references, 32 titles. Anti-retroviral medications (ARV) are effective at treating HIV/AIDS. Medicare, Medicaid, and ADAP are public programs that supply ARVs to needy patients in the U.S. Studies have documented dispartities in AIDS incidence/prevalence, insurance, and ARV-use. The study described demographic, clinical, and insurance characteristics of a sample of HIV+ persons. The study explored relationships between AIDS diagnosis, health status, and ARV-receipt and demographic, insurance, and clinical variables. Disparities in ARV-receipt, AIDS diagnosis, and health-status were found for gender, age, race, geographic region, and SES. Policy recommendations included: shortening the disability waiting-period for Medicare-eligibility, and relaxing Medicaid’s income-eligibility requirements.Item A Study of Hepatitis A Seropositivity in Dallas County, 1998-1999(2001-05-01) Fulda, Kimberly G.; Antonio Rene; John Licciardone; Sally BlakelyFulda, Kimberly G., A Study of Hepatitis A Seropositivity in Dallas County, 1998 – 1999. Master of Public Health (Epidemiology), May 2001, 39 pp., 4 tables, 9 figures, references, 28 titles. The purpose of this study was to determine incidence rates per 100,000 population of hepatits A (HAV) in Dallas County for 1998 and 1999. Individuals who tested seropositive for hepatitis A between January 1, 1998 and December 31, 1999 were included. The variables of interest were sex, race, age, Zone Improvement Plan (ZIP code), and date of occurrence. Rates for 1998 were 1.9 times higher in Dallas County than the United States. In 1999, the Dallas County rate increased over 1.6 times. Rates were significantly higher in males for both years, and rates were highest among Hispanics and lowest among Blacks. Differences in age distribution varied between years by increasing in ages 50 and older in 1999. Several ZIP codes exceeded rates of 20 per 100,000 for both 1998 and 1999. Dallas County met the Advisory Committee on Immunization Practices guidelines for routine vaccination of all children in 1999.Item A Study of Pesticide Safety and Health Perceptions Among Tarrant County Pesticide Applicators(2001-05-01) Martinez, Robert A.; Terrance B. Gratton; Claudia S. Coggin; Sam AtkinsonPesticides have become an important part of our lives. We rely on them to help protect our crops from pest; they rid our homes of unwanted pests and help us make our lawns and public parks beautiful. Pesticides are also important to public health. They are a major source of vector control and help stop the spread of vector-borne disease. Even though we used them in our everyday lives, it is important to remember that pesticides are poisons, and that great care must be taken to ensure the safety of the public and safety of those who work with pesticides. This study looked at the safety knowledge and health perceptions among Tarrant County, Texas licensed applicators. Much research has been focused on the effects of pesticides on human health. Much of this research has been focus on the farmer applicator (Alavanja, 1999). This study focuses on applicators that work mostly in the urban areas of the County, as well as ranchers live in the County. These licensed urban applicators included those who work for city parks departments, golf courses, commercial applicators, lawn care service, pest control and some private ranchers. The Texas Pesticide Regulations require that a person may not use a restricted-use or state-limited use pesticides or herbicides unless licensed by the Texas Department of Agriculture (2000). Therefore the purpose of this study is to see if an association between health beliefs and pesticide safety knowledge exist. The reason it is important is because these people can have either a positive or negative impact on the safety of themselves and their crews. Acute pesticide poisoning is one of the biggest risks that applicators face. The state of Texas conducts an active surveillance of occupational-related pesticide poisonings. The Environmental Epidemiology and Toxicology Division at the Texas Department of Health (TDH) have had this system in place since 1985. TDH reported that 107 work related cases occurred during 1998, with 55 confirmed as occupational pesticide poisoning (1998). The most frequent symptoms reported were neuromuscular symptoms such as headaches, dizziness, confusion, irritability, and twitching muscles. Pyrethroids and pyrethins were the most commonly reported class of pesticides exposure (51%) followed by Organophosphates (25%), which are the most widely used form of insecticides, as well as herbicides and fungicides. Pesticide safety and the TDH surveillance system are two very important ways of informing pesticide applicators about the risk and what can be done to minimize that risk to themselves and their crew.Item A Study to Determine Improved Compliance of Biophosphonate Treatment in Subjects with Osteoporosis(2005-02-01) Enard, April T.; Gwirtz, Patricia A.; Jimenez-Williams, Cynthia; Rubin, BernardEnard, April T. A Study to Determine Improved Compliance of Bisphosphonate Treatment in Subjects with Osteoporosis. Master of Science, February 11, 2005. The ability of patients to adhere to treatment regimens is very poor and continues to impede optimal therapy of osteoporosis. The shortcomings in treating osteoporosis are: a) noncompliance and/or lack of continued persistence of therapy, b) efficacy of therapy on bone turnover marker levels and fracture prevalence, and c) tolerability of therapy to patients. Studies have shown that interventions such as education and awareness of bone mineral density promote patient usage compliance. The slightest improvement in compliance allows further understanding of accurate efficacy of medication therapy to fractures, bone marker levels, and overall improvement of bone mass. Increased compliance/persistence allows accurate comparison of bisphosphonates to one another for effectiveness on osteoporosis patients and allows improvement opportunity in treatment modalities that can positively influence the course of osteoporosis. This phase IV study targets compliancy/persistence in bisphosphonate therapy in treatment of osteoporosis.Item A Sun Awareness Pilot Project(2002-05-01) Franklin, Gillian A.; Claudia Coggin; Kristine A. Lykens; Doug A. MainsFranklin, Gillian A., A Sun Awareness Pilot Project. Masters of Public Health (Health Management and Policy), May 2002, 53 pp., 7 tables, bibliography, 48 titles. The most common cancer in the United States today is skin cancer; it is also the most preventable. At least 90% of all skin cancers is caused by sun exposure. Americans have a one in six lifetime risk of developing skin cancer and in Texas the rate is one in three. The purpose of this pilot project was to increase the level of sun protection knowledge and awareness in parents who brought their children in for a six-month immunization visit. The project was modeled after the Australian Cancer Council’s “Slip! Slop! Slap!” campaign. Data was collected from five pediatric clinics in this pretest/posttest design study. Multiple variables regarding demographics, skin type, knowledge, beliefs, sun-protective practices, and attitudes were included. Overall, parental sun protective knowledge and awareness increased. The information obtained from this pilot project may influence future public health decisions regarding education and prevention of skin cancers.Item Access to Care and Hospitalizations for Diabetes Complications Among Elderly Hispanics and African Americans in Texas(2005-08-01) Chaudhary, Prateek; Kristine Lykens; Julian Borejdo; Antonio A. ReneChaudhary, Prateek. Access to Care and Hospitalizations for Diabetes Complications Among Elderly Hispanics and African Americans in Texas. Master of Public Health, August 2005, 52 pp, 6 tables, bibliography. The mismanagement of diabetes care, due to disparities in access, deficiencies in health insurance, or poor quality of primary care, can lead to preventable microvascular complications which force diabetics to utilize hospital emergency departments (ED). This study uses 2002 hospital discharge data from the Texas Health Care Information Collection to determine whether diabetic and elderly (65+) African Americans and Hispanics from Texas counties with a low ratio of physicians per, 1,000 population (PPR) are more likely to be admitted through the ED with complications from diabetes. Findings indicate that while Hispanic ethnicity is significantly associated with ED use as a source of admission, diabetics from counties with higher PPR are more likely to be admitted through the ED for diabetes complications than diabetics from counties with a lower PPR.