Urban Medicine and Health Care Disparities Scholarly Concentration works

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    The Impacts of the COVID-19 Pandemic on Youth Violence: Insights from Professional Key Informants
    (University of Minnesota Libraries Publishing, 2023-06-14) Aldallal, Mohamed; Omari, Deeb; Muvuka, Baraka; Ryan, Elizabeth R.
    Introduction: The COVID-19 pandemic has had drastic effects on youth violence protective and risk factors by isolating many at risk youth. While youth violence is a growing global health problem, there are limited studies exploring youth violence during the COVID-19 pandemic. Lake County in Northwest Indiana presents an opportunity for youth violence research and prevention given its socio-demographic context and its limited youth violence data. This study explored the COVID-19 pandemic’s impacts on youth violence and its risk and protective factors from the perspectives of professional key informants in Lake County, Indiana. Methods: This study utilized a descriptive qualitative design inspired by the constructivist grounded theory. We recruited professional key informants through purposive and snowball sampling. Data collection consisted of virtual semi-structured key informant interviews that were audio-recorded and transcribed verbatim. Data analysis consisted of inductive thematic analysis with open line-by-line coding, focused coding in Dedoose, and theme identification. Results: A total of six key informants were interviewed, representing diverse youth-serving occupations. These interviews revealed five general themes portraying the impacts of the COVID-19 pandemic on youth violence: mental health impacts on youth; socialization of youth; youth as victims, perpetrators, or witnesses; shifting of learning environments; and parent-child relationships. Key informants observed an increase in less visible types of youth violence, underlying pandemic-induced or-exacerbated youth mental and behavioral health issues, strained parent-child relationships, and the educational marginalization of youth in underserved communities during online learning transitions. Conclusions: This study highlighted underserved youth’s vulnerability to the COVID-19 pandemic’s adverse impacts on youth violence experiences, risk, and protective factors. Our findings support the need to prioritize youth during and after crises, to utilize innovative strategies to better reach underserved youth, and to develop ethical and integrated youth violence data systems. Future research should explore youth’s lived experiences with violence throughout the pandemic.
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    “Vets Restoring Vets”: An Innovative Peer Support Program
    (University of Minnesota Libraries Publishing, 2023-06-14) Stewart, Cody C.; Muvuka, Baraka; Hutwagner, Will; McCollum, Hunter; Dyer, William K.; Ryan, Elizabeth R.
    Introduction: Military Veterans disproportionately experience mental health issues due to unique service-related experiences. Peer and social support interventions have shown promise in improving Veterans’ mental health alongside clinical mental health interventions yet there are limited studies on Veteran-designed and Veteran–led peer or social support interventions. This study explored the perceptions and experiences of Veterans participating in an innovative Veteran-designed and Veteran-led peer and social support program. It was a preliminary study in a long-term Community Based Participatory Research partnership between Indiana University School of Medicine-Northwest regional campus and Operation Combat Bikesaver (OCB). Methods : This mixed methods study utilized a limited dataset from pre-and-post-session surveys collected by OCB between September 2019 and August 2021. We examined pre-post differences in participants’ self-rated “feelings” (i.e., emotional state) with the following independent variables through Linear Mixed Models in SPSS: OCB location, OCB event attended, day of the week, time of day, duration of attendance, frequency of attendance, and social assistance. We analyzed participants’ qualitative OCB experiences using inductive thematic analysis in Dedoose.  This study was reviewed and exempted by The Indiana University Human Research Protection Program (Protocol # 12499) on August 16, 2021. Results: A total of 128 participants completed pre-post surveys for 746 OCB sessions. There was a statistically significant pre-post session increase in participants’ feelings (mean=34.6; SD=21.7; p<0.001), with increasing effects by duration (p=0.002) in an OCB session. There was no linear trend in individual pre-and-post session changes in feelings over time. The following themes describe participants’ OCB experiences: sense of purpose and meaning, regaining comradery and brotherhood, “Vets restoring Vets,” satisfaction with OCB structure and processes, and experiencing OCB impacts. Conclusions: Convening Veterans with shared experiences around innovative and supportive social activities may develop their perceived sense of purpose, belonging, and mutual support and produce improvements in perceived mental health. Future research within this community-regional medical campus research partnership will explore jointly determined research questions to follow-up on the main findings and limitations of the current study.
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    Association of Socio-Demographic Factors, Social Determinants of Health and Weekly Physical Activity in an Urban Hospital in Northwest Indiana
    (2023-07) Gad, Wael; Chandler, Brianna; Jones, Brendan; Mangum, Joshua
    Background: Engaging in regular physical activity has been proven to have beneficial health effects such as preventing chronic diseases and improving mental health. Recent studies have demonstrated correlations between socio-demographic factors and physical activity levels. This study determined the associations between socio-demographic factors, social determinants of health and the amount of weekly physical activity in patients occupying an urban underserved area. Methods: This study retrospectively analyzed a dataset generated by St. Mary Medical Center from EPIC™ with demographic characteristics and physical activity levels partitioned by time per week for adult inpatient visits from January 2021 to March 2023. Patients were stratified into physical activity levels based upon published guidelines: inactive (no physical activity), insufficiently active (<150 minutes per week) or sufficiently active (≥150 minutes per week). Data analysis was conducted in SPSS 28.0 using tests of association including Kruskal Wallis H and multivariate ordinal regression model. This study was exempted by Indiana University Human Research Protection Program (IRB # 14040). Results: The sample of individuals from the dataset who answered physical activity questions was comprised of 1498 patients. There was a statistically significant difference in physical activity level by age group (p<0.001), sex (p<0.05), insurance category (p<0.001), and social connections risk score (p<0.001); with race (p=0.057) and language (p=0.054) approaching significance. Multivariate analysis showed that age was the only significant factor when accounting for all variables, with higher age groups reporting lower proportions of physically active individuals. Conclusion: Determining how socio-demographic factors influence physical activity levels will direct efforts to form and implement new interventions in the Northwest Indiana urban area and support community health initiatives. This data makes it possible to inform practitioners of the demographics that are at risk of being insufficiently active and having them direct those patients to programs in place to help bridge the lapse.
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    Analysis of COVID-19 Case Demographics and Disease Outcomes in Gary, Indiana
    (MDPI, 2023-09-07) Sabir, Maryam; Al-Tarshan, Yazan; Snapp, Cameron; Brown, Martin; Walker, Roland; Han, Amy; Kostrominova, Tatiana
    Background: The COVID-19 pandemic further exposed the prevalence of existing health disparities in Black communities in the U.S. The current study evaluates COVID-19 data collected in Gary, Indiana, from June 2020 to June 2021. We hypothesized that the number of COVID-19 cases, hospitalizations, and deaths were influenced by race and income. Methods: In collaboration with the Gary Health Department (GHD), we analyzed demographic data on COVID-19-positive cases. Results: Compared to Gary's non-Black population, age- and population-adjusted rates of hospitalizations and deaths in the Black population were 3-fold (p < 0.0001) and 2-fold (p < 0.05) higher, respectively. This is despite a higher infection rate (p < 0.0001) in the non-Black population. The median household income of a zip code was negatively correlated with COVID-19 hospitalizations (R2 = 0.6345, p = 0.03), but did not correlate with infections and deaths. Conclusions: The current study demonstrates clear health disparities of income and race in the context of COVID-19-related infections and outcomes in the city of Gary. Indiana University School of Medicine Northwest and GHD officials can collaborate to utilize these data for the reallocation of resources and health education efforts in Gary's highly populated, low-income, and predominantly Black neighborhoods. It should also prompt further investigation into national health resource allocation.