Browsing by Subject "Urban"

Now showing 1 - 7 of 7
  • Thumbnail Image
    Item
    Barriers and facilitators to implementing an urban co-responding police-mental health team
    (Springer, 2018-11-22) Bailey, Katie; Paquet, Staci Rising; Ray, Bradley R.; Grommon, Eric; Lowder, Evan M.; Sightes, Emily; School of Public and Environmental Affairs
    BackgroundIn an effort to reduce the increasing number of persons with mental illness (PMI) experiencing incarceration, co-responding police-mental health teams are being utilized as a way to divert PMI from the criminal justice system. Co-response teams are typically an inter-agency collaboration between police and mental health professionals, and in some cases include emergency medical personnel. These teams are intended to facilitate emergency response by linking patients to mental health resources rather than the criminal justice system, thus reducing burdens on both the criminal justice systems as well as local healthcare systems. The current study examines the barriers and facilitators of successfully implementing the Mobile Crisis Assistance Team model, a first-responder co-response team consisting of police officers, mental health professionals, and paramedics. Through content analysis of qualitative focus groups with team members and interviews with program stakeholders, this study expands previous findings by identifying additional professional cultural barriers and facilitators to program implementation while also exploring the role of clear, systematic policies and guidelines in program success.ResultsFindings demonstrate the value of having both flexible and formal policies and procedures to help guide program implementation; ample community resources and treatment services in order to successfully refer clients to needed services; and streamlined communication among participating agencies and the local healthcare community. A significant barrier to successful program implementation is that of role conflict and stigma. Indeed, members of the co-response teams experienced difficulty transitioning into their new roles and reported negative feedback from other first responders as well as from within their own agency. Initial agency collaboration, information sharing between agencies, and team building were also identified as facilitators to program implementation.ConclusionThe current study provides a critical foundation for the implementation of first-responder police-mental health co-response teams. Cultural and systematic barriers to co-response team success should be understood prior to program creation and used to guide implementation. Furthermore, attention must be directed to cultivating community and professional support for co-response teams. Findings from this study can be used to guide future efforts to implement first-response co-response teams in order to positively engage PMI and divert PMI from the criminal justice system.
  • Thumbnail Image
    Item
    The Butler-Tarkington Neighborhood Association and the Fight Against Residential Segregation in Indianapolis
    (2021-07) Prebish, Lydia Anne; Morgan, Anita; Mullins, Paul; Robertson, Nancy
    The Butler-Tarkington Neighborhood Association (BTNA) is a community group organized in 1956 by a few concerned couples living in the Butler-Tarkington neighborhood on the north side of Indianapolis. These couples, both Black and white, witnessed a demographic change in their community as their white neighbors fled for the suburbs as the black population expanded. The BTNA, inspired to create an organization that would promote residential integration rather than continued segregation, worked to educate neighbors on the realities of integration, promote neighborhood conversation and comradery, and worked to influence the local and state governments on the impact of segregation that harmed their community. One of the first neighborhood organizations of its kind in the country, the BTNA still exists today, but little is known about their early history. This paper looks at the BTNA’s efforts to promote residential segregation in their community through activism, conversation, and legislative change. Additionally, this paper analyzes the BTNA success in its efforts to integrate the community during their first decade of existence.
  • Thumbnail Image
    Item
    Examining Rural-Urban Differences in Fatalism and Information Overload: Data from Twelve NCI-designated Cancer Centers
    (American Association for Cancer Research, 2022) Jensen, Jakob D.; Shannon, Jackilen; Iachan, Ronaldo; Deng, Yangyang; Kim, Sunny Jung; Demark-Wahnefried, Wendy; Faseru, Babalola; Paskett, Electra D.; Hu, Jinxiang; Vanderpool, Robin C.; Lazovich, DeAnn; Mendoza, Jason A.; Shete, Sanjay; Robertson, Linda B.; Balkrishnan, Rajesh; Briant, Katherine J.; Haaland, Benjamin; Haggstrom, David A.; Rural Workgroup of the Population Health Assessment in Cancer Center Catchment Areas Consortium; Medicine, School of Medicine
    Background: Rural populations experience a disproportionate cancer burden relative to urban populations. One possibility is that rural populations are more likely to hold counterproductive cancer beliefs such as fatalism and information overload that undermine prevention and screening behaviors. Methods: Between 2016 and 2020, 12 U.S. cancer centers surveyed adults in their service areas using online and in-person survey instruments. Participants (N = 10,362) were designated as rural (n = 3,821) or urban (n = 6,541). All participants were 18 and older (M = 56.97, SD = 16.55), predominately non-Hispanic White (81%), and female (57%). Participants completed three items measuring cancer fatalism ("It seems like everything causes cancer," "There's not much you can do to lower your chances of getting cancer," and "When I think about cancer, I automatically think about death") and one item measuring cancer information overload ("There are so many different recommendations about preventing cancer, it's hard to know which ones to follow"). Results: Compared with urban residents, rural residents were more likely to believe that (i) everything causes cancer (OR = 1.29; 95% CI, 1.17-1.43); (ii) prevention is not possible (OR = 1.34; 95% CI, 1.19-1.51); and (iii) there are too many different recommendations about cancer prevention (OR = 1.26; 95% CI, 1.13-1.41), and cancer is always fatal (OR = 1.21; 95% CI, 1.11-1.33). Conclusions: Compared with their urban counterparts, rural populations exhibited higher levels of cancer fatalism and cancer information overload. Impact: Future interventions targeting rural populations should account for higher levels of fatalism and information overload.
  • Thumbnail Image
    Item
    Geochemical legacies and the future health of cities: A tale of two neurotoxins in urban soils
    (University of California Press, 2015) Filippelli, Gabriel M.; Risch, Martin; Laidlaw, Mark A. S.; Nichols, Deborah E.; Crewe, Julie; Earth and Environmental Sciences, School of Science
    The past and future of cities are inextricably linked, a linkage that can be seen clearly in the long-term impacts of urban geochemical legacies. As loci of population as well as the means of employment and industry to support these populations, cities have a long history of co-locating contaminating practices and people, sometimes with negative implications for human health. Working at the intersection between environmental processes, communities, and human health is critical to grapple with environmental legacies and to support healthy, sustainable, and growing urban populations. An emerging area of environmental health research is to understand the impacts of chronic exposures and exposure mixtures—these impacts are poorly studied, yet may pose a significant threat to population health. Acute exposure to lead (Pb), a powerful neurotoxin to which children are particularly susceptible, has largely been eliminated in the U.S. and other countries through policy-based restrictions on leaded gasoline and lead-based paints. But the legacy of these sources remains in the form of surface soil Pb contamination, a common problem in cities and one that has only recently emerged as a widespread chronic exposure mechanism in cities. Some urban soils are also contaminated with another neurotoxin, mercury (Hg). The greatest human exposure to Hg is through fish consumption, so eating fish caught in urban areas presents risks for toxic Hg exposure. The potential double impact of chronic exposure to these two neurotoxins is pronounced in cities. Overall, there is a paradigmatic shift from reaction to and remediation of acute exposures towards a more nuanced understanding of the dynamic cycling of persistent environmental contaminants with resultant widespread and chronic exposure of inner-city dwellers, leading to chronic toxic illness and disability at substantial human and social cost.
  • Thumbnail Image
    Item
    Social Determinants of Health Associated with Inpatient Admissions for Congestive Heart Failure, Diabetes, Chronic Obstructive Pulmonary Disease, and Asthma
    (2023-07) Deckbar, John Quentin; DeMichael, Kelly; Gad, Wael; Guerrero, Jonathan; Muvuka, Baraka
    Introduction: The CDC and American Lung Association estimate that congestive heart failure (CHF), diabetes, chronic obstructive pulmonary disorder (COPD), and asthma (COPD/asthma) cost Americans $30.7 billion, $327 billion, and $50 billion respectively each year. They account for most inpatient readmissions at St. Mary Medical Center (SMMC), an urban hospital in Northwest Indiana. There is need for further research on the social, behavioral, and demographic determinants associated with these conditions. This study examined the social, behavioral, and demographic determinants associated with inpatient admission for CHF, diabetes, COPD/asthma in SMMC’s service area.  Methods: This retrospective study was part of a multi-phased Community-Based Participatory Research partnership between SMMC and Indiana University School of Medicine Northwest. SMMC implemented a pilot screening and referral program to assess social determinants of health in their service area as part of their Hospital Readmission Reduction Program. This study included data from 10,953 inpatient admissions between January 2021 to March 2023, majority of whom were transferred from the emergency department. Data analysis consisted of univariate, bivariate (Chi-square), and multivariate (binary logistic regression) analysis in SPSS 29.0. Results: Bivariate analysis revealed a statistically significant association between CHF and smoking, age, insurance type, and income. Diabetes was significantly associated with smoking, smokeless tobacco use, age group, race, income, and sex. COPD/asthma was significantly associated with smoking, age group, transportation needs, stress, insurance, ethnicity, and sex. Multivariate analysis found the following significant associations: age group with both CHF (p<0.001) and diabetes (p<0.001), former smoking with both CHF (p = 0.007) and COPD/asthma (p = 0.049), current smoking with COPD/asthma (p = 0.016), and sex with diabetes (p <0.001).   Conclusions: These findings indicate significant associations between multiple socio-behavioral factors and admission for CHF, diabetes, COPD/asthma. Multi-risk-factor interventions may address these interactions and contribute to reducing readmission.
  • Thumbnail Image
    Item
    Substance Abuse in Indiana: An Urban-Rural Perspective
    (The Center for Health Policy, 2017-06-01) Kooreman, Harold E.; Greene, Marion S.
    The use of alcohol and drugs is a significant public health problem in the United States. Indiana, like many other states in the nation, is lacking in substance abuse treatment services and rural areas are particularly underserved. Rural residents may encounter additional barriers to receiving substance abuse treatment, including stigma, fear that they may know their treatment providers, a lack of access to specialized services, inferior quality of care, and having to pay more for treatment.
  • Thumbnail Image
    Item
    Urban Sixth Graders Reason about Combinatorics Problems
    (Office of the Vice Chancellor for Research, 2011-04-08) Tillema, Erik; Tan, Paul; Mockler, Samantha
    15 sixth grade students at three different developmental levels solved combinatorics problems as a basis for reasoning about multi-digit multiplication. Each student was interviewed three times. The first interview was an un-recorded selection interview, which was used to identify the student’s developmental level. The second and third interviews were video recorded, and involved students in solving combinatorics problems. The results from the study include: (1) models of how students at different developmental levels solved the combinatorics problems; and (2) a framework for integrating research on mathematical cognition and urban education.