• Educational attainment and self-rated health among African-Americans in Pitt County, NC

      Chandrasekar, Eeshwar; Banta, Zimo; Ragan, Kathleen; Schmitz, Michelle; James, Sherman; Emory University (Georgia Public Health Association, 2016)
      Background: To help fill the knowledge gap regarding relationships between educational attainment and self-rated health (SRH) in minority populations, we analyzed the data of a community-based cohort of African-Americans residing in Pitt County, NC, between 1988 and 2001. Methods: Data from the Pitt County Study (a community-based, longitudinal survey of risk factors for hypertension and related disorders disproportionately affecting African-Americans) were used to explore associations between educational attainment and SRH, stratified by sex, in a cohort of individuals from 1988 (n=1,773), 1993 (n=1,195), and 2001 (n=1,117) using continuous, ordinal, and binary correlated data analyses. Results: For males and females with less than a high school education, the odds of reporting poor or fair health (compared to excellent, very good, or good health) were 2.75 (95% CI: 1.54-4.91) and 1.78 (95% CI: 1.15-2.75) times greater, respectively, than among those who completed a college degree or higher. Conclusions: Across all analyses, individuals with lower educational attainment reported lower SRH scores, and the association differed by sex. Social support may be a factor in these differences. More research is needed, however, to assess relationships between educational attainment, social support, and SRH for African-Americans and other minority populations.
    • Predictors of mammogram and Pap screenings among US women

      Akuse, Sewuese; Tate, Koren; Addision, Tiffany; Drayton, Tierra; Kanda, Deborah; Sullivan, Kelly; Jiann-Ping Hsu College of Public Health; Georgia Southern University (Georgia Public Health Association, 2016)
      Background: The most common cancers among women are breast and cervical cancer. Although early detection of cancer has been shown to increase the likelihood of survival, many women are not screened for these cancers as often as practice guidelines recommend. The objective of this study was to examine the mammography and Papanicolaou (Pap) smear screening practices among women within the United States, and to determine predictors of screening. Methods: Data from the 2012 and 2014 Behavioral Risk Factor Surveillance System were used. The association between demographic predictors (age, marital status, education level, employment status, income, health insurance, and medical cost concerns) and having Pap or mammogram screening consistent with guideline recommendations was assessed using logistic regression analysis. Results: Pap and mammography screenings were positively associated with younger age, minority race, being married, having a higher level of education, being employed, having higher household income, having health insurance and not having financial concerns regarding affording doctor visits. Blacks and Hispanic women were more than twice as likely to have Pap screenings (Black: OR=2.16, 95% CI 1.97-2.36; Hispanic: OR=2.33, 95% CI = 2.11-2.58) and mammograms (Blacks: OR=2.11, 95% CI 1.88-2.36; Hispanics OR=1.82, 95% CI 1.60-2.07) compared to White women. Women earning less than $10,000 per annum were much less likely to have cervical cancer screenings (OR=0.57, 95% CI 0.51-0.65) compared to women with higher incomes while mammography screening was less likely among women who reported financial barriers to health care (OR=0.59, 95% CI 0.53-0.64). Conclusions: Women from minority ethnic groups were more likely to be screened for cervical cancer compared to White, non-Hispanic women. Women from low-income households and women who could not visit a doctor due to costs had the strongest association with lacking screenings.
    • Quality Rated childcare programs and social determinants of health in rural and nonrural Georgia

      Webb, Nancy C.; Gates, Madison L.; Augusta University (Georgia Public Health Association, 2016)
      Background: Early childhood is linked to school readiness and early school achievement. Through its Quality Rated (QR) program, which was designed to improve the quality of care in early childhood programs, the state of Georgia has been a trailblazer in funding universal preschool and in improving the quality of childcare programs. We have assessed differences in the availability of QR childcare programs in Georgia to learn if, in rural versus non-rural counties, there is a relationship between QR childcare programs and health-related outcomes. Methods: This cross-sectional study evaluated county-level data to evaluate the relationship between QR childcare programs and social determinants of health. County-level data for Georgia were extracted from the Georgia Department of Early Care and Learning, County Health Rankings and Roadmaps, and the Georgia Juvenile Justice Data Clearinghouse. Results: Counties without QR childcare programs had child mortality rates 3.5 times higher than those for the state overall. Other differences in health-related outcomes included, but were not limited to, teen birth rates, low birth-weight babies, children in poverty, housing problems, and food insecurity. Conclusions: It is now appropriate to address the prevalence of health disparities in rural areas of Georgia and focus on some of the disparities through the QR early childhood programs and other state agencies. Empowering rural communities to address health disparities may be the most favorable path toward diminishing these inequalities.