• Association between intimate partner violence and mentally unhealthy days in women in the U.S.

      Broadnax, Danielle; Waldrop, Reinetta Thompson; Claridy, Mechelle D; Booker, Elain Archie; Alema-Mensah, Ernest; Morehouse School of Medicine (Georgia Public Health Association, 2016)
      Background: In the United States (U.S.), intimate partner violence (IPV) is a serious public health concern, mainly affecting the health and well-being of women. The objective of this study was to identify the IPV and socio-demographic factors associated with mentally unhealthy days among women in the U.S. of ages ≥18 years. Methods: Data for this study were obtained from the 2007 Behavioral Risk Factor Surveillance System. Multivariable analyses were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) for factors associated with IPV and 14 or more mentally unhealthy days per month. Analyses were conducted using SAS 9.3. Results: The analyses show that the following factors increase the likelihood of self-reported 14 or more mentally unhealthy days: having a high school level of education or less (AOR: 1.732; 95% CI: 1.415-2.119) and having an income < $50,000. In addition, experiencing IPV such as: ever being threatened by a sex partner (AOR: 1.499; 95% CI: 1.264-1.779); having a sex partner ever attempt violence (AOR: 1.461; 95% CI: 1.224-1.743); having a sex partner ever become violent (AOR: 1.541; 95% CI: 1.303-1.823); and ever having unwanted sex with a partner (AOR: 1.929; 95% CI: 1.584-2.350) also increased the likelihood of self-reported 14 or more mentally unhealthy days per month. Conclusions: The results indicate that, for women in the U.S., IPV and socio-demographic factors have an effect on self-reported 14 or more mentally unhealthy days. Improving access to services that offer protection and guidance for women abused by their intimate partner could decrease the likelihood of self-reported 14 or more mentally unhealthy days and long-term negative mental health outcomes among women
    • The association of stress with anxiety and depression: Evidence from a community health needs assessment

      Tournous, Nicloe La; Bagwell-Adams, Grace; University of Georgia (Georgia Public Health Association, 2016)
      Background: Mental illness affects approximately 1 in 5 Americans, making mental health an important area of study for public health. Much research has been conducted on two of the most prevalent mental health disorders, anxiety and depression. However, the association of stress with these disorders, especially specific types of stress (e.g., financial, health, relationship), has been under-studied at the local level. This study aimed to gain insight into the relationship between stress, anxiety, and depression in Athens-Clarke County, Georgia. Methods: Data collected in the 2015 Athens-Clarke County Community Health Needs Assessment were analyzed using linear regression models to explore the association between stress and anxiety and depression. Results: When the data were aggregated, the presence of stress in a respondent’s household was associated with a 17.8% (p<0.001; t=5.21) increase in the likelihood of reporting the presence of anxiety and a 10.0% (p<0.01; t=2.96) increase in the likelihood of reporting the presence of depression. Significant associations with mental health status were also found for race, insurance status, perceptions of neighborhood safety, and discrimination. Conclusions: The results demonstrated that, in Athens-Clarke County, Georgia, stress was significantly and positively associated with both anxiety and depression. Financial, home environment, and neighborhood safety stressors were the strongest predictors of household mental health disorders. These results have implications for public health policy and clinical professionals, including the possibility of tailoring treatment strategies to the types of stress present in a patient’s life. Further research is needed to explore this relationship in other communities.
    • A cross sectional study of mostly African-American men examining mental health and child behavior

      Jackson, Matt; Osborne, Melissa; Self-Brown, Shannon; Georgia State University (Georgia Public Health Association, 2016)
      Background: Home visiting receives bipartisan support at both the state and federal level, because several models have demonstrated significant results in both reduction of child maltreatment as well as parenting behavior modification. Yet, parenting research and services lack further engagement and involvement as a primary component. That is, even though research has shown that fathers play an integral role in child development, there is very little research done in which fathers are the primary focus; most of this research focuses on mothers. When it comes to serving children who are victims of child abuse and neglect, this is a problem at both the programmatic and legislative level. Methods: This study took place within the context of a broader NIH funded trial to examine the efficacy of an adapted (technologically enhanced) version of an evidence-based parenting program, SafeCare, for fathers. This was a cross-sectional examination of the results from a survey in which mostly African-American, at-risk fathers (n=84), reported on – using putative measures – parenting practices, mental health, and behavior of their children. This initial assessment used linear regression to examine the association between fathers’ mental health and their child’s externalizing and internalizing problem behaviors. Results: On average, higher levels of father depression and anxiety corresponded to higher scores for child behavior problems. That is, there was a significant correlation between the fathers’ anxiety and depression and the child’s problem behaviors. Conclusions: These findings suggest a need for acknowledging the father’s role in child development as well as any potential external factors that might have a pernicious effect on the father’s mental state[s]. In addition, more attention should be given to separating data within studies that examine both mothers and fathers in order to assess individual effects by each parent.
    • 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.
    • Reflections on mental health advocacy across differing ecological levels

      Thompson, J Nancy; McGee, E Robin; Munoz, C Leslie; Walker, R Elizabeth (Georgia Public Health Association, 2015)
      ABSTRACT Background: According to the World Health Organization, mental health advocacy is comprised of a range of actions designed to change aspects of attitudes and structures that impede the achievement of positive mental health in populations. Methods: According to the World Health Organization, mental health advocacy is comprised of a range of actions designed to change aspects of attitudes and structures that impede the achievement of positive mental health in populations. Results: We have proposed interventions and advocacy effort for each ecological level. Project UPLIFT, a distance-delivered intervention for mental health is presented as an example of an effort that can affect several levels of the social ecology. Conclusions: Advocacy and interventions that make an effort to encompass the levels of the social-ecological model may contribute to greater progress in improving mental health outcomes.
    • Sexual risk-taking among at-risk alcohol and drug users presenting to emergency departments

      Howell, Rebecca; Johnson, Aaron; Augusta University (Georgia Public Health Association, 2016)
      Background: Alcohol use is linked to increased sexual risk-taking, including unprotected sexual contacts, and illegal drug use is associated with an increased likelihood of sexual risk-taking and at-risk alcohol use. Risky sexual behavior is co-morbid with anxiety, depression, and mood disorders. The purpose this study was to identify factors associated with sexual risk-taking among adult, at-risk alcohol or drug users presenting to emergency departments (EDs). Methods: Data were derived from self-report surveys conducted with a random sample of ED patients screening positive for at-risk alcohol or drug use. As part of an alcohol and drug assessment completed by a health education specialist, patients were asked questions about their sexual behaviors. If warranted, patients also received a brief intervention addressing their alcohol and/or drug use. A negative binomial regression was conducted to identify risk factors associated with sexual risk-taking, defined here as unprotected sexual contacts. Results: Six of nine factors included in the model were statistically significant. White race was associated with more unprotected sexual contacts relative to non-whites. Females had fewer unprotected sexual contacts relative to males. Both the frequency of drinking days and illegal drug use days in the last 30 days were associated with unprotected sexual contacts. As patient age increased, the number of unprotected sexual contacts decreased. Mental health problems, as measured by the Global Assessment of Individual Needs (GAIN) Internalizing subscale, were associated with more unprotected sexual contacts. Conclusions: Gender, race, age, frequency of drug and alcohol use, and mental health problems are risk factors associated with unprotected sexual contacts among at-risk alcohol users. In the ED, those administering brief interventions for unhealthy alcohol and drug use may consider including safe sex education and/or providing patients with preventive measures for sexually transmitted infections, particularly to those whose assessments indicate higher frequencies of alcohol and drug use or possible mental health problems.