Heterogeneity within the Hispanic population in the United States (US) has important implications for health. Despite the empirical work examining heterogeneity in Hispanic health and mortality by nativity, generational status, and country of origin, relatively little research has been devoted to understanding if and how racial identification impacts Hispanic health outcomes. Racial differences in health and mortality are well documented throughout the literature, particularly for non-Hispanic blacks and non-Hispanic whites. Meanwhile, current socio-demographic and health literature commonly compares US non-Hispanic racial groups with people who claim Hispanic ethnicity, the latter of whom are comprised of multiple racial groups. Thus, this dissertation examines the racial heterogeneity of the Hispanic population and the implications of race for physical health among Hispanics. Using the National Health Interview Survey and the National Centers for Health Statistics Linked Birth/Infant Death Cohort Files, the key findings of this dissertation are (1) racial identity is associated with socioeconomic status among Hispanics, (2) infants born to Hispanic black mothers displayed statistically significant higher odds of being born with low birth weight when compared to infants born to Hispanic white mothers, (3) there is evidence of weathering in the infant health of Hispanics, as measured using birth weight, (4) black-white disparities in the risk of infant mortality exist within the Hispanic population, (5) both Hispanic blacks and those of other races have greater odds of functional limitations than Hispanic whites and for Hispanic blacks; moreover, this disadvantage increases with age, (6) I show no race differences in the odds of hypertension or poorly self-assessed health status. In short, the results of this dissertation suggest that the social experience for Hispanic blacks and whites is different and that this difference affects health outcomes. It is imperative that future research and health policy recognize the racial heterogeneity of this population, in both empirical analyses and policy decisions regarding social influences on physical health. / text

The inverse association between individuals' own education and adverse health outcomes is well established, but the influence of other people's education -- particularly those with close social ties or who are family members -- and adult health outcomes is not. The material and non-material resources available to individuals via their own education likely are shared within a marriage to become resources at the household or family-level. Research on spousal education and adult health outcomes is sparse -- especially in the United States. Therefore, this dissertation examines how husbands and wives' education combine within marriage to influence each other's self-rated health and annual risk of death in the United States. The analyses utilize two nationally representative data sources: the National Health Interview Survey (NHIS) and the National Health Interview Survey Linked Mortality File (NHIS-LMF). Chapter Two establishes an inverse association between spousal education and poor/fair self-rated health among married adults in the United States. The results also showed that spousal education attenuated the association between one's own education and fair/poor self-rated health more for married women than married men and age-specific analyses revealed that these differences were largest among married persons ages 45-64. Chapter Three reveals that individuals' own education and their spouse's education each share an inverse association with the annual risk of death among married adults. Although this association generally does not vary by gender, spousal education apparently is a more important determinant of all-cause mortality risk among married non-Hispanic whites in comparison to married non-Hispanic blacks. Age-specific analyses also suggest that the influence of own and spousal education on adult mortality risk weakened with increasing age. Chapter Four assesses life expectancy differentials between men and women in different marital status groups at different points in the educational distribution. The results imply that spousal education substantially contributes to life expectancy disparities between married and unmarried persons. The results also imply that focusing only on the relationship between married persons' own education and life expectancy masks substantial heterogeneity within educational groups attributable to spousal education. Overall, the findings strongly suggest that education is a shared or household health resource among husbands and wives. / text

Wind energy development and its stigma of avian mortality provide a case for exploring the complexities that can occur between science, law, politics, and planning. The present method of measuring mortality appears flawed and may hamper the ability of resource agencies, the public, and industry in making educated decisions about siting wind farms and protecting species. The U.S. Fish and Wildlife Service has the ability to take an active role and affect a project already constructed. The Migratory Bird Treaty Act appears to keep the issue of avian mortality within the minds of wind energy developers. Protecting species on the brink of extinction is codified in the Endangered Species Act, which seems to be well suited for protecting most species. The significance of avian mortality can be linked to public perceptions. The industry in Texas has taken the approach of not sharing avian-related data, except in very few instances. Providing such substantial federal incentives through the Production Tax Credit rather than direct federal funding bypasses the National Environmental Policy Act and its requirement that federal governments consider impacts to the environment. / text

published_or_final_version / Public Health / Master / Master of Public Health

Introduction A future healthy world is highly associated with the children and their mothers, the Millennium Development Goals (MDGs) prioritize the child and maternal health with the targets “the under-five mortality rate should be reduced by two thirds from 1990 to 2015”. A transform program in the Philippines, launched by a NGO, aims to change the life of ultra-poor, and the interventions’ impact was measured in this study. Method The study selected participants who had completed the surveys in the short term (n=2183) and long term (n=196). The Chi-square test, Cochran-Armitage trend test, and Generalized Estimating Equation (GEE) model were applied to examine the hypotheses: (1) the program would have positive impacts on child health, (2) the child mortality is related to the maternal social-demographic factors and health behaviors. In the GEE model, the univariate and multivariate binary logistic regression was used to estimate the crude and adjusted odds ratio (OR). Result The univariate and multivariate analysis both show the maternal age is closely associated with the child mortality, and the child mortality of older women is higher than the younger in the short term survey (univariate: OR:8.36, 95%CI:4.17-16.77, multivariate: OR: 8.89, 95%CI: 4.27-18.54). In the long term, the results demonstrate that the child mortality of delivering in hospital (OR:0.29, 95%CI:0.11-0.76) and birthing home (OR: 0.46, 95%CI: 0.21-0.98) both lower than home (reference group). Compared to Bacolod, the child mortality rate of Gensan and Koronadal is lower in the short term. We found no difference in other maternal social-demographic factors and health behaviors. During the survey period, the literacy, PhilHealth, institutional delivery, delivery care provider, postnatal home visits, breastfeeding, and child mortality all improved, and the improvements of PhilHealth, postnatal home visits, breastfeeding were statistically significant. Conclusion The findings suggest that the program needs to constantly deliver more community-based interventions, such as: institutional delivery, skilled birth attendance, postnatal care, which would transform the children health of ultra poverty in the long run. / published_or_final_version / Public Health / Master / Master of Public Health

The Romantic period coincides with a fundamental shift in Western attitudes toward death and dying. This dissertation examines how Romantic poets engage this shift. It argues that "Romantic mortal consciousness" - a form of mortal reflection characteristic of English Romantic poetry - is fundamentally social and political in its outlook and strikingly similar to what one might now call a liberal social consciousness. During the Romantic period, mortally conscious individuals, less able or willing to depend on old spiritual consolations, began to regard Death not as the Great Leveler of society but rather as a force that sealed social inequality into the records of history. Intimations of mortality forced one to look beyond the self and, to quote Keats, "think of the Earth." This dissertation considersthe development of Romantic mortal consciousness. Death’s transformation from the Great Leveler of social inequality into its crystallizing agent is evident in the Romantic response to Graveyard School poetry. This is the subject of my first chapter, which focuses on Gray’s "Elegy" and Wordsworth’s "The Ruined Cottage." Chapter Two examines Lord Byron’s Cain, where mortal consciousness transforms Cain’s personal lament about mortality into a protest on behalf of a doomed race. Cain anticipates death studies by dramatizing the shift from what Ariès calls the "death of the self" to the "death of the other" and by recognizing that mortality is essentially a cultural construct. However, the other idea of mortality as a solitary reckoning with death does not disappear entirely. Poems by Hemans and Keats, the subjects of my third and fourth chapters, show how the "death of the self" flourishes as the other side of Romantic mortal consciousness. Romantic mortal consciousness has centripetal and centrifugal aspects. It exhorts the ruminative soul to engage sympathetically with the suffering of others. At the same time, it turns the soul inwards, bringing the fate of the self into focus. One aim of this dissertation is to unify these aspects through an analysis of the sublime. In Chapter Five, which focuses on Byron and Smith, I illustrate the connection between mortal consciousnesses, social or political consciousness, and aesthetic awareness.

Maternal mortality is an important public health problem in Mexico. Although the Mexican government has invested many physical and economic resources to strategies specifically created to reduce this problem and reach the Millennium Development Goals, Mexico is not going to achieve this goal on time. Maternal Mortality is a problem of inequality and social injustice. Access to health services is unequally distributed among regions and among population within those regions. Despite a general decline in childbirth deaths worldwide, differences still exist depending on the level of urbanization and size of residence. Because of extreme inequality in Mexico, pregnant women living in rural and highly marginalized areas face the highest risk of dying for maternal causes. The main strategies Mexican government has adopted to reduce maternal mortality target the unsecure, rural and poor population, with the aim of closing the significant gap between geographic regions and social groups. / text

Current efforts to measure child mortality for municipalities in Brazil are hampered by the relative rarity of child deaths, which often results in unstable and unreliable estimates. As a result, it is not possible to accurately assess true levels of child mortality for many areas, hindering efforts towards constructing and implementing effective policy initiatives for the reduction of child mortality. However, with a spatial smoothing process based upon Bayesian Statistics it is possible to “borrow” information from neighboring areas in order to generate more stable and accurate estimates of mortality in smaller areas. The objective of this study is to use this spatial smoothing process to derive estimates of child mortality at the level of the municipality in Brazil. Using data from the 2000 Brazil Census, I derive both Bayesian and non-Bayesian estimates of mortality for each municipality. In comparing the smoothed and raw estimates of this parameter, I find that the Bayesian estimates yield a clearer spatial pattern of child mortality with smaller variances in less populated municipalities, thus, more accurately reflecting the true mortality situation of those municipalities. These estimates can then be used, ultimately, to lead to more effective policies and health initiatives in the fight for the reduction of child mortality in Brazil. / text

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

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