Life expectancy and overall health have improved in recent years for most Americans, thanks in part to an increased focus on preventive medicine and dynamic new advances in medical technology. However, not all Americans are benefiting equally. This suggests a level of urgency for need to assist our public health professionals in obtaining specific skills sets that will assist them in working better with ethnic and racial minority populations. The overall goal of the research was to assess cultural competence knowledge and programmatic skill sets of individuals employed by an urban department of health located in the southwest region of the US. The Theory of Planned Behavior (TPB) guided the research design to effectively evaluate the correlation between behavior and beliefs, attitudes and intention, of an individual, as well as their level of perceived control. Within the program design, 90 participants were identified using convenience sampling. In order to effectively evaluate these constructs, a quantitative research approach was employed to assess attitudes, beliefs, knowledge and competencies of the subject matter. Participants completed the Cultural Competence Assessment (CCA), which is designed to explore individual knowledge, feelings and actions of respondents when interacting with others in health service environments (Schim, 2009). The instrument is based on the cultural competence model, and measures cultural awareness and sensitivity; cultural competence behaviors and cultural diversity experience on a 49 item scale. It seeks to assess actual behaviors through a self report, rather than self-efficacy of performing behaviors. In addition, information was obtained to assess participant perception of organizational promotion of culturally competent care and; availability of opportunities to participate in professional development training. The analysis suggested healthcare professionals who are more knowledgeable and possess attitudes which reflect increased cultural sensitivity, are more likely to engage in culturally competent behaviors. In addition, positive attitudes and increased knowledge were associated with diversity training participation. Respondents reported high levels of interaction with patients from ethnic and racial minorities. Observing the clinical and non-clinical respondents, approximately 47% and 57% respectively, stated their cultural diversity training was an employer sponsored program.

Background: Rotavirus is one of the most common diarrheal diseases in children less than 5 years of age. Rotavirus vaccines have greatly reduced this burden in the United States. An examination was conducted to determine possible disparities in RV vaccination rates compared to DTaP. Methods: Children were actively enrolled during two rotavirus seasons from January-June of 2010 and 2011 in the Emergency Departments (ED) and inpatient floors from all Children's Healthcare of Atlanta (CHOA) sites (Scottish Rite, Egleston, and Hughes Spalding) with acute gastroenteritis (AGE). Data and a stool sample were collected from enrolled children and samples were tested for presence of rotavirus using an enzyme immunoassay (EIA) kit (Rotaclone). Vaccination records were abstracted from the state immunization registry and primary healthcare providers to examine complete and incomplete vaccination status. This cohort of children with vaccination records were used for this analysis. Cases were identified as children receiving a complete RV dose series and controls were identified as children with incomplete RV doses. A logistic regression model was used to determine disparities seen amongst children with incomplete vaccination status. Results: Of the 660 patients that were approached for this study, 414 participants were included in this retrospective cohort analysis. 46.9% had incomplete rotavirus vaccination status and were more likely to be positive for rotavirus AGE (OR 1.76, 95% CI 1.46-2.13). Black infants had a higher rate of incomplete RV compared to whites (p-value 0.0006). When controlling for covariates, racial differences were no longer significant (OR 1.37 95% CI 0.77-2.57); however household size (p-value 0.0343), age at onset of illness (p-value 0.0061), and DTaP vaccination status (p-value < 0.0001) were all significant in determining vaccination status for children. Conclusions: Racial disparities and socioeconomic differences are not evident in determining rotavirus vaccination rates; however, household size, a possible social determinant, has an effect on RV status. In addition, timely vaccinations are important in preventing incomplete RV vaccination status, due to RV vaccine age restrictions.

Dissertation (Ph.D.).--University of Texas Graduate School of Biomedical Sciences at San Antonio, 2005. / Vita. Includes bibliographical references.

Thesis (doctoral)--Universität Kiel, 1976. / Includes bibliographical references (p. 171-182).

Thesis (Ph. D.)--University of Massachusetts Amherst, 2009. / Includes bibliographical references (p. 149-153). Print copy also available.

Thesis (Ph. D.)--Cornell University, 1994. / Includes bibliographical references (leaves 271-280).

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2006. / Title from title screen (site viewed on Nov. 22, 2006). PDF text: 179 p. : ill. (some col.) ; 1.09Mb. UMI publication number: AAT 3215319. Includes bibliographical references. Also available in microfilm and microfiche format.

Asthma is the most common chronic illness in children. Preschool children (age 0 to 5) in particular experience a disproportionate disease burden compared to all other age groups. Part of the puzzle is the diagnostic challenge presented in this age group, and another is the difficulties in the care and management of asthma. Compounding the issue are the well-documented racial disparities experienced by minorities. This paper reviews the literature documenting the difficulties and disparities facing minority preschoolers with respect to providing and receiving care for asthma and qualitative improvement strategies targeting healthcare. Due to the complexity of the disease, more research on evidence based strategies targeting this age group is needed as well as better documentation of implementation processes.

This dissertation investigates race as a determinant of health trajectories for immigrants to the United States. Previous research suggests that integration into U.S. society can be detrimental to the health and mortality outcomes of many minority immigrant groups. Popular explanations for post-migration health changes have focused on individual-level mechanisms, such as behavioral changes associated with acculturation. I use multiple sources of data and a variety of quantitative methods to situate these changes in a context of racial inequality for three migrant groups. In my first case, I draw on historical data collected from the Vital Statistics of the United States and the U.S. Census to analyze the changing health trajectories associated with European immigrants’ transition from marginalized minorities to members of the white majority in the early 20th century. My second case draws on restricted-use data from the National Survey of American Life to test how interpersonal and institutionalized racial discrimination influence health patterns of black immigrants from the Caribbean. In my third case, I use population-level birth data from New York City (2000-2010) to investigate changes in birth outcomes associated with elevated anti-Muslim sentiment after the attacks of September 11, 2001. Taken together, these cases demonstrate how racial formation in the United States shapes patterns of post-migration outcomes. I find that marginalized European immigrants exhibited patterns of worsening mortality trajectories, but the overall gap between European immigrants and native-born whites narrowed as racial categories were redefined in the early 20th century. This pattern of intergenerational health improvement contrasts with the segmented trajectories of contemporary Caribbean black immigrants, whose health is shaped by experiences of both interpersonal and institutionalized racism. Similarly, rates of low birth weight births increased for Middle Eastern and Asian Indian immigrants in the decade after the attacks of September 11, 2001, likely due to increased experiences of discrimination. By tying health trajectories and outcome disparities to the construction and stratification of racial boundaries, I advance theory about the "upstream" social causes of health and illness and develop a framework for analyzing the sociohistorical formation of health disparities.

The aim of this work is to identify socio-economic disparities between villages of four municipalities of the South Bohemia and to suggest some ways of reducing the founded differences. Two villages of the Prachatice district and two villages of the Strakonic district were selected for the analyse