Cervical cancer rates among Vietnamese American women are the highest when compared to other women of color and white women. In an article by Taylor, Nguyen, and McPhee, a majority of Vietnamese Americans immigrated to the United States over the last three decades; and the President's Advisory Commission on Asian Americans identified cervical cancer among Vietnamese women as one of the most important health disparities experienced by the Asian American population. HPV vaccination, according to the CDC, helps prevent cervical cancer and it is recommended that female and male preteens, ages 11 or 12, receive the vaccination. My research aims to better understand what second generation Vietnamese American women know about the HPV vaccination, their relationship to healthcare, and their overall health. By interviewing second generation Vietnamese American women, I hope they become more empowered to ask their doctors about health disparities that affect their communities. In looking at preventative measures to cervical cancer and trying to better understand a vulnerable population's relationship to healthcare, I hope that the rates of cervical cancer will go down in Vietnamese American women. Furthermore, I hope to push for greater disaggregation of data collection among Asian American populations to better understand the health disparities that affect the various ethnicities that fall under the umbrella term, Asian American.

This research explored health decision-making processes among people recently diagnosed with type 2 diabetes. Our analysis suggested that diagnosis with type 2 was followed by a period of intense emotional and cognitive disequilibrium. Subsequently, the informants were observed to proceed to health decision-making which was affected by three separate and interrelated factors: knowledge, self-efficacy, and purpose. Knowledge included cognitive or factual components and emotional elements. Knowledge influenced the degree of upset or disequilibrium the patient experienced, and affected a second category, agency: the informants’ confidence in their ability to enact lifestyle changes. The third factor, purpose, summarized the personal and deeply held reasons people gave as they made decisions concerning their health, eating and exercising. We propose this model, grounded in informant stories, as a heuristic, to guide further inquiry. From these stories, the patient is seen as more active and the interrelated influences of knowledge, agency, and purpose, synergistically interact to explain changes in health behaviors.

This thesis recounts my personal experience working as a volunteer medical interpreter for the Language and Culture Resource Center at East Tennessee State University. The result of my time spent volunteering as a medical interpreter, shadowing professional medical interpreters, and witnessing patient-provider interactions during interpreted sessions was an inspiration to study medical interpretation further and delve into the challenges faced by patients who require medical interpreters. During my time researching this topic, I found that the United States is severely lacking in Spanish medical interpreters—with some healthcare facilities employing no medical interpreters—even though the size of the Hispanic population is on the rise. I also found that the language and cultural barriers to the Hispanic population receiving quality healthcare are a significant reason why the Hispanic population reports a lower satisfaction with U.S. healthcare. Through years of observation and practice, I developed research questions to help guide one in discovering what areas the Hispanic population is least satisfied with in healthcare. To discern what those areas of the greatest dissatisfaction are exactly, this research study manifests in the creation of a survey designed to improve the quality of healthcare received by the Hispanic population of Northeast Tennessee by identifying some of the principal issues faced by the Hispanic population within the U.S. healthcare system. The goal of this thesis is to highlight these issues as areas of focus for healthcare providers when they care for patients specifically in interpreted appointments.

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This project is an exploration of 20th century dystopian literature through the lens of germ theory. This scientific principle, which emerged in the late 19th century, asserts that microorganisms pervade the world; these invisible and omnipresent germs cause specific diseases which are often life threatening. Additionally, germ theory states that vaccines and antiseptics can prevent some of these afflictions and that antibiotics can treat others. This concept of a pervasive, invisible, infection-causing other is not just a biological principle, though; in this paper, I argue that one can interpret it as an ideological framework for understanding human existence as a whole. Particularly, I believe that authors of prominent 20th century dystopian novels applied the tenets of germ theory in order to explore the potential “pathogens” that furtively exist within the human mind. These pseudo-germs are various human tendencies that, when left “untreated” by governments, create nonnormative members of society. In the eyes of dystopian regimes, it is precisely this nonnormativity that poses a lethal threat, in that it challenges the continued existence of society with the current ruling body at the helm. In this paper, I trace love (both sexual and familial) and individuation (as a function of social hierarchy, recreational activities, and the use of language) as social disease-causing pathogens in George Orwell’s 1984 and in Aldous Huxley’s Brave New World.

The purpose of this dissertation was to examine patterns of antenatal stressful life events (SLEs) experienced by women in the United States (U.S.) and their association with postpartum depression (PPD). It further explored the role of women's state-level socio-economic status (SES) on PPD; the racial/ethnic dispartites in SLE-PPD relationship; and the role of provider communication on perinatal depression. Data from 2009–11 Pregnancy Risk Assessment Monitoring System (PRAMS) and SES indicators published by the Institute of Women’s Policy Research (IWPR) were used. Latent class analysis (LCA) was performed to identify unobserved class membership based on antenatal SLEs. Multilevel generalized linear mixed models examined whether state-level SES moderated the antenatal SLE-PPD relationship. Of 116,595 respondents to the PRAMS 2009-11, the sample size for our analyses ranged from 78% to 99%. The majority (64%) of participants were in low-stress class. The illness/death related-stress class (13%) had a high prevalence of severe illness (77%) and death (63%) of a family member or someone very close to them, while those in the multiple-stress (22%) class endorsed most other SLEs. Eleven percent had PPD; women who experienced all types of stressors, had the highest odds (adjusted odds ratio [aOR]: 5.43; 95% confidence interval [CI]: 5.36, 5.51) of PPD. The odds of PPD decreased with increasing state-level social/economic autonomy index (aOR: 0.75; 95% CI: 0.64, 0.88), with significant cross-level interaction between stressors and state-level SES. Among non-Hispanic blacks and non-Hispanic whites, husband/partner not wanting the pregnancy (aOR: 1.47; 95% CI: 1.14, 1.90) and drug/drinking problems of someone close (aOR: 1.37; 95% CI: 1.21, 1.55) were respectively associated with PPD. Provider communication was protective. That 1 out of every 5 and 1 out of every 8 women were in the high- and emotional-stress classes suggests that SLEs are common among pregnant women. Our results suggest that screening for antenatal SLEs might help identify women at risk for PPD. The finding that the odds of PPD decrease with increasing social/economic autonomy, could have policy implications and motivate efforts to improve these indices. This study also indicates the benefits of antenatal health care provider communication on perinatal depression.

<p>Since the late 1970s, biomedical researchers have heavily invested in the development of portable insulin pumps that allow people with Type 1 Diabetes (T1D) to carry several days-worth of insulin to be injected on an as-needed basis. That means fewer needles and syringes, making regular insulin injections less time consuming and troublesome. As insulin pump use has become more widespread over the past twenty years among people with T1D, the social and cultural effects of using these medical devices on their everyday experiences have become both increasingly apparent for individuals yet consistently absent from social and cultural studies of the disease.</p><p><br></p><p>In this dissertation, I explore the technological, medical, and cultural networks of insulin pump treatment to identify the role(s) these biomedicalized treatment acts play in the structuring of people, their bodies, and the cultural values constructed around various medical technologies. As I will show, insulin pump treatment alters people’s bodies and identities as devices become integrated as co-productive actors within patient-users’ biological and social systems. By analyzing personal interviews and digital media produced by people with T1D alongside archival materials, this study identifies compulsory patterns in the practices, structures, and narratives related to insulin pump use to center chapters around the productive (and sometimes stifling) relationship between people, bodies, technologies, and American culture.</p><p><br></p><p>By analyzing the layered and intersecting sites of insulin pump treatment together, this project reveals how medical technologies, health identities, bodies, and cultures are co-constructed and co-defined in ways that bind them together—mutually constitutive, medically compelled, cultural and social. New bodies and new systems, I argue, come with new (in)visibilities, and while this new technologically-produced legibility of the body provides unprecedented management of the symptoms and side-effects of the disease, it also brings with it unforeseen social consequences that require changes to people’s everyday lives and practices. </p>