This white paper serves as an accumulation of research to guide needle exchange program (NEP) policies in the state of Arizona to decrease the transmission of infectious diseases such as HIV and HCV.
Many women are subject to role conflict. Between participating in their jobs and social expectations about duties as a mother, they might experience considerable stress trying to fulfill both those demanding roles. Data was analyzed from 182,617 women in 38 low- and middle-income countries from MICS surveys, using linear regression to examine how a number of children and working status interact to predict life satisfaction and happiness. Having more children was almost always associated with lower life satisfaction and happiness. The only exception was that among women who worked, more children to a point was associated with greater life satisfaction. Notably, work had different associations with emotional well-being depending on how it was measured. Having a job was generally associated with lower happiness, but greater life satisfaction. There is little evidence of an interaction between work and children indicating role conflict. Indeed, for life satisfaction, working seems to counteract the negative effect of having more children. Determining how large the effect of having both children and jobs are in women's lives can help determine the burden placed on women today and how that burden can be alleviated.
With the accelerated emergence of telehealth systems being deployed with promises to access unreachable populations in today’s socially distant environment, it is increasingly important to understand the barriers that underprivileged populations face when trying to access healthcare through digital platforms. This research investigates the use of telehealth in social and cultural sub-populations, focusing on how the diverse student population at Arizona State University (ASU) use the recently-launched ASU Telehealth system. Statistical analysis of demographic factors spanning the five categories of social determinants of health were coupled with population studies of the ASU student body to evaluate the reach of services and patient diversity across telehealth and in person health platforms. Results show that insurance, racial and international student identity influence the percentage of students within these demographic categories Also, though the ASU Telehealth patient body reflects ASU’s general student population, the platform did not increase the reach of Health Services and the magnitude of students served. using ASU Telehealth. Due to the COVID-19 pandemic, it is difficult to determine the validity and reliability of these findings. However, the findings and background research point to targeted marketing campaigns, intentional policy decision-making, post-pandemic telehealth resilience, and the continuation of quantitative and qualitative data collection as means to expand the impact and equity of ASU Telehealth into future iterations of the platform. Outputs of this study include web communication materials and qualitative data collection mechanisms for future use and implementation by ASU Health Services.
Background: Extreme heat is a public health challenge. The scarcity of directly comparable studies on the association of heat with morbidity and mortality and the inconsistent identification of threshold temperatures for severe impacts hampers the development of comprehensive strategies aimed at reducing adverse heat-health events.
Objectives: This quantitative study was designed to link temperature with mortality and morbidity events in Maricopa County, Arizona, USA, with a focus on the summer season.
Methods: Using Poisson regression models that controlled for temporal confounders, we assessed daily temperature–health associations for a suite of mortality and morbidity events, diagnoses, and temperature metrics. Minimum risk temperatures, increasing risk temperatures, and excess risk temperatures were statistically identified to represent different “trigger points” at which heat-health intervention measures might be activated.
Results: We found significant and consistent associations of high environmental temperature with all-cause mortality, cardiovascular mortality, heat-related mortality, and mortality resulting from conditions that are consequences of heat and dehydration. Hospitalizations and emergency department visits due to heat-related conditions and conditions associated with consequences of heat and dehydration were also strongly associated with high temperatures, and there were several times more of those events than there were deaths. For each temperature metric, we observed large contrasts in trigger points (up to 22°C) across multiple health events and diagnoses.
Conclusion: Consideration of multiple health events and diagnoses together with a comprehensive approach to identifying threshold temperatures revealed large differences in trigger points for possible interventions related to heat. Providing an array of heat trigger points applicable for different end-users may improve the public health response to a problem that is projected to worsen in the coming decades.
Maricopa County, Arizona, anchor to the fastest growing megapolitan area in the United States, is located in a hot desert climate where extreme temperatures are associated with elevated risk of mortality. Continued urbanization in the region will impact atmospheric temperatures and, as a result, potentially affect human health. We aimed to quantify the number of excess deaths attributable to heat in Maricopa County based on three future urbanization and adaptation scenarios and multiple exposure variables.
Two scenarios (low and high growth projections) represent the maximum possible uncertainty range associated with urbanization in central Arizona, and a third represents the adaptation of high-albedo cool roof technology. Using a Poisson regression model, we related temperature to mortality using data spanning 1983–2007. Regional climate model simulations based on 2050-projected urbanization scenarios for Maricopa County generated distributions of temperature change, and from these predicted changes future excess heat-related mortality was estimated. Subject to urbanization scenario and exposure variable utilized, projections of heat-related mortality ranged from a decrease of 46 deaths per year (− 95%) to an increase of 339 deaths per year (+ 359%).
Projections based on minimum temperature showed the greatest increase for all expansion and adaptation scenarios and were substantially higher than those for daily mean temperature. Projections based on maximum temperature were largely associated with declining mortality. Low-growth and adaptation scenarios led to the smallest increase in predicted heat-related mortality based on mean temperature projections. Use of only one exposure variable to project future heat-related deaths may therefore be misrepresentative in terms of direction of change and magnitude of effects. Because urbanization-induced impacts can vary across the diurnal cycle, projections of heat-related health outcomes that do not consider place-based, time-varying urban heat island effects are neglecting essential elements for policy relevant decision-making.
Preventing heat-associated morbidity and mortality is a public health priority in Maricopa County, Arizona (United States). The objective of this project was to evaluate Maricopa County cooling centers and gain insight into their capacity to provide relief for the public during extreme heat events. During the summer of 2014, 53 cooling centers were evaluated to assess facility and visitor characteristics. Maricopa County staff collected data by directly observing daily operations and by surveying managers and visitors. The cooling centers in Maricopa County were often housed within community, senior, or religious centers, which offered various services for at least 1500 individuals daily. Many visitors were unemployed and/or homeless. Many learned about a cooling center by word of mouth or by having seen the cooling center’s location. The cooling centers provide a valuable service and reach some of the region’s most vulnerable populations. This project is among the first to systematically evaluate cooling centers from a public health perspective and provides helpful insight to community leaders who are implementing or improving their own network of cooling centers.