Matching Items (5)
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- All Subjects: water insecurity
- All Subjects: Breast
- Creators: Wutich, Amber
Description
While women in higher income countries can expect to survive a diagnosis of breast cancer, women in lower- and middle-income countries such as Bangladesh have mortality rates near 50%, suggesting that there are significant barriers to care seeking for breast problems. Given limited literature on barriers to care among native, rural South Asian populations, this study thus sought to understand 1) the impacts of breast problems on women and their families, including the extent of abuse among women with breast problems, and 2) the barriers and facilitators of care for women with breast problems in rural Bangladesh.
Sixty-three study participants (43 women and 20 men) were interviewed about their experiences. Interviewers elicited barriers to care, facilitators of care, and questions about the attitudes and behaviors of family and community members were in structured interviews.
The study found that breast problems and their treatment put significant resource and emotional strains on the family. Furthermore, over a third of women in this study reported abuse of some kind, with emotional abuse, neglect, and abandonment being the most frequently reported.
The study reinforced barriers to care identified in the literature for South Asian populations, but only a quarter of participants reported stigma of any kind. Lack of knowledge about breast cancer and inability to pay for care were the most frequently reported barriers, followed by access to care and fear of treatment. Facilitators of care among women who received a biopsy point to the importance of support by the husband and husband’s family, as well as the ability to identify economic support for and knowledge about care.
This study contributes to the understanding of two overarching themes: structural violence and the value of women, as well as how these themes influence poor outcomes for women with breast cancer in rural Bangladesh. Suggestions for future studies and short and long-term interventions to address study findings are offered.
Sixty-three study participants (43 women and 20 men) were interviewed about their experiences. Interviewers elicited barriers to care, facilitators of care, and questions about the attitudes and behaviors of family and community members were in structured interviews.
The study found that breast problems and their treatment put significant resource and emotional strains on the family. Furthermore, over a third of women in this study reported abuse of some kind, with emotional abuse, neglect, and abandonment being the most frequently reported.
The study reinforced barriers to care identified in the literature for South Asian populations, but only a quarter of participants reported stigma of any kind. Lack of knowledge about breast cancer and inability to pay for care were the most frequently reported barriers, followed by access to care and fear of treatment. Facilitators of care among women who received a biopsy point to the importance of support by the husband and husband’s family, as well as the ability to identify economic support for and knowledge about care.
This study contributes to the understanding of two overarching themes: structural violence and the value of women, as well as how these themes influence poor outcomes for women with breast cancer in rural Bangladesh. Suggestions for future studies and short and long-term interventions to address study findings are offered.
ContributorsSteiness, Heather Lynn Story (Author) / Hruschka, Daniel J (Thesis advisor) / Wutich, Amber (Committee member) / Ginsburg, Ophira (Committee member) / Arizona State University (Publisher)
Created2016
Description
U.S. border colonias, otherwise known as Disadvantaged Unincorporated Communities, are rural settlements along the U.S. Mexico border with substandard housing conditions. Colonia residents often face inadequate access to necessities such as appropriate shelter, septic and sewer systems, and potable water. Water insecurity in colonias poses a particularly difficult challenge for residents who require clean water not only for consumption, but also household use in sanitation and hygienic practices. As of 2015, an estimated 30% of over five million US colonia residents lack access to clean drinking water, resulting in health complications and unsanitary living conditions. Preliminary health data collected indicates that due to water insecurity, colonia residents are more likely to contract gastrointestinal disease, be exposed to carcinogenic compounds from contaminated water, and experience psychosocial distress. Yet more comprehensive research needs to be conducted to understand the full breadth of the public health issue. A scoping review on water insecurity in colonias has not been completed before and could be beneficial in informing policymakers and other stakeholders on the severity of the situation while advising possible solutions.
ContributorsZheng, Madeleine (Author) / Wutich, Amber (Thesis director) / Brewis, Alexandra (Committee member) / Kavouras, Stavros (Committee member) / Barrett, The Honors College (Contributor) / School of Molecular Sciences (Contributor) / School of International Letters and Cultures (Contributor)
Created2021-12
Description
Introduction: Often it is presumed that in high-income countries, like the United States, water insecurity is not an issue. Yet, more than 2 million individuals in the United States are affected by water insecurity. Experiencing the effects of water insecurity are informal settlements and impoverished communities termed as “colonias”, characterized by the lack of possessing basic infrastructures and services, including water systems and wastewater disposal amongst many. Purpose: To critically analyze how water insecurity manifests in the colonias and the impacts it has on the health and well-being of the community members.
Methods: An extensive systematic literature review was conducted in the effort to bring a meaningful framework of existing challenges and potential resolutions and theorize water insecurity in colonias.
Results: The effects of water insecurity due to water scarcity and water contamination in the colonias led to health complications, unsanitary living conditions and mental distress for residents. The causes of water insecurity in the colonias were because of political exclusion, municipal underbounding and the failure to monitor water quality.
Conclusion: The dire consequences of household water insecurity to an individual, no less an entire population, are detrimental to health and well-being. Despite this acknowledgement of a critical and basic human necessity, literature reveals a robust water governance infrastructure is much needed for the people in colonias. For meaningful progress and developments to be made in addressing water insecurity for the people of colonias, this review was approached through a transdisciplinary lens - one that achieves convergence.
ContributorsPatwoary, Nargish (Author) / Wutich, Amber (Thesis advisor) / Sabo, John (Thesis advisor) / Roque, Anais (Committee member) / Arizona State University (Publisher)
Created2021
Description
The 2017 Atlantic hurricane season is considered as one of the costliest in U.S. history. In the case of the archipelago of Puerto Rico, 3.2 million people were without energy, approximately a third of the residents were without municipal water services, houses and larger infrastructures were severely damaged among other challenges. While both the local and federal government have been highlighted to be inefficient to meet resident’s needs, the people took the streets to assist family, neighbors as well as to collaborate with non-profits and faith-based groups. These organizational efforts allowed the supply of water, food, clothes, and emotional support in areas with the most needs. In light of this knowledge, this dissertation focuses on two main areas: (1) communities’ capacities to absorb and adapt in the wake of a disaster (2) how households addressed large-scale water infrastructure failure. I investigate resilience in the communities of Corcovada, Anasco and Mariana, Humacao, and water insecurity in the municipalities of Anasco, Rincon, and Mayaguez. I do this through a mixed-methods approach including semi-structured interviews, participant observations, and an open-ended structured protocol with egocentric network elicitation. I engage with the literature on social capital, water sharing, social networks in disaster context, autogestion (self-management) and informality to examine the dynamics occurring in response and recovery efforts. The three sub-study mixed-method dissertation examines: 1) how social capital in low-income communities can support resilience, 2) the role of social networks and water sharing to cope with water insecurity in the wake of Hurricane Maria, 3) autogestion (self-management) at the household and community level and how does it fit with both the larger political economic dynamics in the archipelago as well as the post-disaster context. The results have theoretical and practical implications for future hurricane planning in Puerto Rico and for other sites at high disaster risk around the world.
ContributorsRoque, Anais Delilah (Author) / Wutich, Amber (Thesis advisor) / Jepson, Wendy (Thesis advisor) / Brewis, Alexandra (Committee member) / Arizona State University (Publisher)
Created2021
Description
There is an enormous unmet need for services, education, and outreach to improve women’s breast health. Healthcare systems and insurance systems vary widely around the world, and this may play an important role in understanding variability in women’s breast health knowledge and behavior globally. The goal of this study is to determine how varying healthcare systems in three countries (Japan, Paraguay, US) affect a woman’s likelihood of seeing a physician in regard to their breasts. For example, Japan is a clear example of a region that provides universal health insurance to its citizens. The government takes responsibility in giving accessible and equitable healthcare to its entire population (Zhang & Oyama, 2016). On the other hand, a country such as Paraguay is composed of both public and private sectors. In order for citizens to gain insurance, one would have to either be formally employed or choose to pay out-of-pocket for hospital visits (“Paraguay”, 2017). A country such as the United States does not have universal health insurance. However, it does have a mix of public and private sectors, meaning there is little to no coverage for its citizens. To accommodate for this, the United States came up with the Affordable Care Act, which extends coverage to the uninsured. Although the United States might be a country that spends more on healthcare than any other nation, there are residents that still lack healthcare (De Lew, Greenberg & Kinchen, 1992). This study, then, compares women’s breast health knowledge and behavior in Japan, Paraguay, and the US. Other variables, which are also considered in this study, that might affect this include wealth level, education, having general awareness of breast cancer, having regular health checks, and having some breast education. Using statistical analysis of breast check rates of women in Japan, Paraguay, and the United States, this research found that women sampled in Asunción, Paraguay check their breasts more often than either women sampled from Scottsdale, U.S. or Osaka, Japan. It was also found that women sampled from Paraguay were more confident in detecting changes in their breast compared to women sampled from the Japan or the US. Finally, it was noted that women sampled from Japan were least likely to partake in seeing a doctor in concern of changes in their breasts compared to women sampled from the other two research locations. These findings have relevance for the implementation of advocacy and public education about breast health.
ContributorsKumar, Navneet Surjit (Co-author) / Kumar, Navneet (Co-author) / Wutich, Amber (Thesis director) / Brewis, Alexandra (Committee member) / School of Human Evolution & Social Change (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05