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- Genre: Academic theses
Description
Food system and health characteristics were evaluated across the last Waorani hunter-gatherer group in Amazonian Ecuador and a remote neighboring Kichwa indigenous subsistence agriculture community. Hunter-gatherer food systems like the Waorani foragers may not only be nutritionally, but also pharmaceutically beneficial because of high dietary intake of varied plant phytochemical compounds. A modern diet that reduces these dietary plant defense phytochemicals below levels typical in human evolutionary history may leave humans vulnerable to diseases that were controlled through a foraging diet. Few studies consider the health impact of the recent drastic reduction of plant phytochemical content in the modern global food system, which has eliminated essential components of food because they are not considered "nutrients". The antimicrobial and anti-inflammatory nature of the food system may not only regulate infectious pathogens and inflammatory disease, but also support beneficial microbes in human hosts, reducing vulnerability to chronic diseases. Waorani foragers seem immune to certain infections with very low rates of chronic disease. Does returning to certain characteristics of a foraging food system begin to restore the human body microbe balance and inflammatory response to evolutionary norms, and if so, what implication does this have for the treatment of disease? Several years of data on dietary and health differences across the foragers and the farmers was gathered. There were major differences in health outcomes across the board. In the Waorani forager group there were no signs of infection in serious wounds such as 3rd degree burns and spear wounds. The foragers had one-degree lower body temperature than the farmers. The Waorani had an absence of signs of chronic diseases including vision and blood pressure that did not change markedly with age while Kichwa farmers suffered from both chronic diseases and physiological indicators of aging. In the Waorani forager population, there was an absence of many common regional infectious diseases, from helminthes to staphylococcus. Study design helped control for confounders (exercise, environment, genetic factors, non-phytochemical dietary intake). This study provides evidence of the major role total phytochemical dietary intake plays in human health, often not considered by policymakers and nutritional and agricultural scientists.
ContributorsLondon, Douglas (Author) / Tsuda, Takeyuki (Thesis advisor) / Beezhold, Bonnie L (Committee member) / Hruschka, Daniel (Committee member) / Eder, James (Committee member) / Arizona State University (Publisher)
Created2012
Description
The health situation of indigenous peoples is comparable to that of the world's poorest populations, but with the additional burdens of social and cultural marginalization, geographic and cultural barriers to accessing health services, and, in some areas, appropriation of land and natural resources. Cultural transmission (the transfer of beliefs, ideas, and behaviors from one culture to another) from outsider health institutions should presumably aid in closing this health gap by transferring knowledge, practices, and infrastructure to prevent and treat disease. This study examines the biosocial construction of the disease ecology of tuberculosis (TB) in indigenous communities of the Paraguayan Chaco with varying degrees of cultural transmission from outside institutions (government, religious, and NGOs), to determine the influence of cultural transmission on local disease ecologies. Using a biocultural epidemiological framework for the analysis of human infectious disease ecology, this study employed an interdisciplinary, mixed methods approach to examine the interactions of host, pathogen, and the environment in the Paraguayan Chaco. Three case studies examining aspects of TB disease ecology in indigenous communities are presented: (1) The effective cultural transmission of biomedical knowledge to isolated communities, (2) Public health infrastructure, hygiene, and the prevalence of intestinal parasites: co-morbidities that promote the progression to active TB disease, and (3) Community-level risk factors for TB and indigenous TB burden. Findings from the case studies suggest that greater influence from outside institutions was not associated with greater adoption of biomedical knowledge of TB. The prevalence of helminthiasis was unexpectedly low, but infection with giardia was common, even in a community with cleaner water sources. Communities with a health post were more likely to report active adult TB, while communities with more education were less likely to report active pediatric TB, suggesting that healthcare access is the major determinant of TB detection. More research is needed on the role of non-indigenous community residents and other measures of acculturation or integration in TB outcomes, especially at the household level. Indigenous TB burden in the Chaco is disproportionately high, and better understanding of the mechanisms that produce higher incidence and prevalence of the disease is needed.
ContributorsVansteelandt, Amanda (Author) / Hurtado, Ana Magdalena (Thesis advisor) / Stone, Anne (Thesis advisor) / Hruschka, Daniel (Committee member) / Rojas de Arias, Antonieta (Committee member) / Arizona State University (Publisher)
Created2014
Description
This dissertation is intended to tie together a body of work which utilizes a variety of methods to study applied mathematical models involving heterogeneity often omitted with classical modeling techniques. I posit three cogent classifications of heterogeneity: physiological, behavioral, and local (specifically connectivity in this work). I consider physiological heterogeneity using the method of transport equations to study heterogeneous susceptibility to diseases in open populations (those with births and deaths). I then present three separate models of behavioral heterogeneity. An SIS/SAS model of gonorrhea transmission in a population of highly active men-who-have-sex-with-men (MSM) is presented to study the impact of safe behavior (prevention and self-awareness) on the prevalence of this endemic disease. Behavior is modeled in this examples via static parameters describing consistent condom use and frequency of STD testing. In an example of behavioral heterogeneity, in the absence of underlying dynamics, I present a generalization to ``test theory without an answer key" (also known as cultural consensus modeling or CCM). CCM is commonly used to study the distribution of cultural knowledge within a population. The generalized framework presented allows for selecting the best model among various extensions of CCM: multiple subcultures, estimating the degree to which individuals guess yes, and making competence homogenous in the population. This permits model selection based on the principle of information criteria. The third behaviorally heterogeneous model studies adaptive behavioral response based on epidemiological-economic theory within an $SIR$ epidemic setting. Theorems used to analyze the stability of such models with a generalized, non-linear incidence structure are adapted and applied to the case of standard incidence and adaptive incidence. As an example of study in spatial heterogeneity I provide an explicit solution to a generalization of the continuous time approximation of the Albert-Barabasi scale-free network algorithm. The solution is found by recursively solving the differential equations via integrating factors, identifying a pattern for the coefficients and then proving this observed pattern is consistent using induction. An application to disease dynamics on such evolving structures is then studied.
ContributorsMorin, Benjamin (Author) / Castillo-Chavez, Carlos (Thesis advisor) / Hiebeler, David (Thesis advisor) / Hruschka, Daniel (Committee member) / Suslov, Sergei (Committee member) / Arizona State University (Publisher)
Created2012
Description
Background In the United States (US), first-year university students typically live on campus and purchase a meal plan. In general, meal plans allow the student a set number of meals per week or semester, or unlimited meals. Understanding how students’ use their meal plan, and barriers and facilitators to meal plan use, may help decrease nutrition-related issues.
Methods First-year students’ meal plan and residence information was provided by a large, public, southwestern university for the 2015-2016 academic year. A subset of students (n=619) self-reported their food security status. Logistic generalized estimating equations (GEEs) were used to determine if meal plan purchase and use were associated with food insecurity. Linear GEEs were used to examine several potential reasons for lower meal plan use. Logistic and Linear GEEs were used to determine similarities in meal plan purchase and use for a total of 599 roommate pairs (n=1186 students), and 557 floormates.
Results Students did not use all of the meals available to them; 7% of students did not use their meal plan for an entire month. After controlling for socioeconomic factors, compared to students on unlimited meal plans, students on the cheapest meal plan were more likely to report food insecurity (OR=2.2, 95% CI=1.2, 4.1). In Fall, 26% of students on unlimited meal plans reported food insecurity. Students on the 180 meals/semester meal plan who used fewer meals were more likely to report food insecurity (OR=0.9, 95% CI=0.8, 1.0); after gender stratification this was only evident for males. Students’ meal plan use was lower if the student worked a job (β=-1.3, 95% CI=-2.3, -0.3) and higher when their roommate used their meal plan frequently (β=0.09, 99% CI=0.04, 0.14). Roommates on the same meal plan (OR=1.56, 99% CI=1.28, 1.89) were more likely to use their meals together.
Discussion This study suggests that determining why students are not using their meal plan may be key to minimizing the prevalence of food insecurity on college campuses, and that strategic roommate assignments may result in students’ using their meal plan more frequently. Students’ meal plan information provides objective insights into students’ university transition.
Methods First-year students’ meal plan and residence information was provided by a large, public, southwestern university for the 2015-2016 academic year. A subset of students (n=619) self-reported their food security status. Logistic generalized estimating equations (GEEs) were used to determine if meal plan purchase and use were associated with food insecurity. Linear GEEs were used to examine several potential reasons for lower meal plan use. Logistic and Linear GEEs were used to determine similarities in meal plan purchase and use for a total of 599 roommate pairs (n=1186 students), and 557 floormates.
Results Students did not use all of the meals available to them; 7% of students did not use their meal plan for an entire month. After controlling for socioeconomic factors, compared to students on unlimited meal plans, students on the cheapest meal plan were more likely to report food insecurity (OR=2.2, 95% CI=1.2, 4.1). In Fall, 26% of students on unlimited meal plans reported food insecurity. Students on the 180 meals/semester meal plan who used fewer meals were more likely to report food insecurity (OR=0.9, 95% CI=0.8, 1.0); after gender stratification this was only evident for males. Students’ meal plan use was lower if the student worked a job (β=-1.3, 95% CI=-2.3, -0.3) and higher when their roommate used their meal plan frequently (β=0.09, 99% CI=0.04, 0.14). Roommates on the same meal plan (OR=1.56, 99% CI=1.28, 1.89) were more likely to use their meals together.
Discussion This study suggests that determining why students are not using their meal plan may be key to minimizing the prevalence of food insecurity on college campuses, and that strategic roommate assignments may result in students’ using their meal plan more frequently. Students’ meal plan information provides objective insights into students’ university transition.
Contributorsvan Woerden, Irene (Author) / Bruening, Meg (Thesis advisor) / Hruschka, Daniel (Committee member) / Schaefer, David (Committee member) / Vega-Lopez, Sonia (Committee member) / Adams, Marc (Committee member) / Arizona State University (Publisher)
Created2019
Description
Background: This study examines how pro-vaccine flu messages, guided by the Extended Parallel Process Model (EPPM), affect parents’ intentions to vaccinate their children.
Methods: Parents of children six months to five years old (N = 975) were randomly exposed to one of four high-threat/high-efficacy messages (narrative, statistical, combined, control) and completed a follow-up survey. Differences between message conditions were assessed with one-way ANOVAs, and binary logistic regressions were used to show how constructs predicted intentions.
Results: There were no significant differences in the ANOVA results at p = .05 for EPPM variables or risk EPPM variables. There was a significant difference between message conditions for perceived manipulation (p = 0.026), authority, (p = 0.024), character (p = 0.037), attention (p < .000), and emotion (p < .000). The EPPM model and perceptions of message model (positively), and the risk EPPM model and fear control model (negatively), predicted intentions to vaccinate. Significant predictor variables in each model at p < .05 were severity (aOR = 1.83), response efficacy (aOR = 4.33), risk susceptibility (aOR = 0.53), risk fear (aOR = 0.74), issue derogation (aOR = 0.63), perceived manipulation (aOR = 0.64), character (aOR = 2.00), and personal relevance (aOR = 1.88). In a multivariate model of the significant predictors, only response efficacy significantly predicted intentions to vaccinate (aOR = 3.43). Compared to the control, none of the experimental messages significantly predicted intentions to vaccinate. The narrative and combined conditions significantly predicted intentions to search online (aOR = 2.37), and the combined condition significantly predicted intentions to talk to family/friends (aOR = 2.66).
Conclusions: The EPPM may not be effective in context of a two-way threat. Additional constructs that may be useful in the EPPM model are perceptions of the message and fear control variables. One-shot flu vaccine messages will be unlikely to directly influence vaccination rates; however they may increase information-seeking behavior. The impact of seeking more information on vaccination uptake requires further research. Flu vaccine messages should be presented in combined form. Future studies should focus on strategies to increase perceptions of the effectiveness of the flu vaccine.
Methods: Parents of children six months to five years old (N = 975) were randomly exposed to one of four high-threat/high-efficacy messages (narrative, statistical, combined, control) and completed a follow-up survey. Differences between message conditions were assessed with one-way ANOVAs, and binary logistic regressions were used to show how constructs predicted intentions.
Results: There were no significant differences in the ANOVA results at p = .05 for EPPM variables or risk EPPM variables. There was a significant difference between message conditions for perceived manipulation (p = 0.026), authority, (p = 0.024), character (p = 0.037), attention (p < .000), and emotion (p < .000). The EPPM model and perceptions of message model (positively), and the risk EPPM model and fear control model (negatively), predicted intentions to vaccinate. Significant predictor variables in each model at p < .05 were severity (aOR = 1.83), response efficacy (aOR = 4.33), risk susceptibility (aOR = 0.53), risk fear (aOR = 0.74), issue derogation (aOR = 0.63), perceived manipulation (aOR = 0.64), character (aOR = 2.00), and personal relevance (aOR = 1.88). In a multivariate model of the significant predictors, only response efficacy significantly predicted intentions to vaccinate (aOR = 3.43). Compared to the control, none of the experimental messages significantly predicted intentions to vaccinate. The narrative and combined conditions significantly predicted intentions to search online (aOR = 2.37), and the combined condition significantly predicted intentions to talk to family/friends (aOR = 2.66).
Conclusions: The EPPM may not be effective in context of a two-way threat. Additional constructs that may be useful in the EPPM model are perceptions of the message and fear control variables. One-shot flu vaccine messages will be unlikely to directly influence vaccination rates; however they may increase information-seeking behavior. The impact of seeking more information on vaccination uptake requires further research. Flu vaccine messages should be presented in combined form. Future studies should focus on strategies to increase perceptions of the effectiveness of the flu vaccine.
ContributorsHall, Sarah (Author) / Jehn, Megan (Thesis advisor) / Mongeau, Paul (Committee member) / Hruschka, Daniel (Committee member) / Margolis, Eric (Committee member) / Arizona State University (Publisher)
Created2015
Description
Suicide is one of the fastest-growing and least-understood causes of death, particularly in low and middle income countries (LMIC). In low-income settings, where the technical capacity for death surveillance is limited, suicides may constitute a significant portion of early deaths, but disappear as they are filtered through reporting systems shaped by social, cultural, and political institutions. These deaths become unknown and unaddressed. This dissertation illuminates how suicide is perceived, contested, experienced, and interpreted in institutions ranging from the local (i.e., family, community) to the professional (i.e., medical, law enforcement) in Nepal, a country purported to have one of the highest suicide rates in the world. Drawing on a critical medical anthropology approach, I bridge public health and anthropological perspectives to better situate the problem of suicide within a greater social-political context. I argue that these complex, contestable deaths, become falsely homogenized, or lost. During 18 months of fieldwork in Nepal, qualitative, data tracing, and psychological autopsy methodologies were conducted. Findings are shared through three lenses: (1) health policy and world systems; (2) epidemiology and (3) socio-cultural. The first investigates how actors representing familial, legal, and medical institutions perceive, contest, and negotiate suicide documentation, ultimately failing to accurately capture a leading cause of death. Using epidemiologic perspectives, surveillance data from medical and legal agencies are analyzed and pragmatic approaches to better detect and prevent suicidal death in the Nepali context are recommended. The third lens provides perceived explanatory models for suicide. These narratives offer important insights into the material, social, and cultural factors that shape suicidal acts in Nepal. Findings are triangulated to inform policy, prevention, and intervention approaches to reduce suicidal behavior and improve health system capabilities to monitor violent deaths. These approaches go beyond typical psychological investigations of suicide by situating self-inflicted death within broader familial, social, and political contexts. Findings contribute to cultural anthropological theories related to suicide and knowledge production, while informing public health solutions. Looking from the margins towards centers of power, this dissertation explicates how varying institutional numbers can obfuscate and invalidate suffering experienced at local levels.
ContributorsHagaman, Ashley (Author) / Wutich, Amber (Thesis advisor) / Hruschka, Daniel (Committee member) / Kohrt, Brandon (Committee member) / Arizona State University (Publisher)
Created2017
Description
Lay theories of healthy eating are a potentially important consideration for public health and nutrition efforts as perceptions and beliefs about “healthiness” are key determinants of dietary choices (Furst et al. 1996; Grunert, 2007). A rich body of social science literature has examined how people across cultures decide what counts as healthy eating, yet such work has focused mainly on what people think is good and bad to consume, overlooking another important aspect- how one eats. The ways one eats can include patterns and timing of meal intake, as well as mental and emotional states during eating (henceforth, “eating styles”). This dissertation aims to 1) examine whether beliefs on eating styles constitute a separate category of healthy eating perceptions, 2) describe American and Eastern European lay models of how both food characteristics and styles of eating shape health outcomes, and 2) investigate cross-cultural variation in the endorsement of eating styles as important for health in the United States and Eastern Europe. Aims 1 and 2 use pile sorts (n=48), in-person interviews (n=49), and online surveys (n=283) to elicit subjective perspectives on how different eating considerations impact health, and aim 3 involves two sets of questionnaires collected in the U.S. (n=50; n=42) and Eastern Europe (n=42; n=35) to test the hypothesis that levels of collectivism influence variation in endorsement of eating styles for health. Results demonstrate that “eating styles” is a separate category of beliefs in people’s models of healthy eating and individuals in both cultures perceive a variety of important health outcomes from how one eats- weight management, energy levels, digestive health, and overall feeling of wellbeing. These perceptions are not uniform, as participants held contrasting models of how styles of food consumption can influence weight control, and Eastern European respondents held additional views on how aspects of food timing can affect long-term health. Finally, results show that individual level of collectivism, not differences in nationality, accounts for variation in endorsement of eating styles for health. These results suggest that the holistic pattern of attention characteristic of the collectivist social orientation extends to the domain of diet.
ContributorsVoytyuk, Mariya (Author) / Hruschka, Daniel (Thesis advisor) / Slade, Alexandra (Committee member) / Bruening, Meredith (Committee member) / Arizona State University (Publisher)
Created2017
Description
Social norms are unwritten behavioral codes. They direct individual behaviors, facilitate interpersonal coordination and cooperation, and lead to variation among human populations. Understanding how norms are maintained and how they change is critical for understanding human evolutionary psychology, social organization, and cultural change. This dissertation uses a mathematical model and a field study to answer two questions: First, what factors determine the content and dynamics of a social norm? Second, how do people make decisions in a normative context? The mathematical model finds that contrary to the popular belief that even arbitrary or deleterious social norms can be maintained once established because deviants suffer coordination failures and social sanctions, norms with continuously varying options cannot be maintained by the pressure to do what others do. Instead, continuous norms evolve to the optimum determined by environmental pressure, individual preferences, or cognitive processes. Therefore, the content of norms across human societies may be less historically constrained than previously assumed. The field study shows that unlike what rational choice theory predicts, people in a small-scale subsistence society do not calculate the ecological and social payoffs of different behaviors in a normative context, even when they have the information to do so. Instead, they rely heavily on social information about what others do. This decision-making algorithm, together with mental categorization that ignores small deviations, and cognitive biases that favor the division prescribed by the norm, maintain an ecologically inefficient and widely disliked cooperative surplus division norm in a Derung village, Dizhengdang, in Yunnan, China.
ContributorsYan, Minhua (Author) / Boyd, Robert (Thesis advisor) / Mathew, Sarah (Thesis advisor) / Hruschka, Daniel (Committee member) / Arizona State University (Publisher)
Created2023
Description
Latest estimates show that roughly 188 individuals in the United States die everyday due to an opioid-related overdose. This dissertation explores three avenues for
mitigating opioid use disorder (OUD) and the opioid epidemic in the United States (1.)
How can researchers and public health professionals identify areas most in need of
treatment for OUD in an easy-to-use and publicly accessible interface?; (2.) What do
practitioners see as opportunities for reducing barriers to treatment?; and (3.) Why do
differences in opioid mortality exist between demographic groups? To address question
one, I developed an interactive web-based to assist in identifying those counties with the
greatest unmet need of medically assisted treatment (MAT). To answer question two, I
conducted a study of stakeholders (medical providers, peer support specialists, public
health practitioners, etc.) in four New Mexico counties with high unmet need of MAT. to
identify cultural and structural barriers to MAT provision in underserved areas as well as
opportunities for improving access. To answer the third question. I conducted a
systematic review of peer-reviewed literature and government reports to identify how
previous research accounts for race/ethnic and sex disparities in opioid-related
mortality. While many opioid mortality studies show demographic differences, little is
known about why they exist. According to the findings of this systematic review, research
needs to go beyond identifying demographic differences in opioid-related mortality to
understand the reasons for those differences to reduce these inequities.
ContributorsDrake, Alexandria (Author) / Hruschka, Daniel (Thesis advisor) / Jehn, Megan (Committee member) / Scott, Mary Alice (Committee member) / Arizona State University (Publisher)
Created2023
Description
Previous work suggests that lower-income individuals are more likely to engage in mutual aid as a means to manage risk, giving rise to a psychology that is other-oriented, including an empathetic disposition and a proclivity to help people in need. While no study has directly investigated whether helping in times of need increases dispositional empathic concern over time, this assumption is deep-seated among social psychologists. Employing a two-year longitudinal survey of US adults (N = 915), I show that people who experience more needs report helping others when in need a greater number of times, in turn leading to a small but positive increase in their empathetic disposition. This study also identifies the types of needs that elicit empathic concern (i.e., those that arise from unpredictable sources of risk), and shows why cultivating an empathetic disposition is likely to pay off in the long run: those who provide help are more likely to receive help during future times of need. Moreover, this study identifies the types of targets for whom providing help might cultivate an empathetic disposition: those with whom people are likely to share lower interdependence. While previous theoretical frameworks posit that empathic concern selectively directs investment towards interdependent others, providing help to non-interdependent targets might allow people to build positive interdependence with prospective risk pooling partners. Cultivating an empathetic disposition and building interdependence with prospective risk pooling partners can allow people to manage needs that arise from unpredictable sources of risk.
ContributorsGuevara Beltran, Diego (Author) / Aktipis, Athena (Thesis advisor) / Hruschka, Daniel (Committee member) / Kenrick, Douglas (Committee member) / Shiota, Michelle (Committee member) / Arizona State University (Publisher)
Created2023