Search Results (37)

Flourishing in children is an indicator of positive development in the areas of emotional, social, and cognitive development. Using a recent dataset from the US National Survey of Children’s Health, this study investigates the association between access to a quality healthcare system and flourishing indicators in school-aged children with autism. The outcome variable describes the proportion of children aged 6–17 with autism meeting the flourishing criteria, which include measures related to learning, resilience, and self-regulation. The main independent variable includes six core indicators for school-aged children and adolescents, which assess whether the family feels like a partner in their child’s care, the child has a medical home, receives regular medical and dental preventive care, has adequate insurance, has no unmet needs or barriers to accessing services, and has prepared for transition to adult healthcare. Multivariable logistic regression models were used to examine the relationships between various independent variables and the outcome of interest. The results show that children with autism who receive comprehensive and coordinated care are more likely to flourish compared to those without such care for five of these six indicators, while controlling for sex, race, parental education, household income, self-reported autism severity, general health status, and the number of adverse childhood experiences. Children with autism are more likely to flourish when their families and healthcare providers work together effectively. Addressing gaps in the quality care system is essential for developing holistic approaches that empower children with autism to thrive and reach their full potential. Supportive health policies and effective coordination between families and healthcare providers are crucial for fostering the flourishing of children with autism, ensuring comprehensive, individualized, and continuous care. Full article

Methods. Through the lens of childhood trauma theory, a qualitative phenomenological study was conducted using purposive and snowball sampling methods to gain a deeper understanding of the experiences of former students with corporal punishment and how those experiences have shaped their academic and psychological outcomes. Interviews were conducted via Zoom with 19 men and women of different ages and races who attended schools in Mississippi. Results/Conclusions. The study revealed that parents and school personnel collaborated to punish the student corporally both on campus and at home. Related, beaten students did not share their punishment with their parents/caregivers, and if their families did find out, they received another beating at home. There was a general lack of consistency in how and who administered corporal punishment. In addition to the well-documented ways that corporal punishment is administered in school, we also found that students were made to hold painful positions or perform painful tasks. There were also peer effects of trauma, with students experiencing fear or anger following a friend or classmate being beaten in front of them. Race was an influence if the abused students felt that their punishment was racist, with Black American participants feeling there were racial undertones regardless of the perpetrator’s race. The study’s findings align with those of previously conducted research, but also extend them and can be used to create policy to allow schools to address trauma and create instructional practices that eliminate the fear and racial disparities that have been proven to exist in schools with corporal punishment. Full article

Introduction: The COVID-19 pandemic disrupted routine childhood vaccinations schedules, posing significant challenges among underserved communities. Understanding how different sociodemographic groups in Tennessee perceive and navigate childhood vaccination barriers is critical for developing strategies to improve vaccination rates and reduce vulnerability to vaccine-preventable diseases. Methods: A cross-sectional survey was conducted to explore barriers to vaccination across diverse sociodemographic groups in Tennessee. Data were collected from caregivers/parents of children aged 18 years and younger across all 95 counties in Tennessee at community events and through partnerships with schools and other local organizations. Parental responses were analyzed to identify barriers in access, concern, and importance domains. The distribution of barriers across different sociodemographic groups such as race, income, education level, and insurance status was identified. Descriptive statistics, non-parametric tests, and log-binomial regressions were used to address the research objectives. Results: This study found that the most prominent barriers to childhood vaccination were concerns regarding vaccine safety and side effects. Significant differences in vaccine barriers were observed across racial and ethnic groups for access barriers (p < 0.001), concern barriers (p = 0.006), and importance barriers (p < 0.001). Parents with lower education levels, children without health insurance, and lower-income families faced disproportionate challenges across two of the three barrier domains studied (access and perceived importance of vaccines). Additionally, concern barriers (aPR = 0.998, p < 0.001) and importance barriers (aPR = 0.997, p < 0.001) were strongly associated with the parent-reported prevalence of up-to-date vaccination status. Conclusions: Addressing parental vaccination barriers related to concern, access, and perceived importance is crucial, particularly for underserved populations including low-income families, uninsured parents, racial/ethnic minorities, and those with limited education. A sustained, equity-focused approach integrating scientific communication, community engagement, and policy interventions is essential for increasing vaccine uptake and ensuring equitable vaccination access. Full article

Vaccinations are among the most effective means of preventing hospitalizations related to infections. Despite this, high hospitalization rates for vaccine-preventable diseases strain available healthcare resources and imply deficiencies in primary care. Barriers to vaccinations exist, such as the recent pandemic, vaccine hesitancy, misinformation, and access to care. This study analyzes hospitalization rates due to vaccine-preventable conditions and identifies factors contributing to an increase in these rates in the southeast United States. This study used data from four different data sources. The data covers four pre-pandemic years (2016 to 2019) and the pandemic period (2020 to 2022). The analysis categorized the numbers and rates of hospitalizations for conditions with an available preventative vaccine across three age groups: pre-school aged children, school-aged children, and adults. Comparisons between school- versus non-school-mandated vaccines and a focus on differences between rural versus urban communities, as well as demographic characteristics (i.e., gender, race, and ethnicity), are included. Chi-squared tests were used to assess differences in this descriptive part of the analysis. Linear multiple regression was used to examine the independent influence of geographic location while accounting for potential longitudinal trends and the dimensions of the SVI, including socioeconomic status, household composition, disability, minority status and language, and household type and transportation. The dataset included data from 22,797,826 inpatient episodes, including 32,358 for which the principal reason for hospitalization was a vaccine-preventable condition, not including COVID-19. The analysis shows a consistent pattern characterized by higher rates of hospitalization for counties classified as rural. The pattern holds for preschool age (p < 0.001), school age (p = 0.004), and adults (p = 0.009). The differences are statistically significant in the white population (p = 0.008); in pre-school children, school-age children, and adults (p < 0.001); in females (p = 0.08 in pre-school, and p = 0.013 in adults); and black adults (p = 0.02). The regression results confirmed the findings of the descriptive analysis, indicating significantly higher rates in rural communities. Finally, the regression analysis also showed significantly higher rates associated with greater social vulnerability. This study highlights gaps in vaccination opportunities. These gaps can be seen geographically and in terms of social vulnerability, affected by factors such as poverty, language barriers, household composition, and access to care. Hospitalizations due to immunizable diseases were found to be higher in rural areas, particularly among adults. Communities with a high SVI show a significant increase in hospitalization rates. Community-engaged vaccination outreach programs and state policies could improve vaccination rates, and therefore, public health in rural areas, reducing hospitalizations, and lowering infectious disease risks in these areas. Full article

Background: Bullying is a global public health problem with severe adverse effects on behavioral health. Understanding the predictors of victimization by bullying is essential for public policy initiatives to respond to the problem effectively. In addition to traditional in-person bullying, electronic bullying has become more prevalent due to increasing social interaction and identity formation in virtual communities. This study aims to determine the predictors of in-school and electronic bullying. Methods: We employed multivariable logistic regression to analyze a nationally representative sample of 17,232 high school students in the United States, the 2021 Youth Risk Behavior Surveillance System national component. The survey was conducted during the COVID-19 pandemic, from September through December 2021. The factors examined included sociodemographic characteristics (age, gender, race), appearance (obesity), physically active lifestyles (being physically active, spending a long time on digital games), and risk-taking behavior (using marijuana). Results: Our results indicated that sociodemographic characteristics were strong predictors of being bullied in school and electronically. Being obese is more likely to result in bullying in school (AOR = 1.32, p = 0.003) and electronically (AOR = 1.30, p = 0.004). Adolescent students showing marijuana use had higher odds of being bullied in school (AOR = 2.15, p < 0.001) and electronically (AOR = 1.81, p < 0.001). While spending a long time on digital devices raises the risk of being electronically bullied (AOR = 1.25, p = 0.014), being physically active is not associated with being bullied. Neither of the two lifestyle factors was associated with in-school bullying. Conclusions: Interventions addressing violence among adolescents can benefit from empirical evidence of risk factors for bullying victimization in high school. Full article

This paper examines school leaders’ evasive attitudes towards race in Salt Lake City (SLC), Utah, between 1969 and 1975. Salt Lake’s unique demographic status as predominantly white and Mormon underscored elements of white anti-Black racism under the guise of innocence. Utilizing critical whiteness theory and historical inquiry to analyze archival documents and interviews, I highlight one white superintendent, Arthur Wiscombe, and his failed attempts to confront anti-Blackness in schools as he navigated his conflicting values of racial justice, good intentions, and white Niceness. Framing the past as prologue, I uncover the historical legacy of white supremacy’s influence on local school policies and leaders’ actions, and make explicit connections to the repetition of these patterns today. Contemporary iterations of white supremacy rely on the same tools of whiteness used during intense periods of integration and racial awareness in Salt Lake City in the 1960s and 1970s. I conclude that white educational leaders must look more closely at the ‘nice’, color-evasive discourse that enables them to maintain power and privilege in their communities. Full article

The escalating rates of obesity since the 1950s poses a critical public health challenge across all age groups in the United States. While numerous studies have examined cross-sectional disparities across racial, ethnic, and socioeconomic groups, there has been limited research on long-term trends. To address this gap, we analyzed average adult body mass index (BMI) trends from 1959 to 2018, using data from the National Health and Nutrition Examination Survey (NHANES) and the National Health Examination Survey (NHES). Employing time series analysis, we evaluated BMI trends across income, education, and race/ethnicity. The results revealed a consistent upward trajectory in average BMI across all groups over the six-decade period, with no significant differences by income or education levels among high school graduates. However, individuals with less than a high school education displayed a more gradual increase in BMI. Racial disparities were also evident, with Black adults showing higher BMI growth rates compared to White adults, while Hispanic and other racial groups experienced slower increases. These findings underscore the need for systemic interventions to address the ongoing obesity epidemic, emphasizing the importance of research to identify trends over time and a system-thinking approach to inform effective population-level interventions and policy decisions. Full article

Men who have sex with men who suffer stigmatization and discrimination become more fragile in facing life’s problems, such as the search for treatment in health services. In the present study, the social aspects related to discrimination and violence among men who have sex with men in Belém, Pará, are evaluated. Data were obtained by applying the respondent-driven sampling method to recruit 349 participants aged 18 years or older and who reported having had at least one sexual relationship with a man in the last 12 months. Data were collected from June to December 2016 in a semi-structured interview. Five seeds were initially recruited who applied RDS. The vast majority were between 18 and 35 years old, had completed elementary school but not high school, and were of mixed race. Almost a third lived in peripheral neighborhoods and were employed/self-employed. Additionally, most participants reported having suffered aggression/discrimination, more often in religious contexts, with family or in health services. The findings reported here may contribute to the development of public policies aimed at this population and indicate the need for new strategies to combat sexually transmitted infections, stigma, and discrimination suffered by this population. Full article

Background: Multiple studies have shown a link between high education and better self-rated health (SRH). However, recent studies have suggested that immigrants may experience a weaker association between education and SRH than native-born individuals. Aim: Using a national sample of US older adults, this investigation studied whether there is an inverse association between education and SRH and whether immigration status moderates this association. Methods: This study is based on marginalized diminished returns (MDRs) that argues socioeconomic status (SES) resources, such as education, may generate less favorable health outcomes for marginalized groups. Data were from the General Social Survey (GSS) 1972–2021, a cross-sectional survey in the US. A total of 7999 participants who were 65+ years old were included. The independent variable was education, measured as years of schooling and treated as a continuous variable. The dependent variable was poor/fair (poor) SRH. Immigration status was the moderator. Age, sex, and race were control variables. Logistic regressions were used for data analysis. Results: We found that higher levels of education were protective against poor SRH. However, this effect was weaker for immigrants than for US-born individuals. Conclusions: This study found that native-born US older individuals are more likely to experience the protective effect of their education against poor SRH compared to their immigrants. Eliminating health inequality between immigrant and US-born individuals needs policies that go beyond socioeconomic status (SES) equality and address barriers that hinder highly-educated immigrants. Full article

College sports is a multi-billion-dollar business, and universities are looking for ways to remain competitive, including recruiting and retaining athletes from historically underrepresented groups to predominantly white institutions (PWI), many of which have a documented history of excluding non-white students, including blacks, indigenous peoples, and other people of color (often referred to as BIPOC). This article will examine the legacy of the racist teachings, past controversies, and compromises of the Church of Jesus Christ of Latter-day Saints (LDS, Mormons) along with persistent struggles to shake off its 130-year-old racist past in efforts for its flagship school, Brigham Young University, to stay competitive in the lucrative Big 12 Athletic Conference. Deeply ingrained in the LDS culture is a politic of religious conservatism. Politics has often been intertwined with organized religion with much influence, and the LDS faith is no different. The cumulation of these interlocking systems generates thoughts, attitudes, and feelings that foster a racial climate at Brigham Young University where black students have reported feeling unsafe and unsupported. While this is a well-documented problem at predominately white institutions (PWIs) across the country, BYU is in many ways unique, given the discriminatory overt policies and practices employed for generations. We contend that the LDS Church’s history of racial marginalization and exclusion of black people made its way into the sports consciousness of the church’s flagship school and is not likely to change anytime soon. Understanding religion in the tradition of Charles Long as an orientation and utilizing Derrick Bell’s notion of racial realism are critical to our analyses. The confluence of politics, religion, race, and sport cannot be easily untangled. Full article

The COVID-19 pandemic has created a severe upheaval in the U.S., with a particular burden on the state of Mississippi, which already has an exhausted healthcare burden. The main objectives of this study are: (1) to analyze the county-level COVID-19 cases, deaths, and vaccine distribution and (2) to determine the correlation between various social determinants of health (SDOH) and COVID-19 vaccination coverage. We analyzed COVID-19-associated data and county-level SDOH factors in 82 counties of Mississippi. The cumulative COVID-19 and socio-demographic data variables were grouped into feature and target variables. The statistical and exploratory data analysis (EDA) was conducted using Python 3.8.5. The correlation between the target and feature variables was performed by Pearson Correlation analysis. The heat Map Correlation Matrix was visually presented to illustrate the correlation between each pair of features and each target variable. Results indicated that people of Asian descent had the highest vaccination coverage of 77% fully vaccinated compared to 52%, 46%, 42% and 25% for African Americans, Whites, Hispanics, and American Indians/Alaska Natives, respectively. The county-level vaccination rate was significantly higher among the minority populations than the White population. It was observed that COVID-19 cases and deaths were positively correlated with per capita income and negatively correlated with the percentage of persons without a high school diploma (age 25+). This study strongly demonstrates that different SDOH factors influence the outcome of the COVID-19 vaccination rate, which also affects the total number of COVID-19 cases and deaths. Vaccine promotion should be given to all populations regardless of race and ethnicity to achieve uniform acceptance. Therefore, statewide policy recommendations focusing on specific community needs should help achieve health equity in COVID-19 vaccination management. Full article

Schools are well-positioned to provide physical activity opportunities to help youth achieve the recommended 60 or more daily minutes of moderate-to-vigorous physical activity. The Children’s Physical Activity Research Group (CPARG) at the University of South Carolina has focused on understanding physical activity in school-aged youth for 30+ years. The purpose of this article was to critically review (CPARG) contributions to the field in school settings and school-age youth. We reviewed 127 published CPARG articles from six research projects conducted between 1993–2019. The review was guided by questions in five categories: measurement of physical activity and its determinants, characteristics of physical activity behavior, correlates/determinants of physical activity, physical activity interventions, and race/ethnicity and physical activity. Results were summarized by question and synthesized across categories. CPARG contributions included assessing physical activity levels, patterns, forms, and contexts; identifying and measuring physical activity correlates/determinants; and conducting school-based physical activity interventions. Identifying multiple domains of physical activity determinants enables researchers and practitioners to select/design age-appropriate, valid, and reliable instruments to assess determinants. Focusing on determinants enables them to create effective physical activity interventions, environments, programs, and policies in schools. These efforts must address race/ethnicity differences, ensuring that measurement instruments and intervention strategies are culturally appropriate. Full article

This is a critical moment of extraordinary rates of teacher burnout exacerbated by the COVID-19 pandemic. In order to implement effective intervention and policy, we must identify the drivers of educators’ stress and factors that may act as protective mechanisms. The complexity of this problem calls for a social–ecological approach. In this study, we investigated the impact of individual, organizational, and relational factors on educators’ pandemic-related stress. Using hierarchical multiple regression, we found that secondary traumatic stress and family, school, student, and community relationships significantly predicted pandemic-related stress after controlling for race, age, and gender. Family, school, and community collaboration is well-documented to benefit students; however, our results suggest that these relationships also benefit teachers, and may have been a protective factor on pandemic-related stress. That is, the positive influence of family, school, and community relationships flows both ways—to students and their families as well as to educators. Our findings highlight the importance of more research on secondary traumatic stress and home–school–community collaborations to mitigate teacher stress and burnout, as well as the implication for practice to increase emphasis on these issues in teacher preparation and ongoing professional development. Full article

It is important to better understand factors associated with physical activity (PA) levels in adolescents in rural areas. Cross-sectional data were used to obtain self-reported PA levels among adolescents in a school-based intervention in fall 2018. Demographic data, environmental variables, and cardiovascular fitness (PACER score) were also measured. Analyses included a two-sample t-test, ANOVA, a Chi-square test_, and a linear regression model. Participants included 3799 7th graders. Male (p < 0.0001), white (p < 0.0001), and healthy weight (p < 0.0001) participants reported more days of PA. The correlation between school physical education (PE) and PACER was modest (r = 0.27, p < 0.0001). Multiple linear regression model showed significant effects of school PE (p = 0.0011), gender (p < 0.0001), race (p < 0.0001), and weight category (p < 0.0001) on self-reported PA. The percentage of students reporting 60 min of PA for 5 (p < 0.0001) or 7 (p = 0.0307) days per week tended to be higher with increased days per week of school PE. Policy changes that increase PA and PE in middle schools may present opportunities to improve PA levels in adolescents, with emphasis on being inclusive and mindful of minority and female youth. Full article

Research on the impact of school climate and culture on campus violence has yielded some promising responses for improving school safety. Evaluations of school policies and practices have shown that strict discipline and enforcement may have negative consequences and a disparate impact on students of color. Using a sample of 2092 respondents from the 2015–2016 School Survey on Crime and Safety from the Department of Education, the present research assessed the effectiveness of supportive programs and the impact of punitive responses to school violence within predominantly minority schools. Results from this study found that there were more statistically significant supportive policies that were associated with reductions in serious violence and disciplinary actions in predominately minority schools as compared to predominately white schools. Policy and research implications are discussed. Full article