Exploring Social, Economic and Environmental Determinants of Health
BTC PROJECT GALLERY
COMPOUNDING FACTORS
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Limited Educational Services
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Limited Health Care Services
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Limited Social Capital
Alexandra Jurewitz, JD, MPH
Colin Crawford PhD
Tulane University School of Law ane School of Public Health and Tropical Medicine, New Orleans, Louisiana, US
Legal Instruments to Lower the Risk of Mother-to-Child Transmission of HIV
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This project considered the question, "How can legal instruments be used to increase access to antiretroviral therapy in order to halt mother-to-child HIV transmission and break the cycle of health disparities?"This chapter will consider whether there is an international right of access to HIV/AIDS treatment that is enforceable either through the international community or through domestic law. The issue of maternal and child access to HIV/AIDS medication and treatment will specifically be
addressed.
Jessica H Knight, Michael R Kramer and Carolyn Drews-Botsch, Ph.D., MPH
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Department of Epidemiology, Rollins School of Public Health and Laney Graduate School, Emory University, Atlanta, Georgia, US
How Does the Socio-Demographic Composition of Schools Affect the Prevalence of Children with Mild Intellectual Disability?
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Mild intellectual disability (ID) has been associated with socio-demographic
characteristics on the individual level, but it is unclear how the socio-
the demographic composition of schools affects the identification of children with mild ID. This chapter aims to answer this question. We hypothesized that the prevalence of mild ID would be higher in schools located in rural areas,
serving lower-income populations, and serving a higher proportion of Black
students. The study was conducted using 2001-2005 public elementary school records and 2004-2009 Criterion-Referenced Competency Tests (CRCT) data from all counties in Georgia (N=1,172 schools). This ecologic study focused on school-and community-based characteristics, as well as school-wide pass rates of the CRCT. The outcomes of interest were measured by the percent of children in each school identified with mild ID in third and fifth grades. Analyses were conducted using Poisson regression models. After adjustment, schools with higher proportions of children eligible for free or low-cost lunch compared to those with lower proportions of such children had approximately an 80% higher prevalence of children served for mild ID [prevalence ratio (PR) = 1.8 (95% confidence interval: 1.7, 1.9)]. Schools located in poor rural areas had prevalence rates that were twice as high as schools located in suburban areas [PR of 2.0 (95% confidence interval: 1.8, 2.2)]. This suggests that schools in poor rural areas and those attended by children of lower economic status should be targeted to ensure the special education needs are being met for all children with mild ID.
Danielle L Oves, MPH
School of Public Health, Georgia State University, Atlanta, Georgia, US
Impact of Maternal Health Literacy Training on the Knowledge of Women who have been Homeless
Children‘s health outcomes are affected by multiple variables, including
biological, environmental, psychological, and social factors. Many determinants are decided after birth, depending on the surrounding physical,
psychological and social environment that the child enters. Elements such as
socioeconomic status, marital status, race, education level, and access to
healthcare greatly affect a mother‘s health literacy, and, thus, her ability to
adequately care for her child(ren). This chapter examines the impact of
maternal health literacy training on the behavior and knowledge of mothers
who have been homeless, and on their children. A group of these mothers was given a six-hour maternal health literacy training, and a survey was
administered before and after the training. Due to the small sample size and
the transient population, there is a chance that the data may not be robust
enough to substantiate our expectation to establish short-term benefits of the training, so an additional questionnaire was given to several women who were still in the program a few months after the training. The anticipation is that enough data will prove the benefits of the maternal health literacy training in order to move forward with the implementation of a more consistent health literacy training program for this population of women wherever they may be.
Jacqueline A Towson, MS, CCC-SLP, and Peggy A Gallagher, PhD
Department of Educational Psychology and Special Education, Georgia State University, Atlanta, Georgia, US
Training Head Start Parents in Dialogic Reading to Improve Outcomes for Children
This project examined the effects of training in dialogic shared book
reading on parents of preschool children from low-income families. The
primary purpose of this study was to extend the literature on the effects of
dialogic shared book reading in young children by including children who
were younger (age three years), as well as by including children whose
primary language is Spanish, and those children identified as having a
disability. Participants in the study were 3-year old children (n=25) and
their parents enrolled in one of three Head Start centers in the southeastern United States. Approximately fifty percent of the parent-child dyads participated in a five-week intervention that took place in the child‘s home environment. The remaining participants ̳read as they normally would‘ with specified frequency and duration. The results of pre and post-test standardized measures in the areas of receptive and expressive vocabulary, language, and literacy skills indicated no significant differences between the treatment and control groups. However, comparison of pre and post-test means suggested modest changes in children‘s vocabulary scores as well as in the parents‘ frequency, duration, and quality of reading for those in the treatment group. Limitations and future research are discussed.