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Article Reference Troff document (with manpage macros)Reconsidering Approaches to Estimating Health Disparities Across Multiple Measures of Sexual Orientation
Purpose:  We propose a new theoretically grounded approach for estimating sexual orientation-related health risk that accounts for the unique and shared variance of sexual identity across other measures of sexual orientation (i.e., attraction and behavior). We argue and illustrate that this approach provides specificity not demonstrated by approaches that independently estimate and compare health risk based on sexual identity, attraction, and behavior. Methods:  Data were from the National Epidemiologic Survey on Alcohol and Related Conditions-III, collected in 2012–2013 (N = 36,309, ages 18 and older). The Karlson-Holm-Breen method tested the degree to which attraction- and behavior-based disparities in mental health and substance use disorders change after adjusting for sexual identity. Results:  Sexual attraction- and behavior-based disparities in mental health and substance use disorders statistically varied when comparing models that did and did not adjust for sexual identity. Adjusting for sexual identity appeared to have a larger influence on attraction- and behavior-based health associations among men; sexual minority and majority differences were attenuated on nearly every outcome after adjusting for sexual identity. This attenuation was less common among women. Among women, some behavior-based disparities were wider in sexual identity-adjusted models relative to unadjusted models. Conclusion:  We demonstrate more accurate approaches to capturing and comparing sexual orientation-related health disparities across multiple measures of sexual orientation, which account for the shared variance between sexual identity and measures of attraction and behavior. Adjusted estimates provide more specificity regarding relative health risk across specific subgroups of sexual minority people, and the intervention and prevention strategies needed to address them.
Located in MPRC People / Jessica N Fish, Ph.D. / Jessica N Fish Publications
Article Reference Troff document (with manpage macros)Reforming medical education admission and training in low- and middle-income countries: who gets admitted and why it matters
Recent studies reveal public-sector healthcare providers in low- and middle-income countries (LMICs) are frequently absent from work, solicit informal payments for service delivery, and engage in disrespectful or abusive treatment of patients. While extrinsic factors may foster and facilitate these negative practices, it is not often feasible to alter the external environment in low-resource settings. In contrast, healthcare professionals with strong intrinsic motivation and a desire to serve the needs of their community are less likely to engage in these negative behaviors and may draw upon internal incentives to deliver a high quality of care. Reforming medical education admission and training practices in LMICs is one promising strategy for increasing the prevalence of medical professionals with strong intrinsic motivation.
Located in MPRC People / Kenneth Leonard, Ph.D. / Kenneth Leonard Publications
Rendall comments on Baltimore population erosion
Current Census estimates place its population at a 100-year low
Located in News
Rendall comments on new marriage data
Trend shows marriage brings health benefits
Located in News
Reproductive readiness predicts a woman’s non-use of contraception in the postpartum months in U.S.
Michael S. Rendall and Monica L. Caudillo examine reproductive readiness in U.S. Women’s Postpartum Non-Use of Contraception
Located in Research / Selected Research
File Troff document (with manpage macros)Revisiting Swidler, Again: Brain, Self, and Culture in Action
Christine Bachrach, University of Maryland and Duke University; 2012-011
Located in Research / Working Papers / WP Documents
Richardson co-leads UMD initiative on gun violence
PROGRESS initiative joins UMD researchers with Maryland policy makers
Located in News
Richardson comments on gun violence docuseries
Documentary series aims to reach young men at risk for violence
Located in News
Richardson comments on Washington DC murder rate
Perpetual stress brings long-term health impacts
Located in News
Article Reference Troff document (with manpage macros)Risk and protective factors associated with BV chronicity among women in Rakai, Uganda
Objectives To assess risk and protective factors associated with bacterial vaginosis (BV) chronicity ascertained by Nugent score criteria. Methods A longitudinal cohort study included 255 sexually experienced, postmenarcheal women who provided weekly self-collected vaginal swabs for up to 2 years. Vaginal swabs were scored using Nugent criteria and classified as normal (≤3), intermediate (4–6) and Nugent-BV (≥7). Detailed behavioural/health information were assessed every 6 months. A per-woman longitudinal summary measure of BV chronicity was defined as the percentage of each woman’s weekly vaginal assessments scored as Nugent-BV over a 6-month interval. Risk and protective factors associated with BV chronicity were assessed using multiple linear regression with generalised estimating equations. Results Average BV chronicity was 39% across all follow-up periods. After adjustment, factors associated with BV chronicity included baseline Nugent-BV (β=35.3, 95% CI 28.6 to 42.0) compared with normal baseline Nugent scores and use of unprotected water for bathing (ie, rainwater, pond, lake/stream) (β=12.0, 95% CI 3.4 to 20.5) compared with protected water sources (ie, well, tap, borehole). Women had fewer BV occurrences if they were currently pregnant (β=−6.6, 95% CI −12.1 to 1.1), reported consistent condom use (β=−7.7, 95% CI −14.2 to 1.3) or their partner was circumcised (β=−5.8, 95% CI −11.3 to 0.3). Conclusions Factors associated with higher and lower values of BV chronicity were multifactorial. Notably, higher values of BV chronicity were associated with potentially contaminated bathing water. Future studies should examine the role of waterborne microbial agents in the pathogenesis of BV.
Located in MPRC People / Marie Thoma, Ph.D. / Marie Thoma Publications