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Michael S. Rendall, University of Maryland; Elizabeth H. Baker and Margaret M. Weden, RAND Corporation; 2012-010

Christine Bachrach, University of Maryland and Duke University; 2012-011

Monica Das Gupta, University of Maryland, et al. // Keywords: Public health, Sanitation, Urban, Local government, India, Governance, Devolution; 2017-005

Caryn N. Bell, University of Maryland; Tina K. Sacks, University of California Berkeley; Courtney S. Thomas Tobin, University of California Los Angeles; Roland J. Thorpe, Jr. Johns Hopkins University; 2019-004

Caryn N. Bell University of Maryland: Jessica L. Owens-Young American University: 2019-005

Caryn N. Bell University of Maryland: Loneke T. Blackman Carr Duke University: 2019-006

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.

For hospital-based violence intervention programs (HVIPs), gun violence intervention and the treatment of firearm-related injuries for male survivors require a  sui generis  network of team members that includes physicians, caseworkers, mental health care providers, and violence intervention specialists (VIS). The VIS can play a vital part in the success of HVIPs, but there is no published literature about the roles, functions, and best practices of this position. A case study conducted at the Capital Region Violence Intervention Program, an emerging HVIP at the University of Maryland Prince George's Hospital Center, demonstrates the importance of the VIS fostering deep levels of interpersonal connection with survivors of violent injury. The VIS actively seeks to increase the rate of psychosocial services usage. Due to cultural competence, street experience, and a willingness to share lived experiences as a survivor of violent injury, the VIS has credibility when discussing mental health symptomatology and usage of services for young Black male survivors of violence. The relationship between the VIS and male survivors of violent injury markedly enhanced the provision of trauma-informed care, peer support, and mentoring. This case study demonstrates the importance of marshalling the shared lived experiences of the VIS to increase trust and perceived credibility by young Black male survivors of gun violence as a means to decrease trauma recidivism.

Objective: Cardiometabolic disease is the leading cause of mortality in the United States. Cardiometabolic function during adolescence predicts future cardiometabolic disease, yet few studies have examined early determinants of cardiometabolic function. Informed by evidence of sex differences in the prevalence and severity of cardiometabolic disorders and evidence of sexual dimorphism in the stress response, we examined sex differences in the association between living in poverty and cardiometabolic function during adolescence, a precursor of later cardiometabolic disorders. Methods: We linked data from 10 415 adolescents aged 12-19 in the National Health and Nutrition Examination Survey (1999-2012) with US Census–tract data on area-level poverty (percentage of the population living in poverty, grouped into quartiles). We parameterized cardiometabolic dysfunction by summing the z scores of 6 cardiometabolic biomarkers, grouped into quintiles. Hierarchical ordinal models estimated associations. Results: Compared with residents in low-poverty areas, residents in high-poverty areas had elevated odds of cardiometabolic dysfunction (highest quartile of poverty odds ratio [OR] = 1.27; 95% confidence interval [CI], 1.08-1.50). This association was more pronounced among boys than girls (highest quartile of poverty for boys: OR = 1.36; 95% CI, 1.10-1.70; highest quartile of poverty for girls: OR = 1.17; 95% CI, 0.94-1.47). Conclusion: Our study supports the existence of sex-specific associations. These results highlight the potential for community-based programs, such as housing assistance, to improve population health.

The dramatic changes in the accessibility of home ownership may have “set the stage” for the baby boom