Suicide and socioeconomic context in the Appalachian region

Halverson, Joel

doi:10.33915/etd.4154

Cited by 11 publications

(13 citation statements)

References 29 publications

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“…However, because BMI calculations were completed using self-reported height and weight, they may underestimate actual population proportions. These demographic and health risk data are generally consistent with estimates for Appalachia from nationally representative data sources (Halverson et al 2004) [see Supplemental Material, Table 2 (doi:10.1289/ehp.0800379.S1)].…”

Section: Resultssupporting

confidence: 73%

The C8 Health Project: Design, Methods, and Participants

Frisbee

Brooks

Maher

et al. 2009

Environ Health Perspect

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BackgroundThe C8 Health Project was created, authorized, and funded as part of the settlement agreement reached in the case of Jack W. Leach, et al. v. E.I. du Pont de Nemours & Company (no. 01-C-608 W.Va., Wood County Circuit Court, filed 10 April 2002). The settlement stemmed from the perfluorooctanoic acid (PFOA, or C8) contamination of drinking water in six water districts in two states near the DuPont Washington Works facility near Parkersburg, West Virginia.ObjectivesThis study reports on the methods and results from the C8 Health Project, a population study created to gather data that would allow class members to know their own PFOA levels and permit subsequent epidemiologic investigations.MethodsFinal study participation was 69,030, enrolled over a 13-month period in 2005–2006. Extensive data were collected, including demographic data, medical diagnoses (both self-report and medical records review), clinical laboratory testing, and determination of serum concentrations of 10 perfluorocarbons (PFCs). Here we describe the processes used to collect, validate, and store these health data. We also describe survey participants and their serum PFC levels.ResultsThe population geometric mean for serum PFOA was 32.91 ng/mL, 500% higher than previously reported for a representative American population. Serum concentrations for perfluorohexane sulfonate and perfluorononanoic acid were elevated 39% and 73% respectively, whereas perfluorooctanesulfonate was present at levels similar to those in the U.S. population.ConclusionsThis largest known population study of community PFC exposure permits new evaluations of associations between PFOA, in particular, and a range of health parameters. These will contribute to understanding of the biology of PFC exposure. The C8 Health Project also represents an unprecedented effort to gather basic data on an exposed population; its achievements and limitations can inform future legal settlements for populations exposed to environmental contaminants.

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Section: Resultssupporting

confidence: 73%

The C8 Health Project: Design, Methods, and Participants

Frisbee

Brooks

Maher

et al. 2009

Environ Health Perspect

Self Cite

290

340

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“…A 2008 Appalachian Region Commission study attributed these disparities to a number of factors, most notably the Appalachian residents’ high rates of poverty and lack of insurance. 20 While individual proximal (e.g., smoking/tobacco use) and distal (e.g., lower education and income) risk factors for poor health outcomes explain some of the disparities, it is likely that the interplay of these various levels strongly influences health outcomes. This appears particularly evident for substance abuse and the relative paucity of behavioral health prevention and treatment services.…”

Section: Discussionmentioning

confidence: 99%

Neonatal Abstinence Syndrome in East Tennessee: Characteristics and Risk Factors among Mothers and Infants in One Area of Appalachia

Erwin¹,

Meschke²,

Ehrlich³

et al. 2017

Journal of Health Care for the Poor and Underserved

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Objective To describe the epidemiology of Neonatal Abstinence Syndrome (NAS) in a 16-county Appalachian area of eastern Tennessee. Methods The Tennessee Surveillance System for NAS provided data on maternal sources of opioids. Data linking hospital discharge diagnosis for NAS to birth certificate data allowed us to compare maternal, delivery, and infant characteristics for NAS births with those for non-NAS births. Results There were 339 cases of NAS in 2013 and 367 in 2014, for NAS rates of 25.5 and 28.5 per 1,000 live births, respectively. When compared with the state overall, mothers of NAS infants in eastern Tennessee were more likely to use opioids that had been prescribed to another person. There were numerous maternal, infant, and delivery characteristics that were significantly different for NAS births compared with non-NAS births. Conclusion NAS is epidemic in the eastern Tennessee area of Appalachia, with unique maternal and infant characteristics that have important implications for primary, secondary, and tertiary prevention.

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“…The Appalachian region is a known area of health disparity [ 31 ]. A disproportionate segment of the region’s population is rural [ 32 ], impoverished, lowly educated, and physically ill, all of which are linked to poor mental health outcomes [ 33 ]. Therefore, more adults in Appalachia may be suffering from loneliness [ 15 ] or untreated depression [ 34 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of LISTEN on loneliness, neuroimmunological stress response, psychosocial functioning, quality of life, and physical health measures of chronic illness

Theeke

Mallow

Moore

et al. 2016

International Journal of Nursing Sciences

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ObjectivesLoneliness is a biopsychosocial determinant of health and contributes to physical and psychological chronic illnesses, functional decline, and mortality in older adults. This paper presents the results of the first randomized trial of LISTEN, which is a new cognitive behavioral intervention for loneliness, on loneliness, neuroimmunological stress response, psychosocial functioning, quality of life, and measures of physical health.MethodsThe effectiveness of LISTEN was evaluated in a sample population comprising 27 lonely, chronically ill, older adults living in Appalachia. Participants were randomized into LISTEN or educational attention control groups. Outcome measures included salivary cortisol and DHEA, interleukin-6, interleukin-2, depressive symptoms, loneliness, perceived social support, functional ability, quality of life, fasting glucose, blood pressure, and body mass index.ResultsAt 12 weeks after the last intervention session, participants of the LISTEN group reported reduced loneliness (p = 0.03), enhanced overall social support (p = 0.05), and decreased systolic blood pressure (p = 0.02). The attention control group reported decreased functional ability (p = 0.10) and reduced quality of life (p = 0.13).ConclusionsLISTEN can effectively diminish loneliness and decrease the systolic blood pressure in community-dwelling, chronically ill, older adults. Results indicate that this population, if left with untreated loneliness, may experience functional impairment over a period as short as 4 months. Further studies on LISTEN are needed with larger samples, in varied populations, and over longer periods of time to assess the long-term effects of diminishing loneliness in multiple chronic conditions.

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Suicide and socioeconomic context in the Appalachian region

Abstract: Significant economic changes have occurred over the past thirty years that have altered the geoeconomic landscape of the United States. Although a considerable literature I would also like to thank my family for their tolerance of my time away from them over the years in this effort. v

Cited by 11 publications

References 29 publications

The C8 Health Project: Design, Methods, and Participants

The C8 Health Project: Design, Methods, and Participants

Neonatal Abstinence Syndrome in East Tennessee: Characteristics and Risk Factors among Mothers and Infants in One Area of Appalachia

Effectiveness of LISTEN on loneliness, neuroimmunological stress response, psychosocial functioning, quality of life, and physical health measures of chronic illness

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