Abstract: Many community-based participatory research (CBPR) partnerships address social determinants of health as a central consideration. However, research studies that explicitly address racism are scarce in the CBPR literature, and there is a dearth of available community-generated data to empirically examine how racism influences health disparities at the local level. In this paper, we provide results of a cross-sectional, population-based health survey conducted in the urban areas of Genesee and Saginaw Counties in Michigan to assess how a sustained community intervention to reduce racism and infant mortality influenced knowledge, beliefs, and experiences of racism and to explore how perceived racism is associated with self-rated health and birth outcomes. We used ANOVA and regression models to compare the responses of intervention participants and non-participants as well as African Americans and European Americans (N = 629). We found that intervention participants reported greater acknowledgment of the enduring and differential impact of racism in comparison to the non-intervention participants. Moreover, survey analyses revealed that racism was associated with health in the following ways: (1) experiences of racial discrimination predicted self-rated physical health, mental health, and smoking status; (2) perceived racism against one's racial group predicted lower self-rated physical health; and (3) emotional responses to racism-related experiences were marginally associated with lower birth-weight births in the study sample. Our study bolsters the published findings on perceived racism and health outcomes and highlights the usefulness of CBPR and community surveys to empirically investigate racism as a social determinant of health.
Abstract: Few empirical studies have been devoted to exploring behaviors occurring immediately following sexual intercourse. Therefore, this study conducts an exploratory investigation of various post-coital behaviors that the authors propose may reflect the divergent adaptive reproductive strategies of each sex as understood from an evolutionary perspective. An online questionnaire was administered to 170 individuals examining sex differences in post-coital compared to pre-coital activities related to pair-bonding with long-term mates, as well as a variety of common post-coital activities comparing short- and long-term mating contexts. It was found that females were more likely than males to initiate and place greater importance on several behaviors related to intimacy and bonding following sex with long-term partners. Males were more likely to initiate kissing before sex, and females after sex. Intimate talk and kissing were rated by both sexes as more important before intercourse with a long-term partner, whereas cuddling and professing one's love was rated more important after sex. In a second set of more specific post-coital behaviors, females were more likely to engage in post-coital behaviors related to bonding with both short- and long-term partners, whereas males were more likely to engage in ones that were extrinsically rewarding or increased the likelihood of further coital acts.
Abstract: This study reports the use of a community-based health survey to share local health information with faith leaders. Geographical information systems software identified survey respondents within 2 km (1.25 miles) of places of worship. Results were tabulated for the community surrounding each place of worship and were compared with city- and county-level data. Faith leaders were presented with community-specific reports describing the health attributes of residents who lived in the surrounding area, in order to assist with the identification issues of concern and opportunities to develop health ministries to address these issues. Faith leaders were encouraged to share this information with members of their faith community and develop means of obtaining additional information on the people of interest. We believe that engaging faith leaders with neighborhood-specific health information will be critical in providing an understanding of the importance of their voice in improving health outcomes of their faith community, the surrounding neighborhood, and the community at large. Our goal is to empower faith leaders to understand personal and community health issues and to act as a conduit for health-related information and health promotion at a local level. Church health teams developed an HIV and sexually transmitted infection prevention program for African American adolescents and young adults.
Abstract: Community-Based Participatory Research (CBPR) has the twin goals of generating data and shaping policy decisions, yet examples that combine these goals are scarce in the literature. We describe how a community-based survey was created and used to help develop a county health plan. The Genesee Health Plan (GHP), a community-initiated non-profit organization, provides primary care, prescription drugs, and specialty care to uninsured, low-income adults through a network of independent physicians, clinics, and hospital systems. As part of an advocacy effort, GHP supporters used results from the Speak to Your Health! Community Survey to gain financial and political support for GHP. Our study, which used CBPR principles, was created by the community, local health department, and university partners. As a result, Genesee County became one of the first counties in the United States to make basic health care available to nearly all of its uninsured, low-income adults.
Abstract: The Prevention Research Center of Michigan provided technical assistance for the evaluation of 10 projects funded by the Michigan Department of Community Health's (MDCH) Health Disparities Reduction Program. These projects varied considerably in focus, methodology, geographical coverage, and populations served. The authors developed a cross-site evaluation tool to complement the internal evaluations of the projects. The tool contains four sections based on priorities identified by MDCH: evidence-based practice, research-based learning/evaluation (including process, impact, and outcomes indicators), cultural competence, and sustainability. Recognizing the diversity of programmatic efforts and organizational evaluation capacity, the authors sought to enable each project to create the best evaluation possible given the resources and data available. Each section contains a range of components from basic questions to more advanced evaluation techniques. The instrument attempts to use the highest quality of information available for each project. This evaluation tool can be used by programs with diverse goals and methodology.
Abstract: The Speak to Your Health! community survey is a biennial community-based survey designed and implemented by the Prevention Research Center of Michigan whose central mission is to strengthen the capacity of the community to improve health.
Abstract: Bureau of Justice Statistics data indicate that the United States has the highest incarceration rate in the world, and substantial disparities exist between incarceration rates for Whites and minorities. Research on the impact of incarceration usually focuses on the sentenced individual and occasionally on the children of incarcerated parents. The health consequences of incarceration may also extend to other family members and friends left behind in the community, exacerbating racial disparities in physical and mental health.
Abstract: We conducted an analysis of a demographically representative community health survey to examine the association between psychosocial factors and asthma. Data from the Speak to Your Health! Community Survey, a community-based survey designed and implemented by university and community partners using Community Based Public Health (CBPH) principles to investigate health and social issues in Genesee County, Michigan, was used in the analysis presented. The survey gathered information on self-reported mental and physical health status, disease diagnoses, health access and utilization, health-promoting and health-adverse behaviors, neighborhood conditions, and other topics. We sampled households in all residential census tracts in Genesee County, Michigan. One resident over 18 years of age was randomly selected within each household and participated in a telephone interview. The total sample size for the telephone survey in 2007 was 1,748. The mean age of the participants was 54.7 (SD = 15.69); 66% of participants were white, 26% African American, and 7% other race/ethnicity; and 15% of the population reported being diagnosed with asthma. Adults with asthma had significantly higher body mass index, higher levels of social support, and higher levels of stress than adults without asthma. Clinicians and researchers should be aware of psychosocial factors affecting their adult patient populations and tailor patient care, communication, and community-based educational interventions to specifically address these.
Abstract: Data from a community survey were analyzed geographically to help facilitate local diabetes prevention efforts. Data were available from the Speak to Your Health! Community Survey, designed and implemented by The Prevention Research Center of Michigan (PRC/MI), whose central mission is to strengthen community capacity to improve health. This survey was developed collaboratively by the university and community partners that comprise the PRC/MI and focuses on health and social issues at the heart of the community of Genesee County, Michigan. Survey data were used to calculate and geographically map diabetes-risk scores and mapped diabetes-screening rates. These maps indicated that those areas where the estimated risk of diabetes was the highest had only moderate rates of diabetes screening relative to other areas. It is hoped that these results will reach those involved in local diabetes-intervention programs with the intent that the data will be used in planning local prevention and intervention efforts.
Abstract: Collecting community-level data to inform health interventions and monitor health status is critical to improving community health and eliminating health disparities. Ideally, the process for designing and utilizing these data collection tools will include representation from community, service, and academic institutions. The process for incorporating these entities' diverse needs and perspectives, however, can be challenging.
Abstract: This study investigates how neighborhood deterioration is associated with stress and depressive symptoms and the mediating effects of perceived neighborhood social conditions. Data come from a community survey of 801 respondents geocoded and linked to a systematic on-site assessment of the physical characteristics of nearly all residential and commercial structures around respondents' homes. Structural equation models controlling for demographic effects indicate that the association between neighborhood deterioration and well-being appear to be mediated through social contact, social capital, and perceptions of crime, but not through neighborhood satisfaction. Specifically, residential deterioration was mediated by social contact, then, social capital and fear of crime. Commercial deterioration, on the other hand, was mediated only through fear of crime. Additionally, data indicate that the functional definition of a "neighborhood" depends on the characteristics measured. These findings suggest that upstream interventions designed to improve neighborhood conditions as well as proximal interventions focused on social relationships, may promote well-being.
