- Hispanic Aging in the Americas Conference
- NLSY 1997 Postsecondary Research Network Conference
- PHI Kickoff Conference
- Michael Geruso and Dean Spears (Economics)
- Air Pollution and Child Health Across the Developing World
- This project aims to better understand how airborne pollutants in poor countries shape population health outcomes in–utero, as well as during infancy and childhood. While there is good evidence on the impacts of airborne pollution on infant and child health from rich countries, we know little to date about whether and to what extent the adverse health effects of pollutants might differ for populations in poor countries. Nonetheless, there are many reasons to suspect that the impacts of pollution on health might be significantly different in the developing world. This is both because the poor may have limited mitigation avenues (e.g., climate controlled homes) and because the typical concentrations of airborne pollutants in the developing world are many times higher than in even the most polluted locations of the US. With the help of a former NASA climate scientist, we will compile the most comprehensive linked pollution–child health data ever assembled for the developing world. Our data will contain representative national samples from more than 50 countries (116 DHS surveys) linked to historical satellite imagery from which we will extract atmospheric pollution data. Using this newly–generated dataset, we will analyze the dynamics of pollution’s impact on child health and survival from gestation through early childhood. Our analysis will produce some of the first scientific evidence on these impacts in developing countries. By focusing on the poor to an extent never attempted in the prior empirical literature, this project is likely to broaden our understanding of the rich–poor stratifications of pollution’s impact within rich countries as well. Ultimately, we intend for our analysis to inform the debate over the value (in terms of health benefits) of pollution reduction policies domestically and throughout the world.
- Bo Xie (Nursing)
- Values and Preferences in Dementia Family Caregivers’ End-of-Life Decision-Making
- Alzheimer’s disease and other dementia (hereafter referred to as dementia) is one of the largest public health
concerns facing the U.S. population. Today, one-third of older adults die suffering from dementia, and the number of people living with dementia is projected to increase from 5.4 million in 2016 to 13.8 million in 2050 with the highest growth among those in the severe or end stage of dementia. Despite the significant mortality rate among persons with Alzheimer’s disease and other dementia (PWAD), many of them receive less than optimal end-of-life (EOL) care. When placed in nursing homes, approximately 40% receive costly and burdensome interventions, such as hospitalization for treatment of infections and tube feeding in the last months of life. Also, treatments that PWAD receive are often inconsistent with previously stated wishes.
The decision making responsibility for PWAD at EOL mostly falls on their family members as well as health care professionals. EOL decisions are high-stake and value-laden, however many dementia family caregivers (hereafter referred to as caregivers) do not fully understand their loved ones’ preferences for EOL treatments and report inadequate support from professionals in decision-making. At the same time, professionals often lack skills and tools to help families communicate and engage in shared decision-making. Rich evidence suggests human values (e.g., self-enhancement vs. self-transcendence; conservation vs. openness to change) and preferences for health information and for participation in healthcare decision-making affect individuals’ behaviors and choices. Similarly in the case of EOL decision-making by caregivers, caregivers’ understanding of PWAD’s values is a key determinant of decisional uncertainty and confidence in caregivers. Yet, few psychometrically validated instruments are available to assess values and preferences to guide caregivers’ EOL decision-making. This study intends to fill this gap.
- Esther Calzada (Social Work)
- Examining Disparities in Internalizing Disorders among Mexican American Youth
- The proposed study focuses on internalizing problems in Latino children and youth with the aim of broadening understanding of ethnic disparities in anxiety, depression and suicidality. Consistent with a population health approach, we recognize that mental health disparities reflect complex, multi-factorial and dynamic pathways at all levels of a child’s ecological context. For Latino children, context is uniquely shaped by cultural—as well as universal (i.e., cross-culturally robust)—experiences, resulting in what is likely to be a distinct (but heretofore unknown) risk profile for internalizing problems. Thus, our interdisciplinary research team plans to develop a comprehensive, culturally-informed model of Latino child mental health to be tested in a Mexican-American sample (the largest Latino subgroup) in a federally-funded research study. The aims of the proposed federally-funded study are to: Aim 1: Describe the prevalence of anxiety disorders, depression and suicidality (ideation and attempts) in a community sample of Mexican-American children and youth, ages 3 – 18. Aim 2: Examine age of onset, patterns of stability, and patterns of comorbidity between classes of disorders. Aim 3: Examine risk factors, and how they interact over time, to produce anxiety, depression and suicidality.To best position ourselves for a successful federal grant application (anticipated submission date: summer 2017), we are seeking funds from PHI to support the following aims:
PilotAim 1: to further develop our investigative team, with an emphasis on incorporating researchers with sociological and cognitive developmental expertise. Currently, our interdisciplinary team includes a clinical psychologist (Calzada), a cultural anthropologist (Gulbas), a social worker (Haussman-Stabile), and a developmental psychologist (Kim). We believe there are a number of UT-based researchers (e.g., in Psychology, Sociology) who would compliment the existing team, and we plan to reach out to faculty to gauge interest in and commitment to joining the investigative team. We may also pursue collaborations with researchers outside of UT to serve as consultants.
PilotAim 2: to further develop a model of Latino child internalizing disorders, drawing on the expertise of our interdisciplinary research team. Currently, the core investigative team has expertise in the functioning and well-being of early childhood (Calzada), school-aged (Kim) and adolescent (Gulbas and Hausmann-Stabile) Latino populations, and in cultural and family factors associated with child and youth emotional functioning (i.e., anxiety, depression, suicidality). At the center of our current model is parenting and culture (e.g., acculturative stress, parenting practices). We expect that the fully-formed investigative team will support the enhancement of the model to incorporate a focus on individual characteristics (e.g., child temperament) and extrafamilial (e.g., peer networks) correlates and risk factors.
PilotAim 3: to refine our methodological approach based on the theoretical model developed in PilotAim2. PilotAim3a: We plan to work with methodologists and analysts to critically evaluate our methodological approach to ensure its alignment with the final theoretical model. PilotAim3b: We also plan to critically evaluate our recruitment plan to ensure its alignment with the final theoretical model. Co-PIs Calzada and Gulbas have existing partnerships with health clinics that serve the local Latino community. Co-I Kim has several years of experience in conducting research through Austin Independent School District. We are also working towards a multi-site design that would involve data collection in Austin, Houston, El Paso, and McAllen, TX. Co-PI Gulbas has strong ties to the medical/pediatric clinic community in El Paso; Co-PI Hausmann-Stabile has ties to the school and health clinic community in Houston; and Co-PI Calzada is in the intial phases of establishing a research collaboration with the superintendent of McAllen Independent School District. We will explore these and other potential partnerships as part of the PHI-funded pilot. Specifically, we plan to: 1) learn more about the characteristics of the community served by these partner organizations; 2) critically evaluate the fit of the community characteristics with final project goals; 3) formalize the partnership with recruitment sites, considering mutual priorities, needs and constraints.
- Leticia Marteleto (Sociology) / Weitzman
- Fertility Responses to the Zika Virus in Brazil
- The objective of this proposal is to provide the first in-depth analyses of fertility responses to the Zika epidemic in Brazil. These analyses will include investigations into how the Zika epidemic affected reproductive-aged adults’ desired family size, birth spacing, sexual behavior, contraception use, and investments in current children’s health and education during and after the 2015-2016 epidemic. Understanding fertility responses to the epidemic is key to understanding the effects of population health shocks on individual family health and healthcare utilization more broadly, and is especially important in a developing country context where large disparities in healthcare persist. Currently, little research is available on the effects of the Zika epidemic on fertility in Brazil. The proposed study will build upon a preexisting survey, the National Health Survey (PNS, collected prior to the outbreak), to collect new data from a population-representative sample from two states in Brazil to identify how the Zika epidemic—an epidemic with perceived antenatal health consequences—has altered fertility desires and related behaviors among reproductive-aged adults. The specific aims of this project will be to: (1) collect new, detailed measures of Zika virus exposure (2) collect detailed measures of desired family size, sexual behaviors, contraception use, birth spacing, and parents’ investments in existing children’s health and education during and after the epidemic (3) provide estimates of the effects of the geographic concentration of the virus on desired family size, fertility behaviors, and investments in children and (4) determine which sociological aspects of the epidemic (beliefs about the virus, perceived risk of contraction, and knowledge of specific cases) explain observed fertility responses. To meet these aims, the proposed study will collect and analyze survey data based on the sampling frame and questionnaire used by the PNS with the additional inclusion of unique measures of Zika virus exposure. The combination of new data and comparable, preexisting PNS survey data will facilitate the identification of appropriate counterfactuals, reduce bias introduced by preexisting differences across groups with varying levels and types of Zika exposure, and reduce bias introduced by changes in fertility desires and behaviors that would have occurred even in the absence of the Zika outbreak. After the collection of comprehensive baseline survey data mirroring the PNS, a random sample of households (20% of the original, post-epidemic sample) will be selected for 1 and 2-year follow-up surveys with the goal of understanding changes in the effects of the Zika epidemic on fertility over time. Difference-in difference, regression discontinuity, fixed effects and nested regression models will be used to assess how fertility responses to the Zika epidemic vary with the timing and quality of Zika virus exposure, socioeconomic status, geographic location, and number of existing children at the time of the outbreak.