Browsing by Subject "women's health"

Now showing 1 - 5 of 5
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    Diagnosis, treatment, and survival among older women with breast cancer: the effect of pre-existing mental illness.
    (2021-04) Bhattacharya, Manami
    BackgroundPeople with a mental illness die 8-25 years earlier than people without a mental illness. Among women, decreased life expectancy is partially due to higher mortality from breast cancer; women with mental illnesses experience up to 367% increased hazards of mortality after breast cancers compared to women without mental illnesses. Yet, with timely detection and appropriate treatment breast cancer is very survivable. ObjectivesThis research focuses on how a pre-existing diagnosis of mental illness affects breast cancer outcomes across the cancer continuum, focusing on differences in stage of diagnosis, receipt of guideline-concordant care, and survival. I also examine whether outcomes vary by type and severity of mental illness. Finally, I evaluate whether the impact of mental illness varies by race, arguing that having marginalized identities associated with multiple forms of oppression may worsen outcomes. MethodsThis project uses the linked Surveillance and Epidemiology and End Results (SEER) cancer registry and Medicare claims (SEER-Medicare), a data national source that captures a significant proportion of breast cancer cases nationally among women over 65 years old. Mental illness is defined and categorized as having a diagnosis of serious mental illness (schizophrenia, bipolar disorder, depression with psychosis, and other psychotic disorders); depression or anxiety; and other mental illnesses excluding cognitive disabilities, in the two years prior to cancer diagnosis. Outcomes examined include AJCC staging, receipt of NCCN guideline-concordant care, focusing on surgery, radiation, and chemotherapy, and months of survival. A total of 96,034 women were included, though sample sizes vary depending on the analysis. ResultsPre-existing mental illnesses are common for women diagnosed with breast cancer. Overall, I found that 28.6% of women in this study had at least one diagnosis of a mental illness in the two years prior to their breast cancer diagnosis and 1.7 % had a serious mental illness. Women with SMI are more likely to be diagnosed with Stage II or III breast cancers than women without mental illnesses and women with depression or anxiety are less likely to be diagnosed with Stage IV cancers. In terms of treatment, I find that among women with AJCC stage I-III cancer, where either a mastectomy or breast conserving surgery and a full course of radiation is recommended, women with SMI less likely to receive surgery than women without. Women with mental illnesses (regardless of type) have a higher risk of not completing radiation after breast conserving surgery. Among women with AJCC stage I-III triple negative or HER2+ cancers, women with SMI are more likely to not complete surgery, radiation, and chemotherapy. Finally, I find that women with mental illnesses (regardless of type) have higher risks for mortality after cancer from both breast cancers and other causes, and that this risk is not entirely explained by stage of diagnosis and treatment received. Differences in survival are greatest for persons with SMI. I also investigated whether the effects of mental illness on cancer outcomes vary by race/ethnicity and find evidence that Black and Hispanic women may have especially high risks for later staging of breast cancer, incomplete treatment, and higher mortality. ConclusionsBreast cancer and mental illness are both common illnesses facing older women in the United States. This work provides new insights into issues of equity around breast cancer outcomes for older women with mental illnesses and provides entry points for considering interventions that will improve outcomes. This work also provides information for areas where inequities among Black and Hispanic women with mental illnesses experiencing breast cancer should be investigated further.
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    An Elective Course in Women’s Health Issues
    (University of Minnesota, College of Pharmacy, 2014) DiPietro, Natalie A.
    Purpose: To develop, implement, and evaluate an elective course for the Doctor of Pharmacy (PharmD) curriculum that provides students with a comprehensive overview of women’s health across the lifespan and exposes them to social and economic issues that impact women’s health. Case Study: At the time of this writing, the class has been delivered 3 times to a total of 56 students. Students read and discussed (both in-class and online) timely articles in women’s health issues on topics including sex-based biology; women in clinical trials; maternal and child health; women’s health coverage and access to care in the United States; gender and health communication; abuse and the role of healthcare professionals; and international issues in women’s health and women’s rights. Students completed a pre- and post-test; developed seminar presentations regarding women’s health issues; wrote reflective essays about the course; and designed and implemented health promotion projects for National Women’s Health Week (NWHW). At the end of the course, the number of correct answers on the post-test significantly improved from the pre-test (p<0.001). Through anonymous course evaluations, students indicated that the assignments fulfilled the learning objectives (mean 4.68 on a 5-point Likert scale) and the exercises were useful in helping their understanding of the material (mean 4.66 on a 5-point Likert scale). Over 500 women from the campus and community participated in the NWHW projects. Implications: An elective course was designed to educate pharmacy students regarding women’s health issues and to provide students with an opportunity to perform community outreach.
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    Family-friendly workplace policies in the United States: Associations with maternal and child health
    (2016-05) Jou, Judy
    Women in the United States face uniquely challenging circumstances regarding employment and childbirth. Unlike all but two other countries worldwide, the U.S. does not guarantee paid leave to employed women who give birth, and the 12 weeks of unpaid leave provided under the Family and Medical Leave Act falls far short of most industrialized nations. This dissertation examines the associations between family-friendly workplace policies such as paid maternity leave and indicators for maternal and child health outcomes, care utilization, and access to health care services in the U.S. context. Data from Listening to Mothers III, a national survey of U.S. women ages 18-45 who gave birth in 2011-12, were used to conduct multivariate logistic regression predicting infant health, maternal physical/mental health, and maternal health behavior outcomes by use and duration of paid maternity leave among 700 women who indicated working during pregnancy. A second aim explored the associations between workplace accommodations during pregnancy and women’s access to health insurance coverage after childbirth, via employment continuity. Data from the National Survey of Family Growth 2006-10 were then used to examine variations in access to paid and unpaid maternity leave across U.S. states by state-level leave policies among a sample of 2,708 U.S. women ages 18-44 who gave birth in 2001-2010. Across all three aims, paid maternity leave was consistently associated with positive indicators for maternal and infant health. Women taking paid maternity leave had significantly lower odds of re-hospitalizing themselves and their infants after giving birth and higher odds of positive health behaviors. Availability of maternity leave predicted women’s return to work postpartum, and in turn, lowered the odds of losing health insurance coverage. Women in states with more generous maternity leave policies were more likely to take leave, and for longer durations; this association was especially pronounced for lower-income women, suggesting that public policies may play an important role in addressing socio-demographic disparities in maternal/child health via access to paid maternity leave. Future research, especially using longitudinal or prospective cohort designs, is recommended to shed further light on the potential benefits of expanded access to paid leave for maternal/child health.
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    Turjun Health: Increasing Comfort in the Clinical Setting for Somali Women in the Twin Cities
    (2023) Makovec, Allison M; Schiemann, Erin; Xiong, Choua
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    Young Women and Online Health Information: A Study of Credibility, Access, and Usability
    (2015-03) Kinlin, Samantha
    Seeking health information online is a common practice in society today, especially among young people and women. Due to the increasing prevalence of this practice, I have reviewed current research on issues of credibility and access in online women’s health information to establish how credibility is conveyed online, and how improving access to online resources could decrease the number of barriers between individuals and health information in general (particularly for those individuals who might not have ready access to health care providers). I then selected a list of current health information websites designed for women and analyzed them according to well-known usability guidelines to determine how well these websites are designed for their audience and which design aspects could improve perceived credibility of or increase access to these sources of information.