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Using Social Theory to Guide Rural P...

Kizer, Elizabeth A.

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Using Social Theory to Guide Rural Public Health Policy and Environmental Change Initiatives.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Using Social Theory to Guide Rural Public Health Policy and Environmental Change Initiatives./
Author:	Kizer, Elizabeth A.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2017,
Description:	183 p.
Notes:	Source: Dissertation Abstracts International, Volume: 78-09(E), Section: B.
Contained By:	Dissertation Abstracts International78-09B(E).
Subject:	Public health. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=10271035
ISBN:	9781369742695

Using Social Theory to Guide Rural Public Health Policy and Environmental Change Initiatives.
Kizer, Elizabeth A.

Using Social Theory to Guide Rural Public Health Policy and Environmental Change Initiatives. - Ann Arbor : ProQuest Dissertations & Theses, 2017 - 183 p.

Source: Dissertation Abstracts International, Volume: 78-09(E), Section: B.

Thesis (D.P.H.)--The University of Arizona, 2017.

The study of health disparities and the social determinants of health has resulted in the call for public health researchers to investigate the mid- and upstream factors that influence the incidence of chronic diseases (Adler & Rehkopf, 2008; Berkman, 2009; Braveman P. , 2006; Braveman & Gottlieb, 2014; Krieger, 2011; Rose, 1985). Social ecological models (SEMs) provide important conceptual tools to inform this research and practice (Krieger, 2011; Golden & Earp, 2012; Story, Kaphingst, Robinson O'Brien, & Glanz, 2008; Glanz, Rimer, & Lewis, 2002). These models can help us look at the social and physical environments in rural Arizona communities and consider how health policies and environmental interventions address mediating factors, such as disparities in access to fresh food, that contribute to ill health in marginalized, rural, populations. Rural residents are at greater risk for obesity than their urban counterparts (Jackson, Doescher, Jerant, & Hart, 2006; Story, Kaphingst, Robinson O'Brien, & Glanz, 2008). And while human life expectancy has steadily increased over the past thousand years, current projections indicate that the rise in obesity-related illnesses will soon result in its decline (Olshansky, et al., 2005). One reason for this decline, may be the reduced availability of healthy food---an important predictor of positive health outcomes including reduced obesity and chronic disease---in many parts of the United States (Brownson, Haire-Joshu, & Luke, 2006; Ahen, Brown, & Dukas, 2011; Braveman & Gottlieb, 2014; Braveman, Egerter, & Williams, 2011). The United States Department of Agriculture (USDA) defines food deserts as geographic areas in which there is limited access to grocery stores and whose populations have a high rate of poverty. In Arizona, 24% of the rural census tracts are considered food deserts; compared to an average of eight percent of rural census tracts across the nation (United States Department of Agriculture, 2013). Food deserts are one example of the upstream factors influencing the health of rural populations.

ISBN: 9781369742695Subjects--Topical Terms:

534748
Public health.

Using Social Theory to Guide Rural Public Health Policy and Environmental Change Initiatives.
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500 $a Source: Dissertation Abstracts International, Volume: 78-09(E), Section: B.
500 $a Adviser: Kenneth Schachter.
502 $a Thesis (D.P.H.)--The University of Arizona, 2017.
520 $a The study of health disparities and the social determinants of health has resulted in the call for public health researchers to investigate the mid- and upstream factors that influence the incidence of chronic diseases (Adler & Rehkopf, 2008; Berkman, 2009; Braveman P. , 2006; Braveman & Gottlieb, 2014; Krieger, 2011; Rose, 1985). Social ecological models (SEMs) provide important conceptual tools to inform this research and practice (Krieger, 2011; Golden & Earp, 2012; Story, Kaphingst, Robinson O'Brien, & Glanz, 2008; Glanz, Rimer, & Lewis, 2002). These models can help us look at the social and physical environments in rural Arizona communities and consider how health policies and environmental interventions address mediating factors, such as disparities in access to fresh food, that contribute to ill health in marginalized, rural, populations. Rural residents are at greater risk for obesity than their urban counterparts (Jackson, Doescher, Jerant, & Hart, 2006; Story, Kaphingst, Robinson O'Brien, & Glanz, 2008). And while human life expectancy has steadily increased over the past thousand years, current projections indicate that the rise in obesity-related illnesses will soon result in its decline (Olshansky, et al., 2005). One reason for this decline, may be the reduced availability of healthy food---an important predictor of positive health outcomes including reduced obesity and chronic disease---in many parts of the United States (Brownson, Haire-Joshu, & Luke, 2006; Ahen, Brown, & Dukas, 2011; Braveman & Gottlieb, 2014; Braveman, Egerter, & Williams, 2011). The United States Department of Agriculture (USDA) defines food deserts as geographic areas in which there is limited access to grocery stores and whose populations have a high rate of poverty. In Arizona, 24% of the rural census tracts are considered food deserts; compared to an average of eight percent of rural census tracts across the nation (United States Department of Agriculture, 2013). Food deserts are one example of the upstream factors influencing the health of rural populations.
520 $a Local health departments have been encouraged through the National Association for City and County Health Officials (NACCHO) and through the Public Health Accreditation Board (PHAB) to conduct community health assessments (CHAs) in order to identify unique contexts and community resources, health disparities, and the social determinants of health as well as potential areas for advocacy, policy change, environmental interventions, and health promotion interventions. Public health challenges like chronic diseases, which have multiple causes, can be explored in-depth through CHAs. CHAs often contain recommendations for action and/or are followed by community health improvement plans (CHIPs) which help local health departments prioritize resources and set measurable goals. In Florence, AZ recommendations made in a CHA are being acted upon by a non-profit agency, the Future Forward Foundation (3F). This investigation explores two interrelated issues regarding the use of CHAs and CHIPs as practical tools to set public health priorities. First, what makes a CHA useful to rural public health practitioners? What methods of conducting a CHA and subsequently analyzing the data results in actionable policy recommendations and/or environmental level interventions? Second, to what extent can public health agencies engage nontraditional partners to work in partnership to address the social determinants of health? As an example, I will look at the impact of a volunteer-based non-profit agency, located in a rural food desert on improving the social and physical nutrition environment as recommended by a local CHA. This inquiry will provide insights to public health practitioners seeking to identify and implement policy and environmental change addressing complex, multi-causal, public health issues, and provide insights regarding engaging nontraditional partners who may not self-identify as public health agencies.
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