Dissertation
Urban determinants and disparities in chronic liver disease
Doctor of Philosophy (Ph.D.), Drexel University
Nov 2023
DOI:
https://doi.org/10.17918/00001893
Abstract
Introduction: Chronic Liver Disease (CLD) is a significant global health concern, with notable disparities in morbidity and mortality rates among different racial/ethnic groups, particularly between Hispanics and non-Hispanic whites in the United States, and across various urban settings in Latin America and the US. This thesis aims to explore these disparities in-depth, examining the contributing factors and trends in liver disease outcomes and mortality rates across diverse geographical contexts. Methods: This thesis encompasses three comprehensive studies. The first study uses cross-sectional data from NHANES (2017-March 2020) to assess racial/ethnic disparities in hepatic steatosis, inflammation, and fibrosis among the US population. The second study analyzes CLD mortality data from 57 US cities (2005-2009 and 2015-2019) to explore spatial disparities and trends. The third study focuses on CLD mortality across 343 Latin American cities and 64 US cities with substantial Hispanic populations, using data from the Salud Urbana en America Latina (SALURBAL) project (2010-2019). Results: The findings reveal significant racial/ethnic disparities in liver disease manifestations in the US, with Hispanics showing the highest prevalence. Spatial analysis of CLD mortality in US cities indicates decreasing disparities over time, with regional variations. The study of Latin American cities and Hispanics in the US highlights considerable geographic and temporal heterogeneity in CLD mortality rates, with city-level socioeconomic factors playing a significant role in these variations. Discussion: These studies collectively underscore the complex interplay of racial/ethnic identity, geographic location, and socioeconomic status in influencing CLD outcomes. They highlight the need for tailored public health strategies and interventions that address the specific needs and contexts of diverse populations, particularly focusing on reducing disparities and improving liver health outcomes among at-risk groups.
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Details
- Title
- Urban determinants and disparities in chronic liver disease
- Creators
- Kevin Martinez-Folgar
- Contributors
- Usama Bilal (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- ii, 95 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Dana and David Dornsife School of Public Health; Epidemiology and Biostatistics; Drexel University
- Other Identifier
- 991021819215404721