More than 760,000 families in Cook County are food insecure and more than 30% live in the suburbs. We believe there is a strong correlation between food insecurity and poor health among women and children.

Using a population health approach, the Cook County Department of Public Health (CCDPH) Nursing Division and Integrated Health Support Services (IHSS) investigated and identified low income families who were food insecure in diverse communities of Cook County. The first goal of this study was to establish a baseline, by identifying low income, food insecure families including new mothers who had given birth between 2017 and 2019. We hypothesized by connecting women and their families to social services and other needed resources within these communities, we can improve overall health over time.

Using the Adverse Pregnancy Outcomes Reporting System (APORS) of Illinois, the public health nurses during their home visits, identified those low income families that were food insecure. Data was collected using surveys and entered into the Cornerstone system, a new foundation for the delivery and management of community health services in Illinois. Using regression analysis method, the data provided the short and long term impacts of food insecurity on health.

The results of this study showed that food insecurity was prevalent among 50% of all APORS families. We concluded that public health nurses and professionals can play a critical role in reducing food insecurity and improving women health by creating new pathways to help bridge the gap between families and social services.

Background: Colorectal cancer remains a significant case of mortality in the USA, accountable for about 259,662 deaths from 2012-2016. Healthy People 2020 objectives seek to increase the proportion of Americans ages 50 and above who receive timely cancer screening. The objective of this study is to determine factors contributing to differences in the uptake colorectal cancer screening using the Take-home test kit. Methods: Combined data for Americans ages 35 and above from the 2014 and 2015 Behavioral Risk Factor Surveillance System (n=137, 823) were weighted and analyzed using Stata 15 for windows and alpha = 0.05. Frequency distributions, chi-square distributions [95% Confidence Interval (CI)], and adjusted OR were computed to determine association between the covariates and use of the home test kit. Results: The sample was predominately white (72.4%) compared to 10.4% African American. Race, insurance, age, alcohol use, and smoking were associated with use Home test kit (p<0.01) at bivariate level. Having a high school diploma (OR=1.5; CI: 1.32-1.61; p<0.001) and college degree (OR=1.5; CI: 1.82; CI: 1.64-2.01; p<0.001) was associated with higher odds of home stool kit. Having a regular doctor and seeing doctor in preceding 12 month period were also significant ((OR=1.60; CI: 1.41-1.74; p<0.01). Conclusion: The results underscore the importance of providing patients with a medical home with regular patient-provider interactions which provides opportunity for encouraging screening behaviors. Eliminating barriers to insurance coverage will increase the number of Americans receiving early screening for colorectal cancer thus improving survival and quality of life.

Background: Race and culture are influential in decision-making in healthcare, particularly for women of color determining their mode of birth. Haitian women have increasing rates of cesarean section and low rates of vaginal birth compared to White women. We hypothesized that integrating key elements of Haitian culture with a Group Counseling and Shared Decision-Making (GCSDM) program will empower Haitian women to make informed decisions on modes of birth. Methodology: This three-phase exploratory sequential mixed-methods study at Boston Medical Center was designed to: (1) identify key determinants of mode of birth among Haitian women and their healthcare providers using focus groups; (2) develop a GCSDM curriculum using the Health Belief Model theoretical framework; (3) evaluate the curriculum using surveying. Results: Key determinants included: Haitian cultural beliefs and norms around birth, lacking health education in Haitian Creole, the importance of family and friends in decision-making, and pain as a major influence. After the GCSDM session, the rate for planned cesarean decreased, however, upon hospital admission, the percent of Haitian women with cesarean delivery increased. All (n=10) women reported being “very satisfied” with the session; 90% (n=9) stated the session gave them enough information to confidently decide their mode of birth. Conclusion: The GCSDM session was coveted among Haitian women, demonstrating the power of culturally appropriate education and group counseling. Further research should be conducted to understand the change in mode of birth decision upon hospital admission. The GCSDM curriculum could be adapted to improve shared decision-making for other races and cultures.

Background: Homicide by an intimate partner is the 2^nd leading cause of death for young black women in America. Black feminists argue that intimate partner violence (IPV) disproportionately affects black women because of their many intersecting identities that place them at greater risk of experiencing IPV. More recently, scholars purport that religion should be explored as another intersection of risk for IPV, especially among American Muslims. African Americans comprise one of the largest ethnic groups among American Muslims, and the unique cultural and religious aspects of this community may put African American Muslim women at increased risk for IPV.

Purpose: To understand the lived experiences of African American Muslim women with IPV to inform the development of culturally competent programs and services for this growing population.

Methods: Using interpretive phenomenology to explore, describe, and analyze the experiences of IPV through interview data collected from 12 African American Muslim women.

Results: IPV was not salient among these women. None felt Islam (the religion itself) supports IPV against women, and most expressed a sense of security in the rights the religion affords them in marriage. Some participants were in polygamous unions (i.e., their husbands had additional wives) as permitted in Islam, and described experiences of marital stress, emotional and financial abuse, and violence between co-wives. Others conveyed that polygamy led to more strength, power, and autonomy in their relationship.

Conclusion: Further research is needed to understand how marriage type could be associated with IPV, in which direction, and for whom.

Mass incarceration is a population driver that has been likened to a diaspora within many populations. To demonstrate the scale of this community impact, this study measures incarceration as both a forced migration and a health disparity, with demographic and epidemiologic measures.

The per capita Expected Incarcerations and the Incarceration-Adjusted Life Expectancy for communities in Illinois (IL), US, are calculated per year and averaged across the study period (2013-2017). Communities are defined by race, gender, age, and locale, allowing rigorous stratification of results. Preliminary results show the average Black male in Illinois will spend over 2 years of his adult life incarcerated, compared to 0.37 for their White counterparts. In communities where they are less represented, the average Black male resident can also expect to be incarcerated at least once in his lifetime. Though Hispanic and White males have similar state-wide averages, the limited geographic spread of Hispanic IL residents generates high-expectancy neighborhoods.

Dividing person-time and frequency of incarcerations among all community members places the study focus on free individuals who are members of highly-incarcerated communities. Expressing these findings through interdisciplinary metrics estimates this collective burden in technical terms and encourages empathetic sentencing policy development.

A demographic understanding of how disparity accrues in highly-incarcerated communities will elucidate some effects of over policing, racial profiling, youth criminalization, community violence, and neighborhood impoverishment.

The public health problem of police violence has been an enduring manifestation of institutional racism. Discourse on police violence has centered the disproportionate impacts on Black boys and men and has largely excluded Black women that represent the only group, by race and gender, for whom the majority of those killed by police are unarmed. Black women experience uniquely racialized and gendered non-lethal violence and are overrepresented among those targeted for police violence, such as, among, people with disabilities, non-gender conforming people and people experiencing homelessness. I use an intersectional lenses and Critical Race Theory and Black Feminist Thought approaches to explore the experiences and views of Black women in a historically Black neighborhood by engaging in semi-structured interviews with residents. The findings reflect their analyses of policing and the health implications of policing in their neighborhood, their experiences of police violence and their views on solutions to the problem with implications for researchers, activists and policy makers.