Purdue University Graduate School
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Addressing health disparities: evidence-based policy and intervention strategies

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Addressing health disparities: evidence-based policy and intervention strategies

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posted on 2024-07-18, 03:47 authored by Min Kyung LeeMin Kyung Lee

Health equity remains a fundamental goal in public health, driven by the significant disparities in health outcomes experienced by marginalized populations. This study investigates the multifaceted factors contributing to health disparities and highlights the necessity of comprehensive approaches to mitigate these inequalities.

First, we examine the impact of legislative climates on health outcomes for transgender and cisgender populations. We implemented a marginal structural model with inverse probability weighting to understand the causal relationship between state-level policy environments and transgender health disparities. Our findings reveal that while cisgender individuals generally experience consistent healthcare utilization and better health outcomes, transgender people in less supportive states face significant barriers and worse health outcomes.

Second, we explore the role of gender-affirming medical care during adolescence in influencing adult psychological and general health outcomes. Using data from the 2015 US Transgender Survey, we compare the health outcomes of transgender and non-binary individuals who received gender affirming medical care (GAMC) during adolescence with those who did not. Our causal moderation analysis demonstrates that GAMC during adolescence is associated with reduced psychological distress in adulthood, with the effect significantly moderated by state-level policy stigma.

Lastly, we conduct a qualitative study on breast cancer disparities between Black and White patients, using semi-structured interviews and health services data to map patient journeys across the cancer control continuum. Our thematic analysis identifies significant barriers faced by Black women, including cultural discordance, communication challenges, and delays in diagnosis, underscoring the need for tailored interventions to enhance provider-patient communication and support.

This study emphasizes the importance of a holistic approach to achieving health equity, addressing individual, systemic, and legislative factors. By advocating for inclusive policies, improving provider-patient communication, and ensuring access to comprehensive care, we can work toward eliminating health disparities and promoting equitable health outcomes for all populations. The findings provide a foundation for future research and policy development aimed at achieving these critical goals.


History

Degree Type

  • Doctor of Philosophy

Department

  • Industrial Engineering

Campus location

  • West Lafayette

Advisor/Supervisor/Committee Chair

Yuehwern Yih

Additional Committee Member 2

Deanna Willis

Additional Committee Member 3

Denny Yu

Additional Committee Member 4

Ephrem Abebe

Additional Committee Member 5

Mark Lehto

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