Dr. David Strogatz, Director

GOALS

• Support the implementation of proposed research projects
• Support the development of additional applications for funding of studies that will address health disparities in small cities and that are planned and conducted through collaboration between university-based and community-based partners
• Provide expertise on statistical issues in designing and conducting studies, analyzing the data and interpreting and presenting results
• Increase interactions across units of UAlbany and between university-based and community-based groups to discuss the significance of health disparities and to identify new opportunity for multidisciplinary collaboration in research

Our Research Projects (Research Core section of 2011 progress report follows)

1. Overcoming Barriers to African American Women's Reproductive Healthcare Seeking

2. Toxicants in the Ecology of Reproductive Health

3. Decomposing Racial/Ethnic Disparities in Health
   

1.  Overcoming Barriers to Underserved and Minority Women’s Reproductive Healthcare Seeking

The purpose of this project, known in its local focus community as the Women’s Health Project, is to identify strategies for encouraging underserved and minority women to seek regular reproductive healthcare services, including family planning, STI screening, and breast and cervical cancer screening. The Project is rooted in the recognition of significant disparities in disease incidence and health outcomes for adult African American women on multiple indicators of reproductive health, and focuses on the city of Hudson, New York. It is led by Drs. Annis Golden and Anita Pomerantz of the Department of Communication, and is conducted in collaboration with Upper Hudson Planned Parenthood.

The two primary interventions of the Project are community health education events on themes related to women’s reproductive health and a transportation voucher program for improving access to care. The community health education events have two distinctive features. One is to bring women in the community together with representatives of community-based health and human service organizations, which helps to build knowledge and trust on both sides. Events begin with resource fairs during which women can get on-site preventive health screenings (e.g. blood pressure, cholesterol, glucose, STI/HIV screening) and receive assistance from Upper Hudson Planned Parenthood in scheduling an annual GYN appointment and obtaining a taxi voucher for transportation to the appointment. The second distinctive feature of the health education events is to have presentations made by persons who are from the community and reflect the diversity of the audience. This not only represents best practice in terms of connecting with the audience but also is a strategy for building a sustainable model of community health promotion past the life of the grant. The research team is incorporating lessons learned during the initial phase of the project into its strategies for working with the community, as well as continuing to document its activities and outcomes through an innovative mix of qualitative and quantitative methods.

Environmental Contaminants and Reproductive Health of Akwesasne Mohawk Women

This project seeks to determine whether the reproductive health of women of the St. Regis Mohawk Tribe on the St. Lawrence River has been adversely affected by exposure to chemical pollutants, primarily polychlorinated biphenyls (PCBs). The Akwesasne community is adjacent to one federal, and two state Superfund sites. There is considerable concern in the Akwesasne community regarding difficulties in conceiving and bearing healthy children. This project is a collaborative effort between the St. Regis Mohawk Health Service (SRMHS) headed by Debra Martin, and the University at Albany/CEMHD. The community is solidly behind the project, and we greatly appreciate all the help SRMHS has given us. When the study began, then Tribal Chief James Ransom remarked, “Akwesasne has long been impacted by PCBs from neighboring industries. Women of child-bearing age are a particularly vulnerable at-risk group. We hope this research leads to improved health in our community and we thank UAlbany for the opportunity to participate with them on this important project.”

The study will follow 180 women ages 21-38 through one menstrual cycle to investigate the effect of PCBs, DDT, lead and other pollutants on the pattern of hormones that affect reproduction. In addition to Dr. Schell who is the principal investigator, Drs. Mia Gallo, David Carpenter, Glenn Deane, and Cheryl Frye are collaborating on this multifaceted project. PCBs and other organic toxicants are analyzed by Dr. Carpenter’s team in the School of Public Health. An innovative aspect of this project is that some of the hormones are measured in saliva that is collected daily through the menstrual cycle. Measurements of these hormones in blood supplement these salivary measurements. An additional innovation of this study is that it examines the effects of several pollutants simultaneously whereas most studies have looked at one pollutant at a time. Results from an earlier study of Akwesasne youth conducted by this group showed that age at menarche, a commonly used marker of the progress of sexual maturation, was delayed in relation to lead levels but advanced in relation to PCB levels. Thus, these results support the community's concern about larger effects of pollutants on reproduction.

Decomposing Racial/Ethnic Disparities in Health

The overarching goal of this project is to examine the nature and determinants of health disparities not only between but also within racial/ethnic groups (non-Latino whites, Latinos, African-Americans, Asians, American Indians/Alaskan Natives) in the US. We focus on community size (e.g., urban vs. rural) as a potential determinant of disparities. The basic premise of the study is that by targeting the most vulnerable of the vulnerable groups, the health disparity between groups and in the overall population can be reduced more effectively. Different groups have different quality of health as well as different socioeconomic and demographic characteristics that can affect health and health inequality. Thus, the causes of health inequality might differ for different racial/ethnic groups.

We use several nationally representative, secondary data sets in this study, including the Health & Retirement Study (HRS), the Panel Study on Income Dynamics (PSID), and Behavioral Risk Factor Surveillance System (BRFSS). Part of our work involves constructing indices of individual quality of health. These indices are based on a 5-category self-assessed health status measure and other binary ill-health indicators (e.g., diabetes, obesity, asthma etc.), supplemented by several objective determinants of overall health including different diseases/risk factors and socio-demographic characteristics. Initial analyses in older adults have examined disparities not only in the frequency of chronic conditions but also in the extent to which individuals are unaware that the condition is present. Analyses of children have assessed the magnitude of health disparities and their impact on educational achievements.

2011 Progress Report


SPECIFIC AIMS (unmodified from original) STUDIES AND RESULTS

To support the first Specific Aim, the Research Core has convened meetings of the Principal Investigators for each project with the Core Co-Directors and Core Biostatistician. The standard agenda for the Research Core meeting is a review of accomplishments since the last meeting, a discussion of any problems that arose, a summary of goals to be achieved by the time of the next Research Core meeting, and recommendations for strategies to address problems that are still unresolved or looming on the horizon. There has been general consensus for a quarterly meeting schedule of the full group of project Principal Investigators with the Research Core Co-Directors and Biostatistician, with the option for scheduling meetings involving individual projects with Research Core staff as needed. For example, Project 3 has established monthly meetings of the project team which the Research Core Director and Biostatistician are able to attend. This additional interaction between faculty from the College of Arts and Sciences and the School of Public Health has led to a broader awareness of relevant scientific literature and methods and to potential opportunities for cross-discipline collaboration.

The Research Core has also supported additional projects addressing health disparities (Specific Aim 2), with a specific emphasis on disparities in small cities and towns and projects linking the university with a variety of community partners. Dr. Strogatz, the Co-Director of the Research Core, has served as a member of the Advisory Board of the Pediatric Asthma Coalition of the Capital Region, which is funded by the New York State Department of Health and led by the Whitney M. Young Jr. Health Center, a federally designated neighborhood health center and a primary partner of the CEMHD.

During 2011 Dr. Strogatz collaborated on the successful application for the next cycle of funding (2012-2016) for the coalition. In this phase the interventions will include adults as well as children with asthma and will again be guided by the Chronic Care Model to work with community resources to reinforce successful self-management skills for asthma. Dr. Strogatz will lead the evaluation of intervention efforts.

 The Research Core provided support in 2011 for Dr. Akiko Hosler’s NIH applications for research on the food environment and risk of diabetes in minority communities of the Capital Region. Dr. Hosler submitted an R15 application in spring 2011 to assess longitudinal changes in the food environment and associations with diabetes in predominantly African American neighborhoods of Albany, and she submitted an R21 application in October 2011 to address the role of the food environment and other factors affecting the unexpectedly high prevalence of diabetes in the Indo-Guyanese community of Schenectady. Dr. Hosler’s proposed research in Schenectady will complement an ongoing community survey of diabetes funded by the CDC REACH (Racial and Ethnic Approaches to Community Health) program led by Dr. David Pratt, Commissioner of Schenectady County Public Health Services. Dr. Pratt has agreed to become a member of the Research Core Advisory Committee and has expressed interest in additional opportunities for collaboration.

With respect to the third and fourth Specific Aims, Dr. Recai Yucel’s role as the Core Biostatistician includes supporting statistical and methodological needs of existing projects and projects being proposed. He works with the Center’s Training Core so that students and junior faculty from the College of Arts and Sciences and the School of Social Welfare also have access to his presentations and consultation on projects related to health disparities.

In addition to supporting the work of others, Dr. Yucel has developed novel techniques for imputation strategies with incomplete data, and he has used the problem of missing data on race in the Child Development Supplement of the Panel Study of Income Dynamics to illustrate how imputation may lead to more valid inferences pertaining to health disparities; the manuscript describing this work was published this year in Statistics in Medicine (2011; 30:1137-1156).

In support of the fourth Specific Aim, the Research Core sponsored a visit and presentation in December 2010 by Dr. Robert Kaplan of the Albert Einstein School of Medicine, who spoke about initial findings from the Hispanic Community Health Study, a longitudinal study of multiple health outcomes in 16,000 Hispanic adults from New York, Chicago, Miami and San Diego.

Dr. Strogatz has also engaged the CEMHD and the School of Public Health’s HRSA-funded Empire State Public Health Training Center as participants in the Rural Minority Health Project of the NYS Health Department’s Office on Minority Health. This project conducted regional forums in summer and fall of 2011 to identify needs and resources; the results will be used in a community participatory process to develop and implement interventions.

The Empire State Public Health Training Center is supporting a graduate research assistant to provide technical assistance to local health departments to prepare for the forums and plan for interventions. These activities, and the design for implementation and evaluation of the interventions, will also draw on the expertise of the Outreach and Training Cores, as well as the Research Core.

SIGNIFICANCE

The existing and emerging research projects continue to focus on conditions (e.g. reproductive health, breast and cervical cancer, asthma, diabetes) that are major sources of health disparities and concerns of the communities in which the projects are located. The Center’s projects include quantitative and qualitative research; studies addressing etiology and prevention of disease; the use of primary and secondary data; and disparities affecting a variety of racial and ethnic groups. This diversity is also a strength of the Center.

PLANS During the next year, the Research Core will continue support of the Center’s main research projects and new projects through regular meetings with the project Principal Investigators, through advisement from the Core Advisory Committee, and through collaboration with other Cores of the Center on activities to foster skills and interest for research on health disparities.

PUBLICATIONS

Wicks AF, Lumley T, Lemaitre RN, Sotoodehnia N, Rea TD, McKnight B, Strogatz DS, Bovbjerg VE, Siscovick DS. Major life events as potential triggers of sudden cardiac arrest. Epidemiology. 2011; under review.

Yucel RM, He Y, Zaslavsky AM. Gaussian-based routines to impute categorical variables in health surveys. Statistics in Medicine. 2011; October 4. doi: 10.1002/sim.4355

Yucel RM. State of the multiple imputation software. Journal of Statistical Software. 2011.

Yucel RM, Tomaskovic-Devey, D. Multiple imputation in multiple classification and multiple-membership structures. Journal of the Royal Statistical Society, Series C. 2011

Yucel RM. Logistic mixed-effects models with ambiguous cluster membership. Computational Statistics and Data Analysis. 2011; under review.

PROJECT 1. Overcoming Barriers to African American Women’s Reproductive Healthcare Seeking (Golden, A. & Pomerantz, A - PIs)

Specific Aims (Unmodified from original).

1.    Evaluate the impact of intervention strategies for overcoming barriers to reproductive healthcare seeking for African American women residing in the study’s setting (Hudson, New York). Primary intervention strategies include a series of community health education events and a transportation voucher program.
2.    Increase (by the end of the data collection period of the project, December 2012) by at least 25% the number of African American women in Hudson, New York and environs who are receiving reproductive healthcare as demonstrated by increased clinical attendance at the local publicly funded reproductive healthcare provider, Upper Hudson Planned Parenthood.

Studies and Results

1.    In 2011, through October 20th, the Project conducted 5 Community Health Education Events (one every two months) on topics related to women’s reproductive health. Venues and formats were varied to assess their effectiveness in engaging underserved women in  the community. Assessment tools and measures included attendance numbers, pre- and post-event questionnaires measuring knowledge, attitudes, and behavioral intentions, qualitative interviews ascertaining participants’ reactions to events, and the number of       participants who signed up to receive services.

2.    The Project expanded the range of interventions it designed and conducted to increase underserved women’s access to services related to reproductive health.

3.    In March 2011, the Project initiated monthly HIV/STD testing events out of the Project’s field office in collaboration with the AIDS Council of Northeastern NY.

4.    In May 2011, the Project initiated weekly outreach sessions at the subsidized housing complex in collaboration with Upper Hudson Planned Parenthood, during which UHPP supplied free safer sex kits and emergency contraception kits. Reproductive and sexual health information was offered, and an opportunity to sign up for clinical services at UHPP and taxi vouchers from the Project were available.

5.    In August, 2011 the Project began a peer outreach assistant initiative: 6 women from community were hired to assist with weekly reproductive/sexual health outreach, and to assist with promoting and carrying out monthly community health education events. The group is receiving training on outreach techniques and reproductive/sexual health facts (through UHPP). The group meets weekly for discussion and planning activities.

6.    The Community Advisory Board met January 26 and May 19, and November 3. Meetings provide a forum for discussing past events and planning future events. The Board members are both advisory and represent community partners who participate in the health resource fairs. As local community members, the Board members have been a valuable source of guidance about leveraging event participation around other community events and groups.

7.    The research team continued to collect knowledge, attitude, and behavioral intention data using and pre- and post-event questionnaires, and to collect data on participants’ reactions to events through post-event qualitative interviews, from UHPP clients, and from users of the Taxi Voucher program to collect participants’ perceptions of its impact on their reproductive healthcare seeking behavior. The team continued qualitative data analysis of interview transcripts using NVivo, and quantitative data analysis of pre- and post-interview questionnaires. We added post-testing interviews in connection with AIDS Council testing to collect participants’ perceptions of the importance of availability of on-site testing. We conducted 3 focus group discussions with women in the community on perceptions of women’s health needs, availability of resources, and barriers to healthcare seeking.

8.    Nov. 15 will be Mammography Night at Columbia Memorial Hospital held in partnership with the CMH Medical Imaging Unit and the Columbia County Community Healthcare Consortium.  In December the project will conduct a multiple CBO event including a health education/entertainment presentation.

9.    Gather quantitative outcome data and qualitative process data on experiences of peer outreach assistants.

10.  Continue to collect and analyze qualitative (interview, ethnographic) and quantitative (pre- and post-questionnaire; attendance) data.

Significance

1.    During the project’s third year, the Project has continued to explore new venues and new formats for engaging underserved women in the community. The 14 health education events and resource fairs conducted so far, together with our more recent smaller scale interventions and analysis of the data gathered from them, have helped the research team identify effective strategies for planning and conducting community events. The primary challenges the project faces are eliciting participation in interventions and moving individuals who do participate to take the next step to signing up to receive healthcare services. In the second half of Year 3, and going forward into Year 4, the Project is shifting its strategy to work more intensively and individually with organizations whose missions most closely align with the Project’s central goals; however, the Project will continue to maintain relationships with community organizations and promote women’s reproductive health as part of overall healthy lifestyle through at least 2 multi-organization events in Year 4.

2.    In addition to encouraging underserved women to seek reproductive and sexual health-related services at UHPP and other health service organizations, the Project will continue to emphasize bringing the services to the women, for example in weekly outreach sessions and monthly on-site testing.

PLANS

Continue to conduct community health education events every 1 to 2 months.

Continue to work with peer outreach assistants on community activities and to gather qualitative process data on their experiences.

Continue to partner with agencies such as UHPP, Healthcare Consortium, and the AIDS Council to bring services related to reproductive and sexual health to underserved women in the focus community.  

Continue to collect and analyze data for presentations and publication.

PUBLICATIONS AND PRESENTATIONS

|Golden, A. G., & Pomerantz, A. (2011). Intermediate and behavioral health outcomes of community education events: Evidence from interventions to increase reproductive healthcare seeking among small town, low income African American women. Session presentation at the APHA Annual Meeting, Washington, DC, November.

Golden, A. G., Pomerantz, A., & Scott, M. (2011). Becoming part of the environment of the underserved: An ecologically informed intervention to increase reproductive healthcare seeking among low income African American women. Session presentation at the National Conference on Health Communication, Marketing, and Media of the CDC, Atlanta, August.

Golden, A. G., & Pomerantz, A. (2011). Communicating in time: Temporal dimensions of community health promotion. Competitive poster presented at the D.C. Health Communication Conference, Fairfax, VA, April.

Curry, R., Golden, A. G., & Pluviose, C. (2011). Do you have “C.L.A.S.”? Workshop presentation at the National Lesbian, Gay, Bisexual & Transgender People of Color Health Summit, Albany, NY, October.

Project-generated resources

Project website www.albany.edu/womenshealthproject (established 2009 and updated before and after each event).

PROJECT 2: Environmental contaminants and reproductive health of Akwesasne Mohawk women. 

SPECIFIC AIMS The specific aims of the study are unchanged from original application.

They are summarized here:
1.    Aim 1 is to determine the relationship between the body burden of PCB congeners and specific measures of reproductive function in females, specifically: a) pituitary function as indexed by gonadotropin levels, b) gonadal function as indexed by estradiol (E2) and progesterone (P) levels, and c) other characteristics of the menstrual cycle as reported through diary and questionnaire. 2.    Aim 2 is to determine the relationship between lead levels and measures of reproductive function as described in Aim 1 above. 3.    Aim 3 is to determine whether there are moderating factors (includes susceptibility factors) that influence effects of PCBs and lead on measures of reproductive functioning.

Studies and Results

During the third grant year, continued time and effort was focused on maintaining a high level of effort in recruitment of potential participants, and data collection.

In concert with this effort we concentrated on:
1.    The hire of an additional woman to facilitate data collection and conduct interviews. A community member that is invested in the well-being of the people of Akwesasne, she helps the Project staff on all participant visits with anthropometric measurements and blood draws.
2.    Re-training the Project staff in data collection techniques including conducting interviews, phlebotomy (for certification) and anthropometry, research ethics, and other data collection methods.
3.    Development of the database has been completed, and data entry and checking is ongoing.
4.    Our recruitment has expanded to women who seek care from the Canadian Health Service, with permission and approval by the University at Albany IRB, the Canadian Health Services Director, and the SRMHS Director. Our pool of potential participants has increased.
5.    Recruitment to date: a.    As of 9/30/2011, a total of 641 women have been approached. Of these, 188 were eligible, 453 were ineligible (on birth control, pregnant, nursing, on thyroid medications, or outside age range). b.    128 women have signed informed consent forms. Of these 128, 27 withdrew before completing project requirements (either became pregnant, decided to go on birth control, or were unable to be reached to schedule appointments), 82 have completed all requirements of the study, 7 have yet to finish their saliva collection, and 12 are waiting for their next menstrual cycle to begin. c.    As of 9/30/2011, there is one potential participant who is waiting to meet the eligibility criteria (Completed time post-nursing, post-birth control, post-pregnancy). 6.    Results as of 09/30/2011:

• Toxicant levels:       
  
  •  Of the 102 whole blood serums delivered to the Exposure Assessment Laboratory, final toxicant levels on 41 have been received (includes redraws).
• Clinical chemistries:    
  
  • Of the 109 bloods delivered to LabCorps Inc. for analysis of the clinical chemistries, results on all 109 individuals have been received.
• Salivary estradiol and progesterone levels:    
  
  • Saliva collected over the course of one menstrual cycle on 86 women has been delivered to the Neurobehavioral Laboratory. Preliminary results on 82 women have been completed

SIGNIFICANCE

Scientific significance cannot be assessed until more results are obtained, and this cannot occur until data collection is complete for more participants. The immediate and non-scientific significance is that the work to date shows that there is substantial interest in the research by the community, good participation from those women who are eligible, and that the protocol for data collection and laboratory analyses is workable. It also shows that the partnership between the Akwesasne Mohawk Nation and the University at Albany is on solid footing.

PLANS

Our plans for the near future are as follows:

1.    Continue recruiting participants. We estimate an average of three to four participants a month.
2.    Continue data collection and data entry; start preliminary analyses.
3.    Continue meeting with the SRMHS director to discuss the project and future directions.
4.    Conduct a CKON Radio (local station) interview with the PI (Schell) which will be broadcast in both English and Mohawk (translated) to discuss the project.
5.    Present results to the health providers and the project participants.

Publications and Presentations

Gallo MV, Schell LM, DeCaprio AP, Jacobs, A. Levels of persistent organic pollutant and their predictors among young adults. Chemosphere. 2011 May; 83(10):1374-82.

Behforooz B, Brooke GC, Fan W, Lee JE, Newman J, Gallo MV, Schell, LM, Akwesasne Task Force on the Environment. The Influence of Breastfeeding on the Cognitive Functioning of Children Raised in an Environment Polluted with PCBs (Poster).  Presented at Society for Research in Child Development, Montreal, Canada in March-April 2011.

Burnitz KK, Schell LM, Gallo MV.  The impact of early exposure to PCBs and p,p’-DDE on adult BMI in the Akwesasne Mohawk (Poster) Presented at the 2011 Human Biology Association, Minneapolis, Minnesota, April 2011. 4.   

Karsten JK, Schell LM, Gallo MV.  The impact of toxicants and maternal cigarette use on sex steroid levels in pre-menarcheal Mohawk females (Poster). Presented at the 2011 Human Biology Association, Minneapolis, Minnesota, April 2011.

Nelder KR, Schell LM, Gallo MV. Persistent organic pollutants and testosterone levels in a male adolescent Native American sample (Poster). Presented at the 2011 Human Biology Association, Minneapolis, Minnesota, April 2011.

Schell LM, Gallo MV, Ravenscroft J, Nelder KR , Burnitz KK. Toxic foods: What shouldn’t be for dinner? (Podium Presentation). Presented at the 2011 Human Biology Association, Minneapolis, Minnesota, April 2011.

PROJECT 3: Decomposing Racial/Ethnic Disparities in Health

SPECIFIC AIMS (unmodified from original)

STUDIES AND RESULTS

The project team continues to meet monthly as a large group, as well as weekly in smaller groups that are convened to discuss particular tasks and papers.

We have complete drafts of the following three papers.
(1) Beware of being unaware: racial/ethnic disparities in awareness of chronic disease (Specific Aims 1 and 2) estimates racial/ethnic disparities in individuals’ awareness of chronic disease using biomarker data from the 2006 Health and Retirement Study.  We focus on racial/ethnic differences in disease awareness since these differences may be a critical factor underlying disparities in treatment and adequate control of disease. The findings suggest that African-Americans are more likely than non-Latino whites to have hypertension, but we find no statistically significant differences in awareness of hypertension between African-Americans and non-Latino whites. All minority groups are more likely than non-Latino whites to have diabetes but, among those with diabetes, African-Americans and Latinos are less likely to be aware of their condition compared to non-Latino whites.

(2) Child health inequality and its dynamics through adolescence (Specific Aim 3) applies innovative methods from econometrics to estimate racial/ethnic disparities in child health in U.S., and examine how disparities change as children enter adolescence. Data come from the Panel Study on Income Dynamics – Child Development Supplement.  The results indicate parental education and employment are important factors underlying income-related health inequality among children in the US. Especially for African-American children, effective policies to reduce disparities would include policies that target family structure and mother’s education and employment.  Living in a large metropolitan area (1 million+ population) in the US is associated with higher levels of child health after controlling for other factors.  Urban residence is an important factor in the decomposition of child health inequality both across and within racial/ethnic groups.

(3) Early health conditions and disparities in academic achievement, uses data from the Child Development (CDS) and the Transition into Adulthood (TA) Supplements of the Panel Study of Income Dynamics (PSID) to examine the role of health at birth and in early childhood as a contributor to racial disparities in academic achievement and educational attainment later in life. Our preliminary findings show that poor health at birth and in childhood indeed is more prevalent among African-American children compared to non-Latino white children.  However, the negative effects of poor health on academic outcomes appear to be concentrated among non-Latino white children, and the effects of poor health at birth on academic outcomes are small in magnitude.  As a result, early health is not an important contributor to racial differences in test scores or educational attainment.  Racial differences in educational attainment, in fact, are fully accounted for by racial differences in maternal SES at the time of the child’s birth. All three papers were presented at the American Society of Health Economists (ASHE) biennial conference in July 2010.  The third paper was part of a session our group organized on this topic.  In addition, the second paper was accepted for and presented at a selective meeting on health and SES research hosted by the Panel Study on Income Dynamics in Ann Arbor, MI in September 2010. Project staff had training opportunities, including taking on-line courses in STATA and attending a selective Summer Institute on Health and Aging held at RAND in July, 2010.

SIGNIFICANCE

The completion of these analyses, particularly the analyses associated with Specific Aim 3, will provide unique data on the magnitude and persistence of health disparities along an urban-rural continuum. These results will identify health disparities that may be especially important to address in the smaller cities and towns comparable to the communities in which the Center is developing its intervention research.

PLANS

In the next year, we will work to obtain community level data which can be merged to individual records in these large secondary data sets.  This will allow us to examine effects of community size and community attributes at a more disaggregated level.

PRESENTATIONS AND PUBLICATIONS

Chatterji P, Heesoo J, Lahiri K. Beware of Being Unaware: Disparities in the Awareness of Major Chronic Illnesses. American Society of Health Economists, 3rd Biennial Conference, Ithaca, NY, June 2010.

Chatterji P, Lahiri K, Song J. Child health disparity analysis and income gradient: evidence from PSID-CDS Data. American Society of Health Economists, 3rd Biennial Conference, Ithaca, NY, June 2010.

Chatterji P, Lahiri K. Early Health Conditions and Racial Disparities in Academic Achievement. American Society of Health Economists, 3rd Biennial Conference, Ithaca, NY, June 2010.

Chatterji P, Lahiri K, Song J. Child health disparity analysis and income gradient: evidence from PSID-CDS Data. Panel Study on Income Dynamics Conference: Research on Connections between Health and Socioeconomic Status Using PSID Data. Ann Arbor, MI, September 2010.

Chatterji P, Joo H, Lahiri K. Beware of being unaware: Racial/ethnic disparities in awareness of chronic disease, National Bureau of Economic Research (NBER) working paper, 2010.

Lahiri K, Pulungan Z. Health inequality and its determinants in New York. Journal of Human Capital. Submitted for publication, 2010.