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Introduction
Current institution
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September 2017 - August 2020
September 2014 - July 2017
Education
August 2012 - July 2017
August 2010 - September 2011
Publications
Publications (87)
Background: Rural areas have higher cardiovascular disease (CVD) incidence and age-adjusted mortality rates in the general population. However, the impact of rurality on CVD development and outcomes in patients with prostate cancer (PC) remains unclear. Patients and Methods: This retrospective cohort study used the SEER-Medicare database to analyze...
Background: While previous studies suggested a relationship between circulating Cystatin-C (Cys-C), a cysteine protease inhibitor involved in regulating tissue inflammation and a renal filtration marker, and both cancer and CVD, they often lacked long-term follow-up or did not account for the impact of CVD on the relationship between Cys-C and canc...
Background: Men with prostate cancer (PC) frequently die of cardiovascular disease (CVD). Rurality has shown to increase adverse outcomes in PC men. 26% of Georgians live outside Urban centers and 120/159 counties of Georgia (GA) are considered rural.
Aim: To identify CVD mortality (CVDm) risk factors in GA public health districts (PHD) and map the...
There has been steady progress in documenting the psychosocial risk factors of hypertension. However, most of the extant evidence is based on population from the developed countries. Using nationally representative data from India, this cross-sectional study explores whether spousal age gap is associated with risk of hypertension in married women a...
Purpose: Breastfeeding initiation and longer duration are known to reduce risk of breast and ovarian cancer. While racial disparities in breast cancer diagnosis and mortality rates exist in the United States, disparate rates of breastfeeding initiation and duration continue to widen. The positive effects of these community lactation support through...
Objective
Child marriage forces a girl into adult roles before physical and psychological maturity, which can take a toll on women's health over the life course. This article aims to assess whether child marriage and adolescent childbearing are associated with elevated risk of gynaecologic disorders leading to hysterectomy.
Design
Cross‐sectional...
Introduction
Medical financial hardship in the United States is a growing public health concern. This study aims to assess the south vs. non-south disparities in medical financial hardship among US adults of different generations – Boomers (born between 1946 and 1964), Generation X (born between 1965 and 1980), and the Millennials (born between 198...
Background
Cardiovascular disease (CVD) and cancer frequently co‐occur due to shared risk factors such as obesity, which is linked to CVD and 14 cancer types. This study explores whether CVD pathophysiologies, combined with obesity, increase cancer risk, impacting clinical management.
Methods and Results
Data from the ARIC (Atherosclerosis Risk in...
Objective
The provisions and recognition of Schedule Castes (SCs), the constitutional term for the Dalits in India, have been exclusively extended to Hindus, Buddhists, and Sikhs (HBS). Omission of Dalit Muslims and Christians (MC) from the SC category stripped them of the affirmative action benefits tied with the SC status. This study aimed to exp...
Discrimination based on religion and communal violence against religious minorities have been on the rise worldwide. Despite growing incidences of violence against religious minorities, little is known on the relationship between minority status and population health outcomes in the low-and-middle income countries (LMICs). This study intends to fil...
There has been steady progress in documenting the psychosocial risk factors of hypertension. However, most of the extant evidence is based on population from the developed countries. Using nationally representative data from India, this cross-sectional study explores whether spousal age gap is associated with risk of hypertension in married women a...
Objective
Gun safety practices can play a pivotal role in preventing suicide and unintentional injuries involving a firearm. This study aimed to assess whether psychosocial well-being, measured by emotional support, feeling of social isolation and life satisfaction, influenced safe storage practices among individuals who had firearms in or around t...
263
Background: Allostatic load (AL)/chronic toxic stress is linked to a higher risk of adverse cancer-specific and cardiac events in prostate cancer (PC) patients especially non-Hispanic Blacks (NHBs). We hypothesize that NHBs experience more adverse social determinants of health (SDOH) that increases this AL. Methods: We included men≥18 years dia...
265
Background: The impact of rural residence status as a social determinant of health on prostate cancer (PC) outcomes, considering both patient and provider location, remains unexplored. Methods: We utilized the Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked database to identify males aged ≥66 with new primary PC diagnoses (20...
Colorectal cancer (CRC) is a major clinical and public health burden. Screening has been shown to be effective in preventing CRC. In 2021, less than 72% of adult Americans had received CRC screening based on the most recent guidelines. This study examined the relationship between social support and screening colonoscopy or sigmoidoscopy uptake amon...
Child marriage, defined as marriage before the age of 18 years, is a precocious transition from adolescence to adulthood, which may take a long-term toll on health.
This study aims to assess whether child marriage was associated with added risk of adverse cardiovascular outcomes in a nationally representative sample of Indian adults.
Applying the n...
Background
Prevalence of intellectual disability (ID) is currently estimated through parent report on surveys of children. It is difficult to estimate the number of adults living with ID in the United States because no comprehensive survey or surveillance allows for identification. The purpose of this study was to estimate the prevalence and number...
Background: Child marriage, defined as marriage before the age of 18 years, could have detrimental impacts on women’s physical and psychological development affecting health outcomes in adulthood. This observational study aimed to examine whether women’s nutritional status, measured by body mass index (BMI) categories, was associated with being mar...
Introduction: The effect of rurality as a social determinant of health in cardiovascular events (CVE) in patients with prostate cancer (PC) is unknown.
Methods: Using the Surveillance, Epidemiology, and End Results-Medicare linked database, we identified males ≥ 66 years old with a new primary diagnosis of PC between 2009 and 2017. We also identifi...
Introduction: The effect of diabetes mellitus (DM) and DM therapy on cardiovascular events (CVE) in patients with prostate cancer (PC) undergoing androgen deprivation therapy (ADT) is unclear in the contemporary era.
Methods: Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database, we identified males ≥ 66-year-old wit...
Introduction: Cardiovascular disease (CVD) and cancer often occur in the same people, in part due to shared risk factors. In a Global Burden of Disease analysis of cohorts from >180 countries, obesity was a top 3 modifiable risk factor for CVD and cancer. Beyond shared risk factors, CVD pathophysiologies may synergize with obesity to influence carc...
Introduction: Allostatic load (AL) is a measure of the biological “wear and tear” or physiological effects of chronic toxic stress exposure and the body’s adaptive responses over time. High AL is associated with an increased risk of death from cardiovascular disease and cancer.
Hypothesis: We examined Positive Social Determinants of Health (PSDOH)...
Perceived Social Support and Cardiovascular Risk Among Nonelderly Adults in the United States
Biplab Kumar Datta, PhD*, Steven S. Coughlin, PhD, MPH, Aneesha Gummadi, BSc, Daniel Mehrabian, BA, and Benjamin E. Ansa, PhD
Hypertension, diabetes mellitus, dyslipidemia, and obesity are major risk factors of cardiovascular diseases. A recent study pro...
Background:
Maintaining a healthy lifestyle is an important factor in promoting positive outcomes for gynecologic cancer survivors.
Methods:
We examined preventive behaviors among gynecologic cancer survivors (n = 1824) and persons without a history of cancer in a cross-sectional analysis, using data from the 2020 Behavioral Risk Factor Surveill...
Child marriage is associated with negative health trajectories among women in low- and middle-income countries (LMICs). Marital disruptions in LMICs are also associated with adverse socioeconomic and health outcomes in women. Yet, little is known about the compounded health effects of experiencing both child marriage and marital disruptions. Using...
Background:
Vaccine uptake concerns in the Unites States were at the forefront of public health discussions during the COVID-19 pandemic. By the end of 2022, approximately 80% of the U.S. population was vaccinated against the virus. This study examined the relationship between perceived social support and COVID-19 vaccine uptake among U.S. adults....
Introduction
Maintaining a healthy lifestyle is an important factor in promoting positive outcomes for cancer survivors. Health behaviors, such as engaging in physical activity, not consuming large amounts of alcohol, abstaining from cigarette smoking, receiving routine immunizations, and undergoing recommended cancer screening tests, may lead to i...
Extant literature documented various health disparities among immigrants and racial and ethnically marginalized individuals in the United States. However, health disparities in the intersection of nativity and race are generally less visited. This cross-sectional study assessed utilization of routine preventive care among adults with overweight/obe...
Background:
Cardiovascular disease (CVD) is the leading cause of death in men with PC. Accumulated stress plays an important role in CVD development. The cumulative burden of chronic stress and life events can be measured using allostatic load (AL).
Methods:
The initial cohort included males ≥18 years diagnosed with PC (2005-2019). AL was modele...
Background: This study assessed the association between cardiovascular disease (CVD), the leading cause of death in the United States, among parents and child mental health. Methods: Our sample included 9076 children aged 6 to 17 years. Data were pooled from the 2016–2018 waves of the National Health Interview Survey. We fitted a logistic regressio...
Child marriage, defined as union before age 18 years, has detrimental health and socioeconomic consequences. This study examines whether women married as children have a disproportionately higher risk of being obese at adulthood compared to their peers married as adults. Using data from the 2012 and 2017 waves of the Tajikistan Demographic and Heal...
Colorectal cancer (CRC) is the third most prevalent cancer, and the second most common cancer-related cause of death in the United States (USA). Timely screening reduces both CRC incidence and mortality. Understanding population behaviors and factors that influence CRC screening is important for directing interventions targeted at reducing CRC rate...
Marital disruption defined as widowhood, divorce, or separation, has adverse consequences for women’s health and wellbeing. Extant evidence, however, is primarily available for older women or in developed country settings. Consequences of marital disruption for younger women in the developing countries is relatively less visited. The aim of this cr...
Introduction: The cumulative burden of chronic stress and life events can be measured by Allostatic load (AL), whose high values are related to poorer health outcomes and increased risk of cardiovascular disease (CVD). The primary objective of this study is to analyze the impact of androgen deprivation therapy (ADT) on AL variation in patients upon...
Introduction: Prostate cancer (PC) is the leading type of newly diagnosed cancer in males. Cardiovascular disease (CVD) is the leading cause of death in men with PC. Accumulated stress, which is triggered by multiple environmental factors and life events, plays an important role in CVD development. The cumulative burden of chronic stress and life e...
Background:
Hypertension is a major risk factor of cardiovascular diseases, which is the leading cause of premature mortality worldwide. While untreated hypertension heightens the risk of mortality and morbidity among hypertensive individuals, access to hypertension care in low-and-middle income countries has ties with various socioeconomic inequa...
The association between child marriage and the access to or utilization of maternal and antenatal healthcare has been widely studied. However, little is known about child brides’ access to healthcare for illnesses later in life. Using data on 496,283 married women aged 18 to 49 years from the India National Family and Health Survey 2015–2016, we de...
Background
Child marriage, defined as marriage before age 18 years, could impact women’s nutritional status through biological as well as environmental and socioeconomic attributes affecting diet and lifestyle behaviors. This study aims to examine whether women married as children have a differential risk of individual level double burden of overwe...
PURPOSE
There has been increasing concern over the high cost of oncology care and its long-lasting impact on the well-being of cancer survivors.
METHODS
We examined characteristics of impoverished cancer survivors in the United States, including their physical and mental health, using data from the 2020 Behavioral Risk Factor Surveillance System....
Effective control of hypertension at the population level is a global public health challenge. This study shows how improving population coverages at different hypertension care cascade levels could impact population-level hypertension management. We developed an analytical framework and a companion Excel model of multi-level hypertension care casc...
Introduction
The subsidized insurance provision under the Affordable Care Act (ACA) is an important instrument for health insurance coverage among low-income non-elderly individuals. However, unlike health impacts of the Medicaid expansion under the ACA, the effect of subsidized insurance is relatively less explored in extant literature. This study...
Adolescence, the transition phase to adulthood, is a critical period for physical and psychological development. Disruptions during this period, such as getting married, could result in various adverse short- and long-term health outcomes. This study aimed to assess the differential risk of two common chronic conditions—high blood pressure and high...
Hypertension in reproductive age women, particularly in low-and-middle income countries (LMICs) is an area that is less explored. This study assesses the risk of hypertension in relation to two critical women’s health issues in the LMICs – child marriage and adolescent childbearing. The health consequences of these issues have been primarily studie...
Value Added Taxes (VAT) constitute a major share of tax revenues in developing countries in which tax evasion is widespread. The literature on VAT evasion, however, is relatively scant. This paper develops a computable general equilibrium framework for analyzing endogenous VAT tax evasion. The analytical framework entails increasing enforcement thr...
With increasing prevalence, there is a growing population living with cardiovascular (CV) disease and cancer who are concurrently or at risk for developing these 2 disease states. We examined CV conditions and CV risk factors in cancer survivors in a cross-sectional analysis, using data from the 2019 Behavioral Risk Factor Surveillance System. Canc...
Despite notable progress being made in preventing child marriage, a significant proportion of women worldwide are still married before reaching adulthood. Though many aspects of child marriage have been widely studied, little is known on the later life health outcomes of child brides, let alone the critical need for healthcare during adulthood. Thi...
The Affordable Care Act (ACA) has substantially expanded access to health insurance coverage, resulting in a reduction in financial hardship, defined as ability to pay medical bills, among cardiovascular disease (CVD) patients in the post-ACA era. However, it is not known whether implementation of the ACA improved the racial and ethnic inequity in...
Background
Though the harmful impacts of child marriage have been evaluated across several domains, evidence on the relationship between child marriage and health behaviors over the life course is limited. In this paper, we examined whether getting married as a child is associated with one of the most common risky health behaviors, tobacco use, in...
Background
With the increasing prevalence of gynecologic cancer and obesity, there is a growing population living with cardiovascular disease, obesity and gynecologic cancer concurrently or at risk of developing these disease states.
Methods
We examined cardiovascular (CV) conditions and obesity among 1824 gynecologic cancer survivors in a cross-s...
Background: Child marriage is associated with various adverse socio-economic and pregnancy outcomes. However, there remains a dearth of research on the long-term health implications of child marriage. As such, this study sought to expand upon the growing literature on child marriage, specifically examining the associations between child marriage an...
Health literacy is a set of knowledge and skills that enables individuals to obtain, communicate, process and understand information, and services to make appropriate health decisions and to successfully navigate the health care system. Health literacy is important to quality of cancer survivorship care and patient self-management of their disease....
Background
Patients with cancer and cancer survivors commonly rely upon family members and friends to act as caregivers to help manage cancer treatment and the late effects of that treatment. Informal caregivers provide a variety of supportive functions for cancer patients, including emotional, informational, and functional support, and practical a...
Background
The surge in the COVID-19 related hospitalization has been straining the US health system. COVID-19 patients with underlying chronic conditions have a disproportionately higher risk of hospitalization and intensive care unit (ICU) admission. We developed a retrospective analytical model of COVID-19 related hospitalizations and ICU admiss...
Background
Cancer patients and cancer survivors may struggle to pay for housing or fall behind on their monthly bills to pay for out-of-pocket medical costs. Housing insecurity increases the likelihood of poorer health and decreased access to health care. The financial burden of medical care as a cause of poorer health outcomes is worsened by the i...
Women in low-and-middle income countries (LMICs) are disproportionately exposed to secondhand smoke (SHS), particularly in the home environment. Girls married before the age of 18 are more likely to remain at home and may be at higher risk of SHS exposure. This paper investigates whether women who were married as child brides had a higher risk of S...
Objectives
Intake of trans fatty acids (TFA) increases the risk of cardiovascular disease. Assessment of TFA exposure in the population is key for determining TFA burden and monitoring change over time. One approach for TFA monitoring is measurement of TFA levels in plasma. Understanding costs associated with this approach can facilitate program pl...
Background
Adolescent childbearing is associated with various health risks to the mother and child, and potentially with adverse socioeconomic outcomes. However, little is known about the role of adolescent childbearing in maternal health outcomes in adulthood. This study investigates the link between childbirth in adolescence and later-life risk o...
Background
Financial distress among persons with multimorbidity is an important topic which has been inadequately addressed to date.
Objective
We examined the extent of financial distress among persons with multimorbidity, using data from the 2017 Behavioral Risk Factor Surveillance System (BRFSS).
Design
Cross-sectional, population-based study....
Colorectal cancer (CRC) is the third most prevalent cancer and the second most common cause of cancer-related deaths in the United States (USA). Early screening has been demonstrated to improve clinical outcomes for CRC. Assessing patterns in CRC screening utilization is important for guiding policy and implementing programs for CRC prevention and...
Introduction
The 2015 Sustainable Development Goals include the objective of reducing premature mortality from major non-communicable diseases (NCDs) by one-third by 2030. Accomplishing this objective has demographic implications with relevance for countries’ health systems and costs. However, evidence on the system-wide implications of NCD targets...
Background
Uncontrolled hypertension and tobacco use are two major public health issues that have implications for reproductive outcomes. This paper examines the association between tobacco-use status and uncontrolled hypertension among prime childbearing age (20–35) women in India.
Methods
We used the India National Family Health Survey (NFHS-4)...
Background: We revisited the association between progress in MPOWER implementation from 2008 to 2016 and smoking prevalence from 2009 to 2017 and offered an in-depth understanding of differential outcomes for various country-groups.
Methods: We used data from six rounds of the WHO Reports on the Global Tobacco Epidemic and calculated a composite...
Hypertension in low-income and middle-income countries (LMICs) is largely undiagnosed and uncontrolled, representing an untapped opportunity for public health improvement. Implementation of hypertension control strategies in low-resource settings depends in large part on cost considerations. However, evidence on the cost-effectiveness of hypertensi...
Objective
Psychosocial factors, such as environmental stressors, can increase the risk of hypertension. This study examines the role of the household environment in hypertension outcomes by assessing the link between female hypertension status and spousal alcohol consumption in Nepal.
Study design
This is a cross-sectional study.
Methods
We used...
We study the trade-off between “broad-based energy subsidy” and “subsidy reform and targeted transfer” in the developing country context. We analyze the incidence of an electricity tariff differential subsidy program in Pakistan and find that the greater share of subsidy benefit goes to relatively non-poor households. We then conduct a computable g...
Since the ratification of the World Health Organization Framework Convention on Tobacco Control in 2004, Pakistan has made modest but continued progress in implementing various tobacco control measures. By 2014, substantial progress was achieved in areas of monitoring, mass media antitobacco campaigns, and advertising bans. However, the findings fr...
Background
Access to medicines is important for long‐term care of cardiovascular diseases and hypertension. This study provides a cross‐country assessment of availability, prices, and affordability of cardiovascular disease and hypertension medicines to identify areas for improvement in access to medication treatment.
Methods and Results
We used t...
Objective
Carbonated beverage consumption is associated with various adverse health conditions such as obesity, type 2 diabetes and CVD. Pakistan has a high burden of these health conditions. At the same time, the carbonated beverage industry is rapidly growing in Pakistan. In this context, we analyse the trends and socioeconomic factors associated...
The HEARTS technical package, a part of the Global Hearts Initiative to improve cardiovascular health globally, is a strategic approach for cardiovascular disease prevention and control at the primary care level. To support the evaluation of costs associated with HEARTS program components, a costing tool was developed to evaluate the incremental co...
Background:
Elevated blood pressure (i.e. hypertension) and diabetes (BPD) are the two major noncommunicable diseases that expose households to high out-of-pocket treatment costs in low- and middle-income countries. Medication is the biggest share of BPD treatment expenses, and households with someone suffering from BPD may need to adjust consumpt...
Since the ratification of the WHO Framework Convention on Tobacco Control (FCTC) in 2004, Pakistan has taken various measures of tobacco control. This study examines how these tobacco control measures are associated with change in household-level tobacco consumption patterns in Pakistan over the decade (2005 to 2016) after FCTC ratification. We use...
Background:
Treatment of non-communicable diseases (NCDs) in low-and-middle-income countries (LMICs) is costly and could expose households to financial hardship and vulnerability. This paper examines the association between medication costs of two major NCDs - hypertension (blood pressure) and diabetes, and household-level incidences of catastroph...
Background: Treatment of non-communicable diseases (NCDs) in low-and-middle-income countries (LMICs) is costly and could expose households to financial hardship and vulnerability. This paper examines the association between medication costs of two major NCDs – hypertension (blood pressure) and diabetes, and household-level incidences of catastrophi...
The economic burden of noncommunicable diseases (NCDs), including treatment costs and income and productivity losses, is a growing concern in developing countries, where NCD medical expenditure may offset consumption of other essential commodities. This study examines the role of NCDs in household resource allocation in Bangladesh. We use the Bangl...
Background
Tobacco consumption constitutes a sizable portion of household consumption expenditure, which can lead to reduced expenditures on other basic commodities. This is known as the crowding-out effect. This study analyzes the crowding-out effect of tobacco consumption in Bangladesh, and the research findings have relevance for strengthening t...
Background
Treatment of noncommunicable diseases (NCDs) in low-income countries can entail large out-of-pocket (OOP) medical expenditures, which can increase the likelihood of household impoverishment and perpetuate the poverty cycle. This paper studies the implications of NCDs on household medical expenditure, household financial stress (e.g. sell...
A dynamic multi-period general equilibrium model is used to analyse prospects for growth in two very different countries, Egypt and Mauritius. The advantage of using a single model, when comparing alternative policies across countries, is that it removes the concern that different conclusions are based solely upon model differences, which would be...