Gulzar Shah

Georgia Southern University | GSU · Jiann-Ping Hsu College of Public Health

This study aimed to identify social determinants of maternal and child health (SDoH) in Pakistan. Using a qualitative study design, data were collected from community members in seven underserved areas of Lahore City, Pakistan. A total of 22 qualitative in-depth interviews and 10 focus group discussions (FGDs) were conducted. The participants inclu...

Marginalized populations often experience health disparities due to the significant obstacles to care associated with social, economic, and environmental inequities. When compared with advantaged social groups, these populations frequently experience increased risks, poorer health outcomes, and reduced quality of life (QoL). This research examines...

Background: Caregivers of asthmatic children have poor knowledge of proper asthma man-agement practices in Nigeria. The objective of this study was to examine the knowledge, attitudes, and practice behaviors of caregivers in the management of asthma in children under age 5 in Oyo State, Nigeria, using the Health Belief Model. Methods: While a mixed...

Abstract: Background: Suicide-related behaviors increasingly contribute to behavioral health crises in the United States (U.S.) and worldwide. The problem was worsened during the COVID-19 pandemic, especially for youth and young adults. Existing research suggests suicide-related behaviors are a consequence of bullying, while hopelessness is a more...

Objective To assess the “July effect” and the risk of postpartum hemorrhage (PPH) and its risk factors across the U.S. teaching hospitals. Method This study used the 2018 Nationwide Inpatient Sample (NIS) and included 2,056,359 of 2,879,924 single live-birth hospitalizations with low-risk pregnancies across the U.S. teaching hospitals. The Internat...

Child malnutrition persists in low-resource countries such as Pakistan, indicating an urgent need for interventions and policies aimed to address this critical population health issue. The World Health Organization Global Target 2025 includes the reduction of malnourishment in the form of stunting, wasting, and low weight. This study aims to examin...

Background: Electronic cigarettes (e-cigarettes) were introduced to the United States marketplace in 2007 and had dominated all other tobacco products used by youth by 2014. In May 2016, the Food and Drug Administration extended the final rule to include e-cigarettes in implementing text-based health warnings on cigarette packs and advertising, as...

This paper examines the efficacy of telemedicine (TM) technology compared to traditional face-to-face (F2F) visits as an alternative healthcare delivery service for managing diabetes in populations residing in urban medically underserved areas (UMUPAs). Retrospective electronic patient health records (ePHR) with type 2 diabetes mellitus (T2DM) were...

Context: Mental health is a public health concern that requires national attention at the local level. Major issues facing local health departments (LHDs) to actively engage in mental health activities include inadequate surveillance data and limited resources. Objective: To examine the levels of engagement in access to mental health services, as w...

Background: Postpartum hemorrhage (PPH) is one of the leading causes of maternal morbidity and mortality in the United States. It occurs when blood loss exceeds 1000mL regardless of the delivery route. Careful assessment of various causes and risk factors of PPH is essential to reduce and prevent further complications, avoid maternal morbidity and...

Background: The coronavirus disease 2019 (COVID-19) pandemic resulted in unique programmatic opportunities to test hypotheses related to the initiation of antiretroviral treatment (ART) and viral load (VL) suppression during a global health crisis, which would not otherwise have been possible. Objectives: To generate practice-relevant evidence on t...

Background and objectives: Public health workforce recruitment and retention continue to challenge public health agencies. This study aims to describe the trends in intention to leave and retire and analyze factors associated with intentions to leave and intentions to stay. Design: Using national-level data from the 2017 and 2021 Public Health W...

Background: Orphans and vulnerable children (OVC) are a high-risk group for HIV infection, particularly in Sub-Saharan Africa. Purpose: This study aims to portray the socioeconomic profile of OVC and examine the association of household and parent/guardian characteristics with the HIV status of OVC. Methods: For this quantitative retrospective study...

Interruptions in the continuum of care for HIV can inadvertently increase a patient's risk of poor health outcomes such as uncontrolled viral load and a greater likelihood of developing drug resistance. Retention of people living with HIV (PLHIV) in care and determinants of attrition, such as adherence to treatment, are among the most critical link...

The impact of the COVID-19 pandemic extends beyond the immediate physical effects of the virus, including service adjustments for people living with the human immunodeficiency virus (PLHIV) on antiretroviral therapy (ART). Purpose: To compare treatment interruptions in the year immediately pre-COVID-19 and after the onset of COVID-19 (10 April 20...

(1) Background: Several agencies in the United States play a primary role in ensuring food safety, yet foodborne illnesses result in about 3000 deaths and cost more than USD 15.6 billion each year. The study objectives included analyzing local health departments’ (LHDs) level of engagement in food safety and other related services, and LHDs’ charac...

(1) Background: Several agencies in the United States play a primary role in ensuring food safety, yet foodborne illnesses result in about 3,000 deaths and cost more than $15.6 billion each year. The study objectives included analyzing local health departments’ (LHDs) level of engagement in food safety and other related services, and LHDs’ characte...

Background: Given the current public health crisis caused by opioid abuse across the United States, this study analyzed factors in the school environment associated with the misuse of prescription opioids among adolescents in the United States. Methods: This study used secondary data collected by the Centers for Disease Control and Prevention for t...

Background Lycopene is a carotenoid found in some fruits and vegetables that is responsible for the red pigment in tomatoes and tomato products. While many studies have shown a link between lycopene and protection against the initiation and/or progression of lung cancer, data on its effect on lung cancer survivability is limited. Objective The pri...

Objective: Chronic kidney disease has emerged as a devastating global health crisis. This cohort study identifies predictive factors for the survival prognosis of patients receiving dialysis. Methods: This retrospective observational cohort study uses data on 1,137 patients undergoing hemodialysis for at least 3 months at multiple clinics in the Pu...

Human immunodeficiency virus (HIV) infections and less-than-optimal care of people living with HIV (PLHIV) continue to challenge public health and clinical care organizations in the communities that are most impacted by HIV. In the era of evidence-based public health, it is imperative to monitor viral load (VL) in PLHIV according to global and nati...

Introduction: Higher personal mastery is associated with better physical functioning, wellbeing, and longevity among older populations. However, few studies have focused on whether personal mastery is protective against mortality among older adults living with diabetes over time. Methods: A total of 1,779 participants were identified from an off-y...

The 2019 coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus has affected the social determinants of health, worsening health inequities and deteriorating healthcare capacities around the globe. The objective of this study is to investigate the COVID-19 prevention behaviors within the framework of the Health Belief Model in the city of D...

Context: Despite the increased recognition of the importance of having informatics-competent public health professionals, the competency level of the public health workforce in public health informatics (PHI) has not been examined extensively in the literature. Objective: The purpose of this study was to assess public health workforce informatics...

Context: Despite the increased recognition of the importance of having informatics-competent public health professionals, the competency level of the public health workforce in public health informatics (PHI) has not been examined extensively in the literature. Objective: The purpose of this study was to assess public health workforce informatic...

Context: In this era of patient-centered care, it is increasingly important for HIV/AIDS care and treatment programs to customize their services according to patients' clinical stage progression and other risk assessments. To enable such customization of HIV care and treatment delivery, the research evidence explaining factors associated with pati...

(1) Background: In resource-limited countries, patients with tuberculosis (TB)/HIV coinfection commonly face economic, sociocultural, and behavioral barriers to effective treatment. These barriers manifest from low treatment literacy, poverty, gender inequality, malnutrition, societal stigmas regarding HIV, and an absence of available care. It is c...

Objective: The primary aim of this study was to investigate whether students in minority race categories are more likely to experience race-related bias and hatred in their lifetime and since the onset of COVID-19, after controlling the effect of demographic and other variables. Methods: This quantitative study used primary data from the survey...

Background: The COVID-19 pandemic affects population groups differently, worsening existing social, economic, and health inequities. Purpose: This study examined 159 counties within Georgia to identify community characteristics associated with county-level COVID-19 case, hospitalization, and death rates. Methods: Data from the 2020 County Heal...

The evolving public health in Public Health 3.0 era, has serious implications for public health education. This invited editorial answers many questions. For prospective public health degree–seeking students, many nu- anced questions may be about hot jobs, salaries, and potential employers. For instance, which study areas in public health will incr...

The principal aim of this study was to determine the impact of teachers’ classroom manners, teaching strategies, and parents’ socioeconomic status on students’ academic performance. We used a two-stage probability sampling to select a final sample of 610 secondary school students of 9th and 10th grade based on a sampling frame targeting all governm...

Abstract: Objective: The purpose of this research was to assess the workforce characteristics associated with public health employees’ perceived impact of emerging trends in public health on their day-to-day work. Methods: Multinomial logistic regression was performed to analyze data from the 2017 PH WINS, a cross-sectional survey utilizing a natio...

Background With the indiscriminate spread of COVID-19 globally, many populations are experiencing negative consequences such as job loss, food insecurity, and inability to manage existing medical conditions and maintain preventive measures such as social distancing and personal preventative equipment. Some of the most disadvantaged in the COVID-19...

Objectives Theoretical models and conceptual frameworks are often used to design research methods. This study aims to provide an overview of the application of theoretical models and conceptual frameworks in Public Health Services and Systems Research (PHSSR). We also examine how the integration of such terms in research can improve intervention de...

COVID-19 is a public health crisis that has strained healthcare resources, especially in rural areas of the U.S. Surveillance is an essential tool for assessing and addressing the impact of the pandemic. As countries and communities around the globe are easing lockdown restrictions, the focus is increasingly on targeting COVID-19 hot spots and impo...

Systemic inequity concerning the social determinants of health has been known to affect morbidity and mortality for decades. Significant attention has focused on the individual-level demographic and co-morbid factors associated with rates and mortality of COVID-19. However, less attention has been given to the county-level social determinants of he...

Recent studies have found that racial health disparities are a direct result of the residential segregation, racial differences in socioeconomic status, health care access, and other social determinants of health that affect segregated minority groups. This study analyzed local health departments' (LHDs') efforts to decrease health disparities in t...

Background: Accreditation is one of the macro trends shaping the future of public health practice, and The Community Guide to Preventive Services is a decision-making tool used to select evidence-based interventions. Although local health departments (LHDs) seeking accreditation use The Community Guide, the relationship between the two remains unk...

Several emerging concepts with significant implications for practice relate to the interpretation and use of data, given the data-driven nature of modern public health. In particular, there is increasing recognition of the value of EBPH among public health practitioners. EBPH requires that the workforce be skilled in taking advantage of the best sc...

Aims: To examine the extent to which local health departments (LHDs) conduct activities to address opioid use and abuse. To test the hypothesis that (i) LHDs' access to data from an electronic syndromic surveillance system is associated with conducting activities to address opioid use and abuse, and (ii) among those LHDs with access to syndromic s...

This is a podcast/blog on smart health communities. Smart health communities is a movement toward state and local government systems to modernize and use innovation to support overarching population health and healthcare goals. Health informatics and its role in promoting smart health communities are discussed. The podcast is available at the follo...

This is a combination of a blog and podcast about how to leverage informatics to improve population health. The definition of population health as we know it today is somewhat new. In the following podcast interview with Dr. Khurshid, we discuss the definition of population health and how it has evolved in recent decades. Here is part of Dr. Khursh...

Wastewater workers are exposed to different occupational hazards such as chemicals, gases, viruses, and bacteria. Personal protective equipment (PPE) is a significant factor that can reduce or decrease the probability of an accident from hazardous exposures to chemicals and microbial contaminants. The purpose of this study was to examine wastewater...

Objectives: To examine: (a) the level of public health agency employees’ perceived desirability for impacting health equity and SDoH, and (b) the impact of employee characteristics such as public health degree and awareness of Health in All Policies on such desirability. Methods: Data from the 2017 Public Health Workforce Interests and Needs Surve...

Background: The continuous improvement function, 1 of the 6 public health governance functions, can be usefully applied in the context of local boards of health (LBoHs) operations to target self-improvements. Purpose: The purpose of this study was to determine the engagement level of LBoHs in continuous improvement efforts and to identify factor...

Public health workforce development efforts during the past 50 years have evolved from a focus on enumerating workers to comprehensive strategies that address workforce size and composition, training, recruitment and retention, effectiveness, and expected competencies in public health practice. We provide new perspectives on the public health workf...

Context: Despite a growing consensus in public health to address health inequities and leverage social determinants of health (SDoH), the level of public health practitioners' readiness to become the agents of change in promoting health equity and shaping SDoH is not well researched. Objectives: To examine (1) the level of public health agency e...

Introduction: We describe videos posted to the YouTube video-sharing Web site by US state health departments (SHDs) and associated institutional factors. Methods: YouTube channels from SHDs were identified, their data retrieved, and their videos saved to a playlist on January 10, 2016. Ten randomly sampled videos from each channel were manually...

The thrust of this podcat/blog is on informatics silos and the potential role of informatics to incentivize partnership between health care and public health. This focus grew out of a brainstorming session between two health care informatics experts, Dr. Zahid Butt, CEO of Medisolv Inc., and Mr. Mark Renfro, Executive Director of HealtHIE Georgia C...

Public health practice has benefited from health information systems much before the widespread use of the term “public health informatics” (PHI). Claiming its leadership in high- lighting and disseminating evidence for public health practice, the Journal of Public Health Management and Practice (JPHMP) started recognizing the significance of PHI e...

ABSTRACT Introduction: Efficient provision of essential public health services may be influenced by collaborative capacity of local health departments (LHDs). Local boards of health (LBoHs) are well positioned to facilitate partnerships. Objectives: We examined the degree to which LBoHs serve as a linkage between LHDs and 2 types of community organ...

Introduction: Efficient provision of essential public health services may be influenced by collaborative capacity of local health departments (LHDs). Local boards of health (LBoHs) are well-positioned to facilitate partnerships. Objectives: We examined the degree to which LBoHs serve as a linkage between LHD and two type of community organizations,...

Introduction Healthcare and public health industries have history of working in siloes, but those silos are beginning to give way to collaborations, due to community health needs assessment (CHNA) conducted by hospitals requiring hospitals to use perspectives of a broad range of community stakeholders. Purpose The purpose of this research included...

Objectives: The primary purpose of this study is to examine whether engagement in Public Health Accreditation Board (PHAB) accreditation process and its prerequisites are associated with financial resiliency of local health departments (LHDs). Methods: For this study, we performed multinomial logistic regression using the 2016 National Profile of L...

The study examines the extent to which a Local Health Department's top executive characteristics impact the level of service delivery change within each program area.

In the current public health landscape, big data generated from healthcare and other community partners are ready to talk about SDoH and their impact on health. For the big data to talk, greater expertise in public health is needed for data management, underscoring the need for training and recruitment of data scientists in public health. Given tha...

Objectives: The objectives of this study were to (1) determine the degree of alignment between an existing public health curricula and disease intervention specialist (DIS) workforce training needs, (2) assess the appropriateness of public health education for DISs, and (3) identify existing curriculum gaps to inform future DIS training efforts....

This was one of the three papers presented at the session titled: Local Health Department Information Systems, their Interoperability and Impact on Health Disparities. This session will begin with interactive discussion with session participants about their understanding of the barriers to informatics, interoperability of information systems used b...

Background: The Public Health Accreditation Board (PHAB) accreditation program in this post Affordable Care Act (ACA) era has incentivized inter-organization collaborations and use of “big data” available from other community partners. It is imperative to assess the local health departments’ (LHDs) informatics capacity and the interoperability of t...

This oral presentation was a part of the session that began with interactive discussion with session participants about their understanding of the barriers to informatics, interoperability of information systems used by health departments, and potential linkage of health information systems with strategies for addressing health disparities. The dis...

ABSTRACT Introduction: Local health departments (LHDs) are increasingly using national standards to meet the challenges presented by the complex environments in which these agencies operate. Local boards of health (LBoHs) might play an instrumental role in improving LHDs’ engagement in activities to meet these standards. Objectives: To assess the...

Context: Health disparities and health inequities can lead to poor health outcomes. However, health disparities continue to persist in communities across the United States, presenting a crucial public health challenge. Persisting budget cuts and workforce challenges tend to hinder local health departments' (LHDs') ability to assess and address heal...