Hossein Zare

• MS, PhD
• Analyst at Johns Hopkins University, UMUC

Background Hypertension and obesity are major public health problems in the United States and Maryland. Objectives To assess the impact of Medication Therapy Management (MTM) on controlling hypertension and obesity in a sample in Southern Maryland: Prince George’s, Calvert, Charles, and St. Mary’s counties. Methods 171 patients with high blood pr...

Prior disparities in obesity research emphasize socioeconomic status as a potential driver of White-Black differences in obesity prevalence, but there is a paucity of research examining the influence of education on the observed racial difference among men. The objective of this study was to determine whether the relationship between race and obesi...

Objective To examine racial/ethnic differences in the associations of family socioeconomic status (SES), neighborhood SES, and inhibitory control with body mass index (BMI) in 9–10-year-old children using data from the Adolescent Brain Cognitive Development (ABCD) study. Methods This cross-sectional study included a diverse sample of children aged...

Background Educational attainment is generally associated with reduced reliance on Social Security and disability benefits; however, the Minorities’ Diminished Returns (MDRs) theory suggests that the socioeconomic benefits of education are weaker for minoritized populations. This study investigates the relationship between educational attainment an...

Background While educational attainment is generally associated with reduced reliance on Social Security and disability benefits, Minorities' Diminished Returns (MDRs) theory suggests that the socioeconomic benefits of educational attainment are not equally distributed across racial groups and are weaker for minoritized populations. This study expl...

Background Low socioeconomic status (SES) has been linked to higher rates of tobacco and marijuana use initiation; however, the contributions of environmental and neurocognitive factors remain underexplored. This study investigates a potential pathway connecting low SES, fine particulate matter (PM2.5) exposure, brain functional connectivity, and i...

Background Puberty is a crucial developmental milestone that involves significant physiological, emotional, and behavioral changes. Early puberty onset, influenced by both biological and social factors, is associated with an increased risk of engaging in substance use, such as tobacco and marijuana. While high family income is generally linked to d...

Background Climate change has raised significant concerns about its impact on health, particularly for vulnerable populations such as children and adolescents. While extensive research has examined physical health effects, limited attention has been given to the influence of extreme heat on developmental and behavioral outcomes. Objectives This st...

Background The rising concerns surrounding climate change have drawn attention to its potential impact on health, particularly among vulnerable groups such as children and older adults. Despite extensive research on health consequences, limited studies have explored the connection between extreme heat exposure and tobacco use initiation among adole...

Background: Puerto Rico (PR) has experienced significant demographic changes, characterized primarily by an aging population and an unprecedented exodus of medical doctors. Ophthalmologists are of particular concern as they commonly serve older populations, and the island has high rates of some age-related eye diseases in the United States (US). Ou...

Background Retirement is a universal life stage, marking the culmination of an individual’s working years. However, many people face financial challenges during retirement due to insufficient financial planning. Retirement preparedness is essential for ensuring economic security and maintaining a high quality of life in later years. Education is of...

Background Education is widely regarded as a key driver of financial literacy, yet racial and ethnic disparities persist. Even among highly educated individuals, African American and Hispanic populations may face challenges in financial literacy, likely due to structural racism and socioeconomic inequalities that diminish the benefits of education....

Aim: Our aim was to examine the association between emergency dental care use and dental providers’ availability and ZIP code social vulnerability index. Methods: This cross-sectional observational study mapped variations in emergency dental care and analyzed their association with social vulnerability using generalized spatial two-stage least-squa...

To examine the interaction between minimum wage policy, income inequality, and obesity rates among U.S. counties, and how this relationship is shaped by policy, place, and racial/ethnic composition in a county. We used the County Health Rankings Data for obesity ratio (measured by Body Mass Index ≥ 30 kg/m2) in US counties and combined it with the...

Background: Telomere length is a critical biomarker of cellular aging and overall health. While childhood socioeconomic status (SES) indicators such as education and poverty can have long-lasting effects on biological aging, research has shown contradictory results regarding the impact of adulthood SES on future telomere length, particularly in rac...

Background Education is widely recognized as a key driver of wealth generation, providing individuals with the opportunity to enhance their socioeconomic status. However, the effectiveness of education in generating wealth varies significantly across different social groups. In the United States, research has shown that Black individuals experience...

Background Early initiation of tobacco use among adolescents is a significant public health concern. While there is extensive research on overall tobacco use, much of it focuses on initiation in late adolescence, uses cross-sectional designs, and lacks specific exploration of electronic versus conventional cigarette use. This study aims to investig...

Background Recent research has identified structural racism—systemic policies and practices that perpetuate racial inequalities—as a significant social determinant of population health. Studies utilizing data from the Adolescent Brain Cognitive Development (ABCD) study have shown an association between higher levels of state-level structural racism...

Introduction College education is typically associated with the ability to work in less physically demanding occupations, allowing for a later retirement age. However, research indicates that highly educated Black individuals often work in more demanding occupations, which affects their retirement age. Aim Building on the Minorities’ Diminished Re...

Background: American Indian and Alaska Native (AIAN) communities face pronounced economic and health disparities compared to White Americans, a situation rooted in long-standing historical injustices and segregation. The theory of Minorities’ Diminished Returns (MDR) provides insight beyond the traditional focus on socioeconomic status (SES) dispar...

The Prince George’s County Health Department encountered several challenges to increasing access to cardiac rehabilitation (CR) services among disadvantaged populations. They include excessive patient out-of-pocket costs; requirements that CR orders must be signed by a physician; provider reluctance to refer patients to CR, with most primary care p...

To estimate the association between income inequality and allostatic load score (AL) in adults ages 20 years and older, with a particular focus on the differential impacts across racial and gender groups. By examining this association, the study seeks to inform targeted policy interventions to mitigate health disparities exacerbated by economic ine...

Background: Occupational classes play a significant role in influencing both individual and population health, serving as a vital conduit through which higher education can lead to better health outcomes. However, the pathway from education to corresponding occupational classes does not apply uniformly across different racial and ethnic groups, hin...

Background Early life socioeconomic conditions and race/ethnicity are critical determinants of long-term health and behavioral outcomes. Epigenetic changes, particularly those measured by the GrimAge biomarker, may mediate the impact of these early adversities on later life outcomes. This study investigates the relationships between race/ethnicity,...

Objectives: Although educational attainment is a major social determinant of health, according to Marginalization-related Diminished Returns (MDRs), the effect of education tends to be weaker for marginalized groups compared to the privileged groups. While we know more about marginalization due to race and ethnicity, limited information is availabl...

Background: Educational attainment has well established and widely recognized the effects on employment conditions and job demands. However, the way in which educational attainment correlates with perceived job demands may be inconsistent across racial groups as suggested by Minorities’ Diminished Returns (MDRs). The aim was to test the moderating...

Obesity prevalence in the United States has increased drastically in the last two decades. Racial differences in obesity have emerged with the increase in obesity, with temporal trends because of individual, socioeconomic, and environmental factors, eating behaviors, lack of exercise, etc., raising questions about understanding the mechanisms drivi...

There is a pressing need to develop and evaluate culturally tailored, community-based interventions that address hypertension management among low-income African American women. We employed a randomized controlled trial to test the effectiveness of the Prime Time Sister Circles® Program in reducing blood pressure and body mass index among low-incom...

Objectives Educational attainment is a protective factor against poor health, but high educational attainment has a weaker effect on black people than on white people; this pattern has been called marginalization-related diminished returns (MDRs). Using a national sample of white people and black people 25 years and above, this study estimates the...

Background The Prime Time Sister Circles®, a randomized controlled trial (PTSC-RCT), assessed the impact of a community-based peer support program on hypertension management among African American women 40–75 years of age. While the PTSC-RCT was designed to evaluate changes in blood pressure control, subsequent sub-analyses revealed a high proporti...

Background: COVID-19 pandemic has immensely impacted the social and personal lives of individuals around the globe. Marginalized-related diminished returns (MDRs) theory suggests that educational attainment shows a weaker protective effect for health and behavioral outcomes for Black individuals compared to White individuals. Previous studies cond...

This study aimed to examine whether hypertension prevalence varies by race/ethnicity and within age groups in a nationally representative sample of men in the United States. Hypertension was defined as blood pressure (BP) readings of 140 mm Hg and higher for systolic BP, 90 mm Hg and higher for diastolic BP, or self-reports of taking medication for...

Background: Educational attainment has been linked to reduced risk of health problems such as obesity, but research suggests that this effect may be weaker for non-Hispanic Black individuals compared to non-Hispanic White individuals, a pattern known as minorities' diminished returns (MDRs). Objectives: This study is aimed at examining the diffe...

In 2019 more than one-third of US nonprofit hospitals compensated their trustees. These hospitals provided less charity care than nonprofit hospitals that did not compensate their trustees. We found that trustee compensation was negatively associated with hospitals' charity care provision and that it may affect the self-selection of trustees and th...

Goal: We examined the variation in community benefit and charity care reporting standards mandated by states to determine whether state-mandated community benefit and charity care reporting is associated with greater provision of these services. Methods: We used 2011-2019 data from IRS Form 990 Schedule H for 1,423 nonprofit hospitals to create...

Background: Multiple studies have been conducted to test the moderating effect of immigration on the positive health results yielded through educational attainment. However, no study has been conducted to examine the role of immigration as a moderator in the association between educational level and perceived discrimination in Europe. Aim: We ai...

Background: The broad scientific community generally associates high socioeconomic status (SES) with better health. However, the protective effects of high educational attainment on health may be weaker for racial and ethnic minorities than non-Latino White individuals. It is important to study whether this difference holds for chronic pain among B...

Non-profit hospitals are expected to provide charity care and other community benefits to adjust their tax exemption status. Using the Medicare Hospital Cost Report, American Hospital Association Annual Survey, and the American Community Survey datasets, we examined if church-affiliated hospitals spent more on charity care and community benefit. Fo...

Objective The PreventionLink of Southern Maryland is a 5-year project to eliminate barriers to participation and retention in the National Diabetes Prevention Program (DPP) lifestyle change program to prevent or delay the onset of type 2 diabetes in adults with prediabetes. This is the study to identify the obstacles to participation and retention...

Obesity is a significant public health problem globally and within the United States. It varies by multiple factors, including but not limited to income. The literature indicates little evidence of the association between income and obesity. We examined the association between income and obesity in U.S. adult men ages 20 years and older and tested...

Objective: To determine if greater non-profit hospital spending for community benefits is associated with better health outcomes in the county where they are located. Data sources and study setting: Community benefit data from IRS Form 990 / Schedule H was linked to health outcome data from Area Health Resource Files, Map the Meal Gap, and Medic...

Aim: To estimate the association between income and depressive symptoms in adult women, ages 20 years and older. Methods: Data for this study came from the 2005–2016 National Health and Nutrition Examination Survey (NHANES). We measured the presence of depressive symptoms by using a 9-item PHQ (Public Health Questionnaire, PHQ-9) and the Poverty to...

Place and race are two important predictors of fatal police shootings. We used Mapping Police Violence Data and the Washington Post Fatal Force Data to determine whether a county's deprivation status within communities influences the association between the number of fatal police shootings, and how the number of fatal police shootings differs by ra...

This is an analytical, descriptive, and cross-sectional case study to identify a pharmaceutical company’s organizational life cycle (OLC) situation using clustering methods. Data came from Iran’s pharmaceutical firms in 2001–2018. We used sales growth, dividend per ratio, and performance indicators, including the return on assets, return on equity,...

Patient Engagement (PE) promotes the patient's interaction with and contribution to all aspects of care, where patients play an active and informed role in improving healthcare systems in addition to individual care decisions, enhancing health outcomes, and avoiding extra costs. Understanding the PE concept is essential for e-health professionals t...

Importance: Depression is one of the leading causes of disability in the United States. Depression prevalence varies by income and sex, but more evidence is needed on the role income inequality may play in these associations. Objective: To examine the association between the Poverty to Income Ratio (PIR)-as a proxy for income-and depressive symp...

Education continues to be a key factor contributing to increased access to critical life-improving opportunities and has been found to be protective against Allostatic Load (AL). The purpose of this study was to assess AL among Non-Hispanic (NH) White and NH Black men with the same level of education. We used 1999–2016 National Health and Nutrition...

Background: Product life cycle (PLC) refers to the time ranging from when a product is introduced into the market to when it is taken off the shelves. The PLC management can guarantee product survival and prevent its decline. Objectives: This study investigated generic antibiotic PLCs and detected factors affecting them in the competitive pharma...

Research indicates that income is significantly associated with allostatic load (AL) and that this association may differ between White and Black Americans. Most existing income-AL link work focuses on women and less is known about this association among men. Using data from the National Health and Nutrition Examination Survey (NHANES), we examined...

Police violence is a multidimensional issue that requires consideration of the violent events and how these events reflect systemic oppression. Violence and policing practices are influenced by race and ethnicity, place/neighborhood, structural inequality, and racism. We performed an integrated literature review to critically evaluate the current e...

This economic evaluation uses 2019 Medicare cost report data to examine the unreimbursed Medicaid costs among nonprofit and for-profit US hospitals.

The purpose of this study is to identify elements that influence the sale of generic pharmaceutical products during their life cycle in order to achieve more comprehensive planning and to prevent a decline stage of the product life cycle (PLC). We used a system dynamic model to identify the behaviors of demand, supply, and competition as three majo...

Although Black-White disparities in health and mortality among men persist, there has been a paucity of work focusing on race differences in physiological dysregulation of biological processes resulting from the cumulative impact of stressors among men. The purpose of this study was to assess potential race differences in Allostatic Load (AL) among...

BACKGROUND The Hospital Price Transparency Final Rule, effective January 1, 2021, requires hospitals to post online a machine-readable file that includes payer-specific negotiated commercial prices for all services. The regulation aims to improve the affordability of hospital care by promoting price competition. However, a low compliance level amon...

Background: Socioeconomic Status (SES) indicators such as educational attainment protect people against health problems, including but not limited to depressive symptoms. However, according to the marginalization-related Diminished Returns Framework (MDRs), SES indicators such as educational attainment show weaker health effects for marginalized th...

Obesity is a major public health problem both globally and within the U.S. It varies by multiple factors, including but not limited to income and sex. After controlling for potential covariates, there is little evidence to determine the association between income and obesity and how obesity may be moderated by sex and family income. We examined the...

Background: While socioeconomic status (SES) indicators such as educational attainment and employment are among the major drivers of health and illness, the health returns of SES indicators may differ across racial groups. Built on Marginalization related Diminished Returns framework (MDRs) that refers to weaker health effects of SES indicators fo...

Nonprofit hospitals provide charity care to financially disadvantaged patients according to their self-designed eligibility policies. The Affordable Care Act may have prompted nonprofit hospitals to adopt more generous eligibility policies, but no prior research has examined the longitudinal trend. The expansion of Medicaid coverage in many states...

Objective: To identify predictors of unmet dental needs for adults 18 y of age or older in the United States. Method: Using the Aday and Andersen framework and data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS), we ran logistic regression to estimate predictors for adults of not having a dental visit within 5 y and having lost...

Obesity is a major public health problem that varies by income and sex, yet there is little evidence to determine the association between income inequality and obesity. We examined the association between income and obesity in adults ages 20 years and older and tested whether this relationship differs by sex in the United States. We used the 1999–2...

Policymakers are using different ways to measure the community benefit provided by non-profit hospitals because different policy makers have different policy objectives. We compare 3 commonly used measures of community benefit; examine the correlation across the 3 measures; examine how the distribution of community benefits varies across non-profit...

Objective: The authors conducted an integrative literature review of recent studies that explored the impact of interventions implemented in the U.S. that focused on improving access to dental care for low-income and vulnerable populations. Methods: The authors conducted an integrative literature review of studies published between 2012-2018 that a...

Objective We examined the characteristics of non‐profit hospitals providing more community benefits and charity care than value of their tax exemptions and how this relationship changed between 2011 and 2018. Data sources Primary dataset was schedule H Form IRS 990 data. This data was merged with the American Hospital Association, Medicare Hospita...

The different tax treatment of government, nonprofit, and for-profit hospitals implies different charity care obligations, with the greatest obligation for government hospitals and the least for for-profit hospitals. Prior research has not examined charity care provision among all three ownership types at the national level. Using 2018 Medicare Hos...

Background The Prime-Time Sister Circles® (PTSC) program is a multifaceted, community-based peer support intervention targeting African American women who are 40 to 75 years of age. It aims to reduce hypertension disparities observed among African American women by promoting adherence to antihypertensive therapies, including lifestyle modification...

Importance: Depression is one of the leading causes of disability in the United States. African American women of low socioeconomic status with uncontrolled hypertension are at risk of having severe depressive symptoms, yet there is limited research about the mental health of this vulnerable population. Data from the Prime Time Sister Circles rand...

The US government imposed two travel restriction policies to prevent the spread of the COVID-19 but may have funneled asymptomatic air travelers to selected major airports and transportation hubs. Using the most recent JHU COVID-19 database, American Community Survey, Airport and Amtrak data form Bureau of Transportation Statistics from 3,132 US co...

Background Obesity is a major public problem that varies by income and sex. However, there is little evidence that exists to determine the association between income and obesity may be moderated by sex and family income after controlling for potential covariates. Objectives To examine the association between income and obesity in adults ages 20 ye...

The authors have withdrawn this preprint due to author disagreement.

Objectives To learn dentists' perceptions, attitudes, and concerns about the problems of access to oral health care for low income and rural Marylanders and to ascertain whether the dentists believe dental therapy is a viable solution. Methods We conducted three focus group discussions of 27 dentists during August and September 2018 in three locat...

Objective This study decomposes race and ethnic differences in hypertension, waist circumference, obesity and allostatic load between black non-Hispanic (BNH), Mexican American (MA), and white non-Hispanic (WNH) women.DataThis study uses 10,109 observations from The National Health and Nutrition Examination Survey from years 1999–2014 for BNH, MA w...

Introduction Currently there is no expert consensus regarding what activities and programs constitute hospital community benefits. In China, the hospital community benefit movement started gaining attention after the recent health care system reform in 2009. In the United States, the Internal Revenue Service and the nonprofit hospital sector have s...

Although Black-White disparities in health and mortality among men persist, there is a paucity of work focusing on race differences in physiological dysregulation of biological processes resulting from the cumulative impact of stressors among men. The purpose of this study was to assess potential race differences in Allostatic Load (AL) among adult...

Executive summary: We explore whether nonprofit hospitals report similar amounts of charity care to the Internal Revenue Service (IRS) and Centers for Medicare & Medicaid Services (CMS). We use nonprofit hospitals' financial reports to the IRS and the CMS Medicare costs report for 2011 and 2012. In 2012, hospitals reported spending 7.6% more in ch...

To determine if the Centers for Medicare and Medicaid Services Hospital Readmission Reduction Program reduced hospital discharges for penalized conditions in minority and low-income communities, we used hospital discharge data for 2006 and 2013 from Arizona, California, Colorado, Florida, New Jersey, New York, North Carolina, and Wisconsin and read...

Evidence collection of digital devices is the most important step of Forensic Investigation. We discuss four major evidence’s sources focusing on Cellphones, Global Positioning Systems (GPSs), Email and Network. Cellphone provides tremendous evidence, but it needs to be isolated to protect risk of being wiped up and overwritten. GPSs are valuable s...

This paper, compared three well-known technologies in cybersecurity: BlackRidge Transport Access Control, brain wave authentication technology, and SSL-VA. In addition to the determining the impact of these technologies on cyberspace, we compared them in the viewpoint of the CIA (Confidentiality, Integrity and Availability). Transport Access Contro...

Abstract Background Aging and rural-urban disparities are two major social problems in today’s ever-developing China. Much of the existing literature has supported a negative association between adverse community setting with the cognitive functioning of seniors, but very few studies have empirically investigated the impact of rural-urban community...

Background: The Hospital Readmission Reduction Program (HRRP) disproportionately penalizes hospitals serving minority communities. The National Academy of Science, Engineering, and Medicine has recommended that the Centers for Medicare and Medicaid Services (CMS) consider adjusting for social risk factors in their risk adjustment methodology. This...

This paper analyzes denial of service (DoS) attacks and countermeasures based on a systematic review analysis conducted of papers between 2000 and 2016. The paper is based on three searches. The first was conducted using suitable keywords, the second using references used by selected papers, and, the third considered the most cited English-language...

Background Strategic purchasing in healthcare services is a key component in improving health system performance, and it has been one of the most important issues in health system reform around the world, especially Europe in the last decade. Iran health system and insurance, although sometimes considered the issue of strategic purchasing goals, ha...

The tax-exempt status of nonprofit hospitals has received increased attention from policymakers interested in examining the value they provide instead of paying taxes. We use 2012 data from the Internal Revenue Service (IRS) Form 990, Centers for Medicare and Medicaid Services (CMS) Hospital Cost Reports, and American Hospital Association’s (AHA) A...

For analysis information technology and computer system vulnerabilities, this paper benefits from “systematic review analysis: 2000-2015” with two-time searches: One established using suitable keywords, the second performed inside references used by selected papers. A detailed approach for analysis vulnerabilities of an organization includes physic...

ecent widely-known hacking exploits have increased the focus on computer and network security. System users need systems to provide confidentiality, integrity, availability and authenticity for their data. Access control, firewalls, and antivirus software are three ways to provide system security. They address different aspects of computer security...