Irene H Yen

University of California, Merced | UCM · Department of Public Health

Environmental chemical exposure has been rising over the past few decades but its impact on fertility remains uncertain. We assessed exposures to 23 common chemicals across a range of sociodemographic characteristics and their relationship with self-reported infertility. The analytic sample was non-pregnant women aged 18–49 years without a history...

Substantial research has focused on how social networks help individuals navigate the illness experience. Sociologists have begun to theorize beyond the binary of strong and weak social network ties (e.g., compartmental, elastic, and disposable ties), citing the social, economic, and health conditions that shape their formation. However, limited re...

Objective: We sought to examine the experiences of community partners in a community–academic partnership to promote COVID-19 testing in two majority Latino communities. Methods: We conducted semistructured, in-depth interviews in English and Spanish with community-based organization leaders and community health workers/ promotoras ( n = 10) from J...

Objective: We sought to examine the experiences of community partners in a community-academic partnership to promote COVID-19 testing in two majority Latino communities. Methods: We conducted semistructured, in-depth interviews in English and Spanish with community-based organization leaders and community health workers/promotoras (n = 10) from...

Activating social ties is a critical mechanism for satisfying individuals’ social, emotional, and material needs. Researchers have offered a number of hypotheses around tie activation about when and why particular supporters step in to help, ranging from strategic activation via functional specificity to opportunistic mobilization. To date, few stu...

As part of a larger project focused on the intersection of educational and health trajectories over the life course, we use in-depth interviews with 28 adults who experienced multiple non-promotional school changes during the course of their K-12 schooling in three U.S. urban centers to advance understanding of frequent student mobility. Prior rese...

Objective: Pesticide exposure via take-home pathways is a major health concern among farmers. However, little is known about the effects of pesticide take-home pathways on small-scale Hmong farmers in the Central Valley. This study explored factors that contribute to pesticide exposure via the take-home pathway among small-scale Hmong farmers in t...

The study objective was to investigate the effects of childhood residential mobility on older adult physical and mental health. In REasons for Geographic and Racial Differences in Stroke (REGARDS) Study, we used linear regression models to investigate if number of moves during childhood predicted mental and physical health (SF-12 MCS, PCS), adjusti...

Objective To evaluate implementation of a community-engaged approach to scale up COVID-19 mass testing in low-income, majority-Latino communities. Methods In January 2021, we formed a community-academic “Latino COVID-19 Collaborative” with residents, leaders, and community-based organizations (CBOs) from majority-Latinx, low-income communities in...

Background: Low-income U.S. adults experiencing food insecurity have a disproportionately high prevalence of cigarette smoking, and quantitative studies suggest that food insecurity is a barrier to quitting. To guide effective tobacco control strategies, this study aimed to understand the experiences, perceptions, and context of tobacco use and ce...

Housing is a key social determinant of health and health care utilization. Although stigmatized due to poor quality, public housing may provide stability and affordability needed for individuals to engage in health care utilization behaviors. For low-income women of reproductive age (15-44 y), this has implications for long-term reproductive health...

The vast majority of studies investigating participation in, persistence through, and consequences of postsecondary education focus on educational attainment status among the so-called traditional population of collegegoers between the ages of 18 and 24. This narrow focus leaves largely invisible the role that an expanding set of educational trajec...

Health care systems in the United States are experimenting with a form of surveillance and intervention known as “hot spotting,” which targets high‐cost patients—the so‐called “super‐utilizers” of emergency departments—with intensive health and social services. Through a calculative deployment of resources to the costliest patients, health care hot...

As medicine integrates social and structural determinants into health care, some health workers redefine housing as medical treatment. This article discusses how health workers in two U.S. urban safety‐net hospitals worked with patients without stable housing. We observed ethnographically how health workers helped patients seek housing in a sharply...

Purpose: This study examines risk factors for heat-related mortality due to hyperthermia in emergency department patients, a vulnerable population. Methods: This matched case-control study used statewide, longitudinally linked emergency department (ED) data and death records from California. Cases comprised California residents (≥18 years) who p...

Background Higher educational attainment predicts lower hypertension. Yet, associations between non-traditional educational trajectories (e.g., interrupted degree programs) and hypertension are less well understood, particularly among structurally marginalized groups who are more likely to experience these non-traditional trajectories. Methods In...

Objectives: Individuals increasingly experience delays or interruptions in schooling; we evaluate the association between these non-traditional education trajectories and mental health. Methods: Using year-by-year education data for 7,501 National Longitudinal Survey of Youth 1979 participants, ages 14-48 (262,535 person-years of education data)...

Objective Using an adaption of the Photovoice method, this study explored how food insecurity affected parents’ ability to provide food for their family, their strategies for managing household food insecurity, and the impact of food insecurity on their well-being. Design Parents submitted photos around their families’ experiences with food insecu...

Background: Complex Care Management (CCM) programs record patients’ progress toward health and healthcare utilization goals using a tracking tool in order to ascertain whether the patient is ready to transition to routine primary care. High-need, high-cost (HNHC) patients enrolled in CCM programs make progress, but existing tracking tools do not re...

The Supplemental Nutrition Assistance Program (SNAP) is critical to alleviating food insecurity, but low diet quality among program participants is a concern. Nutrition-related interventions have focused on SNAP-authorized food retailers, but the perspectives of small food store owners and managers have not been represented in national policy discu...

We share findings from a larger ethnographic study of two urban complex care management programs in the Western United States. The data presented stem from in-depth interviews conducted with 17 complex care management RNs and participant observations of home visits. We advance the concept of social literacy as a nursing attribute that comprises an...

In the United States, in the wake of health care reform, health care systems have been subject to intensifying demands to increase patient engagement, a term that refers broadly to participation in care. We draw from ethnographic research in urban health care safety-net settings in California to examine efforts to increase patient engagement among...

Housing status affects drug using behaviors, but less is known about the relationship between housing patterns and hepatitis C virus (HCV) infection. HCV-negative young people who inject drugs (PWID) were enrolled into a prospective cohort (2003-2019) with quarterly study visits. We used Cox regression to estimate the independent association of rec...

Introduction: Social factors across one's lifespan may contribute to the relationship between low educational attainment and depression, but this relationship has been understudied. Previous studies assessing the association between educational attainment and depression did not fully account for prior common determinants across the life course and...

Non-traditional education trajectories are common, but their influence on physical health is understudied. We constructed year-by-year education trajectories for 7,501 National Longitudinal Survey of Youth 1979 participants, from age 14 to 48 (262,535 person-years of education data from 1979 - 2014). We characterized trajectory similarity using seq...

Over 2.5 million people experience homelessness yearly in the United States. Black persons are overrepresented by three-fold among those experiencing homelessness but little research has examined the relationship between race and homelessness. We aimed to understand the relationship between race and the experience of homelessness for older adults....

This Letter to the Editor raises questions regarding a recently published article, “Food insecurity transitions and smoking behavior among older adults who smoke.”

Gentrification may play an important role in influencing health outcomes, but few studies have examined these associations. One major barrier to producing empirical evidence to establish this link is that there is little consensus on how to measure gentrification. To address this barrier, we compared three gentrification classification methodologie...

The contribution of medical mistrust to healthcare utilization delays has gained increased public health attention. However, few studies examine these associations among African-American men, who delay preventive healthcare more often and report higher levels of medical mistrust than non-Hispanic White men. Additionally, studies rarely account for...

In this article, we share our mixed-methods community-engaged approach to study the association between public housing renovation funded through the Rental Assistance Demonstration (RAD) program and the health status and outcomes of the residents living in RAD developments. RAD addresses the nationwide backlog of deferred maintenance at public hous...

This chapter presents information about three types of study designs commonly used for liver disease research. Each section provides a set of terms used when presenting research using the given design, an overview of the design, key aspects of the methods used, strengths and limits of the design, and a clinical vignette which draws from relevant re...

Purpose:: To examine whether food insecurity longitudinally affects smoking status. Design:: Population-based prospective study. Setting:: Data from the 2003 and 2015 Panel Study of Income Dynamics (PSID). Participants:: Four thousand five hundred sixty-three adults who were smokers and nonsmokers, participating in the 2003 (current study ba...

Objectives To determine whether children surviving to hospital discharge after firearm and non‐firearm assault are at increased risk of mortality relative to survivors of unintentional trauma. Secondarily, to elucidate the factors associated with long‐term mortality after pediatric trauma. Methods This was a multicenter, retrospective cohort study...

Hospitals throughout the United States are implementing new forms of care delivery meant to address social needs for structurally vulnerable patients as a strategy to prevent emergency department visits and hospitalizations and to thereby reduce costs. This article examines how the deployment of social assistance within a neoliberal institutional l...

Obesity disproportionately affects low‐income communities. Leveraging federal food programs is one potential strategy that can improve the diet‐related health outcomes of low‐income individuals. Stakeholders for the Supplemental Nutrition Assistance Program (SNAP) have proposed strategies for improving the retailer food environment (e.g. stricter s...

In February 2016, USDA proposed a rule to strengthen stocking standards for retailers under the national Supplemental Nutrition Assistance Program (SNAP). The proposed rule would require SNAP retailers to carry at least seven items in four staple food groups, perishable items in at least three staple food groups, and stock at least six items of eac...

Our paper explores how legal status stratification shapes the health and health care of low-income patients with chronic illnesses in the U.S. healthcare safety net. Drawing on data from over two years of ethnographic fieldwork at urban safety-net clinics, we examine efforts by Complex Care Management (CCM) teams to stabilize patients with uncontro...

The subjective nature of pain has always rendered it a point of entry for power and corresponding stratifying processes within biomedicine. The opioid crisis has further exacerbated these challenges by increasing the stakes of prescribing decisions for providers, which in turn has resulted in greater treatment disparities. Using the theoretical fra...

Purpose: Evidence suggests education is an important life course determinant of health, but few studies examine differential returns to education by sociodemographic subgroup. Methods: Using National Longitudinal Survey of Youth 1979 (n = 6158) cohort data, we evaluate education attained by age 25 years and physical health (PCS) and mental healt...

Background: Neighborhood context plays a role in binge drinking, a behavior with major health and economic costs. Gentrification, the influx of capital and residents of higher socioeconomic status into historically-disinvested neighborhoods, is a growing trend with the potential to place urban communities under social and financial pressure. Hypot...

This article explores the complicated and often-contradictory notions of choice at play in complex care management (CCM) programmes in the US healthcare safety net. Drawing from longitudinal data collected over two years of ethnographic fieldwork at urban safety-net clinics, our study examines the CCM goal of transforming frequent emergency departm...

Background: The patient-centered medical home model intends to improve patient experience and primary care quality. Within an urban safety net setting in Northern California, United States, these desired outcomes are complicated by both the diversity of the patient community and the care continuity implications of a residency program. Objective:...

In this paper, we delineate how staff of two complex care management (CCM) programs in urban safety net hospitals in the United States understand trauma. We seek to (1) describe how staff in CCM programs talk about trauma in their patients' lives; (2) discuss how trauma concepts allow staff to understand patients’ symptoms, health-related behaviors...

We sought to examine the literature using the Patient Activation Measure (PAM) or the Patient Enablement Instrument (PEI) with high-need, high-cost (HNHC) patients receiving care in urban safety net settings. Urban safety net care management programs serve low-income, racially/ethnically diverse patients living with multiple chronic conditions. Alt...

Aim: This paper articulates how political ecology can be a useful tool for asking fundamental questions and applying relevant methods to investigate structures that impact relationship between neighborhood and health. Through a narrative analysis, we identify how political ecology can develop our future agendas for neighborhood-health research as...

Increasing “patient engagement” has become a priority for health care organizations and policy-makers seeking to reduce cost and improve the quality of care. While concepts of patient engagement have proliferated rapidly across health care settings, little is known about how health care providers make use of these concepts in clinical practice. Thi...

Background: Neighborhood socioeconomic status (nSES) has been found to be associated with breast cancer risk. It remains unclear whether this association applies across racial/ethnic groups independent of individual-level factors, and is attributable to other neighborhood characteristics. Methods: We examined the independent and joint associatio...

Introduction Neighborhood factors are increasingly recognized as determinants of health. Neighborhood social cohesion may be associated with physical activity, but previous studies examined data aggregated across racial/ethnic groups. We assessed whether neighborhood social cohesion was associated with physical activity in a nationally representati...

Introduction: Asthma is a common health condition for children in childcare. National recommendations for asthma in childcare exist. However, no studies have investigated the extent to which childcare centers adhere to these recommendations. We aimed to assess childcare center adherence to National Asthma Education and Prevention Program (NAEPP) r...

Research suggests that workplace discrimination plays a role in absenteeism, productivity, and turnover. A link among workplace discrimination, mental health, and health disparities may also exist. The purpose of this study was to determine whether self-reported workplace discrimination is associated with alcohol abuse among hospital workers. Cross...

Introduction Cardiovascular disease (CVD) is the second leading cause of death in Alameda County, CA. Poor quality diet has been identified as an important contributor. Methods This study assessed the association between the neighborhood modified retail food environment index (mRFEI), an indicator of patients' access to nutritious foods, and CVD d...

Introduction: Neighborhood social cohesion is associated with physical activity (PA), but prior studies have used local population samples and presented results in aggregate across racial/ethnic groups. Hypothesis: Neighborhood social cohesion is associated with PA in a large, nationally representative dataset and may be modified by race/ethnicity....

Poster on multilingual qualitative patient experience research

Objective: We aim to calculate the 5-year mortality after surviving to hospital discharge after a firearm injury and estimate the association of firearm injury with later mortality. Methods: We performed a retrospective cohort study of patients from an urban emergency department (ED) and trauma centre in Oakland, California, USA, in 2007. We cre...

Introduction: Asthma is a common condition affecting many children in child-care centers. The National Asthma Education and Prevention Program offers recommendations about creating an asthma-friendly child-care setting. However, no studies have investigated the extent to which child-care centers adhere to these recommendations. This study describes...

Neighborhood social and built environments have been recognized as important contexts in which health is shaped. The authors reviewed the extent to which these neighborhood factors have been addressed in population-level cancer research by scanning the literature for research focused on specific social and/or built environment characteristics and t...

Few studies have examined the health-related consequences of gardening among older adults. This scoping review summarizes and characterizes current research that examines the relationship between physical health and participation in planned gardening activities, including establishing, maintaining, or caring for plants. Six databases were searched....

The articles in this special issue make it clear that there are interesting and policy-relevant research to identify place-based strategies to improve health and reduce health disparities among older adults. The articles also reveal important areas of future research and policy innovation that are needed related to place and aging.

Background and objectives: The neighborhoods in which children live, play, and eat provide an environmental context that may influence obesity risk and ameliorate or exacerbate health disparities. The current study examines whether neighborhood characteristics predict obesity in a prospective cohort of girls. Methods: Participants were 174 girls...

Mobility, broadly defined as movement in all of its forms from ambulation to transportation, is critical to supporting optimal aging. This article describes two projects to develop a framework and a set of priority actions designed to promote mobility among community-dwelling older adults. Project 1 involved a concept-mapping process to solicit and...

Objective: We examined the association of neighborhood social and physical characteristics with ADHD, accounting for individual and family factors. Method: The 2007 National Survey of Child Health, a nationally representative data set, was used (N = 64,076). Three neighborhood scales were generated: social support, amenities, and disorder. Logis...

To describe availability and frequency of use of local snack-food outlets and determine whether reported use of these outlets was associated with dietary intakes. Data were cross-sectional. Availability and frequency of use of three types of local snack-food outlets were reported. Daily dietary intakes were based on the average of up to four 24 h d...

The objective of this study was to determine the environmental features that best support aging in place. We conducted a realist synthesis, a theory-driven interpretive method of evidence synthesis, of 120+ articles (published 1991-2011) that attempts to explain how place may influence older adults' decisions about mobility (e.g., physical activity...

Background: Research is limited on the independent and joint effects of individual- and neighborhood-level socioeconomic status (SES) on breast cancer survival across different racial/ethnic groups. Methods: We studied individual-level SES, measured by self-reported education, and a composite neighborhood SES (nSES) measure in females (1,068 non...

Mobility, broadly defined as movement in all of its forms from ambulation to transportation, is critical to optimal aging. We present a new conceptual framework for mobility among community-dwelling older adults to help promote an integrated perspective and multidisciplinary research and practice response. Concept mapping engages stakeholders in id...

Introduction: Educational attainment is a well-established social determinant of health. It affects health through many mechanisms such as neural development, biological aging, health literacy and health behaviors, sense of control and empowerment, and life chances. However, what is it, specifically, about education that affects health? A literatur...

Typical measures of childhood socioeconomic status (SES), such as father's occupation, have limited the ability to elucidate mechanisms by which childhood SES affects adult health. Mechanisms could include schooling experiences or work opportunities. Having previously used qualitative methods for concept development, we developed new retrospective...

Some studies indicate that older adults lead active lives and travel to many destinations including those not in their immediate residential neighborhoods. We used global positioning system (GPS) devices to track the travel patterns of 40 older adults (mean age: 69) in San Francisco and Los Angeles. Study participants wore the GPS devices for 7 day...

Background: In 2010, over half of U.S. private sector occupational injuries and illnesses resulted in lost time, job transfer, or work restrictions. The purpose of this study is to assess the economic, social, and psychological effects on the family members of individuals who suffered a work-related injury. Methods: Telephone survey data were colle...

There is an increasing interest in neighbourhoods in the public health and epidemiology literature. Conventional epidemiologic investigations of neighbourhood health associations have primarily used census and administrative data to describe neighbourhoods. These studies report that people who live in neighbourhoods with higher proportions of peopl...