Nina S Parikh
Nina S. Parikh
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Clinical Associate Professor of Social and Behavioral Sciences
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Professional overview
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Dr. Nina S. Parikh has years of public health research experience, methodological expertise, and academic training in health services research and medical sociology. A continuing theme of Dr. Parikh’s research involves the examination of social, psychosocial, and cultural factors related to the health needs of ethnic-racial populations and developing evidence-based strategies that address and mitigate health inequities for these and other underserved groups, in particular immigrants, the uninsured, those with inadequate health literacy, and the elderly.
At NYU GPH, Dr. Parikh collaborates with scholars examining the social determinants of health, particularly social network mechanisms and how they relate to primary and secondary prevention of vascular diseases. This work builds on her previous research experience that has been community-based, grant-funded studies in partnership with local agencies and organizations that explore the well-being of older adults and their families, including social cohesion/social support, access to and utilization of health care services of immigrant populations, health disparities, community-based palliative care for chronically ill elders, and the promotion of healthy aging with a particular emphasis on developing and implementing behavioral strategies to combat some of the most prevalent chronic conditions for this group. In addition, Dr. Parikh developed and teaches the two-semester thesis course to MPH candidates.
Prior to coming to NYU, Dr. Parikh served as the Director of Research (Interim) at the Brookdale Center for Healthy Aging of Hunter College where she provided oversight and guidance on all research and evaluation studies conducted by the Center. Her work has received grant support from the Robert Wood Johnson Foundation, the Commonwealth Fund, Agency for Healthcare Research and Quality, and the NYC Department for the Aging.
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Education
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BS, Biology and minor in Sociology, John Carroll University, Cleveland, OHMPH, Health Policy and Management, Emory University, Atlanta, GAPhD, Sociomedical Sciences, Columbia University, New York, NY
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Areas of research and study
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Aging and the Life CourseCultural Determinants of HealthImmigrationRacial/Ethnic DisparitiesSocial Determinants of Health
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Publications
Publications
Mental health burdens among North American Asian adults living with chronic conditions: a systematic review
AbstractIslam, J. Y., Parikh, N. S., Lappen, H., Venkat, V., Nalkar, P., & Kapadia, F. (n.d.).Publication year
2023Journal title
Epidemiologic ReviewsVolume
45Issue
1Page(s)
82-92AbstractAsians are likely to experience a high burden of chronic conditions, including, but not limited to, diabetes, cardiovascular disease, and cancer, due to differences in biologic, genetic, and environmental factors across Asian ethnic groups. A diagnosis of any chronic condition can contribute to increased mental health burdens, including depression, psychological distress, and posttraumatic stress disorder (PTSD). However, few studies have examined these comorbid conditions across distinct Asian ethnic groups—an important limitation given the differences in social, cultural, and behavioral drivers of mental health burdens within and across Asian ethnicities. To understand the disparities in mental health burdens among Asians living with a chronic health condition, we conducted a systematic literature review of relevant, peer-reviewed publication databases to identify studies reporting on mental health burdens (e.g., depression, anxiety, distress, PTSD) in distinct Asian ethnic groups in North America. Thirteen studies met the inclusion criteria for this review and collectively demonstrated a high burden of depression, psychological distress, and PTSD among Asians living with chronic conditions. Moreover, there were distinct disparities in mental health burdens across chronic conditions and across Asian ethnic groups. Despite the detrimental impact of poor mental health on chronic disease–specific outcomes, such as death and poor quality of life, few data exist that characterize mental health outcomes among Asian ethnicities living in North America with chronic conditions. Future work should prioritize estimating the national prevalence of mental health outcomes among adults with chronic conditions, by Asian ethnicities, to inform culturally tailored interventions to address this public health burden.Acculturation and Depressive Symptoms Among Dominicans in New York City
AbstractHagen, D., Goldmann, E., Parikh, N. S., Goodman, M., & Boden-Albala, B. (n.d.).Publication year
2022Journal title
Journal of Immigrant and Minority HealthVolume
24Issue
5Page(s)
1186-1195AbstractLittle is known about the association between acculturation and mental health among Dominican populations in the United States. Data came from a community survey of Dominican residents of New York City (n = 2744). Associations between two indicators of acculturation, proportion of life spent in the U.S. and interview language (English/Spanish), with lifetime depressive symptoms (Patient Health Questionnaire-9 score ≥ 5) were examined using logistic regression overall and by gender. In adjusted models, respondents with English-language interview and above-median proportion of life spent in the U.S. had 77% higher odds (95% CI 1.28, 2.44) of lifetime depressive symptoms than those with Spanish-language interview and below-median proportion of life spent in the U.S. There was some evidence of elevated odds of depressive symptoms among men with English-language interview and below-median proportion of life spent in the U.S. Additional research is needed to elucidate gender-specific impacts of acculturation on mental health in this population.Recruitment, Inclusion, and Diversity in Clinical Trials
AbstractBoden-Albala, B., Waddy, S. P., Appleton, N., Kuczynski, H., Nangle, E., & Parikh, N. S. (n.d.). In The Science of Health Disparities Research (1–).Publication year
2021Page(s)
413-428AbstractIn this chapter, we discuss the importance of diversity and the inclusion of women and racial/ethnic minority groups in clinical research as a foundation for addressing health disparities. First, we provide a brief background on the scientific and ethical significance of diversity and inclusion in clinical research. Next, we discuss barriers to recruiting representative study populations, including: (i) optimizing the screening pool, (ii) converting eligible participants to enrolled research subjects, and (iii) retaining subjects in a study. We specifically examine patient/community-, investigator-, and structural/institutional-level barriers. Finally, we summarize various best practices for enhancing inclusion of under-represented groups in clinical research, as well as future directions and research needs.Positive health beliefs and blood pressure reduction in the deserve study
AbstractGoldmann, E., Jacoby, R., Finfer, E., Appleton, N., Parikh, N. S., Roberts, E. T., & Boden-Albala, B. (n.d.).Publication year
2020Journal title
Journal of the American Heart AssociationVolume
9Issue
9AbstractBACKGROUND: There is growing recognition that positive health beliefs may promote blood pressure (BP) reduction, which is critical to stroke prevention but remains a persistent challenge. Yet, studies that examine the association between positive health beliefs and BP among stroke survivors are lacking. METHODS AND RESULTS: Data came from the DESERVE (Discharge Educational Strategies for Reduction of Vascular Events) study, a randomized controlled trial of a skills-based behavioral intervention to reduce vascular risk in a multiethnic cohort of 552 transient ischemic attack and mild/moderate stroke patients in New York City. The exposure was perception that people can protect themselves from having a stroke (ie, prevention self-efficacy) at baseline. The association between systolic BP (SBP) reduction at 12-month follow-up and self-efficacy was examined using linear regression adjusted for key confounders, overall and stratified by age, sex, race/ethnicity, and intervention trial arm. Approximately three quarters endorsed self-efficacy. These participants had, on average, 5.6 mm Hg greater SBP reduction compared with those who did not endorse it (95% CI, 0.5–10.7 mm Hg; P=0.032). Self-efficacy was significantly associated with greater SBP reduction, particularly among female versus male, younger versus older, and Hispanic versus non-Hispanic white patients. Sensitivity analysis adjusting for baseline SBP instead of elevated BP yielded no association between self-efficacy and SBP reduction, but showed sex differences in this association (women: β=5.3; 95% CI, −0.2 to 10.8; P=0.057; men: β=−3.3; 95% CI, −9.4 to 2.9; P=0.300; interaction P=0.064). CONCLUSIONS: Self-efficacy was linked with greater SBP reduction among female stroke survivors. Targeted strategies to improve health beliefs after stroke may be important for risk factor management.Assessing the palliative care needs and service use of diverse older adults in an urban medically-underserved community
AbstractGardner, D. S., Parikh, N. S., Villanueva, C. H., Ghesquiere, A., Kenien, C., Callahan, J., & Reid, M. C. (n.d.).Publication year
2019Journal title
Annals of Palliative MedicineVolume
8Issue
5Page(s)
769-774AbstractAlthough palliative care (PC) has become increasingly familiar, considerable gaps persist in access to and use of services. Community-based programs remain rare, and low-income, minority communities significantly under-utilize hospice and palliative services. We used community-based participatory research (CBPR) methods to conduct a mixed-methods community needs assessment of seriously-ill older adults (n=100) and providers from community-based programs and churches (n=41) in an urban medically-underserved community in the U.S. to explore: (I) the prevalence and severity of illness-related symptoms and psychosocial-spiritual concerns; (II) the scope and quality of community supports helping older adults manage their symptoms; and (III) the perceptions and utilization of palliative and supportive care services among older adults and community-based service providers. Participants reported high rates of chronic illness-related symptoms (i.e., pain, fatigue, sleeping difficulties, depression, and anxiety), and many described unmet needs around symptom management. Few had ever utilized PC or pain management services, and most relied primarily on family, friends, and faith communities to help them manage burdensome symptoms. Barriers included lack of familiarity with PC, limited access and financial concerns. Older adults were largely unfamiliar with PC, and many described unmet needs and desire for help with symptom burden. Findings support the need to further explore community-level and cultural barriers to PC among diverse, underserved older adults. Development of innovative community partnerships may help raise awareness of PC and address the physical and psychosocial-spiritual challenges facing chronically-ill minority older adults and their families.Efficacy of a Discharge Educational Strategy vs Standard Discharge Care on Reduction of Vascular Risk in Patients with Stroke and Transient Ischemic Attack: The DESERVE Randomized Clinical Trial
AbstractBoden-Albala, B., Goldmann, E., Parikh, N. S., Carman, H., Roberts, E. T., Lord, A. S., Torrico, V., Appleton, N., Birkemeier, J., Parides, M., & Quarles, L. (n.d.).Publication year
2019Journal title
JAMA NeurologyVolume
76Issue
1Page(s)
20-27AbstractImportance: Despite secondary prevention strategies with proven efficacy, recurrent stroke rates remain high, particularly in racial/ethnic minority populations who are disproportionately affected by stroke. Objective: To determine the efficacy of a culturally tailored skills-based educational intervention with telephone follow-up compared with standard discharge care on systolic blood pressure reduction in a multiethnic cohort of patients with mild/moderate stroke/transient ischemic attack. Design, Setting, and Participants: Randomized clinical trial with 1-year follow-up. Participants were white, black, and Hispanic patients with mild/moderate stroke/transient ischemic attack prospectively enrolled from 4 New York City, New York, medical centers during hospitalization or emergency department visit between August 2012 and May 2016. Through screening of stroke admissions and emergency department notifications, 1083 eligible patients were identified, of whom 256 declined to participate and 275 were excluded for other reasons. Analyses were intention to treat. Interventions: The Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) intervention is a skills-based, culturally tailored discharge program with follow-up calls delivered by a community health coordinator. This intervention was developed using a community engagement approach. Main Outcomes and Measures: The primary outcome was systolic blood pressure reduction at 12 months postdischarge. Results: A total of 552 participants were randomized to receive intervention or usual care (281 women [51%]; mean [SD] age, 64.61 [2.9] years; 180 Hispanic [33%], 151 non-Hispanic white [27%], and 183 non-Hispanic black [33%]). At 1-year follow-up, no significant difference in systolic blood pressure reduction was observed between intervention and usual care groups (β = 2.5 mm Hg; 95% CI, -1.9 to 6.9). Although not powered for subgroup analysis, we found that among Hispanic individuals, the intervention arm had a clinically and statically significant 9.9 mm Hg-greater mean systolic blood pressure reduction compared with usual care (95% CI, 1.8-18.0). There were no significant differences between arms among non-Hispanic white (β = 3.3; 95% CI, -4.1 to 10.7) and non-Hispanic black participants (β = -1.6; 95% CI, -10.1 to 6.8). Conclusions and Relevance: Few behavioral intervention studies in individuals who have had stroke have reported clinically meaningful reductions in blood pressure at 12 months, and fewer have focused on a skills-based approach. Results of secondary analyses suggest that culturally tailored, skills-based strategies may be an important alternative to knowledge-focused approaches in achieving sustained vascular risk reduction and addressing racial/ethnic stroke disparities; however, these findings should be tested in future studies. Trial Registration: ClinicalTrials.gov identifier: NCT01836354.Immigration Status, Visa Types, and Body Weight Among New Immigrants in the United States
AbstractYeh, M. C., Parikh, N. S., Megliola, A. E., & Kelvin, E. A. (n.d.).Publication year
2018Journal title
American Journal of Health PromotionVolume
32Issue
3Page(s)
771-778AbstractPurpose: To investigate the relationship between immigration-related factors and body mass index (BMI) among immigrants. Design: Secondary analyses of cross-sectional survey data. Setting: The New Immigrant Survey (NIS-2003) contains data from in-person or telephone interviews between May and November 2003, with a probability sample of immigrants granted legal permanent residency in the United States. Participants: A total of 8573 US immigrants. Measures: The NIS-2003 provided data on sociobehavioral domains, including migration history, education, employment, marital history, language, and health-related behaviors. The visa classifications are as follows: (1) family reunification, (2) employment, (3) diversity, (4) refugee, and (5) legalization. Analysis: Nested multivariable linear regression analysis was used to estimate the independent relationships between BMI and the variables of interest. Results: Overall, 32.6% of participants were overweight and 11.3% were obese (mean BMI = 25). Participants who were admitted to the United States with employment, refugee, or legalization visas compared with those who came with family reunion visas had a significantly higher BMI (P <.001, P <.001, P <.01, respectively). Duration in the United States predicted BMI, with those immigrants in the United States longer having a higher BMI (P <.001). Conclusion: Our findings suggest that immigrants who obtain particular visa categorizations and immigration status might have a higher risk of being overweight or obese. Immigrants need to be targeted along with the rest of the US population for weight management interventions.The experiences of providing caregiving for patients with schizophrenia in the Ghanaian context
Gloria, O., Osafo, J., Goldmann, E., Parikh, N. S., Nonvignon, J., & Kretchy, I. M. (n.d.).Publication year
2018Journal title
Archives of Psychiatric NursingVolume
32Issue
6Page(s)
815-822Age-related differences in antihypertensive medication adherence in hispanics: A cross-sectional community-based survey in New York City, 2011-2012
AbstractBandi, P., Goldmann, E., Parikh, N. S., Farsi, P., & Boden-Albala, B. (n.d.).Publication year
2017Journal title
Preventing Chronic DiseaseVolume
14Issue
7AbstractIntroduction US Hispanics, particularly younger adults in this population, have a higher prevalence of uncontrolled hypertension than do people of other racial/ethnic groups. Little is known about the prevalence and predictors of antihypertensive medication adherence, a major determinant of hypertension control and cardiovascular disease, and differences between age groups in this fast-growing population. Methods The cross-sectional study included 1,043 community-dwelling Hispanic adults with hypertension living in 3 northern Manhattan neighborhoods from 2011 through 2012. Age-stratified analyses assessed the prevalence and predictors of high medication adherence (score of 8 on the Morisky Medication Adherence Scale [MMAS-8]) among younger (< 60 y) and older (≥60 y) Hispanic adults. Results Prevalence of high adherence was significantly lower in younger versus older adults (24.5% vs 34.0%, P = .001). In younger adults, heavy alcohol consumption, a longer duration of hypertension, and recent poor physical health were negatively associated with high adherence, but poor self-rated general health was positively associated with high adherence. In older adults, advancing age, higher education level, high knowledge of hypertension control, and private insurance or Medicare versus Medicaid were positively associated with high adherence, whereas recent poor physical health and health-related activity limitations were negatively associated with high adherence. Conclusion Equitable achievement of national hypertension control goals will require attention to suboptimal antihypertensive medication adherence found in this study and other samples of US Hispanics, particularly in younger adults. Age differences in predictors of high adherence highlight the need to tailor efforts to the life stage of people with hypertension.Barriers and Strategies for Recruitment of Racial and Ethnic Minorities: Perspectives from Neurological Clinical Research Coordinators
AbstractHaley, S. J., Southwick, L. E., Parikh, N. S., Rivera, J., Farrar-Edwards, D., & Boden-Albala, B. (n.d.).Publication year
2017Journal title
Journal of Racial and Ethnic Health DisparitiesVolume
4Issue
6Page(s)
1225-1236AbstractIntroduction: Randomized controlled trials (RCTs) are the gold standard within evidence-based research. Low participant accrual rates, especially of underrepresented groups (e.g., racial-ethnic minorities), may jeopardize clinical studies’ viability and strength of findings. Research has begun to unweave clinical trial mechanics, including the roles of clinical research coordinators, to improve trial participation rates. Methods: Two semi-structured focus groups were conducted with a purposive sample of 29 clinical research coordinators (CRCs) at consecutive international stroke conferences in 2013 and 2014 to gain in-depth understanding of coordinator-level barriers to racial-ethnic minority recruitment and retention into neurological trials. Coded transcripts were used to create themes to define concepts, identify associations, summarize findings, and posit explanations. Results: Barriers related to translation, literacy, family composition, and severity of medical diagnosis were identified. Potential strategies included a focus on developing personal relationships with patients, community and patient education, centralized clinical trial administrative systems, and competency focused training and education for CRCs. Conclusion: Patient level barriers to clinical trial recruitment are well documented. Less is known about barriers facing CRCs. Further identification of how and when barriers manifest and the effectiveness of strategies to improve CRCs recruitment efforts is warranted.Chronic Physical Illness Burden and Suicidal Ideation Among Dominicans in New York City
AbstractGoldmann, E., Roberts, E. T., Parikh, N. S., & Boden-Albala, B. (n.d.).Publication year
2017Journal title
Journal of Immigrant and Minority HealthVolume
19Issue
3Page(s)
616-622AbstractLittle is known about the association between chronic illness and suicidal ideation (SI) among Dominicans living in the United States. This study used data from a community survey of 2753 Dominican adults in New York City. SI included thoughts of self-harm or being better off dead in the past month. Chronic physical illness burden was categorized as having 0, 1, or 2+ diagnosed conditions. Adjusted logistic regressions evaluated the association between number of conditions and SI, overall and stratified by sex and age. Adjusted models yielded a strong association between chronic illness burden and SI among men [odds ratio (OR) 5.57, 95 % confidence interval (CI) 2.19–14.18] but not women (OR 0.80, 95 % CI 0.50–1.29; interaction p = 0.011). The association of interest did not differ significantly between younger and older adults. Screening for SI in health care practice, particularly among Dominican men with multiple chronic health conditions, may be warranted.Gender, Social Networks, and Stroke Preparedness in the Stroke Warning Information and Faster Treatment Study
AbstractMadsen, T. E., Roberts, E. T., Kuczynski, H., Goldmann, E., Parikh, N. S., & Boden-Albala, B. (n.d.).Publication year
2017Journal title
Journal of Stroke and Cerebrovascular DiseasesVolume
26Issue
12Page(s)
2734-2741AbstractBackground and Purpose The study aimed to investigate the effect of gender on the association between social networks and stroke preparedness as measured by emergency department (ED) arrival within 3 hours of symptom onset. Methods As part of the Stroke Warning Information and Faster Treatment study, baseline data on demographics, social networks, and time to ED arrival were collected from 1193 prospectively enrolled stroke/transient ischemic attack (TIA) patients at Columbia University Medical Center. Logistic regression was conducted with arrival to the ED ≤3 hours as the outcome, social network characteristics as explanatory variables, and gender as a potential effect modifier. Results Men who lived alone or were divorced were significantly less likely to arrive ≤3 hours than men who lived with a spouse (adjusted odds ratio [aOR]:.31, 95% confidence interval [CI]:.15-0.64) or were married (aOR:.45, 95% CI:.23-0.86). Among women, those who lived alone or were divorced had similar odds of arriving ≤3 hours compared with those who lived with a spouse (aOR: 1.25, 95% CI:.63-2.49) or were married (aOR:.73, 95% CI:.4-1.35). Conclusions In patients with stroke/TIA, living with someone or being married improved time to arrival in men only. Behavioral interventions to improve stroke preparedness should incorporate gender differences in how social networks affect arrival times.Race/ethnic differences in post-stroke depr ession (PSD): Findings from the stroke warning information and faster treatment (SWIFT ) study
AbstractGoldmann, E., Roberts, E. T., Parikh, N. S., Lord, A. S., & Boden-Albala, B. (n.d.).Publication year
2016Journal title
Ethnicity and DiseaseVolume
26Issue
1Page(s)
1-8AbstractObjectives: Post-stroke depression (PSD) is common and associated with poor stroke outcomes, but few studies have examined race/ethnic disparities in PSD. Given the paucity of work and inconsistent findings in this important area of research, our study aimed to examine race/ethnic differences in depression in a multi-ethnic cohort of stroke patients. Design: Longitudinal. Setting: Prospective trial of a post-stroke educational intervention. Patients or Participants: 1,193 mild/moderate ischemic stroke/transient ischemic attack (TIA) patients. Main Outcome Measures: We used the Center for Epidemiologic Studies Depression (CES-D) Scale to assess subthreshold (CES-D score 8-15) and full (CES-D score ≥ 16) depression at one month ("early") and 12 months ("late") following stroke. Multinomial logistic regression analyses examined the association between race/ethnicity and early and late PSD separately. Results: The prevalence of subthreshold and full PSD was 22.5% and 32.6% in the early period and 22.0% and 27.4% in the late period, respectively. Hispanics had 60% lower odds of early full PSD compared with non-Hispanic Whites after adjusting for other covariates (OR=.4, 95% CI: .2, .8). Race/ ethnicity was not significantly associated with late PSD. Conclusions: Hispanic stroke patients had half the odds of PSD in early period compared with Whites, but no difference was found in the later period. Further studies comparing trajectories of PSD between race/ ethnic groups may further our understanding of race/ethnic disparities in PSD and help identify effective interventions.Examining Barriers and Practices to Recruitment and Retention in Stroke Clinical Trials
AbstractBoden-Albala, B., Carman, H., Southwick, L., Parikh, N. S., Roberts, E., Waddy, S., & Edwards, D. (n.d.).Publication year
2015Journal title
Stroke; a journal of cerebral circulationVolume
46Issue
8Page(s)
2232-2237AbstractBACKGROUND AND PURPOSE: The National Institutes of Health policy calls for the inclusion of under-represented groups, such as women and minorities, in clinical research. Poor minority recruitment and retention in stroke clinical trials remain a significant challenge limiting safety and efficacy in a general population. Previous research examines participant barriers to clinical trial involvement, but little is known about the investigator perspective. This study addresses this gap and examines researcher-reported barriers and best practices of minority involvement in stroke clinical trials.METHODS: Quantitative and qualitative methods, including surveys, focus groups, and key informant interviews were used.RESULTS: In a survey of 93 prominent stroke researchers, 43 (51.2%; 70% response rate) respondents reported proactively setting recruitment goals for minority inclusion, 29 respondents (36.3%) reported requiring cultural competency staff training, and 44 respondents (51.2%) reported using community consultation about trial design. Focus groups and key informant interviews highlighted structural and institutional challenges to recruitment of minorities, including mistrust of the research/medical enterprise, poor communication, and lack of understanding of clinical trials. Researcher-identified best practices included using standardized project management procedures and protocols (eg, realistic budgeting to support challenges in recruitment, such as travel/parking reimbursement for participants), research staff cultural competency and communication training, and developing and fostering community partnerships that guide the research process.CONCLUSIONS: This study's formative evaluation contributes a new dimension to the literature as it highlights researcher-reported barriers and best practices for enhancing participation of minority populations into stroke clinical trials.Restaurant management views on the views on the new national menu labeling laws
Yeh, M., Platkin, C., Fishman, J., L., F., & Parikh, N. (n.d.).Publication year
2014Journal title
International Journal of Nutrition DieteticsVolume
2Issue
1Page(s)
1-18Mind-body techniques, race-ethnicity, and depression among urban senior center participants
AbstractMorano, C., Giunta, N., Parikh, N. S., Panuska, S., Fahs, M. C., & Gallo, W. T. (n.d.).Publication year
2013Journal title
Health and Social WorkVolume
38Issue
3Page(s)
167-172AbstractAs the older adult population grows and becomes more diverse, more of its members are turning to complementary and alternative medicine (CAM). There are mixed findings regarding racial and ethnic differences in the use of CAM. This article explores racial and ethnic differences in use of a category of CAM known as mind-body techniques (MBT) among senior center participants with symptoms of depression. It also examines the relationship between use of MBT and depression severity. A cross-sectional survey was conducted with a representative sample of senior center participants in New York City, from which a subsample of those with depressive symptoms was drawn. Racial and ethnic differences in MBT use were identified, as was a significant negative relationship between MBT use and depression severity. African American elders were more likely to have used MBT than other racial or ethnic groups. When controlling for race or ethnicity, health status, and barriers to medical care, predictors of depression severity included health status, experiencing barriers to medical care, and Hispanic identity. Findings suggest that being female or younger is associated with a higher likelihood of using CAM. Contrary to some prior research, education level was not associated with use of MBT.Linking neighborhood characteristics to food insecurity in older adults: The role of perceived safety, social cohesion, and walkability
AbstractChung, W. T., Gallo, W. T., Giunta, N., Canavan, M. E., Parikh, N. S., & Fahs, M. C. (n.d.).Publication year
2012Journal title
Journal of Urban HealthVolume
89Issue
3Page(s)
407-418AbstractAmong the 14.6% of American households experiencing food insecurity, approximately 2 million are occupied by older adults. Food insecurity among older adults has been linked to poor health, lower cognitive function, and poor mental health outcomes. While evidence of the association between individual or household-level factors and food insecurity has been documented, the role of neighborhood-level factors is largely understudied. This study uses data from a representative sample of 1,870 New York City senior center participants in 2008 to investigate the relationship between three neighborhood-level factors (walkability, safety, and social cohesion) and food insecurity among the elderly. Issues relating to food security were measured by three separate outcome measures: whether the participant had a concern about having enough to eat this past month (concern about food security), whether the participant was unable to afford food during the past year (insufficient food intake related to financial resources), and whether the participant experienced hunger in the past year related to not being able to leave home (mobility-related food insufficiency). Unadjusted and adjusted logistic regression was performed for each measure of food insecurity. Results indicate that neighborhood walkability is an important correlate of mobilityrelated food insufficiency and concern about food insecurity, even after controlling the effects of other relevant factors.Racial and Ethnic Diversity in Senior Centers: Comparing Participant Characteristics in More and Less Multicultural Settings
AbstractGiunta, N., Morano, C., Parikh, N. S., Friedman, D., Fahs, M. C., & Gallo, W. T. (n.d.).Publication year
2012Journal title
Journal of Gerontological Social WorkVolume
55Issue
6Page(s)
467-483AbstractThe 2008 Health Indicators Project surveyed a probability sample (N = 1,870) of New York City senior center participants. Attendees of racially and ethnically diverse and nondiverse senior centers were compared across 5 domains: demographics; health and quality of life; social support networks; neighborhood perceptions and engagement; health service access/utilization. Although homogeneous and diverse center participants demonstrate similar health and quality-of-life outcomes, those from diverse centers demonstrate greater risk of social isolation, receive less family support, and more likely seek medical care from hospitals or community clinics. Implications and future directions for research, practice and policy are discussed.The association between neighbourhood social cohesion and hypertension management strategies in older adults
Schmitz, M. F., Giunta, N., Parikh, N. S., Chen, K. K., Fahs, M. C., & Gallo, W. T. (n.d.). In Age and Ageing (1–).Publication year
2012Volume
41Issue
3Page(s)
388-392The influence of neighborhood factors on the quality of life of older adults attending New York City senior centers: Results from the Health Indicators Project
AbstractFriedman, D., Parikh, N. S., Giunta, N., Fahs, M. C., & Gallo, W. T. (n.d.).Publication year
2012Journal title
Quality of Life ResearchVolume
21Issue
1Page(s)
123-131AbstractPurpose To examine the association between selfassessed quality of life (QOL) and perceived neighborhood safety, social cohesion, and walkability among older adults in New York City (NYC). Methods We used data from the 2008 Health Indicators Project, a cross-sectional survey of 1,870 older adults attending 56 NYC senior centers. QOL, a binary measure, was created by dichotomizing a 5-point Likert-scaled global assessment. Neighborhood safety, social cohesion, and walkability were multi-component scale variables that were standardized due to varying response metrics. Multivariate binomial logistic regression analysis was performed on 1,660 participants with complete data. Results After adjusting for covariates, QOL was significantly associated with neighborhood safety and social cohesion. A one-standard deviation increase in neighborhood safety and social cohesion increased the log odds of having higher QOL by 30% (odds ratio (OR) = 1.30; 95% confidence interval (CI) = 1.14, 1.48; P ≤ 0.001) and 36% (OR = 1.36; 95% CI = 1.16, 1.59; P ≤ 0.001), respectively. Higher QOL was not significantly associated with neighborhood walkability. Conclusion The results of this study underscore the need for initiatives that focus on enhancing age-friendly neighborhood features in large urban centers such as NYC and beyond.Ethnic disparities in self-reported oral health status and access to care among older adults in NYC
AbstractShelley, D., Russell, S., Parikh, N. S., & Fahs, M. (n.d.).Publication year
2011Journal title
Journal of Urban HealthVolume
88Issue
4Page(s)
651-662AbstractThere is a growing burden of oral disease among older adults that is most significantly borne by minorities, the poor, and immigrants. Yet, national attention to oral heath disparities has focused almost exclusively on children, resulting in large gaps in our knowledge about the oral health risks of older adults and their access to care. The projected growth of the minority and immigrant elderly population as a proportion of older adults heightens the urgency of exploring and addressing factors associated with oral health-related disparities. In 2008, the New York City Health Indicators Project (HIP) conducted a survey of a representative sample of 1,870 adults over the age of 60 who attended a random selection of 56 senior centers in New York City. The survey included questions related to oral health status. This study used the HIP database to examine differences in self-reported dental status, dental care utilization, and dental insurance, by race/ethnicity, among community-dwelling older adults. Non-Hispanic White respondents reported better dental health, higher dental care utilization, and higher satisfaction with dental care compared to all other racial/ethnic groups. Among minority older adults, Chinese immigrants were more likely to report poor dental health, were less likely to report dental care utilization and dental insurance, and were less satisfied with their dental care compared to all other racial/ethnic groups. Language fluency was significantly related to access to dental care among Chinese immigrants. Among a diverse community-dwelling population of older adults in New York City, we found significant differences by race/ethnicity in factors related to oral health. Greater attention is needed in enhancing the cultural competency of providers, addressing gaps in oral health literacy, and reducing language barriers that impede access to care.Body weight and length of residence in the US among Chinese Americans
AbstractYeh, M. C., Fahs, M., Burton, D., Yerneni, R., Parikh, N. S., & Shelley, D. (n.d.).Publication year
2009Journal title
Journal of Immigrant and Minority HealthVolume
11Issue
5Page(s)
422-427AbstractBackground: It has been shown that as immigrants' length of residence increases, so does their weight. However, little is known about factors associated with weight status among Chinese Americans, one of the fastest growing immigrant populations in the US. Methods: Baseline datafrom a National Cancer Institute-funded longitudinal study involving a multi-stage probability sample of Chinese Americans residing in two communities in New York City were collected. Results: Chinese Americans had a low BMI (mean = 22.81) and a lower proportion of obese individuals compared with other ethnic groups in the US reported in the literature. While the prevalence of being overweight (21%) and obese (2%) was low, length of residence was positively associated with weight status (P < 0.005). Conclusions: Innovative strategies to help Chinese Americans maintain healthy weight status and to prevent them from becoming overweight and obese are needed.Health behaviors of older Chinese adults living in New York City
AbstractParikh, N. S., Fahs, M. C., Shelley, D., & Yerneni, R. (n.d.).Publication year
2009Journal title
Journal of Community HealthVolume
34Issue
1Page(s)
6-15AbstractThe dramatic increase in the number of older immigrants living in the U.S. presents new challenges to policy makers concerned with promoting healthy aging. To date, however, strikingly little is known regarding the health and health trajectories of older immigrants. This paper examines the prevalence and predictors of important health behaviors associated with chronic disease prevention, including current smoking status, physical activity, alcohol use, and body mass index (BMI). We analyzed data from the 2003 New York City Chinese Health Survey (NYC CHS), the largest probability-based sample of Chinese immigrants residing in two distinct communities. In-person interviews were conducted with 517 representative men and women aged 55-75. Logistic regression modeling was used to test the influence of demographic, socioeconomic status, acculturation, and health characteristics on selected health behaviors. Results revealed that having more education and better physical health status were associated with greater participation in physical activity. Gender-specific analyses indicated that the effect of selected predictors varied between the sexes. For example, among older Chinese women, acculturation was negatively associated with alcohol use. This study provides some of the first evidence on health behaviors of one of the fastest growing older immigrant groups in the U.S. Study results add to the emerging literature on the complex nature of immigrant health trajectories, and demonstrate that contrary to prior research, living a greater proportion of time in the U.S. can be associated with selected positive health behaviors. Further longitudinal studies are needed to help inform policy initiatives to encourage healthy aging among diverse older immigrant groups.Immigrants and urban planning: Towards a policy frameowrk
Parikh, N., Fahs, M., & Viladrich, A. (n.d.). In Urban Health and Society (1–).Publication year
2009Page(s)
239-270Patients' shame and attitudes toward discussing the results of literacy screening
AbstractWolf, M. S., Williams, M. V., Parker, R. M., Parikh, N. S., Nowlan, A. W., & Baker, D. W. (n.d.).Publication year
2007Journal title
Journal of Health CommunicationVolume
12Issue
8Page(s)
721-732AbstractWe investigated patients' willingness to have their reading ability documented in their medical records and the degree of shame and embarrassment associated with such disclosure. Structured interviews were conducted among a consecutive sample of 283 primary care patients at an urban public hospital. Patients' literacy was measured using the Rapid Estimate of Adult Literacy in Medicine (REALM). Self-report of degree of shame and embarrassment related to literacy skills was measured using an orally administered questionnaire. Fifty-one percent of patients had low literacy skills (≤sixth grade) and 27.9% were assessed as having marginal literacy (seventh-eighth grade). Half (47.6%) of patients reading at or below the third-grade level admitted feeling ashamed or embarrassed about their difficulties reading, compared with 19.2% of those reading at the fourth-sixth-grade level and 6.5% of those reading at the seventh-eighth-grade level (p<0.001). More than 90% of patients with low or marginal literacy reported it would be helpful for the doctor or nurse to know they did not understand some medical words. Patients with limited literacy were more likely to report feelings of shame as a result of disclosure (p<0.05). Health care providers must recognize the potential shame patients might experience as a result of literacy screening.