Texas Community Research Articles

Applying Intersectionality to Address Racial and Spatial Postsecondary Disparities—Rural Latino Youth

Background/Context: There is a growing concern about the ways in which geography affects the educational opportunity for America’s rural youth. Most research on this population has assumed that rural America is primarily White and that rural college access is stratified by an individual’s ability to complete the application process. Such approaches ignore race and the interplay among geography, admissions practices, and individual behavior and decision-making. Purpose/Objective/Research Question/Focus of Study: This study examines the postsecondary experiences and opportunity structures for Latino youth living in rural Latino communities in South Texas. The purpose of this study is to understand quantitively and qualitatively how the geographic context of a predominantly rural Latino area shaped the college-going process and pathway decisions for the Latino youth living within these rural communities. To critically understand beyond the individual and learn about how systemic conditions in rural Latino communities can usher in (dis)advantages in their postsecondary experiences and sort students into pathways, this study employed Núñez’s (2014) multilevel model of intersectionality framework. As such, this study asked the following research questions: (1) What is the college access experience for Latino youth living in rural communities in South Texas? (2) In what ways, if any, do rural Latino youth describe how their rural geography structures (in) equalities in the college-going process? (3) How are rural Latino youths’ college access and opportunity structured, and does this differ from other geographic contexts? Research Design: Using a three-phase mixed-methods design (QUAL→quan), this study interviewed 101 Latino youth living in three different rural areas in South Texas toward the end of their senior year of high school. The quantitative component of the study used descriptive and spatial data to further expand on, complement, and confirm the intersectional findings in the qualitative data. In the last phase, data were integrated, and inferences were made about how college access opportunities are structured for Latino youth living in rural communities. Conclusions/Recommendations: Using an intersectionality framework, this study identified several ways in which the geography of rural Latino communities is structured that render and perpetuate inequities and disadvantages for Latino youth pursuing college. Rural Latino youth lived in communities that systemically experienced higher poverty, lower median incomes, and less access to resources and opportunities as compared with (sub)urban metro areas. Most students discussed how these geographic conditions played a role in the ways that bounded the opportunities they experienced during their college-going process and their decision to enroll at a college within close proximity to their rural region. This study has implications for how intersectionality frames can expand our understanding of the unique characteristics of rural regions that creates both opportunities and challenges for rural Latino youth pursuing postsecondary opportunities. This is significant given that most higher education researchers, policymakers, and practitioners conflate the racial/ethnic diversity of rural areas with whiteness and being White. In doing so, they overlook the presence of Latinos in rural areas and ignore their intersecting assets and challenges, hindering effective policy solutions that can better support historically marginalized students.

Defining the “Community” in Community College: A National Overview and Implications for Racial Imbalance in Texas

At least 38 states have created service areas or “districts” for each of their community colleges. However, little is known about the geographic boundaries of community college districts and the policymaking process that defines them. We studied state policy documents nationally and the actual district boundaries of Texas community colleges to investigate the larger policymaking processes of determining boundaries. We found significant variation across the United States, including in who determines the boundaries and whether the districts have associated tuition reductions. In our case study, we also found evidence that the majority of Texas’s community college districts appear to reflect their larger local environments, although a small number may exhibit evidence of racial imbalance.

Texas Community College Students’ Perceptions of Culturally Sustaining Pedagogy in a Learning Community at a Hispanic Serving Institution

ABSTRACT The purpose of this study was to better understand the perceptions and experiences of students in a learning community that incorporated culturally sustaining pedagogy (CSP) into its curriculum. The field site of this instrumental case study was a community college learning community situated in a Hispanic Serving Institution in Texas. Data from interviews, focus groups, classroom observations, learning community events, and campus observations were collected and analyzed. Findings revealed a specific set of foci by students. While students discussed culturally relevant assignments, they did not highlight curricular elements usually associated with CSP. Instead, students emphasized familial aspects of the learning community, perceptions of validation by instructors, and aspects of instructors’ feedback. This study uncovers student participants’ perspectives regarding instruction, learning communities, and their college experiences.

Quality of Stormwater Infrastructure Systems in Vulnerable Communities: Three Case Studies from Texas.

A properly functioning local stormwater drainage system is essential for mitigating flood risks. This study evaluates the quality of roadside drainage channels in three underserved communities in Texas: the Sunnyside neighborhood in Houston (Harris County), a neighborhood in the City of Rockport (Aransas County), and the Hoehn colonia (Hidalgo County). These communities have a history of flooding, are highly socially vulnerable, and rely on roadside ditches as their principal stormwater drainage system for runoff control. Mobile lidar (Light Detection and Ranging) measurements were collected for 6.09 miles of roadside channels in these communities. The raw lidar measurements were processed to evaluate drainage conditions based on the channel's geometric properties, hydraulic capacity, and level of service. The assessment results are linked to a Geographic Information System (GIS) tool for enhanced visualization. Finally, the paper provides insights regarding the quality of stormwater infrastructure in the study communities and discusses their practical implications.

Borderlands Curanderos: The Worlds of Santa Teresa Urrea and Don Pedrito Jaramillo by Jennifer Koshatka Seman

Reviewed by: Borderlands Curanderos: The Worlds of Santa Teresa Urrea and Don Pedrito Jaramillo by Jennifer Koshatka Seman Jethro Hernández Berrones Jennifer Koshatka Seman. Borderlands Curanderos: The Worlds of Santa Teresa Urrea and Don Pedrito Jaramillo. Austin: University of Texas Press, 2021. 224 pp. Ill. $29.95 (978-1-4773-2192-8). Jennifer Seman’s Borderlands Curanderos is a cultural and microhistory of borderlands medicine that examines the healing activities of Teresa Urrea and Pedro Jaramillo as well as their cultural and social contributions to support the wellbeing of Mexican American communities in California and Texas, marginalized by cultural norms and state policies in the United States at the turn of the twentieth century. Building on the work of Alan Goldberg, John McKiernan, and Natalia Molina, who have examined the racialized construction of disease and sanitary interventions in the region, Seman argues that these curanderos provided medicine for the oppressed at a time when medical innovations promised to shape healthier communities—at the cost of marginalization and abuse. With their medicine, these curanderos helped shape the Mexican American identity, one marked by mestizaje—mixture of cultures that helped these curanderos and their communities navigate and negotiate their lives in the United States. Seman examines each curandero in two chapters, describing their healing skills, their shifting practices across the border, the racial and gendered framing and reception of their activities, the effect of different national cultures on healer-patient-community relationships, and the expansion of their healing to the social body through activism. Chapter 1, “The Mexican Joan the Arc,” places Urrea’s healing practices in the context of rebellion and resistance against Porfirio Díaz’s regime (1884–1911) in Mexico. Teresa’s altruistic healings constituted a political inspiration for the dispossession- and labor-based Yaqui—indigenous communities that live in the limits of the states of Sonora and Sinaloa in Mexico—rebellions. In addition, influential friends framed her healings as an alternative model of modernity that disrupted gender, religious, and medical norms, challenging the limitation of women’s action to domestic spaces, Catholic devotion based on miracles and faith, and the científicos’—Díaz’s technocrats—authority over the physical and the social body. Díaz’s government exiled her in the United States from where she continued her healings and political activism. Chapter 2, “Laying on Hands,” examines U.S. audiences’ reception of Teresa’s healings. If the diverse U.S. medical marketplace accepted her therapies associating them with botanical medicine, mesmerism, and homeopathy, the public description of her hands—key in her therapies—as “lovely, slender, gentle, magnetic, electric, and white” (p. 65) suggests that gender and race mediated such acceptability, for only her sexualized hands, charm, and whiteness rendered her closer to the U.S. society. The chapter concludes examining the racialized public health policies in Los Angeles that excluded Mexican immigrants from social services based on their status as vectors of incurable disease and that contributed to shaping Urrea’s practices as a cultural refugee space. Chapter 3, “All Roads Lead to Don Pedrito Jaramillo,” focuses on Los Olmos Ranch as a place of pilgrimage. Seman uses Ann Harrington’s cultural scripts to explain the power of pilgrimage as a healing narrative that boosted the effect [End Page 162] of Pedro’s healing interventions. This cultural script was essential for the Rio Grande Valley’s communities of Mexicans who endured internal colonialism, land dispossession, a severe drought, famine, and an economic depression in the late nineteenth century. Jaramillo supplemented his water cures with other activities that benefitted the community such as finding water, digging wells, and providing food. Chapter 4, “In the Clutches of Black Magic,” examines the tensions between academic medicine and Jaramillo’s healing activities. Using newspaper articles that denounced the treatments as sorcery and that defended Jaramillo for his community work, Seman describes how race shaped definitions of disease, medical interventions, the lack of state services, and the defense for the curandero’s livelihood. The case filed against him for postal fraud by members of the American Medical Association shows how his unpaid services, lack of academic medical training, and use of traditional healing approaches did not fit the growing...

Retrospective Study of Psychiatric Hospitalizations in a West Texas Mental Health Treatment Facility during the COVID-19 Pandemic.

The association between the coronavirus disease (COVID-19) pandemic and adverse mental health outcomes has been well documented; however, little is known about its impact in rural areas of the United States. This study aims to characterize and compare inpatient psychiatric admissions in West Texas before and during the initial months of the COVID-19 pandemic. A retrospective study was conducted using the electronic health records of 1392 inpatient psychiatric admissions from period A (March 13, 2019-July 3, 2019) to period B (March 13, 2020-July 3, 2020). During period B, there was a significant increase in the length of stay (P < 0.01) compared with period A. The pandemic was associated with an increased history of psychiatric medication use (P < 0.01), substance use (P ≤ 0.01), and suicide risk at the time of admission (P < 0.01). Significant differences were found in employment status (P < 0.01), living situation (P < 0.01), and ethnicity (P = 0.03). Rural communities in West Texas experienced a decrease in psychiatric hospitalizations during the beginning of the COVID-19 pandemic, followed by an increase as lockdown restrictions began to lift; this warrants further investigation into healthcare service utilization during the pandemic.

COVID-19 Related Protocol Considerations and Modifications within a Rural, Community-Engaged Health Promotion Randomized Trial.

Rural communities are at higher risk for physical inactivity, poor dietary behaviors, and related chronic diseases and obesity. These disparities are largely driven by built environment, socioeconomic, and social factors. A community-based cluster randomized controlled trial of an intervention, the Change Club, aims to address some of these disparities via civic engagement for built environment change. Baseline data collection began in February 2020, only to be paused by the COVID-19 pandemic. In this context, the investigators evaluated multiple approaches for collecting data when the study resumed, focusing on Life's Simple 7, and additional anthropometric, physiologic, and behavioral outcomes in rural and micropolitan (&lt;50,000 population) communities in Texas and New York. Life's Simple 7 includes fasting blood glucose, total cholesterol, blood pressure, weight, physical activity, diet, and smoking. Rigor and feasibility were considered across a variety of in-person versus at-home measurement options. After a comprehensive input from participants, partners, staff, researchers, and the funding liaison, the study team chose self-measurement and use of validated questionnaires/surveys to measure the Life's Simple 7 components. This case provides an example of how a study team might adjust data collection protocol during unexpected and acute events while giving consideration to rigor, feasibility, stakeholder views, and participants' health and safety.

The Watershed House: A Water Harvesting Prototype For Vulnerable Communities

A potential answer to the call for a human right to sustainable and equitable housing, water access, and environmental justice may be found in the wings of a desert beetle. This paper presents a housing prototype integrating various water harvesting strategies and biomimetic solutions derived from the Namib beetle. An exploration of issues at the intersection of water access and equitable housing is presented through a literature review that demonstrates how housing conditions, access, and affordability are linked to a lack of infrastructural services, including water, which has subsequent health implications. The paper reviews both passive and active water harvesting opportunities for architectural integration. The paper concludes with a description of the prototype through a case study addressing the housing and water access needs of colonias communities in Texas, and sheds light on water access and housing affordability challenges, proposing architectural and policy strategies to address these issues. The speculative housing prototype integrates water harvesting solutions using a prefabricated kit of parts approach allowing for flexibility and adaptability across various communities where centralized infrastructure is technically or economically not feasible.

Women’s Lives in a Spanish-Texas Community: San Antonio de Béxar, 1718–1821

Women’s Lives in a Spanish-Texas Community: San Antonio de Béxar, 1718–1821 Jesús F. de la Teja (bio) Click for larger view View full resolution Béxar’s women enjoyed a full social life and, under certain circumstances, a public economic life as well. The woman at the center of scene might well be operating a cantina in her home—note the crosses, toys, and household items hanging on the walls—while the young woman on the right, possibly a family member or criada (servant, but literally “raised” or “brought up”) helps with the seemingly perpetual task of making tortillas, while the woman at the lower left holds a child in her arms. General Research Division, The New York Public Library. “Trajes mexicanos, un Fandango = Costumes mexicains = Mexican dresses.” New York Public Library Digital Collections, https://digitalcollections.nypl.org/items/510d47e2-16b9-a3d9-e040-e00a18064a99 [Accessed Aug. 24, 2022]. [End Page 332] Jane Long is not the mother of Texas, although that is how she was identified at least by the 1870s, and that is how she has been depicted in Texas history books for over a century.1 Former U.S. senator Kay Bailey Hutchison repeated this sobriquet in her book, Unflinching Courage: Pioneering Women Who Shaped Texas, which does not include a single Tejana2 or American Indian female. One look at Hutchison’s bibliography tells the story; it does not even list Teresa Palomo Acosta and Ruthe Winegarten’s Las Tejanas: 300 Years of History, published by the University of Texas Press in 2003. Hutchison’s myopia is neither new nor surprising. She represents a vision of what it means to be Texan and sends a very particular message (although one with fewer and fewer adherents all the time): that Jane Long could be the mother of Texas because only Anglo [End Page 333] women are really Texan. While most historians in the academy long ago abandoned this myopic perspective, it remains entrenched in the state’s popular history.3 But history is also driven by the record, and traditional use of the archival record has not been kind to borderlands women generally and Indigenous and Hispanic4 women specifically. Records have been most plentiful about the actions of public men doing public things. Records of statecraft, business, and religion are dominated by the presence of men, who since the time that history became a formal part of the academy have also been its principal writers. Men are also much more abundant in government and legal records, so when historians have looked at social and cultural themes, they have been conditioned to see men first. With the professionalization of history in the nineteenth century and men dominating the academy, historical research and writing became a principally male endeavor, and women and their actions and roles, already poorly represented in many types of records, fell by the wayside. This male-dominated landscape has undergone a substantial transformation in the last half-century, particularly with regard to more recent history, but the farther back in time one looks, the more difficult it becomes to center women in historical narratives.5 Spanish Texas is a particularly good example of how unkind the historical record can be to women’s history, although the situation extends throughout the borderlands. Few local records (where women would be most likely to be found) survive for the province’s first capital, Nuestra Señora de los Adaes, now a historical site in western Louisiana. As Francis [End Page 334] Galán points out, “The women of Los Adaes evidently did not leave behind any wills during the fort’s existence.”6 Likewise, there is almost a complete dearth of local records for La Bahía del Espíritu Santo, now Goliad, and for Nacogdoches. For those places the bulk of the surviving documentation addresses government and military matters and the activities of missionaries. Only San Antonio of the original Spanish Texas communities has a fairly extensive set of local sacramental, legal, and administrative records from which colonial-era gender issues can be identified and analyzed.7 As Donald Chipman and Harriett Denise Joseph note in their one chapter...

RURAL HOSPICE SOCIAL WORK: SUPPORTING PRACTITIONERS IN END-OF-LIFE WORK WITH LIMITED RESOURCES

Abstract Rural areas and the agencies, including hospice, that serve them face immense challenges in terms of accessibility, and service delivery. Small hospices face an enigmatic combination of higher operating costs and lower reimbursement payments, forcing higher caseloads on staff, and straining already limited available resources. Multiple cost benefit studies indicate that Medicare hospice reimbursement rules are well suited to the expense structure of large volume hospices, usually in urban, population dense areas; however, it is not clear that they apply as abundantly to smaller volume, rural hospices. This study sought to garner a deeper understanding of the roles and challenges required for rural hospice social work practice. Individual interviews with 9 rural hospice social workers across organizations in Texas and New Mexico were conducted. A maximum variation sampling technique was used to purposefully sample social workers from hospice agencies in areas deemed as rural by the Association of Rural Communities in Texas, with fewer than 200,000 occupants in their counties. Using emergent thematic analysis, key themes materialized including the challenge of dual relationships, required tasks beyond the scope of practice, issues of autonomy, and meeting them (patients/families) where they are at. Results demonstrate the complexities of rural hospice social work practice, the culture of rural communities, and the need for research into evidence-based intervention strategies specific to rural hospice social work, that will guide practitioners through navigating these challenging conditions.

Instructor-Generated Interactions and Course Outcomes in Online History Courses

Abstract &#x0D; This article highlights a 2021 quantitative, correlational study examining the relationship between the weekly number of instructor-generated posts and two course outcomes within fully online, asynchronous history classes managed by one large, urban Texas community college serving a 35% Hispanic/ Latino student population. Framed by Communities of Inquiry (CoI), the study utilized archival data spanning four academic terms to answer two research questions: 1) to what degree, if any, is there a relationship between the weekly number of instructor-generated discussion posts and pass percentage rates in online history classes? and 2) to what degree, if any, is there a relationship between the weekly number of instructor-generated discussion posts and withdrawal percentage rates in online history classes? The sample contained 106 sections of History 1301 delivered via Blackboard LMS. Two data sources were collected; one showed total number of posts in the given sections, allowing calculation of a weekly mean value. The other showed course pass and withdrawal percentage rates for the sections. A positive, weak correlation was found between number of posts and pass percentage rates (r (104) = .32, p &lt; .001). A negative, weak correlation was found between number of posts and withdrawal percentage rates (r (104) = -.47, p = .001). This article discusses the findings and provides supplemental insights for Hispanic Serving Institutions (HSIs).&#x0D; Keywords: Community college, online discussion board, LMS course tools, interaction, Hispanic Serving Institutions

Achieving Calm: A Study on the Health Care Experiences of People With Lived Experience of Homelessness in Central Texas.

The experiences of care of people with lived experience of homelessness are rarely embraced to change care delivery. We conducted qualitative group and one-on-one interviews utilizing experience group methodology with 27 people with lived experience of homelessness currently housed in one permanent housing community in central Texas. We analyzed data using an inductive thematic approach to identify shared obstacles and barriers to receiving health care. We then analyzed findings with the capability, comfort, and calm value framework to identify health outcomes that matter most to study participants. Poor access to care, discontinuities in care, distrust in providers, and confusing terminology were identified as the biggest barriers to health. The overwhelming majority of experiences reflected poor health outcomes of calm, the outcome of a health care experience that adds ease to one's life rather than logistical and administrative chaos. We propose three practical approaches to achieve calm for this population as follows: systems-level embracement of compassionate care, integration of relationship-based care navigation into all levels of care, and building efficient transportation into care design. We conclude that designing health care that works in the lives of people with lived experience of homelessness is critical to address the gaps in care that fuel the health disparity these individuals face compared to people without this lived experience.

Faith Leaders' Views on Collaboration with Mental Health Professionals.

When faced with experiences of mental struggle, Americans often turn to faith leaders as their first recourse. Although studies have explored religious leaders' mental health literacy, few studies have investigated how religious leaders believe faith communities and mental health professionals should collaborate. The data gathered for this research is from in-depth and focus group interviews with faith leaders from Christian, Jewish, Buddhist, and Sikh communities in South Texas and the Mid-Atlantic region between 2017-2019 (n=67). This research analyzed faith leaders' response to the question "How can mental health professionals and faith communities better work together" by utilizing the flexible coding approach (Deterding and Waters 2018). Four distinct themes emerged from the faith leaders' responses: education, relationship building, external factors, and dismissal. By learning about how faith leaders believe they can better work together with mental health professionals we can help bridge the gap between religion and mental health further by fostering a much-needed dialogue between these two groups.

Autoethnographic chronicle

There is a lack of African American community archives in Black libraries, museums, and institutions of higher learning in the Midwest and South of the United States. To better understand why this was/is happening, my doctoral research explores how individuals in Black communities archiving their personal and communal history. It is informed by a mixed-methods approach including autoethnography, phenomenology, material probing, and creative research techniques. By extension, the methods are non-exhaustive to help examine issues affecting African American communities in Texas from a personal and communal perspective in that prohibit its participation, and responsibility for self-documenting and collecting its local narratives for inclusion in Black Spaces, i.e., Black Galleries, Libraries, Archives, and Museums (BGLAM). The results of the first stage of this study suggest the need for a researcher to be involved as a participant and documentarian in community archival work in the African American community.

The Impact of Corequisite Math on Community College Student Outcomes: Evidence from Texas

Abstract Developmental education (dev-ed) aims to help students acquire knowledge and skills necessary to succeed in college-level coursework. The traditional prerequisite approach to postsecondary dev-ed—where students take remedial courses that do not count toward a credential—appears to stymie progress toward a degree. At community colleges across the country, most students require remediation in math, creating a barrier to college-level credits under the traditional approach. Corequisite coursework is a structural reform that places students directly into a college-level course in the same term they receive dev-ed support. Using administrative data from Texas community colleges and a regression discontinuity design, we examine whether corequisite math improves student success compared with traditional prerequisite dev-ed. We find that corequisite math quickly improves student completion of math requirements without any obvious drawbacks, but students in corequisite math were not substantially closer to degree completion than their peers in traditional dev-ed after three years.

Late Pleistocene megafauna extinction leads to missing pieces of ecological space in a North American mammal community.

The conservation status of large-bodied mammals is dire. Their decline has serious consequences because they have unique ecological roles not replicated by smaller-bodied animals. Here, we use the fossil record of the megafauna extinction at the terminal Pleistocene to explore the consequences of past biodiversity loss. We characterize the isotopic and body-size niche of a mammal community in Texas before and after the event to assess the influence on the ecology and ecological interactions of surviving species (>1 kg). Preextinction, a variety of C4 grazers, C3 browsers, and mixed feeders existed, similar to modern African savannas, with likely specialization among the two sabertooth species for juvenile grazers. Postextinction, body size and isotopic niche space were lost, and the δ13C and δ15N values of some survivors shifted. We see mesocarnivore release within the Felidae: the jaguar, now an apex carnivore, moved into the specialized isotopic niche previously occupied by extinct cats. Puma, previously absent, became common and lynx shifted toward consuming more C4-based resources. Lagomorphs were the only herbivores to shift toward C4 resources. Body size changes from the Pleistocene to Holocene were species-specific, with some animals (deer, hare) becoming significantly larger and others smaller (bison, rabbits) or exhibiting no change to climate shifts or biodiversity loss. Overall, the Holocene body-size-isotopic niche was drastically reduced and considerable ecological complexity lost. We conclude biodiversity loss led to reorganization of survivors and many "missing pieces" within our community; without intervention, the loss of Earth's remaining ecosystems that support megafauna will likely suffer the same fate.

Reducing opioid use disorder health inequities within Latino communities in South Texas.

Reducing opioid use disorder health inequities within Latino communities in South Texas.

Hiding in plain sight: Cryptic enemies are found on cochineal (Hemiptera: Dactylopiidae), a scale insect of economic and cultural significance.

Cochineal is the common name for cactus‐feeding scale insects in the Dactylopiidae. These ruby‐red insects include the domesticated dye insect Dactylopius coccus. Dactylopius coccus and congeners have been introduced around the world, some accidentally, to become pests of prickly pear cactus species (Opuntia), and some intentionally, for dye production or biological control of pest Opuntia. In the northern Sonoran Desert (Tucson, AZ, USA), we studied the enemy complex of D. opuntiae and D. confusus on Opuntia and characterized two cryptic enemies, a coccinellid beetle predator and a parasitoid wasp. (1) Hyperaspis sp. The coccinellid predator Hyperaspis trifurcata shares a niche with a similar, typically all‐black beetle. Morphological data, crossing tests, and phylogenetic results showed the black beetle to be a distinct, undescribed species in the genus Hyperaspis, with a rare spotted phenotype that is similar in appearance to H. trifurcata. Crossing tests among black and spotted forms showed the spotted morph is inherited as a single‐locus dominant allele. (2) Formicencyrtus thoreauini. Rearing of this ant‐like parasitoid wasp (Encyrtidae) in pure culture of D. opuntiae showed it to be a semi‐gregarious primary parasitoid of cochineal. To our knowledge, this is the first confirmed instance of a cochineal parasitoid. Observations of development show early instar larvae keep their posterior end within the egg chorion, attached to an aeroscopic plate with a connection to the cochineal body wall. Late instar larvae are eventually surrounded by a membrane, likely of larval origin. Wasps then pupate in a dry air‐filled chamber within the desiccated scale remains before chewing out as an adult. Both Hyperaspis sp. and F. thoreauini may have restricted distributions. Hyperaspis sp. does not appear to be a member of the cochineal community in Mexico or Texas, and scant records suggest F. thoreauini may also be restricted to the Southwestern USA.

Sociodemographic Determinants in Breast Cancer Screening among Uninsured Women of West Texas.

Background and Objectives: Early detection through appropriate screening is key to curing breast cancer. The Access to Breast Care for West Texas (ABC4WT) program offers no-cost mammography to underserved women in West Texas. The U.S. Preventative Task Force (USPSTF) guidelines are breast cancer screening guidelines which suggest screening for all women at the age of 50 years. The focus of this study was to identify sociodemographic barriers and determinants for breast cancer screenings, as well as screening outcomes, in low income, uninsured, or under-insured communities in West Texas. Materials and Methods: The ABC4WT program’s patient database was queried from 1 November, 2018, to 1 June, 2021, for sociodemographic variables, screening history, and results to identify high-risk groups for outreach. The American College of Radiology’s risk assessment and quality assurance tool, BI-RADS (Breast Imaging-Reporting and Data System), a widely accepted lexicon and reporting schema for breast imaging, was used for risk differentiation. Results: The cancer rate for ABC4WT’s program was significantly higher than the national mean (5.1), at 23.04 per 1000 mammograms. Of the 1519 mammograms performed, women between 40 and 49 years old represented the highest percentages of BI-RADS 4 and 5 (42.0% and 28.0%, respectively; p = 0.049). This age group also received 43.7% of biopsies performed and comprised 28.6% (n = 10) of cancers diagnosed (n = 35) (p = 0.031). Additionally, participants with a monthly household income of less than USD 800/month/person were more likely to result in a cancer diagnosis (70.6%) than higher incomes (29.4%) (p = 0.021). Conclusions: These determinants most starkly impacted women 40–49 years old who would not have been screened by U.S. Preventative Services Task Force (USPSTF) guidelines. This population with increased cancer risk should be encouraged to undergo screening for breast cancer via mammography.

Mental Health, Chronic Disease, and Substance Use: Findings From Rural Texas

There are vital links among mental health conditions, chronic diseases, and substance use disorders. Simultaneous examination of the relationship among these three conditions is essential for providing well-integrated care to rural residents who have limited resources and for representing medically underserved areas. We aimed to assess the burden of behavioral health conditions and chronic diseases from a rural Texas community to garner context-specific insights and inform effective health promotion strategies in similar communities. We conducted a cross-sectional study among 181 residents from various zip codes in a rural Texas county. A self-administered, 18-item health-needs questionnaire was used to collect data from the participants. Of the total participants, 30.0% reported mental health conditions, 16.0% reported substance use disorders, and 44.2% reported having at least one type of chronic disease. Overall, mental health conditions were associated with substance use disorders [OR: 1.58 (95% CI: 0.73–2.42)] and chronic disease [OR: 1.07 (95% CI: 0.39–1.75)], but no associations were observed between substance use and chronic disease [OR: 0.62 (95% CI: -0.20–1.43)]. The economic and accessibility barriers that rural residents commonly face call attention to the need for integrated care that combines primary care and behavioral health services.