In recovering from one of the worst educational crises in recorded history due to the pandemic, in a mission to rebuild and become more resilient, there has been a heightened urgency to provide resources to communities most in need. However, precisely identifying those needs have become all the more important due to the increase in popularity of e-learning as a suitable option and the improvement of technologies. Most notably, socially disadvantaged and historically marginalized communities were disproportionately and severely impacted by several aspects of the pandemic, in terms of health, economics, access to education, and sustainable well-being. This differential effect was modeled spatially with the combination of aerial photogrammetry, traditional geospatial mapping, and other robust AI-driven techniques to synthesize and analyze the various types of data. In this original research study, we apply various spatial health variables, relate them to educational variables in an initial empirical process of understanding how to address equity-related considerations from the context of the learner’s experience, providing the empirical evidence for the development of locally tailored learner support and assistance, meeting students where they are by specifically identifying and targetting geographically underserved areas. We found that there were clear statistically significant relationships between educational attainment and several physical (p < 0.001), mental (p = 0.003), access to healthy food/food security (p < 0.001), and uptake of preventative health measures (p < 0.001), which also varied geographically. Geographic variations in learning experiences demonstrates the unquestionable need to understand a variety of physical, mental, and dietary factors surrounding the student’s success. Understanding a combination of these factors in a geospatial context will allow educational institutions to best serve the needs of learners.

Smoking and chronic kidney disease (CKD) have a disproportionately high prevalence among African American (AA) adults, but their impact on mortality among AA adults is not well known. Given the lack of evidence in published literature on specific factors affecting the relationship between CKD and mortality among AA adults, we examined the influence of smoking on mortality among AA adults with CKD. National Health and Nutrition Examination Survey (NHANES, 1999-2010) data were analyzed with study participants prospectively followed up for mortality analysis through December 31, 2019, using National Death Index (NDI) death certificate records. A total of 6,108 AA adults were included in the study sample, with more than two-fifths (44.9%) being smokers and 6.3% having CKD. AA individuals with CKD had 2.22 (95% CI = 1.38-3.57) times the risk of cardiovascular mortality, but when stratified by smoking, AA individuals with CKD who were current smokers had 3.21 times the risk of cardiovascular mortality. Similarly, in AA with CKD, the risk of all-cause mortality was 3.53 (95% CI = 1.31-9.47), but when stratified by smoking status, AA individuals with CKD who were current smokers had 5.54 times the risk of all-cause mortality. Smoking and CKD are highly prevalent in AA individuals and frequently cooccur, leading to higher rates of mortality. Smoking cessation interventions should be a priority in collaborative care models and interdisciplinary care teams for AA with CKD and current smoker status.

Background: Stroke continues to be a major cause of morbidity mortality in the United States. In this study, we determined if the food insecurity status interacted with a history of stroke to influence the overall mortality risk. Methods: Data from the 2015–2018 National Health and Nutrition Examination Survey, a nationally representative survey among the non-institutionalized population that is published in two-year cycles, with a mortality follow-up through 31 December 2019 was analyzed in this investigation. Results: In stroke survivors, upon follow-up, a higher proportion of those with food insecurity died (38.1% vs. 31.6%, p < 0.05) than food-secure individuals. For overall mortality, the crude hazard ratio (HR) for stroke survivors was 5.87 (95% confidence interval [CI], 3.18–10.86, p < 0.01). After adjustment for multiple variables, the HR was significantly elevated, 3.66 (CI 1.64–8.14, p < 0.01), among stroke survivors with food insecurity, but among those with stroke only or just food insecurity, the HR was not significantly elevated. Similar interactions were seen among females but not among males. Conclusions: Food insecurity substantially increases mortality from all causes among stroke survivors. When considering various chronic diseases, such as stroke, the role of social problems must be taken into consideration.

C-reactive protein is an important inflammatory biomarker that is indicative of chronic disease. Additionally sexual frequency is an important indicator of overall sexual health. In this study, we tested the impact of inflammation on low sexual frequency-related outcomes like mortality. From the 2003-2010 National Health and Nutrition Examination Survey, we analyzed data on adults (≥ 20 years). Sexual frequency was categorized (<52 times/year vs. ≥52 times/year). C-reactive protein was measured by Latex Nephelometry. Complex samples Cox regression was used to assess if inflammation influenced the connection between sexual frequency and mortality. For all-cause mortality, the overall unadjusted hazard ratio (HR) of high C-reactive protein was 1.91 (95% confidence interval [CI], 1.05-3.45, p < 0.03). The adjusted HR was elevated, 2.39 (CI 1.11-5.15, p = 0.03) among individuals who had elevated C-reactive protein and low sexual frequency but close to 1.0 (1.48 CI 0.40-5.45, p = 0.53) among individuals who had elevated C-reactive protein and high sexual frequency after adjusting for medical (obesity) and demographic (age, education, and ethnicity) risk factors, indicating a 139% increase in mortality among individuals with low sexual frequency and inflammation than inflammation alone. Sexual activity is important for overall cardiovascular health.

Introduction: Chlamydia trachomatis is an important indicator of overall health and plays a vital role in various health conditions. In 2018, C. trachomatis reached the highest level ever recorded, resulting in USD 691 million in expenditures, with 1.8 million reported cases. This amount reflects a 19% increase since 2014, according to the Centers for Disease Control and Prevention. Depression has also been on the rise between 2013 (8.2%) to 2023 (13.1%). C. trachomatis and depression may have inflammation as a final common pathway. The purpose of this study was to explore a potential connection between Chlamydia and depression, and whether C-reactive protein (CRP) modifies this effect. Methods: For this study, we utilized the 2005–2016 National Health and Nutrition Examination Survey (NHANES) and US adults aged between 20 and 59 years. Depression was determined from the Patient Health Questionnaire (PHQ-9). Logistic regression models were used to determine if C. trachomatis in the previous year was predictive of depression. Models were adjusted for known confounders, including age, gender, race/ethnicity, poverty, and education. Results: For C. trachomatisra, the unadjusted Odds Ratio (OR) for C. trachomatis to no C. trachomatis was OR = 2.9. The adjusted OR was elevated, at OR = 6.3 among individuals who had both CT and elevated CRP, but close to 1.0 among individuals who had C. trachomatis but reported low CRP after adjusting for demographic and health variables. Conclusions: Using a nationally representative sample, our study was the first to demonstrate, across unadjusted and adjusted models, that there is a strong connection between a history of C. trachomatis and high CRP leading to worse outcomes in individuals with depression than C. trachomatis infection alone. This finding indicates the need to conduct mental health screening among individuals with Sexually Transmitted Infections (STIs) or other infectious diseases.

Introduction: Sexual frequency is an important indicator of overall health and plays a vital role in various health conditions. There is a wide array of physical and mental health benefits that are associated with sexual activity. Cardiovascular disease (CVD) is the most common cause of mortality each year. The purpose of this study was to explore a connection between CVD and all-cause mortality and if sexual frequency modified this effect. Methods: For this study, we utilized the 2005–2016 National Health and Nutrition Examination Survey (NHANES) and the NDI-linked all-cause mortality data of US adults aged between 20–59 years. Low sexual frequency was determined by individuals who had sexual intercourse less than once a month. Survival curves showed the combined effect of sexual frequency and all-cause mortality, using the Kaplan–Meier product-limit method to estimate the percent survival of the subject at each point in time. Results: For all-cause mortality, the unadjusted hazard ratio (HR) for CVD to no CVD was HR = 5.1. The adjusted HR was elevated HR = 2.3 among individuals who had CVD and low sexual frequency but close to 1.0 among individuals who had a history of CVD but reported moderate-to-high/high sexual frequency after adjusting for demographic and health variables. Conclusions: From a nationally representative sample, our study was the first to demonstrate, in unadjusted and adjusted models, that CVD and low sexual frequency combined have worse outcomes than CVD alone. This finding indicates the need to conduct a sexual history among individuals with CVD or other chronic diseases.