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Measuring the Hidden Burden of Violence: Use of Explicit and Proxy Diagnoses Codes for Violence Identification and Its Association with Economic Hardship- [electronic resource]
Measuring the Hidden Burden of Violence: Use of Explicit and Proxy Diagnoses Codes for Vio...
Measuring the Hidden Burden of Violence: Use of Explicit and Proxy Diagnoses Codes for Violence Identification and Its Association with Economic Hardship- [electronic resource]

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자료유형  
 학위논문파일 국외
최종처리일시  
20240214095843
ISBN  
9798379950729
DDC  
614
저자명  
Santaularia, Natalie Jean.
서명/저자  
Measuring the Hidden Burden of Violence: Use of Explicit and Proxy Diagnoses Codes for Violence Identification and Its Association with Economic Hardship - [electronic resource]
발행사항  
[S.l.]: : University of Minnesota., 2021
발행사항  
Ann Arbor : : ProQuest Dissertations & Theses,, 2021
형태사항  
1 online resource(147 p.)
주기사항  
Source: Dissertations Abstracts International, Volume: 85-01, Section: A.
주기사항  
Advisor: Mason, Susan M.;Osyupk, Theresa.
학위논문주기  
Thesis (Ph.D.)--University of Minnesota, 2021.
사용제한주기  
This item must not be sold to any third party vendors.
초록/해제  
요약Violence is a common and serious public health problem. Substantial evidence suggests that economic hardship causes violence. However, a large majority of this research relies on traditional violence surveillance systems that may suffer from selection bias and potentially over-represent the most vulnerable populations, such as people of color. Emerging research has operationalized violence in new ways by identifying injuries highly correlated with violence (proxy-identified violence) in hospital discharge data, which may be more representative of the total population, in conjunction with explicitly identified violence (injuries identified in the medical record to be caused by a violent event). The three studies presented here investigated how economic hardship is associated with these different identifications of violence.Using Minnesota hospital discharge data from 2004 to 2014, this dissertation included three studies that investigated 1) the trends of child maltreatment, elder abuse, and intimate partner abuse in Minnesota by county from 2004 to 2014, and the association of county-level demographic characteristics with violence rates as measured through explicit codes, proxy codes, and a combination of the two; 2) the associations of a range of county-level economic hardship indicators (unemployment rate, male mass layoffs, female mass layoffs, foreclosure rate, and unemployment rate change) with rates of explicit- and proxy-identified violence-related child abuse, elder abuse, and intimate partner violence (IPV) injuries; and 3) the change of county-level violence victimization rates (child abuse, elder abuse, IPV, and all subtypes combined) as a function of the Great Recession comparing more- to less-affected counties with a quasi-experimental design. The main finding from paper one was that the patterns of county-level violence differed depending on whether one used explicit or proxy codes. In particular, explicit codes suggested that child abuse and IPV trends were flat or decreased slightly from 2004 to 2014, while proxy codes suggested the opposite. Elder abuse increased during this timeframe for both explicit and proxy codes, but more dramatically when using proxy codes. In regard to the associations between county level characteristics and each violence subtype, previously identified county-level risk factors were more strongly related to explicitly-identified violence than to proxy-identified violence. Given the larger number of proxy-identified cases as compared with explicit-identified violence cases, the trends and associations of combined codes align more closely with proxy codes, especially for elder abuse and IPV.Paper two further examined the association of five measures of economic hardship and their contemporaneous and lagged associations with explicit- and proxy-identified child abuse, elder abuse and IPV rates. After adjustment for county sociodemographic factors and all other measures of economic hardship, a county's higher foreclosure rate was the factor most strongly and consistently associated with higher violence across subtypes. Unemployment rate was the second strongest and most consistent adverse measure in its relation to violence subtypes. Lastly, there appeared to be a gender-specific association of mass lay-offs with child abuse, i.e., male mass-lay-offs were associated with increased rates while female mass-lay-offs were associated with decreased rates. Paper three employed a quasi-experimental design to assess the impact of the Great Recession on explicit and proxy child maltreatment, IPV, and elder abuse. The findings suggested that the Great Recession had little or no impact on explicit-identified violence but was associated with an increased risk for proxy-identified violence. Specifically, over the course of the Great Recession, counties that were more highly affected by the Great Recession's impact saw a greater increase in the average rate of proxy-identified child abuse, elder abuse, intimate partner, and combined violence when compared to less affected counties.This dissertation makes substantial contributions to violence surveillance and injury research. Hospital discharge data, particularly proxy codes, may identify cases of violence that traditional surveillance misses. Most importantly, explicit and proxy codes indicate different associations with county sociodemographic characteristics and with the impact of the Great Recession. Future research should examine hospital discharge data for violence identification to validate proxy codes that can be utilized to help to identify the hidden burden of violence. In addition, understanding the pathways to violence (proxy- and explicit-identified) through economic hardship is another step in developing and targeting more holistic prevention and intervention efforts.
일반주제명  
Public health.
일반주제명  
Criminology.
일반주제명  
Statistics.
키워드  
Violence
키워드  
Economic hardship
키워드  
Hospital discharge data
키워드  
Explicit codes
키워드  
Child abuse
기타저자  
University of Minnesota Epidemiology
기본자료저록  
Dissertations Abstracts International. 85-01A.
기본자료저록  
Dissertation Abstract International
전자적 위치 및 접속  
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■040    ▼aMiAaPQ▼cMiAaPQ
■0820  ▼a614
■1001  ▼aSantaularia,  Natalie  Jean.
■24510▼aMeasuring  the  Hidden  Burden  of  Violence:  Use  of  Explicit  and  Proxy  Diagnoses  Codes  for  Violence  Identification  and  Its  Association  with  Economic  Hardship▼h[electronic  resource]
■260    ▼a[S.l.]:▼bUniversity  of  Minnesota.  ▼c2021
■260  1▼aAnn  Arbor  :▼bProQuest  Dissertations  &  Theses,  ▼c2021
■300    ▼a1  online  resource(147  p.)
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  85-01,  Section:  A.
■500    ▼aAdvisor:  Mason,  Susan  M.;Osyupk,  Theresa.
■5021  ▼aThesis  (Ph.D.)--University  of  Minnesota,  2021.
■506    ▼aThis  item  must  not  be  sold  to  any  third  party  vendors.
■520    ▼aViolence  is  a  common  and  serious  public  health  problem.  Substantial  evidence  suggests  that  economic  hardship  causes  violence.  However,  a  large  majority  of  this  research  relies  on  traditional  violence  surveillance  systems  that  may  suffer  from  selection  bias  and  potentially  over-represent  the  most  vulnerable  populations,  such  as  people  of  color.  Emerging  research  has  operationalized  violence  in  new  ways  by  identifying  injuries  highly  correlated  with  violence  (proxy-identified  violence)  in  hospital  discharge  data,  which  may  be  more  representative  of  the  total  population,  in  conjunction  with  explicitly  identified  violence  (injuries  identified  in  the  medical  record  to  be  caused  by  a  violent  event).  The  three  studies  presented  here  investigated  how  economic  hardship  is  associated  with  these  different  identifications  of  violence.Using  Minnesota  hospital  discharge  data  from  2004  to  2014,  this  dissertation  included  three  studies  that  investigated  1)  the  trends  of  child  maltreatment,  elder  abuse,  and  intimate  partner  abuse  in  Minnesota  by  county  from  2004  to  2014,  and  the  association  of  county-level  demographic  characteristics  with  violence  rates  as  measured  through  explicit  codes,  proxy  codes,  and  a  combination  of  the  two;  2)  the  associations  of  a  range  of  county-level  economic  hardship  indicators  (unemployment  rate,  male  mass  layoffs,  female  mass  layoffs,  foreclosure  rate,  and  unemployment  rate  change)  with  rates  of  explicit-  and  proxy-identified  violence-related  child  abuse,  elder  abuse,  and  intimate  partner  violence  (IPV)  injuries;  and  3)  the  change  of  county-level  violence  victimization  rates  (child  abuse,  elder  abuse,  IPV,  and  all  subtypes  combined)  as  a  function  of  the  Great  Recession  comparing  more-  to  less-affected  counties  with  a  quasi-experimental  design.  The  main  finding  from  paper  one  was  that  the  patterns  of  county-level  violence  differed  depending  on  whether  one  used  explicit  or  proxy  codes.  In  particular,  explicit  codes  suggested  that  child  abuse  and  IPV  trends  were  flat  or  decreased  slightly  from  2004  to  2014,  while  proxy  codes  suggested  the  opposite.  Elder  abuse  increased  during  this  timeframe  for  both  explicit  and  proxy  codes,  but  more  dramatically  when  using  proxy  codes.  In  regard  to  the  associations  between  county  level  characteristics  and  each  violence  subtype,  previously  identified  county-level  risk  factors  were  more  strongly  related  to  explicitly-identified  violence  than  to  proxy-identified  violence.  Given  the  larger  number  of  proxy-identified  cases  as  compared  with  explicit-identified  violence  cases,  the  trends  and  associations  of  combined  codes  align  more  closely  with  proxy  codes,  especially  for  elder  abuse  and  IPV.Paper  two  further  examined  the  association  of  five  measures  of  economic  hardship  and  their  contemporaneous  and  lagged  associations  with  explicit-  and  proxy-identified  child  abuse,  elder  abuse  and  IPV  rates.  After  adjustment  for  county  sociodemographic  factors  and  all  other  measures  of  economic  hardship,  a  county's  higher  foreclosure  rate  was  the  factor  most  strongly  and  consistently  associated  with  higher  violence  across  subtypes.  Unemployment  rate  was  the  second  strongest  and  most  consistent  adverse  measure  in  its  relation  to  violence  subtypes.  Lastly,  there  appeared  to  be  a  gender-specific  association  of  mass  lay-offs  with  child  abuse,  i.e.,  male  mass-lay-offs  were  associated  with  increased  rates  while  female  mass-lay-offs  were  associated  with  decreased  rates.    Paper  three  employed  a  quasi-experimental  design  to  assess  the  impact  of  the  Great  Recession  on  explicit  and  proxy  child  maltreatment,  IPV,  and  elder  abuse.    The  findings  suggested  that  the  Great  Recession  had  little  or  no  impact  on  explicit-identified  violence  but  was  associated  with  an  increased  risk  for  proxy-identified  violence.  Specifically,  over  the  course  of  the  Great  Recession,  counties  that  were  more  highly  affected  by  the  Great  Recession's  impact  saw  a  greater  increase  in  the  average  rate  of  proxy-identified  child  abuse,  elder  abuse,  intimate  partner,  and  combined  violence  when  compared  to  less  affected  counties.This  dissertation  makes  substantial  contributions  to  violence  surveillance  and  injury  research.  Hospital  discharge  data,  particularly  proxy  codes,  may  identify  cases  of  violence  that  traditional  surveillance  misses.    Most  importantly,  explicit  and  proxy  codes  indicate  different  associations  with  county  sociodemographic  characteristics  and  with  the  impact  of  the  Great  Recession.  Future  research  should  examine  hospital  discharge  data  for  violence  identification  to  validate  proxy  codes  that  can  be  utilized  to  help  to  identify  the  hidden  burden  of  violence.  In  addition,  understanding  the  pathways  to  violence  (proxy-  and  explicit-identified)  through  economic  hardship  is  another  step  in  developing  and  targeting  more  holistic  prevention  and  intervention  efforts.
■590    ▼aSchool  code:  0130.
■650  4▼aPublic  health.
■650  4▼aCriminology.
■650  4▼aStatistics.
■653    ▼aViolence
■653    ▼aEconomic  hardship
■653    ▼aHospital  discharge  data
■653    ▼aExplicit  codes
■653    ▼aChild  abuse
■690    ▼a0573
■690    ▼a0627
■690    ▼a0463
■71020▼aUniversity  of  Minnesota▼bEpidemiology.
■7730  ▼tDissertations  Abstracts  International▼g85-01A.
■773    ▼tDissertation  Abstract  International
■790    ▼a0130
■791    ▼aPh.D.
■792    ▼a2021
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T16930959▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.
■980    ▼a202402▼f2024

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