The Columbia University Journal of Global Health

Bridging Gaps in Youth Mental Health: Insights from the MOST Program

Sebastian Acevedo — 2025-03-14

Objective: This study evaluates the efficacy of a community-based mental health workshop intervention aimed at increasing mental health literacy and reducing stigma among high school students in Newark, New Jersey, predominantly from African American and Latino backgrounds. Methods: The intervention, conducted in partnership with United Community Corporation, comprised bi-weekly workshops over five weeks, integrating didactic and activity-based components. Participants (n=23) were high school students. The workshop curriculum covered various mental health topics, supplemented by activities aimed to enhance positive coping mechanisms. Data collection included pre- and post-intervention surveys using the Peer Mental Health Stigmatization Scale and the Mental Health Literacy questionnaire, along with a focus group discussion. Results: The intervention demonstrated a significant reduction in stigma awareness (p<0.05) and an increase in positive attitudes towards recovery from mental illness. However, no significant changes were observed in overall mental health literacy scores. Qualitative analysis revealed a perceived distance from mental illness issues among participants and a preference for activities aligned with their interests. The study faced limitations, including a small sample size and inconsistency in survey matching. Conclusions: The study suggests that community-based interventions can effectively reduce mental health stigma among minority adolescents. However, enhancing mental health literacy may require more targeted and culturally relevant approaches. The findings highlight the importance of tailoring mental health education to the specific interests and cultural contexts of minority youth to improve engagement and outcomes.

The burden of vision loss due to Diabetic Retinopathy in Asia from 1990-2021

Dongyan Zhang — 2025-03-14

Background and Objectives:

Diabetic Retinopathy (DR) has become the leading cause of vision impairment (VI) worldwide. Leveraging the most recent data and analytical techniques from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced comprehensive estimates of VI due to DR in Asia. These estimates were segmented by location, age, and gender for the period between 1990 and 2021. Furthermore, we projected the burden of DR up to 2050.

Methods:

We analyzed data from the GBD 2021 to assess the prevalence and Years Lived with Disability (YLDs) due to DR in Asia, examining age structure, trends over time, and gender differences. The study included an analysis of DR-induced VI severity across Asian countries. The Estimated Annual Percentage Change (EAPC) was calculated to illustrate trends at regional and national levels. Bayesian age-period-cohort (BAPC) analysis was used to project future prevalence trends up to 2050.

Results:

从 1990 年到 2021 年，亚洲 DR 的年龄标准化患病率（ASR）和 YLD 率显著增加，女性的患病率始终较高。老年人承受的负担更大，VI 和 YLDs 的发生率随着年龄的增长而增加。中度视力障碍（MVI）构成了亚洲 DR 相关 ASR 的大部分。亚洲国家 DR 负担存在显著差异。2021 年，毛里求斯、塞舌尔、马来西亚和文莱的 ASR 最高，而孟加拉国、不丹、蒙古和日本的 ASR 最低。柬埔寨的增长最快，而新加坡和巴基斯坦则出现下降。大多数亚洲国家的社会人口指数（SDI）处于中低水平，相应的 ASR 也很低。根据 BAPC 的预测，到 2050 年，亚洲男性 DR 的 YLD 率将降至 3.92 和女性 4.96。

结论：

在过去的 30 年里，亚洲的 DR 负担有所增加，各国之间持续存在性别差异和巨大差异。这项研究显示了预防 DR 的重要性，尤其是对女性和老年人。BAPC 预测表明，未来 30 年由 DR 引起的 YLD 率呈下降趋势。

The Longstanding Issues Within Long-Term Care

Jodie Meng — 2025-03-14

The COVID-19 pandemic unveiled frightening vulnerabilities within the long-term care system in the United States, as evidenced by disorganized management and high proportions of outbreaks within facilities. Systemic faults can be explained by historical roots of nursing home facilities as poorhouses and the longstanding tug-and-pull conflict between prioritizing resident autonomy versus safety. Moreover, legal and financial conflicts of interest have interfered with the optimal implementation of ideal long-term care principles. Tracing flaws within the long-term care system is vital to prevent similar crises from unfolding in the future, as the elderly population grows worldwide.

A COMMON PROBLEM INCREASINGLY WITHOUT A SOLUTION: The Rise of Antibiotic-Resistant Urinary Tract Infections

Emma Kaufman — 2025-03-14

Urinary tract infections (UTIs) are one of the most common infections globally for both inpatients and outpatients. The bacteria causing these infections, primarily E.coli, have demonstrated increasing levels of resistance to traditionally prescribed antibiotics. Contributors to this rise in resistance include over-prescription of antibiotics and poor patient compliance, both of which are affected by cultural attitudes. Incidence of antibiotic resistance is higher in areas of lower socioeconomic status (SES) due to a lack of trained medical professionals, non-prescription antibiotic use, and inadequate infrastructure for both sanitation and water distribution. To combat the spread of resistance, many health departments and physicians have begun to practice antibiotic stewardship, avoiding the prescription of antibiotics if not absolutely necessary. There has also been a movement towards prophylactic non-antibiotic remedies including cranberry juice and probiotics which, combined with antibiotic stewardship, can reduce bacterial exposure to antibiotics and thus reduce the development of resistance.

Community Engagement to Reduce Soil-Transmitted Helminth Infections Among Mobile and Migrant Populations in Southeast Asia

Cora Cunningham — 2025-03-14

Soil-transmitted helminths (STHs) are neglected tropical diseases that disproportionately affect mobile and migrant populations (MMPs). With a high burden on low-and middle-income countries, especially in Southeast Asia (SEA), STH infection is associated with a lack of improved water, sanitation, and hygiene (WASH), and is often treated with mass drug administration (MDA) of anthelmintic medications, which fails to reach MMPs in transit. Community engagement (CE) is necessary to address the high burden of STH infection in MMPs and is characterized by participatory research and the integration of community voices, needs, and interests through self-governance and utilization of community assets. However, past STH literature commonly fails to incorporate CE in their interventions and programs. We conducted a literature review to contextualize STH infection among MMPs in SEA, identify vulnerable populations, and address the knowledge gap on the impacts of CE in reducing disease burden. By including community preferences and perceptions into MDA and surveillance programs, school-based control programs to promote health education, and the research process, including research development, data collection, and dissemination, community compliance with primary STH interventions can be improved. CE has proven effective in other geographical and health contexts, and the lessons learned may be applicable to the incorporation of CE in STH infection among MMPs in SEA. Our findings illustrate that leveraging and integrating the voices of MMPs through CE in integration with MDA and WASH may improve community support for STH interventions and effectively reduce STH infection among MMPs in SEA.

The Selected Markers of Development of Diabetes among HIV-positive Individuals Receiving Anti-Retroviral Treatment in Ghana; A Narrative Review of risk factors and determinants | The Columbia University Journal of Global Health

Jannatun Nayem — 2025-03-14

Abstract

An increasing focus on the HIV epidemic and chronic diseases like diabetes has made it crucial to have a comprehensive understanding of the existing research on these subjects. This narrative review specifically examines the development of diabetes in HIV-positive individuals in Ghana who are undergoing antiretroviral treatment (ART). The review covers various aspects including the immuno-pathogenesis of HIV, randomized trials of ART, the occurrence of diabetes during ART, factors associated with diabetes after ART, prevalence of HIV-related illnesses in Ghana, socio-demographic characteristics, and behavioral characteristics. The analysis is based on 45 articles published between 2013 and 2023, written in English. The study reveals consistent links between determinants such as employment, immunological status, symptoms, depression, social support, and medication adherence among HIV-positive individuals. It emphasizes the need to integrate diabetic screening into existing HIV care programs, enhance healthcare provider training, involve community-based initiatives, and utilize technology to improve access to diabetic screening for HIV patients in Ghana. The objective of this study is to provide an overview of HIV research in Ghana, raise awareness about the increasing prevalence of diabetes among people living with HIV, identify any research gaps, and recommend new research themes to guide future interventions.

Keywords

Ghana, HIV-positive, Anti-Retroviral Treatment, Diabetes, Selected Markers, Socio-demographic and Behavioral factors

Letter from the Editor

Ann Thanh Phan — 2025-03-14

Dear Reader,

We are honored to publish The Columbia University Journal of Global Health Fall 2024 Issue. Health disparities—across communities, countries, and continents—persist, undermining livelihoods and shortening lives. With this in mind, our journal strives to advance scholarly discourse on health inequities, both their social determinants and structural solutions, while publishing diverse perspectives from researchers and practitioners. This issue critically explores present challenges to the well-being of vulnerable communities: the rise of antibiotic resistance in low- and middle-income countries and the prevalence of tropical disease infections among mobile populations, among others. The studies in this issue examine and propose community-led interventions, intentionally positioning disadvantaged communities as active architects of their public health systems rather than passive recipients of care.

This year, we have continued to engage experts through educational events. In the face of global health crises in Sudan, Palestine, and Somalia, our journal co-hosted the “Frontlines in Focus” panel, welcoming Dr. Unni Karunakara, the former International President of Médecins Sans Frontières, and other scholars to discuss the emerging challenges of humanitarian aid delivery in conflict zones. Titled “Publishing Playbook,” our most-recent event brought together student leaders of peer journals—the Columbia Medical Review, Gyneca, and the Columbia Undergraduate Science Journal. The gathering became a space for academic publications to reflect on and renew established commitments to open access and author diversity.

In keeping with our long-standing tradition of centering student voices, we have once again expanded opportunities for staff to share their perspectives on public health. On our blog, we published a staff article written in English and translated to Spanish, “Honoring Hispanic Heritage: Prioritizing Mental Health in Our Communities.” We welcomed the first cohort of our high school fellowship program, an opportunity for local students to publish pieces with our journal. With guidance from our staff, students from across New York have begun literature reviews on global health topics and drafted their blog posts.

The past year has also come with exciting developments for our journal: our published manuscripts received over 16,000 downloads and were accessed by 8,500 site users from most countries in the world. True to the “Global” in our name, our journal is proud to publish scholarship with such a broad readership.

This Fall 2024 issue is an accomplishment we will cherish with our staff members, whose dedication made this publication possible. The mentorship of our faculty advisors, Dr. Julianna A. Bol, PhD, and Dr. Ana Navas-Acien, MD, PhD, MPH, ensured a smooth editorial process, and for their guidance, our journal is incredibly grateful. To the authors, who submitted rigorous manuscripts, and the peer reviewers, whose insights made them all the more refined, we send our gratitude. Finally, we are indebted to our readers. You are a vital part of The Columbia University Journal of Global Health community, and we hope you find these manuscripts to be insightful and compelling.

Sincerely,

Ann Thanh Phan & Jorge Hernandez-Perez

Co-Editors-in-Chief, The Columbia University Journal of Global Health