Rural Health
Women’s health in rural areas is even more concerning, particularly in preventive health screening, access to mental health services, and maternal healthcare. In Indiana, women experience higher rates of obesity (37.7% vs 34.1% nationally) and face one of the highest maternal mortality rates in the US (44 vs 22 deaths per 100,00 live births). Additionally, Indiana lags behind the national average for women receiving mammograms (72.6% vs 76.5%) and mental health challenges are also more prevalent (25.8% vs 21%). As a result, the life expectancy for women in Indiana is 75 years, significantly below the national average of 80.2 years. Given the critical role women play as caregivers within their families, improving women’s health is vital for the well-being of entire rural communities.
Vision: Purdue Women’s Global Health Institute (WGHI) is dedicated to improving the health and well-being of women through research on disease prevention and early detection. Situated in Indiana, the WGHI recognizes the challenges and significance of women’s health in rural areas and the substantial barriers to optimal health in rural populations. These barriers include limited access to healthcare services due to distance and transportation, gaps in health insurance coverage, low health literacy, underutilization of preventative services, significant healthcare workforce shortages (61% shortage areas in rural areas), and a lack of community support such as flexible work schedules, breastfeeding assistance, and affordable childcare options.
We propose to leverage Purdue’s strength in engineering and technology to improve family health in underserved areas, using Indiana as a test bed to develop and implement scalable strategies that can be applied nationally and globally. With the extensive experience in promoting collaborative research, the WGHI is spearheading efforts to establish a dynamic hub, aiming to facilitate knowledge exchange by enabling experienced faculty to share best practices and methodologies for conducting rural health research. Additionally, WGHI strives to identify critical issues, support the development of solutions to address the gaps in rural health, and foster collaboration to build vital connections within rural communities. Through these initiatives, we are committed to empowering faculty members and driving impactful research that will significantly improve women and family health in rural Indiana, with the potential for broader application across rural areas nationwide and globally.
Funded Research Projects on Rural Health:
Kathryn J. LaRoche
2023
Kathryn J. LaRoche, Ph.D.
Assistant Professor of Public HealthDepartment of Public Health
Project title: “Exploring Patient Experiences with Miscarriage Care in Indiana in the Midst of a Shifting Regulatory Environment”
Miscarriage is an extremely common reproductive health experience; approximately 20% of pregnancies in the United States end in miscarriage each year. Indiana has recently introduced legislation (SB1) to restrict access to abortion and experts have expressed concern that this policy will also negatively impact access to essential miscarriage care. Abortion and miscarriage use the same medications and procedures as a part of routine care. However, the effects of SB1 on patients and providers are not well understood and not been rigorously investigated. This study is designed to help us begin to understand the impact of SB1 on the provision of miscarriage care across the state of Indiana and to fill a much-needed gap in the literature by centering women’s voices in research about miscarriage in the United States. Miscarriage remains an understudied topic and current legislative changes in the state and across the country mean that studying this issue is both timely and critical.
(This project is funded with the partnerships of the Purdue College of Health and Human Sciences and the Indiana Clinical and Translational Sciences Institute)
(Left to right) Faria Chaudhry and Sonak Pastakia
Multi-PI:
Faria Chaudhry, PharmD, BCPS
Assistant Professor of Pharmacy Practice
Department of Pharmacy Practice
Sonak Pastakia, PharmD, MPH, Ph.D., BCPS, FCCP
Professor of Pharmacy Practice
Department of Pharmacy Practice
Project title: “Evaluating the Impact of a Community Health Worker for Diabetes Management in Self-Employed Women in India”
The Self-Employed Women’s Association (SEWA) is the largest trade union of women in the world advocating for the rights of low-income female laborers in Southeast Asia. Through a nearly 10-year-long collaboration with Purdue faculty and Abbott laboratories, SEWA has tried to expand SEWA’s mandate to respond to the growing burden of non-communicable diseases. With the growing number of people in India with diabetes, India has the unfortunate designation of having one of the world’s highest burdens. While there are numerous barriers to managing the clinical aspects of diabetes, these barriers are further complicated by the social determinant of health barriers that the women of SEWA disproportionately face. Many of these women battle economic distress and family needs while trying to navigate the complex healthcare system of India. SEWA has tried to address these barriers for women and their families by hiring and training their union members to become community health workers (CHWs) who provide a comprehensive set of health-promoting services. This includes health education, socio-behavioral support and counseling, socioeconomic assistance, and direct provision of clinical services such as glucose screening. While SEWA has been offering this comprehensive package of services for over 5 years, a formal evaluation documenting the impact of SEWA’s unique CHW model has not been completed. The objective of this proposal is to provide detailed tracking and evaluate the process and clinical outcomes for community members participating in SEWA’s non-communicable disease (NCD) activities. We hypothesize that the SEWA CHW-supported model will result in higher linkage and retention in care and a lower HbA1c compared to the standard model of care.
(This project is funded with the partnerships of the Indiana Clinical and Translational Sciences Institute,
the Purdue College of Pharmacy and the Department of Pharmacy Practice)
(Left to right)
Jennifer L. Freeman, Douglas Samuel, Ulrike Dydak
2022
Multi-PI:
Jennifer L. Freeman, Ph.D.
Professor of Toxicology
School of Health Sciences
Douglas Samuel, Ph.D.
Associate Professor of Clinical Psychology
Department of Psychological Sciences
Ulrike Dydak, Ph.D.
Professor of Health Sciences
School of Health Sciences
Project title: “Sex Differences in Neurological Outcomes Associated with Agrichemical Exposure in Rural Populations: A Feasibility Study”
Atrazine is the second most common agricultural herbicide used in the Midwestern US and the leading agricultural contaminant of drinking water. Evidence is growing that atrazine, a recognized endocrine disrupting chemical, also distinctively targets a number of neurotransmitter systems that appears to be sexually dimorphic. The majority of atrazine neurotoxicity studies are in male rodents and primarily report locomotor behavioral alterations. Alternatively, the limited studies that have assessed females indicate nonlocomotor behavioral changes related to anxiety and stress. Recent studies in the Freeman laboratory also confirm sexual dimorphic behavior alterations in zebrafish exposed to atrazine. Families living in rural Midwestern US are at most risk of exposure based on living in close proximity to agricultural fields where atrazine is applied. The goal of this study is to determine sex differences in neurological outcomes associated with agrichemical exposure in rural populations.
(This project is funded with the partnerships of The Purdue Institute for Integrative Neuroscience and The College of Health and Human Sciences)
Jacqueline Linnes
2020
Jacqueline Linnes, Ph.D.
Marta E. Gross Assistant Professor
Weldon School of Biomedical Engineering
co-PI:
Professor of Cancer Biology, Department of Comparative Pathobiology
Project title: “Lateral Flow Immunoassay for Sensitive and Specific Cervical Cancer Detection”
Cervical cancer incidence and mortality are five times higher in low- and middle-income countries (LMICs) than in high-income countries. This wide disparity is attributed to both higher HPV infection rates and a lack of accessible screening and treatment. This project aims to create an integrated point-of-care test that can be used by healthcare providers in under-resourced settings to obtain relevant clinical insights, including cervical cancer risk stratification, and enable same-visit treatment of high risk cervical lesions.
Craig Goergen
2018
Craig Goergen, Ph.D.
Leslie A. Geddes Associate Professor
Weldon School of Biomedical Engineering
Project title: “Automated Supine Pressor Test Device for Prediction of Preeclampsia”
Preeclampsia is an advanced form of pregnancy-induced hypertension that can lead to multi-organ dysfunction and preterm birth and can be fatal for both the expecting mother and the fetus. In the 1970s, the supine pressor test (SPT) was developed to predict the risk for preeclampsia in pregnant women based on elevation in their diastolic blood pressures between different body positions. This test fell out of favor due to its low sensitivity, manual application and lack of specific instructions. This project aims to automate the SPT (Auto-SPT) to ensure both repeatability and accuracy of test results through an innovative mobile phone application that will provide feedback to users as they conduct the test. Ultimately the Auto-SPT device will allow pregnant women to track blood pressures at home related to position changes in order to monitor their risk for preeclampsia development and to improve the wellness outcomes of expecting mothers and their children.
Sonak Pastakia
2017
Sonak Pastakia, Ph.D.
Associate Professor
Department of Pharmacy Practice
Project title: “A Contextualized Community Based Approach for the Early Identification and Treatment of Breast and Cervical Cancer in Rural Western Kenya”
This project focuses on the lack of access to preventative screening and early treatment for cancer amongst rural women living in low- and middle- income countries (LMICs). Countries like Kenya, continue to face an unacceptably high mortality to cervical and breast cancer owing in large part to late presentation of patients for care and limited access to treatment. We intend to address this deficiency by bringing together an internationally renowned interdisciplinary team of experts to assess the difference in care accession for cervical and breast cancer when utilizing the novel Bridging Income Generation through grouP Integrated Care Model (BIGPIC) compared to the standard facility based model typically used by the Ministry of Health.