Whitney E Zahnd
Biographic Data
| ID | 4426646 |
|---|---|
| NAME | Whitney E Zahnd |
| GIVEN NAMES | Whitney E |
| FAMILY NAME | Zahnd |
| SIGNATURE | ZAHND W E |
| AFFILIATIONS | University of South Carolina |
| ORCID | 0000-0001-5174-8666 |
| VERIFIED | Yes |
| TOTAL WORKS | 28 |
| TOTAL CITATIONS | 5 |
| AUTHOR COUNT | 28 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2009 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 1 |
Metropolitan/nonmetropolitan differences of the impact of Covid‐19 on cancer survivors' care
PURPOSE: To evaluate pandemic-related changes in cancer-related care for cancer survivors residing in nonmetropolitan and metropolitan areas. METHODS: We used data from the Health Information National Trends-Surveillance Epidemiology End Results (HINTS-SEER) survey administered to cancer survivors from the Greater San Francisco Bay Area, Iowa, and New Mexico between January and August 2021. Respondents were queried on changes to their cancer-rela…
Health care access barriers among metropolitan and nonmetropolitan populations of eight geographically diverse states, 2018
INTRODUCTION: Nonmetropolitan populations face frequent health care access barriers compared to their metropolitan counterparts, but differences in the number of these barriers across groups are not known. Our objective was to examine the differences in health care access barriers across metropolitan, micropolitan, and noncore populations. METHODS: We used Behavioral Risk Factor Surveillance System data from the optional "Health Care Access" modu…
Video versus audio telehealth in safety net clinic patients
BACKGROUND: Understanding the mix of video versus audio telehealth modality is critical to informing care for low-income safety net clinic patients. Our study examined whether telehealth modality and continued use of telehealth varied by rurality and whether that changed over time. METHODS: Encounters from adults in the OCHIN national network of primary care safety net clinics were identified by encounter type (in-person vs telehealth) and telehe…
What cancers explain the growing rural‐urban gap in human papillomavirus‐associated cancer incidence
PURPOSE: Human papillomavirus (HPV) can cause cancers of the genital system, anus/rectum, and oropharynx. Prior research showed that HPV-associated cancer incidence was rising faster in nonmetro than in metro populations. Our study identified which cancers contributed to the widening disparity. METHODS: Representing ∼93% of all cancers in the United States, we analyzed data from the North American Association of Central Cancer Registries (2000-20…
An Investigation of Travel Distance and Timeliness of Breast Cancer Treatment Among a Diverse Cohort in the United States
Travel to and from distant cancer treatment facilities can place a significant burden on cancer patients, particularly rural and minority survivors. Thus, the purpose of our investigation was to examine the association between patient travel distance and delays in types of treatment for breast cancer (surgery, radiation, chemotherapy, and hormonal therapy) and treatment delays. Using a novel linkage between the state cancer registry and administr…
Evaluating intersectional variation of HPV-associated cancers in rural America
Appreciating the diversity of the rural cancer burden can be used to effectively develop and implement public health interventions to address HPV-related cancer disparities in rural communities. Actions are needed to prioritize reducing the burden of HPV-associated cancer in AIAN populations in high-poverty rural communities
Iowa spatial accessibility to screening mammography is improving, but utilization among privately insured women remains stable, 2016–2022
Understanding the impacts of rural hospital closures
Availability of hospital‐based cancer services before and after rural hospital closure, 2008‐2017
INTRODUCTION: Rural populations have less access to cancer care services and experience higher cancer mortality rates than their urban counterparts, which may be exacerbated by hospital closures. Our objective was to examine the impact of hospital closures on access to cancer-relevant hospital services across hospital service areas (HSAs). METHODS: We used American Hospital Association survey data from 2008 to 2017 to examine the change in access…
The Covid‐19 pandemic impact on independent and provider‐based rural health clinics’ operations and cancer prevention and screening provision in the United States
INTRODUCTION: The COVID-19 pandemic has disrupted cancer care, but it is unknown how the pandemic has affected care in Medicare-certified rural health clinics (RHCs) where cancer prevention and screening services are critical for their communities. This study examined how the provision of these cancer services changed pre- and peri-pandemic overall and by RHC type (independent and provider-based). METHODS: We administered a cross-sectional survey…
Low‐dose CT lung cancer screening uptake
PURPOSE: The US Preventive Services Task Force recommends lung cancer screening with Low-Dose Computed Tomography (LDCT) in high-risk individuals. Our objective was to identify demographic, health, and financial factors associated with screening uptake, with a focus on urban-rural differences. METHODS: We analyzed data from the 2018 and 2019 Behavioral Risk Factor Surveillance System and its optional Lung Cancer Screening Module to examine factor…
Interventions to address cancer‐related financial toxicity
PURPOSE: Addressing financial toxicity among cancer patients is a complex process that requires a multifaceted approach, particularly for rural patients who may face additional cost-related barriers to care. In this study, we examined interventions being implemented by financial navigation staff at various cancer centers that help address financial toxicity experienced by oncology patients. METHODS: We conducted semistructured interviews with a c…
Geographic, racial/ethnic, and socioeconomic inequities in broadband access
INTRODUCTION: Broadband access is a "super determinant of health." Understanding the spatial distribution and predictors of access may help target government programs and telehealth applications. Our aim was to examine broadband access across geography and sociodemographic characteristics using American Community Survey (ACS) data. METHODS: We used 5-year ACS estimates from 2014 to 2018 to evaluate broadband access across contiguous US census tra…
Rural and racial disparities in colorectal cancer incidence and mortality in South Carolina, 1996 – 2016
PURPOSE: Colorectal cancer (CRC) is the third leading cause of cancer mortality among men and women in the United States and South Carolina (SC). Since SC has one of the highest proportions of Black (27.9%) and rural residents (33.7%), the purpose of this investigation was to describe the burden of CRC on racial disparities in rural populations. METHODS: Count data from 2012 to 2016 were obtained from the state central cancer registry using an on…
The Covid‐19 Pandemic Illuminates Persistent and Emerging Disparities among Rural Black Populations
On April 7, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, spoke at a COVID-19 press conference noting the then emerging racial disparities in COVID-19 cases and deaths in large cities like Chicago and Milwaukee. Specifically, he noted, “...[h]ealth disparities have always existed for the African American community...it's shining a bright light on how unacceptable that is, because yet again, when you hav…
Association between Neighborhood Social Deprivation and Stage at Diagnosis among Breast Cancer Patients in South Carolina
The purpose of this study was to examine the association between neighborhood social deprivation and individual-level characteristics on breast cancer staging in African American and white breast cancer patients. We established a retrospective cohort of patients with breast cancer diagnosed from 1996 to 2015 using the South Carolina Central Cancer Registry. We abstracted sociodemographic and clinical variables from the registry and linked these d…
Impact of Rurality on National Trends in Thyroid Cancer Incidence and Long‐Term Survival
PURPOSE: Thyroid cancer incidence is rising, possibly secondary to increased imaging and surveillance. Based on rural access to care disparities, we hypothesized that incidence would be greater in urban compared to rural counties with no significant difference in long-term survival. METHODS: An observational study was performed on thyroid cancer patients using Surveillance Epidemiology and End Results data (2000-2012). Age-adjusted incidence rate…
Rural-Urban Mortality Disparities
Objectives. To examine rural-urban disparities in overall mortality and leading causes of death across Hispanic (any race) and non-Hispanic White, Black, American Indian/Alaska Native (AI/AN), and Asian/Pacific Islander populations. Methods. We performed a retrospective analysis of age-adjusted death rates for all-cause mortality and 5 leading causes of death (cardiovascular, cancer, unintentional injuries, chronic lower respiratory disease, and …
Population Structure Analyses Provide Insight into the Source Populations Underlying Rural Isolated Communities in Illinois
We have previously hypothesized that relatively small and isolated rural communities may experience founder efffects, defijined as the genetic ramifijications of small population sizes at the time of a community’s establishment. To explore this, we used an Illumina Infijinium Omni2.5Exome-8 chip to collect data from 157 individuals from four Illinois communities, three rural and one urban. Genetic diversity estimates of 999,259 autosomal markers …
Disparities in Utilization of Medical Specialists for Colonoscopy
Purpose: Colonoscopy is the preferred screening modality for colorectal cancer (CRC) prevention. The quality of the procedure varies although medical specialists such as gastroenterologists and colorectal surgeons tend to have better outcomes. We aimed to determine whether there are demographic and clinical differences between those who received a colonoscopy from a specialist versus those who received a colonoscopy from a nonspecialist. Methods:…
Spatial Accessibility to Mammography Services in the Lower Mississippi Delta Region States
PURPOSE: To characterize spatial access to mammography services across 8 Lower Mississippi Delta Region (LMDR) states. These states include the Delta Region, a federally designated, largely rural, and impoverished region with a high proportion of black residents and low mammography utilization rates. METHODS: Using the enhanced 2-step floating catchment area method, we calculated spatial accessibility scores for mammography services across LMDR c…
Rural‐Urban Differences in Human Papillomavirus‐associated Cancer Trends and Rates
PURPOSE: Human papillomavirus (HPV) is the most prevalent sexually transmitted disease and a known cause of many cancers. Previous research explored HPV-associated (HPVa) cancer differences by gender or race, but rural-urban differences in rates and trends have received little attention. This study examined rural-urban differences in rates and temporal trends for individual HPVa cancers. METHODS: The North American Association of Central Cancer R…
Knowledge, attitudes, and perceived barriers towards genetic testing across three rural Illinois communities
Identifying Areas with Disproportionate Local Health Department Services Relative to Opioid Overdose, HIV and Hepatitis C Diagnosis Rates
Background: U.S. rural populations have been disproportionately affected by the syndemic of opioid-use disorder (OUD) and the associated increase in overdoses and risk of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) transmission. Local health departments (LHDs) can play a critical role in the response to this syndemic. We utilized two geospatial approaches to identify areas of discordance between LHD service availability and dis…
Population Structure Analyses Provide Insight into the Source Populations Underlying Rural Isolated Communities in Illinois
We have previously hypothesized that relatively small and isolated rural communities may experience founder effects, defined as the genetic ramifications of small population sizes at the time of a community's establishment. To explore this, we used an Illumina Infinium Omni2.5Exome-8 chip to collect data from 157 individuals from four Illinois communities, three rural and one urban. Genetic diversity estimates of 999,259 autosomal markers suggest…
Rural-Urban Mortality Disparities
Objectives. To examine rural-urban disparities in overall mortality and leading causes of death across Hispanic (any race) and non-Hispanic White, Black, American Indian/Alaska Native (AI/AN), and Asian/Pacific Islander populations. Methods. We performed a retrospective analysis of age-adjusted death rates for all-cause mortality and 5 leading causes of death (cardiovascular, cancer, unintentional injuries, chronic lower respiratory disease, and …
Health Literacy Skills in Rural and Urban Populations
Health literacy is lower in the rural population although this difference is explained by known confounders
Engaging rural communities in genetic research
Statistical analyses of health and disease in rural communities is frequently limited by low sample counts. Still, some studies indicate increased risk for some diseases even after adjustment for known risk factors. It has been hypothesized that the context of community formation in rural areas facilitates the propagation of genetic founder effects-potentially impacting disease susceptibility. However, outright examination of genetic diversity in…
Rural–Urban Differences in Cancer Incidence and Trends in the United States
Background: Cancer incidence and mortality rates in the United States are declining, but this decrease may not be observed in rural areas where residents are more likely to live in poverty, smoke, and forego cancer screening. However, there is limited research exploring national rural–urban differences in cancer incidence and trends. Methods: We analyzed data from the North American Association of Central Cancer Registries' public use dataset, wh…
Disparities in Utilization of Medical Specialists for Colonoscopy
Purpose: Colonoscopy is the preferred screening modality for colorectal cancer (CRC) prevention. The quality of the procedure varies although medical specialists such as gastroenterologists and colorectal surgeons tend to have better outcomes. We aimed to determine whether there are demographic and clinical differences between those who received a colonoscopy from a specialist versus those who received a colonoscopy from a nonspecialist. Methods:…
Spatial Accessibility to Mammography Services in the Lower Mississippi Delta Region States
PURPOSE: To characterize spatial access to mammography services across 8 Lower Mississippi Delta Region (LMDR) states. These states include the Delta Region, a federally designated, largely rural, and impoverished region with a high proportion of black residents and low mammography utilization rates. METHODS: Using the enhanced 2-step floating catchment area method, we calculated spatial accessibility scores for mammography services across LMDR c…
Rural‐Urban Differences in Human Papillomavirus‐associated Cancer Trends and Rates
PURPOSE: Human papillomavirus (HPV) is the most prevalent sexually transmitted disease and a known cause of many cancers. Previous research explored HPV-associated (HPVa) cancer differences by gender or race, but rural-urban differences in rates and trends have received little attention. This study examined rural-urban differences in rates and temporal trends for individual HPVa cancers. METHODS: The North American Association of Central Cancer R…
Knowledge, attitudes, and perceived barriers towards genetic testing across three rural Illinois communities
Identifying Areas with Disproportionate Local Health Department Services Relative to Opioid Overdose, HIV and Hepatitis C Diagnosis Rates
Background: U.S. rural populations have been disproportionately affected by the syndemic of opioid-use disorder (OUD) and the associated increase in overdoses and risk of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) transmission. Local health departments (LHDs) can play a critical role in the response to this syndemic. We utilized two geospatial approaches to identify areas of discordance between LHD service availability and dis…
Population Structure Analyses Provide Insight into the Source Populations Underlying Rural Isolated Communities in Illinois
We have previously hypothesized that relatively small and isolated rural communities may experience founder effects, defined as the genetic ramifications of small population sizes at the time of a community's establishment. To explore this, we used an Illumina Infinium Omni2.5Exome-8 chip to collect data from 157 individuals from four Illinois communities, three rural and one urban. Genetic diversity estimates of 999,259 autosomal markers suggest…
Impact of Rurality on National Trends in Thyroid Cancer Incidence and Long‐Term Survival
PURPOSE: Thyroid cancer incidence is rising, possibly secondary to increased imaging and surveillance. Based on rural access to care disparities, we hypothesized that incidence would be greater in urban compared to rural counties with no significant difference in long-term survival. METHODS: An observational study was performed on thyroid cancer patients using Surveillance Epidemiology and End Results data (2000-2012). Age-adjusted incidence rate…
Rural-Urban Mortality Disparities
Objectives. To examine rural-urban disparities in overall mortality and leading causes of death across Hispanic (any race) and non-Hispanic White, Black, American Indian/Alaska Native (AI/AN), and Asian/Pacific Islander populations. Methods. We performed a retrospective analysis of age-adjusted death rates for all-cause mortality and 5 leading causes of death (cardiovascular, cancer, unintentional injuries, chronic lower respiratory disease, and …
Population Structure Analyses Provide Insight into the Source Populations Underlying Rural Isolated Communities in Illinois
We have previously hypothesized that relatively small and isolated rural communities may experience founder efffects, defijined as the genetic ramifijications of small population sizes at the time of a community’s establishment. To explore this, we used an Illumina Infijinium Omni2.5Exome-8 chip to collect data from 157 individuals from four Illinois communities, three rural and one urban. Genetic diversity estimates of 999,259 autosomal markers …
The Covid‐19 Pandemic Illuminates Persistent and Emerging Disparities among Rural Black Populations
On April 7, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, spoke at a COVID-19 press conference noting the then emerging racial disparities in COVID-19 cases and deaths in large cities like Chicago and Milwaukee. Specifically, he noted, “...[h]ealth disparities have always existed for the African American community...it's shining a bright light on how unacceptable that is, because yet again, when you hav…
Association between Neighborhood Social Deprivation and Stage at Diagnosis among Breast Cancer Patients in South Carolina
The purpose of this study was to examine the association between neighborhood social deprivation and individual-level characteristics on breast cancer staging in African American and white breast cancer patients. We established a retrospective cohort of patients with breast cancer diagnosed from 1996 to 2015 using the South Carolina Central Cancer Registry. We abstracted sociodemographic and clinical variables from the registry and linked these d…
Low‐dose CT lung cancer screening uptake
PURPOSE: The US Preventive Services Task Force recommends lung cancer screening with Low-Dose Computed Tomography (LDCT) in high-risk individuals. Our objective was to identify demographic, health, and financial factors associated with screening uptake, with a focus on urban-rural differences. METHODS: We analyzed data from the 2018 and 2019 Behavioral Risk Factor Surveillance System and its optional Lung Cancer Screening Module to examine factor…
Interventions to address cancer‐related financial toxicity
PURPOSE: Addressing financial toxicity among cancer patients is a complex process that requires a multifaceted approach, particularly for rural patients who may face additional cost-related barriers to care. In this study, we examined interventions being implemented by financial navigation staff at various cancer centers that help address financial toxicity experienced by oncology patients. METHODS: We conducted semistructured interviews with a c…
Geographic, racial/ethnic, and socioeconomic inequities in broadband access
INTRODUCTION: Broadband access is a "super determinant of health." Understanding the spatial distribution and predictors of access may help target government programs and telehealth applications. Our aim was to examine broadband access across geography and sociodemographic characteristics using American Community Survey (ACS) data. METHODS: We used 5-year ACS estimates from 2014 to 2018 to evaluate broadband access across contiguous US census tra…
Rural and racial disparities in colorectal cancer incidence and mortality in South Carolina, 1996 – 2016
PURPOSE: Colorectal cancer (CRC) is the third leading cause of cancer mortality among men and women in the United States and South Carolina (SC). Since SC has one of the highest proportions of Black (27.9%) and rural residents (33.7%), the purpose of this investigation was to describe the burden of CRC on racial disparities in rural populations. METHODS: Count data from 2012 to 2016 were obtained from the state central cancer registry using an on…
Availability of hospital‐based cancer services before and after rural hospital closure, 2008‐2017
INTRODUCTION: Rural populations have less access to cancer care services and experience higher cancer mortality rates than their urban counterparts, which may be exacerbated by hospital closures. Our objective was to examine the impact of hospital closures on access to cancer-relevant hospital services across hospital service areas (HSAs). METHODS: We used American Hospital Association survey data from 2008 to 2017 to examine the change in access…
The Covid‐19 pandemic impact on independent and provider‐based rural health clinics’ operations and cancer prevention and screening provision in the United States
INTRODUCTION: The COVID-19 pandemic has disrupted cancer care, but it is unknown how the pandemic has affected care in Medicare-certified rural health clinics (RHCs) where cancer prevention and screening services are critical for their communities. This study examined how the provision of these cancer services changed pre- and peri-pandemic overall and by RHC type (independent and provider-based). METHODS: We administered a cross-sectional survey…
Understanding the impacts of rural hospital closures
Metropolitan/nonmetropolitan differences of the impact of Covid‐19 on cancer survivors' care
PURPOSE: To evaluate pandemic-related changes in cancer-related care for cancer survivors residing in nonmetropolitan and metropolitan areas. METHODS: We used data from the Health Information National Trends-Surveillance Epidemiology End Results (HINTS-SEER) survey administered to cancer survivors from the Greater San Francisco Bay Area, Iowa, and New Mexico between January and August 2021. Respondents were queried on changes to their cancer-rela…
Health care access barriers among metropolitan and nonmetropolitan populations of eight geographically diverse states, 2018
INTRODUCTION: Nonmetropolitan populations face frequent health care access barriers compared to their metropolitan counterparts, but differences in the number of these barriers across groups are not known. Our objective was to examine the differences in health care access barriers across metropolitan, micropolitan, and noncore populations. METHODS: We used Behavioral Risk Factor Surveillance System data from the optional "Health Care Access" modu…
Video versus audio telehealth in safety net clinic patients
BACKGROUND: Understanding the mix of video versus audio telehealth modality is critical to informing care for low-income safety net clinic patients. Our study examined whether telehealth modality and continued use of telehealth varied by rurality and whether that changed over time. METHODS: Encounters from adults in the OCHIN national network of primary care safety net clinics were identified by encounter type (in-person vs telehealth) and telehe…
What cancers explain the growing rural‐urban gap in human papillomavirus‐associated cancer incidence
PURPOSE: Human papillomavirus (HPV) can cause cancers of the genital system, anus/rectum, and oropharynx. Prior research showed that HPV-associated cancer incidence was rising faster in nonmetro than in metro populations. Our study identified which cancers contributed to the widening disparity. METHODS: Representing ∼93% of all cancers in the United States, we analyzed data from the North American Association of Central Cancer Registries (2000-20…
Medicine (26 works) · Demography (17 works) · Environmental health (16 works) · Geography (13 works) · Global Cancer Incidence and Screening (12 works) · Internal Medicine (12 works) · Population (12 works) · Cancer (11 works) · Rural area (10 works) · Health care (9 works)