This semester, Eleanor Garlow ’14 became F&M’s first-ever public health major to conduct an independent study upon completion of a research project dedicated to analyzing the mental health of the residents of Lancaster. Garlow ran statistical analyses on the Behavioral Risk Factor Surveillance System (BRFSS) survey administered to a little over 1,000 people in Lancaster by the Center for Disease Control and Prevention (CDC) in 2011.
Garlow worked under the supervision of Kirk Miller, B.F. Fackenthal, Jr. professor of biology and public health program chair, with additional assistance from Christina Abbott, visiting assistant professor of psychology and Garlow’s second reader.
At the commencement of what turned out to be a three-month process, Miller and Garlow were directed to the BRFSS survey by Berwood Yost, director of the Floyd Institute for Public Policy Analysis and the Institute’s Center for Opinion Research. Garlow was instructed to conduct any research she wanted on the survey, which left her a multitude of possibilities.
“I decided to focus on the mental health section of the survey because I’d been talking with a lot of my public health friends about how mental health is a topic that is severely under-studied in the public health realm,” Garlow said. “I wanted to look at this and see what the mental health situation was in Lancaster,” Garlow elaborated, noting that 20 percent of the mental health budget in Lancaster was cut in the past year, following pre-existing cuts to preventative health programs during the debt crisis of 2008.
The model Garlow created based on her findings aims to help healthcare workers in Lancaster to re-evaluate who is at risk of developing a mental illness, to re-adjust their budgets to assist this demographic, and to secure further funding to treat those affected.
“I’m going to send my paper to all the mental health workers in Lancaster who I’ve interviewed,” she said. “I think this will be a useful resource for them just to see what this Lancaster-specific data looks like so they can re-adjust their resources if they so choose.”
Miller says he will make Garlow’s findings available to the Lancaster Health Improvement Partnership (LHIP).
One organization Garlow contacted was the Spanish American Civic Association (SACA), as her findings correlate well with previous studies that suggest minorities in Lancaster are more prone to mental illness than Caucasians.
“I’m going to send [SACA] my paper so when they are applying for these grants, they can show these Lancaster-specific statistics I found for Hispanics and Latinos about how they are statistically more likely to have a mental illness than some other races,” Garlow said. “This is the purpose of my research: to help these organizations better direct their services towards the populations that need it and to help them have more credibility when applying for grants.”
In addition to bolstering the pre-existing notion that minorities are at a higher risk of developing a mental illness, Garlow’s research supports the ideas that women and smokers are at risk as well. Lancaster residents who were sexually abused, had divorced parents, or lived with someone mentally ill as children seem to be at the highest risk, according to Garlow’s analysis.
“A lot of journal [articles] talk about how women are more likely to have depression, for example, than men, and minorities are more likely to have depression than whites,” Garlow said. “There is a lot of literature that says that, and those results were confirmed through my research. I did, however, find that factors like adverse childhood experiences were much more correlated with a mental illness than being black or being a woman.”
Garlow arrived at this conclusion by focusing on the BRFSS survey questions to determine Lancaster residents who were diagnosed with depression or anxiety and those with symptoms who were undiagnosed. She analyzed the diagnosed population to determine factors that most often lead to co-occurring mental illness and then revealed a subset of the undiagnosed population that is at high risk of developing depression or anxiety based on these factors.
“I figured out this group of 221 people [of the roughly 1,000 surveyed] in the community who have symptoms of depression or anxiety, but are not diagnosed,” Garlow said. “I wanted to figure out who they were, what were the demographic trends, and why they were undiagnosed.”
Garlow traced the trend of high-risk members of the community going undiagnosed to financial barriers and the lack of a consistent doctor.
“[My findings] made me think back to the problem of — now that we have very limited resources because the budget has been cut — where is it most beneficial to submit all of our resources?” Garlow said. “My main conclusion was that we should be looking into doing mental health prevention in children. The average age of onset for a mental illness is 14 in the US. That means, in Lancaster, we should be focusing on everyone below that age for prevention.
“At the end of my paper I was advocating for these prevention programs for youth in Lancaster schools because I have shown through my research that all these adverse childhood experiences are really what correlate with mental illness,” Garlow continued. “Because I found that 20 percent of the Lancaster population is undiagnosed and high risk, I argue that the government should be increasing our mental health budget by 20 percent so it can serve this population.”
Garlow hopes to one day work as an epidemiologist for the CDC, and this Summer, she will be putting the skills she learned through her independent study to use at Johns Hopkins University as a quality management analyst.
“Without my background in biology or my background in government, this wouldn’t be possible,” Garlow said. “I think my major is one that is a really good example of what it means to be a liberal arts student. I’m so glad to have done this research because I hope it inspires other public health majors to go on and do independent studies.”
Garlow’s work brings attention to a relatively new department.
“The first independent study in Public Health is, of course, a milestone, for the program and for F&M,” Miller said.
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