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Mir Mohamad Tabar SA, Brewis A, Sohrabi M. Status, social norms, or safety? understanding intended and reported bottled water use in Urban Mashhad, Iran. JOURNAL OF WATER AND HEALTH 2023; 21:81-93. [PMID: 36705499 DOI: 10.2166/wh.2022.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Personal plastic-bottled water use is highly commodified, raising an array of cost and environmental concerns, and continues to grow globally. Studies in lower-income nations suggest safety as a primary motivation for such water purchases, but studies in high-income nations with greater relative affordability suggest it is more tied to socially situated consumer decisions like status and aesthetics. Here, we consider what motivates bottled water use in an urban city (Mashhad) in a middle-income predominantly Muslim country (Iran), where there is a likely intersection of safety (due to contamination), social norms, and status concerns. Surveys were collected with a random population-representative sample of resident adults from discrete households (n = 970). Structured equation modeling testing the relative effects on reported bottled water intentions and use shows that all these factors are shaping people's decisions. Both higher- and lower-income residents' responses suggest that status and social norms considerably influence intentions to use. Overall, even despite real safety issues with tap water, social norms and status concerns seem to weigh more heavily on residents' decisions to drink bottled water.
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Affiliation(s)
| | - Alexandra Brewis
- Department of Anthropology, School of Human Evolution and Social Change, Arizona State University, Tempe AZ 85287, USA
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2
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Zhang H, Xia Y, Chang Q, Zhang X, Zhao Y. Association between water source and chronic gastrointestinal diseases in Chinese: A cross-sectional and longitudinal study. Front Public Health 2022; 10:992462. [PMID: 36438297 PMCID: PMC9685615 DOI: 10.3389/fpubh.2022.992462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/24/2022] [Indexed: 11/12/2022] Open
Abstract
Background Gastrointestinal health is closely associated with the quality of the water supply. However, long-term associations between the water supply type and chronic gastrointestinal disease (CGD) are unclear. Method The water supply was categorized as "tap-water" or "non-tap water" use. Changes in water source use were categorized into four types: "non-tap water both at baseline and in follow-ups," "non-tap water at baseline and tap-water in follow-ups," "tap-water at baseline and non-tap water in follow-ups," or "tap-water at baseline and in follow-ups." We explored the association between tap-water use (and changes therein) and the risk of CGD in a cross-sectional and longitudinal population study based on national cohort data from 2011 to 2018. Results After the inclusion and exclusion process, 13,332 and 9,688 participants were included in the cross-sectional and longitudinal analyses, respectively. Tap-water use was associated with fewer CGD cases at baseline (OR = 0.98, 95% CI: 0.90, 1.07). Tap-water use at baseline was associated with significantly lower incidence of CGD in follow-ups (HR = 0.70, 95% CI: 0.70, 0.90). Compared with consistent non-tap water use in both baseline and follow-ups, switching from non-tap water to tap-water use in follow-ups was associated with a lower risk of CGD (HR = 0.79, 95% CI: 0.64, 0.97), tap water use at both baseline and in follow-ups was associated with a lower risk of CGD (HR = 0.72, 95% CI: 0.59, 0.88). The decreased risk of CGD followed a linear trend (P fortrend < 0.01). Adjustment for indoor solid fuel use and outdoor air pollution exposure to PM2.5 did not change the association between tap water use and CGD. Conclusion Tap water use was associated with a reduced risk of incident CGD. The results from this study should aid in effect assessment for water purification strategies and public decision support for gastrointestinal health management.
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Affiliation(s)
- Hehua Zhang
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qing Chang
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiangsu Zhang
- International Education School, China Medical University, Shenyang, China
| | - Yuhong Zhao
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China,Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China,*Correspondence: Yuhong Zhao ;
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3
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Bauer KW, Weeks HM, Clayson M, Needham B. Perceptions of tap water associated with low-income Michigan mothers' and young children's beverage intake. Public Health Nutr 2022; 25:1-10. [PMID: 35570674 PMCID: PMC9666652 DOI: 10.1017/s1368980022001136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 03/14/2022] [Accepted: 04/19/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To quantify perceptions of tap water among low-income mothers with young children residing in Michigan and examine associations between perceptions of tap water, mothers' and young children's beverage intake, and mothers' infant feeding practices. DESIGN Cross-sectional study. SETTING Online survey. PARTICIPANTS Medicaid-insured individuals who had given birth at a large Midwestern US hospital between fall 2016 and fall 2020 were invited by email to complete a survey in winter 2020 (N 3881); 15·6 % (N 606) completed eligibility screening, 550 (90·8 %) were eligible to participate, and 500 (90·9 %) provided valid survey data regarding perceptions of tap water, self and child beverage intake, and infant feeding practices. RESULTS Two-thirds (66·2 %) of mothers reported that their home tap water was safe to drink without a filter, while 21·6 % were unsure about the safety of their home tap water. Mothers' perceptions of their home tap water were associated with their own tap and bottled water intake and their young children's tap water and bottled water intake. Mothers with more negative perceptions of tap water in general, independent of their perceptions about their home tap water, consumed more bottled water and sugar-sweetened beverages, and their young children drank bottled water and fruit drinks more frequently. Few associations were observed between mothers' perceptions of tap water and infant feeding practices. CONCLUSIONS Uncertainty about tap water safety and negative perceptions of tap water are common among low-income Michigan mothers. These beliefs may contribute to less healthful and more costly beverage intake among mothers and their young children.
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Affiliation(s)
- Katherine W Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI48104, USA
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI48104, USA
| | - Michelle Clayson
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI48104, USA
| | - Belinda Needham
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Anthonj C, Setty KE, Ferrero G, A Yaya AM, Mingoti Poague KIH, Marsh AJ, Augustijn EW. Do health risk perceptions motivate water - and health-related behaviour? A systematic literature review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 819:152902. [PMID: 34998758 DOI: 10.1016/j.scitotenv.2021.152902] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/30/2021] [Accepted: 12/31/2021] [Indexed: 05/26/2023]
Abstract
Health-related risk perceptions are important determinants of health behaviours and components of behaviour change theories. What someone thinks or feels will motivate or hinder their intention or hesitancy to implement a certain behaviour. Thus, a perceived potential risk to our health and well-being can influence our health-promoting and/or health-seeking behaviour. We aimed to review and synthesize available peer-reviewed literature to better understand the links between water and health-related risk perceptions and behaviours. We conducted the first systematic review of peer-reviewed literature on risk perceptions and behaviours in the context of water and health, published between 2000 and 2021. A total of 187 publications met the inclusion criteria. We extracted data relating to study characteristics and categorized our results according to the major themes emerging from the literature, namely drinking water, sanitation, hygiene and wasterelated topics, health risk factors, diseases and mental health implications, and preventative measures. Our review shows that the literature has grown over the past twenty years, reporting information from different countries belonging to different income groups around the globe, conducted in various settings and contexts, among different target populations, from various disciplinary angles, using different methods, theories and approaches. Our review provides evidence of health risk perceptions determining behaviour particularly related to drinking water sources and water safety. Evidence on disease prevention, health seeking, variations and changes in perception and behaviour over space, geography, socioeconomic differences and time, and the relevance of cultural context is provided. Our review shows that risk perception studies are vital for WASH governance in terms of policy, raising awareness, education and behaviour change. In order to make risk perception and behaviour studies even more relevant to effective public health planning and health messaging, future research needs to increasingly focus on early culturally sensitive interventions and changes in perceptions and behaviours over time.
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Affiliation(s)
- Carmen Anthonj
- Faculty of Geo-Information Science and Earth Observation, ITC, University of Twente, Enschede, the Netherlands.
| | - Karen E Setty
- ICF, Durham, NC, USA; The Aquaya Institute, P.O. Box 1603, San Anselmo, CA 94979, USA
| | - Giuliana Ferrero
- WASH consulting, Delft, the Netherlands; IHE Delft Institute for Water Education, Delft, the Netherlands
| | - Al-Mounawara A Yaya
- Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA; UNC Microbiome Core, Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | | | - Alan J Marsh
- Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA; UNC Microbiome Core, Center for Gastrointestinal Biology and Disease, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Ellen-Wien Augustijn
- Faculty of Geo-Information Science and Earth Observation, ITC, University of Twente, Enschede, the Netherlands
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Lin M, Griffin SO, Park S, Li C, Robison V, Espinoza L. Associations between Household Water Fluoridation Status and Plain Tap or Bottled Water Consumption. JDR Clin Trans Res 2020; 6:440-447. [PMID: 32940115 DOI: 10.1177/2380084420960419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The benefits of community water fluoridation for preventing dental caries are attenuated if people do not consume tap water. OBJECTIVES We examined associations between household water fluoride content and consuming plain tap or bottled water among US youth. METHODS We used National Health and Nutrition Examination Survey data for 2013 to 2016 for 5,193 youth aged 2 to 19 y. Fluoride content in youth's household tap water samples was measured electrometrically with ion-specific electrodes and designated low (<0.6 mg/L) or about optimal (0.6 to 1.2 mg/L). Plain tap and bottled water consumption was obtained from one 24-h dietary recall. We used binomial regression models to estimate adjusted prevalence ratios (APRs) and 95% CIs for consuming plain tap water (including tap only or both tap and bottled) and consuming only bottled water as related to household water fluoride content (low or about optimal) and sociodemographic characteristics. RESULTS On a given day, 52.6% of youth consumed plain tap water (43.8% exclusively and 8.8% both tap and bottled) and 28%, only bottled water. Neither tap water (APR, 0.96; 95% CI, 0.84 to 1.10) nor only bottled water (APR, 1.03; 95% CI, 0.86 to 1.22) consumption was associated with household water fluoride content. Non-Hispanic Black youth and Hispanic youth were about 30% relatively less likely to consume tap water and 60% to 80% relatively more likely to consume only bottled water than non-Hispanic Whites. Low income, low parental education, and no past-year dental visit were associated with not consuming tap water. CONCLUSION Half of youth consumed plain tap water on a given day. Consuming plain tap water was not associated with community water fluoridation status. This study is the first to find that up to 50% of the population served by fluoridated water may not receive its full caries-preventive benefits due to not consuming plain tap water. KNOWLEDGE TRANSFER STATEMENT Half of US youth consumed plain tap water on a given day. Consuming plain tap water was not associated with community water fluoridation status. This finding suggests that up to 50% of the population served by fluoridated water systems may not receive its full caries-preventive benefits due to not consuming plain tap water. Our findings add support for the need to identify and address barriers to tap water consumption and promote health benefits of fluoridation.
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Affiliation(s)
- M Lin
- Division of Oral Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S O Griffin
- Division of Oral Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - S Park
- Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - C Li
- Northrop Grumman Corporation, Atlanta, GA, USA
| | - V Robison
- Division of Oral Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - L Espinoza
- Division of Oral Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Robles B, Jewell MP, Thomas Tobin CS, Smith LV, Kuo T. Varying levels of depressive symptoms and lifestyle health behaviors in a low income, urban population. J Behav Med 2020; 44:212-221. [PMID: 32936373 DOI: 10.1007/s10865-020-00179-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/02/2020] [Indexed: 01/02/2023]
Abstract
This study examined the relationships between varying levels of depressive symptoms and key dietary indicators of chronic disease risk, sugar-sweetened beverage (SSB) and fruit and vegetable (F + V) consumption, among a racially/ethnically diverse urban population in Los Angeles County (LAC). Analyses were carried out using data from a 2012 cross-sectional health survey of 1401 low-income public health center clients. Participants with a high level of depressive symptoms consumed 30% more SSBs (IRR = 1.30, 95% CI = 1.08, 1.55) than participants with a lower level of these symptoms. Other predictors of higher SSB consumption included being African American/Black (IRR = 1.65, 95% CI = 1.32, 2.05), male (IRR = 1.20, 95% CI = 1.06, 1.35), U.S. born (IRR = 1.32, 95% CI = 1.11, 1.57), and using tobacco (IRR = 1.26, 95% CI = 1.11, 1.43). Similar associations with F + V consumption were not found. Findings suggest that depressive symptoms may influence certain health behaviors in certain groups under certain situations. Policy and practice implications are discussed within this context.
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Affiliation(s)
- Brenda Robles
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, 3530 Wilshire Blvd., 8th Floor, Los Angeles, CA, 90010, USA. .,Department of Community Health Sciences, UCLA Fielding School of Public Health, P.O. Box 951772, Los Angeles, CA, 90095, USA.
| | - Mirna Ponce Jewell
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, 3530 Wilshire Blvd., 8th Floor, Los Angeles, CA, 90010, USA
| | - Courtney S Thomas Tobin
- Department of Community Health Sciences, UCLA Fielding School of Public Health, P.O. Box 951772, Los Angeles, CA, 90095, USA
| | - Lisa V Smith
- Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, 313 N. Figueroa St., Suite 127, Los Angeles, CA, 90012, USA.,Department of Epidemiology, UCLA Fielding School of Public Health, P.O. Box 951772, Los Angeles, CA, 90095, USA
| | - Tony Kuo
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, 3530 Wilshire Blvd., 8th Floor, Los Angeles, CA, 90010, USA.,Department of Epidemiology, UCLA Fielding School of Public Health, P.O. Box 951772, Los Angeles, CA, 90095, USA.,Department of Family Medicine, David Geffen School of Medicine at UCLA, 10880 Wilshire Blvd, Suite 1800, Los Angeles, CA, 90024, USA.,Population Health Program, UCLA Clinical and Translational Science Institute, BE-144 Center of Health Sciences, Los Angeles, CA, 90095, USA
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Geerts R, Vandermoere F, Van Winckel T, Halet D, Joos P, Van Den Steen K, Van Meenen E, Blust R, Borregán-Ochando E, Vlaeminck SE. Bottle or tap? Toward an integrated approach to water type consumption. WATER RESEARCH 2020; 173:115578. [PMID: 32058152 DOI: 10.1016/j.watres.2020.115578] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 01/29/2020] [Accepted: 01/31/2020] [Indexed: 06/10/2023]
Abstract
While in many countries, people have access to cheap and safe potable tap water, the global consumption of bottled water is rising. Flanders, Belgium, where this study is located, has an exceptionally high consumption of bottled water per capita. However, in the interest of resource efficiency and global environmental challenges, the consumption of tap water is preferable. To our knowledge, an integrated analysis of the main reasons why people consume tap and bottled water is absent in Flanders, Belgium. Using Flemish survey data (N = 2309), we first compared tap and bottled water consumers through bivariate correlation analysis. Subsequently, path modelling techniques were used to further investigate these correlations. Our results show that bottled water consumption in Flanders is widespread despite environmental and financial considerations. For a large part, this is caused by negative perceptions about tap water. Many consumers consider it unhealthy, unsafe and prefer the taste of bottled water. Furthermore, we found that the broader social context often inhibits the consumption of tap water. On the one hand, improper infrastructures (e.g. lead piping) can limit access to potable tap water. On the other hand, social norms exist that promote bottled water. Lastly, results suggest that the consumption of bottled water is most common among men, older people and less educated groups. We conclude that future research and policy measures will benefit from an approach that integrates all behavioural aspects associated with water type consumption. This will enable both governments and tap water companies to devise more effective policies to manage and support tap water supply networks.
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Affiliation(s)
- Robbe Geerts
- Department of Sociology, University of Antwerp, Sint-Jacobstraat 2, 2000, Antwerp, Belgium.
| | - Frédéric Vandermoere
- Department of Sociology, University of Antwerp, Sint-Jacobstraat 2, 2000, Antwerp, Belgium.
| | - Tim Van Winckel
- Department of Bioscience Engineering, University of Antwerp, Groenenborgerlaan 171, Antwerp, Belgium.
| | - Dirk Halet
- Flanders Knowledge Center Water (VLAKWA), Flemish Institute for Technological Research (VITO), Graaf Karel de Goedelaan 34, 8500, Kortrijk, Belgium.
| | - Pieter Joos
- Department of Bioscience Engineering, University of Antwerp, Groenenborgerlaan 171, Antwerp, Belgium; Water-link, Mechelsesteenweg 111, 2840, Rumst, Belgium.
| | | | | | - Ronny Blust
- Department of Biology, University of Antwerp, Middelheimlaan 1, 2020, Antwerp, Belgium.
| | | | - Siegfried E Vlaeminck
- Department of Bioscience Engineering, University of Antwerp, Groenenborgerlaan 171, Antwerp, Belgium.
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Abstract
In recent years, mold has been blamed for many symptoms or a constellation of symptoms. These symptoms are usually vague and subjective and difficult or impossible to measure or quantify. Moreover, there is no scientific evidence that mold has anything to do with these symptoms. In particular, the concept of toxic mold syndrome has permeated the public consciousness, and mycotoxins have falsely been associated with autoimmune diseases and a variety of other conditions. In fact, there is no evidence that the presence of mycotoxins in the air is enough to cause any disease known to man. Molds legitimately can cause allergies and can be a trigger for asthma. Certain specific molds such as Aspergillus can be a cause of hypersensitivity pneumonitis. In immunocompromised hosts, both dermatologic and systemic infections can result from various fungi and can be associated with significant morbidity or even mortality. However, the existence of toxic mold syndrome has been disproven, despite the numerous disreputable practices such as testing homes for mold spores, measuring "mycotoxins" in the urine, and testing patients for IgG to mold. In truth, none of these techniques have been validated, nor do they have any relevance to any clinical disease. All that these tests that are being performed by laboratories of disrepute does is to further propagate misinformation and inflict unnecessary and often exorbitant costs on patients desperate for a clinical diagnosis, right or wrong, for their constellation of maladies.
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Affiliation(s)
- Christopher Chang
- Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis, Davis, CA, 95616, USA. .,Division of Pediatric Immunology and Allergy, Joe DiMaggio Children's Hospital, Hollywood, FL, 33021, USA.
| | - M Eric Gershwin
- Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis, Davis, CA, 95616, USA.
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Pierce G, Gonzalez SR, Roquemore P, Ferdman R. Sources of and solutions to mistrust of tap water originating between treatment and the tap: Lessons from Los Angeles County. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 694:133646. [PMID: 31390577 DOI: 10.1016/j.scitotenv.2019.133646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/23/2019] [Accepted: 07/27/2019] [Indexed: 06/10/2023]
Abstract
Tap water mistrust has adverse impacts on health and welfare. This study identifies, defines and motivates attention to cases of mistrust of tap water which originate between the treatment plant and the tap where people ultimately consume it. Between treatment and the tap, water quality contamination can be introduced within two segments of the built environment with two distinct responsible parties- community water system's distributional networks and property owner's premise plumbing. This contamination is considered secondary from a health perspective but elevates consumer concern. We use examples from Los Angeles County, an area with high resident tap water mistrust especially among disadvantaged communities, despite there being relatively few health-related water quality violations. We triangulate evidence from primary and secondary sources to illustrate how such water quality concerns occur. We identify potential solutions to address concerns using a series of case studies of communities with high levels of tap water mistrust, a stakeholder workshop and associated working group on premise plumbing concerns, and customer concern data from the city of Los Angeles' water system. Findings suggest that there are numerous instances where the distributional network, and secondarily premise plumbing, introduce water quality contamination which contributes to tap mistrust in urban communities by making water unclean, but not necessarily unsafe per existing regulation. In cases where water systems' distributional networks have introduced water quality contamination, responses to assuage concerns have largely rested upon pressure from the press and advocates. Premise plumbing issues have been harder to address. Our study suggests that an evidence-based path forward to comprehensively addressing these issues involves new requirements for systems to report quality contamination in distributional networks and incentives for property owners to upgrade premise plumbing. Moreover, this study reasserts that infrastructure neglect contributes to rational, but costly decision-making by disadvantaged urban communities to consume tap alternatives.
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Affiliation(s)
- Gregory Pierce
- UCLA Luskin Center for Innovation, 3323 Luskin School of Public Affairs, 337 Charles E. Young Drive, United States of America.
| | - Silvia R Gonzalez
- UCLA Luskin Center for Innovation, 3323 Luskin School of Public Affairs, 337 Charles E. Young Drive, United States of America
| | - Peter Roquemore
- UCLA Luskin Center for Innovation, 3323 Luskin School of Public Affairs, 337 Charles E. Young Drive, United States of America
| | - Rebecca Ferdman
- UCLA Luskin Center for Innovation, 3323 Luskin School of Public Affairs, 337 Charles E. Young Drive, United States of America
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