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Abu-Freha N, Eraki L, Weissmann S, Cohen B, Gordon M, Kaf HA, Etzion O, Tailakh MA, Delgado JS. Nonalcoholic Fatty Liver Disease and Ethnicity: Lessons Learned from the Arab Population in Israel. J Immigr Minor Health 2024; 26:859-865. [PMID: 38767740 DOI: 10.1007/s10903-024-01604-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2024] [Indexed: 05/22/2024]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease. We aimed to investigate the potential similarities and differences regarding the disease among Arabs and Jews. Retrospective study included all patients older than 18 years with NAFLD diagnosis according to ICD-10 codes. Data regarding demographics, comorbidities, and outcomes were retrieved using the MdClone platform from "Clalit" in Israel. Data concerning 34,090 Arab patients and 173,500 Jewish patients with NAFLD were included. Arab patients were significantly younger at diagnosis (35.0 ± 13 years vs. 43.6 ± 15 years, p < 0.001) and had higher rates of obesity and diabetes mellitus (69.5% vs. 56.5% and 27.0% vs. 22.7%, p < 0.001, respectively). Arab patients had higher rates of cirrhosis and portal hypertension-related complications (2.5% vs. 2.0%, p < 0.001), esophageal varices (0.9% vs. 0.5%, p < 0.001), spontaneous bacterial peritonitis (0.3% vs. 0.1%, p < 0.001), and hepatorenal syndrome (0.3% vs. 0.1%, p < 0.001). There was no significant difference in the prevalence of hepatocellular carcinoma between study groups (0.4% vs. 0.5%, p = 0.156). Liver transplantation was performed in 0.2% of Arab NAFLD patients compared to 0.07% of Jewish NAFLD patients (p < 0.001). Lower rates of all-cause mortality were found among the Arab NAFLD patients versus Jewish NAFLD patients (7.7% versus 11.5%, p < 0.001). According to the Cox regression model, Arab ethnicity is a risk factor for death with OR of 1.36. Significant differences regarding comorbidities, complications, liver transplantations rates, and all-cause mortality were found among NAFLD patients of different ethnicities, hence specific population need specific consideration in prevention, early diagnosis and follow up.
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Affiliation(s)
- Naim Abu-Freha
- The Institute of Gastroenterology and Hepatology, Soroka University Medical Center, P.O. Box 151, Beer-Sheva, 84101, Israel.
- Faculty of Health Sciences, Ben-Gurion University in the Negev, Beer-Sheva, Israel.
| | - Lior Eraki
- Faculty of Health Sciences, Ben-Gurion University in the Negev, Beer-Sheva, Israel
| | - Sarah Weissmann
- Faculty of Health Sciences, Ben-Gurion University in the Negev, Beer-Sheva, Israel
- Soroka Clinical Research Center, Soroka University Medical Center, Beer- Sheva, Israel
| | - Bracha Cohen
- Soroka Clinical Research Center, Soroka University Medical Center, Beer- Sheva, Israel
| | - Michal Gordon
- Soroka Clinical Research Center, Soroka University Medical Center, Beer- Sheva, Israel
| | - Heba Abu Kaf
- The Institute of Gastroenterology and Hepatology, Soroka University Medical Center, P.O. Box 151, Beer-Sheva, 84101, Israel
- Faculty of Health Sciences, Ben-Gurion University in the Negev, Beer-Sheva, Israel
| | - Ohad Etzion
- The Institute of Gastroenterology and Hepatology, Soroka University Medical Center, P.O. Box 151, Beer-Sheva, 84101, Israel
- Faculty of Health Sciences, Ben-Gurion University in the Negev, Beer-Sheva, Israel
| | - Muhammad Abu Tailakh
- Faculty of Health Sciences, Ben-Gurion University in the Negev, Beer-Sheva, Israel
- Recanati School for Community Health Professions, Department of Nursing, Faculty of Health Sciences, Ben Gurion university of the Negev, Soroka University Medical Center, Beer Sheva, Beer-Sheva, Israel
| | - Jorge-Shmuel Delgado
- Faculty of Health Sciences, Ben-Gurion University in the Negev, Beer-Sheva, Israel
- Gastroenterology and Hepatology Department, Assuta Ashdod University Hospital, Ashdod, Israel
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Jennings V, Rigolon A, Thompson J, Murray A, Henderson A, Gragg RS. The Dynamic Relationship between Social Cohesion and Urban Green Space in Diverse Communities: Opportunities and Challenges to Public Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:800. [PMID: 38929046 PMCID: PMC11204079 DOI: 10.3390/ijerph21060800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/04/2024] [Accepted: 06/09/2024] [Indexed: 06/28/2024]
Abstract
Social cohesion is a key factor within social determinants of health and well-being. Urban green spaces can provide environments that potentially facilitate meaningful and positive social interactions that promote social cohesion, equity, human health, and well-being. However, the lack of integration of existing research on social cohesion, urban green spaces, and public health in diverse (e.g., racially and ethnically) communities limits culturally relevant strategies to address health disparities. In this manuscript, we synthesize research on the potential of urban green spaces to promote social cohesion and public health in historically excluded communities. Particularly, we explore the development of social cohesion as it relates to the social environment, built environment, leisure opportunities, green space maintenance, safety, and green gentrification. We highlight key factors and their application to meet opportunities and challenges to social and public health. A conceptual framework is presented to provide an overview and illustrate connections found in the literature.
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Affiliation(s)
- Viniece Jennings
- School of the Environment, Florida Agricultural and Mechanical University, Tallahassee, FL 32307, USA;
| | - Alessandro Rigolon
- Department City and Metropolitan Planning, The University of Utah, Salt Lake City, UT 84112, USA
| | - Jasmine Thompson
- Department of Public Health, Agnes Scott College, Decatur, GA 30030, USA
| | - Athena Murray
- Department of Public Health, Agnes Scott College, Decatur, GA 30030, USA
| | - Ariel Henderson
- Department of Public Health, Agnes Scott College, Decatur, GA 30030, USA
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Tulve NS, Geller AM, Hagerthey S, Julius SH, Lavoie ET, Mazur SL, Paul SJ, Frey HC. Challenges and opportunities for research supporting cumulative impact assessments at the United States environmental protection agency's office of research and development. LANCET REGIONAL HEALTH. AMERICAS 2024; 30:100666. [PMID: 38292929 PMCID: PMC10825320 DOI: 10.1016/j.lana.2023.100666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 02/01/2024]
Affiliation(s)
- Nicolle S. Tulve
- United States Environmental Protection Agency, Office of Research and Development, Research Triangle Park, NC, USA
| | - Andrew M. Geller
- United States Environmental Protection Agency, Office of Research and Development, Research Triangle Park, NC, USA
| | - Scot Hagerthey
- United States Environmental Protection Agency, Office of Research and Development, Washington, DC, USA
| | - Susan H. Julius
- United States Environmental Protection Agency, Office of Research and Development, Washington, DC, USA
| | - Emma T. Lavoie
- United States Environmental Protection Agency, Office of Research and Development, Washington, DC, USA
| | - Sarah L. Mazur
- United States Environmental Protection Agency, Office of Research and Development, Washington, DC, USA
| | - Sean J. Paul
- United States Environmental Protection Agency, Office of Research and Development, Washington, DC, USA
| | - H. Christopher Frey
- United States Environmental Protection Agency, Office of Research and Development, Washington, DC, USA
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Smarr MM, Avakian M, Lopez AR, Onyango B, Amolegbe S, Boyles A, Fenton SE, Harmon QE, Jirles B, Lasko D, Moody R, Schelp J, Sutherland V, Thomas L, Williams CJ, Dixon D. Broadening the Environmental Lens to Include Social and Structural Determinants of Women's Health Disparities. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:15002. [PMID: 38227347 PMCID: PMC10790815 DOI: 10.1289/ehp12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 12/06/2023] [Accepted: 12/14/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND Due to the physical, metabolic, and hormonal changes before, during, and after pregnancy, women-defined here as people assigned female at birth-are particularly susceptible to environmental insults. Racism, a driving force of social determinants of health, exacerbates this susceptibility by affecting exposure to both chemical and nonchemical stressors to create women's health disparities. OBJECTIVES To better understand and address social and structural determinants of women's health disparities, the National Institute of Environmental Health Sciences (NIEHS) hosted a workshop focused on the environmental impacts on women's health disparities and reproductive health in April 2022. This commentary summarizes foundational research and unique insights shared by workshop participants, who emphasized the need to broaden the definition of the environment to include upstream social and structural determinants of health. We also summarize current challenges and recommendations, as discussed by workshop participants, to address women's environmental and reproductive health disparities. DISCUSSION The challenges related to women's health equity, as identified by workshop attendees, included developing research approaches to better capture the social and structural environment in both human and animal studies, integrating environmental health principles into clinical care, and implementing more inclusive publishing and funding approaches. Workshop participants discussed recommendations in each of these areas that encourage interdisciplinary collaboration among researchers, clinicians, funders, publishers, and community members. https://doi.org/10.1289/EHP12996.
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Affiliation(s)
- Melissa M. Smarr
- Division of Extramural Research and Training, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | | | | | | | - Sara Amolegbe
- Office of the Director, National Institutes of Health, Bethesda, Maryland, USA
| | - Abee Boyles
- Division of Extramural Research and Training, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Suzanne E. Fenton
- Division of Translational Toxicology, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Quaker E. Harmon
- Division of Intramural Research, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Bill Jirles
- Office of the Director, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Denise Lasko
- Division of Translational Toxicology, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Rosemary Moody
- Division of Extramural Research, National Institute on Drug Abuse, Bethesda, Maryland, USA
| | - John Schelp
- Office of the Director, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Vicki Sutherland
- Division of Translational Toxicology, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Laura Thomas
- Division of Translational Research, National Institute of Mental Health, Bethesda, Maryland, USA
| | - Carmen J. Williams
- Division of Intramural Research, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Darlene Dixon
- Division of Translational Toxicology, National Institute of Environmental Health Sciences, Durham, North Carolina, USA
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Carmichael AE, Lennon NH, Qualters JR. Analysis of social determinants of health and individual factors found in health equity frameworks: Applications to injury research. JOURNAL OF SAFETY RESEARCH 2023; 87:508-518. [PMID: 38081722 PMCID: PMC10775896 DOI: 10.1016/j.jsr.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 10/10/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION This research evaluated existing health equity frameworks as they relate to social determinants of health (SDOHs) and individual factors that may impact injury outcomes and identify gaps in coverage using the Healthy People (HP) 2030 key domains. METHODS The study used a list of health equity frameworks sourced from previous literature. SDOHs and individual factors from each framework were identified and categorized into the Healthy People 2030 domains. Five injury topic areas were used as examples for how SDOHs and individual factors can be compared to injury topic-specific health disparities to identify health equity frameworks to apply to injury research. RESULTS The study identified 59 SDOHs and individual factors from the list of 33 health equity frameworks. The number of SDOHs and individual factors identified varied by Healthy People 2030 domain: Neighborhood and Built Environment contained 16 (27.1%) SDOHs and individual actors, Social and Community Context contained 22 (37.3%), Economic Stability contained 10 (16.9%), Healthcare Access and Quality contained 10 (16.9%), and Education Access and Quality contained one (1.7%). Twenty-three (39.0%) SDOHs/individual factors related to traumatic brain injury, thirteen (22.0%) related to motor vehicle crashes and suicide, 11 (18.6%) related to drowning and older adult falls. Eight frameworks (24.2%) covered all HP 2030 key domains and may be applicable to injury topics. CONCLUSIONS Incorporating health equity into research is critical. Health equity frameworks can provide a way to systematically incorporate health equity into research. The findings from this study may be useful to health equity research by providing a resource to injury and other public health fields. PRACTICAL APPLICATIONS Health equity frameworks are a practical tool to guide injury research, translation, evaluation, and program implementation. The findings from this study can be used to guide the application of health equity frameworks in injury research for specific topic areas.
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Affiliation(s)
- Andrea E Carmichael
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Natalie H Lennon
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Judith R Qualters
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Weiss MC, Wang L, Sargis RM. Hormonal Injustice: Environmental Toxicants as Drivers of Endocrine Health Disparities. Endocrinol Metab Clin North Am 2023; 52:719-736. [PMID: 37865484 PMCID: PMC10929240 DOI: 10.1016/j.ecl.2023.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
The toll of multiple endocrine disorders has increased substantially in recent decades, and marginalized populations bear a disproportionate burden of disease. Because of the significant individual and societal impact of these conditions, it is essential to identify and address all modifiable risk factors contributing to these disparities. Abundant evidence now links endocrine dysfunction with exposure to endocrine-disrupting chemicals (EDCs), with greater exposures to multiple EDCs occurring among vulnerable groups, such as racial/ethnic minorities, those with low incomes, and others with high endocrine disease burdens. Identifying and eliminating EDC exposures is an essential step in achieving endocrine health equity.
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Affiliation(s)
- Margaret C Weiss
- School of Public Health, University of Illinois at Chicago, 1603 West Taylor Street, Chicago, IL 60612, USA; College of Medicine, University of Illinois at Chicago, 1853 West Polk Street, Chicago, IL 60612, USA; Division of Endocrinology, Diabetes, and Metabolism, University of Illinois at Chicago, 835 South Wolcott, Suite E625, M/C 640, Chicago, IL 60612, USA
| | - Luyu Wang
- College of Medicine, University of Illinois at Chicago, 1853 West Polk Street, Chicago, IL 60612, USA; Division of Endocrinology, Diabetes, and Metabolism, University of Illinois at Chicago, 835 South Wolcott, Suite E625, M/C 640, Chicago, IL 60612, USA
| | - Robert M Sargis
- College of Medicine, University of Illinois at Chicago, 1853 West Polk Street, Chicago, IL 60612, USA; Division of Endocrinology, Diabetes, and Metabolism, University of Illinois at Chicago, 835 South Wolcott, Suite E625, M/C 640, Chicago, IL 60612, USA; Chicago Center for Health and Environment, School of Public Health, University of Illinois at Chicago, 1603 West Taylor Street, Chicago, IL 60612, USA; Section of Endocrinology, Diabetes, and Metabolism, Jesse Brown Veterans Affairs Medical Center, 820 South Damen, Chicago, IL 60612, USA.
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Rushing BR, Thessen AE, Soliman GA, Ramesh A, Sumner SCJ. The Exposome and Nutritional Pharmacology and Toxicology: A New Application for Metabolomics. EXPOSOME 2023; 3:osad008. [PMID: 38766521 PMCID: PMC11101153 DOI: 10.1093/exposome/osad008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
The exposome refers to all of the internal and external life-long exposures that an individual experiences. These exposures, either acute or chronic, are associated with changes in metabolism that will positively or negatively influence the health and well-being of individuals. Nutrients and other dietary compounds modulate similar biochemical processes and have the potential in some cases to counteract the negative effects of exposures or enhance their beneficial effects. We present herein the concept of Nutritional Pharmacology/Toxicology which uses high-information metabolomics workflows to identify metabolic targets associated with exposures. Using this information, nutritional interventions can be designed toward those targets to mitigate adverse effects or enhance positive effects. We also discuss the potential for this approach in precision nutrition where nutrients/diet can be used to target gene-environment interactions and other subpopulation characteristics. Deriving these "nutrient cocktails" presents an opportunity to modify the effects of exposures for more beneficial outcomes in public health.
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Affiliation(s)
- Blake R. Rushing
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Anne E Thessen
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Ghada A. Soliman
- Department of Environmental, Occupational and Geospatial Health Sciences, City University of New York-Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Aramandla Ramesh
- Department of Biochemistry, Cancer Biology, Neuroscience & Pharmacology, Meharry Medical College, Nashville, TN, USA
| | - Susan CJ Sumner
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Sprague NL, Zonnevylle HM, Jackson Hall L, Williams R, Dains H, Liang D, Ekenga CC. Environmental health perceptions of urban youth from low-income communities: A qualitative photovoice study and framework. Health Expect 2023; 26:1832-1842. [PMID: 37317064 PMCID: PMC10485307 DOI: 10.1111/hex.13776] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 04/26/2023] [Accepted: 04/30/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Children are amongst the most susceptible groups to environmental exposures, for both immediate and life-course health outcomes. Despite their increased susceptibility, children's knowledge, experiences and voices are understudied. A deeper understanding of children's environmental health perceptions has the potential to better inform policy, develop targeted interventions and improve public health outcomes. METHODS In this study, our community-academic partnership used the Photovoice research method to examine how urban children from low-income communities perceive environmental influences on their health. Twenty children, ages 10-12, took photographs and participated in focus group interviews regarding their perspectives on how the environment influences their health. RESULTS Qualitative analyses revealed five major thematic categories: environmental exposures, environmental health sentiments, environmental health outcomes, interest in environmental health and environmental health solutions. We used the findings to develop an environmental health perspective theoretical framework that can inform future work designed to promote the environmental health and well-being of children from low-income communities in urban communities. CONCLUSION Photovoice enabled children from low-income communities to capture and communicate their environmental health perceptions. These findings have the potential to inform and identify potential targets and opportunities for environmental health interventions and promotion in their communities. PATIENT OR PUBLIC CONTRIBUTION Partnerships with community-based organizations were central to the present study. By design, these community-based partners were involved in the conduct and procedures of the study.
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Affiliation(s)
- Nadav L. Sprague
- Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew York CityNew YorkUSA
- Gateway to the Great OutdoorsSt. LouisMissouriUSA
| | - Hannah M. Zonnevylle
- Gateway to the Great OutdoorsSt. LouisMissouriUSA
- Gangarosa Department of Environmental Health, Rollins School of Public HealthEmory UniversityAtlantaGeorgiaUSA
| | | | | | - Hannah Dains
- Gateway to the Great OutdoorsSt. LouisMissouriUSA
| | - Donghai Liang
- Gangarosa Department of Environmental Health, Rollins School of Public HealthEmory UniversityAtlantaGeorgiaUSA
| | - Christine C. Ekenga
- Gangarosa Department of Environmental Health, Rollins School of Public HealthEmory UniversityAtlantaGeorgiaUSA
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Clougherty JE, Ocampo P. Perception Matters: Perceived vs. Objective Air Quality Measures and Asthma Diagnosis among Urban Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6648. [PMID: 37681788 PMCID: PMC10487870 DOI: 10.3390/ijerph20176648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/09/2023] [Accepted: 08/23/2023] [Indexed: 09/09/2023]
Abstract
Urban air pollution is consistently linked to poorer respiratory health, particularly in communities of lower socioeconomic position (SEP), disproportionately located near highways and industrial areas and often with elevated exposures to chronic psychosocial stressors. Fewer studies, however, have considered air pollution itself as a psychosocial stressor and whether pollution may be impacting health through both direct physiologic and psychosocial pathways. We examined data on perceived air pollution exposures from a spatially representative survey of New York City adults through summer and winter 2012 (n = 1183) using residence-specific ambient nitrogen dioxide (NO2) and fine particulate matter (PM2.5) exposure estimates. We used logistic regression to compare associations for perceived and objective air quality on self-reported asthma and general health, adjusting for sociodemographics and mental health. In models including all exposure metrics, we found small but significant associations for perceived air quality (OR = 1.12, 95% CI: 1.04-1.22) but not for NO2 or PM2.5. Neither perceived nor objective pollution was significantly associated with self-reported general health. Results suggest that perceived air quality may be significantly associated with adult asthma, more so than objective air pollution and after adjusting for mental health-associations not observed for self-reported general health.
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Affiliation(s)
- Jane E. Clougherty
- Department of Environmental & Occupational Health, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, USA
| | - Pilar Ocampo
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
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Oluyomi AO, Mazul AL, Dong Y, White DL, Hartman CM, Richardson P, Chan W, Garcia JM, Kramer JR, Chiao E. Area deprivation index and segregation on the risk of HIV: a U.S. Veteran case-control study. LANCET REGIONAL HEALTH. AMERICAS 2023; 20:100468. [PMID: 36992707 PMCID: PMC10041556 DOI: 10.1016/j.lana.2023.100468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 01/13/2023] [Accepted: 02/20/2023] [Indexed: 03/31/2023]
Abstract
Background Preventing HIV infection remains a critically important tool in the continuing fight against HIV/AIDS. The primary aim is to evaluate the effect and interactions between a composite area-level social determinants of health measure and an area-level measure of residential segregation on the risk of HIV/AIDS in U.S. Veterans. Methods Using the individual-level patient data from the U.S. Department of Veterans Affairs, we constructed a case-control study of veterans living with HIV/AIDS (VLWH) and age-, sex assigned at birth- and index date-matched controls. We geocoded patient's residential address to ascertain their neighborhood and linked their information to two measures of neighborhood-level disadvantage: area deprivation index (ADI) and isolation index (ISOL). We used logistic regression to estimate the odds ratio (OR) and 95% confidence interval (CI) for comparing VLWH with matched controls. We performed analyses for the entire U.S. and separately for each U.S. Census division. Findings Overall, living in minority-segregated neighborhoods was associated with a higher risk of HIV (OR: 1.88 (95% CI: 1.79-1.97) while living in higher ADI neighborhoods was associated with a lower risk of HIV (OR: 0.88; 95% CI: 0.84-0.92). The association between living in a higher ADI neighborhood and HIV was inconsistent across divisions, while living in minority-segregated neighborhoods was consistently associated with increased risk across all divisions. In the interaction model, individuals from low ADI and high ISOL neighborhoods had a higher risk of HIV in three divisions: East South Central; West South Central, and Pacific. Interpretation Our results suggest that residential segregation may prevent people in disadvantaged neighborhoods from protecting themselves from HIV independent from access to health care. There is the need to advance knowledge about the neighborhood-level social-structural factors that influence HIV vulnerability toward developing interventions needed to achieve the goal of ending the HIV epidemic. Funding US National Cancer Institute.
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Affiliation(s)
- Abiodun O. Oluyomi
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
- Gulf Coast Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA
| | - Angela L. Mazul
- Gulf Coast Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA
- Department of Otolaryngology/Head and Neck Surgery, Washington University School of Medicine, Saint Louis, MO, USA
| | - Yongquan Dong
- VA Health Services Research Center of Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Donna L. White
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
- VA Health Services Research Center of Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Center for Translational Research in Inflammatory Disease (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Section of Health Services Research, Department of Medicine, Baylor College of Medicine, USA
| | - Christine M. Hartman
- VA Health Services Research Center of Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Peter Richardson
- VA Health Services Research Center of Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Section of Health Services Research, Department of Medicine, Baylor College of Medicine, USA
| | - Wenyaw Chan
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston, USA
| | - Jose M. Garcia
- Geriatric Research, Education, and Clinical Center, VA Puget Sound Health Care System and Div. of Geriatrics, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Jennifer R. Kramer
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
- VA Health Services Research Center of Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Section of Health Services Research, Department of Medicine, Baylor College of Medicine, USA
| | - Elizabeth Chiao
- Department of Epidemiology, Division of Cancer Prevention and Population Sciences, Department of General Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Corresponding author. Epidemiology Department, T 713-792-3020 F 713-563-1367, Unit 1340, 1155 Pressler, Duncan Building (CPB), 4th Floor, D 713-792-1860 C 713-303-1978, USA.
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11
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Hicken MT, Payne-Sturges D, McCoy E. Evaluating Race in Air Pollution and Health Research: Race, PM 2.5 Air Pollution Exposure, and Mortality as a Case Study. Curr Environ Health Rep 2023; 10:1-11. [PMID: 36689136 PMCID: PMC10947792 DOI: 10.1007/s40572-023-00390-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE OF REVIEW Racial inequities in air pollution exposure have been documented. There is also interest in documenting the modifying role of race in the link between air pollution and health. However, the empirical literature in this area has yielded mixed results with potentially unclear policy implications. We critically evaluate recent empirical papers on the interactive association between race and air pollution exposure on adult mortality in the USA as a case study of the race, pollution, and health literature. Specifically, we evaluate these studies for the conceptualization and discussion of race and the use of race variables that may contribute to the ambiguous results and policy implications both in this specific literature and in the broader literature. RECENT FINDINGS We evaluate ten empirical studies from 2016 to 2022 on the modifying role of race in the association between short- and long-term PM2.5 exposure and specific types of adult mortality (all cause, non-accidental, and heart or cardiovascular diseases) in the USA. In addition to comparing and contrasting the empirical results, we focus our review on the conceptualization, measurement, modeling, and discussion of race and the race variables. Overall, the results indicate no consistent role of race in the association between PM2.5 exposure and mortality. Moreover, conceptualization and discussion of race was often brief and incomplete, even when the empirical results were unexpected or counterintuitive. To build on recent discussions in the epidemiology and environmental epidemiology literature more specifically, we provide a detailed discussion of the meaning of race, the race variables, and the cultural and structural racism that some argue are proxied by race variables. We use theoretical scholarship from the humanities and social sciences along with empirical work from the environmental literature to provide recommendations for future research that can provide an evidence base to inform both social and environmental policy.
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Affiliation(s)
- Margaret T Hicken
- Institute for Social Research, University of Michigan, 426 Thompson Street3358 ISR, Ann Arbor, MI, 48106, USA.
| | - Devon Payne-Sturges
- School of Public Health, Maryland Institute for Applied Environmental Health, University of Maryland, 255 Valley Drive, College Park, MD, 20742, USA
| | - Ember McCoy
- School for Environment and Sustainability, University of Michigan, 440 Church Street; 4503 Dana, Ann Arbor, MI, 48109, USA
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Amolegbe SM, Lopez AR, Velasco ML, Carlin DJ, Heacock ML, Henry HF, Trottier BA, Suk WA. Adapting to Climate Change: Leveraging Systems-Focused Multidisciplinary Research to Promote Resilience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14674. [PMID: 36429393 PMCID: PMC9690097 DOI: 10.3390/ijerph192214674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/02/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Approximately 2000 official and potential Superfund sites are located within 25 miles of the East or Gulf coasts, many of which will be at risk of flooding as sea levels rise. More than 60 million people across the United States live within 3 miles of a Superfund site. Disentangling multifaceted environmental health problems compounded by climate change requires a multidisciplinary systems approach to inform better strategies to prevent or reduce exposures and protect human health. The purpose of this minireview is to present the National Institute of Environmental Health Sciences Superfund Research Program (SRP) as a useful model of how this systems approach can help overcome the challenges of climate change while providing flexibility to pivot to additional needs as they arise. It also highlights broad-ranging SRP-funded research and tools that can be used to promote health and resilience to climate change in diverse contexts.
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Affiliation(s)
- Sara M. Amolegbe
- Superfund Research Program, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (HHS), Durham, NC 27709, USA
| | | | | | - Danielle J. Carlin
- Superfund Research Program, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (HHS), Durham, NC 27709, USA
| | - Michelle L. Heacock
- Superfund Research Program, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (HHS), Durham, NC 27709, USA
| | - Heather F. Henry
- Superfund Research Program, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (HHS), Durham, NC 27709, USA
| | - Brittany A. Trottier
- Superfund Research Program, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (HHS), Durham, NC 27709, USA
| | - William A. Suk
- Superfund Research Program, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (HHS), Durham, NC 27709, USA
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Lennon NH, Carmichael AE, Qualters JR. Health equity guiding frameworks and indices in injury: A review of the literature. JOURNAL OF SAFETY RESEARCH 2022; 82:469-481. [PMID: 36031278 PMCID: PMC10569058 DOI: 10.1016/j.jsr.2022.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND In early 2021, CDC released the CORE Health Equity Strategy, which resolves to integrate a comprehensive health equity approach to the work of the Agency. One priority of the Injury Center's Division of Injury Prevention is to move health equity research in injury forward. The purpose of this research is to perform an initial exploration of health equity guiding frameworks and indices to better understand which of these has been applied to injury research topics. METHODS A PubMed and CINAHL search of meta-analysis and systematic review articles was conducted from January 1998 through April 2022. Articles of any type and additional frameworks/indices were also identified from staff knowledge of the literature. Books were also considered, where accessible. The following areas were reviewed for each resource: population addressed, guiding framework/index, other health equity variables, gaps identified, and whether the articles addressed an injury topic. FINDINGS The PubMed/CINAHL search produced 230 articles, and an additional 29 articles and 8 books were added from previous knowledge of the literature, resulting in a total of 267 resources for review. There were 60 frameworks/indices compiled that were relevant to health equity. Out of all the resources, three reported on an injury topic and used the PROGRESS-Plus framework, the WHO Social Determinants of Health Conceptual Framework, and a social-ecological framework. CONCLUSIONS This study found there were many frameworks/indices for measuring health equity; however, there were few injury-related meta-analysis and systematic review articles. Some frameworks/indices may be more appropriate than others for measuring health equity in injury topic areas, depending on which social determinants of health (SDOHs) they address. PRACTICAL APPLICATIONS Measuring health equity in injury and other public health research areas can help build a foundation of evidence. Moving forward, injury researchers can consider the frameworks/indices identified through this study in their health equity injury research.
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Affiliation(s)
- Natalie H Lennon
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, GA 30341, USA; Oak Ridge Associated Universities (ORAU), Division of Injury Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
| | - Andrea E Carmichael
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, GA 30341, USA
| | - Judith R Qualters
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, GA 30341, USA
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Ebrahimi H, Sattari F, Lefsrud L, Macciotta R. Human vulnerability modeling and risk analysis of railway transportation of hazardous materials. J Loss Prev Process Ind 2022. [DOI: 10.1016/j.jlp.2022.104882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Zhao H, Yue L, Jia Z, Su L. Spatial Inequalities and Influencing Factors of Self-Rated Health and Perceived Environmental Hazards in a Metropolis: A Case Study of Zhengzhou City, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7551. [PMID: 35742800 PMCID: PMC9224377 DOI: 10.3390/ijerph19127551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 02/01/2023]
Abstract
Research on environmental pollution and public health has aroused increasing concern from international scholars; particularly, environmental hazards are among the important issues in China, focusing public attention on significant health risks. However, there are few studies concentrated on how perceived environmental hazards are characterized by spatial variation and on the impact of these risks on residents' health. Based on a large-scale survey of Zhengzhou City in 2020, we investigated how the self-rated health of residents and the environmental hazards perceived by them were spatially inequal at a fine (subdistrict) scale in Zhengzhou City, China, and examined the relationship among self-rated health, environmental hazards, and geographical context. The Getis-Ord Gi* method was applied to explore the spatially dependent contextual (neighborhood) effect on environmental health inequality, and the ordered multivariate logistic regression method was used to examine the correlative factors with environmental hazards, geographical context, and health inequality. The results reveal that self-rated health and environmental hazards were disproportionately distributed across the whole city and that these distributions showed certain spatial cluster characteristics. The hot spot clusters of self-rated health had favorable environmental quality where the hot spot clusters of environmental hazards were located and vice versa. In addition, health inequality was evident and was related to gender, income level, educational attainment, and housing area of residents, and the inequalities of environmental hazards existed with respect to income and housing area. Meanwhile, environmental risk inequalities associated with the social vulnerability of residents (the poor and those with low educational attainment) were obvious, with those residents experiencing a disproportionately high exposure to environmental hazards and reporting bad health conditions. The role of the geographical context (subdistrict location feature) also helps to explain the spatial distribution of health and environmental inequalities. Residents with better exposure to green coverage generally reported higher levels of self-rated health condition. In addition, the geographical location of the subdistrict also had a significant impact on the difference in residents' self-rated health status. The purpose of this study is to provide reference for policy makers to optimize the spatial pattern of urban public services and improve public health and environmental quality at a fine scale.
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Affiliation(s)
| | - Li Yue
- Key Research Institute of Yellow River Civilization and Sustainable Development & Collaborative Innovation, Center on Yellow River Civilization Jointly Built by Henan Province and Ministry of Education, Henan University, Kaifeng 475001, China; (H.Z.); (Z.J.); (L.S.)
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Salvo D, Lemoine P, Janda KM, Ranjit N, Nielsen A, van den Berg A. Exploring the Impact of Policies to Improve Geographic and Economic Access to Vegetables among Low-Income, Predominantly Latino Urban Residents: An Agent-Based Model. Nutrients 2022; 14:646. [PMID: 35277005 PMCID: PMC8839639 DOI: 10.3390/nu14030646] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/19/2022] [Accepted: 01/26/2022] [Indexed: 02/05/2023] Open
Abstract
Modifying the food environment of cities is a promising strategy for improving dietary behaviors, but using traditional empirical methods to test the effectiveness of these strategies remains challenging. We developed an agent-based model to simulate the food environment of Austin, Texas, USA, and to test the impact of different food access policies on vegetable consumption among low-income, predominantly Latino residents. The model was developed and calibrated using empirical data from the FRESH-Austin Study, a natural experiment. We simulated five policy scenarios: (1) business as usual; (2)−(4) expanding geographic and/or economic healthy food access via the Fresh for Less program (i.e., through farm stands, mobile markets, and healthy corner stores); and (5) expanding economic access to vegetables in supermarkets and small grocers. The model predicted that increasing geographic and/or economic access to healthy corner stores will not meaningfully improve vegetable intake, whilst implementing high discounts (>85%) on the cost of vegetables, or jointly increasing geographic and economic access to mobile markets or farm stands, will increase vegetable intake among low-income groups. Implementing discounts at supermarkets and small grocers is also predicted to be an effective policy for increasing vegetable consumption. This work highlights the utility of agent-based modeling for informing food access policies.
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Affiliation(s)
- Deborah Salvo
- Prevention Research Center, Brown School, Washington University in Saint Louis, Saint Louis, MO 63130, USA
| | - Pablo Lemoine
- Centro Nacional de Consultoría, Bogotá 110221, Colombia;
| | - Kathryn M. Janda
- UTHealth School of Public Health, Austin, TX 78701, USA; (K.M.J.); (N.R.); (A.N.); (A.v.d.B.)
| | - Nalini Ranjit
- UTHealth School of Public Health, Austin, TX 78701, USA; (K.M.J.); (N.R.); (A.N.); (A.v.d.B.)
| | - Aida Nielsen
- UTHealth School of Public Health, Austin, TX 78701, USA; (K.M.J.); (N.R.); (A.N.); (A.v.d.B.)
| | - Alexandra van den Berg
- UTHealth School of Public Health, Austin, TX 78701, USA; (K.M.J.); (N.R.); (A.N.); (A.v.d.B.)
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DeRouen MC, Canchola AJ, Thompson CA, Jin A, Nie S, Wong C, Lichtensztajn D, Allen L, Patel MI, Daida YG, Luft HS, Shariff-Marco S, Reynolds P, Wakelee HA, Liang SY, Waitzfelder BE, Cheng I, Gomez SL. Incidence of Lung Cancer Among Never-Smoking Asian American, Native Hawaiian, and Pacific Islander Females. J Natl Cancer Inst 2022; 114:78-86. [PMID: 34345919 PMCID: PMC8755498 DOI: 10.1093/jnci/djab143] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/17/2021] [Accepted: 07/16/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Although lung cancer incidence rates according to smoking status, sex, and detailed race/ethnicity have not been available, it is estimated that more than half of Asian American, Native Hawaiian, and Pacific Islander (AANHPI) females with lung cancer have never smoked. METHODS We calculated age-adjusted incidence rates for lung cancer according to smoking status and detailed race/ethnicity among females, focusing on AANHPI ethnic groups, and assessed relative incidence across racial/ethnic groups. We used a large-scale dataset that integrates data from electronic health records from 2 large health-care systems-Sutter Health in Northern California and Kaiser Permanente Hawai'i-linked to state cancer registries for incident lung cancer diagnoses between 2000 and 2013. The study population included 1 222 694 females (n = 244 147 AANHPI), 3297 of which were diagnosed with lung cancer (n = 535 AANHPI). RESULTS Incidence of lung cancer among never-smoking AANHPI as an aggregate group was 17.1 per 100 000 (95% confidence interval [CI] = 14.9 to 19.4) but varied widely across ethnic groups. Never-smoking Chinese American females had the highest rate (22.8 per 100 000, 95% CI = 17.3 to 29.1). Except for Japanese American females, incidence among every never-smoking AANHPI female ethnic group was higher than that of never-smoking non-Hispanic White females, from 66% greater among Native Hawaiian females (incidence rate ratio = 1.66, 95% CI = 1.03 to 2.56) to more than 100% greater among Chinese American females (incidence rate ratio = 2.26, 95% CI = 1.67 to 3.02). CONCLUSIONS Our study revealed high rates of lung cancer among most never-smoking AANHPI female ethnic groups. Our approach illustrates the use of innovative data integration to dispel the myth that AANHPI females are at overall reduced risk of lung cancer and demonstrates the need to disaggregate this highly diverse population.
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Affiliation(s)
- Mindy C DeRouen
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Alison J Canchola
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Greater Bay Area Cancer Registry, University of California San Francisco, CA, USA
| | - Caroline A Thompson
- San Diego State University School of Public Health, San Diego, CA, USA
- University of California San Diego School of Medicine, San Diego, CA, USA
- Sutter Health Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
| | - Anqi Jin
- Sutter Health Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
| | - Sixiang Nie
- Kaiser Permanente Hawai’i Center for Integrated Health Care Research, Honolulu, HI, USA
| | - Carmen Wong
- Kaiser Permanente Hawai’i Center for Integrated Health Care Research, Honolulu, HI, USA
| | - Daphne Lichtensztajn
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Greater Bay Area Cancer Registry, University of California San Francisco, CA, USA
| | - Laura Allen
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | | | - Yihe G Daida
- Kaiser Permanente Hawai’i Center for Integrated Health Care Research, Honolulu, HI, USA
| | - Harold S Luft
- Sutter Health Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
| | - Salma Shariff-Marco
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
- Greater Bay Area Cancer Registry, University of California San Francisco, CA, USA
| | - Peggy Reynolds
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Heather A Wakelee
- Division of Oncology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Su-Ying Liang
- Sutter Health Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA
| | - Beth E Waitzfelder
- Kaiser Permanente Hawai’i Center for Integrated Health Care Research, Honolulu, HI, USA
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
- Greater Bay Area Cancer Registry, University of California San Francisco, CA, USA
| | - Scarlett L Gomez
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
- Greater Bay Area Cancer Registry, University of California San Francisco, CA, USA
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Leach C, Schroeck N, Blessman J, Rorai V, Cooper-Sargent M, Lichtenberg PA, Trentacosta CJ. Engaged communication of environmental health science: Processes and outcomes of urban academic-community partnerships. APPLIED ENVIRONMENTAL EDUCATION AND COMMUNICATION (PRINT) 2022; 21:7-22. [PMID: 35479260 PMCID: PMC9037758 DOI: 10.1080/1533015x.2021.1930609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Those who bear the greatest environmental burdens often have the least access to information, and explanations for engaging communities to develop solutions are lacking. We describe, and use a case study to depict, a participatory process of urban academic and community members to co-produce educational and communication tools. Over five years, we interfaced with 763 individuals at eleven events and three times that (n=2,273) through attendees' networks at 109 small group events using snowball methods. The resulting communication tools, paired resources, and mobile dissemination were responsive to residents' circumstances and enhanced their ability to access health protecting information and resources.
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Affiliation(s)
- Carrie Leach
- Center for Urban Responses to Environmental Stressors, Wayne State University, Detroit, US,Institute of Gerontology, Wayne State University, Detroit, US,Correspondence concerning this article should be addressed to Carrie Leach, Center for Urban Responses to Environmental Stressors & Institute of Gerontology, Wayne State University, 87 East Ferry Street, Detroit, MI 48202.
| | - N. Schroeck
- Center for Urban Responses to Environmental Stressors, Wayne State University, Detroit, US,University of Detroit Mercy School of Law, Detroit, US
| | - J. Blessman
- Center for Urban Responses to Environmental Stressors, Wayne State University, Detroit, US,Family Medicine and Public Health Sciences, Wayne State University, Detroit, US
| | - V. Rorai
- Institute of Gerontology, Wayne State University, Detroit, US
| | | | | | - C. J. Trentacosta
- Center for Urban Responses to Environmental Stressors, Wayne State University, Detroit, US,Department of Psychology, Wayne State University, Detroit, US
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Liu M, Nordstrom M, Forand S, Lewis-Michl E, Wattigney WA, Kannan K, Wang W, Irvin-Barnwell E, Hwang SA. Assessing exposures to per- and polyfluoroalkyl substances in two populations of Great Lakes Basin fish consumers in Western New York State. Int J Hyg Environ Health 2021; 240:113902. [PMID: 34915281 DOI: 10.1016/j.ijheh.2021.113902] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Fish and other seafood are an important dietary source of per- and polyfluoroalkyl substances (PFAS) exposure in many areas of the world, and PFAS were found to be pervasive in fish from the Great Lakes area. Few studies, however, have examined the associations between Great Lakes Basin fish consumption and PFAS exposure. Many licensed anglers and Burmese refugees and immigrants residing in western New York State consume fish caught from the Great Lakes and surrounding waters, raising their risk of exposure to environmental contaminants including PFAS. The aims of this study were to: 1) present the PFAS exposure profile of the licensed anglers and Burmese refugees and 2) examine the associations between serum PFAS levels and local fish consumption. METHODS Licensed anglers (n = 397) and Burmese participants (n = 199) provided blood samples and completed a detailed questionnaire in 2013. We measured 12 PFAS in serum. Multiple linear regression was used to assess associations between serum PFAS concentrations and self-reported consumption of fish from Great Lakes waters. RESULTS Licensed anglers and Burmese participants reported consuming a median of 16 (IQR: 6-36) and 88 (IQR: 44-132) meals of locally caught fish in the year before sample collection, respectively (data for Burmese group restricted to 10 months of the year). Five PFAS were detected in almost all study participants (PFOS, PFOA, PFHxS, PFNA and PFDA; 97.5-100%). PFOS had the highest median serum concentration in licensed anglers (11.6 ng/mL) and the Burmese (35.6 ng/mL), approximately two and six times that of the U.S. general population, respectively. Serum levels of other PFAS in both groups were generally low and comparable to those in the general U.S. POPULATION Among licensed anglers, Great Lakes Basin fish meals over the past year were positively associated with serum PFOS (P < 0.0001), PFDA (P < 0.0001), PFHxS (P = 0.01), and PFNA (P = 0.02) and the number of years consuming locally caught fish was positively associated with serum PFOS (P = 0.01) and PFDA (P = 0.01) levels. In the Burmese group, consuming Great Lakes Basin fish more than three times a week in the past summer was positively associated with serum PFOS (P = 0.004) and PFDA (P = 0.02) among the Burmese of non-Karen ethnicity, but not among those of Karen ethnicity, suggesting potential ethnic differences in PFAS exposure. CONCLUSIONS Great Lakes Basin fish consumption was associated with an increase in blood concentrations of some PFAS, and especially of PFOS, among licensed anglers and Burmese refugees and immigrants in western New York State. In the Burmese population, there may be other important PFAS exposure routes related to residential history and ethnicity. Continued outreach efforts to increase fish advisory awareness and reduce exposure to contaminants are needed among these populations.
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Affiliation(s)
- Ming Liu
- New York State Department of Health, Bureau of Environmental & Occupational Epidemiology, Empire State Plaza-Corning Tower, Room 1203, Albany, NY, 12237, United States.
| | - Monica Nordstrom
- New York State Department of Health, Bureau of Environmental & Occupational Epidemiology, Empire State Plaza-Corning Tower, Room 1203, Albany, NY, 12237, United States
| | - Steven Forand
- New York State Department of Health, Bureau of Environmental & Occupational Epidemiology, Empire State Plaza-Corning Tower, Room 1203, Albany, NY, 12237, United States
| | - Elizabeth Lewis-Michl
- New York State Department of Health, Bureau of Environmental & Occupational Epidemiology, Empire State Plaza-Corning Tower, Room 1203, Albany, NY, 12237, United States
| | - Wendy A Wattigney
- Agency for Toxic Substances and Disease Registry, Division of Toxicology and Human Health Science, 4770 Buford Highway, Atlanta, GA, 30341, United States
| | - Kurunthachalam Kannan
- New York State Department of Health, Wadsworth Center, Empire State Plaza, Albany, NY, 12201, United States; New York University School of Medicine, Department of Pediatrics and Department of Environmental Medicine, New York, NY, 10016, United States
| | - Wei Wang
- New York State Department of Health, Wadsworth Center, Empire State Plaza, Albany, NY, 12201, United States
| | - Elizabeth Irvin-Barnwell
- Agency for Toxic Substances and Disease Registry, Division of Toxicology and Human Health Science, 4770 Buford Highway, Atlanta, GA, 30341, United States
| | - Syni-An Hwang
- New York State Department of Health, Bureau of Environmental & Occupational Epidemiology, Empire State Plaza-Corning Tower, Room 1203, Albany, NY, 12237, United States; University at Albany, School of Public Health, Department of Epidemiology & Biostatistics, One University Place, Rensselaer, NY, 12144, United States
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Land use mix and leukocyte telomere length in Mexican Americans. Sci Rep 2021; 11:19742. [PMID: 34611226 PMCID: PMC8492751 DOI: 10.1038/s41598-021-99171-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/30/2021] [Indexed: 12/04/2022] Open
Abstract
It has been well-known that built environment features influence the risk of chronic diseases. However, the existing data of its relationship with telomere length, a biomarker of biological aging, is still limited, with no study available for Mexican Americans. This study investigates the relationship between several factors of the built environment with leukocyte telomere length among 5508 Mexican American adults enrolled in Mano-A-Mano, the Mexican American Cohort Study (MACS). Based on the quartile levels of telomere length, the study population was categorized into four groups, from the lowest (1st quartile) to the highest telomere length group (4th quartile). For individual built environment factors, their levels did not differ significantly across four groups. However, in the multinominal logistic regression analysis, increased Rundle’s land use mixture (LUM) and Frank’s LUM were found statistically significantly associated with increased odds of having high levels of telomere length (Rundle’s LUM: 2nd quartile: Odds ratio (OR) 1.26, 95% Confidence interval (CI) 1.07, 1.48; 3rd quartile: OR 1.25, 95% CI 1.06, 1.46; 4th quartile: OR 1.19, 95% CI 1.01, 1.41; Frank’s LUM: 2nd quartile: OR 1.34, 95% CI 1.02, 2.63; 3rd quartile: OR 1.55, 95% CI 1.04, 2.91; 4th quartile: OR 1.36, 95% CI 1.05, 2.72, respectively). The associations for Rundle’s LUM remained significant after further adjusting other non-redundant built environment factors. Finally, in stratified analysis, we found the association between Rundle’s LUM and telomere length was more evident among younger individuals (< 38 years old), women, and those with obesity, born in Mexico, having low levels of physical activity, and having low levels of acculturation than their relative counterparts. In summary, our results indicate that land use mixture may impact telomere length in leukocytes in Mexican Americans.
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Anderson KF, Lopez A, Simburger D. Racial/Ethnic Residential Segregation and the First Wave of SARS-CoV-2 Infection Rates: A Spatial Analysis of Four U.S. Cities. SOCIOLOGICAL PERSPECTIVES : SP : OFFICIAL PUBLICATION OF THE PACIFIC SOCIOLOGICAL ASSOCIATION 2021; 64:804-830. [PMID: 38603057 PMCID: PMC8404417 DOI: 10.1177/07311214211041967] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Previous research has linked racial/ethnic residential segregation to a number of poor health conditions, including infectious disease. Here, we examine how racial/ethnic residential segregation is related to the novel coronavirus, SARS-CoV-2. We examine infection rates by zip code level segregation in four major cities across the U.S.: New York City, Chicago, Houston, and San Diego. We also include a number of area-level Census variables in order to analyze how other factors may help account for the infection rate. We find that both Black and Latino residential clustering are significantly and positively related to a higher SARS-CoV-2 infection rate across all four cities, and that this effect is strong even when accounting for a number of other social conditions and factors that are salient to the transmission of infectious disease. As a result, we argue that neighborhood-level racial/ethnic patterning may serve as an important structural mechanism for disparities in SARS-CoV-2 infection.
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Olivas MI, Kanda D, Trivedi R, Shah GH, Waterfield KC. An Analysis of Local Health Departments' Responsiveness to Community Segregation in Their Efforts to Address Health Disparities. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2021; 27:437-441. [PMID: 32810073 DOI: 10.1097/phh.0000000000001228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Recent studies have found that racial health disparities are a direct result of the residential segregation, racial differences in socioeconomic status, health care access, and other social determinants of health that affect segregated minority groups. This study analyzed local health departments' (LHDs') efforts to decrease health disparities in their communities by using negative binomial regression models to examine the relationship between residential segregation and LHD health disparity activity engagement from the 2016 National Profile of LHDs-National Association of County & City Health Officials (NACCHO) and the 2017 County Health Rankings (CHRs). Significant associations were found between the incident rate ratios of activities performed by LHDs and the nonwhite/white residential segregation index, use of CHRs, LHD governance, per capita expenditures, and race of LHD top executive. The findings will help improvement in collaborative efforts between community agencies and LHDs in order to improve health disparity responsiveness.
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Affiliation(s)
- Maria I Olivas
- Departments of Health Policy and Community Health (Mss Olivas and Trivedi and Drs Shah and Waterfield) and Biostatistics, Epidemiology and Environmental Health Sciences (Ms Kanda), Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia
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Lu Y, Chen L, Liu X, Yang Y, Sullivan WC, Xu W, Webster C, Jiang B. Green spaces mitigate racial disparity of health: A higher ratio of green spaces indicates a lower racial disparity in SARS-CoV-2 infection rates in the USA. ENVIRONMENT INTERNATIONAL 2021; 152:106465. [PMID: 33684736 PMCID: PMC9754786 DOI: 10.1016/j.envint.2021.106465] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 05/04/2023]
Abstract
There is striking racial disparity in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates in the United States. We hypothesize that the disparity is significantly smaller in areas with a higher ratio of green spaces. County level data on the SARS-CoV-2 infection rates of black and white individuals in 135 of the most urbanized counties across the United States were collected. The total population in these counties is 132,350,027, comprising 40.3% of the U.S. population. The ratio of green spaces by land-cover type in each county was extracted from satellite imagery. A hierarchical regression analysis measured cross-sectional associations between racial disparity in infection rates and green spaces, after controlling for socioeconomic, demographic, pre-existing chronic disease, and built-up area factors. We found a higher ratio of green spaces at the county level is significantly associated with a lower racial disparity in infection rates. Four types of green space have significant negative associations with the racial disparity in SARS-CoV-2 infection rates. A theoretical model with five core mechanisms and one circumstantial mechanism is presented to interpret the findings.
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Affiliation(s)
- Yi Lu
- Department of Architecture and Civil Engineering, College of Engineering, City University of Hong Kong, Hong Kong Special Administrative Region
| | - Long Chen
- Department of Architecture and Civil Engineering, College of Engineering, City University of Hong Kong, Hong Kong Special Administrative Region
| | - Xueming Liu
- Virtual Reality Lab of Urban Environments and Human Health, HKUrbanLabs, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Yuwen Yang
- Virtual Reality Lab of Urban Environments and Human Health, HKUrbanLabs, The University of Hong Kong, Hong Kong Special Administrative Region; Division of Landscape Architecture, Department of Architecture, The University of Hong Kong, Hong Kong Special Administrative Region
| | - William C Sullivan
- Smart, Healthy Communities Initiative, University of Illinois at Urbana-Champaign, USA
| | - Wenyan Xu
- Virtual Reality Lab of Urban Environments and Human Health, HKUrbanLabs, The University of Hong Kong, Hong Kong Special Administrative Region; Division of Landscape Architecture, Department of Architecture, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Chris Webster
- HKUrbanLabs, Faculty of Architecture, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Bin Jiang
- Virtual Reality Lab of Urban Environments and Human Health, HKUrbanLabs, The University of Hong Kong, Hong Kong Special Administrative Region; Division of Landscape Architecture, Department of Architecture, The University of Hong Kong, Hong Kong Special Administrative Region.
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Padmanabhan V, Song W, Puttabyatappa M. Praegnatio Perturbatio-Impact of Endocrine-Disrupting Chemicals. Endocr Rev 2021; 42:295-353. [PMID: 33388776 PMCID: PMC8152448 DOI: 10.1210/endrev/bnaa035] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Indexed: 02/07/2023]
Abstract
The burden of adverse pregnancy outcomes such as preterm birth and low birth weight is considerable across the world. Several risk factors for adverse pregnancy outcomes have been identified. One risk factor for adverse pregnancy outcomes receiving considerable attention in recent years is gestational exposure to endocrine-disrupting chemicals (EDCs). Humans are exposed to a multitude of environmental chemicals with known endocrine-disrupting properties, and evidence suggests exposure to these EDCs have the potential to disrupt the maternal-fetal environment culminating in adverse pregnancy and birth outcomes. This review addresses the impact of maternal and fetal exposure to environmental EDCs of natural and man-made chemicals in disrupting the maternal-fetal milieu in human leading to adverse pregnancy and birth outcomes-a risk factor for adult-onset noncommunicable diseases, the role lifestyle and environmental factors play in mitigating or amplifying the effects of EDCs, the underlying mechanisms and mediators involved, and the research directions on which to focus future investigations to help alleviate the adverse effects of EDC exposure.
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Affiliation(s)
| | - Wenhui Song
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
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Padmanabhan V, Moeller J, Puttabyatappa M. Impact of gestational exposure to endocrine disrupting chemicals on pregnancy and birth outcomes. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2021; 92:279-346. [PMID: 34452689 DOI: 10.1016/bs.apha.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
With the advent of industrialization, humans are exposed to a wide range of environmental chemicals, many with endocrine disrupting potential. As successful maintenance of pregnancy and fetal development are under tight hormonal control, the gestational exposure to environmental endocrine disrupting chemicals (EDC) have the potential to adversely affect the maternal milieu and support to the fetus, fetal developmental trajectory and birth outcomes. This chapter summarizes the impact of exposure to EDCs both individually and as mixtures during pregnancy, the immediate and long-term consequences of such exposures on the mother and fetus, the direct and indirect mechanisms through which they elicit their effects, factors that modify their action, and the research directions to focus future investigations.
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Affiliation(s)
| | - Jacob Moeller
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, United States
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Kim JHJ, Lu Q, Stanton AL. Overcoming constraints of the model minority stereotype to advance Asian American health. AMERICAN PSYCHOLOGIST 2021; 76:611-626. [PMID: 34410738 PMCID: PMC8384115 DOI: 10.1037/amp0000799] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Asian Americans are the fastest growing U.S. immigrant group, projected to become the largest immigrant group by 2065, but the quantity of research on Asian Americans' health has not mirrored changing demographics. Asian Americans have been understudied for more than 25 years, with only 0.17% of National Institutes of Health (NIH) expenditures allocated to projects including Asian American, Native Hawaiian, and Pacific Islander populations (Ðoàn et al., 2019). This disproportionality may result in part from the model minority stereotype (MMS) being extended to health, perpetuating the ideas that Asian Americans are well-positioned with regard to health status and that associated research is not essential. Accordingly, the aims for this article are threefold: (a) bring attention to the inadequate representation of the Asian American population in health-related science, (b) question the MMS in health, and (c) outline potential pathways through which the MMS limits what is knowable on Asian American health issues and needs. We discuss the limited meaningfulness of nonrepresentative aggregated statistics purporting the model minority image and provide counterexamples. We also present a stereotype-constraints model with the MMS contributing to a bottleneck for Asian American health-related knowledge, accompanied by present-day circumstances (e.g., sparse data, few psychologists/behavioral medicine scientists focused on Asian American health). We conclude with initial recommendations for addressing MMS-associated constraints in psychology and more broadly. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Qian Lu
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center
| | - Annette L. Stanton
- Department of Psychology, University of California, Los Angeles
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles
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Jelks NO. Pathways to advancing environmental and health justice: Addressing cumulative risks and impacts. Explore (NY) 2021; 17:274-276. [PMID: 33745849 DOI: 10.1016/j.explore.2021.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Na'Taki Osborne Jelks
- Spelman College, Environmental and Health Sciences Program, 350 Spelman Lane SW, Box 235, Atlanta, GA 30314 USA.
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Relationship between Long-Term Residential Green Exposure and Individuals' Mental Health: Moderated by Income Differences and Residential Location in Urban China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238955. [PMID: 33271997 PMCID: PMC7730860 DOI: 10.3390/ijerph17238955] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 01/22/2023]
Abstract
Environmental health effects during urbanization have attracted much attention. However, knowledge is lacking on the relationship between long-term cumulative residential environment and health effects on individuals during rapid transformations in urban physical and social space. Taking Guangzhou, China, as a case example, this study analyzed the relationship between long-term exposure to green environments and residents’ mental health under urban spatial restructuring. Based on a household survey in 2016, 820 residents who have lived in Guangzhou for more than 15 years were used as the sample. High-resolution remote sensing images were used to assess the long-term green exposure of residents. The results indicate that long-term green exposure in residential areas had a negative correlation with residents’ mental health (p < 0.05), and the correlation was strongest for the cumulative green environment in the last five years. However, this significant effect was moderated by income and residential location. Green exposure had a positive relationship with mental health for low income groups, and a negative relationship for middle and high income groups. In addition, residents living farther away from the city center were likely to have fewer green environmental health benefits. Residential relocation in a rapidly urbanizing and transforming China has led to the continuous differentiation of residential green environments among different income groups, which has also caused different mental health effects from green exposure. It provides empirical evidence and theoretical support for policymakers to improve the urban environment and reduce environmental health disparities by considering social differences and residential location.
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Abstract
Birthweight is a well-known predictor of adult-onset chronic disease. The placenta plays a necessary role in regulating fetal growth and determining birth size. Maternal stressors that affect placental function and prenatal growth include maternal overnutrition and undernutrition, toxic social stress, and exposure to toxic chemicals. These stressors lead to increased vulnerability to disease within any population. This vulnerability arises from placental and fetal exposure to stressors during fetal life. The biological drivers linking various social determinants of health to compromised placental function and fetal development have been little studied.
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Leukocyte mitochondrial DNA copy number and built environment in Mexican Americans: a cross-sectional study. Sci Rep 2020; 10:14988. [PMID: 32917938 PMCID: PMC7486918 DOI: 10.1038/s41598-020-72083-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 08/17/2020] [Indexed: 12/15/2022] Open
Abstract
Mitochondrial DNA (mtDNA) copy number in leukocytes has been regarded as a biomarker for various environmental exposures and chronic diseases. Our previous study showed that certain demographic factors (e.g. age, gender, BMI, etc.) significantly affect levels of leukocyte mtDNA copy number in Mexican Americans. However, the effect of the built environment on leukocyte mtDNA copy number has not been studied previously. In this cross-sectional study, we examined the association between multiple components of the built environment with leukocyte mtDNA copy number among 5,502 Mexican American adults enrolled in Mano-A-Mano, the Mexican American Cohort Study (MACS). Based on the median levels of mtDNA copy number, the study population was stratified into low mtDNA copy number group (< median) and high mtDNA copy number group (≥ median). Among all built environment exposure variables, household density and road/intersection ratio were found to be statistically significant between groups with low and high mtDNA copy number (P < 0.001 and 0.002, respectively). In the multivariate logistic regression analysis, individuals living in areas with elevated levels of household density had 1.24-fold increased odds of having high levels of mtDNA copy number [Odds ratio (OR) = 1.24, 95% confidence interval (CIs) 1.08, 1.36]. Similarly, those living in areas with elevated levels of road/intersection ratio had 1.12-fold increased odds of having high levels of mtDNA copy number (OR = 1.12, 95% CI 1.01, 1.27). In further analysis, when both variables were analyzed together in a multivariate logistic regression model, the significant associations remained. In summary, our results suggest that selected built environment variables (e.g. population density and road/intersection ratio) may influence levels of mtDNA copy number in leukocytes in Mexican Americans.
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Jennings V, Gragg RS, Brown CP, Hartel D, Kuehler E, Sinykin A, Johnson E, Kondo M. Structural Characteristics of Tree Cover and the Association with Cardiovascular and Respiratory Health in Tampa, FL. J Urban Health 2019; 96:669-681. [PMID: 31502180 PMCID: PMC6814662 DOI: 10.1007/s11524-019-00380-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Urban tree cover can provide several ecological and public health benefits. Secondary datasets for Tampa, FL, including sociodemographic variables (e.g., race/ethnicity), health data, and interpolated values for features of tree cover (e.g., percent canopy and leaf area index) were analyzed using correlation and regression. Percent canopy cover and leaf area index were inversely correlated to respiratory and cardiovascular outcomes, yet only leaf area index displayed a significant association with respiratory conditions in the logistic regression model. Percent racial/ethnic minority residents at the block group level was significantly negatively correlated with median income and tree density. Leaf area index was also significantly lower in block groups with more African-American residents. The percentage of African Americans (p = 0.101) and Hispanics (p < 0.001) were positively associated with respiratory outcomes while population density (p < 0.001), percent canopy (p < 0.01), and leaf area index (p < 0.01) were negatively associated. In multivariate models, higher tree density, leaf area index, and median income were significantly negatively associated with respiratory cases. Block groups with a higher proportion of African Americans had a higher odds of displaying respiratory admissions above the median rate. Tree density and median income were also negatively associated with cardiovascular cases. Home ownership and tree condition were significantly positively associated with cardiovascular cases.
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Affiliation(s)
| | - Richard Schulterbrandt Gragg
- School of the Environment, Florida Agricultural and Mechanical University, FSH Science Research Bldg, 1515 South Martin Luther King Jr. Blvd, Tallahassee, FL, 32307, USA.
| | - C Perry Brown
- Institute of Public Health, Florida Agricultural and Mechanical University, Tallahassee, FL, USA
| | - Dudley Hartel
- Southern Research Station, USDA Forest Service, Athens, GA, USA
| | - Eric Kuehler
- Southern Research Station, USDA Forest Service, Athens, GA, USA
| | - Alex Sinykin
- Department of Geography, University of North Carolina-Greensboro, Greensboro, NC, USA
| | - Elijah Johnson
- School of the Environment, Florida Agricultural and Mechanical University, FSH Science Research Bldg, 1515 South Martin Luther King Jr. Blvd, Tallahassee, FL, 32307, USA
| | - Michelle Kondo
- Northern Research Station, USDA Forest Service, Philadelphia, PA, USA
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Zhang X, Zhao H, Chow WH, Durand C, Markham C, Zhang K. Associations between the built environment and body mass index in the Mexican American Mano A Mano Cohort. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 654:456-462. [PMID: 30447584 DOI: 10.1016/j.scitotenv.2018.11.122] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 11/04/2018] [Accepted: 11/08/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Obesity is highly prevalent in Mexican American adults. Studies on the role of the built environment in relation to obesity among this population are scarce. OBJECTIVES To investigate cross-sectional associations between multiple components of the built environment, and Body Mass Index (BMI) as well as obesity status among Mexican American adults enrolled in the Mano a Mano Cohort (MAC) study in Houston, Texas. METHODS We calculated BMI from measured height and weight among 9534 Mexican American adults (aged 20-60) who participated in the baseline survey during 2008-2013. Several metrics of exposure to the built environment (physical activity environment, land use, and food environment) were generated using Geographic Information System and Google Maps based on participants' residential address. Generalized linear regression and logistic regression models were used to estimate associations between exposure to the built environment, a continuous BMI variable and categorical BMI variables (<30, ≥30 and ≥35), respectively. RESULTS Among all built environment exposure variables investigated, road density (total road length per km2) [0.21 (0.06, 0.36) as coefficient (95% CI)], intersection density (intersection links per km2) [0.74 (0.21, 1.28)], networked distance (km) [-0.29 (-0.47, -0.10)], and walking time (mins) [-0.02 (-0.04, -0.01)] to the nearest parks had statistically significantly linear associations with BMI. Those variables were found to have statistically significant associations with BMI ≥ 35 in logistic regression models, the odds ratio was 1.08 (1.02, 1.14) for road density, 1.31 (1.07, 1.60) for intersection density, 0.91 (0.85, 0.98) for networked distance, and 0.99 (0.99, 1.00) for walking time. None of the built environment exposure variables were found to be associated with BMI ≥ 30. CONCLUSIONS Living in areas with high density of roads exhibited significant associations with increased BMI, in particular BMI ≥ 35, among enrolled Mexican American adults in the MAC study.
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Affiliation(s)
- Xueying Zhang
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Hua Zhao
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Wong-Ho Chow
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Casey Durand
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Christine Markham
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Kai Zhang
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; Southwest Center for Occupational and Environmental Health, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
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Grineski S, Morales DX, Collins T, Hernandez E, Fuentes A. The burden of carcinogenic air toxics among Asian Americans in four US metro areas. POPULATION AND ENVIRONMENT 2019; 40:257-282. [PMID: 31485094 PMCID: PMC6726401 DOI: 10.1007/s11111-018-0308-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
This study investigated disparities in residential exposure to carcinogenic air pollutants among Asian Americans, including Asian ancestry subgroups, in four US metro areas with high proportions of Asians, i.e., Honolulu, Los Angeles, San Francisco Bay Area, and Seattle. Generalized estimating equations adjusting for socioeconomic status, population density and clustering show that a greater proportion of Asian Americans in census tracts was associated with significantly greater health risk in all four metro areas. Intracategorical disparities were uncovered for Asian ancestry. A greater proportion Korean was positively associated with risk in four metro areas; greater proportion Chinese and Filipino were positively associated with risk in three of the four metro areas. While Asian Americans are infrequently examined in environmental justice research, these results demonstrate that Asian Americans experience substantial distributional environmental injustices in these four metro areas and that ancestry is an important dimension of intracategorical complexity.
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Affiliation(s)
- Sara Grineski
- Department of Sociology, University of Utah, 480 S 1530 E; Salt Lake City, UT 84112; Tele: 801-581-6153 (work); ;
| | | | - Timothy Collins
- Department of Geography, University of Utah, Salt Lake City, UT
| | - Estefania Hernandez
- Department of Sociology and Anthropology, University of Texas at El Paso, El Paso, TX
| | - Ana Fuentes
- Department of Sociology and Anthropology, University of Texas at El Paso, El Paso, TX
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Ports KA, Holman DM, Guinn AS, Pampati S, Dyer KE, Merrick MT, Lunsford NB, Metzler M. Adverse Childhood Experiences and the Presence of Cancer Risk Factors in Adulthood: A Scoping Review of the Literature From 2005 to 2015. J Pediatr Nurs 2019; 44:81-96. [PMID: 30683285 PMCID: PMC6355255 DOI: 10.1016/j.pedn.2018.10.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/11/2018] [Accepted: 10/12/2018] [Indexed: 02/07/2023]
Abstract
Exposure to Adverse Childhood Experiences (ACEs) is associated with a host of harmful outcomes, including increased risk for cancer. A scoping review was conducted to gain a better understanding of how ACEs have been studied in association with risk factors for cancer. This review includes 155 quantitative, peer-reviewed articles published between 2005 and 2015 that examined associations between ACEs and modifiable cancer risk factors, including alcohol, environmental carcinogens, chronic inflammation, sex hormones, immunosuppression, infectious agents, obesity, radiation, ultraviolet (UV) radiation, and tobacco, among U.S. adults. This review highlights the growing body of research connecting ACEs to cancer risk factors, particularly alcohol, obesity, and tobacco. Fewer studies investigated the links between ACEs and chronic inflammation or infectious agents. No included publications investigated associations between ACEs and environmental carcinogens, hormones, immunosuppression, radiation, or ultraviolet radiation. Mitigating the impact of ACEs may provide innovative ways to effect comprehensive, upstream cancer prevention.
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Affiliation(s)
- Katie A Ports
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Dawn M Holman
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Angie S Guinn
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Sanjana Pampati
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Karen E Dyer
- Virginia Commonwealth University, School of Medicine, Department of Health Behavior and Policy, Richmond, VA, USA.
| | - Melissa T Merrick
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Natasha Buchanan Lunsford
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Marilyn Metzler
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Parnia A, Chakravartty D, Wiseman CLS, Archbold J, Copes R, Zawar N, Chen SX, Cole DC. Environmental factors associated with blood lead among newcomer women from South and East Asia in the Greater Toronto Area. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 624:558-566. [PMID: 29268227 DOI: 10.1016/j.scitotenv.2017.11.336] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 11/27/2017] [Accepted: 11/28/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Newcomers bring with them histories of environmental exposure in their home countries and may have different sources of lead (Pb) exposure compared to other residents of their adopted country. AIMS To describe past and current factors associated with Pb exposure and blood Pb among South and East Asian newcomer women of reproductive age in the Greater Toronto Area (GTA), Ontario, Canada. METHODS In collaboration with public health units and community organizations a community-based research model was utilized by recruiting peer researchers to assist in all aspects of the study. Blood samples were taken and phone interviews were conducted. Canadian Health Measures Survey (CHMS) cycles 1, 2, and 3 data was used to contextualize the distribution blood Pb levels. Multiple regression was applied to log-transformed blood lead measurements, using a hierarchical model building process. RESULTS In total, 211 participants were recruited from Bangladesh, China, India, Pakistan and Sri Lanka. The distribution of the blood Pb varied by country of origin, and higher blood Pb values were found above 75th percentile compared to the CHMS. Distal factors significantly influencing blood Pb concentrations related to life history, such as duration of stay in Canada (RR=0.91; 95% CI 0.86-0.97), living near agricultural fields (RR=0.78; 95% CI 0.62-0.93), and country of origin. Proximal factors with significant contribution were use of cosmetics, traditional remedies, and smoking cigarettes. RECOMMENDATIONS Different past and current exposures may be important in various newcomer populations, informing international stakeholders, public health agencies, and primary care practitioners to adapt health education and exposure reduction programs to consider pre- and post-migration factors.
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Affiliation(s)
- Abtin Parnia
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Dolon Chakravartty
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Clare L S Wiseman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; School of the Environment, University of Toronto, Toronto, Canada
| | | | - Ray Copes
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Public Health Ontario, Toronto, Canada
| | - Noureen Zawar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Shirley X Chen
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; School of the Environment, University of Toronto, Toronto, Canada
| | - Donald C Cole
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; School of the Environment, University of Toronto, Toronto, Canada
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Urban Green Space and the Pursuit of Health Equity in Parts of the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111432. [PMID: 29165367 PMCID: PMC5708071 DOI: 10.3390/ijerph14111432] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/13/2017] [Accepted: 11/16/2017] [Indexed: 12/29/2022]
Abstract
Research has demonstrated that inequitable access to green space can relate to health disparities or inequalities. This commentary aims to shift the dialogue to initiatives that have integrated green spaces in projects that may promote health equity in the United States. Specifically, we connect this topic to factors such as community revitalization, affordable housing, neighborhood walkability, food security, job creation, and youth engagement. We provide a synopsis of locations and initiatives in different phases of development along with characteristics to support effectiveness and strategies to overcome challenges. The projects cover locations such as Atlanta (GA), Los Angeles (CA), the District of Columbia (Washington D.C.), South Bronx (NY), and Utica (NY). Such insight can develop our understanding of green space projects that support health equity and inform the dialogue on this topic in ways that advance research and advocacy.
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Clark LP, Millet DB, Marshall JD. Changes in Transportation-Related Air Pollution Exposures by Race-Ethnicity and Socioeconomic Status: Outdoor Nitrogen Dioxide in the United States in 2000 and 2010. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:097012. [PMID: 28930515 PMCID: PMC5915204 DOI: 10.1289/ehp959] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 06/07/2017] [Accepted: 06/09/2017] [Indexed: 05/04/2023]
Abstract
BACKGROUND Disparities in exposure to air pollution by race-ethnicity and by socioeconomic status have been documented in the United States, but the impacts of declining transportation-related air pollutant emissions on disparities in exposure have not been studied in detail. OBJECTIVE This study was designed to estimate changes over time (2000 to 2010) in disparities in exposure to outdoor concentrations of a transportation-related air pollutant, nitrogen dioxide (NO2), in the United States. METHODS We combined annual average NO2 concentration estimates from a temporal land use regression model with Census demographic data to estimate outdoor exposures by race-ethnicity, socioeconomic characteristics (income, age, education), and by location (region, state, county, urban area) for the contiguous United States in 2000 and 2010. RESULTS Estimated annual average NO2 concentrations decreased from 2000 to 2010 for all of the race-ethnicity and socioeconomic status groups, including a decrease from 17.6 ppb to 10.7 ppb (-6.9 ppb) in nonwhite [non-(white alone, non-Hispanic)] populations, and 12.6 ppb to 7.8 ppb (-4.7 ppb) in white (white alone, non-Hispanic) populations. In 2000 and 2010, disparities in NO2 concentrations were larger by race-ethnicity than by income. Although the national nonwhite-white mean NO2 concentration disparity decreased from a difference of 5.0 ppb in 2000 to 2.9 ppb in 2010, estimated mean NO2 concentrations remained 37% higher for nonwhites than whites in 2010 (40% higher in 2000), and nonwhites were 2.5 times more likely than whites to live in a block group with an average NO2 concentration above the WHO annual guideline in 2010 (3.0 times more likely in 2000). CONCLUSIONS Findings suggest that absolute NO2 exposure disparities by race-ethnicity decreased from 2000 to 2010, but relative NO2 exposure disparities persisted, with higher NO2 concentrations for nonwhites than whites in 2010. https://doi.org/10.1289/EHP959.
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Affiliation(s)
- Lara P Clark
- Department of Civil, Environmental, and Geo-Engineering, University of Minnesota , Minneapolis, Minnesota, USA
- Department of Civil and Environmental Engineering, University of Washington , Seattle, Washington, USA
| | - Dylan B Millet
- Department of Civil, Environmental, and Geo-Engineering, University of Minnesota , Minneapolis, Minnesota, USA
- Department of Soil, Water, and Climate, University of Minnesota , St. Paul, Minnesota, USA
| | - Julian D Marshall
- Department of Civil and Environmental Engineering, University of Washington , Seattle, Washington, USA
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Grineski SE, Collins TW, Morales DX. Asian Americans and disproportionate exposure to carcinogenic hazardous air pollutants: A national study. Soc Sci Med 2017; 185:71-80. [PMID: 28554161 DOI: 10.1016/j.socscimed.2017.05.042] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 04/19/2017] [Accepted: 05/17/2017] [Indexed: 12/20/2022]
Abstract
Studies have demonstrated disparate exposures to carcinogenic hazardous air pollutants (HAPs) in neighborhoods with high densities of Black and Hispanic residents in the US. Asians are the fastest growing racial/ethnic group in the US, yet they have been underemphasized in previous studies of environmental health and injustice. This cross-sectional study investigated possible disparities in residential exposure to carcinogenic HAPs among Asian Americans, including Asian American subgroups in the US (including all 50 states and the District of Columbia, n = 71,208 US census tracts) using National Air Toxics Assessment and US Census data. In an unadjusted analysis, Chinese and Korean Americans experience the highest mean cancer risks from HAPs, followed by Blacks. The aggregated Asian category ranks just below Blacks and above Hispanics, in terms of carcinogenic HAP risk. Multivariate models adjusting for socioeconomic status, population density, urban location, and geographic clustering show that an increase in proportion of Asian residents in census tracts is associated with significantly greater cancer risk from HAPs. Neighborhoods with higher proportions (as opposed to lower proportions) of Chinese, Korean, and South Asian residents have significantly greater cancer risk burdens relative to Whites. Tracts with higher concentrations of Asians speaking a non-English language and Asians that are US-born have significantly greater cancer risk burdens. Asian Americans experience substantial residential exposure to carcinogenic HAPs in US census tracts and in the US more generally.
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Affiliation(s)
- Sara E Grineski
- Department of Sociology and Anthropology, BUILDing SCHOLARS, University of Texas at El Paso, 500 W. University Ave., El Paso, TX, USA.
| | - Timothy W Collins
- Department of Sociology and Anthropology, BUILDing SCHOLARS, University of Texas at El Paso, 500 W. University Ave., El Paso, TX, USA.
| | - Danielle X Morales
- Department of Sociology and Anthropology, BUILDing SCHOLARS, University of Texas at El Paso, 500 W. University Ave., El Paso, TX, USA.
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Evans-Agnew RA. Asthma Disparity Photovoice: The Discourses of Black Adolescent and Public Health Policymakers. Health Promot Pract 2017; 19:213-221. [PMID: 29161900 DOI: 10.1177/1524839917691039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Policies in U.S. public schools that address asthma management for Black adolescents may not sufficiently transform sociocultural determinants of disparities. A critical analysis of public health policy maker and adolescent discourses on asthma management using an ecological framework could inform policy development. This study describes the discourses of asthma management disparities of school and other public health policymakers and Black adolescents with asthma during a statewide asthma planning activity. METHOD I conducted a qualitative critical discourse analysis on transcripts and phototexts from a photovoice project with Black adolescents with asthma (n = 19), an asthma-planning meeting with school and public health policymakers (n = 12), and an observation of a photovoice dissemination event that included the same adolescents and policymakers. RESULTS Policymakers did not discuss sociocultural discourses concerning asthma management disparities such as racism and discrimination, but the adolescents did. The only shared discourses between adolescents and policymakers were on the management of indoor environments, health care quality, inadequate housing, and outdoor air pollution. CONCLUSIONS Including Black adolescents in policymaking activities concerning asthma management disparities furthers the identification of differing and shared discourses. School policies should include multilevel strategies that address structural inequities. Photovoice presents an opportunity for including the voice of marginalized youth in policy-planning processes.
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Palmeira Wanderley V, Affonso Fonseca FL, Vala Quiaios A, Nuno Domingues J, Paixão S, Figueiredo J, Ferreira A, de Almeida Pinto C, da Silva OR, Alvarenga R, Machi Junior A, Luiz Savóia EJ, Daminello Raimundo R. Socio-Environmental and Hematological Profile of Landfill Residents (São Jorge Landfill-Sao Paulo, Brazil). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E64. [PMID: 28085053 PMCID: PMC5295315 DOI: 10.3390/ijerph14010064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 12/29/2016] [Accepted: 12/31/2016] [Indexed: 11/26/2022]
Abstract
We are experiencing an unprecedented urbanization process that, alongside physical, social and economic developments, has been having a significant impact on a population's health. Due to the increase in pollution, violence and poverty, our modern cities no longer ensure a good quality of life so they become unhealthy environments. This study aims to assess the effect of social, environmental and economic factors on the hematologic profile of residents of Santo André's landfill. In particular, we will assess the effect of social, economic, and environmental factors on current and potential disease markers obtained from hematological tests. The research method is the observational type, from a retrospective cohort, and by convenience sampling in Santo André in the Greater ABC (municipalities of Santo André, São Bernardo do Campo and São Caetano do Sul, southeast part of the Greater São Paulo Metropolitan Area, Brazil). The study determined a socio-environmental profile and the hematologic diseases screening related to a close location to the landfill. The disease manifests itself within a broad spectrum of symptoms that causes changes in blood count parameters. The objective of this work is to show that there is an association between social, environmental and economic factors and a variety of serious disease outcomes that may be detected from blood screening. A causal study of the effect of living near the landfill on these disease outcomes would be a very expensive and time-consuming study. This work we believe is sufficient for public health officials to consider policy and attempt remediation of the effects of living near a landfill.
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Affiliation(s)
| | - Fernando Luiz Affonso Fonseca
- Environmental Health Management Department, ABC MedSchool, Santo André 09060-650, SP, Brazil.
- Biological Sciences Department, Institute of Environmental, Chemistry and Pharmaceutical Sciences, Federal University of São Paulo, Diadema 04060-650, SP, Brazil.
| | - André Vala Quiaios
- Environmental Health Sciences Department, IPC, EsTesC, Coimbra Health School, Coimbra 3046-854, Portugal.
| | - José Nuno Domingues
- Environmental Health Sciences Department, IPC, EsTesC, Coimbra Health School, Coimbra 3046-854, Portugal.
| | - Susana Paixão
- Environmental Health Sciences Department, IPC, EsTesC, Coimbra Health School, Coimbra 3046-854, Portugal.
| | - João Figueiredo
- Environmental Health Sciences Department, IPC, EsTesC, Coimbra Health School, Coimbra 3046-854, Portugal.
| | - Ana Ferreira
- Environmental Health Sciences Department, IPC, EsTesC, Coimbra Health School, Coimbra 3046-854, Portugal.
| | | | - Odair Ramos da Silva
- Environmental Health Management Department, ABC MedSchool, Santo André 09060-650, SP, Brazil.
| | - Rogério Alvarenga
- Environmental Health Management Department, ABC MedSchool, Santo André 09060-650, SP, Brazil.
| | - Amaury Machi Junior
- Environmental Health Management Department, ABC MedSchool, Santo André 09060-650, SP, Brazil.
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Williams EM, Terrell J, Anderson J, Tumiel-Berhalter L. A Case Study of Community Involvement Influence on Policy Decisions: Victories of a Community-Based Participatory Research Partnership. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E515. [PMID: 27213418 PMCID: PMC4881140 DOI: 10.3390/ijerph13050515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 05/06/2016] [Accepted: 05/13/2016] [Indexed: 11/21/2022]
Abstract
The Buffalo Lupus Project was a community-university partnership that investigated associations between exposure to a local waste site and high rates of lupus and other autoimmune diseases. The partnership's major accomplishment was successful advocacy for containment and clean-up of the site. As a result of community education, the remediation plan suggested by the community was adopted. Additionally, when a local childhood lead poisoning testing program was canceled, community members signed a letter to legislators urging them to replace the funding, which was restored within one week. This demonstrated how coordinated community-based capacity-building efforts can influence health policy.
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Affiliation(s)
- Edith M Williams
- Department of Public Health Sciences, Medical University of South Carolina (MUSC), 135 Cannon Street, Charleston, SC 29425, USA.
| | - Julien Terrell
- The Brotherhood/Sister Sol (Bro/Sis), 512 West 143rd Street, New York, NY 10031, USA.
| | - Judith Anderson
- Environmental Justice Action Group (EJAG) of Western NY, Buffalo, NY 14203, USA.
| | - Laurene Tumiel-Berhalter
- Primary Care Research Institute, University at Buffalo, UB Gateway Building, 77 Goodell St, Suite 220, Buffalo, NY 14203, USA.
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Gonzales FA, Jones RR, Deardorff J, Windham GC, Hiatt RA, Kushi LH. Neighborhood deprivation, race/ethnicity, and urinary metal concentrations among young girls in California. ENVIRONMENT INTERNATIONAL 2016; 91:29-39. [PMID: 26908165 PMCID: PMC6360017 DOI: 10.1016/j.envint.2016.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 01/31/2016] [Accepted: 02/02/2016] [Indexed: 05/26/2023]
Abstract
BACKGROUND Although metals can adversely impact children's health, the distribution of exposures to many metals, particularly among vulnerable subpopulations, is not well characterized. OBJECTIVES We sought to determine whether neighborhood deprivation was associated with urinary concentrations of thirteen metals and whether observed relationships varied by race/ethnicity. METHODS We obtained neighborhood characteristics from the 2005-2009 American Community Survey. Demographic information and urine samples from 400 healthy young girls in Northern California were obtained during a clinical visit. Urine samples were analyzed for metals using inductively-coupled plasma-mass spectrometry and levels were corrected for creatinine. We ran analysis of variance and generalized linear regression models to estimate associations of urinary metal concentrations with neighborhood deprivation and race/ethnicity and stratified multivariable models to evaluate possible interactions among predictors on metals concentrations. RESULTS Urinary concentrations of three metals (barium, lead, antimony) varied significantly across neighborhood deprivation quartiles, and four (barium, lead, antimony, tin) varied across race/ethnicity groups. In models adjusted for family income and cotinine, both race/ethnicity (F3,224=4.34, p=0.01) and neighborhood deprivation (F3,224=4.32, p=0.01) were associated with antimony concentrations, but neither were associated with lead, barium, or tin, concentrations. Examining neighborhood deprivation within race/ethnicity groups, barium levels (pinteraction<0.01) decreased with neighborhood deprivation among Hispanic girls (ptrend<0.001) and lead levels (pinteraction=0.06) increased with neighborhood deprivation among Asian girls (ptrend=0.04). CONCLUSIONS Our results indicate that children's vulnerability to some metals varies by neighborhood deprivation quartile and race/ethnicity. These differential distributions of exposures may contribute to environmental health disparities later in life.
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Affiliation(s)
- Felisa A Gonzales
- National Cancer Institute, Health Systems and Interventions Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, BG 9609 RM 3E502 MSC 9712, 9609 Medical Center Drive, Rockville, MD 20850-9712, United States.
| | - Rena R Jones
- National Cancer Institute, Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, BG 9609 RM 6E124 MSC 9771, 9609 Medical Center Drive, Rockville, MD 20850-9771, United States.
| | - Julianna Deardorff
- University of California at Berkeley, School of Public Health, Department of Community Health and Human Development, 50 University Hall #7360, Berkeley, CA 94720-7360, United States.
| | - Gayle C Windham
- California Department of Public Health, Environmental Health Investigations Branch, 850 Marina Bay Parkway, Building P, 3rd Floor, Richmond, CA 94804, United States.
| | - Robert A Hiatt
- University of California at San Francisco, Department of Epidemiology and Biostatistics, Helen Diller Family Comprehensive Cancer Center, Box 0560, San Francisco, CA 94143-0560, United States.
| | - Lawrence H Kushi
- Kaiser Permanente, Division of Research, 2000 Broadway, Oakland, CA 94612, United States.
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Jennings V, Larson L, Yun J. Advancing Sustainability through Urban Green Space: Cultural Ecosystem Services, Equity, and Social Determinants of Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:196. [PMID: 26861365 PMCID: PMC4772216 DOI: 10.3390/ijerph13020196] [Citation(s) in RCA: 209] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 01/25/2016] [Accepted: 02/02/2016] [Indexed: 02/01/2023]
Abstract
Urban green spaces provide an array of benefits, or ecosystem services, that support our physical, psychological, and social health. In many cases, however, these benefits are not equitably distributed across diverse urban populations. In this paper, we explore relationships between cultural ecosystem services provided by urban green space and the social determinants of health outlined in the United States Healthy People 2020 initiative. Specifically, we: (1) explore connections between cultural ecosystem services and social determinants of health; (2) examine cultural ecosystem services as nature-based health amenities to promote social equity; and (3) recommend areas for future research examining links between urban green space and public health within the context of environmental justice.
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Affiliation(s)
- Viniece Jennings
- Southern Research Station, Integrating Human and Natural Systems, USDA Forest Service, 320 Green Street, Athens, GA 30602, USA.
| | - Lincoln Larson
- Department of Parks, Recreation, and Tourism Management, Clemson University, Clemson, SC 29634, USA.
| | - Jessica Yun
- Department of Science, Technology and International Affairs, Georgetown University, Washington, DC 20057, USA.
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Bowler RM, Beseler CL, Gocheva VV, Colledge M, Kornblith ES, Julian JR, Kim Y, Bollweg G, Lobdell DT. Environmental exposure to manganese in air: Associations with tremor and motor function. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 541:646-654. [PMID: 26437342 PMCID: PMC4803294 DOI: 10.1016/j.scitotenv.2015.09.084] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 08/19/2015] [Accepted: 09/16/2015] [Indexed: 05/20/2023]
Abstract
BACKGROUND Manganese (Mn) inhalation has been associated with neuropsychological and neurological sequelae in exposed workers. Few environmental epidemiologic studies have examined the potentially neurotoxic effects of Mn exposure in ambient air on motor function and hand tremor in adult community residents. Mn exposed residents were recruited in two Ohio towns: Marietta, a town near a ferro-manganese smelter, and East Liverpool, a town adjacent to a facility processing, crushing, screening, and packaging Mn products. METHODS Chronic (≥ 10 years) exposure to ambient air Mn in adult residents and effects on neuropsychological and neurological outcomes were investigated. Participants from Marietta (n=100) and East Liverpool (n=86) were combined for analyses. AERMOD dispersion modeling of fixed-site outdoor air monitoring data estimated Mn inhalation over a ten year period. Adult Mn-exposed residents' psychomotor ability was assessed using Finger Tapping, Hand Dynamometer, Grooved Pegboard, and the Computerized Adaptive Testing System (CATSYS) Tremor system. Bayesian structural equation modeling was used to assess associations between air-Mn and motor function and tremor. RESULTS Air-Mn exposure was significantly correlated in bivariate analyses with the tremor test (CATSYS) for intensity, center frequency and harmonic index. The Bayesian path analysis model showed associations of air-Mn with the CATSYS non-dominant center frequency and harmonic index; while the Bayesian structural equation model revealed associations between air-Mn and lower Finger Tapping scores. Household income was significantly associated with motor dysfunction but not with tremor. CONCLUSION Tremor and motor function were associated with higher exposure to airborne Mn.
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Affiliation(s)
- Rosemarie M Bowler
- San Francisco State University, Department of Psychology, San Francisco, CA, United States.
| | | | - Vihra V Gocheva
- San Francisco State University, Department of Psychology, San Francisco, CA, United States
| | | | - Erica S Kornblith
- California School of Professional Psychology at Alliant International University, San Francisco, CA, United States
| | | | - Yangho Kim
- Ulsan University Hospital, University of Ulsan College of Medicine, Department of Occupational and Environmental Medicine, Ulsan, South Korea
| | | | - Danelle T Lobdell
- U.S. EPA, National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC, United States
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Kravitz-Wirtz N, Crowder K, Hajat A, Sass V. THE LONG-TERM DYNAMICS OF RACIAL/ETHNIC INEQUALITY IN NEIGHBORHOOD AIR POLLUTION EXPOSURE, 1990-2009. DU BOIS REVIEW : SOCIAL SCIENCE RESEARCH ON RACE 2016; 13:237-259. [PMID: 28989341 PMCID: PMC5628744 DOI: 10.1017/s1742058x16000205] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Research examining racial/ethnic disparities in pollution exposure often relies on cross-sectional data. These analyses are largely insensitive to exposure trends and rarely account for broader contextual dynamics. To provide a more comprehensive assessment of racial-environmental inequality over time, we combine the 1990 to 2009 waves of the Panel Study of Income Dynamics (PSID) with spatially- and temporally-resolved measures of nitrogen dioxide (NO2) and particulate matter (PM2.5 and PM10) in respondents' neighborhoods, as well as census data on the characteristics of respondents' metropolitan areas. Results based on multilevel repeated measures models indicate that Blacks and Latinos are, on average, more likely to be exposed to higher levels of NO2, PM2.5, and PM10 than Whites. Despite nationwide declines in levels of pollution over time, racial and ethnic disparities persist and cannot be fully explained by individual-, household-, or metropolitan-level factors.
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Affiliation(s)
| | - Kyle Crowder
- Department of Sociology, University of Washington
| | - Anjum Hajat
- Department of Epidemiology, School of Public Health, University of Washington
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Oyana TJ, Matthews-Juarez P, Cormier SA, Xu X, Juarez PD. Using an External Exposome Framework to Examine Pregnancy-Related Morbidities and Mortalities: Implications for Health Disparities Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 13:ijerph13010013. [PMID: 26703702 PMCID: PMC4730404 DOI: 10.3390/ijerph13010013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 11/13/2015] [Accepted: 11/17/2015] [Indexed: 11/16/2022]
Abstract
Objective: We have conducted a study to assess the role of environment on the burden of maternal morbidities and mortalities among women using an external exposome approach for the purpose of developing targeted public health interventions to decrease disparities. Methods: We identified counties in the 48 contiguous USA where observed low birthweight (LBW) rates were higher than expected during a five-year study period. The identification was conducted using a retrospective space-time analysis scan for statistically significant clusters with high or low rates by a Discrete Poisson Model. Results: We observed statistically significant associations of LBW rate with a set of predictive variables. However, in one of the two spatiotemporal models we discovered LBW to be associated with five predictive variables (teen birth rate, adult obesity, uninsured adults, physically unhealthy days, and percent of adults who smoke) in two counties situated in Alabama after adjusting for location changes. Counties with higher than expected LBW rates were similarly associated with two environmental variables (ozone and fine particulate matter). Conclusions: The county-level predictive measures of LBW offer new insights into spatiotemporal patterns relative to key contributory factors. An external framework provides a promising place-based approach for identifying “hotspots” with implications for designing targeted interventions and control measures to reduce and eliminate health disparities.
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Affiliation(s)
- Tonny J Oyana
- Research Center on Health Disparities, Equity & the Exposome, Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
| | - Patricia Matthews-Juarez
- Pediatrics, Infectious Disease and Microbiology, Immunology & Biochemistry, University of Tennessee Health Science Center, Le Bonheur Children's Medical Center, Memphis, TN 36163, USA.
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA.
| | - Stephania A Cormier
- Pediatrics, Infectious Disease and Microbiology, Immunology & Biochemistry, University of Tennessee Health Science Center, Le Bonheur Children's Medical Center, Memphis, TN 36163, USA.
| | - Xiaoran Xu
- Pediatrics, Infectious Disease and Microbiology, Immunology & Biochemistry, University of Tennessee Health Science Center, Le Bonheur Children's Medical Center, Memphis, TN 36163, USA.
| | - Paul D Juarez
- Pediatrics, Infectious Disease and Microbiology, Immunology & Biochemistry, University of Tennessee Health Science Center, Le Bonheur Children's Medical Center, Memphis, TN 36163, USA.
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA.
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White BM, Hall ES. Perceptions of environmental health risks among residents in the "Toxic Doughnut": opportunities for risk screening and community mobilization. BMC Public Health 2015; 15:1230. [PMID: 26652846 PMCID: PMC4676177 DOI: 10.1186/s12889-015-2563-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 12/03/2015] [Indexed: 11/10/2022] Open
Abstract
Background Surrounded by landfills, and toxic and hazardous facilities, Altgeld Gardens is located in a “toxic doughnut”. With high rates of environmentally-related conditions, residents have called for a community-based environmental health assessment to improve overall health in their community. The purpose of this study was to investigate the attitudes and beliefs of environmental health risks of Altgeld’s residents which would assist community organizing efforts and provide the groundwork for a community-based environmental health assessment. Methods A questionnaire was designed and administered to 42 Altgeld residents who also participated in focus groups to assess their perceptions of environmental health risks. Results All participants were Altgeld residents for at least two years and were fairly representative of the broader community. Physical and social hazards were primarily identified as posing risks to participants’ family and the broader community. Physical hazards included the dumping of hazardous waste and landfills; social hazards were crime and drugs. Conclusions These findings have been useful in community organizing efforts and in program planning for local community-based organizations and public health agencies. The results have also been used to prioritize health and environmental risk issues impacting the community. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2563-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Brandi M White
- Department of Health Professions, College of Health Professions, Medical University of South Carolina, 151 Rutledge Avenue, Charleston, SC, 29425-1600, USA.
| | - Eric S Hall
- Office of Research and Development, US Environmental Protection Agency, 109 T.W. Alexander Drive, Research Triangle Park, NC, 27711-0001, USA.
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Jennings V, Gaither CJ. Approaching environmental health disparities and green spaces: an ecosystem services perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:1952-68. [PMID: 25674782 PMCID: PMC4344703 DOI: 10.3390/ijerph120201952] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 12/22/2014] [Accepted: 01/28/2015] [Indexed: 11/22/2022]
Abstract
Health disparities occur when adverse health conditions are unequal across populations due in part to gaps in wealth. These disparities continue to plague global health. Decades of research suggests that the natural environment can play a key role in sustaining the health of the public. However, the influence of the natural environment on health disparities is not well-articulated. Green spaces provide ecosystem services that are vital to public health. This paper discusses the link between green spaces and some of the nation’s leading health issues such as obesity, cardiovascular health, heat-related illness, and psychological health. These associations are discussed in terms of key demographic variables—race, ethnicity, and income. The authors also identify research gaps and recommendations for future research.
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Affiliation(s)
- Viniece Jennings
- USDA Forest Service, Southern Research Station, Integrating Human and Natural Systems, 320 Green Street, Athens, GA 30602, USA.
| | - Cassandra Johnson Gaither
- USDA Forest Service, Southern Research Station, Integrating Human and Natural Systems, 320 Green Street, Athens, GA 30602, USA.
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Landrine H, Corral I. Advancing research on racial-ethnic health disparities: improving measurement equivalence in studies with diverse samples. Front Public Health 2014; 2:282. [PMID: 25566524 PMCID: PMC4273553 DOI: 10.3389/fpubh.2014.00282] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 12/04/2014] [Indexed: 11/24/2022] Open
Abstract
To conduct meaningful, epidemiologic research on racial-ethnic health disparities, racial-ethnic samples must be rendered equivalent on other social status and contextual variables via statistical controls of those extraneous factors. The racial-ethnic groups must also be equally familiar with and have similar responses to the methods and measures used to collect health data, must have equal opportunity to participate in the research, and must be equally representative of their respective populations. In the absence of such measurement equivalence, studies of racial-ethnic health disparities are confounded by a plethora of unmeasured, uncontrolled correlates of race-ethnicity. Those correlates render the samples, methods, and measures incomparable across racial-ethnic groups, and diminish the ability to attribute health differences discovered to race-ethnicity vs. to its correlates. This paper reviews the non-equivalent yet normative samples, methodologies and measures used in epidemiologic studies of racial-ethnic health disparities, and provides concrete suggestions for improving sample, method, and scalar measurement equivalence.
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Affiliation(s)
- Hope Landrine
- Center for Health Disparities, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Irma Corral
- Department of Psychiatry and Behavioral Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, USA
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Langston MA, Levine RS, Kilbourne BJ, Rogers GL, Kershenbaum AD, Baktash SH, Coughlin SS, Saxton AM, Agboto VK, Hood DB, Litchveld MY, Oyana TJ, Matthews-Juarez P, Juarez PD. Scalable combinatorial tools for health disparities research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:10419-43. [PMID: 25310540 PMCID: PMC4210988 DOI: 10.3390/ijerph111010419] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 09/30/2014] [Accepted: 10/01/2014] [Indexed: 11/16/2022]
Abstract
Despite staggering investments made in unraveling the human genome, current estimates suggest that as much as 90% of the variance in cancer and chronic diseases can be attributed to factors outside an individual’s genetic endowment, particularly to environmental exposures experienced across his or her life course. New analytical approaches are clearly required as investigators turn to complicated systems theory and ecological, place-based and life-history perspectives in order to understand more clearly the relationships between social determinants, environmental exposures and health disparities. While traditional data analysis techniques remain foundational to health disparities research, they are easily overwhelmed by the ever-increasing size and heterogeneity of available data needed to illuminate latent gene x environment interactions. This has prompted the adaptation and application of scalable combinatorial methods, many from genome science research, to the study of population health. Most of these powerful tools are algorithmically sophisticated, highly automated and mathematically abstract. Their utility motivates the main theme of this paper, which is to describe real applications of innovative transdisciplinary models and analyses in an effort to help move the research community closer toward identifying the causal mechanisms and associated environmental contexts underlying health disparities. The public health exposome is used as a contemporary focus for addressing the complex nature of this subject.
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Affiliation(s)
- Michael A Langston
- Department of Electrical Engineering and Computer Science, University of Tennessee, Knoxville, TN 37996, USA.
| | - Robert S Levine
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA.
| | - Barbara J Kilbourne
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA.
| | - Gary L Rogers
- National Institute for Computational Sciences, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA.
| | - Anne D Kershenbaum
- Department of Public Health, University of Tennessee, Knoxville, TN 37996, USA.
| | - Suzanne H Baktash
- Department of Electrical Engineering and Computer Science, University of Tennessee, Knoxville, TN 37996, USA.
| | - Steven S Coughlin
- Department of Epidemiology, Emory University, Atlanta, GA 30322, USA.
| | - Arnold M Saxton
- Department of Animal Science, Institute of Agriculture, University of Tennessee, Knoxville, TN 37996, USA.
| | - Vincent K Agboto
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA.
| | - Darryl B Hood
- Division of Environmental Health Sciences, College of Public Health, Ohio State University, Columbus, OH 43210, USA.
| | - Maureen Y Litchveld
- Department of Global Environmental Health Sciences, Tulane University, New Orleans, LA 70112, USA.
| | - Tonny J Oyana
- Research Center on Health Disparities, Equity, and the Exposome, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
| | - Patricia Matthews-Juarez
- Research Center on Health Disparities, Equity, and the Exposome, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
| | - Paul D Juarez
- Research Center on Health Disparities, Equity, and the Exposome, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
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