Perceived health change in the aftermath of a petrochemical accident: an examination of pre-accident, within-accident, and post-accident variables

Does living close to a petrochemical complex increase the adverse psychological effects of the COVID-19 lockdown?

The petrochemical industry has made the economic development of many local communities possible, increasing employment opportunities and generating a complex network of closely-related secondary industries. However, it is known that petrochemical industries emit air pollutants, which have been related to different negative effects on mental health. In addition, many people around the world are being exposed to highly stressful situations deriving from the COVID-19 pandemic and the lockdowns adopted by national and regional governments. The present study aims to analyse the possible differential effects on various psychological outcomes (stress, anxiety, depression and emotional regulation strategies) stemming from the COVID-19 pandemic and consequent lockdown experienced by individuals living near an important petrochemical complex and subjects living in other areas, nonexposed to the characteristic environmental pollutants emitted by these kinds of complex. The sample consisted of 1607 subjects who answered an ad hoc questionnaire on lockdown conditions, the Perceived Stress Scale (PSS), the Hospital Anxiety and Depression Scale (HADS), the Barratt Impulsivity Scale (BIS) and the Emotional Regulation Questionnaire (ERQ). The results indicate that people living closer to petrochemical complexes reported greater risk perception [K = 73.42, p < 0.001, with a medium size effect (η2 = 0.061)]. However, no significant relationship between psychological variables and proximity to the focus was detected when comparing people living near to or far away from a chemical/petrochemical complex. Regarding the adverse psychological effects of the first lockdown due to COVID-19 on the general population in Catalonia, we can conclude that the conditions included in this survey were mainly related to changes in the participants' impulsivity levels, with different total impulsivity scores being obtained if they had minors in their care (p<0.001), if they had lost their jobs, if they were working (p<0.001), if they were not telecommuting (p<0.001), if they went out to work (p<0.001) or if they established routines (p = 0.009). However, we can also be fairly certain that the economic effects are going to be worse than those initially detected in this study. More research will be necessary to corroborate our results.

An Evaluation of Perceived Health Risk and Depressive Symptoms Before a Disaster in Predicting Postdisaster Inflammation

OBJECTIVE

Exposure to major life stressors is associated with subsequent enhanced inflammation-related disease processes. Depressive symptoms exacerbate stress-induced inflammatory responses. Moreover, those who report a high degree of perceived health risk before being exposed to a major life stressor such as a disaster are at risk for poor health outcomes. The present study examined whether perceived health risk and depressive symptoms before a disaster were associated with postdisaster inflammation markers.

METHODS

The sample included 124 participants (mean [standard deviation] age = 55 [16] years; 69% women). At a baseline visit, participants completed self-report measures of perceived health risk and depressive symptoms (Center for Epidemiologic Studies Depression Scale) in addition to a blood draw for the assessment of inflammation markers (C-reactive protein, tumor necrosis factor receptor 1, and interleukin 6). All participants lived near a large petrochemical complex where an unexpected explosion occurred. A second blood sample was obtained 2 to 6 months after the explosion.

RESULTS

No significant differences in inflammation markers were found between predisaster and postdisaster assessment (p > .21). An interaction between predisaster perceived health risk and depressive symptoms in predicting postdisaster circulating inflammation markers was identified (Cohen f = 0.051). Specifically, predisaster perceived health risk was associated with postdisaster circulating inflammation markers if predisaster depressive symptoms were greater than 8.10 on the Center for Epidemiologic Studies Depression Scale.

CONCLUSIONS

These findings add to our understanding of the complex interactions between stress, depression, and immune responses. Indeed, findings provide a potential mechanism (i.e., inflammation) explaining the association between exposure to major life stressors and negative mental and physical health outcomes.

Problem drinking among Mexican-Americans: the influence of nativity and neighborhood context?

PURPOSE

We examined the influence of nativity and community context (Hispanic neighborhood concentration) on two measures of problem drinking among Mexican-Americans.

DESIGN

Cross-sectional study.

SETTING

Texas City Stress and Health Study conducted in Texas City, Texas during 2004-2006.

PARTICIPANTS

A total of 1435 Mexican-Americans aged 25 years and older.

MEASURES

Binge drinking (≥6 drinks per occasion by men and ≥4 drinks per occasion by women) and scoring positive on the CAGE (a four-item clinical measure of problem drinking) as dependent variables. Key independent variables included a measure of language acculturation, proportion of Hispanics in the participant's neighborhood according to 2000 U.S. Census data, and being foreign-born compared with being U.S.-born.

ANALYSIS

Logistic regression analysis was used to predict being a binge drinker and being positive on the CAGE. RESULTS . Foreign-born women were less likely to be binge drinkers than U.S.-born women. Nativity was not significant among men. Moreover women were less likely to be binge drinkers if they lived in heavily Hispanic neighborhoods. No such effect was found among men. Similar results were obtained with the CAGE.

CONCLUSIONS

We found a powerful influence of nativity (being U.S.-born compared with foreign born) and neighborhood Hispanic concentration on problem drinking among women but not among men. It is likely that cultural norms in heavily Hispanic environments discourage problem drinking among women but not among men.

The socio-spatial neighborhood estimation method: an approach to operationalizing the neighborhood concept

The literature on neighborhoods and health highlights the difficulty of operationalizing "neighborhood" in a conceptually and empirically valid manner. Most studies, however, continue to define neighborhoods using less theoretically relevant boundaries, risking erroneous inferences from poor measurement. We review an innovative methodology to address this problem, called the socio-spatial neighborhood estimation method (SNEM). To estimate neighborhood boundaries, researchers used a theoretically informed combination of qualitative GIS and on-the-ground observations in Texas City, Texas. Using data from a large sample, we assessed the SNEM-generated neighborhood units by comparing intra-class correlation coefficients (ICCs) and multi-level model parameter estimates of SNEM-based measures against those for census block groups and regular grid cells. ICCs and criterion-related validity evidence using SF-36 outcome measures indicate that the SNEM approach to operationalization could improve inferences based on neighborhoods and health research.

A prospective population based study of changes in alcohol use and binge drinking after a mass traumatic event

Few studies have assessed changes in alcohol use before and after a massive disaster. We investigated the contribution of exposure to traumatic events and stressors related to Hurricanes Katrina and Rita to alcohol use and binge drinking. We used data from the Panel Study of Income Dynamics collected in Mississippi, Louisiana and Alabama on adults aged 18-85 (n=439): (1) data from 1968 to 2005 on household income; (2) data from 2005 and 2007 on total number of drinks per year and number of days the respondent binged; and (3) data from 2007 on exposure to hurricane-related traumatic events and post-hurricane stressors. Exposure to each additional hurricane-related traumatic event was associated with 79.2 more drinks and 2.46 times higher odds of binge drinking for more days in the past year (95% CI: 1.09, 5.55), while more post-disaster stressors were associated with 16.5 more drinks and 1.23 times higher odds of binge drinking for more days in the past year (95% CI: 0.99, 1.51). Respondents who had followed a lower lifetime income trajectory and were exposed to more lifetime traumatic events experienced the highest risk of reporting increased alcohol use given exposure to hurricane-related traumatic events and post-hurricane stressors. Disaster-related traumatic events and the proliferation of post-disaster stressors may result in increased post-disaster alcohol use and abuse. Disaster-related exposures may have a particularly strong impact among individuals with a history of social and economic adversity, widening preexisting health disparities.

Allostatic load in an environmental riskscape: the role of stressors and gender

Stressors are theorized to be associated with higher allostatic load (AL), a concept of physiological wear measured as a composite of physical biomarkers. Risk of high AL may vary by gender and may be intensified in places with significant environmental risks, otherwise known as 'environmental riskscapes'. Yet, no study has examined the relationship between stressors, gender, and allostatic load in an environmental riskscape. Using primary data collected in a sample (N=1072) exposed to various environmental and social stressors, we find that long-term residence in Texas City (30 or more years), residential proximity to petrochemical plants, perceived poor neighborhood conditions, and daily hassles are associated with higher allostatic load components. Variation in AL differs by gender and the types of biomarkers examined. Gender moderates the effect of length of residence in Texas City on cardiovascular health risk. We discuss our findings in light of current research on stressors, gender, allostatic load, and double jeopardy within environmental riskscapes.

Herpesvirus reactivation and socioeconomic position: a community-based study

BACKGROUND

Elevated antibodies to latent herpesviruses have been demonstrated to be a reliable marker of diminished cellular immunity and recently have been associated with low socioeconomic position (SEP) in older adults. Extending these observations in a community-based study over a wide age range would provide an important new direction for investigating mechanisms underlying poor health outcomes in individuals with low SEP.

METHODS

Anti-herpes simplex virus (HSV)-1 and anti-Epstein-Barr virus (EBV) antibodies were measured in blood samples from 1457 adults aged 25-90. Regression models were then used to determine the relationships between viral reactivation, age, gender, ethnicity and SEP.

RESULTS

Individuals were significantly more likely to have higher antiviral antibodies (ie, reactivation) to both EBV and HSV-1 than one virus alone. Individuals in the lowest age group had less reactivation, whereas greater reactivation was observed in women and those with the least education. Compared to white non-Hispanics, Hispanics and black non-Hispanics experienced more viral reactivation. These relationships remained strong after controlling for sociodemographic factors as well as smoking status, body mass index and physical activity.

CONCLUSIONS

These results demonstrate that herpesvirus reactivation is associated with variables such as age, gender, ethnicity and education, and may play a role in poorer health outcomes in both younger and older adults.

Allostatic load among non-Hispanic Whites, non-Hispanic Blacks, and people of Mexican origin: effects of ethnicity, nativity, and acculturation

OBJECTIVES

We investigated ethnic differences in allostatic load in a population-based sample of adults living in Texas City, TX, and assessed the effects of nativity and acculturation status on allostatic load among people of Mexican origin.

METHODS

We used logistic regression models to examine ethnic variations in allostatic load scores among non-Hispanic Whites, non-Hispanic Blacks, and people of Mexican origin. We also examined associations between measures of acculturation and allostatic load scores among people of Mexican origin only.

RESULTS

Foreign-born Mexicans were the least likely group to score in the higher allostatic load categories. Among individuals of Mexican origin, US-born Mexican Americans had higher allostatic load scores than foreign-born Mexicans, and acculturation measures did not account for the difference.

CONCLUSIONS

Our findings expand on recent research from the National Health and Nutrition Examination Survey with respect to ethnicity and allostatic load. Our results are consistent with the healthy immigrant hypothesis (i.e., newer immigrants are healthier) and the acculturation hypothesis, according to which the longer Mexican immigrants reside in the United States, the greater their likelihood of potentially losing culture-related health-protective effects.

Environmental hazards and stress: evidence from the Texas City Stress and Health Study

BACKGROUND

Substantial research has suggested that exposure to environmental health hazards, such as polluting industrial activity, has deleterious effects on psychological and physiological well-being. However, one gap in the existing literature is comparative analysis of objective and subjective exposure's relative association with various measurable outcomes of exposure.

METHODS

These relationships were explored within a community sample of 2604 respondents living near a large petrochemical complex in Texas City, Texas, USA. Objective exposure was investigated using distance of residence from a cluster of petrochemical plants and subjective exposure using residents' concern about potential health effects from those plants. Regression models were then used to examine how each type of exposure predicts perceived stress, physiological markers of stress and perceived health.

RESULTS

Results suggest that objective exposure was associated primarily with markers of physiological stress (interleukin-6 and viral reactivation), and subjective exposure (concern about petrochemical health risk) was associated with variables assessing perceived health.

CONCLUSIONS

From the analysis, it can be inferred that, in the context of an environmental hazard of this type, subjective exposure may be at least as important a predictor of poor health outcomes as objective exposure.

Approaching health disparities from a population perspective: the National Institutes of Health Centers for Population Health and Health Disparities

Addressing health disparities has been a national challenge for decades. The National Institutes of Health-sponsored Centers for Population Health and Health Disparities are the first federal initiative to support transdisciplinary multilevel research on the determinants of health disparities. Their novel research approach combines population, clinical, and basic science to elucidate the complex determinants of health disparities. The centers are partnering with community-based, public, and quasi-public organizations to disseminate scientific findings and guide clinical practice in communities. In turn, communities and public health agents are shaping the research. The relationships forged through these complex collaborations increase the likelihood that the centers' scientific findings will be relevant to communities and contribute to reductions in health disparities.