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Bloom MS, Clark JM, Pearce JL, Ferguson PL, Newman RB, Roberts JR, Grobman WA, Sciscione AC, Skupski DW, Garcia K, Vena JE, Hunt KJ. Impact of Skin Care Products on Phthalates and Phthalate Replacements in Children: the ECHO-FGS. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:97001. [PMID: 39230332 PMCID: PMC11373421 DOI: 10.1289/ehp13937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
BACKGROUND Phthalates and their replacements have been implicated as developmental toxicants. Young children may be exposed to phthalates/replacements when using skin care products (SCPs). OBJECTIVES Our objective is to assess the associations between use of SCPs and children's urinary phthalate/replacement metabolite concentrations. METHODS Children (4-8 years old) from the Environmental Influences on Child Health Outcomes-Fetal Growth Study (ECHO-FGS) cohort provided spot urine samples from 2017 to 2019, and mothers were queried about children's SCP use in the past 24 h (n = 906 ). Concentrations of 16 urinary phthalate/replacement metabolites were determined by liquid chromatography-tandem mass spectrometry (n = 630 ). We used linear regression to estimate the child's use of different SCPs as individual predictors of urinary phthalate/replacement metabolites, adjusted for urinary specific gravity, age, sex assigned at birth, body mass index, and self-reported race/ethnic identity, as well as maternal education, and season of specimen collection. We created self-organizing maps (SOM) to group children into "exposure profiles" that reflect discovered patterns of use for multiple SCPs. RESULTS Children had lotions applied (43.0%) frequently, but "2-in-1" hair-care products (7.5%), sunscreens (5.9%), and oils (4.3%) infrequently. Use of lotions was associated with 1.17-fold [95% confidence interval (CI): 1.00, 1.34] greater mono-benzyl phthalate and oils with 2.86-fold (95% CI: 1.89, 4.31) greater monoethyl phthalate (MEP), 1.43-fold (95% CI: 1.09, 1.90) greater monobutyl phthalate (MBP), and 1.40-fold (95% CI: 1.22, 1.61) greater low-molecular-weight phthalates (LMW). Use of 2-in-1 haircare products was associated with 0.84-fold (95% CI: 0.72, 0.97) and 0.78-fold (95% CI: 0.62, 0.98) lesser mono(3-carboxypropyl) phthalate (MCPP) and MBP, respectively. Child's race/ethnic identity modified the associations of lotions with LMW, oils with MEP and LMW, sunscreen with MCPP, ointments with MEP, and hair conditioner with MCPP. SOM identified four distinct SCP-use exposure scenarios (i.e., profiles) within our population that predicted 1.09-fold (95% CI: 1.03, 1.15) greater mono-carboxy isononyl phthalate, 1.31-fold (95% CI: 0.98, 1.77) greater mono-2-ethyl-5-hydroxyhexyl terephthalate, 1.13-fold (95% CI: 0.99, 1.29) greater monoethylhexyl phthalate, and 1.04-fold (95% CI: 1.00, 1.09) greater diethylhexyl phthalate. DISCUSSION We found that reported SCP use was associated with urinary phthalate/replacement metabolites in young children. These results may inform policymakers, clinicians, and parents to help limit children's exposure to developmental toxicants. https://doi.org/10.1289/EHP13937.
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Affiliation(s)
- Michael S Bloom
- Department of Global and Community Health, George Mason University, Fairfax, Virginia, USA
| | - Juliana M Clark
- Department of Global and Community Health, George Mason University, Fairfax, Virginia, USA
| | - John L Pearce
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Pamela L Ferguson
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Roger B Newman
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - James R Roberts
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA
| | - William A Grobman
- Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Anthony C Sciscione
- Department of Obstetrics and Gynecology, Christiana Care Health System, Newark, Delaware, USA
| | - Daniel W Skupski
- Department of Obstetrics and Gynecology, New York-Presbyterian Queens Hospital, Queens, New York, USA
| | - Kelly Garcia
- Department of Global and Community Health, George Mason University, Fairfax, Virginia, USA
| | - John E Vena
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Kelly J Hunt
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
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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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Libenson A, Karasaki S, Cushing LJ, Tran T, Rempel JL, Morello-Frosch R, Pace CE. PFAS-Contaminated Pesticides Applied near Public Supply Wells Disproportionately Impact Communities of Color in California. ACS ES&T WATER 2024; 4:2495-2503. [PMID: 38903201 PMCID: PMC11186009 DOI: 10.1021/acsestwater.3c00845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 04/27/2024] [Accepted: 04/29/2024] [Indexed: 06/22/2024]
Abstract
Contaminated drinking water from widespread environmental pollutants such as perfluoroalkyl and polyfluoroalkyl substances (PFAS) poses a rising threat to public health. PFAS monitoring in groundwater is limited and fails to consider pesticides found to contain PFAS as a potential contamination source. Given previous findings on the disproportionate exposure of communities of Color to both pesticides and PFAS, we investigated disparities in PFAS-contaminated pesticide applications in California based on community-level sociodemographic characteristics. We utilized statewide pesticide application data from the California Department of Pesticide Regulation and recently reported concentrations of PFAS chemicals detected in eight pesticide products to calculate the areal density of PFAS applied within 1 km of individual community water systems' (CWSs) supply wells. Spatial regression analyses suggest that statewide, CWSs that serve a greater proportion of Latinx and non-Latinx People of Color residents experience a greater areal density of PFAS applied and greater likelihood of PFAS application near their public supply wells. These results highlight agroecosystems as potentially important sources of PFAS in drinking water and identify areas that may be at risk of PFAS contamination and warrant additional PFAS monitoring and remediation.
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Affiliation(s)
- Arianna Libenson
- Environmental
Science, Policy, and Management, University
of California Berkeley, Berkeley, California 94720, United States
| | - Seigi Karasaki
- Energy
and Resources Group, University of California
Berkeley, Berkeley, California 94720 United States
| | - Lara J. Cushing
- Fielding
School of Public Health, University of California
Los Angeles, Los Angeles, California 90095, United States
| | - Tien Tran
- Community
Water Center, Sacramento and Visalia, California 93291, United States
| | - Jenny L. Rempel
- Energy
and Resources Group, University of California
Berkeley, Berkeley, California 94720 United States
| | - Rachel Morello-Frosch
- Environmental
Science, Policy, and Management, University
of California Berkeley, Berkeley, California 94720, United States
- School
of Public Health, University of California
Berkeley, Berkeley, California 94720, United States
| | - Clare E. Pace
- Environmental
Science, Policy, and Management, University
of California Berkeley, Berkeley, California 94720, United States
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Schinasi LH, Lawrence JA. Everyday discrimination and satisfaction with nature experiences. FRONTIERS IN EPIDEMIOLOGY 2024; 4:1212114. [PMID: 38872717 PMCID: PMC11169619 DOI: 10.3389/fepid.2024.1212114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/07/2024] [Indexed: 06/15/2024]
Abstract
Introduction There is growing interest in creating public green spaces to promote health. Yet, discussions about these efforts often overlook how experiences of chronic discrimination-which may manifest as racism, sexism, or homophobia, and more-could undermine satisfaction with nature experiences. Methods Using data from the 2018 wave of the National Opinion Research Center (NORC) General Social Survey (GSS), we quantified associations of frequency of everyday discrimination, operationalized using the Everyday Discrimination Scale (EDS, the primary independent variable), with respondents' perceptions of nature experiences and with their reported time spent in nature. Specifically, we quantified associations with the following three variables: (1) dissatisfaction with day-to-day experiences of nature, (2) not spending as much time as they would like in natural environments, and (3) usually spending at least one day per week in nature. We used survey-weighted robust Poisson models to estimate overall associations, and also stratified analyses by racial/ethnic and gender identity categories. Results Of 768 GSS respondents, 14% reported dissatisfaction with nature experiences, 36% reported not spending as much time as they would like in nature, and 33% reported that they did not spend at least one day per week in nature. The median non-standardized EDS, coded such that a higher value indicates greater frequency of discrimination, was 11 (interquartile range: 8, 15). Prevalence of reporting dissatisfaction with day-to-day experiences in nature was 7% higher in association with every one unit increase in EDS score above the median (PR: 1.07, 95% CI: 1.02-1.11). The prevalence of reporting not spending as much time as one would like in nature was 2% higher for every unit increase in higher than median everyday discrimination frequency (PR: 1.02, 95% CI: 1.00-1.05). Higher than median frequency in everyday discrimination was not associated with spending less than one day per week in nature. Race/ethnicity and gender identity did not modify associations. Conclusion Greater frequency of everyday discrimination is associated with less satisfaction with experiences in nature. This relationship could undermine efforts to promote health equity through green interventions.
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Affiliation(s)
- Leah H. Schinasi
- Department of Environmental and Occupational Health, Drexel University, Philadelphia, PA, United States
- Urban Health Collaborative, Drexel University, Philadelphia, PA, United States
| | - Jourdyn A. Lawrence
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA, United States
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Colegate SP, Palipana A, Gecili E, Szczesniak RD, Brokamp C. Evaluating precision medicine tools in cystic fibrosis for racial and ethnic fairness. J Clin Transl Sci 2024; 8:e94. [PMID: 39220818 PMCID: PMC11362628 DOI: 10.1017/cts.2024.532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/28/2024] [Accepted: 04/23/2024] [Indexed: 09/04/2024] Open
Abstract
Introduction Patients with cystic fibrosis (CF) experience frequent episodes of acute decline in lung function called pulmonary exacerbations (PEx). An existing clinical and place-based precision medicine algorithm that accurately predicts PEx could include racial and ethnic biases in clinical and geospatial training data, leading to unintentional exacerbation of health inequities. Methods We estimated receiver operating characteristic curves based on predictions from a nonstationary Gaussian stochastic process model for PEx within 3, 6, and 12 months among 26,392 individuals aged 6 years and above (2003-2017) from the US CF Foundation Patient Registry. We screened predictors to identify reasons for discriminatory model performance. Results The precision medicine algorithm performed worse predicting a PEx among Black patients when compared with White patients or to patients of another race for all three prediction horizons. There was little to no difference in prediction accuracies among Hispanic and non-Hispanic patients for the same prediction horizons. Differences in F508del, smoking households, secondhand smoke exposure, primary and secondary road densities, distance and drive time to the CF center, and average number of clinical evaluations were key factors associated with race. Conclusions Racial differences in prediction accuracies from our PEx precision medicine algorithm exist. Misclassification of future PEx was attributable to several underlying factors that correspond to race: CF mutation, location where the patient lives, and clinical awareness. Associations of our proxies with race for CF-related health outcomes can lead to systemic racism in data collection and in prediction accuracies from precision medicine algorithms constructed from it.
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Affiliation(s)
- Stephen P. Colegate
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | | | - Emrah Gecili
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
| | - Rhonda D. Szczesniak
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
| | - Cole Brokamp
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA
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Tong R, Zhang B. Cumulative risk assessment for combinations of environmental and psychosocial stressors: A systematic review. INTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT 2024; 20:602-615. [PMID: 37526127 DOI: 10.1002/ieam.4821] [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: 05/26/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/02/2023]
Abstract
With the growing awareness of stressors, cumulative risk assessment (CRA) has been proposed as a potential method to evaluate possible additive and synergistic effects of multiple stressors on human health, thus informing environmental regulation and protecting public health. However, CRA is still in its exploratory stage due to the lack of generally accepted quantitative approaches. It is an ideal time to summarize the existing progress to guide future research. To this end, a systematic review of the literature on CRA issues dealing with combinations of environmental and psychosocial stressors was conducted in this study. Using typology and bibliometric analysis, the body of knowledge, hot topics, and research gaps in this field were characterized. It was found that research topics and objectives mainly focus on qualitative analysis and community settings; more attention should be paid to the development of quantitative approaches and the inclusion of occupational settings. Further, the roles of air pollution and vulnerability factors in CRA have attracted the most attention. This study concludes with views on future prospects to promote theoretical and practical development in this field; specifically, CRA is a multifaceted topic that requires substantial collaborations with various stakeholders and substantial knowledge from multidisciplinary fields. This study presents an overall review as well as research directions worth investigating in this field, which provides a historical reference for future study. Integr Environ Assess Manag 2024;20:602-615. © 2023 SETAC.
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Affiliation(s)
- Ruipeng Tong
- School of Emergency Management and Safety Engineering, China University of Mining and Technology-Beijing, Beijing, China
| | - Boling Zhang
- School of Emergency Management and Safety Engineering, China University of Mining and Technology-Beijing, Beijing, China
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7
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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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Shupler M, Huybrechts K, Leung M, Wei Y, Schwartz J, Li L, Koutrakis P, Hernández-Díaz S, Papatheodorou S. Short-Term Increases in NO 2 and O 3 Concentrations during Pregnancy and Stillbirth Risk in the U.S.: A Time-Stratified Case-Crossover Study. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:1097-1108. [PMID: 38175714 PMCID: PMC11152641 DOI: 10.1021/acs.est.3c05580] [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] [Indexed: 01/05/2024]
Abstract
Associations between gaseous pollutant exposure and stillbirth have focused on exposures averaged over trimesters or gestation. We investigated the association between short-term increases in nitrogen dioxide (NO2) and ozone (O3) concentrations and stillbirth risk among a national sample of 116 788 Medicaid enrollees from 2000 to 2014. A time-stratified case-crossover design was used to estimate distributed (lag 0-lag 6) and cumulative lag effects, which were adjusted for PM2.5 concentration and temperature. Effect modification by race/ethnicity and proximity to hydraulic fracturing (fracking) wells was assessed. Short-term increases in the NO2 and O3 concentrations were not associated with stillbirth in the overall sample. Among American Indian individuals (n = 1694), a 10 ppb increase in NO2 concentrations was associated with increased stillbirth odds at lag 0 (5.66%, 95%CI: [0.57%, 11.01%], p = 0.03) and lag 1 (4.08%, 95%CI: [0.22%, 8.09%], p = 0.04) but not lag 0-6 (7.12%, 95%CI: [-9.83%, 27.27%], p = 0.43). Among participants living in zip codes within 15 km of active fracking wells (n = 9486), a 10 ppb increase in NO2 concentration was associated with increased stillbirth odds in single-day lags (2.42%, 95%CI: [0.37%, 4.52%], p = 0.02 for lag 0 and 1.83%, 95%CI: [0.25%, 3.43%], p = 0.03 for lag 1) but not the cumulative lag (lag 0-6) (4.62%, 95%CI: [-2.75%, 12.55%], p = 0.22). Odds ratios were close to the null in zip codes distant from fracking wells. Future studies should investigate the role of air pollutants emitted from fracking and potential racial disparities in the relationship between short-term increases in NO2 concentrations and stillbirth.
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Affiliation(s)
- Matthew Shupler
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
| | - Krista Huybrechts
- Division of Pharmacoepidemiology & Pharmacoeconomics, Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Michael Leung
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
| | - Joel Schwartz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
| | - Longxiang Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
| | - Sonia Hernández-Díaz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
| | - Stefania Papatheodorou
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
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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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Welch BM, Keil AP, Buckley JP, Engel SM, James-Todd T, Zota AR, Alshawabkeh AN, Barrett ES, Bloom MS, Bush NR, Cordero JF, Dabelea D, Eskenazi B, Lanphear BP, Padmanabhan V, Sathyanarayana S, Swan SH, Aalborg J, Baird DD, Binder AM, Bradman A, Braun JM, Calafat AM, Cantonwine DE, Christenbury KE, Factor-Litvak P, Harley KG, Hauser R, Herbstman JB, Hertz-Picciotto I, Holland N, Jukic AMZ, McElrath TF, Meeker JD, Messerlian C, Michels KB, Newman RB, Nguyen RH, O’Brien KM, Rauh VA, Redmon B, Rich DQ, Rosen EM, Schmidt RJ, Sparks AE, Starling AP, Wang C, Watkins DJ, Weinberg CR, Weinberger B, Wenzel AG, Wilcox AJ, Yolton K, Zhang Y, Ferguson KK. Racial and Ethnic Disparities in Phthalate Exposure and Preterm Birth: A Pooled Study of Sixteen U.S. Cohorts. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:127015. [PMID: 38117586 PMCID: PMC10732302 DOI: 10.1289/ehp12831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 11/17/2023] [Accepted: 11/27/2023] [Indexed: 12/22/2023]
Abstract
BACKGROUND Phthalate exposures are ubiquitous during pregnancy and may contribute to racial and ethnic disparities in preterm birth. OBJECTIVES We investigated race and ethnicity in the relationship between biomarkers of phthalate exposure and preterm birth by examining: a) how hypothetical reductions in racial and ethnic disparities in phthalate metabolites might reduce the probability of preterm birth; and b) exposure-response models stratified by race and ethnicity. METHODS We pooled individual-level data on 6,045 pregnancies from 16 U.S. cohorts. We investigated covariate-adjusted differences in nine urinary phthalate metabolite concentrations by race and ethnicity [non-Hispanic White (White, 43%), non-Hispanic Black (Black, 13%), Hispanic/Latina (38%), and Asian/Pacific Islander (3%)]. Using g-computation, we estimated changes in the probability of preterm birth under hypothetical interventions to eliminate disparities in levels of urinary phthalate metabolites by proportionally lowering average concentrations in Black and Hispanic/Latina participants to be approximately equal to the averages in White participants. We also used race and ethnicity-stratified logistic regression to characterize associations between phthalate metabolites and preterm birth. RESULTS In comparison with concentrations among White participants, adjusted mean phthalate metabolite concentrations were consistently higher among Black and Hispanic/Latina participants by 23%-148% and 4%-94%, respectively. Asian/Pacific Islander participants had metabolite levels that were similar to those of White participants. Hypothetical interventions to reduce disparities in metabolite mixtures were associated with lower probabilities of preterm birth for Black [13% relative reduction; 95% confidence interval (CI): - 34 % , 8.6%] and Hispanic/Latina (9% relative reduction; 95% CI: - 19 % , 0.8%) participants. Odds ratios for preterm birth in association with phthalate metabolites demonstrated heterogeneity by race and ethnicity for two individual metabolites (mono-n-butyl and monoisobutyl phthalate), with positive associations that were larger in magnitude observed among Black or Hispanic/Latina participants. CONCLUSIONS Phthalate metabolite concentrations differed substantially by race and ethnicity. Our results show hypothetical interventions to reduce population-level racial and ethnic disparities in biomarkers of phthalate exposure could potentially reduce the probability of preterm birth. https://doi.org/10.1289/EHP12831.
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Affiliation(s)
- Barrett M. Welch
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
- University of Nevada, Reno, Reno, Nevada, USA
| | | | - Jessie P. Buckley
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Stephanie M. Engel
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Tamarra James-Todd
- Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Ami R. Zota
- Columbia University Mailman School of Public Health, Columbia University, New York, New York, USA
| | | | - Emily S. Barrett
- Rutgers School of Public Health, Rutgers University, Piscataway, New Jersey, USA
| | | | - Nicole R. Bush
- University of California, San Francisco, San Francisco, California, USA
| | | | - Dana Dabelea
- University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Brenda Eskenazi
- Center for Environmental Research and Community Health (CERCH), University of California, Berkeley, Berkeley, California, USA
| | | | | | - Sheela Sathyanarayana
- Seattle Children’s Research Institute, University of Washington, Seattle, Washington, USA
| | - Shanna H. Swan
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jenny Aalborg
- University of Colorado, Anschutz Medical Campus, Aurora, Colorado, USA
| | - Donna D. Baird
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | | | - Asa Bradman
- University of California, Merced, Merced, California, USA
| | | | - Antonia M. Calafat
- National Center for Environmental Health, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Kate E. Christenbury
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, North Carolina, USA
| | - Pam Factor-Litvak
- Columbia University Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Kim G. Harley
- Center for Environmental Research and Community Health (CERCH), University of California, Berkeley, Berkeley, California, USA
| | - Russ Hauser
- Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Julie B. Herbstman
- Columbia University Mailman School of Public Health, Columbia University, New York, New York, USA
| | | | - Nina Holland
- Center for Environmental Research and Community Health (CERCH), University of California, Berkeley, Berkeley, California, USA
| | - Anne Marie Z. Jukic
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | | | - John D. Meeker
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Carmen Messerlian
- Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Karin B. Michels
- University of California, Los Angeles, Los Angeles, California, USA
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Roger B. Newman
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Ruby H.N. Nguyen
- University of Minnesota, School of Public Health, Minneapolis, Minnesota, USA
| | - Katie M. O’Brien
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Virginia A. Rauh
- Columbia University Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Bruce Redmon
- University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - David Q. Rich
- University of Rochester Medical Center, Rochester, New York, USA
| | - Emma M. Rosen
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | | | - Anne P. Starling
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Christina Wang
- The Lundquist Institute at Harbor, UCLA Medical Center, West Carson, California, USA
| | - Deborah J. Watkins
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Clarice R. Weinberg
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Barry Weinberger
- Cohen Children’s Medical Center of New York, Northwell Health, Queens, New York, USA
| | - Abby G. Wenzel
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Allen J. Wilcox
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Kimberly Yolton
- Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Yu Zhang
- Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Kelly K. Ferguson
- National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
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11
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Gohlke JM, Harris MH, Roy A, Thompson TM, DePaola M, Alvarez RA, Anenberg SC, Apte JS, Demetillo MAG, Dressel IM, Kerr GH, Marshall JD, Nowlan AE, Patterson RF, Pusede SE, Southerland VA, Vogel SA. State-of-the-Science Data and Methods Need to Guide Place-Based Efforts to Reduce Air Pollution Inequity. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:125003. [PMID: 38109120 PMCID: PMC10727036 DOI: 10.1289/ehp13063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 11/19/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Recently enacted environmental justice policies in the United States at the state and federal level emphasize addressing place-based inequities, including persistent disparities in air pollution exposure and associated health impacts. Advances in air quality measurement, models, and analytic methods have demonstrated the importance of finer-scale data and analysis in accurately quantifying the extent of inequity in intraurban pollution exposure, although the necessary degree of spatial resolution remains a complex and context-dependent question. OBJECTIVE The objectives of this commentary were to a) discuss ways to maximize and evaluate the effectiveness of efforts to reduce air pollution disparities, and b) argue that environmental regulators must employ improved methods to project, measure, and track the distributional impacts of new policies at finer geographic and temporal scales. DISCUSSION The historic federal investments from the Inflation Reduction Act, the Infrastructure Investment and Jobs Act, and the Biden Administration's commitment to Justice40 present an unprecedented opportunity to advance climate and energy policies that deliver real reductions in pollution-related health inequities. In our opinion, scientists, advocates, policymakers, and implementing agencies must work together to harness critical advances in air quality measurements, models, and analytic methods to ensure success. https://doi.org/10.1289/EHP13063.
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Affiliation(s)
- Julia M. Gohlke
- Environmental Defense Fund, Washington, District of Columbia, USA
- Department of Population Health Sciences, Virginia Tech, Blacksburg, Virginia, USA
| | - Maria H. Harris
- Environmental Defense Fund, Washington, District of Columbia, USA
| | - Ananya Roy
- Environmental Defense Fund, Washington, District of Columbia, USA
| | | | - Mindi DePaola
- Environmental Defense Fund, Washington, District of Columbia, USA
| | - Ramón A. Alvarez
- Environmental Defense Fund, Washington, District of Columbia, USA
| | - Susan C. Anenberg
- Department of Environmental and Occupational Health, George Washington University, Washington, District of Columbia, USA
| | - Joshua S. Apte
- Department of Civil and Environmental Engineering, University of California, Berkeley, Berkeley, California, USA
- School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | | | - Isabella M. Dressel
- Department of Environmental Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Gaige H. Kerr
- Department of Environmental and Occupational Health, George Washington University, Washington, District of Columbia, USA
| | - Julian D. Marshall
- Department of Civil and Environmental Engineering, University of Washington, Seattle, Washington, USA
| | - Aileen E. Nowlan
- Environmental Defense Fund, Washington, District of Columbia, USA
| | - Regan F. Patterson
- Department of Civil and Environmental Engineering, University of California, Los Angeles, Los Angeles, California, USA
| | - Sally E. Pusede
- Department of Environmental Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Veronica A. Southerland
- Environmental Defense Fund, Washington, District of Columbia, USA
- Department of Environmental and Occupational Health, George Washington University, Washington, District of Columbia, USA
| | - Sarah A. Vogel
- Environmental Defense Fund, Washington, District of Columbia, USA
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12
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Gordon M, Casey JA, McBrien H, Gemmill A, Hernández D, Catalano R, Chakrabarti S, Bruckner T. Disparities in preterm birth following the July 1995 Chicago heat wave. Ann Epidemiol 2023; 87:S1047-2797(23)00166-7. [PMID: 37678645 PMCID: PMC10842513 DOI: 10.1016/j.annepidem.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 08/20/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE To evaluate if changes in preterm birth (PTB, <37 weeks of gestation) incidence differed between non-Hispanic (NH) Black and NH white births following the July 1995 Chicago heat wave-among the most severe U.S. heat waves since 1950. METHODS We used an ecologic study design. We obtained birth data from January 1990-December 1996 from the National Vital Statistics File to calculate the mean monthly PTB incidence in Chicago's Cook County, Illinois. Births between July 1995 and February 1996 were potentially exposed to the heat wave in utero. We generated time series models for NH Black and NH white births, which incorporated synthetic controls of Cook County based on unexposed counties. We ran a secondary analysis considering socioeconomic status (SES). RESULTS From 1990-1996, the mean monthly PTB incidence among NH Black births was 18.6% compared to 7.8% among NH white births. The mean monthly PTB incidence among NH Black births from August 1995-January 1996 was 16.7% higher than expected (three additional PTBs per 100 live births per month [95% confidence interval (CI): 1, 5]). A similar increase occurred among low-SES NH Black births. No increase appeared among NH white births. CONCLUSIONS Severe heat waves may increase racial disparities in PTB incidence.
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Affiliation(s)
- Milo Gordon
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY
| | - Joan A Casey
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY; Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA
| | - Heather McBrien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY
| | - Alison Gemmill
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Diana Hernández
- Sociomedical Sciences Department, Columbia University Mailman School of Public Health, New York, NY
| | - Ralph Catalano
- School of Public Health, University of California, Berkeley
| | | | - Tim Bruckner
- Program in Public Health, University of California, Irvine.
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13
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Reddy KP, Eberly LA, Julien HM, Giri J, Fanaroff AC, Groeneveld PW, Khatana SAM, Nathan AS. Association between racial residential segregation and Black-White disparities in cardiovascular disease mortality. Am Heart J 2023; 264:143-152. [PMID: 37364747 PMCID: PMC10923556 DOI: 10.1016/j.ahj.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/08/2023] [Accepted: 06/21/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Racial residential segregation is associated with racial health inequities, but it is unclear if segregation may exacerbate Black-White disparities in cardiovascular disease (CVD) mortality. This study aimed to assess associations between Black-White residential segregation, CVD mortality rates among non-Hispanic (NH) Black and NH White populations, and Black-White disparities in CVD mortality. METHODS This cross-sectional study analyzed Black-White residential segregation, as measured by county-level interaction index, of US counties, county-level CVD mortality among NH White and NH black adults aged 25 years and older, and county-level Black-White disparities in CVD mortality in years 2014 to 2017. Age-adjusted, county-level NH Black CVD mortality rates and NH White cardiovascular disease mortality rates, as well as group-level relative risk ratios for Black-White cardiovascular disease mortality, were calculated. Sequential generalized linear models adjusted for county-level socioeconomic and neighborhood factors were used to estimate associations between residential segregation and cardiovascular mortality rates among NH Black and NH White populations. Relative risk ratio tests were used to compare Black-White disparities in the most segregated counties to disparities in the least segregated counties. RESULTS We included 1,286 counties with ≥5% Black populations in the main analysis. Among adults aged ≥25 years, there were 2,611,560 and 408,429 CVD deaths among NH White and NH Black individuals, respectively. In the unadjusted model, counties in the highest tertile of segregation had 9% higher (95% CI, 1%-20% higher, P = .04) rates of NH Black CVD mortality than counties in the lowest tertile of segregation. In the multivariable adjusted model, the most segregated counties had 15% higher (95% CI, 0.5% to 38% higher, P = .04) rates of NH Black CVD mortality than the least segregated counties. In the most segregated counties, NH Black individuals were 33% more likely to die of CVD than NH White individuals (RR 1.33, 95% CI 1.32 to 1.33, P < .001). CONCLUSIONS Counties with increased Black-White residential segregation have higher rates of NH Black CVD mortality and larger Black-White disparities in CVD mortality. Identifying the causal mechanisms through which racial residential segregation widens disparities in CVD mortality requires further study.
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Affiliation(s)
- Kriyana P Reddy
- Penn Cardiovascular Outcomes, Quality, and Evaluative Research Center, University of Pennsylvania, Philadelphia, PA.
| | - Lauren A Eberly
- Penn Cardiovascular Outcomes, Quality, and Evaluative Research Center, University of Pennsylvania, Philadelphia, PA; Division of Cardiology, Hospital of the University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; Penn Cardiovascular Center for Health Equity and Justice, Philadelphia, PA
| | - Howard M Julien
- Penn Cardiovascular Outcomes, Quality, and Evaluative Research Center, University of Pennsylvania, Philadelphia, PA; Division of Cardiology, Hospital of the University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; Penn Cardiovascular Center for Health Equity and Justice, Philadelphia, PA; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - Jay Giri
- Penn Cardiovascular Outcomes, Quality, and Evaluative Research Center, University of Pennsylvania, Philadelphia, PA; Division of Cardiology, Hospital of the University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - Alexander C Fanaroff
- Penn Cardiovascular Outcomes, Quality, and Evaluative Research Center, University of Pennsylvania, Philadelphia, PA; Division of Cardiology, Hospital of the University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Peter W Groeneveld
- Penn Cardiovascular Outcomes, Quality, and Evaluative Research Center, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA; Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Sameed Ahmed M Khatana
- Penn Cardiovascular Outcomes, Quality, and Evaluative Research Center, University of Pennsylvania, Philadelphia, PA; Division of Cardiology, Hospital of the University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA
| | - Ashwin S Nathan
- Penn Cardiovascular Outcomes, Quality, and Evaluative Research Center, University of Pennsylvania, Philadelphia, PA; Division of Cardiology, Hospital of the University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA
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14
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Casey JA, Daouda M, Babadi RS, Do V, Flores NM, Berzansky I, González DJ, Van Horne YO, James-Todd T. Methods in Public Health Environmental Justice Research: a Scoping Review from 2018 to 2021. Curr Environ Health Rep 2023; 10:312-336. [PMID: 37581863 PMCID: PMC10504232 DOI: 10.1007/s40572-023-00406-7] [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] [Accepted: 07/14/2023] [Indexed: 08/16/2023]
Abstract
PURPOSE OF REVIEW The volume of public health environmental justice (EJ) research produced by academic institutions increased through 2022. However, the methods used for evaluating EJ in exposure science and epidemiologic studies have not been catalogued. Here, we completed a scoping review of EJ studies published in 19 environmental science and epidemiologic journals from 2018 to 2021 to summarize research types, frameworks, and methods. RECENT FINDINGS We identified 402 articles that included populations with health disparities as a part of EJ research question and met other inclusion criteria. Most studies (60%) evaluated EJ questions related to socioeconomic status (SES) or race/ethnicity. EJ studies took place in 69 countries, led by the US (n = 246 [61%]). Only 50% of studies explicitly described a theoretical EJ framework in the background, methods, or discussion and just 10% explicitly stated a framework in all three sections. Among exposure studies, the most common area-level exposure was air pollution (40%), whereas chemicals predominated personal exposure studies (35%). Overall, the most common method used for exposure-only EJ analyses was main effect regression modeling (50%); for epidemiologic studies the most common method was effect modification (58%), where an analysis evaluated a health disparity variable as an effect modifier. Based on the results of this scoping review, current methods in public health EJ studies could be bolstered by integrating expertise from other fields (e.g., sociology), conducting community-based participatory research and intervention studies, and using more rigorous, theory-based, and solution-oriented statistical research methods.
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Affiliation(s)
- Joan A. Casey
- University of Washington School of Public Health, Seattle, WA USA
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Misbath Daouda
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Ryan S. Babadi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Vivian Do
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Nina M. Flores
- Columbia University Mailman School of Public Health, New York, NY USA
| | - Isa Berzansky
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
| | - David J.X. González
- Department of Environmental Science, Policy & Management and School of Public Health, University of California, Berkeley, Berkeley, CA 94720 USA
| | | | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA
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15
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Ward-Caviness CK, Cascio WE. A Narrative Review on the Impact of Air Pollution on Heart Failure Risk and Exacerbation. Can J Cardiol 2023; 39:1244-1252. [PMID: 37406802 DOI: 10.1016/j.cjca.2023.06.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 06/05/2023] [Accepted: 06/21/2023] [Indexed: 07/07/2023] Open
Abstract
Air pollution is a risk factor for many cardiovascular diseases, including heart failure (HF). Although the links between air pollution and HF have been explored, the results are scattered and difficult to piece together into a cohesive story. Therefore, we undertook a narrative review of all aspects of the relationship between HF and air pollution exposure, including risks of developing HF when exposed to air pollution, the exacerbation of HF symptoms by air pollution exposure, and the increased susceptibility that individuals with HF have for air pollution-related health risks. We also examined the literature on environmental justice as well as air pollution interventions for HF. We found substantial evidence linking air pollution exposure to HF incidence. There were a limited number of studies that examined air pollution exposure in clearly defined populations with HF to explore exacerbation of HF or the susceptibility of individuals with HF to air pollution health risks. However, there is substantial evidence that HF-related hospitalisations are increased under air pollution exposure and that the air pollution associated increase in HF-related hospitalisations is greater than hospitalisations for other chronic diseases, supporting links between air pollution and both exacerbation of HF and susceptibility of individuals with HF. There is emerging evidence for interventions that can decrease air pollution health risks for individuals with HF, and more studies are needed, particularly randomised controlled trials. Thus, although the air pollution-related health risks for HF incidence and hospitalisations are clear, further studies specifically targeted at identified data gaps will greatly improve our knowledge of the susceptibility of individuals with HF and interventions to reduce risks.
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Affiliation(s)
- Cavin K Ward-Caviness
- Center for Public Health and Environmental Assessment, US Environmental Protection Agency, Chapel Hill, North Carolina, USA.
| | - Wayne E Cascio
- Center for Public Health and Environmental Assessment, US Environmental Protection Agency, Chapel Hill, North Carolina, USA
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16
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Payne-Sturges DC, Taiwo TK, Ellickson K, Mullen H, Tchangalova N, Anderko L, Chen A, Swanson M. Disparities in Toxic Chemical Exposures and Associated Neurodevelopmental Outcomes: A Scoping Review and Systematic Evidence Map of the Epidemiological Literature. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:96001. [PMID: 37754677 PMCID: PMC10525348 DOI: 10.1289/ehp11750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/29/2023] [Accepted: 08/10/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Children are routinely exposed to chemicals known or suspected of harming brain development. Targeting Environmental Neuro-Development Risks (Project TENDR), an alliance of > 50 leading scientists, health professionals, and advocates, is working to protect children from these toxic chemicals and pollutants, especially the disproportionate exposures experienced by children from families with low incomes and families of color. OBJECTIVE This scoping review was initiated to map existing literature on disparities in neurodevelopmental outcomes for U.S. children from population groups who have been historically economically/socially marginalized and exposed to seven exemplar neurotoxicants: combustion-related air pollution (AP), lead (Pb), mercury (Hg), organophosphate pesticides (OPs), phthalates (Phth), polybrominated diphenyl ethers (PBDEs), and polychlorinated biphenyls (PCBs). METHODS Systematic literature searches for the seven exemplar chemicals, informed by the Population, Exposure, Comparator, Outcome (PECO) framework, were conducted through 18 November 2022, using PubMed, CINAHL Plus (EBSCO), GreenFILE (EBSCO), and Web of Science sources. We examined these studies regarding authors' conceptualization and operationalization of race, ethnicity, and other indicators of sociodemographic and socioeconomic disadvantage; whether studies presented data on exposure and outcome disparities and the patterns of those disparities; and the evidence of effect modification by or interaction with race and ethnicity. RESULTS Two hundred twelve individual studies met the search criteria and were reviewed, resulting in 218 studies or investigations being included in this review. AP and Pb were the most commonly studied exposures. The most frequently identified neurodevelopmental outcomes were cognitive and behavioral/psychological. Approximately a third (74 studies) reported investigations of interactions or effect modification with 69% (51 of 74 studies) reporting the presence of interactions or effect modification. However, less than half of the studies presented data on disparities in the outcome or the exposure, and fewer conducted formal tests of heterogeneity. Ninety-two percent of the 165 articles that examined race and ethnicity did not provide an explanation of their constructs for these variables, creating an incomplete picture. DISCUSSION As a whole, the studies we reviewed indicated a complex story about how racial and ethnic minority and low-income children may be disproportionately harmed by exposures to neurotoxicants, and this has implications for targeting interventions, policy change, and other necessary investments to eliminate these health disparities. We provide recommendations on improving environmental epidemiological studies on environmental health disparities. To achieve environmental justice and health equity, we recommend concomitant strategies to eradicate both neurotoxic chemical exposures and systems that perpetuate social inequities. https://doi.org/10.1289/EHP11750.
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Affiliation(s)
| | | | - Kristie Ellickson
- Minnesota Pollution Control Agency, St. Paul, Minnesota, USA
- Union of Concerned Scientists, Cambridge, Massachusetts, USA
| | - Haley Mullen
- Department of Geographical Sciences, University of Maryland, College Park, Maryland, USA
| | | | - Laura Anderko
- M. Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, USA
| | - Aimin Chen
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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17
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Martenies SE, Zhang M, Corrigan AE, Kvit A, Shields T, Wheaton W, Around Him D, Aschner J, Talavera-Barber MM, Barrett ES, Bastain TM, Bendixsen C, Breton CV, Bush NR, Cacho F, Camargo CA, Carroll KN, Carter BS, Cassidy-Bushrow AE, Cowell W, Croen LA, Dabelea D, Duarte CS, Dunlop AL, Everson TM, Habre R, Hartert TV, Helderman JB, Hipwell AE, Karagas MR, Lester BM, LeWinn KZ, Magzamen S, Morello-Frosch R, O’Connor TG, Padula AM, Petriello M, Sathyanarayana S, Stanford JB, Woodruff TJ, Wright RJ, Kress AM. Developing a National-Scale Exposure Index for Combined Environmental Hazards and Social Stressors and Applications to the Environmental Influences on Child Health Outcomes (ECHO) Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6339. [PMID: 37510572 PMCID: PMC10379099 DOI: 10.3390/ijerph20146339] [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: 05/26/2023] [Revised: 06/12/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023]
Abstract
Tools for assessing multiple exposures across several domains (e.g., physical, chemical, and social) are of growing importance in social and environmental epidemiology because of their value in uncovering disparities and their impact on health outcomes. Here we describe work done within the Environmental influences on Child Health Outcomes (ECHO)-wide Cohort Study to build a combined exposure index. Our index considered both environmental hazards and social stressors simultaneously with national coverage for a 10-year period. Our goal was to build this index and demonstrate its utility for assessing differences in exposure for pregnancies enrolled in the ECHO-wide Cohort Study. Our unitless combined exposure index, which collapses census-tract level data into a single relative measure of exposure ranging from 0-1 (where higher values indicate higher exposure to hazards), includes indicators for major air pollutants and air toxics, features of the built environment, traffic exposures, and social determinants of health (e.g., lower educational attainment) drawn from existing data sources. We observed temporal and geographic variations in index values, with exposures being highest among participants living in the West and Northeast regions. Pregnant people who identified as Black or Hispanic (of any race) were at higher risk of living in a "high" exposure census tract (defined as an index value above 0.5) relative to those who identified as White or non-Hispanic. Index values were also higher for pregnant people with lower educational attainment. Several recommendations follow from our work, including that environmental and social stressor datasets with higher spatial and temporal resolutions are needed to ensure index-based tools fully capture the total environmental context.
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Affiliation(s)
- Sheena E. Martenies
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
| | - Mingyu Zhang
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Anne E. Corrigan
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Anton Kvit
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Timothy Shields
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - William Wheaton
- Research Triangle Institute, Research Triangle Park, NC 27709, USA
| | | | - Judy Aschner
- Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | | | - Emily S. Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA
| | - Theresa M. Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | | | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Nicole R. Bush
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
- Department of Pediatrics, University of California San Francisco, San Francisco, CA 94143, USA
| | - Ferdinand Cacho
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Carlos A. Camargo
- Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Kecia N. Carroll
- Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Brian S. Carter
- Department of Pediatrics-Neonatology, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | | | - Whitney Cowell
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Lisa A. Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA;
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Cristiane S. Duarte
- New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA
| | - Anne L. Dunlop
- Department of Obstetrics and Gynecology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Todd M. Everson
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Tina V. Hartert
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Jennifer B. Helderman
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
| | - Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
| | - Barry M. Lester
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI 02903, USA
| | - Kaja Z. LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523, USA
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management and School of Public Health, University of California Berkeley, Berkeley, CA 94720, USA
| | - Thomas G. O’Connor
- Departments of Psychiatry, Psychology, Neuroscience, and Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY 41642, USA
| | - Amy M. Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Michael Petriello
- Institute of Environmental Health Sciences and Department of Pharmacology, Wayne State University, Detroit, MI 48202, USA
| | - Sheela Sathyanarayana
- Seattle Children’s Research Institute, Seattle, WA 98105, USA
- Department of Pediatrics, University of Washington, Seattle, WA 98195, USA
| | - Joseph B. Stanford
- Department of Pediatrics, Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
| | - Tracey J. Woodruff
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Rosalind J. Wright
- Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Amii M. Kress
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Lebow-Skelley E, Scott Tomlinson M, Charles S, Fuller C, Ames B, Pearson MA. A Collaborative Approach to Address Racism in a Community-Academic Partnership. Prev Chronic Dis 2023; 20:E47. [PMID: 37290007 DOI: 10.5888/pcd20.220365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
The HERCULES Exposome Research Center at Emory University uses an exposome approach to study the environment's effect on health and community well-being. HERCULES is guided by a Stakeholder Advisory Board (SAB) that includes representatives of neighborhoods, nonprofit organizations, government agencies, and academic institutions in the Atlanta metropolitan region. This region (and the SAB) has a large proportion of Black residents, many of whom live in areas experiencing environmental injustices. Historic and current racial injustices in Atlanta and public health research made it imperative to initiate dialogue and implement actions to address racism and power dynamics that may impact research and partnerships between affected communities and our institution.After initial discussion, the HERCULES Community Engagement Core and SAB members formed a workgroup to develop an internal anti-racism process. The workgroup drafted an Anti-Racism Commitment, hosted a Racism and Equity Dialogue Series, and initiated a strategic planning process to implement the resulting recommendations, which fell into the following categories: anti-racist guidance/policies and recommendations for research, community engagement, and the department. Center leadership and the SAB were engaged throughout the iterative process.This deliberate and ongoing process allows HERCULES to identify and begin implementing action items that go beyond a written proclamation to address racialized power imbalances and systemic inequities. HERCULES is committed to working collaboratively to earn community trust while addressing systemic issues, recognizing that these are essential to forming research partnerships that address health inequities.
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Affiliation(s)
- Erin Lebow-Skelley
- Emory University, Rollins School of Public Health, Gangarosa Department of Environmental Health, HERCULES Exposome Research Center, Atlanta, Georgia
- Emory University, 1518 Clifton Road NE, Atlanta, GA 30322
| | - Martha Scott Tomlinson
- Emory University, Rollins School of Public Health, Gangarosa Department of Environmental Health, HERCULES Exposome Research Center, Atlanta, Georgia
| | - Simone Charles
- University of Michigan, School of Public Health, Environmental Sciences, Ann Arbor, Michigan
- HERCULES Exposome Research Center, Stakeholder Advisory Board, Atlanta, Georgia
| | - Christina Fuller
- HERCULES Exposome Research Center, Stakeholder Advisory Board, Atlanta, Georgia
- University of Georgia, College of Engineering, School of Environmental, Civil, Agricultural and Mechanical (ECAM) Engineering, Athens, Georgia
| | - Bren Ames
- HERCULES Exposome Research Center, Stakeholder Advisory Board, Atlanta, Georgia
- Aye Open Outcomes, National Human Ecology Action League (HEAL), Atlanta, Georgia
| | - Melanie A Pearson
- Emory University, Rollins School of Public Health, Gangarosa Department of Environmental Health, HERCULES Exposome Research Center, Atlanta, Georgia
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19
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Dickerson AS, Frndak S, DeSantiago M, Mohan A, Smith GS. Environmental Exposure Disparities and Neurodevelopmental Risk: a Review. Curr Environ Health Rep 2023; 10:73-83. [PMID: 37002432 PMCID: PMC11108231 DOI: 10.1007/s40572-023-00396-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 04/03/2023]
Abstract
PURPOSE OF REVIEW Neurotoxicant exposures are of particular concern in historically marginalized communities. Often a consequence of structural racism, low-income minoritized populations experience a disproportionate burden of hazardous exposures through proximity to industrial facilities, high traffic roads, and suboptimal housing. Here, we summarize reports on exposures and neurodevelopment focused on differences by education, income, race/ethnicity, or immigration status from 2015 to 2022, discuss the importance of such investigations in overburdened communities, and recommend areas for future research. RECENT FINDINGS We found 20 studies that investigated exposure disparities and neurodevelopment in children. Most were conducted in the USA, and many focused on air pollution, followed by metal exposures and water contamination. Although several studies showed differences in exposure-outcome associations by income and education, many examining differences by race/ethnicity did not report notable disparities between groups. However, measures of individual race and ethnicity are not reliable measures of discrimination experienced as a consequence of structural racism. Our review supports scientific evidence that the reduction of individual and widespread municipal exposures will improve child development and overall public health. Identified research gaps include the use of better indicators of economic status and structural racism, evaluations of effect modification and attributable fraction of outcomes by these factors, and considerations of multidimensional neighborhood factors that could be protective against environmental insults. Considering that vulnerable populations have disparities in access to and quality of care, greater burden of exposure, and fewer resources to incur associated expenses, such populations should be prioritized.
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Affiliation(s)
- Aisha S Dickerson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
- Hopkins Center for Health Disparities Solution, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
| | - Seth Frndak
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Melissa DeSantiago
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Ankita Mohan
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Genee S Smith
- Hopkins Center for Health Disparities Solution, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
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20
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Wilkins D, Schulz AJ. Antiracist Research and Practice for Environmental Health: Implications for Community Engagement. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:55002. [PMID: 37224068 PMCID: PMC10208422 DOI: 10.1289/ehp11384] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 01/05/2023] [Accepted: 04/14/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Communities who experience disproportionate environmental exposures and associated adverse health outcomes have long been aware of, and worked to draw attention to, the role of racism in shaping those risks. A growing number of researchers are focusing on racism as a fundamental driver of racial inequities in environmental health. Importantly, several research and funding institutions have publicly committed to addressing structural racism within their organizations. These commitments highlight structural racism as a social determinant of health. They also invite reflection on antiracist approaches to community engagement in environmental health research. OBJECTIVES We discuss strategies for taking more explicitly antiracist approaches to community engagement in environmental health research. DISCUSSION Antiracist (as opposed to nonracist, color-blind, or race-neutral) frameworks entail thinking or acting in ways that explicitly question, analyze, and challenge policies and practices that produce or sustain inequities between racial groups. Community engagement is not inherently antiracist. There are, however, opportunities for extending antiracist approaches when engaging communities who are disproportionately harmed by environmental exposures. Those opportunities include a) promoting leadership and decision-making power by representatives from harmed communities, b) centering community priorities in identifying new research areas, and c) translating research into action by applying knowledge from multiple sources to disrupt policies and practices that create and sustain environmental injustices. https://doi.org/10.1289/EHP11384.
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Affiliation(s)
| | - Amy J. Schulz
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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21
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Wilkie AA, Richardson DB, Luben TJ, Serre ML, Woods CG, Daniels JL. Sulfur dioxide reduction at coal-fired power plants in North Carolina and associations with preterm birth among surrounding residents. Environ Epidemiol 2023; 7:e241. [PMID: 37064422 PMCID: PMC10097570 DOI: 10.1097/ee9.0000000000000241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/05/2023] [Indexed: 02/17/2023] Open
Abstract
Coal-fired power plants (CFPP) are major contributors of air pollution, including the majority of anthropogenic sulfur dioxide (SO2) emissions, which have been associated with preterm birth (PTB). To address a 2002 North Carolina (NC) policy, 14 of the largest NC CFPPs either installed desulfurization equipment (scrubbers) or retired coal units, resulting in substantial reductions of SO2 air emissions. We investigated whether SO2 air emission reduction strategies at CFPPs in NC were associated with changes in prevalence of PTB in nearby communities. Methods We used US EPA Air Markets Program Data to track SO2 emissions and determine the implementation dates of intervention at CFPPs and geocoded 2003-2015 NC singleton live births. We conducted a difference-in-difference analysis to estimate change in PTB associated with change in SO2 reduction strategies for populations living 0-<4 and 4-<10 miles from CFPPs pre- and postintervention, with a comparison of those living 10-<15 miles from CFPPs. Results With the spatial-temporal exposure restrictions applied, 42,231 and 41,218 births were within 15 miles of CFPP-scrubbers and CFPP-retired groups, respectively. For residents within 4-<10 miles from a CFPP, we estimated that the absolute prevalence of PTB decreased by -1.5% [95% confidence interval (CI): -2.6, -0.4] associated with scrubber installation and -0.5% (95% CI: -1.6, 0.6) associated with the retirement of coal units at CFPPs. Our findings were imprecise and generally null-to-positive among those living within 0-<4 miles regardless of the intervention type. Conclusions Results suggest a reduction of PTB among residents 4-<10 miles of the CFPPs that installed scrubbers.
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Affiliation(s)
- Adrien A Wilkie
- Oak Ridge Institute for Science and Education (ORISE) Postdoctoral Fellow at US EPA, Research Triangle Park, North Carolina
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - David B Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
- Program in Public Health, University of California at Irvine, Irvine, California
| | - Thomas J Luben
- United States Environmental Protection Agency, Office of Research and Development, Center for Public Health and Environmental Assessment, Research Triangle Park, North Carolina
| | - Marc L Serre
- Department of Environmental Science and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Courtney G Woods
- Department of Environmental Science and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Julie L Daniels
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
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22
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Deziel NC, Warren JL, Bravo MA, Macalintal F, Kimbro RT, Bell ML. Assessing community-level exposure to social vulnerability and isolation: spatial patterning and urban-rural differences. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023; 33:198-206. [PMID: 35388169 PMCID: PMC9535035 DOI: 10.1038/s41370-022-00435-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 05/21/2023]
Abstract
BACKGROUND Environmental health disparity research involves the use of metrics to assess exposure to community-level vulnerabilities or inequities. While numerous vulnerability indices have been developed, there is no agreement on standardization or appropriate use, they have largely been applied in urban areas, and their interpretation and utility likely vary across different geographies. OBJECTIVE We evaluated the spatial distribution, variability, and relationships among different metrics of social vulnerability and isolation across urban and rural settings to inform interpretation and selection of metrics for environmental disparity research. METHODS For all census tracts in North Carolina, we conducted a principal components analysis using 23 socioeconomic/demographic variables from the 2010 United States Census and American Community Survey. We calculated or obtained the neighborhood deprivation index (NDI), residential racial isolation index (RI), educational isolation index (EI), Gini coefficient, and social vulnerability index (SVI). Statistical analyses included Moran's I for spatial clustering, t-tests for urban-rural differences, Pearson correlation coefficients, and changes in ranking of tracts across metrics. RESULTS Social vulnerability metrics exhibited clear spatial patterning (Moran's I ≥ 0.30, p < 0.01). Greater educational isolation and more intense neighborhood deprivation was observed in rural areas and greater racial isolation in urban areas. Single-domain metrics were not highly correlated with each other (rho ≤ 0.36), while composite metrics (i.e., NDI, SVI, principal components analysis) were highly correlated (rho > 0.80). Composite metrics were more highly correlated with the racial isolation metric in urban (rho: 0.54-0.64) versus rural tracts (rho: 0.36-0.48). Census tract rankings changed considerably based on which metric was being applied. SIGNIFICANCE High correlations between composite metrics within urban and rural tracts suggests they could be used interchangeably; single domain metrics cannot. Composite metrics capture different facets of vulnerabilities in urban and rural settings, and these complexities should be examined by researchers applying metrics to areas of diverse urban and rural forms.
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Affiliation(s)
- Nicole C Deziel
- Yale School of Public Health, Department of Environmental Health Sciences, New Haven, CT, USA.
| | - Joshua L Warren
- Yale School of Public Health, Department of Biostatistics, New Haven, CT, USA
| | - Mercedes A Bravo
- Duke University, Global Health Institute, School of Medicine, Durham, NC, USA
| | - Franchesca Macalintal
- Yale School of Public Health, Department of Environmental Health Sciences, New Haven, CT, USA
- Fordham University, Fordham College at Lincoln Center, New York, NY, USA
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23
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Dickerson AS, Dickerson AS. Prenatal socioenvironmental exposures and autism spectrum disorder: A web of confusion. CHILD DEVELOPMENT PERSPECTIVES 2023; 17:32-38. [PMID: 37334167 PMCID: PMC10275509 DOI: 10.1111/cdep.12472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Although evidence of heritability for autism spectrum disorder (ASD) is strong, studies of twin pairs suggest that at least some portion of the etiology is attributable to environmental factors, either directly or through interaction with genes. Given the multitude of environmental and psychosocial exposures that have been reported to increase atypical neurodevelopment in offspring, in this article, we summarize what prenatal air pollutant, chemical, and occupational exposures and psychosocial stressors have been reportedly associated with ASD and co-occurring neurodevelopmental disorders. We highlight consistencies in reported associations and recommend areas for research to close gaps in our understanding of environmental risk for ASD. Because this issue is of particular importance in historically marginalized communities and low- and middle-income countries, we also discuss the importance of environmental justice issues and exposure disparities in research, and we advocate for prioritizing policies to reduce disparities and improve service provision in vulnerable populations.
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Affiliation(s)
- Aisha S. Dickerson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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24
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Biglan A, Prinz RJ, Fishbein D. Prevention Science and Health Equity: A Comprehensive Framework for Preventing Health Inequities and Disparities Associated with Race, Ethnicity, and Social Class. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:602-612. [PMID: 36757658 DOI: 10.1007/s11121-022-01482-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2022] [Indexed: 02/10/2023]
Abstract
The ultimate goal of our public health system is to reduce the incidence of disability and premature death. Evidence suggests that, by this standard, the USA falls behind most other developed countries largely as a function of disparities in health outcomes among significant portions of the US population. We present a framework for addressing these disparities that attributes them, not simply to differences in the behavioral and physical risk factors, but to social, environmental, and structural inequities such as poverty, discrimination, toxic physical setting, and the marketing of harmful products. These inequities result from de facto and instituted public policies. An analysis of the NIH research portfolio indicates a relative lack of investment in experimental evaluations of preventive interventions-especially studies targeting disadvantaged populations. Moreover, experimental research on reducing social inequities is almost entirely lacking. A line of research focusing on the drivers of inequities and their dissolution must include experimental evaluation of strategies for getting policies adopted that will reduce inequities. In conclusion, a summary is provided of the types of research that are needed and the challenges involved in conducting the experimental research that is essential for reducing inequities and disparities and, in turn, prolonging life.
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Affiliation(s)
- Anthony Biglan
- Oregon Research Institute, 2324 West 28th Avenue, Eugene, Eugene, OR, 97405, USA. .,National Prevention Science Coalition to Improve Lives, Pennsylvania, USA.
| | - Ronald J Prinz
- University of South Carolina, Columbia, USA.,National Prevention Science Coalition to Improve Lives, Pennsylvania, USA
| | - Diana Fishbein
- University of North Carolina, Chapel Hill, USA.,The Pennsylvania State University, Pennsylvania, USA.,National Prevention Science Coalition to Improve Lives, Pennsylvania, USA
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25
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Lofton H, Ard JD, Hunt RR, Knight MG. Obesity among African American people in the United States: A review. Obesity (Silver Spring) 2023; 31:306-315. [PMID: 36695059 PMCID: PMC10107750 DOI: 10.1002/oby.23640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/10/2022] [Accepted: 10/27/2022] [Indexed: 01/26/2023]
Abstract
Obesity is a growing public health crisis in the United States and is associated with a substantial disease burden due to an increased risk for multiple complications, including cardiovascular and metabolic diseases. As highlighted in this review, obesity disproportionately affects the African American population, women in particular, regardless of socioeconomic status. Structural racism remains a major contributor to health disparities between African American people and the general population, and it limits access to healthy foods, safe spaces to exercise, adequate health insurance, and medication, all of which impact obesity prevalence and outcomes. Conscious and unconscious interpersonal racism also impacts obesity care and outcomes in African American people and may adversely affect interactions between health care practitioners and patients. To reduce health disparities, structural racism and racial bias must be addressed. Culturally relevant interventions for obesity management have been successfully implemented that have shown benefits in weight management and risk-factor reduction. Strategies to improve health care practitioner-patient engagement should also be implemented to improve health outcomes in African American people with obesity. When managing obesity in African American people, it is critical to take a holistic approach and to consider an individual's social and cultural context in order to implement a successful treatment strategy.
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Affiliation(s)
- Holly Lofton
- NYU Grossman School of Medicine, New York, New York, USA
| | - Jamy D Ard
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Rameck R Hunt
- Penn Medicine Princeton Health, Plainsboro Township, New Jersey, USA
- Rutgers RWJ Medical School, New Brunswick, New Jersey, USA
| | - Michael G Knight
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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26
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Wilson NJ, Friedman E, Kennedy K, Manolakos PT, Reierson L, Roberts A, Simon S. Using exterior housing conditions to predict elevated pediatric blood lead levels. ENVIRONMENTAL RESEARCH 2023; 218:114944. [PMID: 36473524 DOI: 10.1016/j.envres.2022.114944] [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: 04/21/2022] [Revised: 11/06/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
Housing-based lead paint dust is the most common source of lead exposure for US-born children. Although year of housing construction is a critical indicator of the lead hazard to US children, not all housing of the same age poses the same risk to children. Additional information about housing condition is required to differentiate the housing-based lead risk at the parcel level. This study aimed to identify and assess a method for gathering and using observations of exterior housing conditions to identify active housing-based lead hazards at the parcel level. We used a dataset of pediatric blood lead observations (sample years 2000-2013, ages 6-72 months, n = 6,589) to assess associations between observations of exterior housing conditions and housing-based lead risk. We used graphical and Lasso regression methods to estimate the likelihood of an elevated blood lead observation (≥3.5 μg/dL). Our methods estimate a monotonic increase in the likelihood of an elevated blood lead observation as housing conditions deteriorate with the largest changes associated with homes in the greatest disrepair. Additionally we estimate that age of home construction works in consort with housing conditions to amplify risks among those houses built before 1952. Our analysis indicates that a survey of external housing conditions can be used in combination with age of housing in the identification process, at the parcel level, of homes that pose a housing-based lead hazard to children.
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Affiliation(s)
- Neal J Wilson
- Research Associate, Center of Economic Information, Department of Economics, University of Missouri-Kansas City, Kansas City, MO, USA.
| | - Elizabeth Friedman
- Medical Director of Environmental Health Program, Department of Pediatrics, Children's Mercy, Kansas City, Assistant Professor of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
| | - Kevin Kennedy
- Director of Environmental Health Program, Children's Mercy, Kansas City, MO, USA.
| | - Panayiotis T Manolakos
- Director, Center of Economic Information, Department of Economics, University of Missouri-Kansas City, Kansas City, MO, USA.
| | - Lori Reierson
- Research Compliance Coordinator, Children's Mercy, Kansas City, MO, USA.
| | - Amy Roberts
- Program Manager, Childhood Lead Poisoning Prevention and Healthy Homes Program, Kansas City Missouri Health Department, Kansas City, MO, USA.
| | - Steve Simon
- Department of Biomedical and Health Informatics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
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27
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Bather JR, Burke EM, Plepys CM, Goodman MS. Racial and Ethnic Composition of Students, Graduates, and Faculty in Environmental Health Sciences, 2011 to 2021. ENVIRONMENTAL HEALTH INSIGHTS 2023; 17:11786302221150688. [PMID: 36655014 PMCID: PMC9841848 DOI: 10.1177/11786302221150688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
The lack of diversity among the environmental health sciences (EHS) workforce has been an ongoing concern. However, limited research exists on the racial and ethnic composition of EHS students and faculty over time. We analyzed 2011 and 2021 data on EHS students, graduates, and faculty to compare changes in the racial and ethnic composition among Association of Schools and Programs of Public Health-member institutions. Among the institutions that reported data in both years, we observed significant proportion increases among Hispanic enrolled students (overall and master's: both P = .01), Multiracial enrolled students and graduates (overall: both P < .05, master's level: both P < .05), and Asian tenured professors (P = .01). Significant decreases were observed among Unknown enrolled students (overall: P = .01, master's level: P < .001), Unknown master's level graduates (P = .01), AI/AN enrolled students (overall and master's: both P < .05), and White full professors (P < .001) and tenured faculty (P < .001). Despite these findings, no substantial change existed among the other racial and ethnic groups. More efforts are needed to recruit, train, and promote racial and ethnic minorities who can leverage their lived experiences to provide novel solutions to environmental challenges.
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Affiliation(s)
- Jemar R Bather
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Emily M Burke
- Association of Schools and Programs of Public Health, Washington, DC, USA
| | - Christine M Plepys
- Association of Schools and Programs of Public Health, Washington, DC, USA
| | - Melody S Goodman
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, USA
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28
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Malinowska JK, Żuradzki T. Towards the multileveled and processual conceptualisation of racialised individuals in biomedical research. SYNTHESE 2022; 201:11. [PMID: 36591336 PMCID: PMC9795162 DOI: 10.1007/s11229-022-04004-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
In this paper, we discuss the processes of racialisation on the example of biomedical research. We argue that applying the concept of racialisation in biomedical research can be much more precise, informative and suitable than currently used categories, such as race and ethnicity. For this purpose, we construct a model of the different processes affecting and co-shaping the racialisation of an individual, and consider these in relation to biomedical research, particularly to studies on hypertension. We finish with a discussion on the potential application of our proposition to institutional guidelines on the use of racial categories in biomedical research.
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Affiliation(s)
| | - Tomasz Żuradzki
- Institute of Philosophy & Interdisciplinary Centre for Ethics, Jagiellonian University, ul. Grodzka 52, 31-044 Kraków, Poland
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29
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Martenies SE, Hoskovec L, Wilson A, Moore BF, Starling AP, Allshouse WB, Adgate JL, Dabelea D, Magzamen S. Using non-parametric Bayes shrinkage to assess relationships between multiple environmental and social stressors and neonatal size and body composition in the Healthy Start cohort. Environ Health 2022; 21:111. [PMID: 36401268 PMCID: PMC9675112 DOI: 10.1186/s12940-022-00934-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 10/30/2022] [Indexed: 06/09/2023]
Abstract
BACKGROUND Both environmental and social factors have been linked to birth weight and adiposity at birth, but few studies consider the effects of exposure mixtures. Our objective was to identify which components of a mixture of neighborhood-level environmental and social exposures were driving associations with birth weight and adiposity at birth in the Healthy Start cohort. METHODS Exposures were assessed at the census tract level and included air pollution, built environment characteristics, and socioeconomic status. Prenatal exposures were assigned based on address at enrollment. Birth weight was measured at delivery and adiposity was measured using air displacement plethysmography within three days. We used non-parametric Bayes shrinkage (NPB) to identify exposures that were associated with our outcomes of interest. NPB models were compared to single-predictor linear regression. We also included generalized additive models (GAM) to assess nonlinear relationships. All regression models were adjusted for individual-level covariates, including maternal age, pre-pregnancy BMI, and smoking. RESULTS Results from NPB models showed most exposures were negatively associated with birth weight, though credible intervals were wide and generally contained zero. However, the NPB model identified an interaction between ozone and temperature on birth weight, and the GAM suggested potential non-linear relationships. For associations between ozone or temperature with birth weight, we observed effect modification by maternal race/ethnicity, where effects were stronger for mothers who identified as a race or ethnicity other than non-Hispanic White. No associations with adiposity at birth were observed. CONCLUSIONS NPB identified prenatal exposures to ozone and temperature as predictors of birth weight, and mothers who identify as a race or ethnicity other than non-Hispanic White might be disproportionately impacted. However, NPB models may have limited applicability when non-linear effects are present. Future work should consider a two-stage approach where NPB is used to reduce dimensionality and alternative approaches examine non-linear effects.
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Affiliation(s)
- Sheena E Martenies
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S Goodwin Ave, M/C 052, Urbana, IL, 61801, USA.
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA.
| | - Lauren Hoskovec
- Department of Statistics, Colorado State University, Fort Collins, CO, USA
| | - Ander Wilson
- Department of Statistics, Colorado State University, Fort Collins, CO, USA
| | - Brianna F Moore
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Anne P Starling
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD Center), University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - William B Allshouse
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Campus, Aurora, CO, USA
| | - John L Adgate
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Campus, Aurora, CO, USA
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD Center), University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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30
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Collins TW, Grineski SE, Shaker Y, Mullen CJ. Communities of color are disproportionately exposed to long-term and short-term PM 2.5 in metropolitan America. ENVIRONMENTAL RESEARCH 2022; 214:114038. [PMID: 35961542 DOI: 10.1016/j.envres.2022.114038] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
We conducted a novel investigation of neighborhood-level racial/ethnic exposure disparities employing measures aligned with long-term and short-term PM2.5 air pollution benchmarks across metropolitan contexts of the contiguous United States, 2012-2016. We used multivariable generalized estimating equations (GEE) to quantify PM2.5 exposure disparities based on the census tract composition of people of color (POC) and POC groups (Hispanic/Latina/x/o, Black, Asian). We examined eight census tract-level measures of longer-to-shorter term exposures derived from data on modeled daily ambient PM2.5 concentrations. We found associations between increased POC composition and greater exposure to all PM2.5 measures, with associations strengthening across measures of longer-to-shorter term exposures. In a GEE with a negative binomial distribution, a standard deviation increase in POC composition predicted a 0.6% increase (incidence rate ratio (IRR): 1.006, 95% confidence interval (CI): 1.005-1.008) in the number of days PM2.5 concentrations were ≥5 μg/m3 (longest-term benchmark). In a GEE with an inverse Gaussian distribution, a standard deviation increase in POC composition predicted a 0.110 μg/m3 (1.0%) increase (B: 0.110, 95% CI: 0.076-0.143) in mean PM2.5 concentration. In GEEs with a negative binomial distribution, the effect of a standard deviation increase in POC composition on exposure strengthened to 2.6% (IRR:1.026, 95% CI:1.017-1.035), 3.4% (IRR:1.034, 95% CI:1.022-1.047), 4.2% (IRR:1.042, 95% CI:1.025-1.058), 16.2% (IRR:1.162, 95% CI:1.117-1.210), 22.7% (IRR:1.227, 95% CI:1.137-1.325) and 28.3% (IRR:1.283, 95% CI:1.144-1.439) with respect to the number of days PM2.5 concentrations were ≥10, 12, 15, 25, 35 and 55.5 μg/m3. POC group models indicated exposure disparities based on greater Hispanic/Latina/x/o, Asian, and Black composition. Evidence for stronger POC associations with shorter-term (higher concentration) PM2.5 exceedances suggests that reducing PM2.5 would attenuate racial/ethnic exposure disparities.
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Affiliation(s)
- Timothy W Collins
- Department of Geography, University of Utah; 260 Central Campus Dr., Rm. 4625, Salt Lake City, UT, 84112, USA; Center for Natural & Technological Hazards, University of Utah; 260 Central Campus Dr., Rm. 4625, Salt Lake City, UT, 84112, USA.
| | - Sara E Grineski
- Center for Natural & Technological Hazards, University of Utah; 260 Central Campus Dr., Rm. 4625, Salt Lake City, UT, 84112, USA; Department of Sociology, University of Utah; 380 S 1530 E, Rm. 301, Salt Lake City, UT, 84112, USA
| | - Yasamin Shaker
- Center for Natural & Technological Hazards, University of Utah; 260 Central Campus Dr., Rm. 4625, Salt Lake City, UT, 84112, USA; Department of Sociology, University of Utah; 380 S 1530 E, Rm. 301, Salt Lake City, UT, 84112, USA
| | - Casey J Mullen
- Center for Natural & Technological Hazards, University of Utah; 260 Central Campus Dr., Rm. 4625, Salt Lake City, UT, 84112, USA; Department of Sociology, University of Utah; 380 S 1530 E, Rm. 301, Salt Lake City, UT, 84112, USA
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31
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Balanay JAG, Mitchell LD, Richards SL. Racial and Gender Diversity Among Students and Faculty in EHAC-Accredited Environmental Health Sciences Programs: Trend Analysis from 2009 to 2021. ENVIRONMENTAL HEALTH INSIGHTS 2022; 16:11786302221112917. [PMID: 35899223 PMCID: PMC9309757 DOI: 10.1177/11786302221112917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/23/2022] [Indexed: 06/15/2023]
Abstract
Diversity in the environmental health sciences (EHS) workforce is crucial in providing culturally sensitive services to diverse communities. This may be influenced by academic faculty training a diverse student body in the field of environmental health. This study aimed to characterize the diversity of students and faculty in EHS programs accredited by the National Environmental Health Science and Protection Accreditation Council (EHAC). A retrospective analysis was conducted on secondary data obtained from annual surveys administered to program directors in EHAC-accredited academic programs that included both undergraduate and graduate EHS degrees. The database covered surveys on gender and race that were conducted by EHAC for 12 academic years spanning 2009-2010 to 2020-2021. Results show most students (undergraduate and graduate) were female (54.4% and 52.1%, respectively) and white (61.0% and 50.7%, respectively). Increasing trends were observed over the last 12 years (2009-2021) in female undergraduate (from 53.7% to 59.8%) and graduate (from 47.1% to 60.3%) students and in non-white undergraduate students (from 40.0% to 48.2%). Most faculty (teaching in undergraduate and graduate programs) were male (64.4% and 64.3%, respectively) and white (77.9% and 92.1%, respectively). Increasing trends were observed from 2009 to 2021 in female faculty teaching undergraduate (from 27.7% to 42.2%) and graduate (from 31.3% to 42.1%) students. Native American, Alaska Native, Native Hawaiian, and Pacific Islander are consistently the most underrepresented racial groups in both undergraduate and graduate students and faculty. This study provides baseline data on the diversity of students and faculty in EHAC-accredited programs, which is important in informing future research and efforts to increase such diversity. Gender and racial disparity in EHS students and faculty needs to be addressed to provide necessary support to women and non-White constituents by institutional change in culture through active recruitment and by stronger collaboration between professional organizations and minority groups.
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Affiliation(s)
- Jo Anne G Balanay
- Environmental Health Sciences Program,
Department of Health Education and Promotion, College of Health and Human
Performance, East Carolina University, Greenville, NC, USA
| | - Leslie D Mitchell
- National Environmental Health Science
and Protection Accreditation Council (EHAC), Burien, WA, USA
| | - Stephanie L Richards
- Environmental Health Sciences Program,
Department of Health Education and Promotion, College of Health and Human
Performance, East Carolina University, Greenville, NC, USA
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32
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Martenies SE, Zhang M, Corrigan AE, Kvit A, Shields T, Wheaton W, Bastain TM, Breton CV, Dabelea D, Habre R, Magzamen S, Padula AM, Him DA, Camargo CA, Cowell W, Croen LA, Deoni S, Everson TM, Hartert TV, Hipwell AE, McEvoy CT, Morello-Frosch R, O'Connor TG, Petriello M, Sathyanarayana S, Stanford JB, Woodruff TJ, Wright RJ, Kress AM. Associations between combined exposure to environmental hazards and social stressors at the neighborhood level and individual perinatal outcomes in the ECHO-wide cohort. Health Place 2022; 76:102858. [PMID: 35872389 PMCID: PMC9661655 DOI: 10.1016/j.healthplace.2022.102858] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/06/2022] [Accepted: 06/28/2022] [Indexed: 11/04/2022]
Abstract
Limited studies examine how prenatal environmental and social exposures jointly impact perinatal health. Here we investigated relationships between a neighborhood-level combined exposure (CE) index assessed during pregnancy and perinatal outcomes, including birthweight, gestational age, and preterm birth. Across all participants, higher CE index scores were associated with small decreases in birthweight and gestational age. We also observed effect modification by race; infants born to Black pregnant people had a greater risk of preterm birth for higher CE values compared to White infants. Overall, our results suggest that neighborhood social and environmental exposures have a small but measurable joint effect on neonatal indicators of health.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Dana Dabelea
- University of Colorado Anschutz Medical Campus, USA
| | | | | | | | | | | | | | - Lisa A Croen
- Kaiser Permanente Northern California Division of Research, USA
| | | | - Todd M Everson
- Rollins School of Public Health at Emory University, USA
| | | | | | | | | | | | - Michael Petriello
- Wayne State University, Institute of Environmental Health Sciences, USA
| | | | - Joseph B Stanford
- University of Utah, Departments of Family and Preventive Medicine and Pediatrics, USA
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33
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Buckley J, Kuiper JR, Bennett DH, Barrett ES, Bastain T, Breton CV, Chinthakindi S, Dunlop AL, Farzan SF, Herbstman JB, Karagas MR, Marsit CJ, Meeker JD, Morello-Frosch R, O’Connor TG, Romano ME, Schantz S, Schmidt RJ, Watkins DJ, Zhu H, Pellizzari ED, Kannan K, Woodruff TJ. Exposure to Contemporary and Emerging Chemicals in Commerce among Pregnant Women in the United States: The Environmental influences on Child Health Outcome (ECHO) Program. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:6560-6573. [PMID: 35536918 PMCID: PMC9118548 DOI: 10.1021/acs.est.1c08942] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 05/10/2023]
Abstract
Prenatal chemical exposures can influence maternal and child health; however, few industrial chemicals are routinely biomonitored. We assessed an extensive panel of contemporary and emerging chemicals in 171 pregnant women across the United States (U.S.) and Puerto Rico in the Environmental influences on Child Health Outcomes (ECHO) Program. We simultaneously measured urinary concentrations of 89 analytes (103 total chemicals representing 73 parent compounds) in nine chemical groups: bactericides, benzophenones, bisphenols, fungicides and herbicides, insecticides, organophosphate esters (OPEs), parabens, phthalates/alternative plasticizers, and polycyclic aromatic hydrocarbons (PAHs). We estimated associations of creatinine-adjusted concentrations with sociodemographic and specimen characteristics. Among our diverse prenatal population (60% non-Hispanic Black or Hispanic), we detected 73 of 89 analytes in ≥1 participant and 36 in >50% of participants. Five analytes not currently included in the U.S. biomonitoring were detected in ≥90% of samples: benzophenone-1, thiamethoxam, mono-2-(propyl-6-carboxy-hexyl) phthalate, monocarboxy isooctyl phthalate, and monohydroxy-iso-decyl phthalate. Many analyte concentrations were higher among women of Hispanic ethnicity compared to those of non-Hispanic White women. Concentrations of certain chemicals decreased with the calendar year, whereas concentrations of their replacements increased. Our largest study to date identified widespread exposures to prevalent and understudied chemicals in a diverse sample of pregnant women in the U.S.
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Affiliation(s)
- Jessie
P. Buckley
- Department
of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21218, United States
| | - Jordan R. Kuiper
- Department
of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21218, United States
| | - Deborah H. Bennett
- Department
of Public Health Sciences, University of California Davis, Davis, California 95616, United States
| | - Emily S. Barrett
- Department
of Biostatistics and Epidemiology, Rutgers
School of Public Health, Piscataway, New Jersey 08854, United States
| | - Tracy Bastain
- Department
of Population and Public Health Sciences, University of Southern California, Los Angeles, California 90032, United States
| | - Carrie V. Breton
- Department
of Population and Public Health Sciences, University of Southern California, Los Angeles, California 90032, United States
| | - Sridhar Chinthakindi
- Department
of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, New York 10016, United States
| | - Anne L. Dunlop
- Department
of Gynecology and Obstetrics, Emory University
School of Medicine, Atlanta, Georgia 30322, United States
| | - Shohreh F. Farzan
- Department
of Population and Public Health Sciences, University of Southern California, Los Angeles, California 90032, United States
| | - Julie B. Herbstman
- Department
of Environmental Health Sciences, Columbia, New York, NY 10032, United States
| | - Margaret R. Karagas
- Department
of Epidemiology, Dartmouth Geisel School
of Medicine, Lebanon, New Hampshire 03756, United States
| | - Carmen J. Marsit
- Department
of Environmental Health, Rollins School
of Public Health, Emory University, Atlanta, Georgia 30322, United States
| | - John D. Meeker
- Department
of Environmental Health Sciences, University
of Michigan School of Public Health, Ann Arbor, Michigan 48109, United States
| | - Rachel Morello-Frosch
- Department
of Environmental Science, Policy and Management and School of Public
Health, University of California, Berkeley California 94720, United States
| | - Thomas G. O’Connor
- Department
of Psychiatry, University of Rochester, Rochester, New York 14627, United States
| | - Megan E. Romano
- Department
of Epidemiology, Dartmouth Geisel School
of Medicine, Lebanon, New Hampshire 03756, United States
| | - Susan Schantz
- Beckman
Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, Illinois 61801, United States
| | - Rebecca J. Schmidt
- Department
of Public Health Sciences, University of California Davis, Davis, California 95616, United States
| | - Deborah J. Watkins
- Department
of Environmental Health Sciences, University
of Michigan School of Public Health, Ann Arbor, Michigan 48109, United States
| | - Hongkai Zhu
- Department
of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, New York 10016, United States
| | - Edo D. Pellizzari
- RTI International, Research Triangle
Park, North Carolina 27709, United States
| | - Kurunthachalam Kannan
- Department
of Pediatrics and Department of Environmental Medicine, New York University School of Medicine, New York, New York 10016, United States
| | - Tracey J. Woodruff
- Department
of Obstetrics, Gynecology, and Reproductive Sciences and the Philip
R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California 94143, United States
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34
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Slopen N, Heard-Garris N. Social and Physical Environment Inequalities and Childhood Health-Reply. JAMA Pediatr 2022; 176:423. [PMID: 35157016 DOI: 10.1001/jamapediatrics.2021.6289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Natalie Slopen
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Center on the Developing Child, Harvard University, Boston, Massachusetts
| | - Nia Heard-Garris
- Division of Advanced General Pediatrics and Primary Care, Department of Pediatrics, Mary Ann & J. Milburn Smith Child Health Outreach, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, Chicago, Illinois.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, Illinois
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35
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Kaufman JD. Environmental Health Perspectives at 50. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:41001. [PMID: 35442067 PMCID: PMC9020373 DOI: 10.1289/ehp11367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 04/06/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Joel D Kaufman
- Environmental Health Perspectives, National Institute of Environmental Health Sciences, National Institutes of Health, U.S. Department of Health and Human Services, Research Triangle Park, North Carolina, USA
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
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36
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Roberts JD, Dickinson KL, Hendricks MD, Jennings V. "I Can't Breathe": Examining the Legacy of American Racism on Determinants of Health and the Ongoing Pursuit of Environmental Justice. Curr Environ Health Rep 2022; 9:211-227. [PMID: 35244891 PMCID: PMC8894549 DOI: 10.1007/s40572-022-00343-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 12/03/2022]
Abstract
Purpose of Review “I can’t breathe” were the last words spoken by Eric Garner (July 17, 2014), Javier Ambler (March 28, 2019), Elijah McClain (August 30, 2019), Manuel Ellis (March 3, 2020), and George Floyd (May 25, 2020). These were all African American men who died at the hands of police in the United States. Recently, police brutality has gained critical and overdue attention as one clear manifestation of systemic racism. However, historical and current policies related to a wide range of environmental hazards have exposed Black, Indigenous, and People of Color (BIPOC) to disproportionately high levels of physical, mental, social, emotional, and cultural toxicities, thus creating unbreathable and unlivable communities. Recent Findings This paper traces the roots of systemic anti-Black racism in America from its origins in the 1400s, through systems of scientific racism that pathologized Blackness in order to justify slavery, and through evolving policies and structures that have shifted over time but consistently exposed many African American communities to unsafe and unhealthy environments. Summary We conclude with calls for bold solutions to move through and past this oppressive history and toward true environmental justice the enables all communities to thrive together.
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Affiliation(s)
- Jennifer D Roberts
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, 20742, USA.
| | - Katherine L Dickinson
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz, Aurora, CO, 80045, USA
| | - Marccus D Hendricks
- Department of Urban Studies and Planning, School of Architecture, Planning and Preservation, University of Maryland, College Park, MD, 20742, USA
| | - Viniece Jennings
- Department of Public Health, Agnes Scott College, Decatur, GA, 30030, USA
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37
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Balanay JAG, Richards SL. Insights into Diversity in the Environmental Health Science Workforce. ENVIRONMENTAL HEALTH INSIGHTS 2022; 16:11786302221077513. [PMID: 35153487 PMCID: PMC8832615 DOI: 10.1177/11786302221077513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 05/31/2023]
Affiliation(s)
- Jo Anne G Balanay
- Department of Health Education and Promotion, Environmental Health Science Program, East Carolina University, Greenville, NC, USA
| | - Stephanie L Richards
- Department of Health Education and Promotion, Environmental Health Science Program, East Carolina University, Greenville, NC, USA
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38
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Simon MC, Hart JE, Levy JI, VoPham T, Malwitz A, Nguyen D, Bozigar M, Cupples LA, James P, Laden F, Peters JL. Sociodemographic Patterns of Exposure to Civil Aircraft Noise in the United States. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:27009. [PMID: 35167327 PMCID: PMC8846369 DOI: 10.1289/ehp9307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND Communities with lower socioeconomic status and higher prevalence of racial/ethnic minority populations are often more exposed to environmental pollutants. Although studies have shown associations between aircraft noise and property values and various health outcomes, little is known about how aircraft noise exposures are sociodemographically patterned. OBJECTIVE Our aim was to describe characteristics of populations exposed to aviation noise by race/ethnicity, education, and income in the United States. METHODS Aircraft noise contours characterized as day-night average sound level (DNL) were developed for 90 U.S. airports in 2010 for DNL ≥45 dB(A) in 1-dB(A) increments. We compared characteristics of exposed U.S. Census block groups at three thresholds (≥45, ≥55, and ≥65 dB(A)), assigned on the basis of the block group land area being ≥50% within the threshold, vs. unexposed block groups near study airports. Comparisons were made across block group race/ethnicity, education, and income categories within the study areas (n=4,031-74,253). We performed both multinomial and other various multivariable regression approaches, including models controlling for airport and models with random intercepts specifying within-airport effects and adjusting for airport-level means. RESULTS Aggregated across multiple airports, block groups with a higher Hispanic population had higher odds of being exposed to aircraft noise. For example, the multinomial analysis showed that a 10-percentage point increase in a block group's Hispanic population was associated with an increased odds ratio of 39% (95% CI: 25%, 54%) of being exposed to ≥65 dB(A) compared with block groups exposed to <45 dB(A). Block groups with higher proportions of residents with only a high school education had higher odds of being exposed to aircraft noise. Results were robust across multiple regression approaches; however, there was substantial heterogeneity across airports. DISCUSSION These results suggest that across U.S. airports, there is indication of sociodemographic disparities in noise exposures. https://doi.org/10.1289/EHP9307.
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Affiliation(s)
- Matthew C. Simon
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
- John A. Volpe National Transportation Systems Center, U.S. Department of Transportation, Cambridge, Massachusetts, USA
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jonathan I. Levy
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Trang VoPham
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Epidemiology Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Andrew Malwitz
- John A. Volpe National Transportation Systems Center, U.S. Department of Transportation, Cambridge, Massachusetts, USA
| | - Daniel Nguyen
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Matthew Bozigar
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - L. Adrienne Cupples
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Peter James
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Junenette L. Peters
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
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39
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Stieb DM. Strengthening the epidemiological evidence linking air pollution and COVID-19. Am J Respir Crit Care Med 2022; 205:605-606. [PMID: 35100515 DOI: 10.1164/rccm.202112-2813ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- David M Stieb
- Health Canada, Vancouver, Ontario, Canada.,University of Ottawa Faculty of Medicine, 12365, Ottawa, Ontario, Canada;
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Neuwirth LS, Quadros-Mennella PS, Kang YY, Linden ML, Nahmani M, Abrams M, Leussis MP, Illig KR. Revisiting Diversity, Equity, and Inclusion Commitments and Instituting Lasting Actionable Changes in the Faculty for Undergraduate Neuroscience. JOURNAL OF UNDERGRADUATE NEUROSCIENCE EDUCATION : JUNE : A PUBLICATION OF FUN, FACULTY FOR UNDERGRADUATE NEUROSCIENCE 2021; 20:E1-E3. [PMID: 35540951 PMCID: PMC9053422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Lorenz S. Neuwirth
- Department of Psychology, SUNY Old Westbury
- SUNY Neuroscience Research Institute, Old Westbury, NY 11568, USA
| | | | - Yuan Yuan Kang
- Department of Natural Sciences, University of Houston Downtown, Houston, TX 77002, USA
| | - Monica L. Linden
- Department of Neuroscience, Brown University, Providence, RI 02038, USA
| | - Marc Nahmani
- Division of Sciences and Mathematics, University of Washington, Tacoma, WA 98402
| | - Mathew Abrams
- INCF Secretariat, Karolinska Institute, Stockholm, SE-17177, Sweden
| | - Melanie P. Leussis
- Department of Psychology & Neuroscience, Emmanuel College, Boston, MA 02115
| | - Kurt R. Illig
- Department of Biology & Interdisciplinary Neuroscience Program, University of St. Thomas, St. Paul, MN 55105
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Spiller E, Proville J, Roy A, Muller NZ. Mortality Risk from PM2.5: A Comparison of Modeling Approaches to Identify Disparities across Racial/Ethnic Groups in Policy Outcomes. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:127004. [PMID: 34878311 PMCID: PMC8653772 DOI: 10.1289/ehp9001] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 05/25/2023]
Abstract
BACKGROUND Regulatory analyses of air pollution policies require the use of concentration-response functions and underlying health data to estimate the mortality and morbidity effects, as well as the resulting benefits, associated with policy-related changes in fine particulate matter ≤2.5μm (PM2.5)]. Common practice by U.S. federal agencies involves using underlying health data and concentration-response functions that are not differentiated by racial/ethnic group. OBJECTIVES We aim to explore the policy implications of using race/ethnicity-specific concentration-response functions and mortality data in comparison to standard approaches when estimating the impact of air pollution on non-White racial/ethnic subgroups. METHODS Using new estimates from the epidemiological literature on race/ethnicity-specific concentration-response functions paired with race/ethnicity-specific mortality rates, we estimated the mortality impacts of air pollution from all sources from a uniform increase in concentrations and from the regulations imposed by the Mercury Air Toxics Standards. RESULTS Use of race/ethnicity-specific information increased PM2.5-related premature mortality estimates in older populations by 9% and among older Black Americans by 150% for all-source pollution exposure. Under a uniform degradation of air quality and race/ethnicity-specific information, older Black Americans were found to have approximately 3 times higher mortality relative to White Americans, which is obscured under a non-race/ethnicity-specific modeling approach. Standard approaches of using non-racial/ethnic specific information underestimate the benefits of the Mercury Air Toxics Standards to older Black Americans by almost 60% and overestimate the benefits to older White Americans by 14% relative to using a race/ethnicity-specific modeling approach. DISCUSSION Policy analyses incorporating race/ethnicity-specific concentration-response functions and mortality data relative to nondifferentiated inputs underestimate the overall magnitude of PM2.5 mortality burden and the disparity in impacts on older Black American populations. Based on our results, we recommend that the best available race/ethnicity-specific inputs are used in regulatory assessments to understand and reduce environmental injustices. https://doi.org/10.1289/EHP9001.
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Affiliation(s)
| | | | - Ananya Roy
- Environmental Defense Fund, New York, New York, USA
| | - Nicholas Z. Muller
- Tepper School of Business, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
- National Bureau of Economic Research, Cambridge, Massachusetts, USA
- Wilton E. Scott Institute for Energy Innovation, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
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Xu J, Lawrence KG, O'Brien KM, Jackson CL, Sandler DP. Association between neighbourhood deprivation and hypertension in a US-wide Cohort. J Epidemiol Community Health 2021; 76:268-273. [PMID: 34789553 PMCID: PMC8837699 DOI: 10.1136/jech-2021-216445] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 09/03/2021] [Indexed: 11/07/2022]
Abstract
Background Socioeconomic status (SES) at the individual level is associated with hypertension risk. Less is known about neighbourhood level SES or how neighbourhood and individual level SES may jointly affect hypertension risk. Methods The Area Deprivation Index (ADI) includes 17 census-based measures reflecting neighbourhood SES. The ADI was linked to enrolment addresses of 47 329 women in the Sister Study cohort and categorised as ≤10% (low deprivation), 11%–20%, 21%–35%, 36%–55% and >55% (high deprivation). Hypertension was defined as either high systolic (≥140 mm Hg) or diastolic (≥90 mm Hg) blood pressure or taking antihypertensive medication. We used log binomial regression to investigate the cross-sectional association between ADI and hypertension and evaluated interactions between ADI and race/ethnicity and between ADI and individual SES. Results The highest ADI level of >55% was associated with increased prevalence of hypertension, compared with the lowest level of ADI≤10%, in a model adjusted for age, race/ethnicity, educational attainment and annual household income (prevalence ratio=1.26, 95% CI 1.21 to 1.32). We observed interaction between race/ethnicity and ADI (interaction contrast ratio (ICR)=1.9; 95% CI 0.94 to 2.8 comparing non-Hispanic Black women with ADI >55% to non-Hispanic White women with ADI≤10%) and between household income and ADI (ICR 0.38; 95% CI 0.12 to 0.65 comparing participants with household income ≤US$49 999 and ADI>55% to those with household income >US$100 000 and ADI≤10%). Conclusions These findings suggest that neighbourhood deprivation measured by ADI may be a risk factor for hypertension and that ADI may act synergistically with race/ethnicity and individual household income to contribute to hypertension.
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Affiliation(s)
- Jing Xu
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA.,Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China
| | - Kaitlyn G Lawrence
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
| | - Katie M O'Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA.,Intramural Program, National Institute of Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
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Brody JG, Cirillo PM, Boronow KE, Havas L, Plumb M, Susmann HP, Gajos KZ, Cohn BA. Outcomes from Returning Individual versus Only Study-Wide Biomonitoring Results in an Environmental Exposure Study Using the Digital Exposure Report-Back Interface (DERBI). ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:117005. [PMID: 34766835 PMCID: PMC8589017 DOI: 10.1289/ehp9072] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Study participants want to receive their biomonitoring results for environmental chemicals, and ethics guidelines encourage reporting back. However, few studies have quantitively assessed participants' responses to individual exposure reports, and digital methods have not been evaluated. OBJECTIVES We isolated effects of receiving personal results vs. only study-wide findings and investigated whether effects differed for Black participants. METHODS We randomly assigned a subset of 295 women from the Child Health and Development Studies, half of whom were Black, to receive a report with personal environmental chemical results or only study-wide (aggregate) findings. Reports included results for 42 chemicals and lipids and were prepared using the Digital Exposure Report-Back Interface (DERBI). Women were interviewed before and after viewing their report. We analyzed differences in website activity, emotional responses, and intentions to participate in future research by report type and race using Wilcoxon rank sum tests, Wilcoxon-Pratt signed ranks tests, and multiple regression. RESULTS The personal report group spent approximately twice as much time on their reports as the aggregate group before the post-report-back interview. Among personal-report participants (n=93), 84% (78) viewed chemical group information for at least one personal result highlighted on their home page; among aggregate-report participants (n=94), 66% (62) viewed any chemical group page. Both groups reported strong positive feelings (curious, informed, interested, respected) about receiving results before and after report-back and mild negative feelings (helpless, scared, worried). Although most participants remained unworried after report-back, worry increased by a small amount in both groups. Among Black participants, higher post report-back worry was associated with having high levels of chemicals. CONCLUSIONS Participants were motivated by their personal results to access online information about chemical sources and potential health effects. Report-back was associated with a small increase in worry, which could motivate appropriate action. Personal report-back increased engagement with exposure reports among Black participants. https://doi.org/10.1289/EHP9072.
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Affiliation(s)
| | | | | | - Laurie Havas
- Participant Advisory Council, Child Health and Development Studies, Public Health Institute, Oakland, California, USA
| | - Marj Plumb
- Plumbline Coaching and Consulting, Omaha, Nebraska, USA
| | - Herbert P. Susmann
- Department of Biostatistics, School of Public Health and Health Science, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Krzysztof Z. Gajos
- Computer Science, Harvard John A. Paulson School of Engineering and Applied Sciences, Cambridge, Massachusetts, USA
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Lyon D. Oncology Nursing Research: Moving Toward Equitable and Inclusive Science. Oncol Nurs Forum 2021; 48:469-470. [PMID: 34411082 DOI: 10.1188/21.onf.469-470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
One of the challenges for nurse scientists, particularly those of us educated in traditional academic models, is the question of how to make certain that our research addresses critical barriers to achieving health and healthcare equity. Traditional research inculcation taught us to focus on discrete, answerable questions, using an attainable sample given the financial and practical limitations inherent in research implementation. Although these techniques were part of an agreed-upon scientific method, the restrictions can lead to an answer to a circumscribed question but fail to articulate the broader issues inherent in designing and implementing human research that moves from inquiry to impact. Although our strong history in oncology nursing research includes a range of health concerns and responses to cancer, including biologic, socio-cultural, sex and gender, and, more recently, financial, I think that we, as oncology nurse scientists, agree that the focus of our research needs to more explicitly address pernicious aspects of health that lead to health disparities: racism and structural discrimination. Racism and structural barriers cloud all aspects of oncology: early detection, the design and uptake of promising therapeutics, quality of life, and financial well-being during active treatment and survivorship. How do we take the essential steps to not only measure but also address these critical barriers to reduce disparities and bring about more equitable and salubrious outcomes in oncology nursing research?
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Bowen FR, Ward T. Failing to address racism: A commentary on "From Florence to Fossil Fuels: Nursing Has Always Been About Environmental Health". Nurs Outlook 2021; 69:732-734. [PMID: 34389175 DOI: 10.1016/j.outlook.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 07/13/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Felesia R Bowen
- Medical University of South Carolina College of Nursing, Charleston, SC.
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Science Policy to Advance a Climate Change and Health Research Agenda in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157868. [PMID: 34360159 PMCID: PMC8345657 DOI: 10.3390/ijerph18157868] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/16/2021] [Accepted: 07/21/2021] [Indexed: 01/27/2023]
Abstract
Climate change is thought to be one of the greatest public health threats of the 21st century and there has been a tremendous growth in the published literature describing the health implications of climate change over the last decade. Yet, there remain several critical knowledge gaps in this field. Closing these gaps is crucial to developing effective interventions to minimize the health risks from climate change. In this commentary, we discuss policy trends that have influenced the advancement of climate change and health research in the United States context. We then enumerate specific knowledge gaps that could be addressed by policies to advance scientific research. Finally, we describe tools and methods that have not yet been fully integrated into the field, but hold promise for advancing the science. Prioritizing this advancement offers the potential to improve public health-related policies on climate change.
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Deziel NC. Invited Perspective: Oil and Gas Development and Adverse Birth Outcomes: What More Do We Need to Know? ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:71301. [PMID: 34287014 PMCID: PMC8312483 DOI: 10.1289/ehp9715] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Affiliation(s)
- Nicole C. Deziel
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, USA
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Kaufman JD, Hajat A. Confronting Environmental Racism. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:51001. [PMID: 34014764 PMCID: PMC8137098 DOI: 10.1289/ehp9511] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 05/04/2023]
Affiliation(s)
- Joel D. Kaufman
- Environmental Health Perspectives, National Institute of Environmental Health Sciences, National Institutes of Health, U.S. Department of Health and Human Services, Research Triangle Park, North Carolina, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Anjum Hajat
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
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