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Gueye-Ndiaye S, Tully M, Amin R, Baldassari CM, Chervin RD, Cole M, Ibrahim S, Kirkham EM, Mitchell RB, Naqvi K, Ross K, Rueschman M, Tapia IE, Williamson AA, Wei Z, Rosen CL, Wang R, Redline S. Neighborhood Disadvantage, Quality of Life, and Symptom Burden in Children with Mild Sleep-disordered Breathing. Ann Am Thorac Soc 2024; 21:604-611. [PMID: 38241286 PMCID: PMC10995551 DOI: 10.1513/annalsats.202307-653oc] [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: 07/28/2023] [Accepted: 01/18/2024] [Indexed: 01/21/2024] Open
Abstract
Rationale: Neighborhood disadvantage (ND) has been associated with sleep-disordered breathing (SDB) in children. However, the association between ND and SDB symptom burden and quality of life (QOL) has not yet been studied.Objectives: To evaluate associations between ND with SDB symptom burden and QOL.Methods: Cross-sectional analyses were performed on 453 children, ages 3-12.9 years, with mild SDB (habitual snoring and apnea-hypopnea index < 3/h) enrolled in the PATS (Pediatric Adenotonsillectomy Trial for Snoring) multicenter study. The primary exposure, neighborhood disadvantage, was characterized by the Child Opportunity Index (COI) (range, 0-100), in which lower values (specifically COI ⩽ 40) signify less advantageous neighborhoods. The primary outcomes were QOL assessed by the obstructive sleep apnea (OSA)-18 questionnaire (range, 18-126) and SDB symptom burden assessed by the Pediatric Sleep Questionnaire-Sleep-related Breathing Disorder (PSQ-SRBD) scale (range, 0-1). The primary model was adjusted for age, sex, race, ethnicity, maternal education, recruitment site, and season. In addition, we explored the role of body mass index (BMI) percentile, environmental tobacco smoke (ETS), and asthma in these associations.Results: The sample included 453 children (16% Hispanic, 26% Black or African American, 52% White, and 6% other). COI mean (standard deviation [SD]) was 50.3 (29.4), and 37% (n = 169) of participants lived in disadvantaged neighborhoods. Poor SDB-related QOL (OSA-18 ⩾ 60) and high symptom burden (PSQ-SRBD ⩾ 0.33) were found in 30% (n = 134) and 75% (n = 341) of participants, respectively. In adjusted models, a COI increase by 1 SD (i.e., more advantageous neighborhood) was associated with an improvement in OSA-18 score by 2.5 points (95% confidence interval [CI], -4.34 to -0.62) and in PSQ-SRBD score by 0.03 points (95% CI, -0.05 to -0.01). These associations remained significant after adjusting for BMI percentile, ETS, or asthma; however, associations between COI and SDB-related QOL attenuated by 23% and 10% after adjusting for ETS or asthma, respectively.Conclusions: Neighborhood disadvantage was associated with poorer SDB-related QOL and greater SDB symptoms. Associations were partially attenuated after considering the effects of ETS or asthma. The findings support efforts to reduce ETS and neighborhood-level asthma-related risk factors and identify other neighborhood-level factors that contribute to SDB symptom burden as strategies to address sleep-health disparities.Clinical trial registered with www.clinicaltrials.gov (NCT02562040).
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Affiliation(s)
- Seyni Gueye-Ndiaye
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Meg Tully
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Raouf Amin
- Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Cristina M. Baldassari
- Department of Otolaryngology, Eastern Virginia Medical School, Norfolk, Virginia
- Department of Pediatric Sleep Medicine, Children’s Hospital of The King’s Daughters, Norfolk, Virginia
| | | | - Melissa Cole
- Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Sally Ibrahim
- Rainbow Babies and Children’s Hospital and University Hospitals, Cleveland, Ohio
| | | | - Ron B. Mitchell
- Children’s Medical Center of Dallas and UT Southwestern Medical Center, Dallas, Texas
| | - Kamal Naqvi
- Children’s Medical Center of Dallas and UT Southwestern Medical Center, Dallas, Texas
| | - Kristie Ross
- Rainbow Babies and Children’s Hospital and University Hospitals, Cleveland, Ohio
| | - Michael Rueschman
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ignacio E. Tapia
- Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ariel A. Williamson
- The Ballmer Institute for Children’s Behavioral Health, University of Oregon, Eugene, Oregon
| | - Zhuoran Wei
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Carol L. Rosen
- Case Western Reserve University School of Medicine, Cleveland, Ohio; and
| | - Rui Wang
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Susan Redline
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
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Gueye-Ndiaye S, Williamson AA, Redline S. Disparities in Sleep-Disordered Breathing: Upstream Risk Factors, Mechanisms, and Implications. Clin Chest Med 2023; 44:585-603. [PMID: 37517837 PMCID: PMC10513750 DOI: 10.1016/j.ccm.2023.03.012] [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] [Indexed: 08/01/2023]
Abstract
Sleep-disordered breathing (SDB) refers to a spectrum of disorders ranging from habitual snoring without frank episodes of obstructed breathing or desaturation during sleep to obstructive sleep apnea, where apneas and hypopneas repetitively occur with resultant intermittent hypoxia, arousal, and sleep disruption. Disparities in SDB reflect its overall high prevalence in children and adults from racially and ethnically minoritized or low socioeconomic status backgrounds coupled with high rates of underdiagnosis and suboptimal treatment.
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Affiliation(s)
- Seyni Gueye-Ndiaye
- Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Ariel A Williamson
- Children's Hospital of Philadelphia, 2716 South Street Boulevard, Philadelphia, PA 19104, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Susan Redline
- Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA.
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Santri IN, Wardani Y, Phiri YVA, Nyam G, Putri TA, Isni K, Suryani D, Sambo G. Associations Between Indoor Air Pollutants and Risk Factors for Acute Respiratory Infection Symptoms in Children Under 5: An Analysis of Data From the Indonesia Demographic Health Survey. J Prev Med Public Health 2023; 56:255-263. [PMID: 37287203 DOI: 10.3961/jpmph.22.470] [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] [Received: 11/14/2022] [Accepted: 04/06/2023] [Indexed: 06/09/2023] Open
Abstract
OBJECTIVES The study investigated the association between indoor air pollution (IAP) and risk factors for acute respiratory infection (ARI) symptoms in children under 5 years of age. METHODS A cross-sectional study was conducted using data derived from Indonesia Demographic and Health Survey in 2017. Binary logistic regression modeling was employed to examine each predictor variable associated with ARI among children under 5 years of age in Indonesia. RESULTS The study included a total of 4936 households with children. Among children under 5 years old, 7.2% reported ARI symptoms. The presence of ARI symptoms was significantly associated with the type of residence, wealth index, and father's smoking frequency, which were considered the sample's socio-demographic characteristics. In the final model, living in rural areas, having a high wealth index, the father's smoking frequency, and a low education level were all linked to ARI symptoms. CONCLUSIONS The results revealed that households in rural areas had a substantially higher level of reported ARI symptoms among children under 5 years old. Furthermore, the father's smoking frequency and low education level were associated with ARI symptoms.
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Affiliation(s)
| | - Yuniar Wardani
- Faculty of Public Health, Universitas of Ahmad Dahlan, Yogyakarta, Indonesia
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Yohane Vincent Abero Phiri
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
- Institute for Health Research and Communication (IHRC), Lilongwe, Malawi
| | - Gunchmaa Nyam
- Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Tyas Aisyah Putri
- Faculty of Public Health, Universitas of Ahmad Dahlan, Yogyakarta, Indonesia
| | - Khoiriyah Isni
- Faculty of Public Health, Universitas of Ahmad Dahlan, Yogyakarta, Indonesia
| | - Dyah Suryani
- Faculty of Public Health, Universitas of Ahmad Dahlan, Yogyakarta, Indonesia
| | - Grace Sambo
- School of Public Health, Tzu Chi University, Hualien, Taiwan
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Bendezú JJ, Handley ED, Manly JT, Toth SL, Cicchetti D. Psychobiological foundations of coping and emotion regulation: Links to maltreatment and depression in a racially diverse, economically disadvantaged sample of adolescent girls. Psychoneuroendocrinology 2022; 143:105826. [PMID: 35700563 PMCID: PMC9357119 DOI: 10.1016/j.psyneuen.2022.105826] [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: 02/10/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 11/22/2022]
Abstract
Adolescent risk for depression and passive or active suicidal ideation (PASI) involves disturbance across multiple systems (e.g., arousal regulatory, affective valence, neurocognitive). Exposure to maltreatment while growing up as a child or teenager may potentiate this risk by noxiously impacting these systems. However, research exploring how coordinated disturbance across these systems (i.e., profiles) might be uniquely linked to depressogenic function, and how past maltreatment contributes to such disturbance, is lacking. Utilizing a racially diverse, economically disadvantaged sample of adolescent girls, this person-centered study identified psychobiological profiles and linked them to maltreatment histories, as well as current depressive symptoms and PASI. Girls (N = 237, Mage=13.98, SD=0.85) who were non-depressed/non-maltreated (15.1%), depressed/non-maltreated (40.5%), or depressed/maltreated (44.4%) provided morning saliva samples, completed questionnaires, a clinical interview, and a neurocognitive battery. Latent profile analysis of girls' morning cortisol:C-reactive protein ratio, positive and negative affect levels, and attentional set-shifting ability revealed four profiles. Relative to Normative (66.6%), girls exhibiting a Pro-inflammatory Affective Disturbance (13.1%), Severe Affective Disturbance (10.1%), or Hypercortisol Affective Neurocognitive Disturbance (n = 24, 10.1%) profile reported exposure to a greater number of maltreatment subtypes while growing up. Girls exhibiting these dysregulated profiles were also more likely (relative to Normative) to report current depressive symptoms (all three profiles) and PASI (only Pro-inflammatory Affective Disturbance and Hypercortisol Affective Neurocognitive Disturbance). Of note, girls' cognitive reappraisal utilization moderated profile membership-depression linkages (depressive symptoms, but not PASI). A synthesis of the findings is presented alongside implications for person-centered tailoring of intervention efforts.
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Affiliation(s)
- Jason José Bendezú
- The Institute of Child Development, University of Minnesota, USA; Department of Psychology, University of Minnesota, USA.
| | | | - Jody T Manly
- Mt. Hope Family Center, University of Rochester, USA
| | - Sheree L Toth
- Mt. Hope Family Center, University of Rochester, USA
| | - Dante Cicchetti
- The Institute of Child Development, University of Minnesota, USA
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Early environmental quality and life-course mental health effects: The Equal-Life project. Environ Epidemiol 2022; 6:e183. [PMID: 35169662 PMCID: PMC8835570 DOI: 10.1097/ee9.0000000000000183] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 11/14/2021] [Indexed: 11/26/2022] Open
Abstract
Background: There is increasing evidence that a complex interplay of factors within environments in which children grows up, contributes to children’s suboptimal mental health and cognitive development. The concept of the life-course exposome helps to study the impact of the physical and social environment, including social inequities, on cognitive development and mental health over time. Methods: Equal-Life develops and tests combined exposures and their effects on children’s mental health and cognitive development. Data from eight birth-cohorts and three school studies (N = 240.000) linked to exposure data, will provide insights and policy guidance into aspects of physical and social exposures hitherto untapped, at different scale levels and timeframes, while accounting for social inequities. Reasoning from the outcome point of view, relevant stakeholders participate in the formulation and validation of research questions, and in the formulation of environmental hazards. Exposure assessment combines GIS-based environmental indicators with omics approaches and new data sources, forming the early-life exposome. Statistical tools integrate data at different spatial and temporal granularity and combine exploratory machine learning models with hypothesis-driven causal modeling. Conclusions: Equal-Life contributes to the development and utilization of the exposome concept by (1) integrating the internal, physical and social exposomes, (2) studying a distinct set of life-course effects on a child’s development and mental health (3) characterizing the child’s environment at different developmental stages and in different activity spaces, (4) looking at supportive environments for child development, rather than merely pollutants, and (5) combining physical, social indicators with novel effect markers and using new data sources describing child activity patterns and environments.
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Bendezú JJ, Wodzinski A, Loughlin-Presnal JE, Mozeko J, Cobler S, Wadsworth ME. A multiple levels of analysis examination of the performance goal model of depression vulnerability in preadolescent children. Dev Psychopathol 2022; 34:241-261. [PMID: 32924893 PMCID: PMC7956127 DOI: 10.1017/s0954579420000851] [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] [Indexed: 11/06/2022]
Abstract
If performance goals (i.e., motivation to prove ability) increase children's vulnerability to depression (Dykman, 1998), why are they overlooked in the psychopathology literature? Evidence has relied on self-report or observational methods and has yet to articulate how this vulnerability unfolds across levels of analysis implicated in stress-depression linkages; for example, hypothalamic-pituitaryadrenal axis (HPA), sympathetic nervous system (SNS). Utilizing a multiple-levels-of-analysis approach (Cicchetti, 2010), this experimental study tested Dykman's goal orientation model of depression vulnerability in a community sample of preadolescents (N = 121, Mage = 10.60 years, Range = 9.08-12.00 years, 51.6% male). Self-reports of performance goals, attachment security, and subjective experience of internalizing difficulties were obtained in addition to objective behavioral (i.e., task persistence) and physiologic arousal (i.e., salivary cortisol, skin conductance level) responses to the Trier Social Stress Test (TSST) and two randomly assigned coping conditions: avoidance, distraction. Children with performance goals reported greater internalizing difficulties and exhibited more dysregulated TSST physiologic responses (i.e., HPA hyperreactivity, SNS protracted recovery), yet unexpectedly displayed greater TSST task persistence and more efficient physiologic recovery during avoidance relative to distraction. These associations were stronger and nonsignificant in the context of insecure and secure attachment, respectively. Findings illustrate a complex matrix of in-the-moment, integrative psychobiological relationships linking performance goals to depression vulnerability.
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Affiliation(s)
| | | | | | - Jesse Mozeko
- Department of Psychology, The Pennsylvania State University
| | - Sierra Cobler
- Department of Psychology, The Pennsylvania State University
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Sprinkle RH, Payne-Sturges DC. Mixture toxicity, cumulative risk, and environmental justice in United States federal policy, 1980-2016 : Why, with much known, was little done? Environ Health 2021; 20:104. [PMID: 34535123 PMCID: PMC8449500 DOI: 10.1186/s12940-021-00764-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 06/24/2021] [Indexed: 05/12/2023]
Abstract
Toxic chemicals - "toxicants" - have been studied and regulated as single entities, and, carcinogens aside, almost all toxicants, single or mixed and however altered, have been thought harmless in very low doses or very weak concentrations. Yet much work in recent decades has shown that toxicants can injure wildlife, laboratory animals, and humans following exposures previously expected to be harmless. Additional work has shown that toxicants can act not only individually and cumulatively but also collectively and even synergistically and that they affect disadvantaged communities inordinately - and therefore, as argued by reformers, unjustly. As late as December 2016, the last full month before the inauguration of a president promising to rescind major environmental regulations, the United States federal environmental-health establishment, as led by the Environmental Protection Agency (EPA), had not developed coherent strategies to mitigate such risks, to alert the public to their plausibility, or to advise leadership in government and industry about their implications. To understand why, we examined archival materials, reviewed online databases, read internal industry communications, and interviewed experts. We confirmed that external constraints, statutory and judicial, had been in place prior to EPA's earliest interest in mixture toxicity, but we found no overt effort, certainly no successful effort, to loosen those constraints. We also found internal constraints: concerns that fully committing to the study of complex mixtures involving numerous toxicants would lead to methodological drift within the toxicological community and that trying to act on insights from such study could lead only to regulatory futility. Interaction of these constraints, external and internal, shielded the EPA by circumscribing its responsibilities and by impeding movement toward paradigmatic adjustment, but it also perpetuated scientifically dubious policies, such as those limiting the evaluation of commercial chemical formulations, including pesticide formulations, to only those ingredients said by their manufacturers to be active. In this context, regulators' disregard of synergism contrasted irreconcilably with biocide manufacturers' understanding that synergism enhanced lethality and patentability. In the end, an effective national response to mixture toxicity, cumulative risk, and environmental injustice did not emerge. In parallel, though, the National Institute of Environmental Health Sciences, which was less constrained, pursued with scientific investigation what the EPA had not pursued with regulatory action.
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Affiliation(s)
| | - Devon C Payne-Sturges
- Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, 20742, USA
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8
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Mahurin-Smith J, DeThorne LS, Petrill SA. Children Born Prematurely May Demonstrate Catch-Up Growth in Pre-Adolescence. Lang Speech Hear Serv Sch 2021; 52:675-685. [PMID: 33656921 DOI: 10.1044/2020_lshss-20-00111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction Children born prematurely often score lower on standardized tests of language in early childhood. Less is known about longer term outcomes. This investigation considered language outcomes in pre-adolescent children born very preterm/very low birthweight, as assessed by both standardized test scores and language sample measures, and explored attention abilities as a possible moderating factor. Method The present investigation provided a longitudinal follow-up to Mahurin Smith et al. (2014) by examining the language outcomes of 84 children at the 11-year time point (39 with a history of prematurity and 45 born at full term) and a total of 82 at the 12-year time point (37 with a history of prematurity, 45 born at full term). Assessments included subtests of the Clinical Evaluation of Language Fundamentals- Fourth Edition, productive language measures taken from narrative tasks, and parent and examiner ratings of attention. Results Gestational age significantly predicted standardized language scores at age 11 years, but this effect was no longer statistically significant at age 12 years. When parent ratings of attention were considered as additional variables, gestational age was no longer a significant predictor. Gestational age did not serve as a significant predictor for the productive language measures at either time point. Discussion Results indicate that catch-up growth in language may take place in pre-adolescence for many children born prematurely. Clinical implications focus on the need to utilize multiple forms of language assessment and to directly consider the potential role of attention on standard test results.
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Affiliation(s)
- Jamie Mahurin-Smith
- Department of Communication Sciences and Disorders, Illinois State University, Normal
| | - Laura S DeThorne
- Department of Speech, Language, and Hearing Sciences, Western Michigan University, Kalamazoo
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Wallace M, Felker-Kantor E, Madkour A, Ferguson T, Welsh D, Molina P, Theall KP. Adverse Childhood Experiences, Smoking and Alcohol Use, and Allostatic Load Among People Living with HIV. AIDS Behav 2020; 24:1653-1662. [PMID: 31559525 DOI: 10.1007/s10461-019-02684-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Allostatic load is an indicator of multisystem physiologic dysregulation that may arise from prolonged or accumulated exposure to stress, including adverse childhood experiences (ACEs) and chronic stressors persisting into adulthood. People living with HIV (PLWH) may be particularly vulnerable given their high burdens of adversity across the life course. Using data from a cohort of middle aged PLWH, we examined associations between ACEs and two measures of allostatic load. In order to determine whether the negative impact of ACEs on allostatic load operates through increasing the adoption of adverse coping behaviors, we tested for mediation by smoking and alcohol use. PLWH who had experienced 4 or more ACEs had on average higher allostatic load in adulthood compared to those who experienced fewer. Neither smoking nor alcohol use mediated this relationship, however, suggesting alternative mechanisms may be at play.
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Affiliation(s)
- Maeve Wallace
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., suite 2200, New Orleans, LA, 70112, USA.
| | - Erica Felker-Kantor
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., suite 2200, New Orleans, LA, 70112, USA
| | - Aubrey Madkour
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., suite 2200, New Orleans, LA, 70112, USA
| | - Tekeda Ferguson
- Department of Epidemiology, Louisiana State University School of Public Health, 2020 Gravier St., 5th floor, New Orleans, LA, 70112, USA
| | - David Welsh
- Section of Pulmonary/Critical Care, Louisiana State University School of Medicine, 2020 Gravier St., 5th floor, New Orleans, LA, 70112, USA
| | - Patricia Molina
- Department of Physiology, Louisiana State University School of Medicine, 2020 Gravier St., 5th floor, New Orleans, LA, 70112, USA
| | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., suite 2200, New Orleans, LA, 70112, USA
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Billings ME, Hale L, Johnson DA. Physical and Social Environment Relationship With Sleep Health and Disorders. Chest 2019; 157:1304-1312. [PMID: 31870910 DOI: 10.1016/j.chest.2019.12.002] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 11/11/2019] [Accepted: 12/09/2019] [Indexed: 12/14/2022] Open
Abstract
Sleep health is a multidimensional construct that includes adequate duration, quality, and appropriately timed sleep that may be influenced by environmental factors. In this review, we focus on how an individual's living and sleeping environment, both the surrounding neighborhood physical and social features and the atmosphere around them, may impact their sleep health. We explore the associations of the physical environment (urban density, recreational facilities, green space, mixed land use, and healthy food stores), neighborhood deprivation (disadvantage and disorder), and the social environment (social cohesion, safety, and stigma) with sleep in both adult and pediatric populations. We investigate how physical and social environmental features may lead to alterations in the timing, duration, and quality of sleep and contribute to the most prevalent sleep disorders: insomnia, sleep apnea, and circadian rhythm disorders. We also review how ambient factors such as artificial light, environmental noise, and air pollution may contribute to sleep pathology. We have included key studies and recent emerging data regarding how the differential distribution of environmental factors that may affect sleep health may contribute to sleep health disparities.
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Affiliation(s)
- Martha E Billings
- Division of Pulmonary, Critical Care & Sleep Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA.
| | - Lauren Hale
- Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
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Associations between Indoor Air Pollution and Acute Respiratory Infections among Under-Five Children in Afghanistan: Do SES and Sex Matter? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162910. [PMID: 31416159 PMCID: PMC6720819 DOI: 10.3390/ijerph16162910] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/11/2019] [Accepted: 08/12/2019] [Indexed: 02/06/2023]
Abstract
Background: Low-income families often depend on fuels such as wood, coal, and animal dung for cooking. Such solid fuels are highly polluting and are a primary source of indoor air pollutants (IAP). We examined the association between solid fuel use (SFU) and acute respiratory infection (ARI) among under-five children in Afghanistan and the extent to which this association varies by socioeconomic status (SES) and gender. Materials and Methods: This is a cross-sectional study based on de-identified data from Afghanistan’s first standard Demographic and Health Survey (DHS) conducted in 2015. The sample consists of ever-married mothers with under-five children in the household (n = 27,565). We used mixed-effect Poisson regression models with robust error variance accounting for clustering to examine the associations between SFU and ARI among under-five children after adjusting for potential confounders. We also investigated potential effect modification by SES and sex. Additional analyses were conducted using an augmented measure of the exposure to IAP accounting for both SFU and the location of cooking/kitchen (High Exposure, Moderate, and No Exposure). Results: Around 70.2% of households reported SFU, whereas the prevalence of ARI was 17.6%. The prevalence of ARI was higher in children living in households with SFU compared to children living in households with no SFU (adjusted prevalence ratio (aPR) = 1.10; 95% CI: (0.98, 1.23)). We did not observe any effect modification by SES or child sex. When using the augmented measure of exposure incorporating the kitchen’s location, children highly exposed to IAP had a higher prevalence of ARI compared to unexposed children (aPR = 1.17; 95% CI: (1.03, 1.32)). SES modified this association with the strongest associations observed among children from the middle wealth quintile. Conclusion: The findings have significant policy implications and suggest that ARI risk in children may be reduced by ensuring there are clean cookstoves as well as clean fuels and acting on the socio-environmental pathways.
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Methods for Evaluating the Combined Effects of Chemical and Nonchemical Exposures for Cumulative Environmental Health Risk Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122797. [PMID: 30544651 PMCID: PMC6313653 DOI: 10.3390/ijerph15122797] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 12/01/2018] [Accepted: 12/03/2018] [Indexed: 02/01/2023]
Abstract
Cumulative risk assessment (CRA) has been proposed as a means of evaluating possible additive and synergistic effects of multiple chemical, physical and social stressors on human health, with the goal of informing policy and decision-making, and protecting public health. Routine application of CRA to environmental regulatory and policy decision making, however, has been limited due to a perceived lack of appropriate quantitative approaches for assessing combined effects of chemical and nonchemical exposures. Seven research projects, which represented a variety of disciplines, including population health science, laboratory science, social sciences, geography, statistics and mathematics, were funded by the US Environmental Protection Agency (EPA) to help address this knowledge gap. We synthesize key insights from these unique studies to determine the implications for CRA practice and priorities for further research. Our analyses of these seven projects demonstrate that the necessary analytical methods to support CRA are available but are ultimately context-dependent. These projects collectively provided advancements for CRA in the areas of community engagement, characterization of exposures to nonchemical stressors, and assessment of health effects associated with joint exposures to chemical and psychosocial stressors.
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Cozzolino E, Smith C, Crosnoe RL. Family-related Disparities in College Enrollment across the Great Recession. SOCIOLOGICAL PERSPECTIVES : SP : OFFICIAL PUBLICATION OF THE PACIFIC SOCIOLOGICAL ASSOCIATION 2018; 61:689-710. [PMID: 30774188 PMCID: PMC6372127 DOI: 10.1177/0731121418760542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The economic crisis of the Great Recession in the late 2000s had implications for the intergenerational transmission of inequality within families. Studying patterns of college enrollment across the Great Recession among U.S. youth from diverse family contexts provides insight into how economic volatility can either compound or undercut the advantages that some parents can give their children. Although college enrollment among 18- to 21-year-olds did not decline during or after the Great Recession, analyses of the National Longitudinal Survey of Youth 1979-Young Adult cohort revealed that this general trend subsumed variability by family history, local economic conditions, and age. Histories of family stability and sufficiency were associated with higher odds of college enrollment over time and across age, but this advantage was largest during the Recession in high-unemployment communities. These results illuminate how life course consequences of early family life can fluctuate with volatility and opportunity in the broader economy.
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Bendezú JJ, Cole PM, Tan PZ, Armstrong LM, Reitz EB, Wolf RM. Child language and parenting antecedents and externalizing outcomes of emotion regulation pathways across early childhood: A person-centered approach. Dev Psychopathol 2018; 30:1253-1268. [PMID: 29144222 PMCID: PMC5955771 DOI: 10.1017/s0954579417001675] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Decreases in children's anger reactivity because of the onset of their autonomous use of strategies characterizes the prevailing model of the development of emotion regulation in early childhood (Kopp, 1989). There is, however, limited evidence of the varied pathways that mark this development and their proposed antecedents and consequences. This study used a person-centered approach to identify such pathways, antecedents, and outcomes. A sample of 120 children from economically strained rural and semirural households were observed while waiting to open a gift at ages 24, 36, and 48 months. Multitrajectory modeling of children's anger expressions and strategy use yielded three subgroups. As they aged, typically developing children's strategy use (calm bids and focused distraction) increased while anger expressions decreased. Later developing children, though initially elevated in anger expression and low in strategy use, demonstrated marked growth across indicators and did not differ from typically developing children at 48 months. At-risk children, despite developing calm bidding skills, did not display longitudinal self-distraction increases or anger expression declines. Some predicted antecedents (12-24 month child language skills and language-capitalizing parenting practices) and outcomes (age 5 years externalizing behavior) differentiated pathways. Findings illustrate how indicator-specific departures from typical pathways signal risk for behavior problems and point to pathway-specific intervention opportunities.
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How does the social environment during life course embody in and influence the development of cancer? Int J Public Health 2018; 63:811-821. [DOI: 10.1007/s00038-018-1131-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 05/19/2018] [Accepted: 06/01/2018] [Indexed: 12/21/2022] Open
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Kobal Grum D. Interactions between human behaviour and the built environment in terms of facility management. FACILITIES 2018. [DOI: 10.1108/f-03-2017-0040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
In comparison with the relations between the human and natural environments that have been the central focus of environmental psychology for many years, the interactions between the psychological processes underlying human behaviour and the built environment have only recently regained the interest of researchers. In this paper, the author first discusses the reasons for the slower development of human – built environment relations. Afterwards, the author systematically examines the impact that the research of environmental stress, namely, poor housing and poor neighbourhood quality, had on the contemporary understanding of human – built environment relations.
Design/methodology/approach
The author focuses on social, biophilic and evidence-based design. The author proposes deeper psychological engagement in correlation with human behaviour, psychological well-being and society. The author highlights the inclusion of psychologists in interdisciplinary research teams addressing the development of sustainable solutions to the issues of residential environments.
Findings
It has been shown that substandard house quality, high noise, lack of natural light in houses, poorer physical quality of urban neighbourhoods, living in a low-income neighbourhood, etc. are linked to elevated physiological and psychological stress. Despite this evidence, there is still a gap between building designers and building users in modern industrialised societies, which could deepen tenants’ dissatisfaction due to specific behavioural needs and consequently lower their psychological well-being and health risk behaviour.
Research limitations/implications
These are potential risks of error arising from the use of assumptions, limited samples size and data from the secondary resources.
Originality/value
The major contributions of this paper are as follows. If the environment is understood as a dynamic, constantly changing and complex system of a wide range of players, the author can discern in this environment a dynamic that is otherwise characteristic of emotional dynamics. Expressed participants’ high satisfaction with residential status does not necessarily generate high expectations regarding real estate factors.
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Casey JA, Morello-Frosch R, Mennitt DJ, Fristrup K, Ogburn EL, James P. Race/Ethnicity, Socioeconomic Status, Residential Segregation, and Spatial Variation in Noise Exposure in the Contiguous United States. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:077017. [PMID: 28749369 PMCID: PMC5744659 DOI: 10.1289/ehp898] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 02/06/2017] [Accepted: 02/06/2017] [Indexed: 05/18/2023]
Abstract
BACKGROUND Prior research has reported disparities in environmental exposures in the United States, but, to our knowledge, no nationwide studies have assessed inequality in noise pollution. OBJECTIVES We aimed to a) assess racial/ethnic and socioeconomic inequalities in noise pollution in the contiguous United States; and b) consider the modifying role of metropolitan level racial residential segregation. METHODS We used a geospatial sound model to estimate census block group–level median (L50) nighttime and daytime noise exposure and 90th percentile (L10) daytime noise exposure. Block group variables from the 2006–2010 American Community Survey (ACS) included race/ethnicity, education, income, poverty, unemployment, homeownership, and linguistic isolation. We estimated associations using polynomial terms in spatial error models adjusted for total population and population density. We also evaluated the relationship between race/ethnicity and noise, stratified by levels of metropolitan area racial residential segregation, classified using a multigroup dissimilarity index. RESULTS Generally, estimated nighttime and daytime noise levels were higher for census block groups with higher proportions of nonwhite and lower-socioeconomic status (SES) residents. For example, estimated nighttime noise levels in urban block groups with 75% vs. 0% black residents were 46.3 A-weighted decibels (dBA) [interquartile range (IQR): 44.3–47.8 dBA] and 42.3 dBA (IQR: 40.4–45.5 dBA), respectively. In urban block groups with 50% vs. 0% of residents living below poverty, estimated nighttime noise levels were 46.9 dBA (IQR: 44.7–48.5 dBA) and 44.0 dBA (IQR: 42.2–45.5 dBA), respectively. Block groups with the highest metropolitan area segregation had the highest estimated noise exposures, regardless of racial composition. Results were generally consistent between urban and suburban/rural census block groups, and for daytime and nighttime noise and robust to different spatial weight and neighbor definitions. CONCLUSIONS We found evidence of racial/ethnic and socioeconomic differences in model-based estimates of noise exposure throughout the United States. Additional research is needed to determine if differences in noise exposure may contribute to health disparities in the United States. https://doi.org/10.1289/EHP898
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Affiliation(s)
- Joan A Casey
- Robert Wood Johnson Foundation Health & Society Scholars Program, University of California, San Francisco and University of California, Berkeley , California, USA
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy, and Management, and the School of Public Health; University of California , Berkeley, California, USA
| | - Daniel J Mennitt
- Department of Electrical & Computer Engineering, Colorado State University , Fort Collins, Colorado, USA
| | - Kurt Fristrup
- Natural Sounds and Night Skies Division, Natural Resource Stewardship and Science Directorate, National Park Service , Fort Collins, Colorado, USA
| | - Elizabeth L Ogburn
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland, USA
| | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Healthcare Institute; Departments of Epidemiology and Environmental Health, Harvard TH Chan School of Public Health; Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital & Harvard Medical School, Boston, Massachusetts, USA
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Larsson LS, Butterfield P, Christopher S, Hill W. Rural Community Leaders' Perceptions of Environmental Health Risks. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/216507990605400303] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Qualitative description was used to explore how rural community leaders frame, interpret, and give meaning to environmental health issues affecting their constituents and communities. Six rural community leaders discussed growth, vulnerable families, and the action avoidance strategies they use or see used in lieu of adopting health-promoting behaviors. Findings suggest intervention strategies should be economical, use common sense, be sensitive to regional identity, and use local case studies and “inside leadership.” Occupational health nurses addressing the disparate environmental health risks in rural communities are encouraged to use agenda-neutral, scientifically based risk communication efforts and foster collaborative relationships among nurses, planners, industry, and other community leaders.
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Rowe C, Gunier R, Bradman A, Harley KG, Kogut K, Parra K, Eskenazi B. Residential proximity to organophosphate and carbamate pesticide use during pregnancy, poverty during childhood, and cognitive functioning in 10-year-old children. ENVIRONMENTAL RESEARCH 2016; 150:128-137. [PMID: 27281690 PMCID: PMC5207345 DOI: 10.1016/j.envres.2016.05.048] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 05/05/2016] [Accepted: 05/27/2016] [Indexed: 05/26/2023]
Abstract
BACKGROUND Low-income communities and communities of color have been shown to experience disproportionate exposure to agricultural pesticides, which have been linked to poorer neurobehavioral outcomes in infants and children. Few studies have assessed health impacts of pesticide mixtures in the context of socioeconomic adversity. OBJECTIVES To examine associations between residential proximity to toxicity-weighted organophosphate (OP) and carbamate pesticide use during pregnancy, household- and neighborhood-level poverty during childhood, and IQ scores in 10-year-old children. METHODS We evaluated associations between both nearby agricultural pesticide use and poverty measures and cognitive abilities in 10-year-old children (n = 501) using data from a longitudinal birth cohort study linked with data from the California Pesticide Use Reporting system and the American Community Survey. Associations were assessed using multivariable linear regression. RESULTS Children of mothers in the highest quartile compared to the lowest quartile of proximal pesticide use had lower performance on Full Scale IQ [β = -3.0; 95% Confidence Interval (CI) = (-5.6, -0.3)], Perceptual Reasoning [β = -4.0; (-7.6, -0.4)], and Working Memory [β = -2.8; (-5.6, -0.1)]. Belonging to a household earning an income at or below the poverty threshold was associated with approximately two point lower scores on Full Scale IQ, Verbal Comprehension, and Working Memory. Living in the highest quartile of neighborhood poverty at age 10 was associated with approximately four point lower performance on Full Scale IQ, Verbal Comprehension, Perceptual Reasoning, and Working memory. CONCLUSIONS Residential proximity to OP and carbamate pesticide use during pregnancy and both household- and neighborhood-level poverty during childhood were independently associated with poorer cognitive functioning in children at 10 years of age.
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Affiliation(s)
- Christopher Rowe
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States.
| | - Robert Gunier
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States.
| | - Asa Bradman
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States.
| | - Kim G Harley
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States.
| | - Katherine Kogut
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States.
| | - Kimberly Parra
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States; Clinica de Salud del Valle de Salinas (CSVS), Salinas, CA, United States.
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health (CERCH), School of Public Health, University of California at Berkeley, Berkeley, CA, United States.
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Jackson CL, Redline S, Emmons KM. Sleep as a potential fundamental contributor to disparities in cardiovascular health. Annu Rev Public Health 2016; 36:417-40. [PMID: 25785893 DOI: 10.1146/annurev-publhealth-031914-122838] [Citation(s) in RCA: 240] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Optimal sleep is integral to health but is commonly not obtained. Despite its wide-ranging public health impact, sleep health is considered only rarely by policy makers, employers, schools, and others whose policies and structures can adversely affect sleep. An inadequate duration of sleep and poor-quality sleep are prevalent in minority and low-income populations, and may be fundamental to racial and socioeconomic status inequities that contribute to a range of health conditions, including cardiovascular disease (CVD). This review examines the relationship between sleep and disparities in CVD. We describe the public health importance of sleep and the role of sleep duration, as well as the two most common disorders (sleep apnea and insomnia) as risk factors for a number of chronic diseases. We use a multilevel model focused on population health and health disparities, which is based on the notion that individual behaviors, such as sleep, are influenced by complex and dynamic interrelations among individuals and their physical and social environments. We also describe modifiable factors that contribute to insufficient sleep and circadian misalignment, propose potential interventions in various sectors (e.g., neighborhoods, schools, workplaces) that can address social structures that contribute to disparities, and recommend areas for future research. Integrating sleep into public health research will identify novel approaches for closing gaps in health disparities.
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Affiliation(s)
- Chandra L Jackson
- Clinical and Translational Science Center, Harvard Catalyst, Harvard Medical School, Boston, Massachusetts 02115;
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Tenailleau QM, Mauny F, Joly D, François S, Bernard N. Air pollution in moderately polluted urban areas: How does the definition of "neighborhood" impact exposure assessment? ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2015; 206:437-448. [PMID: 26275728 DOI: 10.1016/j.envpol.2015.07.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 07/16/2015] [Indexed: 06/04/2023]
Abstract
Environmental health studies commonly quantify subjects' pollution exposure in their neighborhood. How this neighborhood is defined can vary, however, leading to different approaches to quantification whose impacts on exposure levels remain unclear. We explore the relationship between neighborhood definition and exposure assessment. NO2, benzene, PM10 and PM2.5 exposure estimates were computed in the vicinity of 10,825 buildings using twelve exposure assessment techniques reflecting different definitions of "neighborhood". At the city scale, its definition does not significantly influence exposure estimates. It does impact levels at the building scale, however: at least a quarter of the buildings' exposure estimates for a 400 m buffer differ from the estimated 50 m buffer value (±1.0 μg/m(3) for NO2, PM10 and PM2.5; and ±0.05 μg/m(3) for benzene). This variation is significantly related to the definition of neighborhood. It is vitally important for investigators to understand the impact of chosen assessment techniques on exposure estimates.
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Affiliation(s)
- Quentin M Tenailleau
- Laboratoire Chrono-environnement, UMR6249, Centre National de la Recherche Scientifique, Université de Bourgogne/Franche-Comté, France.
| | - Frédéric Mauny
- Laboratoire Chrono-environnement, UMR6249, Centre National de la Recherche Scientifique, Université de Bourgogne/Franche-Comté, France; Centre Hospitalier Régional Universitaire de Besançon, France
| | - Daniel Joly
- Laboratoire ThéMA, UMR6049, Centre National de la Recherche Scientifique, Université de Bourgogne/Franche-Comté, France
| | | | - Nadine Bernard
- Laboratoire Chrono-environnement, UMR6249, Centre National de la Recherche Scientifique, Université de Bourgogne/Franche-Comté, France; Laboratoire ThéMA, UMR6049, Centre National de la Recherche Scientifique, Université de Bourgogne/Franche-Comté, France
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Grineski SE, Collins TW, Olvera HA. Local Variability in the Impacts of Residential Particulate Matter and Pest Exposure on Children's Wheezing Severity: A Geographically Weighted Regression Analysis of Environmental Health Justice. POPULATION AND ENVIRONMENT 2015; 37:22-43. [PMID: 26527848 PMCID: PMC4627709 DOI: 10.1007/s11111-015-0230-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Two assumptions have underpinned environmental justice over the past several decades: 1) uneven environmental exposures yield correspondingly unequal health impacts and 2) these effects are stable across space. To test these assumptions, relationships for residential pest and PM2.5 exposures with children's wheezing severity are examined using global (ordinary least squares) and local (geographically weighted regression [GWR]) models using cross-sectional observational survey data from El Paso (Texas) children. In the global model, having pests and higher levels of PM2.5 were weakly associated with greater wheezing severity. The local model reveals two types of asthmogenic socio-environments where environmental exposures more powerfully predict greater wheezing severity. The first is a lower-income context where children are disproportionately exposed to pests and PM2.5 and the second is a higher-income socio-environment where children are exposed to lower levels of PM2.5, yet PM2.5is counterintuitively associated with more severe wheezing. Findings demonstrate that GWR is a powerful tool for understanding relationships between environmental conditions, social characteristics and health inequalities.
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Affiliation(s)
- Sara E Grineski
- Department of Sociology and Anthropology, University of Texas at El Paso, 500 W. University Ave. El Paso TX 79968, USA, , 915-747-8471 (tele), 915-747-5505 (fax)
| | - Timothy W Collins
- Department of Sociology and Anthropology, University of Texas at El Paso, 500 W. University Ave. El Paso TX 79968, USA
| | - Hector A Olvera
- Center for Environmental Resource Management & School of Nursing, University of Texas at El Paso, 500 W. University Ave. El Paso TX 79968, USA
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Pacheco CM, Ciaccio CE, Nazir N, Daley CM, DiDonna A, Choi WS, Barnes CS, Rosenwasser LJ. Homes of low-income minority families with asthmatic children have increased condition issues. Allergy Asthma Proc 2014; 35:467-74. [PMID: 25584914 DOI: 10.2500/aap.2014.35.3792] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The home is increasingly associated with asthma. It acts both as a reservoir of asthma triggers and as a refuge from seasonal outdoor allergen exposure. Racial/ethnic minority families with low incomes tend to reside in neighborhoods with low housing quality. These families also have higher rates of asthma. This study explores the hypothesis that black and Latino urban households with asthmatic children experienced more home mechanical, structural condition-related areas of concern than white households with asthmatic children. Participant families (n = 140) took part in the Kansas City Safe and Healthy Homes Program, had at least one asthmatic child, and met income qualifications of no more than 80% of local median income; many were below 50%. Families self-identified their race. Homes were assessed by environmental health professionals using a standard set of criteria and a specific set of on-site and laboratory sampling and analyses. Homes were given a score for areas of concern between 0 (best) and 53 (worst). The study population self-identified as black (46%), non-Latino white (26%), Latino (14.3%), and other (12.9%). Mean number of areas of concern were 18.7 in Latino homes, 17.8 in black homes, 13.3 in other homes, and 13.2 in white homes. Latino and black homes had significantly more areas of concern. White families were also more likely to be in the upper portion of the income. In this set of 140 low-income homes with an asthmatic child, households of minority individuals had more areas of condition concerns and generally lower income than other families.
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Affiliation(s)
- Christina M. Pacheco
- Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, Kansas, USA
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Pujol S, Berthillier M, Defrance J, Lardies J, Levain JP, Petit R, Houot H, Mauny F. Indoor noise exposure at home: a field study in the family of urban schoolchildren. INDOOR AIR 2014; 24:511-520. [PMID: 24417591 DOI: 10.1111/ina.12094] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 01/03/2014] [Indexed: 06/03/2023]
Abstract
This article aims at evaluating indoor noise levels at home and investigating the factors that may influence their variability. An 8-day noise measurement campaign was conducted in the homes of 44 schoolchildren attending the public primary schools of Besançon (France). The presence of the inhabitants in the dwelling and the noisy events occurring indoors and outdoors was daily collected using a time-location-activity diary (TLAD); 902 time periods were analyzed. The indoor noise level increased significantly with the outdoor noise level, along with the duration of the presence or level of activity of the inhabitants at home. However, this effect may vary according to the period of day and the day of the week. Moreover, a significant part of the day and evening indoor noise level variability was explained when considering the TLAD variables: 46% and 45% in the bedroom, 54% and 39% in the main room, respectively. Our results highlight the complexity of the indoor environment in the dwellings of children living in an urban area. Combining the inhabitant presence and indoor noise source descriptors with outdoor noise levels and other dwelling or inhabitant characteristics could improve large-scale epidemiological studies. However, additional efforts are still needed, particularly during the night period.
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Affiliation(s)
- S Pujol
- Laboratoire Chrono-environnement, UMR 6249 CNRS, Université de Franche-Comté, Besançon Cedex, France; Centre de méthodologie clinique, CHRU - Centre hospitalier régional universitaire de Besançon, Besançon Cedex, France
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Population density-dependent hair cortisol concentrations in rhesus monkeys (Macaca mulatta). Psychoneuroendocrinology 2014; 42:59-67. [PMID: 24636502 PMCID: PMC3959662 DOI: 10.1016/j.psyneuen.2014.01.002] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 12/20/2013] [Accepted: 01/02/2014] [Indexed: 01/19/2023]
Abstract
Population density is known to influence acute measures of hypothalamic-pituitary-adrenal (HPA) axis activity in a variety of species, including fish, deer, birds, and humans. However, the effects of population density on levels of chronic stress are unknown. Given the fact that exposure to chronically elevated levels of circulating glucocorticoids results in a host of health disparities in animals and humans alike, it is important to understand how population density may impact chronic stress. We assessed hair cortisol concentrations (HCCs), which are reliable indicators of chronic HPA axis activity, in rhesus monkeys (Macaca mulatta) to determine the influence of population density on these values. In Experiment 1, we compared HCCs of monkeys living in high-density (HD; 1 monkey/0.87m(2)) and low-density (LD; 1 monkey/63.37m(2)) environments (N=236 hair samples) and found that HD monkeys exhibited higher hair cortisol across all age categories (infant, juvenile, young adult, adult, and aged) except infancy and aged (F(5)=4.240, p=0.001), for which differences were nearly significant. HD monkeys also received more severe fight wounds than LD monkeys (χ(2)=26.053, p<0.001), though no effects of dominance status emerged. In Experiment 2, we examined how HCCs change with fluctuating population levels across 5 years in the adult LD monkeys (N=155 hair samples) and found that increased population density was significantly positively correlated with HCCs in this semi-naturalistic population (r(s)=0.975, p=0.005). These are the first findings to demonstrate that increased population density is associated with increased chronic, endogenous glucocorticoid exposure in a nonhuman primate species. We discuss the implications of these findings with respect to laboratory research, population ecology, and human epidemiology.
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Ngure FM, Reid BM, Humphrey JH, Mbuya MN, Pelto G, Stoltzfus RJ. Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links. Ann N Y Acad Sci 2014; 1308:118-128. [PMID: 24571214 DOI: 10.1111/nyas.12330] [Citation(s) in RCA: 239] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
There is scarce research and programmatic evidence on the effect of poor water, sanitation, and hygiene (WASH) conditions of the physical environment on early child cognitive, sensorimotor, and socioemotional development. Furthermore, many common WASH interventions are not specifically designed to protect babies in the first 3 years of life, when gut health and linear growth are established. We review evidence linking WASH, anemia, and child growth, and highlight pathways through which WASH may affect early child development, primarily through inflammation, stunting, and anemia. Environmental enteropathy, a prevalent subclinical condition of the gut, may be a key mediating pathway linking poor hygiene to developmental deficits. Current early child development research and programs lack evidence-based interventions to provide a clean play and infant feeding environment in addition to established priorities of nutrition, stimulation, and child protection. Solutions to this problem will require appropriate behavior change and technologies that are adapted to the social and physical context and conducive to infant play and socialization. We propose the concept of baby WASH as an additional component of early childhood development programs.
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Affiliation(s)
- Francis M Ngure
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
| | - Brianna M Reid
- Department of Design and Environmental Analysis, Cornell University, Ithaca, New York
| | - Jean H Humphrey
- Zvitambo Research Trust, Harare, Zimbabwe.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | | | - Gretel Pelto
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
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REFERENCES. Monogr Soc Res Child Dev 2013. [DOI: 10.1111/mono.12053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lercher P, Evans GW, Widmann U. The ecological context of soundscapes for children's blood pressure. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2013; 134:773-781. [PMID: 23862883 PMCID: PMC4109089 DOI: 10.1121/1.4807808] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 09/11/2012] [Accepted: 12/03/2012] [Indexed: 05/31/2023]
Abstract
Although the majority of studies on community noise levels and children's physiological stress responses are positive, effect sizes vary considerably, and some studies do not confirm these effects. Employing a contextual perspective congruent with soundscapes, a carefully constructed sample of children (N = 115, M = 10.1 yr) living in households in relatively high (>60 dBA) or low (<50 dBA) noise areas created by proximity to major traffic arterials in Austria was reanalyzed. Several personal and environmental factors known to affect resting cardiovascular parameters measured under well-controlled, clinical conditions were incorporated into the analyses. Children with premature births and elevated chronic stress (i.e., overnight cortisol) were more susceptible to adverse blood pressure responses to road traffic noise. Residence in a multi-dwelling unit as well as standardized assessments of perceived quietness of the area did not modify the traffic noise impacts but each had its own, independent effect on resting blood pressure. A primary air pollutant associated with traffic volume (NO2) had no influence on any of these results. The scope of environmental noise assessment and management would benefit from incorporation of a more contextualized approach as suggested by the soundscape perspective.
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Affiliation(s)
- Peter Lercher
- Division of Social Medicine, Medical University Innsbruck, Sonnenburgstrasse 16, A-6020 Innsbruck. Austria.
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Ferguson KT, Cassells RC, MacAllister JW, Evans GW. The physical environment and child development: an international review. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2013; 48:437-68. [PMID: 23808797 PMCID: PMC4489931 DOI: 10.1080/00207594.2013.804190] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Accepted: 04/01/2013] [Indexed: 01/07/2023]
Abstract
A growing body of research in the United States and Western Europe documents significant effects of the physical environment (toxins, pollutants, noise, crowding, chaos, and housing, school and neighborhood quality) on children and adolescents' cognitive and socioemotional development. Much less is known about these relations in other contexts, particularly the global South. We thus briefly review the evidence for relations between child development and the physical environment in Western contexts, and discuss some of the known mechanisms behind these relations. We then provide a more extensive review of the research to date outside of Western contexts, with a specific emphasis on research in the global South. Where the research is limited, we highlight relevant data documenting the physical environment conditions experienced by children, and make recommendations for future work. In these recommendations, we highlight the limitations of employing research methodologies developed in Western contexts (Ferguson & Lee, 2013). Finally, we propose a holistic, multidisciplinary, and multilevel approach based on Bronfenbrenner's (1979) bioecological model to better understand and reduce the aversive effects of multiple environmental risk factors on the cognitive and socioemotional development of children across the globe.
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Affiliation(s)
- Kim T Ferguson
- Psychology Faculty Group, Sarah Lawrence College, Bronxville, NY, USA.
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Housing interventions and control of injury-related structural deficiencies: a review of the evidence. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2012; 16:S34-43. [PMID: 20689373 DOI: 10.1097/phh.0b013e3181e28b10] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Subject matter experts systematically reviewed evidence on the effectiveness of housing interventions that affect safety and injury outcomes, such as falls, fire-related injuries, burns, drowning, carbon monoxide poisoning, heat-related deaths, and noise-related harm, associated with structural housing deficiencies. Structural deficiencies were defined as those deficiencies for which a builder, landlord, or home-owner would take responsibility (ie, design, construction, installation, repair, monitoring). Three of the 17 interventions reviewed had sufficient evidence for implementation: installed, working smoke alarms; 4-sided isolation pool fencing; and preset safe hot water temperature. Five interventions needed more field evaluation, 8 needed formative research, and 1 was found to be ineffective. This evidence review shows that housing improvements are likely to help reduce burns and scalds, drowning in pools, and fire-related deaths and injuries.
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King K. Aggravating conditions: cynical hostility and neighborhood ambient stressors. Soc Sci Med 2012; 75:2258-66. [PMID: 22995667 DOI: 10.1016/j.socscimed.2012.08.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Revised: 07/29/2012] [Accepted: 08/27/2012] [Indexed: 12/01/2022]
Abstract
This study is the first to investigate neighborhood clustering of a personality trait--cynical hostility (a sense of mistrust of others amplified by suspicious antagonism.) Cynical hostility increases physiological reactivity by influencing appraisal and coping when stressful events occur and that has been well established as a predictor of cardiovascular disease, inflammation, and all-cause mortality. The analysis examines the associations of a variety of neighborhood physical and social conditions (especially ambient stressors) with individual cynical hostility, controlling for individual sociodemographics. Data are from the Chicago Community Adult Health Survey, a clustered population-based study of 3105 adults. Variation by neighborhood in cynical hostility is larger than variation of other selected health outcomes, which are commonly studied using ecological methods or for other personality measures. Controlling for neighborhood context reduces the black/white cynical hostility disparity by one-third. A measure of neighborhood ambient stressors (notably noise) significantly predicts cynical hostility, even after individual characteristics are controlled, and the effect size is larger than for other contextual predictors. Health-related psychosocial and personality traits may both cluster in and be influenced by contemporaneous neighborhoods rather than mere exogenous results of genes or early life conditions. Health-relevant psychosocial characteristics may also mediate effects of neighborhood deleterious physical conditions, thereby influencing downstream health outcomes and social disparities therein. Because residential location and neighborhood physical conditions are both modifiable, research on how ambient stressors influence health psychology may be particularly fruitful for health policy and practice.
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Affiliation(s)
- Katherine King
- Environmental Protection Agency, 104 Mason Farm Road, Chapel Hill, NC 27514, USA.
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Knobel KAB, Lima MCMP. Are parents aware of their children's hearing complaints? Braz J Otorhinolaryngol 2012; 78:27-37. [PMID: 23108817 PMCID: PMC9450749 DOI: 10.5935/1808-8694.20120005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Accepted: 01/15/2012] [Indexed: 11/29/2022] Open
Abstract
The accuracy of parents' impressions about their child's hearing status is variable and may not correspond to the child's complaints. Aim To investigate children's self-reported hearing symptoms and parents' impressions about it. Methods 477 children (2nd to 5th grades of elementary schools) were interviewed and parents answered a survey at home. There were 393 matches between the children's interview and the parent's survey. Results 29% of the children reported trouble in understanding what people said, 36.1% had history of 1-3 ear infections, 12.7% had four or more ear infections, 21.7% had continuous tinnitus (positive association with history of exposure to loud sounds, p = 0.0007), 3.8% had pulsatile tinnitus and 2.9% had auditory hallucinations. 28.5% of the children were annoyed by loud sounds (associated with tinnitus, p = 0.0142, and gender, p = 0.0029) 10.4% had had audiological tests, and the determinant factors were history of ear infections (p < 0.001) and parents' concern about their child's hearing (p = 0.043). Parents and their own child's responses were significantly different. Conclusions Children's auditory complaints were prevalent and relevant, but most of them had never had an audiological evaluation and most parents were not aware of their child's complaints. Sound intolerances and auditory hallucinations should be considered in clinical and audiological examinations.
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Schreier HMC, Chen E. Socioeconomic status and the health of youth: a multilevel, multidomain approach to conceptualizing pathways. Psychol Bull 2012; 139:606-54. [PMID: 22845752 DOI: 10.1037/a0029416] [Citation(s) in RCA: 121] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Previous research has clearly established associations between low socioeconomic status (SES) and poor youth physical health outcomes. This article provides an overview of the main pathways through which low SES environments come to influence youth health. We focus on 2 prevalent chronic health problems in youth today, asthma and obesity. We review and propose a model that encompasses (a) multiple levels of influence, including the neighborhood, family and person level; (b) both social and physical domains in the environment; and finally (c) dynamic relationships between these factors. A synthesis of existing research and our proposed model draw attention to the notion of adverse physical and social exposures in youth's neighborhood environments altering family characteristics and youth psychosocial and behavioral profiles, thereby increasing youth's risk for health problems. We also note the importance of acknowledging reciprocal influences across levels and domains (e.g., between family and child) that create self-perpetuating patterns of influence that further accentuate the impact of these factors on youth health. Finally, we document that factors across levels can interact (e.g., environmental pollution levels with child stress) to create unique, synergistic effects on youth health. Our model stresses the importance of evaluating influences on youth's physical health not in isolation but in the context of the broader social and physical environments in which youth live. Understanding the complex relationships between the factors that link low SES to youth's long-term health trajectories is necessary for the creation and implementation of successful interventions and policies to ultimately reduce health disparities.
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Affiliation(s)
- Hannah M C Schreier
- Department of Psychology, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada.
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Masuda JR, Teelucksingh C, Zupancic T, Crabtree A, Haber R, Skinner E, Poland B, Frankish J, Fridell M. Out of our inner city backyards: re-scaling urban environmental health inequity assessment. Soc Sci Med 2012; 75:1244-53. [PMID: 22749441 DOI: 10.1016/j.socscimed.2012.04.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 12/20/2011] [Accepted: 04/26/2012] [Indexed: 11/24/2022]
Abstract
In this paper, we report the results of a three-year research project (2008-2011) that aimed to identify urban environmental health inequities using a photography-mediated qualitative approach adapted for comparative neighbourhood-level assessment. The project took place in Vancouver, Toronto, and Winnipeg, Canada and involved a total of 49 inner city community researchers who compared environmental health conditions in numerous neighbourhoods across each city. Using the social determinants of health as a guiding framework, community researchers observed a wide range of differences in health-influencing private and public spaces, including sanitation services, housing, parks and gardens, art displays, and community services. The comparative process enabled community researchers to articulate in five distinct ways how such observable conditions represented system level inequities. The findings inform efforts to shift environmental health intervention from constricted action within derelict urban districts to more coordinated mobilization for health equity in the city.
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Affiliation(s)
- Jeffrey R Masuda
- Department of Environment and Geography, University of Manitoba, Canada.
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Huang G, London JK. Cumulative environmental vulnerability and environmental justice in California's San Joaquin Valley. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:1593-608. [PMID: 22754459 PMCID: PMC3386574 DOI: 10.3390/ijerph9051593] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 04/16/2012] [Accepted: 04/27/2012] [Indexed: 11/16/2022]
Abstract
The identification of “environmental justice (EJ) communities” is an increasingly common element in environmental planning, policy, and regulation. As a result, the choice of methods to define and identify these communities is a critical and often contentious process. This contentiousness is, in turn, a factor of the lack of a commonly accepted method, the concern among many EJ advocates and some regulators that existing frameworks are inadequate, and ultimately, the significant consequences of such designations for both public policy and community residents. With the aim of assisting regulators and advocates to more strategically focus their efforts, the authors developed a Cumulative Environmental Vulnerability Assessment (CEVA). This CEVA is composed of a Cumulative Environmental Hazard Index and a Social Vulnerability Index, with a Health Index as a reference. Applying CEVA produces spatial analysis that identifies the places that are subject to both the highest concentrations of cumulative environmental hazards and the fewest social, economic and political resources to prevent, mitigate, or adapt to these conditions. We recommended that these areas receive special consideration in permitting, monitoring, and enforcement actions, as well as investments in public participation, capacity building, and community economic development.
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Affiliation(s)
- Ganlin Huang
- Center for Regional Change, University of California at Davis, 152 Hunt Hall, One Shields Avenue, Davis, CA 95616, USA
- Author to whom correspondence should be addressed; ; Tel.: +1-530-752-0425; Fax: +1-530-752-3677
| | - Jonathan K. London
- Department of Human and Community Development, University of California at Davis, 2335 Hart Hall One Shields Avenue, Davis, CA 95616, USA;
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Huang G, London J. Mapping cumulative environmental effects, social vulnerability, and health in the San Joaquin Valley, California. Am J Public Health 2012; 102:830-2. [PMID: 22420800 DOI: 10.2105/ajph.2011.300466] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
To understand the social distribution of environmental hazards, methods to assess cumulative effects and their health implications are needed. We developed a cumulative environmental hazard index integrating environmental data on pollution sites, air quality, and pesticide use; a social vulnerability index to measure residents' resources to prevent or mitigate health effects; and a health index. We found that communities in California's San Joaquin Valley with high social vulnerability face more environmental burdens and have worse health conditions.
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Affiliation(s)
- Ganlin Huang
- Center for Regional Change, University of California, Davis, CA, USA.
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Knobel KAB, Lima MCMP. Knowledge, habits, preferences, and protective behavior in relation to loud sound exposures among Brazilian children. Int J Audiol 2012; 51 Suppl 1:S12-9. [DOI: 10.3109/14992027.2011.637307] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lewis AS, Sax SN, Wason SC, Campleman SL. Non-chemical stressors and cumulative risk assessment: an overview of current initiatives and potential air pollutant interactions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2011; 8:2020-73. [PMID: 21776216 PMCID: PMC3138011 DOI: 10.3390/ijerph8062020] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2011] [Accepted: 05/20/2011] [Indexed: 12/30/2022]
Abstract
Regulatory agencies are under increased pressure to consider broader public health concerns that extend to multiple pollutant exposures, multiple exposure pathways, and vulnerable populations. Specifically, cumulative risk assessment initiatives have stressed the importance of considering both chemical and non-chemical stressors, such as socioeconomic status (SES) and related psychosocial stress, in evaluating health risks. The integration of non-chemical stressors into a cumulative risk assessment framework has been largely driven by evidence of health disparities across different segments of society that may also bear a disproportionate risk from chemical exposures. This review will discuss current efforts to advance the field of cumulative risk assessment, highlighting some of the major challenges, discussed within the construct of the traditional risk assessment paradigm. Additionally, we present a summary of studies of potential interactions between social stressors and air pollutants on health as an example of current research that supports the incorporation of non-chemical stressors into risk assessment. The results from these studies, while suggestive of possible interactions, are mixed and hindered by inconsistent application of social stress indicators. Overall, while there have been significant advances, further developments across all of the risk assessment stages (i.e., hazard identification, exposure assessment, dose-response, and risk characterization) are necessary to provide a scientific basis for regulatory actions and effective community interventions, particularly when considering non-chemical stressors. A better understanding of the biological underpinnings of social stress on disease and implications for chemical-based dose-response relationships is needed. Furthermore, when considering non-chemical stressors, an appropriate metric, or series of metrics, for risk characterization is also needed. Cumulative risk assessment research will benefit from coordination of information from several different scientific disciplines, including, for example, toxicology, epidemiology, nutrition, neurotoxicology, and the social sciences.
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Affiliation(s)
- Ari S. Lewis
- Gradient, 20 University Road, Cambridge, MA 02138, USA; E-Mail:
| | - Sonja N. Sax
- Gradient, 20 University Road, Cambridge, MA 02138, USA; E-Mail:
| | - Susan C. Wason
- Department of Environmental Health, Harvard School of Public Health, 401 Park Drive, Boston, MA 02215, USA; E-Mail:
| | - Sharan L. Campleman
- Electric Power Research Institute, 3420 Hillview Ave., Palo Alto, CA 94304, USA; E-Mail:
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Berg AL, Serpanos YC. High frequency hearing sensitivity in adolescent females of a lower socioeconomic status over a period of 24 years (1985-2008). J Adolesc Health 2011; 48:203-8. [PMID: 21257121 DOI: 10.1016/j.jadohealth.2010.06.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2010] [Revised: 06/16/2010] [Accepted: 06/18/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE To examine annually over a period of 24 years, the high frequency hearing sensitivity in different groups of urban female adolescents with a low socioeconomic status (SES) and residential foster care. METHODS Hearing screening (15 decibel [dB] hearing level ranging from 1,000 to 8,000 Hertz [Hz]) and threshold (>15 dB hearing level) records were obtained from 8,710 female adolescents (mean age, 15.8 years [range, 12-20 years]), predominantly Hispanic and African American from households with a low SES. Data related to the use of personal listening devices (PLDs), daily hours of usage, occurrence of tinnitus, and hearing thresholds between 1,000 and 8,000 Hz over an 8-year period (2001-2008) were obtained from the adolescents. RESULTS High frequency hearing loss (HFHL) doubled over the 24-year period from 10.1% in 1985 to 19.2% in 2008. In comparison with the general adolescent population, this group of female adolescents presented with a higher percentage of bilateral mild or greater degrees of HFHL at two or more frequencies including 3,000, 4,000, and 6,000 Hz. Use of PLDs increased four-fold, from 18.3% (n = 68) in 2001 to 76.4% (n = 227) in 2008. Of the total number reporting tinnitus (n = 286), 99.7% (n = 285) also reported regular PLD use. A significant relationship was found between PLD use and reported tinnitus and HFHL irrespective of time of use of PLD. CONCLUSIONS Increased incidence of HFHL, reported tinnitus, PLD use, and hours of daily use in at-risk female adolescents of a low SES was found. A frequency interval of 3,000-6,000 Hz should be included in hearing screening protocols to identify potentially disabling hearing loss. Hearing conservation strategies need to be developed and/or modified that target and reach at-risk children and adolescents.
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Affiliation(s)
- Abbey L Berg
- Department of Biology and Health Sciences, Communication Sciences and Disorders Program, Dyson College of Arts and Sciences, Pace University, New York, NY 10038, USA.
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Seeman T, Epel E, Gruenewald T, Karlamangla A, McEwen BS. Socio-economic differentials in peripheral biology: Cumulative allostatic load. Ann N Y Acad Sci 2010; 1186:223-39. [PMID: 20201875 DOI: 10.1111/j.1749-6632.2009.05341.x] [Citation(s) in RCA: 377] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Teresa Seeman
- Division of Geriatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095-1687, USA.
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Adler NE, Stewart J. Health disparities across the lifespan: Meaning, methods, and mechanisms. Ann N Y Acad Sci 2010; 1186:5-23. [DOI: 10.1111/j.1749-6632.2009.05337.x] [Citation(s) in RCA: 419] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chen E, Cohen S, Miller GE. How low socioeconomic status affects 2-year hormonal trajectories in children. Psychol Sci 2009; 21:31-7. [PMID: 20424019 DOI: 10.1177/0956797609355566] [Citation(s) in RCA: 114] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Disparities by socioeconomic status (SES) are seen for numerous mental and physical illnesses, and yet understanding of the pathways to health disparities is limited. We tested whether SES alters longitudinal trajectories of cortisol output and what types of psychosocial factors could account for these links. Fifty healthy children collected saliva samples (four times per day for 2 days) at 6-month intervals for 2 years. At baseline, families were interviewed about SES and psychosocial factors. Lower-SES children displayed greater 2-year increases in daily cortisol output compared with higher-SES children. These effects were partially mediated by children's perceptions of threat and by family chaos. These findings may help explain, and provide some first steps toward ameliorating, low-SES children's vulnerability to health problems later in life by identifying the tendency to perceive threat in ambiguous situations and experiences of chaos as factors that link low SES to 2-year hormonal trajectories.
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Affiliation(s)
- Edith Chen
- University of British Columbia, Vancouver, British Columbia, Canada V6T1Z4.
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The TERRA framework: conceptualizing rural environmental health inequities through an environmental justice lens. ANS Adv Nurs Sci 2009; 32:107-17. [PMID: 19461228 DOI: 10.1097/ans.0b013e3181a3ae93] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The deleterious consequences of environmentally associated diseases are expressed differentially by income, race, and geography. Scientists are just beginning to understand the consequences of environmental exposures under conditions of poverty, marginalization, and geographic isolation. In this context, we developed the TERRA (translational environmental research in rural areas) framework to explicate environmental health risks experienced by the rural poor. Central to the TERRA framework is the premise that risks exist within physical-spatial, economic-resources, and cultural-ideologic contexts. In the face of scientific and political uncertainty, a precautionary risk reduction approach has the greatest potential to protect health. Conceptual and technical advances will both be needed to achieve environmental justice.
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Neighborhood stressors, perceived neighborhood quality, and child mental health in New York City. Health Place 2009; 15:148-55. [DOI: 10.1016/j.healthplace.2008.03.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2007] [Revised: 03/11/2008] [Accepted: 03/12/2008] [Indexed: 11/21/2022]
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Downey L, Hawkins B. RACE, INCOME, AND ENVIRONMENTAL INEQUALITY IN THE UNITED STATES. SOCIOLOGICAL PERSPECTIVES : SP : OFFICIAL PUBLICATION OF THE PACIFIC SOCIOLOGICAL ASSOCIATION 2008; 51:759-781. [PMID: 19578560 PMCID: PMC2705126 DOI: 10.1525/sop.2008.51.4.759] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This article asks whether the relationship between neighborhood and household income levels and neighborhood hazard levels varies according to neighborhood and household racial composition. Using a national, census tract-level data set, the authors find that black, white, and Hispanic households with similar incomes live in neighborhoods of dissimilar environmental quality, that the association between neighborhood and household income levels and neighborhood hazard levels varies according to neighborhood and household racial composition, and that increases in neighborhood and household income levels are more strongly associated with declining hazard levels in black neighborhoods and households than in white neighborhoods and households. These findings contradict Wilson's claim that the significance of race has declined in the modern industrial period and demonstrate that environmental racial inequality is not the product of racial income inequality. In addition, these findings suggest that the impact of higher incomes on black/white proximity to environmental hazards has less to do with increases in white geographic mobility (relative to black geographic mobility) than with the ability of higher income blacks to escape the highly polluted, disorganized, and deteriorated neighborhoods to which so many low-income blacks are confined.
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Chakraborty J, Zandbergen PA. Children at risk: measuring racial/ethnic disparities in potential exposure to air pollution at school and home. J Epidemiol Community Health 2008; 61:1074-9. [PMID: 18000130 DOI: 10.1136/jech.2006.054130] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
STUDY OBJECTIVE This paper addresses the environmental justice implications of children's health by exploring racial/ethnic disparities in potential exposure to air pollution, based on both school and home locations of children and three different types of pollution sources, in Orange County, Florida, USA. METHODS Using geocoded school and residence locations of 151 709 children enrolled in the public school system, distribution functions of proximity to the nearest source are generated for each type of air pollution source in order to compare the exposure potential of white, Hispanic, and black children. Discrete buffer distances are utilised to provide quantitative comparisons for statistical testing. MAIN RESULTS At any given distance from each type of pollution source, the cumulative proportion of Hispanic or black children significantly exceeds the corresponding proportion of white children, for both school and home locations. Regardless of race, however, a larger proportion of children are potentially exposed to air pollution at home than at school. CONCLUSIONS This study addresses the growing need to consider both daytime and nighttime activity patterns in the assessment of children's exposure to environmental hazards and related health risks. The results indicate a consistent pattern of racial inequity in the spatial distribution of all types of air pollution sources examined, with black children facing the highest relative levels of potential exposure at both school and home locations.
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Affiliation(s)
- Jayajit Chakraborty
- Department of Geography, University of South Florida, 4202 E. Fowler Avenue, NES107, Tampa, FL 33620, USA.
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Chamberlain LJ, Wang NE, Ho ET, Banchoff AW, Braddock CH, Gesundheit N. Integrating collaborative population health projects into a medical student curriculum at Stanford. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2008; 83:338-344. [PMID: 18367891 DOI: 10.1097/acm.0b013e318166a11b] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The authors describe the population health curriculum at the Stanford University School of Medicine from 2003 to 2007 that includes a requirement for first-year medical students to engage in community-based population health projects. The new curriculum in population health comprises classroom and experiential teaching methods. Population health projects, a key component of the curriculum, are described and classified by topic and topic area (e.g., health education; health services) and the intended outcome of the intervention (e.g., establishing new policies; advocacy). During the past four years, 344 students have entered the curriculum and have participated in 68 population health projects. The projects were determined both by students' interests and community needs, and they represented diverse topics: 51% of the 68 projects addressed topics in the area of disease prevention and health promotion; 28% addressed health care access; 15% addressed health services; 4% addressed emergency preparedness; and 1% addressed ethical issues in health. Each project had one of three targets for intervention: community capacity building, establishing policies and engaging in advocacy, and bringing about change or improvement in an aspect of the health care system. Projects represented diverse stages in the evolution of a community-campus partnership, from needs assessment to planning, implementation, and evaluation of project outcomes. Experience to date shows that classroom-based sessions and experiential learning in the area of population health can be successfully integrated in a medical school curriculum. When contextualized in a population health curriculum, population health projects can provide future physicians with an experiential counterpart to their classroom learning.
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Wright RJ, Subramanian SV. Advancing a multilevel framework for epidemiologic research on asthma disparities. Chest 2008; 132:757S-769S. [PMID: 17998340 DOI: 10.1378/chest.07-1904] [Citation(s) in RCA: 159] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Our understanding of asthma epidemiology is growing increasingly complex. Asthma outcomes are clearly socially patterned, with asthma ranking as a leading cause of health disparities among minority and low socioeconomic groups. Yet, the increasing prevalence and marked disparities in asthma remain largely unexplained by known risk factors. In the United States, asthma disproportionately affects nonwhite children living in urban areas and children living in poverty. Low socioeconomic status (SES), ethnic minority group status, and residence in an inner-city environment are closely intertwined in the United States, making it a challenge to fully disentangle the independent effects of each of these characteristics on asthma morbidity. In addition, studies show geographic variation in asthma outcomes across large cities and neighborhoods within cities that cannot be explained by economic factors alone. Although more limited data are available, studies in rural areas also suggest the stratification of risk based on SES and the proportion of minorities. Among low-SES areas, those with predominantly minority, segregated populations seem especially burdened. Marginalized populations of lower socioeconomic position are disproportionately exposed to irritants (eg, tobacco smoke), pollutants (eg, diesel-related particles), and indoor allergens (eg, cockroach and mouse allergen). Moreover, these marginalized individuals may also live in communities that are increasingly socially toxic, which, in turn, may be related to the increased experience of psychosocial stress that may influence asthma morbidity. Epidemiologic trends suggest that asthma may provide an excellent paradigm for understanding the role of community-level contextual factors in disease. Specifically, a multilevel approach that includes an ecological perspective may help to explain heterogeneities in asthma expression across socioeconomic and geographic boundaries that, to date, remain largely unexplained. Traditionally, asthma epidemiology has focused on individual-level risk factors and family factors. Far less attention has been given to the broader social context in which individuals live. A multilevel approach that explicitly recognizes the embedding of asthma within its biological, psycho-socioeconomic, environmental, and community contexts, is likely to provide a better understanding of asthma disparities at different stages in the life course. Is it simply asthma disparities or is it social disparities in asthma?
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Affiliation(s)
- Rosalind J Wright
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
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Downey L, Hawkins B. Single-Mother Families and Air Pollution: A National Study. SOCIAL SCIENCE QUARTERLY 2008; 89:523-536. [PMID: 19347054 PMCID: PMC2664989 DOI: 10.1111/j.1540-6237.2008.00545.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVE: This study uses tract-level demographic data and toxicity-weighted air pollutant concentration estimates for the continental United States to determine whether (1) single-mother families are overrepresented in environmentally hazardous Census tracts and (2) the percentage of single-mother families in a Census tract is a significant predictor of tract-level toxic concentration estimates. METHODS: After calculating tract-level toxic concentration estimates for the average female-headed family, male-headed family, and married-couple family with and without children, we use fixed-effects regression models to determine whether the percentage of single-mother families in a tract is a significant predictor of tract-level toxic concentration estimates. RESULTS: Single-mother families are overrepresented in environmentally hazardous Census tracts, and the percentage of single-mother families in a tract remains a significant predictor of estimated toxic concentration levels even after controlling for many of the most commonly used variables in the literature. CONCLUSION: Environmental inequality researchers need to broaden their focus beyond race and income to include groups such as single-mother families in their research.
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