Hybrid Resiliency-Stressor Conceptual Framework for Informing Decision Support Tools and Addressing Environmental Injustice and Health Inequities

Conceptual framework for preterm birth review in San Francisco

Preterm birth persists as a leading cause of infant mortality and morbidity despite decades of intervention effort. Intervention null effects may reflect failure to account for social determinants of health (SDH) or jointly acting risk factors. In some communities, persistent preterm birth trends and disparities have been consistently associated with SDH such as race/ethnicity, zip code, and housing conditions. Health authorities recommend conceptual frameworks for targeted action on SDH and precision public health approaches for preterm birth prevention. We document San Francisco, California's experience identifying the need, rationale, methods, and pilot work for developing a conceptual framework for preterm birth review (PTBR) in San Francisco. The PTBR conceptual framework is intended to enable essential public health services in San Francisco that prevent a range of preterm birth phenotypes by guiding plans for data collection, hypothesis testing, analytical methods, reports, and intervention strategy. Key elements of the PTBR conceptual framework are described including, 10 domains of SDH, 9 domains at the whole person level, such as lived experience and health behaviors, 8 domains at the within-person level, such as biomarkers and clinical measures, 18 preterm birth phenotypes, and the interconnections between domains. Assumptions for the PTBR conceptual framework were supported by a scoping review of literature on SDH effects on preterm birth, health authority consensus reports, and PTBR pilot data. Researcher and health authority interest in each of the domains warrants the framework to prompt systematic consideration of variables in each proposed domain. PTBR pilot data, illustrated in heatmaps, confirm the feasibility of data collection based on the framework, prevalence of co-occurring risk factors, potential for joint effects on specific preterm birth phenotypes, and opportunity for intervention to block SDH effects on preterm birth. The proposed PTBR conceptual framework has practical implications for specifying (1) population groups at risk, (2) grids or heatmap visualization of risk factors, (3) multi-level analyses, and (4) multi-component intervention design in terms of patterns of co-occurring risk factors. Lessons learned about PTBR data collection logistics, variable choice, and data management will be incorporated into future work to build PTBR infrastructure based on the PTBR conceptual framework.

Backyard aerosol pollution monitors: foliar surfaces, dust enrichment, and factors influencing foliar retention

Air pollution is one of the leading causes of death from noncommunicable diseases globally, and in Arizona, both mining activities and abandoned agriculture can generate erodible dust. This dust is transported via wind and can carry high amounts of toxic pollutants. Industry-adjacent communities, or "fenceline communities," are generally closer to the pollution sources and are disproportionally impacted by pollution, or in this case, dust. The dust transported from the mine settles into nearby rivers, gardens, and homes, and increases the concentrations of elements beyond their naturally occurring amounts (i.e., enriched). This study was built upon previous community science work in which plant leaves were observed to collect similar concentrations to an accepted dust collection method and illustrated promise for their use as low-cost air quality monitors in these communities. This work investigated the concentration of Na, Mg, Al, K, Ca, Mn, Co, Cu, Zn, Mo, and Ba in dust from the leaves of community-collected backyard and garden plants (foliar dust), as well as if certain variables affected collection efficacy. This assessment evaluated (1) foliar concentration versus surface area for 11 elements, (2) enrichment factor (EF) values and ratios, (3) comparisons of foliar, garden, and yard samples to US Geological Survey data, and (4) what variable significantly affected dust collection efficacy. The EF results indicate that many of the samples were enriched (anthropogenically contaminated) and that the foliar samples were generally more contaminated than the yard and garden soil samples. Leaf surface area was the most influential factor for leaf collection efficiency (p < 0.05) compared to plant family or sampling location. Further studies are needed that standardize the plant species and age and include multiple replicates of the same plant species across partnering communities. This study has demonstrated that foliar dust is enriched in the participating partnering communities and that plant leaf samples can serve as backyard aerosol pollution monitors. Therefore, foliar dust is a viable indicator of outdoor settled dust and aerosol contamination and this is an adoptable monitoring technique for "fenceline communities."

Urban Green Space and Subjective Well-Being of Older People: A Systematic Literature Review

A growing number of articles have identified and reported the benefits and importance of urban green spaces for improving human well-being, but there is a significant knowledge gap regarding the impact of urban green spaces on the subjective well-being of older adults. The literature search (August 2015-August 2022) was derived from two major scientific databases, Google Scholar, and Web of Science. As a result, 2558 articles were found, 1527 of which were retrieved from WOS and the rest from Google Scholar. Bibliometric methods and VOSviewer software were used to screen and organize the articles in the relevant fields. Finally, 65 articles met the review criteria. The included studies aim to capture the benefits of various features of urban green spaces in meeting or enhancing the subjective well-being needs of older adults. The results of our review further support the existence of a strong link between older adults' subjective well-being and various features of urban green spaces, providing new insights for future in-depth reexamination and policy development. Furthermore, the relationship between urban green spaces and older adults' subjective well-being depends not only on the urban green spaces themselves but also on the characteristics of the older adult population that uses them.

Inclusion of Social and Structural Determinants of Health to Advance Understanding of their Influence on the Biology of Chronic Disease

Social Determinants of Health (SDOH) consider social, political, and economic factors that contribute to health disparities in patients and populations. The most common health-related SDOH exposures are food and housing insecurity, financial instability, transportation needs, low levels of education, and psychosocial stress. These domains describe risks that can impact health outcomes more than health care. Epidemiologic and translational research demonstrates that SDOH factors represent exposures that predict harm and impact the health of individuals. International and national guidelines urge health professionals to address SDOH in clinical practice and public health. The further implementation of these recommendations into basic and translational research, however, is lagging. Herein, we consider a precision health framework to describe how SDOH contributes to the exposome and exacerbates physiologic pathways that lead to chronic disease. SDOH factors are associated with various forms of stressors that impact physiological processes through epigenetic, inflammatory, and redox regulation. Many SDOH exposures may add to or potentiate the pathologic effects of additional environmental exposures. This overview aims to inform basic life science and translational researchers about SDOH exposures that can confound associations between classic biomedical determinants of disease and health outcomes. To advance the study of toxicology through either qualitative or quantitative assessment of exposures to chemical and biological substances, a more complete environmental evaluation should include SDOH exposures. We discuss common approaches to measure SDOH factors at individual and population levels and review the associations between SDOH risk factors and physiologic mechanisms that influence chronic disease. We provide clinical and policy-based motivation to encourage researchers to consider the impact of SDOH exposures on study results and data interpretation. With valid measures of SDOH factors incorporated into study design and analyses, future toxicological research may contribute to an evidence base that can better inform prevention and treatment options, to improve equitable clinical care and population health. © 2022 Wiley Periodicals LLC.

Participatory Research for Environmental Justice: A Critical Interpretive Synthesis

BACKGROUND

Environmental health risks are disproportionately colocated with communities in poverty and communities of color. In some cases, participatory research projects have effectively addressed structural causes of health risk in environmental justice (EJ) communities. However, many such projects fail to catalyze change at a structural level.

OBJECTIVES

This review employs Critical Interpretive Synthesis (CIS) to theorize specific elements of participatory research for environmental health that effectively prompt structural change in EJ communities.

METHODS

Academic database search was used to identify peer-reviewed literature describing participatory research with EJ communities to address environmental health. Synthetic constructs were developed iteratively related to study characteristics, design elements, and outcomes; and data were extracted for included records. Statistical analyses were performed to assess correlations between study design elements and structural change outcomes. Through critical, comparative, and contextual analyses of the "structural change" case study group and "non- structural change" group, informed by relevant theoretical literature, a synthesizing argument was generated.

RESULTS

From 505 total records identified, eligibility screening produced 232 case study articles, representing 154 case studies, and 55 theoretical articles for synthesis. Twenty-six case studies resulted in a structural change outcome. The synthesizing argument states that participatory research with EJ communities may be more likely to result in structural change when a) community members hold formal leadership roles; b) project design includes decision-makers and policy goals; and c) long term partnerships are sustained through multiple funding mechanisms. The assumption of EJ community benefit through research participation is critically examined.

DISCUSSION

Recommended future directions include establishing structural change as a goal of participatory research, employing participatory assessment of community benefit, and increased hiring of faculty of color at research institutions. The power, privilege, and political influence that academic institutions are able to leverage in partnership with EJ communities may be as valuable as the research itself. https://doi.org/10.1289/EHP6274.

Susceptibility Variations in Air Pollution Health Effects: Incorporating Neuroendocrine Activation

Diverse host factors/phenotypes may exacerbate or diminish biological responses induced by air pollutant exposure. We lack an understanding of biological indicators of environmental exposures that culminate in a physiological response versus those that lead to adversity. Variations in response phenotype might arise centrally and/or at the local tissue level. In addition to genetic differences, the current evidence supports the roles of preexisting cardiopulmonary diseases, diabetes, diet, adverse prenatal environments, neurobehavioral disorders, childhood infections, microbiome, sex, and psychosocial stressors in modifying the susceptibility to air pollutant exposures. Animal models of human diseases, obesity, nutritional inadequacies, and neurobehavioral conditions have been compared with healthy controls to understand the causes of variations in susceptibility. Although psychosocial stressors have been associated with increased susceptibility to air pollutant effects, the contribution of neuroendocrine stress pathways in mediating these effects is just emerging. The new findings of neuroendocrine activation leading to systemic metabolic and immunological effects of air pollutants, and the potential contribution to allostatic load, emphasize the consideration of these mechanisms into susceptibility. Variations in susceptibility to air pollution health effects are likely to underlie host genetic and physiological conditions in concert with disrupted neuroendocrine circuitry that alters physiological stability under the influence of stressors.