Diversity, Equity, and Inclusion in the Environmental Health Workforce: Mapping the Literature and Moving Toward Liberation

Introduction

Diversity, equity, and inclusion, also known as DEI, is an essential topic being discussed across society. The field of environmental health (EH) should certainly not be excluded from the conversation.

Objective

The purpose of this mini-review was to map the literature and identify gaps on the topic of DEI in the EH workforce.

Methods

A rapid scoping review was conducted using standard synthesis science methods to search and map the published literature. All study titles, abstracts, and full texts were screened by 2 independent reviewers among the authorship team.

Results

The search strategy yielded 179 English language papers. Of those, 37 met all inclusion criteria after full text screening. Overall, the majority of the articles had weak or moderate DEI engagement and only 3 articles had strong DEI engagement.

Discussion

There is a significant need for additional research in this realm. Future studies should explicitly focus on workforce issues, and attempt to achieve the highest level of the evidence possible for this field.

Conclusion

Although DEI initiatives are a step in the right direction, the current evidence suggests that inclusivity and liberation may prove to be more impactful and meaningful constructs to fully advance equity in the EH workforce.

Cognitive impacts of ambient air pollution in the National Social Health and Aging Project (NSHAP) cohort

BACKGROUND

Pathways through which air pollution may impact cognitive function are poorly understood, particularly with regard to whether and how air pollution interacts with social and emotional factors to influence cognitive health.

OBJECTIVE

To examine the association between air pollutant exposures and cognitive outcomes among older adults participating in the National Social Life, Health, and Aging Project (NSHAP) cohort study.

METHODS

Measures of cognitive function, social connectedness, and physical and mental health were obtained for each NSHAP participant starting with Wave 1 of the study in 2005. Cognitive function was assessed using the Chicago Cognitive Function Measure (CCFM) for 3377 participants. Exposures to fine particles (PM_2.5) were estimated for each participant using GIS-based spatio-temporal models, and exposures to nitrogen dioxide (NO₂) were obtained from the nearest EPA monitors.

RESULTS

In adjusted linear regression models, IQR increases in 1 to 7year PM_2.5 exposures were associated with a 0.22 (95% CI: -0.44, -0.01) to a 0.25 (95% CI: -0.43, -0.06) point decrease in CCFM scores, equivalent to aging 1.6years, while exposures to NO₂ were equivalent to aging 1.9years. The impacts of PM_2.5 on cognition were modified by stroke, anxiety, and stress, and were mediated by depression. The impacts of NO₂ were mediated by stress and effect modification by impaired activities of daily living for NO₂ was found.

CONCLUSIONS

Exposures to long-term PM_2.5 and NO₂ were associated with decreased cognitive function in our cohort of older Americans, and individuals who experienced a stroke or elevated anxiety were more susceptible to the effects of PM_2.5 on cognition. Additionally, mediation results suggest that PM_2.5 may impact cognition through pathways related to mood disorders.

Erectile dysfunction and exposure to ambient Air pollution in a nationally representative cohort of older Men

BACKGROUND

Little is known about the association between air pollution and erectile dysfunction (ED), a disorder occurring in 64% of men over the age of 70, and to date, no studies have been published. To address this significant knowledge gap, we explored the relationship between ED and air pollution in a group of older men who were part of the National Social Life, Health, and Aging Project (NSHAP), a nationally representative cohort study of older Americans.

METHODS

We obtained incident ED status and participant data for 412 men (age 57-85). Fine particulate matter (PM_2.5) exposures were estimated using spatio-temporal models based on participants' geocoded addresses, while nitrogen dioxide (NO₂) and ozone (O₃) concentrations were estimated using nearest measurements from the Environmental Protection Agency's Air Quality System. The association between air pollution and incident ED (newly developed in Wave 2) was examined and logistic regression models were run with adjusted models controlling for race, education, season, smoking, obesity, diabetes, depression, and median household income of census tract.

RESULTS

We found positive, although statistically insignificant, associations between PM_2.5, NO₂, and O₃ exposures and odds of incident ED for each of our examined exposure windows, including 1 to 7 year moving averages. Odds ratios (OR) for 1 and 7 year moving averages equaled 1.16 (95% CI: 0.87, 1.55) and 1.16 (95% CI: 0.92, 1.46), respectively, for an IQR increase in PM_2.5 exposures. Observed associations were robust to model specifications and were not significantly modified by any of the examined risk factors for ED.

CONCLUSIONS

We found associations between PM_2.5, NO₂, and O₃ exposures and odds of developing ED that did not reach nominal statistical significance, although exposures to each pollutant were consistently associated with higher odds of developing ED. While more research is needed, our findings suggest a relationship between air pollutant exposure and incident cases of ED, a common condition in older men.

Mass Arsenic Poisoning and the Public Health Response in Maine

Created in the wake of the September 11, 2001 terrorist attacks, Maine's Office of Public Health Emergency Preparedness within the Maine Center for Disease Control and Prevention undertook a major reorganization of epidemiology and laboratory services and began developing relationships with key partners and stakeholders, and a knowledgeable and skilled public health emergency preparedness workforce. In 2003, these newly implemented initiatives were tested extensively during a mass arsenic poisoning at the Gustav Adolph Lutheran Church in the rural northern community of New Sweden, Maine. This episode serves as a prominent marker of how increased preparedness capabilities, as demonstrated by the rapid identification and administration of antidotes and effective collaborations between key partners, can contribute to the management of broader public health emergencies in rural areas. (Disaster Med Public Health Preparedness. 2013;7:319-326)