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Special Issue "Achieving Environmental Health Equity: Great Expectations"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: 31 January 2019

Special Issue Editor

Guest Editor
Professor Timothy E. Ford

Professor and Chair of the Department of Environmental Health Sciences, University of Massachusetts, Amherst, MA 01003, USA
Website | E-Mail
Interests: CBPR; community and population health; water and health; biofilms; waterborne pathogens; contaminant chemicals; microbial biomarkers; molecular diagnostics; microbial interactions with contaminants

Special Issue Information

Dear Colleagues,

I’m delighted to invite you to consider contributing to this special edition on Achieving Environmental Health Equity: Great Expectations.

To the rationally-minded, it has long been obvious that environment and human health are intricately linked, and that there are vast disparities in individual, community and population environmental health risks. These disparities are heavily influenced by socio-economics, geography, occupation, government policies and many other exacerbating factors such as conflict and climate change. In the last decade or so, funding agencies have recognized the importance of addressing health disparities in improving community and population health, and reducing the economic burden of poor health. In the US, centers of excellence have emerged (i.e., NIMHD’s U54 program), and global health centers and institutes that include health disparities in their mandates created. However, how does this help us achieve environmental health equity, and is this even remotely possible? A mining community, whether in Appalachia or the Witwatersrand, will always face greater environmental health challenges than wealthier communities that can afford access to clean air and water!

The premise of this special edition is that we can do more to move closer towards environmental health equity through reducing disparities, and that there are many “lessons learned” to be shared with communities that face these disparities—urban, peri-urban and rural. Invariably, these “lessons” are community driven, and therefore community engagement should be a major focus in addressing health disparities. Papers describing studies that engage communities in sustainable environmental health risk reduction are encouraged, but also research that realistically outlines the challenges researchers and community groups have faced are welcome. We encourage submission from as broad a range of international research groups as possible, representing a wide diversity of communities and their environmental health risks. The goal is to compile a sufficient number of these papers into an online resource to inform future work in this critical area of environmental health.

Prof. Timothy E. Ford
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Health equity
  • Community engagement
  • CBPR
  • Disparities
  • Environmental health
  • Environmental justice
  • Inequalities
  • Marginalized communities
  • Health risks

Published Papers (18 papers)

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Research

Open AccessArticle Socio-Economic Status and Health: Evaluation of Human Biomonitored Chemical Exposure to Per- and Polyfluorinated Substances across Status
Int. J. Environ. Res. Public Health 2018, 15(12), 2818; https://doi.org/10.3390/ijerph15122818 (registering DOI)
Received: 10 October 2018 / Revised: 30 November 2018 / Accepted: 6 December 2018 / Published: 11 December 2018
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Abstract
Research on the environment, health, and well-being nexus (EHWB) is shifting from a silo toward a systemic approach that includes the socio-economic context. To disentangle further the complex interplay between the socio-exposome and internal chemical exposure, we performed a meta-analysis of human biomonitoring
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Research on the environment, health, and well-being nexus (EHWB) is shifting from a silo toward a systemic approach that includes the socio-economic context. To disentangle further the complex interplay between the socio-exposome and internal chemical exposure, we performed a meta-analysis of human biomonitoring (HBM) studies with internal exposure data on per-and polyfluoroalkyl substances (PFASs) and detailed information on risk factors, including descriptors of socio-economic status (SES) of the study population. PFASs are persistent in nature, and some have endocrine-disrupting properties. Individual studies have shown that HBM biomarker concentrations of PFASs generally increase with SES indicators, e.g., for income. Based on a meta-analysis (five studies) of the associations between PFASs and SES indicators, the magnitude of the association could be estimated. For the SES indicator income, changes in income were expressed by a factor change, which was corrected by the Gini coefficient to take into account the differences in income categories between studies, and the income range between countries. For the SES indicator education, we had to conclude that descriptors (<college, x years of study, etc.) differed too widely between studies to perform a meta-analysis. Therefore, the use of the uniform ISCED (International Standard Classification of Education) is recommended in future studies. The meta-analysis showed that a higher income is associated with a higher internal exposure to PFASs (PFOS or perfluorooctanesulfonic acid, PFOA or perfluorooctanoic acid, PFNA or perfluorononanoic acid, PFHxS or perfluorohexane sulfonate). This is opposite to the environmental justice hypothesis, referring to an inequitable distribution of detrimental environmental effects toward poor and minority communities by a practice or policy. With a doubling of the income, internal exposure increased on average by 10%–14%. Possible explanations for this difference are given, e.g., underlying differences in diet. However, other sources can also contribute, and the exact causes of SES-related differences in PFAS concentrations remain unclear. Studies are needed that include social descriptors together with lifestyle and dietary information as explanatory variables for internal chemical exposure levels. This will help clarify the underlying factors that link SES with inequity to environmental exposures, and will raise awareness and knowledge to strengthen the capacities of people and communities to advocate chemical exposure reduction in order to reduce this health inequity. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessArticle Characterization of Environmental Health Inequalities Due to Polyaromatic Hydrocarbon Exposure in France
Int. J. Environ. Res. Public Health 2018, 15(12), 2680; https://doi.org/10.3390/ijerph15122680
Received: 29 October 2018 / Revised: 22 November 2018 / Accepted: 23 November 2018 / Published: 28 November 2018
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Abstract
Reducing environmental health inequalities has become a major focus of public health efforts in France, as evidenced by the French action plans for health and the environment. To evaluate environmental inequalities, routine monitoring networks provide a valuable source of data on environmental contamination,
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Reducing environmental health inequalities has become a major focus of public health efforts in France, as evidenced by the French action plans for health and the environment. To evaluate environmental inequalities, routine monitoring networks provide a valuable source of data on environmental contamination, which can be used in integrated assessments, to identify overexposed populations and prioritize actions. However, available databases generally do not meet sufficient spatial representativeness to characterize population exposure, as they are usually not assembled for this specific purpose. The aim of this study was to develop geoprocessing procedures and statistical methods to build spatial environmental variables (water, air, soil, and food pollutant concentrations) at a fine resolution, and provide appropriate input for the exposure modelling. Those methods were designed to combine in situ monitoring data with correlated auxiliary information (for example, atmospheric emissions, population, and altitude), in order to better represent the variability of the environmental compartment quality. The MODUL’ERS multimedia exposure model developed by INERIS (French Institute for industrial Environment and Risks) was then used to assess the transfer of substances from the environment to humans, through inhalation and ingestion pathway characterization. We applied the methodology to a carcinogenic Polycyclic Aromatic Hydrocarbon substance, benzo[a]pyrene(B[a]P), to map spatialized exposure indicators, at the national scale. The largest environmental contribution corresponded to the ingestion pathway. Data processing algorithms and calculation of exposure will be integrated into the French coordinated integrated environment and health platform PLAINE (PLteforme intégrée d’Analyse des INégalités Environnementales) which has been developed to map and analyze environmental health inequalities. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessArticle Variation in Cold-Related Mortality in England Since the Introduction of the Cold Weather Plan: Which Areas Have the Greatest Unmet Needs?
Int. J. Environ. Res. Public Health 2018, 15(11), 2588; https://doi.org/10.3390/ijerph15112588
Received: 8 October 2018 / Revised: 14 November 2018 / Accepted: 15 November 2018 / Published: 19 November 2018
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Abstract
The Cold Weather Plan (CWP) in England was introduced to prevent the adverse health effects of cold weather; however, its impact is currently unknown. This study characterizes cold-related mortality and fuel poverty at STP (Sustainability and Transformation Partnership) level, and assesses changes in
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The Cold Weather Plan (CWP) in England was introduced to prevent the adverse health effects of cold weather; however, its impact is currently unknown. This study characterizes cold-related mortality and fuel poverty at STP (Sustainability and Transformation Partnership) level, and assesses changes in cold risk since the introduction of the CWP. Time series regression was used to estimate mortality risk for up to 28 days following exposure. Area level fuel poverty was used to indicate mitigation against cold exposure and mapped alongside area level risk. We found STP variations in mortality risk, ranging from 1.74, 1.44–2.09 (relative risk (RR), 95% CI) in Somerset, to 1.19, 1.01–1.40 in Cambridge and Peterborough. Following the introduction of the CWP, national-level mortality risk declined significantly in those aged 0–64 (1.34, 1.23–1.45, to 1.09, 1.00–1.19), but increased significantly among those aged 75+ (1.36, 1.28–1.44, to 1.58, 1.47–1.70) and for respiratory conditions (1.78, 1.56–2.02, to 2.4, 2.10–2.79). We show how spatial variation in cold mortality risk has increased since the introduction of the CWP, which may reflect differences in implementation of the plan. Combining risk with fuel poverty information identifies 14 STPs with the greatest need to address the cold effect, and that would gain most from enhanced CWP activity or additional intervention measures. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessArticle Health Risk in Urbanizing Regions: Examining the Nexus of Infrastructure, Hygiene and Health in Tashkent Province, Uzbekistan
Int. J. Environ. Res. Public Health 2018, 15(11), 2578; https://doi.org/10.3390/ijerph15112578
Received: 16 September 2018 / Revised: 14 November 2018 / Accepted: 15 November 2018 / Published: 18 November 2018
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Abstract
Worldwide, development agencies have increased their investments in water supply and sanitation as a “powerful preventive medicine” to address infectious diseases. These interventions have focused on on-site technical interventions or social engineering approaches, emulating the result-based targets of the development goals. Against this
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Worldwide, development agencies have increased their investments in water supply and sanitation as a “powerful preventive medicine” to address infectious diseases. These interventions have focused on on-site technical interventions or social engineering approaches, emulating the result-based targets of the development goals. Against this backdrop, the study examines the following research question: What is the role of socio-cultural backgrounds, housing characteristics, and environmental hygiene practices in addressing water-transmitted diseases in the Tashkent province of Uzbekistan. In a country where public statistics and official maps are rarely accessible, and research is restrictive, the study carried out a household survey using open data kit (ODK) between July and October 2015 in Olmalik, an industrial district, and the Kibray urbanizing district in the province. The findings reveal that demographic factors, poor sanitation practices, housing characteristics, and social behaviors are key predictors of water-transmitted diseases in the two districts. In the industrial township, poor housing, larger household size, and poor excreta disposal habits increased the occurrence of diseases, while in urbanizing districts, higher household size, frequently eating out, and access to public taps significantly increased the occurrence of water-transmitted diseases. The study, which was carried out in a challenging institutional environment, highlights the need for Uzbekistan to focus their policies on environmental hygiene, demographic factors and social behavior as key interventions rather than merely on on-site drinking water and sanitation interventions. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessArticle A Spatio-Temporal Pattern and Socio-Economic Factors Analysis of Improved Sanitation in China, 2006–2015
Int. J. Environ. Res. Public Health 2018, 15(11), 2510; https://doi.org/10.3390/ijerph15112510
Received: 6 July 2018 / Revised: 29 October 2018 / Accepted: 6 November 2018 / Published: 9 November 2018
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Abstract
Ensuring an adequate and safe access to sanitation is essential to prevent diseases. Using provincial spatial panel data reported in the China Health Statistical Yearbook and the China Statistical Yearbook, this paper analyzed the spatio-temporal characteristics of improved rural sanitation in 30 Chinese
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Ensuring an adequate and safe access to sanitation is essential to prevent diseases. Using provincial spatial panel data reported in the China Health Statistical Yearbook and the China Statistical Yearbook, this paper analyzed the spatio-temporal characteristics of improved rural sanitation in 30 Chinese provinces during the period 2006–2015, and analyzed factors that may affect improved sanitation rates in rural China. Spatial autocorrelations of improved sanitation rates were computed via Global and Local Moran’s I firstly, and then, inter-provincial disparities of improved sanitation were assessed by using the Theil index estimator; finally, the spatial panel model was employed to examine the potential socio-economic factors. Spatial autocorrelations results suggested that the provincial improved sanitation rates changes affect both the provinces themselves and the adjacent regions; Analysis of the spatial panel model revealed that factors such as GDP per capita, investment proportion ratio, centralized water supply, rural residents’ expenditure were positively associated with improved sanitation rates, and illiteracy rate of people older than 15 was negatively related with improved sanitation rates. Socio-economic factors had affected the improved sanitation rates in 30 provinces in rural China. Thus, a series of policies, socio-economic measures and personal latrine literacy education should be given to improve the status of improved sanitation rates in rural China. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessArticle Health Effects of Air Pollution in China
Int. J. Environ. Res. Public Health 2018, 15(7), 1471; https://doi.org/10.3390/ijerph15071471
Received: 6 June 2018 / Revised: 5 July 2018 / Accepted: 9 July 2018 / Published: 12 July 2018
Cited by 2 | PDF Full-text (1139 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Background Rapid economic and social development in China has resulted in severe air pollution and consequent adverse impacts on society. The health effects of air pollution have been widely studied. Methods Using information from the China Health and Retirement Longitudinal Study (CHARLS) database,
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Background Rapid economic and social development in China has resulted in severe air pollution and consequent adverse impacts on society. The health effects of air pollution have been widely studied. Methods Using information from the China Health and Retirement Longitudinal Study (CHARLS) database, we established a hierarchical linear model combining pollution and socioeconomic and psychosocial variables to examine the effects of air pollution on public health in China. Local air pollution was characterized in multiple dimensions. Results The relationship of health to its determinants greatly differed between Eastern and Central/Western China. Higher education, higher income level, better life satisfaction, and long-term marriage were significantly associated with better health status among Chinese. In addition, regional healthcare resources were positively associated with the health of residents. As indicated by the hierarchical model with health as dependent variable, in Central/Western China, longest duration of good air quality in spring/summer was positively associated with health (estimated coefficient = 0.067, standard error = 0.026), while the mean Air Quality Index (AQI) in autumn/winter was inversely associated with health (estimated coefficient = −0.082, standard error = 0.031). Good air quality in the current study is defined as daily average AQI less than 35. Conclusions Duration (in days) of acceptable air quality was particularly important for improving public health. Future policies should target increased duration of good air quality while managing air pollution by controlling or decreasing severe air pollution. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessFeature PaperArticle Independent and Joint Contributions of Fine Particulate Matter Exposure and Population Vulnerability to Mortality in the Detroit Metropolitan Area
Int. J. Environ. Res. Public Health 2018, 15(6), 1209; https://doi.org/10.3390/ijerph15061209
Received: 19 April 2018 / Revised: 25 May 2018 / Accepted: 6 June 2018 / Published: 8 June 2018
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Abstract
Fine particulate matter is associated with adverse health outcomes. Exposure to fine particulate matter may disproportionately affect urban communities with larger numbers of vulnerable residents. We used multilevel logistic regression models to estimate the joint effects of fine particulate matter (PM2.5)
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Fine particulate matter is associated with adverse health outcomes. Exposure to fine particulate matter may disproportionately affect urban communities with larger numbers of vulnerable residents. We used multilevel logistic regression models to estimate the joint effects of fine particulate matter (PM2.5) and population vulnerabilities on cardiopulmonary mortality (CPM). We estimated the health benefits of reductions in PM2.5 across census tracts in the Detroit metropolitan area with varying levels of population vulnerability, using cluster-specific odds ratios scaled to reflect PM2.5-attributable cardiopulmonary risk. PM2.5 and population vulnerability were independently associated with odds of CPM. Odds of CPM and the number of deaths attributable to PM2.5 were greatest in census tracts with both high PM2.5 exposures and population vulnerability. Reducing PM2.5 in census tracts with high PM2.5 would lead to an estimated 18% annual reduction in PM2.5-attributable CPM. Between 78–79% of those reductions in CPM would occur within census tracts with high population vulnerabilities. These health benefits of reductions in PM2.5 occurred at levels below current U.S. reference concentrations. Focusing efforts to reduce PM2.5 in the Detroit metropolitan area in census tracts with currently high levels would also lead to greater benefits for residents of census tracts with high population vulnerabilities. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessArticle Impacts of Haze on Housing Prices: An Empirical Analysis Based on Data from Chengdu (China)
Int. J. Environ. Res. Public Health 2018, 15(6), 1161; https://doi.org/10.3390/ijerph15061161
Received: 26 April 2018 / Revised: 29 May 2018 / Accepted: 31 May 2018 / Published: 2 June 2018
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Based on cross-section data of 20 districts in Chengdu, this article reviews the relationships between haze and housing prices with the combined application of Spatial Error Model (SEM) and Spatial Lag Model (SLM). The results illustrate that haze significantly have negative impacts on
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Based on cross-section data of 20 districts in Chengdu, this article reviews the relationships between haze and housing prices with the combined application of Spatial Error Model (SEM) and Spatial Lag Model (SLM). The results illustrate that haze significantly have negative impacts on both the selling and rental prices of houses. Controlling other variables, if the air quality index rises by 0.1, the housing selling prices and rental prices will drop by 3.97% and 4.01%, respectively. Interestingly, housing rental prices have a more significant response to the air quality than housing sale prices. Residents are willing to pay a premium for better air quality and the influence of air quality is partially reflected in housing prices, which indicates that better air quality has been becoming a scarce resource with the improvement of people’s living standard. Furthermore, the impacts of haze on housing prices are also expected to lead to a “crowding out effect” in different regions. This would be detrimental for human capital accumulation and will accelerate the regional divergence in the internal economy and population structure, thus forming a region “fence” within cities. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessArticle Perspectives on Biological Monitoring in Environmental Health Research: A Focus Group Study in a Native American Community
Int. J. Environ. Res. Public Health 2018, 15(6), 1129; https://doi.org/10.3390/ijerph15061129
Received: 4 May 2018 / Revised: 23 May 2018 / Accepted: 29 May 2018 / Published: 31 May 2018
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Abstract
Background: Reliance on natural resources brings Native American communities into frequent contact with environmental media, which, if contaminated, represents an exposure route for environmental pollutants. Native American communities vary in their perspectives on research and relatively little is known about the range of
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Background: Reliance on natural resources brings Native American communities into frequent contact with environmental media, which, if contaminated, represents an exposure route for environmental pollutants. Native American communities vary in their perspectives on research and relatively little is known about the range of perspectives regarding the use of biological samples for environmental exposure assessment. Methods: Thirty-one members of Zuni Pueblo (median age = 40.0 years, range = 26–59 years) participated a series of four focus groups. Qualitative themes emerging from the focus group discussion transcripts were identified by content analysis. Results: Emergent themes included adequate informed consent, traditional beliefs, and personal choice. Conclusions: The discussions reinforced the central role of traditional values in the decision to participate in research involving biological samples for environmental exposure assessment. Decision-making required a balance between the perceived value of the proposed project and its purpose, with cultural perspectives surrounding the biological sample requested. We examine the potential for study bias and include recommendations to aid in the collaborative identification and control of unintended risks posed by the use of biological samples in environmental health studies in native communities. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
Open AccessArticle Early-Life Air Pollution Exposure, Neighborhood Poverty, and Childhood Asthma in the United States, 1990–2014
Int. J. Environ. Res. Public Health 2018, 15(6), 1114; https://doi.org/10.3390/ijerph15061114
Received: 26 April 2018 / Revised: 14 May 2018 / Accepted: 23 May 2018 / Published: 30 May 2018
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Abstract
Ambient air pollution is a well-known risk factor of various asthma-related outcomes, however, past research has often focused on acute exacerbations rather than asthma development. This study draws on a population-based, multigenerational panel dataset from the United States to assess the association of
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Ambient air pollution is a well-known risk factor of various asthma-related outcomes, however, past research has often focused on acute exacerbations rather than asthma development. This study draws on a population-based, multigenerational panel dataset from the United States to assess the association of childhood asthma risk with census block-level, annual-average air pollution exposure measured during the prenatal and early postnatal periods, as well as effect modification by neighborhood poverty. Findings suggest that early-life exposures to nitrogen dioxide (NO2), a marker of traffic-related pollution, and fine particulate matter (PM2.5), a mixture of industrial and other pollutants, are positively associated with subsequent childhood asthma diagnosis (OR = 1.25, 95% CI = 1.10–1.41 and OR = 1.25, 95% CI = 1.06–1.46, respectively, per interquartile range (IQR) increase in each pollutant (NO2 IQR = 8.51 ppb and PM2.5 IQR = 4.43 µ/m3)). These effects are modified by early-life neighborhood poverty exposure, with no or weaker effects in moderate- and low- (versus high-) poverty areas. This work underscores the importance of a holistic, developmental approach to elucidating the interplay of social and environmental contexts that may create conditions for racial-ethnic and socioeconomic disparities in childhood asthma risk. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
Open AccessArticle Advice and Frequently Asked Questions (FAQs) for Citizen-Science Environmental Health Assessments
Int. J. Environ. Res. Public Health 2018, 15(5), 960; https://doi.org/10.3390/ijerph15050960
Received: 29 March 2018 / Revised: 2 May 2018 / Accepted: 9 May 2018 / Published: 11 May 2018
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Abstract
Citizen science provides quantitative results to support environmental health assessments (EHAs), but standardized approaches do not currently exist to translate findings into actionable solutions. The emergence of low-cost portable sensor technologies and proliferation of publicly available datasets provides unparalleled access to supporting evidence;
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Citizen science provides quantitative results to support environmental health assessments (EHAs), but standardized approaches do not currently exist to translate findings into actionable solutions. The emergence of low-cost portable sensor technologies and proliferation of publicly available datasets provides unparalleled access to supporting evidence; yet data collection, analysis, interpretation, visualization, and communication are subjective approaches that must be tailored to a decision-making audience capable of improving environmental health. A decade of collaborative efforts and two citizen science projects contributed to three lessons learned and a set of frequently asked questions (FAQs) that address the complexities of environmental health and interpersonal relations often encountered in citizen science EHAs. Each project followed a structured step-by-step process in order to compare and contrast methods and approaches. These lessons and FAQs provide advice to translate citizen science research into actionable solutions in the context of a diverse range of environmental health issues and local stakeholders. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessArticle Retooling CalEnviroScreen: Cumulative Pollution Burden and Race-Based Environmental Health Vulnerabilities in California
Int. J. Environ. Res. Public Health 2018, 15(4), 762; https://doi.org/10.3390/ijerph15040762
Received: 16 February 2018 / Revised: 7 April 2018 / Accepted: 10 April 2018 / Published: 16 April 2018
Cited by 4 | PDF Full-text (6853 KB) | HTML Full-text | XML Full-text
Abstract
The California Community Environmental Health Screening Tool (CalEnviroScreen) advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor
[...] Read more.
The California Community Environmental Health Screening Tool (CalEnviroScreen) advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessCommunication Challenges and Opportunities for Tribal Waters: Addressing Disparities in Safe Public Drinking Water on the Crow Reservation in Montana, USA
Int. J. Environ. Res. Public Health 2018, 15(4), 567; https://doi.org/10.3390/ijerph15040567
Received: 9 February 2018 / Revised: 13 March 2018 / Accepted: 17 March 2018 / Published: 21 March 2018
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Abstract
Disparities in access to safe public drinking water are increasingly being recognized as contributing to health disparities and environmental injustice for vulnerable communities in the United States. As the Co-Directors of the Apsaálooke Water and Wastewater Authority (AWWWA) for the Crow Tribe, with
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Disparities in access to safe public drinking water are increasingly being recognized as contributing to health disparities and environmental injustice for vulnerable communities in the United States. As the Co-Directors of the Apsaálooke Water and Wastewater Authority (AWWWA) for the Crow Tribe, with our academic partners, we present here the multiple and complex challenges we have addressed in improving and maintaining tribal water and wastewater infrastructure, including the identification of diverse funding sources for infrastructure construction, the need for many kinds of specialized expertise and long-term stability of project personnel, ratepayer difficulty in paying for services, an ongoing legacy of inadequate infrastructure planning, and lack of water quality research capacity. As a tribal entity, the AWWWA faces additional challenges, including the complex jurisdictional issues affecting all phases of our work, lack of authority to create water districts, and additional legal and regulatory gaps—especially with regards to environmental protection. Despite these obstacles, the AWWWA and Crow Tribe have successfully upgraded much of the local water and wastewater infrastructure. We find that ensuring safe public drinking water for tribal and other disadvantaged U.S. communities will require comprehensive, community-engaged approaches across a broad range of stakeholders to successfully address these complex legal, regulatory, policy, community capacity, and financial challenges. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessArticle Comparing Classic and Interval Analytical Hierarchy Process Methodologies for Measuring Area-Level Deprivation to Analyze Health Inequalities
Int. J. Environ. Res. Public Health 2018, 15(1), 140; https://doi.org/10.3390/ijerph15010140
Received: 7 December 2017 / Revised: 5 January 2018 / Accepted: 12 January 2018 / Published: 16 January 2018
Cited by 3 | PDF Full-text (4000 KB) | HTML Full-text | XML Full-text
Abstract
Deprivation indices are useful measures to study health inequalities. Different techniques are commonly applied to construct deprivation indices, including multi-criteria decision methods such as the analytical hierarchy process (AHP). The multi-criteria deprivation index for the city of Quito is an index in which
[...] Read more.
Deprivation indices are useful measures to study health inequalities. Different techniques are commonly applied to construct deprivation indices, including multi-criteria decision methods such as the analytical hierarchy process (AHP). The multi-criteria deprivation index for the city of Quito is an index in which indicators are weighted by applying the AHP. In this research, a variation of this index is introduced that is calculated using interval AHP methodology. Both indices are compared by applying logistic generalized linear models and multilevel models, considering self-reported health as the dependent variable and deprivation and self-reported quality of life as the independent variables. The obtained results show that the multi-criteria deprivation index for the city of Quito is a meaningful measure to assess neighborhood effects on self-reported health and that the alternative deprivation index using the interval AHP methodology more thoroughly represents the local knowledge of experts and stakeholders. These differences could support decision makers in improving health planning and in tackling health inequalities in more deprived areas. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessFeature PaperArticle Community Engaged Cumulative Risk Assessment of Exposure to Inorganic Well Water Contaminants, Crow Reservation, Montana
Int. J. Environ. Res. Public Health 2018, 15(1), 76; https://doi.org/10.3390/ijerph15010076
Received: 8 November 2017 / Revised: 28 December 2017 / Accepted: 30 December 2017 / Published: 5 January 2018
Cited by 3 | PDF Full-text (3418 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
An estimated 11 million people in the US have home wells with unsafe levels of hazardous metals and nitrate. The national scope of the health risk from consuming this water has not been assessed as home wells are largely unregulated and data on
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An estimated 11 million people in the US have home wells with unsafe levels of hazardous metals and nitrate. The national scope of the health risk from consuming this water has not been assessed as home wells are largely unregulated and data on well water treatment and consumption are lacking. Here, we assessed health risks from consumption of contaminated well water on the Crow Reservation by conducting a community-engaged, cumulative risk assessment. Well water testing, surveys and interviews were used to collect data on contaminant concentrations, water treatment methods, well water consumption, and well and septic system protection and maintenance practices. Additive Hazard Index calculations show that the water in more than 39% of wells is unsafe due to uranium, manganese, nitrate, zinc and/or arsenic. Most families’ financial resources are limited, and 95% of participants do not employ water treatment technologies. Despite widespread high total dissolved solids, poor taste and odor, 80% of families consume their well water. Lack of environmental health literacy about well water safety, pre-existing health conditions and limited environmental enforcement also contribute to vulnerability. Ensuring access to safe drinking water and providing accompanying education are urgent public health priorities for Crow and other rural US families with low environmental health literacy and limited financial resources. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessArticle Race, Ethnicity, Income Concentration and 10-Year Change in Urban Greenness in the United States
Int. J. Environ. Res. Public Health 2017, 14(12), 1546; https://doi.org/10.3390/ijerph14121546
Received: 10 November 2017 / Revised: 4 December 2017 / Accepted: 9 December 2017 / Published: 10 December 2017
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Abstract
Background: Cross-sectional studies suggest urban greenness is unequally distributed by neighborhood demographics. However, the extent to which inequalities in greenness have changed over time remains unknown. Methods: We estimated 2001 and 2011 greenness using Moderate-resolution Imaging Spectroradiometer (MODIS) satellite-derived normalized difference vegetative index
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Background: Cross-sectional studies suggest urban greenness is unequally distributed by neighborhood demographics. However, the extent to which inequalities in greenness have changed over time remains unknown. Methods: We estimated 2001 and 2011 greenness using Moderate-resolution Imaging Spectroradiometer (MODIS) satellite-derived normalized difference vegetative index (NDVI) in 59,483 urban census tracts in the contiguous U.S. We fit spatial error models to estimate the association between baseline census tract demographic composition in 2000 and (1) 2001 greenness and (2) change in greenness between 2001 and 2011. Results: In models adjusted for population density, climatic factors, housing tenure, and Index of Concentration at the Extremes for income (ICE), an SD increase in percent White residents (a 30% increase) in 2000 was associated with 0.021 (95% CI: 0.018, 0.023) higher 2001 NDVI. We observed a stepwise reduction in 2001 NDVI with increased concentration of poverty. Tracts with a higher proportion of Hispanic residents in 2000 lost a small, statistically significant amount of greenness between 2001 and 2011 while tracts with higher proportions of Whites experienced a small, statistically significant increase in greenness over the same period. Conclusions: Census tracts with a higher proportion of racial/ethnic minorities, compared to a higher proportion of White residents, had less greenness in 2001 and lost more greenness between 2001 and 2011. Policies are needed to increase greenness, a health-promoting neighborhood asset, in disadvantaged communities. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessArticle Air Pollution and Dispensed Medications for Asthma, and Possible Effect Modifiers Related to Mental Health and Socio-Economy: A Longitudinal Cohort Study of Swedish Children and Adolescents
Int. J. Environ. Res. Public Health 2017, 14(11), 1392; https://doi.org/10.3390/ijerph14111392
Received: 22 September 2017 / Revised: 9 November 2017 / Accepted: 11 November 2017 / Published: 16 November 2017
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Abstract
It has been suggested that children that are exposed to a stressful environment at home have an increased susceptibility for air pollution-related asthma. The aim here was to investigate the association between air pollution exposure and asthma, and effect modification by mental health
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It has been suggested that children that are exposed to a stressful environment at home have an increased susceptibility for air pollution-related asthma. The aim here was to investigate the association between air pollution exposure and asthma, and effect modification by mental health and by socio-economic status (as markers of a stressful environment). All individuals under 18 years of age in four Swedish counties during 2007 to 2010 (1.2 million people) were included. The outcome was defined as dispensing at least two asthma medications during follow up. We linked data on NO2 from an empirical land use regression to data from national registers on outcome and potential confounders. Data was analyzed with logistic regression. There was an odds ratio (OR) of 1.02 (95% Confidence Interval (CI: 1.01–1.03) for asthma associated with a 10 µg·m−3 increase in NO2. The association only seemed to be present in areas where NO2 was higher than 15 µg·m−3 with an OR of 1.09 (95% CI: 1.07–1.12), and the association seemed stronger in children with parents with a high education, OR = 1.05 (95% CI: 1.02–1.09) and OR = 1.04 (95% CI: 1.01–1.07) in children to mothers and father with a high education, respectively. The association did not seem to depend on medication history of psychiatric disorders. There was weak evidence for the association between air pollution and asthma to be stronger in neighborhoods with higher education levels. In conclusion, air pollution was associated with dispensed asthma medications, especially in areas with comparatively higher levels of air pollution, and in children to parents with high education. We did not observe support for our hypothesis that stressors linked to socio-economy or mental health problems would increase susceptibility to the effects of air pollution on the development of asthma. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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Open AccessArticle Socioeconomic Inequalities in Green Space Quality and Accessibility—Evidence from a Southern European City
Int. J. Environ. Res. Public Health 2017, 14(8), 916; https://doi.org/10.3390/ijerph14080916
Received: 9 July 2017 / Revised: 9 August 2017 / Accepted: 11 August 2017 / Published: 15 August 2017
Cited by 10 | PDF Full-text (541 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Background: The provision of green spaces is an important health promotion strategy to encourage physical activity and to improve population health. Green space provision has to be based on the principle of equity. This study investigated the presence of socioeconomic inequalities in
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Background: The provision of green spaces is an important health promotion strategy to encourage physical activity and to improve population health. Green space provision has to be based on the principle of equity. This study investigated the presence of socioeconomic inequalities in geographic accessibility and quality of green spaces across Porto neighbourhoods (Portugal). Methods: Accessibility was evaluated using a Geographic Information System and all the green spaces were audited using the Public Open Space Tool. Kendall’s tau-b correlation coefficients and ordinal regression were used to test whether socioeconomic differences in green space quality and accessibility were statistically significant. Results: Although the majority of the neighbourhoods had an accessible green space, mean distance to green space increased with neighbourhood deprivation. Additionally, green spaces in the more deprived neighbourhoods presented significantly more safety concerns, signs of damage, lack of equipment to engage in active leisure activities, and had significantly less amenities such as seating, toilets, cafés, etc. Conclusions: Residents from low socioeconomic positions seem to suffer from a double jeopardy; they lack both individual and community resources. Our results have important planning implications and might contribute to understanding why deprived communities have lower physical activity levels and poorer health. Full article
(This article belongs to the Special Issue Achieving Environmental Health Equity: Great Expectations)
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