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Social and Environmental Determinants of Health and Health Disparities

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: closed (29 February 2020) | Viewed by 90592

Special Issue Editors


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Guest Editor
National Institutes of Health, Research Triangle Park, NC 27709, USA
Interests: racial disparities in sleep; health disparities
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Landmark Center West Room 404K, 401 Park Dr., Boston, MA 02215, USA
Interests: housing; health; disparities; indoor air quality; environmental justice
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are organizing a special issue on the social and environmental determinants of health disparities and their interaction in the International Journal of Environmental Research and Public Health (IJERPH). IJERPH is a peer-reviewed scientific journal that publishes research articles examining the intersection of environment and public health. For detailed information regarding the journal, please refer to https://www.mdpi.com/journal/ijerph.

Racial, ethnic, and socioeconomic health disparities in the United States are persistent and costly public health concerns. The causes of these health disparities are complex and involve both social and physical environmental determinants along with their interactions. While the body of research on these mechanisms is growing, many knowledge gaps remain, especially related to the design and implementation of effective intervention strategies to address health disparities. 

This Issue will highlight new research and analyses on the social and environmental determinants of health, and how these pathways can be modified to mitigate negative consequences. Original research papers, metaanalysis, systematic reviews,  case studies, conceptual frameworks, commentaries or editorials, and policy-relevant articles are solicited. Of particular interest are articles involving under-studied topic areas. We also encourage authors to submit studies that address issues and approaches relevant to both developed and developing countries.

We welcome submissions that include, but are not limited to, the following areas:

  • Social and environmental determinants of health;
  • Social (e.g., racial residential segregation) and environmental (e.g., air pollution) determinants of health disparities;
  • Within-group socioeconomic status variation and health;
  • Disaster planning and relief disproportionately affecting vulnerable communities;
  • Natural environments and mental/physical health;
  • Built environment and health;
  • Housing and health;
  • Indoor comfort and health;
  • Energy insecurity and health;
  • Environmental justice;
  • Community-based participatory research;
  • Climate change and health;
  • Public health interventions.

Dr. Chandra L. Jackson
Dr. Gary Adamkiewicz
Guest Editors

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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 2500 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

  • Social determinants of health
  • Built environment
  • Natural environment
  • Air pollution
  • Disaster planning and relief
  • Environmental health disparities
  • Environmental justice
  • Community-based participatory research
  • Citizen’s science

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Published Papers (16 papers)

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19 pages, 1562 KiB  
Article
The Effects of Social, Personal, and Behavioral Risk Factors and PM2.5 on Cardio-Metabolic Disparities in a Cohort of Community Health Center Patients
by Paul D. Juarez, Mohammad Tabatabai, Robert Burciaga Valdez, Darryl B. Hood, Wansoo Im, Charles Mouton, Cynthia Colen, Mohammad Z. Al-Hamdan, Patricia Matthews-Juarez, Maureen Y. Lichtveld, Daniel Sarpong, Aramandla Ramesh, Michael A. Langston, Gary L. Rogers, Charles A. Phillips, John F. Reichard, Macarius M. Donneyong and William Blot
Int. J. Environ. Res. Public Health 2020, 17(10), 3561; https://doi.org/10.3390/ijerph17103561 - 19 May 2020
Cited by 11 | Viewed by 4530
Abstract
(1) Background: Cardio-metabolic diseases (CMD), including cardiovascular disease, stroke, and diabetes, have numerous common individual and environmental risk factors. Yet, few studies to date have considered how these multiple risk factors together affect CMD disparities between Blacks and Whites. (2) Methods: We linked [...] Read more.
(1) Background: Cardio-metabolic diseases (CMD), including cardiovascular disease, stroke, and diabetes, have numerous common individual and environmental risk factors. Yet, few studies to date have considered how these multiple risk factors together affect CMD disparities between Blacks and Whites. (2) Methods: We linked daily fine particulate matter (PM2.5) measures with survey responses of participants in the Southern Community Cohort Study (SCCS). Generalized linear mixed modeling (GLMM) was used to estimate the relationship between CMD risk and social-demographic characteristics, behavioral and personal risk factors, and exposure levels of PM2.5. (3) Results: The study resulted in four key findings: (1) PM2.5 concentration level was significantly associated with reported CMD, with risk rising by 2.6% for each µg/m3 increase in PM2.5; (2) race did not predict CMD risk when clinical, lifestyle, and environmental risk factors were accounted for; (3) a significant variation of CMD risk was found among participants across states; and (4) multiple personal, clinical, and social-demographic and environmental risk factors played a role in predicting CMD occurrence. (4) Conclusions: Disparities in CMD risk among low social status populations reflect the complex interactions of exposures and cumulative risks for CMD contributed by different personal and environmental factors from natural, built, and social environments. Full article
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18 pages, 627 KiB  
Article
Everyday Racial Discrimination and Hypertension among Midlife African American Women: Disentangling the Role of Active Coping Dispositions versus Active Coping Behaviors
by Eli K. Michaels, Alexis N. Reeves, Marilyn D. Thomas, Melisa M. Price, Rebecca E. Hasson, David H. Chae and Amani M. Allen
Int. J. Environ. Res. Public Health 2019, 16(23), 4759; https://doi.org/10.3390/ijerph16234759 - 27 Nov 2019
Cited by 22 | Viewed by 5342
Abstract
Racial discrimination, a psychosocial stressor, may contribute to disproportionate rates of hypertension among African American women. Coping moderates the effects of psychosocial stress on health. Coping dispositions describe stable personality characteristics, whereas contextual frameworks emphasize flexible coping behaviors in response to specific stressful [...] Read more.
Racial discrimination, a psychosocial stressor, may contribute to disproportionate rates of hypertension among African American women. Coping moderates the effects of psychosocial stress on health. Coping dispositions describe stable personality characteristics, whereas contextual frameworks emphasize flexible coping behaviors in response to specific stressful encounters. Using data from the African American Women’s Heart and Health Study—a non-probability cross-section of 208 midlife African American women in Northern California—we estimated the association between everyday racial discrimination (Everyday Discrimination Scale, EDS) and prevalence of hypertension (HTN), and evaluated moderation by coping disposition (John Henryism Active Coping scale, JH) versus context-specific active coping behavior (Active Coping with Racism scale, ACR). There were no main associations between EDS, JH, or ACR on HTN prevalence. There was evidence of statistical interaction between EDS and ACR (p-int = 0.05), but not JH (p-int = 0.90). Among those with high levels of ACR, reporting monthly (prevalence ratio (PR) = 2.35, 95% confidence interval (CI) = 1.13, 4.87), weekly (PR = 2.15, 95% CI = 1.01, 4.61), or daily (PR = 2.36, 95% CI = 1.14, 4.88) EDS was associated with higher HTN prevalence, versus reporting racial discrimination yearly or less. In contrast, among those with low levels of ACR, reporting more chronic racial discrimination was associated with lower hypertension prevalence, although results were less precise. Findings suggest that ongoing active coping with chronic racial discrimination may contribute to hypertension risk among African American women. Full article
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18 pages, 614 KiB  
Article
How Energy Consumption and Pollutant Emissions Affect the Disparity of Public Health in Countries with High Fossil Energy Consumption
by Xinpeng Xing, Jianhua Wang, Tiansen Liu, He Liu and Yue Zhu
Int. J. Environ. Res. Public Health 2019, 16(23), 4678; https://doi.org/10.3390/ijerph16234678 - 24 Nov 2019
Cited by 13 | Viewed by 3635
Abstract
Public health issues are a global focus, but recent research on the links between fossil energy consumption, pollutant emissions, and public health in different regions have presented inconsistent conclusions. In order to quantify the effect of fossil energy use and pollutant emissions on [...] Read more.
Public health issues are a global focus, but recent research on the links between fossil energy consumption, pollutant emissions, and public health in different regions have presented inconsistent conclusions. In order to quantify the effect of fossil energy use and pollutant emissions on public health from the global perspective, this paper investigates 33 countries with high GDP and fossil energy consumption from 1995 to 2015 using a fixed effect model. Further, this paper utilizes heterogeneity analysis to characterize the disparity of countries with different features. Empirical results indicate that total fossil energy consumption is beneficial to the life expectancy of the population (LEP), but pollutant emissions (PM10 concentration and greenhouse gas scale) have a negative effect on LEP. Moreover, the heterogeneity test indicates that pollutant emissions lowers LEP in net energy importers more than in net energy exporters, and the effect of such emissions in low- and middle-income countries on public health is more harmful than that in high-income countries. These findings suggest that it is a greater priority for governments to strengthen the control of pollutant emissions through enhancing the efficiency of energy consumption, rather than by reducing its scale of use in low- and middle-income, and net energy importing countries. Additionally, governments also need to focus on the volatility of pollutant emissions in high-income countries with necessary control measures. Full article
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11 pages, 586 KiB  
Article
Intersectional Discrimination Is Associated with Housing Instability among Trans Women Living in the San Francisco Bay Area
by Theo Beltran, Amani M. Allen, Jess Lin, Caitlin Turner, Emily J. Ozer and Erin C. Wilson
Int. J. Environ. Res. Public Health 2019, 16(22), 4521; https://doi.org/10.3390/ijerph16224521 - 15 Nov 2019
Cited by 28 | Viewed by 6692
Abstract
Trans women face numerous structural barriers to health due to discrimination. Housing instability is an important structural determinant of poor health outcomes among trans women. The purpose of this study was to determine if experiences of intersectional anti-trans and racial discrimination are associated [...] Read more.
Trans women face numerous structural barriers to health due to discrimination. Housing instability is an important structural determinant of poor health outcomes among trans women. The purpose of this study was to determine if experiences of intersectional anti-trans and racial discrimination are associated with poor housing outcomes among trans women in the San Francisco Bay Area. A secondary analysis of baseline data from the Trans *National study (n = 629) at the San Francisco Department of Public Health (2016–2018) was conducted. Multivariable logistic regression was used to analyze the association between discrimination as an ordered categorical variable (zero, one to two, or three or more experiences) and housing status adjusting for age, years lived in the Bay Area, and gender identity. We found that the odds of housing instability increased by 1.25 for every categorical unit increase (1–2, or 3+) in reported experiences of intersectional (both anti-trans and racial) discrimination for trans women (95% CI = 1.01–1.54, p-value < 0.05). Intersectional anti-trans and racial discrimination is associated with increased housing instability among trans women, giving some insight that policies and programs are needed to identify and address racism and anti-trans stigma towards trans women. Efforts to address intersectional discrimination may positively impact housing stability, with potential for ancillary effects on increasing the health and wellness of trans women who face multiple disparities. Full article
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14 pages, 2011 KiB  
Article
A Mixed Methods Evaluation of Sharing Air Pollution Results with Study Participants via Report-Back Communication
by Kathryn S. Tomsho, Claire Schollaert, Temana Aguilar, Roseann Bongiovanni, Marty Alvarez, Madeleine K. Scammell and Gary Adamkiewicz
Int. J. Environ. Res. Public Health 2019, 16(21), 4183; https://doi.org/10.3390/ijerph16214183 - 29 Oct 2019
Cited by 18 | Viewed by 5153
Abstract
We implemented a concurrent triangulation mixed-methods evaluation of an air pollution data report-back to study participants in Chelsea, Massachusetts. We aimed to determine whether the report-back was effective in the following three ways: engagement, understandability, and actionability for the participants. We also evaluated [...] Read more.
We implemented a concurrent triangulation mixed-methods evaluation of an air pollution data report-back to study participants in Chelsea, Massachusetts. We aimed to determine whether the report-back was effective in the following three ways: engagement, understandability, and actionability for the participants. We also evaluated participants’ valuation of the report-back information and process. The evaluation involved both qualitative components, such as ethnographic observation, and quantitative components, such as closed-ended questionnaires and demographic data. The participants who engaged in the report-back process were significantly different from those who did not engage both in terms of their demographics, and in their indoor air pollutant concentrations. Participant understanding generally corresponded with the intended meaning of the research team, suggesting successful data communication. Additionally, many of the participants reported that they were inspired to take action in order to reduce their indoor air pollutant exposure as a result of the report-back process and information provided. These results identify areas of improvement for engagement, particularly regarding populations that may have higher exposures. This work outlines a framework with which to contextualize and evaluate the success of engagement with report-back efforts. Such evaluations can allow research teams to assess whether they are providing information that is equitably useful and actionable for all participants. Full article
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13 pages, 1091 KiB  
Article
Effects of Maternal Homelessness, Supplemental Nutrition Programs, and Prenatal PM2.5 on Birthweight
by Jongeun Rhee, M. Patricia Fabian, Stephanie Ettinger de Cuba, Sharon Coleman, Megan Sandel, Kevin James Lane, Maayan Yitshak Sade, Jaime E. Hart, Joel Schwartz, Itai Kloog, Francine Laden, Jonathan I. Levy and Antonella Zanobetti
Int. J. Environ. Res. Public Health 2019, 16(21), 4154; https://doi.org/10.3390/ijerph16214154 - 28 Oct 2019
Cited by 24 | Viewed by 5433
Abstract
Few studies examined the impact of maternal socioeconomic status and of its combined effects with environmental exposures on birthweight. Our goal was to examine the impact of maternal homelessness (mothers ever homeless or who lived in shelters during pregnancy) and participation in the [...] Read more.
Few studies examined the impact of maternal socioeconomic status and of its combined effects with environmental exposures on birthweight. Our goal was to examine the impact of maternal homelessness (mothers ever homeless or who lived in shelters during pregnancy) and participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) during pregnancy in conjunction with air pollution exposure on birthweight in the Boston-based Children’s HealthWatch cohort from 2007 through 2015 (n = 3366). Birthweight was obtained from electronic health records. Information on maternal homelessness and WIC participation during pregnancy were provided via a questionnaire. Prenatal fine particulate matter (PM2.5) exposures, estimated at the subject’s residential address, were calculated for each trimester. We fit linear regression models adjusting for maternal and child characteristics, seasonality, and block-group-level median household income and examined the interactions between PM2.5 and each covariate. Prenatal maternal homelessness was associated with reduced birthweight (−55.7 g, 95% CI: −97.8 g, −13.7 g), while participating in WIC was marginally associated with increased birthweight (36.1 g, 95% CI: −7.3 g, 79.4 g). Only average PM2.5 during the second trimester was marginally associated with reduced birthweight (−8.5 g, 95% CI: −19.3, 2.3) for a 1 µg/m3 increase in PM2.5. The association of PM2.5 during the second trimester with reduced birthweight was stronger among non-Hispanic Black mothers and trended toward significance among immigrants and single mothers. Our study emphasizes the independent and synergistic effects of social and environmental stressors on birthweight, particularly the potentially protective effect of participating in WIC for vulnerable populations. Full article
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15 pages, 360 KiB  
Article
Stability of Differences in Weight-Related Characteristics of Mothers across Economic, Cultural, Social, and Environmental-Health Indicators of Socioeconomic Status
by Virginia Quick, Kaitlyn M. Eck, Colleen Delaney, Ryan Lewis and Carol Byrd-Bredbenner
Int. J. Environ. Res. Public Health 2019, 16(20), 3866; https://doi.org/10.3390/ijerph16203866 - 12 Oct 2019
Cited by 5 | Viewed by 3877
Abstract
This study explored the differences in weight-related characteristics when socioeconomic status (SES) was assessed by economic, cultural, social, and environmental-health capital individually and as a composite with the goal of determining the stability of differences across types of capital and to ascertain whether [...] Read more.
This study explored the differences in weight-related characteristics when socioeconomic status (SES) was assessed by economic, cultural, social, and environmental-health capital individually and as a composite with the goal of determining the stability of differences across types of capital and to ascertain whether single or a combination of capital indicators of SES should be used in nutrition and public health studies. Mothers (n = 557) of young children completed a survey assessing capital and weight-related characteristics. Mothers with higher economic, cultural, and social capital and composite SES had fewer sugar-sweetened beverage servings, fewer meals in front of the TV, more food security, and greater neighborhood space/supports for physical activity than comparators. Few differences occurred among environmental-health capital groups. Composite SES performed similarly to individual economic, cultural, and social capital measures. Findings suggest single SES indicators may be sufficiently stable to capture differences in weight-related characteristics. Each capital type captures a unique aspect of SES; thus, assessing an array of capital types could advance understanding of SES aspects on weight-related characteristics. Full article
11 pages, 301 KiB  
Article
Factors Associated with Single-Use and Co-Use of Tobacco and Alcohol: A Multinomial Modeling Approach
by Jin-Won Noh, Kyoung-Beom Kim, Jooyoung Cheon, Yejin Lee and Ki-Bong Yoo
Int. J. Environ. Res. Public Health 2019, 16(19), 3506; https://doi.org/10.3390/ijerph16193506 - 20 Sep 2019
Cited by 10 | Viewed by 2803
Abstract
Tobacco smoking and alcohol consumption are among the most important public health concerns not only in South Korea but also globally. This study identified the factors associated with single-use and co-use of tobacco and alcohol in Korean adults and provided more accurate estimates [...] Read more.
Tobacco smoking and alcohol consumption are among the most important public health concerns not only in South Korea but also globally. This study identified the factors associated with single-use and co-use of tobacco and alcohol in Korean adults and provided more accurate estimates using a multinomial modeling approach. This study used the Korea Community Health Survey Data 2017, of which 205,336 respondents were selected as the sample for a multinomial logistic regression analysis. For the group that identified as only drinking monthly compared to the reference group, we found that the direction of the following factors was opposite to that of the results of the only currently smoking group: Age, marital status, educational level, monthly household income, occupation, obesity, self-rated health, hypertension, and hyperlipidemia. For the currently smoking and drinking monthly group relative to the reference group, the overall direction was a mix of the results of only currently smoking and only drinking monthly. These findings support the development of policies that consider the risk of smoking tobacco and consuming alcohol simultaneously. Full article
19 pages, 738 KiB  
Article
Pride, Love, and Twitter Rants: Combining Machine Learning and Qualitative Techniques to Understand What Our Tweets Reveal about Race in the US
by Thu T. Nguyen, Shaniece Criss, Amani M. Allen, M. Maria Glymour, Lynn Phan, Ryan Trevino, Shrikha Dasari and Quynh C. Nguyen
Int. J. Environ. Res. Public Health 2019, 16(10), 1766; https://doi.org/10.3390/ijerph16101766 - 18 May 2019
Cited by 12 | Viewed by 7938
Abstract
Objective: Describe variation in sentiment of tweets using race-related terms and identify themes characterizing the social climate related to race. Methods: We applied a Stochastic Gradient Descent Classifier to conduct sentiment analysis of 1,249,653 US tweets using race-related terms from 2015–2016. [...] Read more.
Objective: Describe variation in sentiment of tweets using race-related terms and identify themes characterizing the social climate related to race. Methods: We applied a Stochastic Gradient Descent Classifier to conduct sentiment analysis of 1,249,653 US tweets using race-related terms from 2015–2016. To evaluate accuracy, manual labels were compared against computer labels for a random subset of 6600 tweets. We conducted qualitative content analysis on a random sample of 2100 tweets. Results: Agreement between computer labels and manual labels was 74%. Tweets referencing Middle Eastern groups (12.5%) or Blacks (13.8%) had the lowest positive sentiment compared to tweets referencing Asians (17.7%) and Hispanics (17.5%). Qualitative content analysis revealed most tweets were represented by the categories: negative sentiment (45%), positive sentiment such as pride in culture (25%), and navigating relationships (15%). While all tweets use one or more race-related terms, negative sentiment tweets which were not derogatory or whose central topic was not about race were common. Conclusion: This study harnesses relatively untapped social media data to develop a novel area-level measure of social context (sentiment scores) and highlights some of the challenges in doing this work. New approaches to measuring the social environment may enhance research on social context and health. Full article
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16 pages, 896 KiB  
Article
Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women
by Shervin Assari, James Smith and Mohsen Bazargan
Int. J. Environ. Res. Public Health 2019, 16(10), 1670; https://doi.org/10.3390/ijerph16101670 - 14 May 2019
Cited by 8 | Viewed by 3700
Abstract
Background. Although chronic medical conditions (CMCs), depression, and self-rated health (SRH) are associated, their associations may depend on race, ethnicity, gender, and their intersections. In predominantly White samples, SRH is shown to better reflect the risk of mortality and multimorbidity for men [...] Read more.
Background. Although chronic medical conditions (CMCs), depression, and self-rated health (SRH) are associated, their associations may depend on race, ethnicity, gender, and their intersections. In predominantly White samples, SRH is shown to better reflect the risk of mortality and multimorbidity for men than it is for women, which suggests that poor SRH among women may be caused not only by CMCs, but also by conditions like depression and social relations—a phenomenon known as “the sponge hypothesis.” However, little is known about gender differences in the links between multimorbidity, depression, and SRH among African Americans (AAs). Objective. To study whether depression differently mediates the association between multimorbidity and SRH for economically disadvantaged AA men and women. Methods. This survey was conducted in South Los Angeles between 2015 to 2018. A total number of 740 AA older adults (age ≥ 55 years) were enrolled in this study, of which 266 were AA men and 474 were AA women. The independent variable was the number of CMCs. The dependent variable was SRH. Age and socioeconomic status (educational attainment and marital status) were covariates. Depression was the mediator. Gender was the moderator. Structural Equation Modeling (SEM) was used to analyze the data. Results. In the pooled sample that included both genders, depression partially mediated the effect of multimorbidity on SRH. In gender specific models, depression fully mediated the effects of multimorbidity on SRH for AA men but not AA women. For AA women but not AA men, social isolation was associated with depression. Conclusion. Gender differences exist in the role of depression as an underlying mechanism behind the effect of multimorbidity on the SRH of economically disadvantaged AA older adults. For AA men, depression may be the reason people with multimorbidity report worse SRH. For AA women, depression is only one of the many reasons individuals with multiple CMCs report poor SRH. Prevention of depression may differently influence the SRH of low-income AA men and women with multimorbidity. Full article
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14 pages, 312 KiB  
Article
Social and Environmental Neighborhood Typologies and Lung Function in a Low-Income, Urban Population
by Jamie L. Humphrey, Megan Lindstrom, Kelsey E. Barton, Prateek Man Shrestha, Elizabeth J. Carlton, John L. Adgate, Shelly L. Miller and Elisabeth Dowling Root
Int. J. Environ. Res. Public Health 2019, 16(7), 1133; https://doi.org/10.3390/ijerph16071133 - 29 Mar 2019
Cited by 13 | Viewed by 4741
Abstract
Consensus is growing on the need to investigate the joint impact of neighborhood-level social factors and environmental hazards on respiratory health. This study used latent profile analysis (LPA) to empirically identify distinct neighborhood subtypes according to a clustering of social factors and environmental [...] Read more.
Consensus is growing on the need to investigate the joint impact of neighborhood-level social factors and environmental hazards on respiratory health. This study used latent profile analysis (LPA) to empirically identify distinct neighborhood subtypes according to a clustering of social factors and environmental hazards, and to examine whether those subtypes are associated with lung function. The study included 182 low-income participants who were enrolled in the Colorado Home Energy Efficiency and Respiratory Health (CHEER) study during the years 2015–2017. Distinct neighborhood typologies were identified based on analyses of 632 census tracts in the Denver-Metro and Front Range area of Colorado; neighborhood characteristics used to identify typologies included green space, traffic-related air pollution, violent and property crime, racial/ethnic composition, and socioeconomic status (SES). Generalized estimating equations were used to examine the association between neighborhood typology and lung function. We found four distinct neighborhood typologies and provide evidence that these social and environmental aspects of neighborhoods cluster along lines of advantage/disadvantage. We provide suggestive evidence of a double jeopardy situation where low-income populations living in disadvantaged neighborhoods may have decreased lung function. Using LPA with social and environmental characteristics may help to identify meaningful neighborhood subtypes and inform research on the mechanisms by which neighborhoods influence health. Full article
10 pages, 459 KiB  
Article
Neighborhood Greenness Attenuates the Adverse Effect of PM2.5 on Cardiovascular Mortality in Neighborhoods of Lower Socioeconomic Status
by Maayan Yitshak-Sade, Peter James, Itai Kloog, Jaime E. Hart, Joel D. Schwartz, Francine Laden, Kevin J. Lane, M. Patricia Fabian, Kelvin C. Fong and Antonella Zanobetti
Int. J. Environ. Res. Public Health 2019, 16(5), 814; https://doi.org/10.3390/ijerph16050814 - 6 Mar 2019
Cited by 58 | Viewed by 5445
Abstract
Features of the environment may modify the effect of particulate matter ≤2.5 µm in aerodynamic diameter (PM2.5) on health. Therefore, we investigated how neighborhood sociodemographic and land-use characteristics may modify the association between PM2.5 and cardiovascular mortality. We obtained residence-level [...] Read more.
Features of the environment may modify the effect of particulate matter ≤2.5 µm in aerodynamic diameter (PM2.5) on health. Therefore, we investigated how neighborhood sociodemographic and land-use characteristics may modify the association between PM2.5 and cardiovascular mortality. We obtained residence-level geocoded cardiovascular mortality cases from the Massachusetts Department of Public Health (n = 179,986), and PM2.5 predictions from a satellite-based model (2001–2011). We appended census block group-level information on sociodemographic factors and walkability, and calculated neighborhood greenness within a 250 m buffer surrounding each residence. We found a 2.54% (1.34%; 3.74%) increase in cardiovascular mortality associated with a 10 µg/m3 increase in two-day average PM2.5. Walkability or greenness did not modify the association. However, when stratifying by neighborhood sociodemographic characteristics, smaller PM2.5 effects were observed in greener areas only among cases who resided in neighborhoods with a higher population density and lower percentages of white residents or residents with a high school diploma. In conclusion, the PM2.5 effects on cardiovascular mortality were attenuated by higher greenness only in areas with sociodemographic features that are highly correlated with lower socioeconomic status. Previous evidence suggests health benefits linked to neighborhood greenness may be stronger among lower socioeconomic groups. Attenuation of the PM2.5–mortality relationship due to greenness may explain some of this evidence. Full article
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18 pages, 2500 KiB  
Article
Spatio-Temporal Distribution, Spillover Effects and Influences of China’s Two Levels of Public Healthcare Resources
by Xueqian Song, Yongping Wei, Wei Deng, Shaoyao Zhang, Peng Zhou, Ying Liu and Jiangjun Wan
Int. J. Environ. Res. Public Health 2019, 16(4), 582; https://doi.org/10.3390/ijerph16040582 - 17 Feb 2019
Cited by 26 | Viewed by 4182
Abstract
In China, upper-level healthcare (ULHC) and lower-level healthcare (LLHC) provide different public medical and health services. Only when these two levels of healthcare resources are distributed equally and synergistically can the public’s demands for healthcare be met fairly. Despite a number of previous [...] Read more.
In China, upper-level healthcare (ULHC) and lower-level healthcare (LLHC) provide different public medical and health services. Only when these two levels of healthcare resources are distributed equally and synergistically can the public’s demands for healthcare be met fairly. Despite a number of previous studies having analysed the spatial distribution of healthcare and its determinants, few have evaluated the differences in spatial equity between ULHC and LLHC and investigated their institutional, geographical and socioeconomic influences and spillover effects. This study aims to bridge this gap by analysing panel data on the two levels of healthcare resources in 31 Chinese provinces covering the period 2003–2015 using Moran’s I models and dynamic spatial Durbin panel models (DSDMs). The results indicate that, over the study period, although both levels of healthcare resources improved considerably in all regions, spatial disparities were large. The spatio-temporal characteristics of ULHC and LLHC differed, although both levels were relatively low to the north-west of the Hu Huanyong Line. DSDM analysis revealed direct and indirect effects at both short-and long-term scales for both levels of healthcare resources. Meanwhile, the influencing factors had different impacts on the different levels of healthcare resources. In general, long-term effects were greater for ULHC and short-term effects were greater for LLHC. The spillover effects of ULHC were more significant than those of LLHC. More specifically, industrial structure, traffic accessibility, government expenditure and family healthcare expenditure were the main determinants of ULHC, while industrial structure, urbanisation, topography, traffic accessibility, government expenditure and family healthcare expenditure were the main determinants of LLHC. These findings have important implications for policymakers seeking to optimize the availability of the two levels of healthcare resources. Full article
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9 pages, 273 KiB  
Article
Relative Deprivation, Poverty, and Mortality in Japanese Older Adults: A Six-Year Follow-Up of the JAGES Cohort Survey
by Masashige Saito, Naoki Kondo, Takashi Oshio, Takahiro Tabuchi and Katsunori Kondo
Int. J. Environ. Res. Public Health 2019, 16(2), 182; https://doi.org/10.3390/ijerph16020182 - 10 Jan 2019
Cited by 8 | Viewed by 5442
Abstract
Most studies have evaluated poverty in terms of income status, but this approach cannot capture the diverse and complex aspects of poverty. To develop commodity-based relative deprivation indicators and evaluate their associations with mortality, we conducted a 6-year follow-up of participants in the [...] Read more.
Most studies have evaluated poverty in terms of income status, but this approach cannot capture the diverse and complex aspects of poverty. To develop commodity-based relative deprivation indicators and evaluate their associations with mortality, we conducted a 6-year follow-up of participants in the Japan Gerontological Evaluation Study (JAGES), a population-based cohort of Japanese adults aged 65 and older. We analyzed mortality for 7614 respondents from 2010 to 2016. Cox regression models with multiple imputation were used to estimate hazard ratios (HRs) for mortality. Seven indicators were significantly associated with mortality: no refrigerator, no air conditioner, cut-off of essential services in the past year for economic reasons, and so on. Among participants, 12.0% met one item, and 3.3% met two items or more. The HRs after adjusting for relative poverty and some confounders were 1.71 (95%CI: 1.18–2.48) for relative deprivation, and 1.87 (95%CI: 1.14–3.09) for a combination of relative poverty and deprivation. Relative deprivation was attributable to around 27,000 premature deaths (2.3%) annually for the older Japanese. Measurement of relative deprivation among older adults might be worthwhile in public health as an important factor to address for healthy aging. Full article

Review

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19 pages, 344 KiB  
Review
The Color of Health: Residential Segregation, Light Rail Transit Developments, and Gentrification in the United States
by Shadi O. Tehrani, Shuling J. Wu and Jennifer D. Roberts
Int. J. Environ. Res. Public Health 2019, 16(19), 3683; https://doi.org/10.3390/ijerph16193683 - 30 Sep 2019
Cited by 30 | Viewed by 12708
Abstract
As the modern urban–suburban context becomes increasingly problematic with traffic congestion, air pollution, and increased cost of living, city planners are turning their attention to transit-oriented development as a strategy to promote healthy communities. Transit-oriented developments bring valuable resources and improvements in infrastructure, [...] Read more.
As the modern urban–suburban context becomes increasingly problematic with traffic congestion, air pollution, and increased cost of living, city planners are turning their attention to transit-oriented development as a strategy to promote healthy communities. Transit-oriented developments bring valuable resources and improvements in infrastructure, but they also may be reinforcing decades-old processes of residential segregation, gentrification, and displacement of low-income residents and communities of color. Careful consideration of zoning, neighborhood design, and affordability is vital to mitigating the impacts of transit-induced gentrification, a socioeconomic by-product of transit-oriented development whereby the provision of transit service “upscales” nearby neighborhood(s) and displaces existing community members with more affluent and often White residents. To date, the available research and, thus, overall understanding of transit-induced gentrification and the related social determinants of health are limited and mixed. In this review, an overview of racial residential segregation, light rail transit developments, and gentrification in the United States has been provided. Implications for future transit-oriented developments are also presented along with a discussion of possible solutions. Full article

Other

Jump to: Research, Review

21 pages, 675 KiB  
Concept Paper
Towards a People’s Social Epidemiology: Envisioning a More Inclusive and Equitable Future for Social Epi Research and Practice in the 21st Century
by Ryan Petteway, Mahasin Mujahid, Amani Allen and Rachel Morello-Frosch
Int. J. Environ. Res. Public Health 2019, 16(20), 3983; https://doi.org/10.3390/ijerph16203983 - 18 Oct 2019
Cited by 16 | Viewed by 7146
Abstract
Social epidemiology has made critical contributions to understanding population health. However, translation of social epidemiology science into action remains a challenge, raising concerns about the impacts of the field beyond academia. With so much focus on issues related to social position, discrimination, racism, [...] Read more.
Social epidemiology has made critical contributions to understanding population health. However, translation of social epidemiology science into action remains a challenge, raising concerns about the impacts of the field beyond academia. With so much focus on issues related to social position, discrimination, racism, power, and privilege, there has been surprisingly little deliberation about the extent and value of social inclusion and equity within the field itself. Indeed, the challenge of translation/action might be more readily met through re-envisioning the role of the people within the research/practice enterprise—reimagining what “social” could, or even should, mean for the future of the field. A potential path forward rests at the nexus of social epidemiology, community-based participatory research (CBPR), and information and communication technology (ICT). Here, we draw from social epidemiology, CBPR, and ICT literatures to introduce A People’s Social Epi—a multi-tiered framework for guiding social epidemiology in becoming more inclusive, equitable, and actionable for 21st century practice. In presenting this framework, we suggest the value of taking participatory, collaborative approaches anchored in CBPR and ICT principles and technological affordances—especially within the context of place-based and environmental research. We believe that such approaches present opportunities to create a social epidemiology that is of, with, and by the people—not simply about them. In this spirit, we suggest 10 ICT tools to “socialize” social epidemiology and outline 10 ways to move towards A People’s Social Epi in practice. Full article
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