Examining the association between safe drinking water act violations and adverse birth outcomes in Virginia.

In 1974, the United States established the Safe Drinking Water Act (SDWA) to protect consumers from potential exposure to drinking water contaminants associated with health risks. Each contaminant is assigned a health-based standard meant to reflect the maximum level at which an adverse human health outcome is unlikely; measurements beyond that level have greater potential to result in adverse health outcomes. Although there is extensive research on human health implications following water contaminant exposure, few studies have specifically examined associations between fetal health and municipal drinking water violations.

Land cover and community water system characteristics as predictors of Safe Drinking Water Act violations in Central Appalachia, USA.

Upstream anthropogenic land cover can degrade source drinking water quality and thereby inhibit the ability of a community water system to provide safe drinking water. This study aimed to predict differences in Safe Drinking Water Act (SDWA) compliance between water systems based on upstream land cover in Central Appalachia and to examine whether national trends correlating violations with system size and source type were relevant for this region. Multiple generalized linear mixed models assessed relationships between SDWA violations and the distance weighted land cover proportions associated with the water system's contributing source watershed, as well as county economic status, system size, and water source.

Associations Between Surface Mining Airsheds and Birth Outcomes in Central Appalachia at Multiple Spatial Scales.

A considerable body of research exists outlining ecological impacts of surface coal mining, but less work has explicitly focused on human health, and few studies have examined potential links between health and surface coal mining at fine spatial scales. In particular, relationships between individual birth outcomes and exposure to air contaminants from coal mining activities has received little attention. Central Appalachia (portions of Virginia, West Virginia, Kentucky, and Tennessee, USA), our study area, has a history of resource extraction, and epidemiologic research notes that the region experiences a greater level of adverse health outcomes compared to the rest of the country that are not fully explained by socioeconomic and behavioral factors.

Identifying exposure pathways mediating adverse birth outcomes near active surface mines in Central Appalachia.

Background: Previous work has determined an association between proximity to active surface mining within Central Appalachia and an increased risk of preterm birth (PTB) and low birthweight (LBW). Multiple potential exposure pathways may exist; however, including inhalation of particulate matter (airshed exposure), or exposure to impacted surface waters (watershed exposure). We hypothesize that this relationship is mediated by exposure to contaminants along one or both of these pathways.

Estimating changes in emergency department visits associated with floods caused by Tropical Storm Imelda using satellite observations and syndromic surveillance.

Background: Satellite observations following flooding coupled with electronic health data collected through syndromic surveillance systems (SyS) may be useful in efficiently characterizing and responding to health risks associated with flooding.

Results: There was a 10% (95% Confidence Interval (CI): 1%-19%) increase in asthma related ED visits and 22% (95% CI: 5%-41%) increase in insect bite related ED visits in the flooded ZCTAs compared to non-flooded ZCTAs during the flood period. One month following the floods, diarrhea related ED visits were increased by 15% (95% CI: 4%-27%) for flooded ZCTAs and children and adolescents from flooded ZCTAs had elevated risk for dehydration related ED visits.

Emergency department visits associated with satellite observed flooding during and following Hurricane Harvey.

Background: Flooding following heavy rains precipitated by hurricanes has been shown to impact the health of people. Earth observations can be used to identify inundation extents for subsequent analysis of health risks associated with flooding at a fine spatio-temporal scale.

Objective: To evaluate emergency department (ED) visits before, during, and following flooding caused by Hurricane Harvey in 2017 in Texas.

Maternal proximity to Central Appalachia surface mining and birth outcomes.

Unlabelled: Maternal residency in Central Appalachia counties with coal production has been previously associated with increased rates of low birth weight (LBW). To refine the relationship between surface mining and birth outcomes, this study employs finer spatiotemporal estimates of exposure.

Methods: We developed characterizations of annual surface mining boundaries in Central Appalachia between 1986 and 2015 using Landsat data.

Understanding the relationship between land use and land cover and malaria in Nepal.

Malaria is a leading cause of mortality and morbidity globally. Land Use and Land Cover (LULC) change have been found to affect the transmission of malaria in other regions, but no study has examined such relationships in Nepal. Therefore, this study has three aims: first, to analyze the spatial and temporal trend of Malaria Incidence Rate (MIR) between 1999 and 2015, second to assess LULC change between 2000 and 2010, and finally to understand the relationship between LULC and malaria in Nepal.

Environmental factors affecting ecological niche of Coccidioides species and spatial dynamics of valley fever in the United States.

Coccidioidomycosis is an understudied infectious disease acquired by inhaling fungal spores of Coccidioides species. While historically connected to the southwestern United States, the endemic region for this disease is not well defined. This study's objective was to estimate the impact of climate, soil, elevation and land cover on the Coccidioides species' ecological niche.

Future Lyme disease risk in the south-eastern United States based on projected land cover.

Lyme disease is the most significant vector-borne disease in the United States, and its southward advance over several decades has been quantified. Previous research has examined the potential role of climate change on the disease's expansion, but no studies have considered the role of future land cover upon its distribution. This research examines Lyme disease risk in the south-eastern U.

Investigating the Relationship Between Climate and Valley Fever (Coccidioidomycosis).

Valley fever (coccidioidomycosis) is a disease caused by inhalation of spores from the soil-dwelling Coccidioides fungal species. The disease is endemic to semiarid areas in the western USA and parts of Central and South America. The region of interest for this study, Kern County, California, accounts for approximately 14% of the reported valley fever cases in the USA each year.

An investigation of the Plasmodium falciparum malaria epidemic in Kavango and Zambezi regions of Namibia in 2016.

Background: Namibia is one of the countries among the eight that are targeting malaria elimination in southern Africa. However, the country has encountered malaria epidemics in recent years. The objective of this study was to investigate malaria epidemics and to contribute to strengthening malaria surveillance and control in an effort to move Namibia toward eliminating malaria.

Environmental health disparities in the Central Appalachian region of the United States.

Health disparities that cannot be fully explained by socio-behavioral factors persist in the Central Appalachian region of the United States. A review of available studies of environmental impacts on Appalachian health and analysis of recent public data indicates that while disparities exist, most studies of local environmental quality focus on the preservation of nonhuman biodiversity rather than on effects on human health. The limited public health studies available focus primarily on the impacts of coal mining and do not measure personal exposure, constraining the ability to identify causal relationships between environmental conditions and public health.

Considering the "public" in public health: popular resistance to the Smallpox Eradication Programme in India.

Public health initiatives, including large-scale vaccination and disease eradication programmes, regularly pit the rights of the individual against broader benefits to society. At times, the public resists such initiatives, with the World Health Organisation's Smallpox Eradication Programme (SEP) in India being a case in point. Here, we critically investigate resistance to smallpox vaccines in India and argue that while the SEP successfully eradicated a global killer; individuals were stripped of human rights through coercion, forcible vaccination and quarantine.

Do the Features, Amenities, and Quality of Physical Activity Resources Differ Between City and County Areas of a Large Rural Region?

The goal of this work was to provide a community-academic partnership with actionable information for physical activity (PA) for a rural health-disparate region. Identified PA outlets were audited and combined with survey data for 813 residents in the region. Less than a third of sampled residents (28%) met PA recommendations, with low perceptions of safety for PA.

An Examination of the Demographic and Environmental Variables Correlated with Lyme Disease Emergence in Virginia.

Lyme disease is the United States' most significant vector-borne illness. Virginia, on the southern edge of the disease's currently expanding range, has experienced an increase in Lyme disease both spatially and temporally, with steadily increasing rates over the past decade and disease spread from the northern to the southwestern part of the state. This study used a Geographic Information System and a spatial Poisson regression model to examine correlations between demographic and land cover variables, and human Lyme disease from 2006 to 2010 in Virginia.

Spatial and temporal emergence pattern of Lyme disease in Virginia.

The emergence of infectious diseases over the past several decades has highlighted the need to better understand epidemics and prepare for the spread of diseases into new areas. As these diseases expand their geographic range, cases are recorded at different geographic locations over time, making the analysis and prediction of this expansion complicated. In this study, we analyze spatial patterns of the disease using a statistical smoothing analysis based on areal (census tract level) count data of Lyme disease cases in Virginia from 1998 to 2011.

Does availability of physical activity and food outlets differ by race and income? Findings from an enumeration study in a health disparate region.

Background: Low-income, ethnic/racial minorities and rural populations are at increased risk for obesity and related chronic health conditions when compared to white, urban and higher-socio-economic status (SES) peers. Recent systematic reviews highlight the influence of the built environment on obesity, yet very few of these studies consider rural areas or populations. Utilizing a CBPR process, this study advances community-driven causal models to address obesity by exploring the difference in resources for physical activity and food outlets by block group race and income in a small regional city that anchors a rural health disparate region.

Reduced death rates from cyclones in Bangladesh: what more needs to be done?

Tropical storms, such as cyclones, hurricanes and typhoons, present major threats to coastal communities. Around two million people worldwide have died and millions have been injured over the past two centuries as a result of tropical storms. Bangladesh is especially vulnerable to tropical cyclones, with around 718 000 deaths from them in the past 50 years.

The role of age, ethnicity and environmental factors in modulating malaria risk in Rajasthali, Bangladesh.

Background: Malaria is endemic in the Rajasthali region of the Chittagong Hill Tracts in Bangladesh and the Rajasthali region is the most endemic area of Bangladesh. Quantifying the role of environmental and socio-economic factors in the local spatial patterns of malaria endemicity can contribute to successful malaria control and elimination. This study aimed to investigate the role of environmental factors on malaria risk in Rajasthali and to quantify the geographical clustering in malaria risk unaccounted by these factors.

Dengue virus seroprevalence among febrile patients in Bamako, Mali: results of a 2006 surveillance study.

Background: Dengue viruses (DENV) are endemic in over 100 countries worldwide, and annually 50 to 100 million people are infected by one of the four DENV serotypes, whereas over 2.5 billion people are at risk for infection. West African countries lack the surveillance to determine the true incidence of dengue; hence, this disease is likely significantly underestimated.

The potential for emergence of Chagas disease in the United States.

To determine the risk for Chagas disease (American trypanosomiasis) in the United States, the characteristics that make the triatomine vector effective and the areas most at risk for transmission were delineated. In addition, the status of Chagas disease awareness among physicians in areas with a potential risk for the disease was determined. A geographical information system (GIS) was used to analyze three triatomine species within the United States known to harbor Trypanosoma cruzi and that exhibit qualities of domesticity.

Flash flood awareness in southwest Virginia.

Flash floods are one of the most dangerous weather-related natural disasters in the world. These events develop less than six hours after a rainfall event and create hazardous situations for people and extensive damage to property. It is critical for flash flood conditions to be warned of in a timely manner to minimize impacts.

Modeling valley fever (coccidioidomycosis) incidence on the basis of climate conditions.

Valley fever (coccidioidomycosis) is a disease endemic to arid regions within the Western Hemisphere, and is caused by a soil-dwelling fungus, Coccidioides immitis. Incidence data for Pima County, reported to the Arizona Department of Health Services as new cases of valley fever, were used to conduct exploratory analyses and develop monthly multivariate models of relationships between valley fever incidence and climate conditions and variability in Pima County, Arizona, USA. Bivariate and compositing analyses conducted during the exploratory portion of the study revealed that antecedent temperature and precipitation in different seasons are important predictors of incidence.