Environ Health Perspect
December 2023
Background: The exposome serves as a popular framework in which to study exposures from chemical and nonchemical stressors across the life course and the differing roles that these exposures can play in human health. As a result, data relevant to the exposome have been used as a resource in the quest to untangle complicated health trajectories and help connect the dots from exposures to adverse outcome pathways.
Objectives: The primary aim of this methods seminar is to clarify and review preprocessing techniques critical for accurate and effective external exposomic data analysis.
Introduction: Little is known about whether a breast or gynecologic cancer diagnosis increases long-term cardiovascular disease (CVD) risk among Black females. The purpose of this study was to determine whether a breast or gynecologic cancer diagnosis is associated with CVD risk and identify determinants of subsequent CVD risk among Black females with an incident breast or gynecologic cancer diagnosis.
Methods: Using the Southern Community Cohort Study data from 2002-2016, this study was designed to analyze CVD incidence among Black females without cancer or CVD at enrollment.
Int J Environ Res Public Health
January 2023
The purpose of this study was to examine how psychosocial factors affect receipt of COVID-19 testing among Black and Hispanic women. In this cross-sectional study of Black and Hispanic women who received services from the YWCAs in Atlanta, El Paso, Nashville, and Tucson between 2019 and 2021 ( = 662), we used Patient-Reported Outcomes Measurement Information Systems (PROMIS) item bank 1.0 short forms to examine the impact of psychosocial factors (i.
View Article and Find Full Text PDFInt J Environ Res Public Health
October 2022
Columbus, Ohio is one of the more prosperous, well-educated, and progressive cities in the United States. However, it ranks as the second worst life expectancy at birth, has a census tract wealth gap (27-year disparity), and one of the higher infant mortality rates in the country. These data suggest that there are likely several high-risk, vulnerable neighborhoods in Columbus with residents experiencing disparate and adverse outcomes.
View Article and Find Full Text PDFInt J Environ Res Public Health
July 2022
During the 2015-2016 Zika Virus (ZIKV) epidemic in Brazil, the geographical distributions of ZIKV infection and microcephaly outbreaks did not align. This raised doubts about the virus as the single cause of the microcephaly outbreak and led to research hypotheses of alternative explanatory factors, such as environmental variables and factors, agrochemical use, or immunizations. We investigated context and the intermediate and structural determinants of health inequalities, as well as social environment factors, to determine their interaction with ZIKV-positive- and ZIKV-negative-related microcephaly.
View Article and Find Full Text PDFThere is growing evidence that pre-exposure prophylaxis (PrEP) prevents HIV acquisition. However, in the United States, approximately only 4% of people who could benefit from PrEP are currently receiving it, and it is estimated only 1 in 5 physicians has ever prescribed PrEP. We conducted a scoping review to gain an understanding of physician-identified barriers to PrEP provision.
View Article and Find Full Text PDFBackground: Non-adherence to antihypertensive medication treatment (AHM) is a complex health behavior with determinants that extend beyond the individual patient. The structural and social determinants of health (SDH) that predispose populations to ill health and unhealthy behaviors could be potential barriers to long-term adherence to AHM. However, the role of SDH in AHM non-adherence has been understudied.
View Article and Find Full Text PDFThe Health Opportunity Index (HOI) is a multivariate tool that can be more efficiently used to identify and understand the interplay of complex social determinants of health (SDH) at the census tract level that influences the ability to achieve optimal health. The derivation of the HOI utilizes the data-reduction technique of principal component analysis to determine the impact of SDH on optimal health at lower census geographies. In the midst of persistent health disparities and the present COVID-19 pandemic, we demonstrate the potential utility of using 13-input variables to derive a composite metric of health (HOI) score as a means to assist in the identification of the most vulnerable communities during the current pandemic.
View Article and Find Full Text PDF(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 (PM) measures with survey responses of participants in the Southern Community Cohort Study (SCCS).
View Article and Find Full Text PDFLittle is known about how medical students are trained to identify and reduce their own biases toward vulnerable patient groups. A survey was conducted among US medical schools to determine whether their curricula addressed physician implicit biases toward three vulnerable patient groups: lesbian, gay, bisexual, transgender, and questioning (LGBTQ) individuals, persons experiencing homelessness, and migrant farmworkers. Of 141 US medical schools, 71 (50%) responded.
View Article and Find Full Text PDFJ Health Care Poor Underserved
January 2020
Scientific evidence is accumulating about the range of adverse health, mental health, and risky behavioral sequelae across the life continuum arising from exposure to Adverse Childhood Experiences (ACEs). Research findings show a clear relationship between the number of ACEs experienced by a person during childhood and the adverse health outcomes of adulthood. The purpose of this systematic review was to assess the extent to which medical schools are teaching medical students about ACEs.
View Article and Find Full Text PDFObjectives: To determine the association between opioid prescribing rates and substantiated abuse and neglect across Tennessee counties during an 11-year period.
Methods: We adopted a Bayesian spatiotemporal approach to determine the association between opioid prescribing and rates of substantiated child abuse and neglect over and above environmental and population-level covariates. Annual county-level data for Tennessee (2006-2016) included rates of substantiated child abuse and neglect, rates of drug and non-drug crime incidents, racial and Hispanic composition, per capita income, child poverty and teen birth rates, and vacant housing.
Background: Lesbian, gay, bisexual, transgender and questioning (LGBTQ) individuals experience higher rates of health disparities. These disparities may be driven, in part, by biases of medical providers encountered in health care settings. Little is known about how medical, nursing, or dental students are trained to identify and reduce the effects of their own biases toward LGBTQ individuals.
View Article and Find Full Text PDFRates of substantiated child abuse and neglect vary significantly across counties. Despite strong cross-sectional support for links between social-contextual characteristics and abuse and neglect, few longitudinal studies have tested relations between these risk factors and substantiated rates of abuse/neglect. The goal of this study was to identify county-level socioeconomic and crime factors associated with substantiated abuse/neglect rates over 13 years (2004-2016).
View Article and Find Full Text PDFWe report integration of the United States Environmental Protection Agency's (USEPA) United States Environmental Justice Screen (EJSCREEN) database with our Public Health Exposome dataset to interrogate 9232 census blocks to model the complexity of relationships among environmental and socio-demographic variables toward estimating adverse pregnancy outcomes [low birth weight (LBW) and pre-term birth (PTB)] in all Ohio counties. Using a hill-climbing algorithm in R software, we derived a Bayesian network that mapped all controlled associations among all variables available by applying a mapping algorithm. The results revealed 17 environmental and socio-demographic variables that were represented by nodes containing 69 links accounting for a network with 32.
View Article and Find Full Text PDFChild maltreatment is a major public health problem. Although maltreatment rates vary over time and are influenced by neighborhood characteristics, the unique effects of crime and disadvantage on risk are not well understood. This study utilized a Bayesian spatiotemporal approach to examine risk factors for substantiated child abuse and neglect over a 9-year period across zip codes in Davidson County, TN.
View Article and Find Full Text PDFObjectives: The aim is to identify exposures associated with lung cancer mortality and mortality disparities by race and gender using an exposome database coupled to a graph theoretical toolchain.
Methods: Graph theoretical algorithms were employed to extract paracliques from correlation graphs using associations between 2162 environmental exposures and lung cancer mortality rates in 2067 counties, with clique doubling applied to compute an absolute threshold of significance. Factor analysis and multiple linear regressions then were used to analyze differences in exposures associated with lung cancer mortality and mortality disparities by race and gender.
Int J Environ Res Public Health
December 2015
A public participatory geographical information systems (PPGIS) demographic, environmental, socioeconomic, health status portal was developed for the Stambaugh-Elwood (SE) community in Columbus, OH. We hypothesized that soil at SE residences would have metal concentrations above natural background levels. Three aims were developed that allowed testing of this hypothesis.
View Article and Find Full Text PDFInt J Environ Res Public Health
December 2014
The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death.
View Article and Find Full Text PDFArch Environ Occup Health
March 2007
The authors analyzed temporal variations in asthma hospital admissions for New Jersey children (0-14 years of age) over a 3-year period. Significant spikes in children's asthma hospital admissions occurred during late September and early October of each of the 3 years of the study. The authors report on an in-depth analysis of the fall peak periods, in an effort to determine whether there was an association between children's asthma hospital admissions and environmental variables.
View Article and Find Full Text PDFMortality from pulmonary embolism (PE) has declined in the United States over the past two decades, yet significant racia l disparities persist with the age-adjusted rates for blacks about twice those for whites. Incidence studies to date have not been successful in defining reasons for this disparity, primarily because they have not enrolled sufficient numbers of blacks to allow for racial comparisons. This study overcomes that limitation by using New Jersey hospital discharge data as a surrogate measure for PE incidence.
View Article and Find Full Text PDFAdverse reproductive outcomes (AROs) disproportionately affect black American infants and significantly contribute to the U.S. infant mortality rate.
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