Self-Reported Effects of the Covid-19 Pandemic on Stewardship Organizations and Their Activities in Southeast New England, USA.

In many communities, regions, or landscapes, there are numerous environmental groups working across different sectors and creating stewardship networks that shape the environment and the benefits people derive from it. The make-up of these networks can vary, but generally include organizations of different sizes and capacities. As the Covid-19 pandemic (2020 to the present) shuts down businesses and nonprofits, catalyzes new initiatives, and generally alters the day-to-day professional and personal lives, it is logical to assume that these stewardship networks and their environmental work are impacted; exactly how, is unknown. In this study, we analyze the self-reported effects of the Covid-19 pandemic on stewardship groups working in southeast New England, USA. Stewardship organizations were surveyed from November 2020 to April 2021 and asked, among other questions, "How is Covid-19 affecting your organization?" We analyzed responses using several qualitative coding approaches. Our analysis revealed group-level impacts including changes in group capacity, challenges in managing access to public green spaces, and altered forms of volunteer engagement. These results provide insights into the varied effects of the Covid-19 pandemic and government responses such as stay-at-home orders and social distancing policies on stewardship that can inform the development of programs to reduce negative outcomes and enhance emerging capacities and innovations.

Childhood Overweight/Obesity and the Physical Activity Environment in Rhode Island.

OBJECTIVE: This study seeks to better understand the relationship between the physical activity environment and child overweight/obesity in Rhode Island. METHODS: Using geographic information systems (GIS), this study calculated distances from residences to physical activity resources to assess the relationship distance has with childhood overweight/obesity. RESULTS: Mean distances in high-risk towns ranged from 0.61 to 3.15 miles compared to physical activity resources in low-risk towns, where distances ranged from 1.25 to 7.43 miles. For each additional mile to reach the closest indoor facility, there is a 0.41 (95% CI: -0.78, -0.03) percentage point decrease in the child overweight/obesity rate.  Conclusion: High-risk block groups and towns have higher rates of child overweight/obesity and show shorter distances to physical activity resources. This study demonstrates that simply having physical activity structures in place is not enough to reduce child overweight/obesity and further research should examine the quality and usage patterns of these resources.

Mapping the Opioid Epidemic in Rhode Island: Where Are We Missing Resources?

Opioid overdose deaths have been rising steadily over the past decade in Rhode Island (RI), and although deaths have decreased slightly over the past year, there were 314 deaths in 2018 and there have been 208 deaths in the first 9 months of 2019.1 The objective of this spatial study is to identify the RI regions with the greatest need for opioid emergency response and rehabilitation resources. Using geographic information systems (GIS), we identify areas in RI with high overdose rates and that are far from emergency departments, and areas with high rates of treatment admissions that are far away from Centers of Excellence (COEs) which provide effective medication-assisted treatment (MAT). Ultimately, we identified Burrillville, Coventry, Bristol, and Portsmouth as towns needing more emergency resources and Western Hopkinton, Western Richmond, and Western Scituate as areas needing more high-quality rehabilitation resources. These findings should inform future decisions when considering new locations for COEs or emergency resources to respond to the Rhode Island opioid epidemic.

Air pollution, land use, and complications of pregnancy.

BACKGROUND: Mounting evidence suggests that the natural and built environment can affect human health, but relatively few studies have considered links between features of the residential natural and built environment other than air pollution and complications of pregnancy. OBJECTIVES: To quantify the impact of features of the maternal residential natural and built environments on risk of gestational diabetes mellitus (GDM), gestational hypertension and preeclampsia among 61,640 women who delivered at a single hospital in Rhode Island between 2002 and 2012. METHODS: We estimated residential levels of ambient fine particulate matter (PM2.5) and black carbon (BC) using spatiotemporal models, neighborhood green space using remote sensing and proximity to recreational facilities, and neighborhood blue space using distance to coastal and fresh water. We used logistic regression to separately estimate the association between each feature and GDM, gestational hypertension, and preeclampsia, adjusting for individual and neighborhood markers of socioeconomic status. RESULTS: GDM, gestational hypertension, and preeclampsia were diagnosed in 8.0%, 5.0%, and 3.6% of women, respectively. We found 2nd trimester PM2.5 (OR = 1.08, 95% CI: 1.00, 1.15 per interquartile range increase in PM2.5) and living close to a major roadway (1.09, 95% CI: 1.00, 1.19) were associated with higher odds of GDM, while living <1 km from the coast was associated with lower odds of GDM (0.87, 95% CI: 0.78, 0.96). Living <500 m from a recreational facility was associated with lower odds of gestational hypertension (0.89, 95% CI: 0.80, 0.99). None of these features were associated with odds of preeclampsia. Results were qualitatively similar in mutually-adjusted models and sensitivity analyses. CONCLUSIONS: In this small coastal US state, risk of GDM was positively associated with PM2.5 and proximity to busy roadways, and negatively associated with proximity to blue space, highlighting the importance of the natural and built environment to maternal health.

Residential green space and birth outcomes in a coastal setting.

BACKGROUND: Residential green space may improve birth outcomes, with prior studies reporting higher birthweight among infants of women living in greener areas. However, results from studies evaluating associations between green space and preterm birth have been mixed. Further, the potential influence of residential proximity to water, or 'blue space', on health has not previously been evaluated. OBJECTIVES: To evaluate associations between green and blue space and birth outcomes in a coastal area of the northeastern United States. METHODS: Using residential surrounding greenness (measured by Normalized Difference Vegetation Index [NDVI]) and proximity to recreational facilities, coastline, and freshwater as measures of green and blue space, we examined associations with preterm birth (PTB), term birthweight, and term small for gestational age (SGA) among 61,640 births in Rhode Island. We evaluated incremental adjustment for socioeconomic and environmental metrics. RESULTS: In models adjusted for individual - and neighborhood-level markers of socioeconomic status (SES), an interquartile range (IQR) increase in NDVI was associated with a 12% higher (95% CI: 4, 20%) odds of PTB and, conversely, living within 500 m of a recreational facility was associated with a 7% lower (95% CI: 1, 13%) odds of PTB. These associations were eliminated after further adjustment for town of residence. NDVI was associated with higher birthweight (7.4 g, 95% CI: 0.4-14.4 g) and lower odds of SGA (OR = 0.92, 95% CI: 0.87-0.98) when adjusted for individual-level markers of SES, but not when further adjusted for neighborhood SES or town. Living within 500 m of a freshwater body was associated with a higher birthweight of 10.1 g (95% CI: 2.0, 18.2) in fully adjusted models. CONCLUSIONS: Findings from this study do not support the hypothesis that residential green space is associated with reduced risk of preterm birth or higher birthweight after adjustment for individual and contextual socioeconomic factors, but variation in results with incremental adjustment raises questions about the optimal degree of control for confounding by markers of SES. We found that living near a freshwater body was associated with higher birthweight. This result is novel and bears further investigation in other settings and populations.

Climate patterns and mosquito-borne disease outbreaks in South and Southeast Asia.

BACKGROUND: Vector-borne infectious diseases, particularly mosquito-borne, pose a substantial threat to populations throughout South and Southeast Asia. Outbreaks have affected this region several times during the early years of the 21st century, notably through outbreaks of Chikungunya and Dengue. These diseases are believed to be highly prevalent at endemic levels in the region as well. With a changing global climate, the impacts of changes in ambient temperatures and precipitation levels on mosquito populations are important for understanding the effects on risk of mosquito-borne disease outbreaks. This study aims to make use of a large data set to determine how risk of mosquito-borne infectious disease outbreaks relates to the highest monthly average temperature and precipitation for each year in South and Southeast Asia. METHODS: Generalized additive models were used in a marked point process to fit nonlinear trends relating temperature and precipitation to outbreak risk, fitting splines for temperature and precipitation. Confounding factors for nation affluence, climate type, and ability to report outbreaks were also included. RESULTS: Parabolic trends for both temperature and precipitation were observed relating to outbreak risk. The trend for temperature, which was significant, showed that outbreak risk peaks near 33.5°C as the highest monthly average temperature. Though not significant, a trend for precipitation was observed showing risk peaking when the highest monthly average precipitation is 650mm. CONCLUSIONS: Peak levels of temperature and precipitation were identified for outbreak risk. These findings support the notion of a poleward shift in the distribution of mosquitoes within this region rather than a poleward expansion in geographic range.

Global rise in human infectious disease outbreaks.

To characterize the change in frequency of infectious disease outbreaks over time worldwide, we encoded and analysed a novel 33-year dataset (1980-2013) of 12,102 outbreaks of 215 human infectious diseases, comprising more than 44 million cases occuring in 219 nations. We merged these records with ecological characteristics of the causal pathogens to examine global temporal trends in the total number of outbreaks, disease richness (number of unique diseases), disease diversity (richness and outbreak evenness) and per capita cases. Bacteria, viruses, zoonotic diseases (originating in animals) and those caused by pathogens transmitted by vector hosts were responsible for the majority of outbreaks in our dataset. After controlling for disease surveillance, communications, geography and host availability, we find the total number and diversity of outbreaks, and richness of causal diseases increased significantly since 1980 (p < 0.0001). When we incorporate Internet usage into the model to control for biased reporting of outbreaks (starting 1990), the overall number of outbreaks and disease richness still increase significantly with time (p < 0.0001), but per capita cases decrease significantly ( p = 0.005). Temporal trends in outbreaks differ based on the causal pathogen's taxonomy, host requirements and transmission mode. We discuss our preliminary findings in the context of global disease emergence and surveillance.

Proximity of US schools to major roadways: a nationwide assessment.

Long-term exposure to traffic pollution has been associated with adverse health outcomes in children and adolescents. A significant number of schools may be located near major roadways, potentially exposing millions of children to high levels of traffic pollution, but this hypothesis has not been evaluated nationally. We obtained data on the location and characteristics of 114,644 US public and private schools, grades prekindergarten through 12, and calculated their distance to the nearest major roadway. In 2005-2006, 3.2 million students (6.2%) attended 8,424 schools (7.3%) located within 100 m of a major roadway, and an additional 3.2 million (6.3%) students attended 8,555 (7.5%) schools located 100-250 m from a major roadway. Schools serving predominantly Black students were 18% (95% CI, 13-23%) more likely to be located within 250 m of a major roadway. Public schools eligible for Title I programs and those with a majority of students eligible for free/reduced price meals were also more likely to be near major roadways. In conclusion, 6.4 million US children attended schools within 250 m of a major roadway and were likely exposed to high levels of traffic pollution. Minority and underprivileged children were disproportionately affected, although some results varied regionally.

Demographic, geographic, and temporal patterns of ambulance runs for suspected opiate overdose in Rhode Island, 1997-20021.

We examine ambulance runs for suspected opiate overdose from 1997 to 2002 using a Rhode Island Department of Health database. Of the 8,763 ambulance runs for overdoses, 18.6% were for suspected opiate overdoses. Most cases were males under age 54. Suspected opiate overdoses were more likely to occur in a private residence, were more frequent on Fridays and Saturdays, and peaked in incidence around 9:00 p.m. The incidence rate of suspected opiate overdose by year was similar. The study results may help identify areas for preventive intervention and demonstrate the limitation of using naloxone as a marker of opiate overdose events.