RESUMO
High COVID-19 mortality among Black communities heightened the pandemic's devastation. In the state of Louisiana, the racial disparity associated with COVID-19 mortality was significant; Black Americans accounted for 50% of known COVID-19-related deaths while representing only 32% of the state's population. In this paper, we argue that structural racism resulted in a synergistic framework of cumulatively negative determinants of health that ultimately affected COVID-19 deaths in Louisiana Black communities. We identify the spatial distribution of social, environmental, and economic stressors across Louisiana parishes using hot spot analysis to develop aggregate stressors. Further, we examine the correlation between stressors, cumulative health risks, COVID-19 mortality, and the size of Black populations throughout Louisiana. We hypothesized that parishes with larger Black populations (percentages) would have larger stressor values and higher cumulative health risks as well as increased COVID-19 mortality rates. Our results suggest two categories of parishes. The first group has moderate levels of aggregate stress, high population densities, predominately Black populations, and high COVID-19 mortality. The second group of parishes has high aggregate stress, lower population densities, predominantly Black populations, and initially low COVID-19 mortality that increased over time. Our results suggest that structural racism and inequities led to severe disparities in initial COVID-19 effects among highly populated Black Louisiana communities and that as the virus moved into less densely populated Black communities, similar trends emerged.
Assuntos
Negro ou Afro-Americano , COVID-19 , Equidade em Saúde , Disparidades em Assistência à Saúde , COVID-19/mortalidade , Disparidades em Assistência à Saúde/etnologia , Humanos , Louisiana/epidemiologia , Densidade Demográfica , Fatores RaciaisRESUMO
In Spring/Summer 2020, most individuals living in the United States experienced several months of social distancing and stay-at-home orders because of the coronavirus (COVID-19) pandemic. Clinicians, restaurant cooks, cashiers, transit operators, and other essential workers (EWs), however, continued to work outside the home during this time in order to keep others alive and maintain a functioning society. In the United States, EWs are often low-income persons of color who are more likely to face socioeconomic vulnerabilities, systemic racism, and health inequities. To assess the various impacts of COVID-19 on EWs, an online survey was distributed to a representative sample of individuals residing in six states during May/June 2020. The sample included 990 individuals who identified as EWs and 736 nonessential workers (NWs). We assessed differences between EW and NW respondents according to three categories related to health equity and social determinants of health: (1) demographics (e.g. race/ethnicity); (2) COVID-19 exposure risk pathways (e.g. ability to social distance); and (3) COVID-19 risk perceptions (e.g. perceived risk of contracting COVID-19). EWs were more likely to be Black or Hispanic than NWs and also had lower incomes and education levels on average. Unsurprisingly, EWs were substantially more likely to report working outside the home and less likely to report social distancing and wearing masks indoors as compared to NWs. EWs also perceived a slightly greater risk of contracting COVID-19. These findings, which we discuss in the context of persistent structural inequalities, systemic racism, and health inequities within the United States, highlight ways in which COVID-19 exacerbates existing socioeconomic vulnerabilities faced by EWs.
Assuntos
COVID-19/prevenção & controle , Demografia/estatística & dados numéricos , Equidade em Saúde , Indústrias/estatística & dados numéricos , Controle de Infecções/métodos , Determinantes Sociais da Saúde , Adolescente , Adulto , COVID-19/psicologia , Comércio , Culinária , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Fatores Socioeconômicos , Inquéritos e Questionários , Estados Unidos , Adulto JovemRESUMO
Blacks and Latinos are less likely than whites to access health insurance and utilize health care. One way to overcome some of these racial barriers to health equity may be through advances in technology that allow people to access and utilize health care in innovative ways. Yet, little research has focused on whether the racial gap that exists for health care utilization also exists for accessing health information online and through mobile technologies. Using data from the Health Information National Trends Survey (HINTS), we examine racial differences in obtaining health information online via mobile devices. We find that blacks and Latinos are more likely to trust online newspapers to get health information than whites. Minorities who have access to a mobile device are more likely to rely on the Internet for health information in a time of strong need. Federally insured individuals who are connected to mobile devices have the highest probability of reliance on the Internet as a go-to source of health information. We conclude by discussing the importance of mobile technologies for health policy, particularly related to developing health literacy, improving health outcomes, and contributing to reducing health disparities by race and health insurance status.
Assuntos
Acesso à Informação , População Negra , Disparidades em Assistência à Saúde , Hispânico ou Latino , Seguro Saúde , Aplicativos Móveis , Atenção à Saúde , Troca de Informação em Saúde , Humanos , Internet , Estados UnidosRESUMO
The term "Wind Turbine Syndrome" was coined in a recently self-published book, which hypothesized that a multitude of symptoms such as headache and dizziness resulted from wind turbines generating low frequency sound (LFS). The objective of this article is to provide a summary of the peer-reviewed literature on the research that has examined the relationship between human health effects and exposure to LFS and sound generated from the operation of wind turbines. At present, a specific health condition has not been documented in the peer-reviewed literature that has been classified as a disease caused by exposure to sound levels and frequencies generated by the operation of wind turbines. Communities are experiencing a heightened sense of annoyance and fear from the development and siting of wind turbine farms. High-quality research and effective risk communication can advance this course from one of panic to one of understanding and exemplification for other environmental advancements.
Assuntos
Exposição Ambiental/efeitos adversos , Som/efeitos adversos , Vento , Medo , Humanos , Humor Irritável , Risco , Transtornos do Sono-Vigília/etiologia , VibraçãoRESUMO
The conflict and discord between Booker T. Washington and W.E.B DuBois regarding their premise and approach to racial uplift for Black Americans have been very well documented. While Washington sought equality with accommodation, DuBois functioned through agitation. However, their biophilic accord and unity within the natural environment have been both underrecognized and underappreciated. As an honor to these esteemed racial and social justice giants, this special issue article reveals the universality of their environmental justice ideologies while also celebrating the beauty, power and foresight of their ecological language in script and speech.
RESUMO
BACKGROUND: Understanding factors that influence information seeking, assessment of risk and mitigation behaviors is critical during a public health crises. This longitudinal study examined the influence of self-reported mental health during the early months of the COVID-19 pandemic on information seeking, risk perception and perceived mask wearing ability. Mental health screener items included fear, anger, and hopelessness in addition to avoidance, diminished functional ability and global distress. Theoretical models inform hypotheses linking mental health items and outcomes. METHODS: The research employed a longitudinal 6-state 3-wave online panel survey, with an initial sample of 3,059 participants (2,232 included in longitudinal analyses). Participants roughly represented the states' age, race, ethnicity, and income demographics. RESULTS: Women, those who identified as Hispanic/Latinx, Black Americans and lower income participants reported higher overall rates of distress than others. Information seeking was more common among older persons, Democrats, retirees, those with higher education, and those who knew people who had died of COVID-19. Controlling for such demographic variables, in multivariable longitudinal models that included baseline mental health measures, distress and fear were associated with increased information seeking. Distress and fear were also associated with increased risk perception, and feelings of hopelessness were associated with lower reported mask-wearing ability. CONCLUSIONS: Results advance understanding of the role mental health can play in information seeking, risk perception and mask wearing with implications for clinicians, public health practitioners and policy makers.
Assuntos
COVID-19 , Autoeficácia , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , Comportamento de Busca de Informação , Estudos Longitudinais , Saúde Mental , Pandemias , PercepçãoRESUMO
PURPOSE OF REVIEW: "I can't breathe" were the last words spoken by Eric Garner (July 17, 2014), Javier Ambler (March 28, 2019), Elijah McClain (August 30, 2019), Manuel Ellis (March 3, 2020), and George Floyd (May 25, 2020). These were all African American men who died at the hands of police in the United States. Recently, police brutality has gained critical and overdue attention as one clear manifestation of systemic racism. However, historical and current policies related to a wide range of environmental hazards have exposed Black, Indigenous, and People of Color (BIPOC) to disproportionately high levels of physical, mental, social, emotional, and cultural toxicities, thus creating unbreathable and unlivable communities. RECENT FINDINGS: This paper traces the roots of systemic anti-Black racism in America from its origins in the 1400s, through systems of scientific racism that pathologized Blackness in order to justify slavery, and through evolving policies and structures that have shifted over time but consistently exposed many African American communities to unsafe and unhealthy environments. We conclude with calls for bold solutions to move through and past this oppressive history and toward true environmental justice the enables all communities to thrive together.
Assuntos
Justiça Ambiental , Racismo , Determinantes Sociais da Saúde , Negro ou Afro-Americano , Humanos , Justiça Social , Racismo Sistêmico , Estados UnidosRESUMO
The COVID-19 pandemic impacted mental health. Growing research has identified the mental health benefits of nature contact, including gardening. We used a cross-sectional survey to investigate the association between gardening and other outdoor activities with anxiety among U.S. adults. The RANG (Reducing Anxiety with Nature and Gardening) survey was distributed online from June−September 2020 through social media (Twitter and Facebook) and a national Master Gardeners listserv. Survey questions captured demographics, COVID-19 experiences, gardening, outdoor activities, and anxiety using the Generalized Anxiety Disorder 7-item scale. Data were analyzed using chi-square, Fisher's exact, and Kruskal−Wallis tests, as well as logistic regression. Among participants, 46% reported anxiety symptoms. Participants who had gardened ≥ 15 years and those gardening > 8 h over two weeks had lower anxiety scores. Spending more time outdoors on weekdays also decreased anxiety scores. After adjusting for covariates, lower odds of anxiety were identified for 50−69 and 70−89-year-olds vs. 18−29-year-olds; males vs. females; and Texas vs. Maryland residents. These findings confirm increased anxiety during the COVID-19 pandemic and suggest that sustained gardening and other outdoor activities could help reduce anxiety.
Assuntos
COVID-19 , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Transtornos de Ansiedade , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estudos Transversais , Feminino , Jardinagem , Humanos , Masculino , Pandemias/prevenção & controle , SARS-CoV-2RESUMO
Benchmarking and monitoring of urban design and transport features is crucial to achieving local and international health and sustainability goals. However, most urban indicator frameworks use coarse spatial scales that either only allow between-city comparisons, or require expensive, technical, local spatial analyses for within-city comparisons. This study developed a reusable, open-source urban indicator computational framework using open data to enable consistent local and global comparative analyses. We show this framework by calculating spatial indicators-for 25 diverse cities in 19 countries-of urban design and transport features that support health and sustainability. We link these indicators to cities' policy contexts, and identify populations living above and below critical thresholds for physical activity through walking. Efforts to broaden participation in crowdsourcing data and to calculate globally consistent indicators are essential for planning evidence-informed urban interventions, monitoring policy effects, and learning lessons from peer cities to achieve health, equity, and sustainability goals.
Assuntos
Saúde Global , Nível de Saúde , Cidades , Humanos , Software , Análise EspacialRESUMO
E. coli and enterococci in recreational waters are monitored as indicators of fecal contamination, pathogen presence, and health risk. Quantitative polymerase chain reaction (qPCR) tests for fecal indicator bacteria can provide beach managers with same-day information about water quality, unlike culture methods which provide that information the following day. The abilities of qPCR measurements of indicator bacteria, as compared to culture measurements of indicator bacteria, as predictors of pathogen presence or density in surface waters are not well understood. The purpose of this study was to make such comparisons between water samples collected from Chicago area surface waters, including rivers, inland lakes, Lake Michigan, and the Chicago Area Waterways System, which is dominated by wastewater effluent. A total of 294 twenty-litre samples were collected and analyzed for Giardia and Cryptosporidium. qPCR and membrane filtration methods were used to quantify E. coli and enterococci. Correlation, logistic regression, and zero-inflated Poisson modeling were utilized to evaluate associations between indicators and parasites. qPCR and culture measures of the indicator bacteria were similar in their ability to predict parasite presence and density. Correlations between parasites and indicators were generally stronger at waters not dominated by effluent. Associations between indicator density and Giarida presence were observed more consistently than between indicator density and Cryptosporidium presence. Associations between enterococci and parasites were generally stronger than associations between E. coli and parasites. The use of qPCR monitoring in our setting would generate more timely results without compromising the ability to predict parasite presence or density.
Assuntos
Monitoramento Ambiental/métodos , Água Doce/microbiologia , Água Doce/parasitologia , Microbiologia da Água , Chicago , Cryptosporidium/crescimento & desenvolvimento , Cryptosporidium/isolamento & purificação , Giardia/crescimento & desenvolvimento , Giardia/isolamento & purificação , Reação em Cadeia da Polimerase , Esporos de Protozoários/crescimento & desenvolvimento , Esporos de Protozoários/isolamento & purificação , Poluição da Água/estatística & dados numéricosRESUMO
The long, fallacious history of attributing racial disparities in public health outcomes to biological inferiority or poor decision making persists in contemporary conversations about the COVID-19 pandemic. Given the disproportionate impacts of this pandemic on communities of color, it is essential for scholars, practitioners, and policymakers to focus on how structural racism drives these disparate outcomes. In May and June 2020, we conducted a 6-state online survey to examine racial/ethnic differences in exposure to COVID-19, risk mitigation behaviors, risk perceptions, and COVID-19 impacts. Results show that Black and Hispanic individuals were more likely than White respondents to experience factors associated with structural racism (eg, living in larger households, going to work in person, using public transportation) that, by their very nature, increase the likelihood of exposure to COVID-19. Controlling for other demographic and socioeconomic characteristics, non-White respondents were equally or more likely than White respondents to take protective actions against COVID-19, including keeping distance from others and wearing masks. Black and Hispanic respondents also perceived higher risks of dying of the disease and of running out of money due to the pandemic, and 40% of Black respondents reported knowing someone who had died of COVID-19 at a time when the US death toll had just surpassed 100,000 people. To manage the current pandemic and prepare to combat future health crises in an effective, equitable, and antiracist manner, it is imperative to understand the structural factors perpetuating racial inequalities in the COVID-19 experience.
Assuntos
Atitude Frente a Saúde/etnologia , COVID-19/psicologia , Etnicidade/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Racismo/estatística & dados numéricos , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Etnicidade/psicologia , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Isolamento Social , Fatores Socioeconômicos , Inquéritos e Questionários , Estados Unidos , População Branca/estatística & dados numéricos , Adulto JovemRESUMO
Active transportation (AT) is widely viewed as an important target for increasing participation in aerobic physical activity and improving health, while simultaneously addressing pollution and climate change through reductions in motor vehicular emissions. In recent years, progress in increasing AT has stalled in some countries and, furthermore, the coronavirus (COVID-19) pandemic has created new AT opportunities while also exposing the barriers and health inequities related to AT for some populations. This paper describes the results of the December 2019 Conference on Health and Active Transportation (CHAT) which brought together leaders from the transportation and health disciplines. Attendees charted a course for the future around three themes: Reflecting on Innovative Practices, Building Strategic Institutional Relationships, and Identifying Research Needs and Opportunities. This paper focuses on conclusions of the Research Needs and Opportunities theme. We present a conceptual model derived from the conference sessions that considers how economic and systems analysis, evaluation of emerging technologies and policies, efforts to address inclusivity, disparities and equity along with renewed attention to messaging and communication could contribute to overcoming barriers to development and use of AT infrastructure. Specific research gaps concerning these themes are presented. We further discuss the relevance of these themes considering the pandemic. Renewed efforts at research, dissemination and implementation are needed to achieve the potential health and environmental benefits of AT and to preserve positive changes associated with the pandemic while mitigating negative ones.
Assuntos
COVID-19 , Exercício Físico , Humanos , SARS-CoV-2 , Meios de TransporteRESUMO
In the past century, dramatic shifts in demographics, globalization and urbanization have facilitated the rapid spread and transmission of infectious diseases across continents and countries. In a matter of weeks, the 2019 coronavirus pandemic devastated communities worldwide and reinforced the human perception of frailty and mortality. Even though the end of this pandemic story has yet to unfold, there is one parallel that is undeniable when a comparison is drawn between the 2019 coronavirus and the 1918 influenza pandemics. The public health response to disease outbreaks has remained nearly unchanged in the last 101 years. Furthermore, the role of environments and human behaviors on the effect and response to the coronavirus pandemic has brought to light many of the historic and contemporaneous inequalities and injustices that plague the United States. Through a reflection of these pandemic experiences, the American burden of disparity and disproportionality on morbidity, mortality and overall social determinants of health has been examined. Finally, a reimagination of a post-coronavirus existence has also been presented along with a discussion of possible solutions and considerations for moving forward to a new and better normal.
Assuntos
Infecções por Coronavirus/epidemiologia , Coronavirus , Comportamentos Relacionados com a Saúde , Influenza Humana/epidemiologia , Pneumonia Viral/epidemiologia , Determinantes Sociais da Saúde , Betacoronavirus , COVID-19 , Criança , Meio Ambiente , Feminino , Disparidades em Assistência à Saúde , Humanos , Vírus da Influenza A Subtipo H1N1 , Pandemias , SARS-CoV-2 , Fatores Socioeconômicos , Estados Unidos/epidemiologiaRESUMO
INTRODUCTION: Impoverished neighbourhoods and communities of colour often bear the brunt of unintended transit-oriented development (TOD) impacts. These impacts have been known to come in the form of transit-induced gentrification (TIG), a socioeconomic by-product of TOD defined as a phenomenon that occurs when the provision of transit service, particularly light rail transit (LRT), 'up-scales' nearby neighbourhood(s) and displaces existing residents. Consequently, TIG or even the perception of TIG can impact health outcomes (eg, anxiety) and social determinants of health (SDOH) (eg, crime). METHODS/ANALYSIS: In 2022, the purple line (PL), a 16.2 mile LRT line, is opening in Prince George's County, Maryland, a suburb of Washington, DC, comprised of over 80% African American and Hispanic residents. By taking advantage of this natural experiment, we are proposing the GENTS (Gauging Effects of Neighborhood Trends and Sickness: Examining the Perceptions of Transit-Induced Gentrification in Prince George's County) Study in order to evaluate perceived TIG and associated health outcome and SDOH changes, at two points in time, among Prince George's County adults in a prospective case-comparison design during the pre-PL LRT period. Descriptive analysis and latent growth curve modelling will be used to examine these changes over time. ETHICS AND DISSEMINATION: Ethics approval has been granted by the University of Maryland Institutional Review Board. The GENTS Study will identify temporal changes in perceived TIG, health outcomes and SDOH among case and comparison residents before the completion and operation of the PL LRT, an under researched period of TOD. The dissemination of GENTS Study findings will be able to address research questions and policy issues that are specifically tailored to PG County while also providing more effective procedural solutions for other regions undergoing TOD and TIG risks.
Assuntos
Percepção , Características de Residência , Instalações de Transporte/economia , Adulto , Estudos de Casos e Controles , Humanos , Maryland , Estudos Prospectivos , Fatores SocioeconômicosRESUMO
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.
Assuntos
Planejamento de Cidades , Características de Residência , Mudança Social , Segregação Social , Meios de Transporte , Humanos , Estados UnidosRESUMO
The use of active transportation (AT), such as walking, cycling, or even public transit, as a means of transport offers an opportunity to increase youth physical activity and improve health. Despite the well-known benefits of AT, there are environmental and social variables that converge on the AT experiences of low-income youth and youth of color (YOC) that have yet to be fully uncovered. This study uses an intersectional framework, largely focusing on the race-gender-class trinity, to examine youth AT within a context of transportation inequity. Theoretically guided by the Ecological Model of Active Transportation, focus groups were completed with two groups of girls (15 participants) and two groups of boys (nine participants) ranging between the ages of 12-15 years who lived within the Washington D.C. area. This research found race, gender, and class to be inhibitors of AT for both boys and girls, but with more pronounced negative influences on girls.
Assuntos
Ciclismo , Meios de Transporte , Caminhada , Adolescente , Criança , Coleta de Dados , District of Columbia , Exercício Físico , Feminino , Humanos , Masculino , Grupos Raciais , Fatores Sexuais , Fatores Socioeconômicos , VirginiaRESUMO
BACKGROUND: Sociodemographic and environmental factors play important roles in determining both indoor and outdoor play activities in children. METHODS: The Built Environment and Active Play Study assessed neighborhood playability for children (7-12 y), based on parental report of their children's active play behaviors, neighborhood characteristics, and geographic locations. Simple logistic regression modeling tested the associations between sociodemographic characteristics and the frequency of and access to venues for indoor and outdoor play. RESULTS: Children of higher socioeconomic status were almost 3 times more likely to live more than a 30-minute walk from indoor recreational facilities compared with their less affluent peers (odds ratio [OR] = 2.9; 95% confidence interval [CI], 1.2-6.8). Non-Hispanic black children were less likely to live more than 30 minutes from indoor facilities (OR = 0.21; 95% CI, 0.08-0.57) and more were likely to engage in indoor activity (OR = 3.40; 95% CI, 1.17-9.88) than were white children. Boys were substantially more likely to play outdoors at a playing fields compared with girls (OR = 5.37; 95% CI, 2.10-13.69). CONCLUSIONS: Findings from this study could be used to enhance indoor and outdoor activity spaces for children and to reduce disparities in access to such spaces.
Assuntos
Exercício Físico/fisiologia , Jogos e Brinquedos/psicologia , Criança , District of Columbia , Feminino , Humanos , Masculino , Classe Social , Estados UnidosRESUMO
During precipitation events, untreated human sewage is often intentionally discharged to surface water bodies via combined sewer overflow (CSO) systems in order to avoid overloading wastewater treatment plants. The purpose of this analysis was to evaluate the risk of pathogen-related disease associated with CSO discharges into the Lower Passaic River. Concentrations of fecal coliform, total coliform, fecal Streptococcus, and fecal Enterococcus bacteria were measured at six river locations on six different days in 2003 (n = 36). In addition, water samples (n = 2) were collected directly from and in the immediate vicinity of a discharging CSO in Newark, NJ. These samples were analyzed for fecal coliforms, total coliforms, fecal Streptococcus, fecal Enterococcus, Giardia lamblia, Cryptosporidium parvum, and several viruses. Risk estimates for gastrointestinal illness and Giardia infection resulting from indirect and direct ingestion of contaminated water were calculated for three potential exposure scenarios: visitor, recreator, and homeless person. Single-event risk was first evaluated for the three individual exposure scenarios; overall risk was then determined over a 1-year period. Monte Carlo techniques were used to characterize uncertainty. Nearly all of the pathogen concentrations measured in the Passaic River exceeded health-based water quality criteria and in some cases were similar to levels reported for raw sewage. The probability of contracting gastrointestinal illness due to fecal Streptococcus and Enterococcus from incidental ingestion of water over the course of a year ranged from 0.14 to nearly 0.70 for the visitor and recreator scenarios, respectively. For the homeless person exposure scenario, the risk for gastrointestinal illness reached 0.88 for fecal Streptococcus and Enterococcus, while the probability of Giardia infection was 1.0. This risk analysis suggests that, due to the levels of pathogens present in the Lower Passaic River, contact with the water poses, and will continue to pose, significant human health risks until CSO discharges are adequately controlled or abated.