Florida neighborhood analysis of social determinants and their relationship to life expectancy.

BACKGROUND: Social determinants of health (SDOH) contribute to unequal life expectancy (LE). Only a handful of papers have analyzed these relationships at the neighborhood level as opposed to the county level. This study draws on both the SDOH and social vulnerability literature to identify relevant factors affecting LE. METHODS: LE was calculated from mortality records for Florida from 2009 to 2013 for 3640 census tracts with reliable estimates. A spatial Durbin error model (SDEM) quantified the direction and magnitude of the factors to LE. The SDEM contains a spatial error term and jointly estimates both local and neighborhood associations. This methodology controls for non-independence between census tracts to provide unbiased statistical estimates. RESULTS: Factors significantly related to an increase in LE, include percentage (%) of the population who identify as Hispanic (beta coefficient [ß]: 0.06, p-value [P] < 0.001) and % of age dependent populations (% population < 5 years old and % population > 65) (ß: 0.13, P < 0.001). Conversely, the following factors exhibited significant negative LE associations, % of households with no automobile (ß: -0.05, P < 0.001), % of mobile homes (ß: -0.02, P < 0.001), and % of female headed households (ß: -0.11, P < 0.001). CONCLUSIONS: Results from the SDEM demonstrate social vulnerability indicators account for additional geographic LE variability beyond commonly studied SDOH. Empirical findings from this analysis can help local health departments identify drivers of spatial health disparities at the local level.

Associations between exposure to ambient benzene and PM(2.5) during pregnancy and the risk of selected birth defects in offspring.

OBJECTIVE: A growing number of studies have investigated the association between air pollution and the risk of birth defects, but results are inconsistent. The objective of this study was to examine whether maternal exposure to ambient PM2.5 or benzene increases the risk of selected birth defects in Florida. METHODS: We conducted a retrospective cohort study of singleton infants born in Florida from 2000 to 2009. Isolated and non-isolated birth defect cases of critical congenital heart defects, orofacial clefts, and spina bifida were identified from the Florida Birth Defects Registry. Estimates of maternal exposures to PM2.5 and benzene for all case and non-case pregnancies were derived by aggregation of ambient measurement data, obtained from the US Environmental Protection Agency Air Quality System, during etiologically relevant time windows. Multivariable Poisson regression was used to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for each quartile of air pollutant exposure. RESULTS: Compared to the first quartile of PM2.5 exposure, higher levels of exposure were associated with an increased risk of non-isolated truncus arteriosus (aPR4th Quartile, 8.80; 95% CI, 1.11-69.50), total anomalous pulmonary venous return (aPR2nd Quartile, 5.00; 95% CI, 1.10-22.84), coarctation of the aorta (aPR4th Quartile, 1.72; 95% CI, 1.15-2.57; aPR3rd Quartile, 1.60; 95% CI, 1.07-2.41), interrupted aortic arch (aPR4th Quartile, 5.50; 95% CI, 1.22-24.82), and isolated and non-isolated any critical congenital heart defect (aPR3rd Quartile, 1.13; 95% CI, 1.02-1.25; aPR4th Quartile, 1.33; 95% CI, 1.07-1.65). Mothers with the highest level of exposure to benzene were more likely to deliver an infant with an isolated cleft palate (aPR4th Quartile, 1.52; 95% CI, 1.13-2.04) or any orofacial cleft (aPR4th Quartile, 1.29; 95% CI, 1.08-1.56). An inverse association was observed between exposure to benzene and non-isolated pulmonary atresia (aPR4th Quartile, 0.19; 95% CI, 0.04-0.84). CONCLUSION: Our results suggest a few associations between exposure to ambient PM2.5 or benzene and specific birth defects in Florida. However, many related comparisons showed no association. Hence, it remains unclear whether associations are clinically significant or can be causally related to air pollution exposures.

Cell Phone Ownership and Cellular Text/Email Capabilities Among Temporary and Payroll Construction Workers.

Background: With high rates of temporary workers and a transient worker population, the U.S. construction workforce presents a challenge for long-term research and outreach activities. Increasing availability of affordable cell phone technologies may provide an opportunity for research follow-up among construction workers once they leave the worksite. Using pilot study survey data we characterize and examine the association of cell phone technology ownership and cellular text/email services among a non-probabilistic sample of payroll and temporary construction workers. Methods: A cross-sectional study design was used to administer a one-time paper-based anonymous survey to construction workers working at construction sites in Florida, USA. The survey featured questions on sociodemographic characteristics, occupational history, cell phone technology ownership, and cellular text/email services capabilities. Results: Among the 223 construction worker survey respondents, 31.4% identified as temporary workers and 68.6% were on payroll and 87.4% owned a cell phone. Construction workers who own a cell phone had greater than a high school education (28.9% vs. 25.0%; p = 0.019), made >$30,000/year (27.1% vs. 14.8%; p = 0.011), had same cell phone number for >1 year (74.4% vs. 40.7%; p = 0.001), and were employed as a payroll worker (71.0% vs. 50.0%; p = 0.037). Temporary construction workers compared to their payroll counterparts were significantly less likely to have email services on their cell phone [unadjusted-odds ratio 0.41 (95% CI: 0.17-0.97)]. Conclusion: Cell phone ownership and smartphone-enabled technologies such as email/texting capabilities are higher among payroll than temporary construction workers. Further research on frequency of cell phone use and types of email/texting services used by construction workers are needed.

Physical Exposures, Work Tasks, and OSHA-10 Training Among Temporary and Payroll Construction Workers.

OBJECTIVE: We characterize and compare the self-reported physical exposures, work tasks, and OSHA-10 training in a non-probabilistic sample of temporary and payroll construction workers. METHODS: In June 2016, a total of 250 payroll and temporary general laborers employed at Florida construction sites completed a survey at the job site as part of the falls reported among minority employees (FRAME) study. RESULTS: Workers employed through temp agencies (57.1%) were significantly more likely to report moving or lifting materials more than 100 pounds than payroll workers (38.5%; P < 0.01). Temporary construction workers with 10-hour OSHA training (22.2%) spent significantly less time with intense hand use/awkward hand posture than temporary workers without 10-hour OSHA training (46.9%; P = 0.048). CONCLUSIONS: Temp construction workers with OSHA 10-hour training reported less hazardous physical postures than workers without the same training.

Uncertainty in maternal exposures to ambient PM2.5 and benzene during pregnancy: Sensitivity to exposure estimation decisions.

We investigate uncertainty in estimates of pregnant women's exposure to ambient PM2.5 and benzene derived from central-site monitoring data. Through a study of live births in Florida during 2000-2009, we discuss the selection of spatial and temporal scales of analysis, limiting distances, and aggregation method. We estimate exposure concentrations and classify exposure for a range of alternatives, and compare impacts. Estimated exposure concentrations were most sensitive to the temporal scale of analysis for PM2.5, with similar sensitivity to spatial scale for benzene. Using 1-12 versus 3-8 weeks of gestational age as the exposure window resulted in reclassification of exposure by at least one quartile for up to 37% of mothers for PM2.5 and 27% for benzene. The largest mean absolute differences in concentration resulting from any decision were 0.78 µg/m(3) and 0.44 ppbC, respectively. No bias toward systematically higher or lower estimates was found between choices for any decision.

Identifying Heat Waves in Florida: Considerations of Missing Weather Data.

BACKGROUND: Using current climate models, regional-scale changes for Florida over the next 100 years are predicted to include warming over terrestrial areas and very likely increases in the number of high temperature extremes. No uniform definition of a heat wave exists. Most past research on heat waves has focused on evaluating the aftermath of known heat waves, with minimal consideration of missing exposure information. OBJECTIVES: To identify and discuss methods of handling and imputing missing weather data and how those methods can affect identified periods of extreme heat in Florida. METHODS: In addition to ignoring missing data, temporal, spatial, and spatio-temporal models are described and utilized to impute missing historical weather data from 1973 to 2012 from 43 Florida weather monitors. Calculated thresholds are used to define periods of extreme heat across Florida. RESULTS: Modeling of missing data and imputing missing values can affect the identified periods of extreme heat, through the missing data itself or through the computed thresholds. The differences observed are related to the amount of missingness during June, July, and August, the warmest months of the warm season (April through September). CONCLUSIONS: Missing data considerations are important when defining periods of extreme heat. Spatio-temporal methods are recommended for data imputation. A heat wave definition that incorporates information from all monitors is advised.