Are perceptions of community safety associated with respiratory illness among a low-income, minority adult population?

BACKGROUND: Growing evidence suggests social disadvantage magnifies the harmful health effects of environmental hazards; however, there is limited research related to perceptions of risk among individuals who live near such environmental hazard sites. We explored the association between individual-level perception of community safety and respiratory illness among low-income, minority adults who live in a region with routine poor air quality exacerbated by the emissions of a nearby freight railyard. METHODS: Interview-administered household surveys were collected (87% response rate; n = 965) in English/Spanish from varying distances surrounding a freight railyard (analytic total n = 792: nearest region n = 215, middle n = 289, farthest n = 288). Illness outcome was an affirmative response to doctor-diagnosed asthma, bronchial condition, emphysema, COPD, or prescribed-inhaler usage. Respiratory symptoms outcome was an affirmative response to chronic cough, chronic mucus, or wheezing. The independent variable was perceived community safety. RESULTS: Outcome prevalences were similar across environmental hazard regions; 205 (25.9%) were diagnosed-illness cases and 166 (21.0%) diagnosis-free participants reported symptoms. Nearly half (47.5%) of participants reported lack of perceived community safety, which was associated with environmental hazard region (p <  0.0001). In multivariable log-binomial regression models adjusting for covariables (age, gender, race/ethnicity, smoking status, smoke exposure, residential duration, and distance from the railyard) respiratory illness diagnosis was associated with lack of perceived community safety (PR = 1.39; 95% CI 1.09, 1.76). Sensitivity analyses showed a non-significant but increasing trend in the strength of association between safety perceptions and illness diagnoses with closer proximity to the railyard. CONCLUSIONS: Our findings contribute to the literature that individuals' perceptions of community safety are associated with adverse respiratory health among a population living in high air pollution exposure areas.

The association between ambient fine particulate matter and incident adenocarcinoma subtype of lung cancer.

BACKGROUND: Adenocarcinoma (AC) is the most common lung cancer among non-smokers, but few studies have assessed the effect of PM2.5 on AC among never smokers. The purpose of this study was to assess the association between ambient PM2.5 and incident lung AC in the Adventist Health and Smog Study-2 (AHSMOG-2), a cohort of 80,044 non-smokers (81% never smokers) followed for 7.5 years (597,177 person-years) (2002-2011). METHODS: Incident lung AC was identified through linkage with U.S. state cancer registries. Ambient PM2.5 levels at subjects' residences were estimated for the years 2000 and 2001, immediately prior to study start. RESULTS: A total of 164 incident lung AC occurred during follow-up. Each 10 µg/m3 increment in PM2.5 was associated with an increase in the hazard rate of lung AC [HR = 1.31 (95% confidence interval (CI) 0.87-1.97)] in the single-pollutant model. Excluding those with prevalent non-melanoma skin cancer (NMSC) strengthened the association with lung AC (HR = 1.62 (95% CI, 1.11-2.36) for each 10 µg/m3 PM2.5 increment. Also, limiting the analyses to subjects who spent more than 1 h/day outdoors, increased the estimate (HR = 1.55, 95% CI: 1.05, 2.30). CONCLUSIONS: Increased risk of AC was observed for each 10 µg/m3 increment in ambient PM2.5 concentrations. The risk was higher among those without prevalent NMSC and those who spent more than 1 h/day outdoors.

Environmental Nutrition: A New Frontier for Public Health.

Food systems must operate within environmental constraints to avoid disastrous consequences for the biosphere. Such constraints must also take into account nutritional quality and health outcomes. Given the intrinsic relationships between the environmental sciences and nutritional sciences, it is imperative that public health embraces environmental nutrition as the new frontier of research and practice and begins a concerted focus on the new discipline of environmental nutrition, which seeks to comprehensively address the sustainability of food systems. We provide an overview to justify our proposition, outline a research and practice agenda for environmental nutrition, and explore how the complex relationships within food systems that affect public health could be better understood through the environmental nutrition model.

The environmental cost of protein food choices.

OBJECTIVE: To investigate the resource efficiency and environmental impacts of producing one kilogram of edible protein from two plant- and three animal-protein sources. DESIGN: Primary source data were collected and applied to commodity production statistics to calculate the indices required to compare the environmental impact of producing 1 kg of edible protein from kidney beans, almonds, eggs, chicken and beef. Inputs included land and water for raising animals and growing animal feed, total fuel, and total fertilizer and pesticide for growing the plant commodities and animal feed. Animal waste generated was computed for the animal commodities. SETTING: Desk-based study at the Department of Nutrition and Department of Occupational and Environmental Health, Loma Linda University. SUBJECTS: None. RESULTS: To produce 1 kg of protein from kidney beans required approximately eighteen times less land, ten times less water, nine times less fuel, twelve times less fertilizer and ten times less pesticide in comparison to producing 1 kg of protein from beef. Compared with producing 1 kg of protein from chicken and eggs, beef generated five to six times more waste (manure) to produce 1 kg of protein. CONCLUSIONS: The substitution of beef with beans in meal patterns will significantly reduce the environmental footprint worldwide and should also be encouraged to reduce the prevalence of non-communicable chronic diseases. Societies must work together to change the perception that red meat (e.g. beef) is the mainstay of an affluent and healthy diet.

Comparing the water, energy, pesticide and fertilizer usage for the production of foods consumed by different dietary types in California.

OBJECTIVE: To compare the use of water, energy, pesticides and fertilizer to produce commodities for two dietary patterns that vary in the content of plant and animal products. DESIGN: A unique analysis using 'real-world' data was performed, in contrast to previous analyses which applied simulated data. Consumption data from the Adventist Health Study were used to identify two dietary patterns with a markedly different consumption of several plant and animal products. State agricultural data were collected and applied to commodity production statistics. Indices were created to allow a comparison of the resource requirements for each dietary pattern. SETTING: California, USA. SUBJECTS: None. RESULTS: The diet containing more animal products required an additional 10 252 litres of water, 9910 kJ of energy, 186 g of fertilizer and 6 g of pesticides per week in comparison to the diet containing less animal products. The greatest contribution to the difference came from the consumption of animal products, particularly beef. CONCLUSIONS: Consuming a more plant-based diet could to an extent alleviate the negative environmental impacts related to food production. As a method to feed ourselves more sustainably, behavioural adjustments appear to be a very important tool.

Linkage between Neighborhood Social Cohesion and BMI of South Asians in the Masala Study.

Introduction. South Asians in the United States have a high prevalence of obesity and an elevated risk for cardiometabolic diseases. Yet, little is known about how aspects of neighborhood environment influence cardiometabolic risk factors such as body mass index (BMI) in this rapidly growing population. We aimed to investigate the association between perceived neighborhood social cohesion and BMI among South Asians. Methods: We utilized cross-sectional data from the MASALA study, a prospective community-based cohort of 906 South Asian men and women from the San Francisco Bay area and the greater Chicago area. Multivariable linear regression models, stratified by sex, were used to examine the association between perceived level of neighborhood social cohesion and individual BMI after adjusting for sociodemographics. Results: Participants were 54% male, with an average age of 55 years, 88% had at least a bachelor's degree, and the average BMI was 26.0 kg/m2. South Asian women living in neighborhoods with the lowest social cohesion had a significantly higher BMI than women living in neighborhoods with the highest cohesion (ß coefficient = 1.48, 95% CI 0.46-2.51, p=0.02); however, the association was not statistically significant after adjusting for sociodemographic factors (ß coefficient = 1.48, 95% CI 0.46-2.51, p=0.02); however, the association was not statistically significant after adjusting for sociodemographic factors (. Conclusion: Perceived neighborhood social cohesion was not significantly associated with BMI among South Asians in our study sample. Further research is recommended to explore whether other neighborhood characteristics may be associated with BMI and other health outcomes in South Asians and the mechanisms through which neighborhood may influence health.

California's county and city environmental health services delivery system.

The purpose of the authors' research was to assess the current status of county and city environmental health service delivery in California with the aim of providing a foundation for informed decision making about environmental health service delivery. Standardized interviews were conducted from March 2005 to May 2005 with 55 (88 percent) of the 62 county and city directors of environmental health; their jurisdictions represented 90 percent of the state's population and 94 percent of the landmass. Relevant databases and other publicly available information germane to project goals were also evaluated. The directors who were interviewed reported a total of 2,477 professional environmental health staff employed in county and city agencies, complemented by 520 support personnel. Percentages of respondents reporting technical-training needs were greatest for Certified Unified Program Agency (CUPA) activities (60 percent), dairy programs (57 percent), and septic-system programs (55 percent), while nontechnical training was desired in conflict resolution (55 percent), written/oral communication (49 percent), and problem solving (49 percent). Sixty-seven percent (67 percent) of directors reported difficulty in recruiting qualified applicants. Fifty-six percent (56 percent) were familiar with the 10 essential services of environmental health, while only 11 percent collected and reported health outcome measures to demonstrate agency effectiveness. The study team concluded that at the local level, environmental health services are largely provided as a reflection of local need; however, this tendency toward customization leads to stakeholder confusion about the purpose and value of environmental health services. The authors offer seven recommendations for improving environmental health services in California. Many of these recommendations can be generalized to the nation at large.

Geographic patterns of change over time in mammography: Differences between Black and White U.S. Medicare enrollees.

U.S. Black women have higher breast cancer mortality compared to White women while their rate of ever having a mammogram has become equal to or slightly surpassed that of Whites. We mapped the distribution of change in screening mammography for Black and White female Medicare enrollees ages 67-69 from 2008 to 2012 by hospital referral region across the contiguous U.S., performed cluster analysis to assess spatial autocorrelation, and examined the screening differences between these groups in 2008 and 2012 respectively. Changes in screening mammography are not consistent across the U.S.: Black and White women have increased and decreased their use of mammography in different regions and Black women's change patterns vary more widely.

The Association between Ambient Fine Particulate Air Pollution and Lung Cancer Incidence: Results from the AHSMOG-2 Study.

BACKGROUND: There is a positive association between ambient fine particulate matter ≤ 2.5 µm in aerodynamic diameter (PM2.5) and incidence and mortality of lung cancer (LC), but few studies have assessed the relationship between ambient PM2.5 and LC among never smokers. OBJECTIVES: We assessed the association between PM2.5 and risk of LC using the Adventist Health and Smog Study-2 (AHSMOG-2), a cohort of health conscious nonsmokers where 81% have never smoked. METHODS: A total of 80,285 AHSMOG-2 participants were followed for an average of 7.5 years with respect to incident LC identified through linkage with U.S. state cancer registries. Estimates of ambient air pollution levels at participants' residences were obtained for 2000 and 2001, the years immediately prior to the start of the study. RESULTS: A total of 250 incident LC cases occurred during 598,927 person-years of follow-up. For each 10-µg/m3 increment in PM2.5, adjusted hazard ratio (HR) with 95% confidence interval (CI) for LC incidence was 1.43 (95% CI: 1.11, 1.84) in the two-pollutant multivariable model with ozone. Among those who spent > 1 hr/day outdoors or who had lived 5 or more years at their enrollment address, the HR was 1.68 (95% CI: 1.28, 2.22) and 1.54 (95% CI: 1.17, 2.04), respectively. CONCLUSION: Increased risk estimates of LC were observed for each 10-µg/m3 increment in ambient PM2.5 concentration. The estimate was higher among those with longer residence at enrollment address and those who spent > 1 hr/day outdoors. Citation: Gharibvand L, Shavlik D, Ghamsary M, Beeson WL, Soret S, Knutsen R, Knutsen SF. 2017. The association between ambient fine particulate air pollution and lung cancer incidence: results from the AHSMOG-2 study. Environ Health Perspect 125:378-384; http://dx.doi.org/10.1289/EHP124.

Climate change mitigation and health effects of varied dietary patterns in real-life settings throughout North America.

BACKGROUND: Greenhouse gas emissions (GHGEs) are a major consequence of our dietary choices. Assessments of plant-based compared with meat-based diets are emerging at the intersection of public health, environment, and nutrition. OBJECTIVES: The objective was to compare the GHGEs associated with dietary patterns consumed in a large population across North America and to independently assess mortality according to dietary patterns in the same population. DESIGN: Data from the Adventist Health Study 2 (AHS-2) were used to characterize the differential environmental and health impacts of the following 3 dietary patterns, which varied in the quantity of animal and plant foods: vegetarian, semivegetarian, and nonvegetarian. The GHGE intensities of 210 foods were calculated through life-cycle assessments and by using published data. The all-cause mortality rates and all-cause mortality HRs for the AHS-2 subjects were adjusted for a range of lifestyle and sociodemographic factors and estimated according to dietary pattern. RESULTS: With the use of the nonvegetarian diet as a reference, the mean reductions in GHGEs for semivegetarian and vegetarian diets were 22% and 29%, respectively. The mortality rates for nonvegetarians, semivegetarians, and vegetarians were 6.66, 5.53, and 5.56 deaths per 1000 person-years, respectively. The differences were significant. Compared with nonvegetarians, mortality HRs were lower for semivegetarians (0.86) and vegetarians (0.91). CONCLUSIONS: Moderate differences in the caloric intake of meat products provided nontrivial reductions in GHGEs and improved health outcomes, as shown through the mortality analyses. However, this does not mean that diets lower in GHGEs are healthy.

Diet and the environment: does what you eat matter?

Food demand influences agricultural production. Modern agricultural practices have resulted in polluted soil, air, and water; eroded soil; dependence on imported oil; and loss of biodiversity. The goal of this research was to compare the environmental effect of a vegetarian and nonvegetarian diet in California in terms of agricultural production inputs, including pesticides and fertilizers, water, and energy used to produce commodities. The working assumption was that a greater number and amount of inputs were associated with a greater environmental effect. The literature supported this notion. To accomplish this goal, dietary preferences were quantified with the Adventist Health Study, and California state agricultural data were collected and applied to state commodity production statistics. These data were used to calculate different dietary consumption patterns and indexes to compare the environmental effect associated with dietary preference. Results show that, for the combined differential production of 11 food items for which consumption differs among vegetarians and nonvegetarians, the nonvegetarian diet required 2.9 times more water, 2.5 times more primary energy, 13 times more fertilizer, and 1.4 times more pesticides than did the vegetarian diet. The greatest contribution to the differences came from the consumption of beef in the diet. We found that a nonvegetarian diet exacts a higher cost on the environment relative to a vegetarian diet. From an environmental perspective, what a person chooses to eat makes a difference.

Residential environmental risks for reproductive age women in developing countries.

Published research suggests there is an association between maternal inhalation of common ambient air pollutants and adverse birth outcomes, including an increased risk for preterm delivery, intrauterine growth retardation, small head circumference, low birth weight, and increased rate of malformations. The air pollutants produced by indoor combustion of biomass fuels, used by 50% of households worldwide, have been linked to acute lower respiratory infections, the single most important cause of mortality in children under the age of 5. This report describes a hypothesis-generating study in West Wollega, Ethiopia, conducted to assess airborne particulate matter concentrations in homes that combust biomass fuels (biomass homes). Respirable suspended particulate matter was measured in biomass homes and nonbiomass homes using NIOSH method 0600. Measured airborne particulate concentrations in biomass homes were up to 130 times higher than air quality standards. These findings, in part, confirm that exposure to indoor air pollutants are a major source of concern for mother/child health. Midwives are encouraged to raise awareness, contribute to research efforts, and assist in interventions.