Evaluating health outcome metrics and their connections to air pollution and vulnerability in Southern California's Coachella Valley.

The ongoing desiccation of California's Salton Sea has led to increasing concerns about air quality and health for its surrounding communities, including the nearby Coachella Valley - a region already experiencing severe air quality and health disparities. Here we explore spatial air pollution and human health disparities in the Coachella Valley with particular attention to disparities arising across population characteristics including both socioeconomic and demographic vulnerabilities. We use two different measures of respiratory and cardiovascular health outcomes at the individual and census tract levels - one measure based on a randomly sampled telephone survey and the other measure based on emergency room visitation data - to investigate the degree to which these health outcomes are connected to air pollution and socioeconomic metrics. We further investigate biases and differences between the health outcome metrics themselves and suggest opportunities to address them in future analyses and survey efforts. We find that more vulnerable communities are associated with higher levels of fine particulates, but lower levels of ozone. While emergency visit rates show a significant positive correlation with both pollutants, no such association is found when using surveyed health outcome data. The ratio of emergency visits versus survey rates shows a positive relationship with socioeconomic and demographic vulnerability, indicating that vulnerable communities are less likely to self-report diagnoses despite higher rates of respiratory or cardiovascular hospitalization. Additionally, survey respondents tend to show less vulnerability relative to their surrounding census-based demographics. These findings suggest the need for greater attention to health issues specifically within disadvantaged communities in the Coachella Valley, building upon and working within existing community networks and local resources, to better address current and projected health needs. Our findings also highlight disparities in air pollution exposure, health outcomes, and population characteristics in the Coachella Valley, providing context for crucial pollution reduction efforts in the face of increasing environmental threats.

Indicators of self-reported human immunodeficiency virus risk and differences in willingness to get tested by age and ethnicity: An observational study.

There are many barriers that prevent people from receiving human immunodeficiency virus (HIV) testing; however, little is known about the impact of age and ethnicity on HIV testing. We explored differences in self-reported HIV risk and willingness to be tested in the 2014 Get Tested Coachella Valley Community Survey by age and ethnicity.Data were collected from 995 participants via survey methods (online, hard copy, and in person). Surveys asked about demographics, sexual history, HIV testing history, thoughts on who should get tested, and future preferences for HIV testing.Most participants were women (62.5%), Hispanic (55.8%), and older than 50 years (51%). Participants who did not receive testing said they did not do so because they did not perceive themselves as at risk of contracting HIV (51.8%). Many participants (24.1%) said they did not receive testing because their health care provider never offered them the HIV test. Participants were more likely to have been tested if they were between 25 and 49 years old, compared to participants aged 50 or older (70.2% vs 48.6%, respectively, P < .001). Participants who were not Hispanic or Latino were more likely to have had an HIV test compared to Hispanic or Latino participants (62.5% vs 51.1%, P < .001).Interventions are needed to reach older adults to address HIV testing and beliefs. These interventions must debunk beliefs among physicians that older adults are not sexually active and beliefs among older adults that only certain populations are at risk of HIV.