Food insecurity among university students in the United States amidst the COVID-19 pandemic.

OBJECTIVE: This study reports on food insecurity (FI) amidst the COVID-19 pandemic. PARTICIPANTS AND METHODS: College students in four regions of the US completed the two-item validated Hunger Vital Sign™ screening tool on Qualtrics. RESULTS: FI increased significantly after March 2020 among US students (worry about food running out: 25% to 35%; food did not last: 17% to 21%) with significant regional increase in the Midwest and South. An adjusted multivariable logistic regression model indicated students that ran out of food were significantly at greater odds of experiencing hardship with paying bills (AOR: 5.59, 95% CI =3.90-8.06). CONCLUSIONS: The findings identified an increase in the prevalence of FI among college students during the pandemic. Suggestions of how to address FI are discussed.

Using geographic information systems to characterize food environments around historically black colleges and universities: Implications for nutrition interventions.

ObjectiveTo understand the distribution of healthy and unhealthy food stores near historically black colleges and universities (HBCUs). Participants and methods: Using ArcGIS Pro's network analysis tools and ReferenceUSA database, this study characterized the healthy (favorable) and unhealthy (unfavorable) retail food stores within a 5-mile radius, 15-min driving, and 15-min walking distance from each HBCU in North Carolina. Results: Most retail food stores within a 5-mile buffer radius of the 10 HBCUs in North Carolina were unfavorable. Within 15-min driving from each HBCU, 1082 stores (76.0%) were unfavorable food stores, while 332 (24.0%) were favorable. Additionally, there were four favorable and 35 unfavorable retail food stores within the 15-min walking distance of each HBCU. Conclusions: Favorable food retail stores around HBCUs in North Carolina are limited. Researchers, policy makers, and community stakeholders should work together to improve food environments surrounding HBCUs.

The Local Food Environment and Food Security: The Health Behavior Role of Social Capital.

Food politics and economic forces may determine the macro conditions for food supply, but the local environment has the most substantial impact on population health. Food security is determined not only by the basic availability of food, but also by social, economic, and cultural factors influencing dietary behaviors. This paper investigates the role of social institutions, specifically social capital, in affecting food security by proposing a theoretical linkage between social capital and health behavior, and an illustrative case is provided. Social capital, defined as the value of the bonding, bridging, and linking relationships between people, is well demonstrated to be related to health. Many mechanisms link social capital to health, including shared access to food and nutritional behaviors. Further, social capital influences health through social status and race. This paper further investigates the links between minority status, food security, social capital, and health. The analysis draws on empirical work in North Carolina with community gardens, faith communities, the local food environment, and other social capital-related variables. By investigating the nature of local food security, particularly for minority populations, this analysis allows for better integration of local conditions with global food politics.

Biomonitoring of metals and trace elements in urine of central Ethiopian populations.

Biomonitoring of chemical concentrations in humans is important for detecting, monitoring, and addressing a wide range of health threats. However, it is virtually absent across many African nations, including Ethiopia. This study aims to determine urinary concentrations for metals and trace elements in populations living in the central Ethiopian Rift Valley. The region is unindustralized, rural, and characterized by unique geologic rifting and volcanic activities that have produced vast pyroclastic materials, forming its aquifer and fertile agricultural soils. Millions of people in the region rely on wells for drinking water and are engaged in cereal-based subsistence agriculture. We enrolled a total of 386 residents aged 10-50 years old (201 females and 185 males). The levels of 23 elements except F─ were quantified in water and urine samples by ICP-MS. Mean concentrations of B, F─, Ca, and Mg were measured in mg/L levels, while concentrations of Mo, Zn, Sr, Rb, and Li ranged between 100 and 700 µg/L. Mean concentrations between 5 and 15 µg/L were found for Ni, Cu, and Mn, while Ag, Be, Cd, Co, Pb, Sb, Th, TI, and U were all below 5 µg/L. Arsenic and Al had mean concentrations between 30 and 50 µg/L. Mean urinary concentrations of Ca, Cu, Mg, Pb, Sr, and Zn were significantly higher in males than females, whereas Co and Mn were higher in females. Finally, younger individuals (10-30 years) had significantly higher mean concentrations of B, Cd, Co, Mg, Mo, and Pb than those between 31 and 50 years, whereas only Ca was higher in the older age group. The concentration ranges of B, Mo, Mn, TI, Li, Zn, and in particular F─ (0.44-44.6 mg/L) and As (2.2-164 µg/L) in urine were higher than the reference ranges reported in healthy unexposed North American and European populations, while those for the remaining 16 elements were comparable to published reference ranges from such settings. The established concentration ranges are important to monitor future changes in exposure, and risk factors for disease, that might stem from the economic growth and industrialization that is currently underway in the region.

A randomized longitudinal factorial design to assess malaria vector control and disease management interventions in rural Tanzania.

The optimization of malaria control strategies is complicated by constraints posed by local health systems, infrastructure, limited resources, and the complex interactions between infection, disease, and treatment. The purpose of this paper is to describe the protocol of a randomized factorial study designed to address this research gap. This project will evaluate two malaria control interventions in Mvomero District, Tanzania: (1) a disease management strategy involving early detection and treatment by community health workers using rapid diagnostic technology; and (2) vector control through community-supported larviciding. Six study villages were assigned to each of four groups (control, early detection and treatment, larviciding, and early detection and treatment plus larviciding). The primary endpoint of interest was change in malaria infection prevalence across the intervention groups measured during annual longitudinal cross-sectional surveys. Recurring entomological surveying, household surveying, and focus group discussions will provide additional valuable insights. At baseline, 962 households across all 24 villages participated in a household survey; 2,884 members from 720 of these households participated in subsequent malariometric surveying. The study design will allow us to estimate the effect sizes of different intervention mixtures. Careful documentation of our study protocol may also serve other researchers designing field-based intervention trials.

Making the environmental justice grade: the relative burden of air pollution exposure in the United States.

This paper assesses whether the Clean Air Act and its Amendments have been equally successful in ensuring the right to healthful air quality in both advantaged and disadvantaged communities in the United States. Using a method to rank air quality established by the American Lung Association in its 2009 State of the Air report along with EPA air quality data, we assess the environmental justice dimensions of air pollution exposure and access to air quality information in the United States. We focus on the race, age, and poverty demographics of communities with differing levels of ozone and particulate matter exposure, as well as communities with and without air quality information. Focusing on PM2.5 and ozone, we find that within areas covered by the monitoring networks, non-Hispanic blacks are consistently overrepresented in communities with the poorest air quality. The results for older and younger age as well as poverty vary by the pollution metric under consideration. Rural areas are typically outside the bounds of air quality monitoring networks leaving large segments of the population without information about their ambient air quality. These results suggest that substantial areas of the United States lack monitoring data, and among areas where monitoring data are available, low income and minority communities tend to experience higher ambient pollution levels.

Blood lead levels among pregnant women: historical versus contemporaneous exposures.

Blood lead among pregnant women, even at modest levels, may impair offspring cognitive development. We examine whether blood lead levels (BLLs) result from current versus historic exposures, among a cohort of pregnant women. Cumulative logit models were used to characterize the relationship between maternal risk factors and higher BLLs. Maternal blood lead levels more likely result from lead remobilization from historic versus contemporaneous exposures. Even if all lead sources were abated immediately, women and their fetuses would experience lead exposure for decades. This work emphasizes the importance of addressing sources of environmental lead exposure in the United States and internationally.

The relationship between early childhood blood lead levels and performance on end-of-grade tests.

BACKGROUND: Childhood lead poisoning remains a critical environmental health concern. Low-level lead exposure has been linked to decreased performance on standardized IQ tests for school-aged children. OBJECTIVE: In this study we sought to determine whether blood lead levels in early childhood are related to educational achievement in early elementary school as measured by performance on end-of-grade (EOG) testing. METHODS: Educational testing data for 4th-grade students from the 2000-2004 North Carolina Education Research Data Center were linked to blood lead surveillance data for seven counties in North Carolina and then analyzed using exploratory and multivariate statistical methods. RESULTS: The discernible impact of blood lead levels on EOG testing is demonstrated for early childhood blood lead levels as low as 2 microg/dL. A blood lead level of 5 microg/dL is associated with a decline in EOG reading (and mathematics) scores that is roughly equal to 15% (14%) of the interquartile range, and this impact is very significant in comparison with the effects of covariates typically considered profoundly influential on educational outcomes. Early childhood lead exposures appear to have more impact on performance on the reading than on the mathematics portions of the tests. CONCLUSIONS: Our emphasis on population-level analyses of children who are roughly the same age linked to previous (rather than contemporaneous) blood lead levels using achievement (rather than aptitude) outcome complements the important work in this area by previous researchers. Our results suggest that the relationship between blood lead levels and cognitive outcomes are robust across outcome measures and at low levels of lead exposure.

Changes in blood lead levels associated with use of chloramines in water treatment systems.

BACKGROUND: More municipal water treatment plants are using chloramines as a disinfectant in order to reduce carcinogenic by-products. In some instances, this has coincided with an increase in lead levels in drinking water in those systems. Lead in drinking water can be a significant health risk. OBJECTIVES: We sought to test the potential effect of switching to chloramines for disinfection in water treatment systems on childhood blood lead levels using data from Wayne County, located in the central Coastal Plain of North Carolina. METHODS: We constructed a unified geographic information system (GIS) that links blood lead screening data with age of housing, drinking water source, and census data for 7,270 records. The data were analyzed using both exploratory methods and more formal multivariate techniques. RESULTS: The analysis indicates that the change to chloramine disinfection may lead to an increase in blood lead levels, the impact of which is progressively mitigated in newer housing. CONCLUSIONS: Introducing chloramines to reduce carcinogenic by-products may increase exposure to lead in drinking water. Our research provides guidance on adjustments in the local childhood lead poisoning prevention program that should accompany changes in water treatment. As similar research is conducted in other areas, and the underlying environmental chemistry is clarified, water treatment strategies can be optimized across the multiple objectives that municipalities face in providing high quality drinking water to local residents.