Introduction: Redlining, a racially discriminatory mortgage appraisal practice in the latter half of the 1930s, established and exacerbated racial segregation boundaries. Investment risk grades, including redlining, assigned >80 years ago through Security Maps by the Home Owners' Loan Corporation (HOLC) are associated with current socioeconomic factors, increased diesel exhaust production, hotter ambient temperatures, and adverse health outcomes. We sought to assess whether HOLC investment grades across the US are associated with recent measures of greenspace, a health-promoting neighborhood resource.Methods: We accessed Security Maps through the University of Richmond's Mapping Inequality Project. Neighborhood investment grades included A ('best', green), B (blue), C (yellow), and D ('hazardous', red, i.e., redlined). We used 2010 satellite imagery to calculate the average normalized difference vegetation index (NDVI) for each HOLC neighborhood in four seasons. Our main outcomes were 2010 annual average NDVI and summer NDVI. We also assigned 1940 census measures to each HOLC neighborhood boundary using areal apportionment. To limit model extrapolation and reduce confounding, we used propensity score restriction and matching and compared HOLC grades as follows: grade B vs. A, C vs. B, and D vs. C.Results: Across the 71 cities from 24 states included in analyses, HOLC neighborhood annual average NDVI was 0.47 (SD=0.09), 0.042 (SD=0.09), 0.38 (SD=0.09), and 0.36 (SD=0.10) in grades A-D, respectively. In analyses adjusted for ecoregion, census region, and 1940s Census measures of socioeconomic status, HOLC grades B, C, and D were associated with 9.4% (95%CI:-10.8%,-8.0%), 5.7% (95%CI:-7.1,-4.3%), and 5.1% (95%CI:-7.9%,-2.2%) decreases in annual average NDVI compared to grade A, B, and C, respectively. Similar decrements were observed in summer.Discussion: Though redlining is now illegal, the institutional and structural racism outlined on Security Maps appears to persist. We observed that worse HOLC grade assignments in the 1930s were associated with reduced present day greenspace.
Background: Psychosocial stress during pregnancy has been associated with a number of adverse birth outcomes, including preterm birth. However, we have a limited understanding of the biologic pathways that might link stress to adverse outcomes. Corticotrophin Releasing Hormone (CRH) may represent one possible mechanism, as elevated levels of CRH have been associated with preterm birth. The purpose of this study was to examine the relationships between maternal self-reported psychosocial stress and CRH during pregnancy. We hypothesized that women who experienced psychosocial stress would have elevated levels of CRH. Methods: Women were enrolled in the Chemicals in Our Bodies-2 cohort (N=496), a demographically diverse cohort of pregnant women in San Francisco. CRH (pg/mL) was measured in plasma obtained at the 2nd trimester visit. Psychosocial stress was assessed via self-reported questionnaire at the 2nd trimester and included dichotomous measures of neighborhood quality, stressful life events, caregiving, discrimination, financial strain, job strain, food insecurity, unplanned pregnancy, perceived stress, depression, and perceived community status. Linear regression was used to examine associations between psychosocial stressors and CRH. Results: Experiencing >2 stressful life events was associated with elevated levels of CRH after adjusting for gestational age at visit, maternal race/ethnicity, maternal education, and marital status (β=0.16, 95% confidence interval [CI]=0.02, 0.31). Women who experienced financial strain (β=0.13, 95% CI=-0.10, 0.36), caregiving for an ill family member (β=0.13, 95% CI=-0.06, 0.32), or who had elevated levels of perceived stress (β=0.20, 95% CI=-0.20, 0.41) also had moderately increased CRH levels. No associations were observed between other psychosocial stressor and CRH levels. Conclusions: We observed a positive association between stressful life events and elevated CRH levels in our study population. Future research should explore the combined effects of psychosocial stress and chemicals on birth outcomes and examine CRH as a mediator of the psychosocial stress and birth outcomes relationships.
Coalitions between labor unions and environmental organizations often dissolve in class tensions that appear to force unions to choose between job security and occupational or environmental health. This article examines a successful blue—green coalition that worked to substitute cleaning products used in Boston public schools with safer alternatives. The coalition succeeded in part through the role of bridge builders, who unified a diverse group of stakeholders, including community and environmental health advocates, labor activists and labor unionists, and school administrators, to discuss their individual and common interests in eliminating toxic chemicals from the school environment. This article also explores the framing strategies used by the coalition partners, especially the logic of the precautionary principle in bridging the concerns of the environmental activists with the safety and health concerns of the union. This case raises questions of how coalition strategies and tactics may bear on the success of blue—green coalitions.
Although the benefits of community-based participatory research (CBPR) for community and university partners have been well documented, these have mostly focused on disseminating research findings. However, how CBPR can function as a useful community organizing tool remains understudied. We present the CBPR process of an environmental health survey conducted by a team of community organizers and academic researchers in Richmond, CA, to describe how survey research can be aligned with community organizing principles and methods. Through a case study of our Richmond health survey that documented and quantified neighborhood concerns and health problems, we describe and analyze three steps through which community organizing and CBPR align: community-driven hypothesis generation and testing, how community surveyors are trained and study participants are recruited, and how results are applied and disseminated to policy advocacy and community action. Our case study of surveying for environmental health justice demonstrates how CBPR can be used for community organizing by: (1) building community capacity in research methods, literacy, and numeracy through training community residents as surveyors and data analysis advisors; (2) supporting organizing goals with community-driven hypothesis generation and hypothesis testing; (3) using research findings to determine future issues to prioritize; and (4) developing strategic initiatives accordingly. We recommend ensuring adequate, funded time for CBPR partners to apply their research findings toward community organizing goals and strategic planning for future community organizing and research.
Author(s): Jerrett, Michael; Su, Jason G.; Reid, Colleen E.; Jesdale, Bill; Ortega Hinojosa, Alberto M.; Shonkoff, Seth B.; Seto, Edmund; Morello-Frosch, Rachel | Abstract: This study reviewed first available frameworks for climate change adaptation in the public health arena. The authors propose a conceptual framework with a three‐step procedure to assess climate change vulnerabilities.nn First, the study team identified and modeled heat stress, environmental, social, and health factors that are closely related to climate change and vulnerability. Second, the team quantified the cumulative impacts of four high‐priority factors at regional level using the cumulative environmental hazard inequality index. Third, the team applied the environmental justice screening tool to map the four high‐priority factors to identify areas with increased vulnerability to the health impacts of climate change. In addition to the heat stress estimated using air monitoring data, the team applied satellite data to create models of the land surface temperature at 30‐meter resolution and provided a measure of small‐scale variations in the urban heat island. Regionally, based on the cumulative environmental hazard inequality index, adaptive capacity had the greatest cumulative inequality in both the San Francisco Bay Area and Fresno regions, and those inequalities were largely contributed by inequalities from tree canopy shading. Social and health vulnerability had the second largest cumulative inequality in both regions. Lack of car ownership was the major impact in creating such inequalities. Air pollution inequality came third, based on the main pollutants in both regions, and this was mainly contributed by inequalities from diesel particulate matter exposure. By contrast, cumulative inequalities in heat stress were the least. However, heat stress inequality was still significant different from the equality line. Locally, based on the environmental justice screening tool, downtown urban areas for both Fresno County and the San Francisco Bay Area showed cumulatively higher vulnerability than more outlying areas, with the exception of the rural western portion of Fresno County. The cumulative inequalities calculated by the cumulative environmental hazard inequality index and the environmental justice screening method can be a useful tool for highlighting areas of greatest vulnerability for targeting adaptation planning.
Objectives. To evaluate universal access to clean drinking water by characterizing relationships between community sociodemographics and water contaminants in California domestic well areas (DWAs) and community water systems (CWSs). Methods. We integrated domestic well locations, CWS service boundaries, residential parcels, building footprints, and 2013-2017 American Community Survey data to estimate sociodemographic characteristics for DWAs and CWSs statewide. We derived mean drinking and groundwater contaminant concentrations of arsenic, nitrate, and hexavalent chromium (Cr[VI]) between 2011 and 2019 and used multivariate models to estimate relationships between sociodemographic variables and contaminant concentrations. Results. We estimated that more than 1.3 million Californians (3.4%) use domestic wells and more than 370 000 Californians rely on drinking water with average contaminant concentrations at or above regulatory standards for 1 or more of the contaminants considered. Higher proportions of people of color were associated with greater drinking water contamination. Conclusions. Poor water quality disproportionately impacts communities of color in California, with the highest estimated arsenic, nitrate, and Cr(VI) concentrations in areas of domestic well use. Domestic well communities must be included in efforts to achieve California's Human Right to Water. (Am J Public Health. 2022;112(1):88-97. https://doi.org/10.2105/AJPH.2021.306561).
Reporting Exposure Biomonitoring Results to Study Participants: Challenges, Benefits, and Scalable MethodsAbstract Number:2199 Julia Brody*, Sarah Dunagan, Phil Brown, Rachel Morello-Frosch, Kenneth Arnold, and Krzysztof Gajos Julia Brody* Silent Spring Institute, United States, E-mail Address: [email protected] , Sarah Dunagan Silent Spring Institute, United States, E-mail Address: [email protected] , Phil Brown Northeastern University, United States, E-mail Address: [email protected] , Rachel Morello-Frosch University of California Berkeley, United States, E-mail Address: [email protected] , Kenneth Arnold Harvard University, United States, E-mail Address: [email protected] , and Krzysztof Gajos Harvard University, United States, E-mail Address: [email protected] AbstractEpidemiologic studies and public health biomonitoring rely on chemical exposure measurements in blood, urine, and other tissues, and in personal environments, such as homes. For many chemicals, the health implications of individual results are uncertain, and the sources and strategies to reduce exposure may not be known. In the past, researchers typically reported personal results only when they exceeded a clinical health guideline, but greater openness in medical practice and increased focus on participants' autonomy have shifted ethical approaches. Eight major ethics statements, including the National Academy of Sciences report on biomonitoring, call for reporting personal exposures; and the California state biomonitoring law requires it. To develop best-practice guidelines and new tools to ethically and effectively report personal exposure results, we interviewed participants, IRB representatives, and researchers in 7 studies and systematically coded and analyzed transcripts. Using results of this investigation, we are developing a digital interface for report-back and have conducted usability testing. Our report-back methods draw on risk communication and data visualization literatures as well as our case studies.Results of the case studies show that participants want to receive their results, can generally understand uncertainties about links to health, and are motivated to reduce exposures.Results reports supported community empowerment and policy change. Both narrative results and graphs are helpful. Comparisons of individual results with others in the study, national norms, and health guidelines are helpful. Researchers found that reporting individual results can prompt scientific insights and strengthen connections with cohort members. To facilitate adoption of effective report-back practices, we developed a handbook, including guidelines and examples ( http://bit.ly/N1K7WV).
Background: Per- and polyfluoroalkyl substances (PFAS) are persistent and ubiquitous chemicals associated with risk of adverse birth outcomes. Results of previous studies have been inconsistent. Associations between PFAS and birth outcomes may be affected by psychosocial stress. Objectives: We estimated risk of adverse birth outcomes in relation to prenatal PFAS concentrations and evaluate whether maternal stress modifies those relationships. Methods: We included 3,339 participants from 11 prospective prenatal cohorts in the Environmental influences on the Child Health Outcomes (ECHO) program to estimate the associations of five PFAS and birth outcomes. We stratified by perceived stress scale scores to examine effect modification and used Bayesian Weighted Sums to estimate mixtures of PFAS. Results: We observed reduced birth size with increased concentrations of all PFAS. For a 1-unit higher log-normalized exposure to perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), perfluorononanoic acid (PFNA), and perfluorohexane sulfonic acid (PFHxS), we observed lower birthweight-for-gestational-age z-scores of β=−0.15 [95% confidence interval (CI): −0.27, −0.03], β=−0.14 (95% CI: −0.28, −0.002), β=−0.22 (95% CI: −0.23, −0.10), β=−0.06 (95% CI: −0.18, 0.06), and β=−0.25 (95% CI: −0.37, −0.14), respectively. We observed a lower odds ratio (OR) for large-for-gestational-age: ORPFNA=0.56 (95% CI: 0.38, 0.83), ORPFDA=0.52 (95% CI: 0.35, 0.77). For a 1-unit increase in log-normalized concentration of summed PFAS, we observed a lower birthweight-for-gestational-age z-score [−0.28; 95% highest posterior density (HPD): −0.44, −0.14] and decreased odds of large-for-gestational-age (OR=0.49; 95% HPD: 0.29, 0.82). Perfluorodecanoic acid (PFDA) explained the highest percentage (40%) of the summed effect in both models. Associations were not modified by maternal perceived stress. Discussion: Our large, multi-cohort study of PFAS and adverse birth outcomes found a negative association between prenatal PFAS and birthweight-for-gestational-age, and the associations were not different in groups with high vs. low perceived stress. This study can help inform policy to reduce exposures in the environment and humans. https://doi.org/10.1289/EHP10723
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