Cohort II – Research Projects

Nature & Health

Nature exposure, mental health, and equity: a multi-method approach
Greg Bratman University of Washington Seattle, WA
Early life adversity has been associated with a variety of negative mental health outcomes. The “second hit” hypothesis posits that the experience of more than one adverse event may be necessary for the onset of certain mental health disorders. For example, childhood adversity may make an individual more vulnerable to anxiety disorders, but it may be the case that this disease only manifests with the occurrence of exposure to another major life stressor in adulthood. Therefore, finding ways to mitigate the severity of acute, present-day stressors may be one means by which to reduce the association of early life adversity with poor mental health, through a decrease in the magnitude and frequency of the “second hit”. Studies have shown that interventions at the individual or neighborhood level may help to prevent the onset of these negative outcomes, possibly acting as a buffer against the occurrence or magnitude of the “second hit”. Stress reduction theory suggests that nature exposure could potentially operate as such a buffer. Our proposed study provides a crucial first step into the investigation of whether the increased sensitivity to stressors that can be resultant from childhood adversity is decreased when experienced in a natural environment.

Understanding the roles of objective versus perception of green space exposure on stress and mental health
Colleen Reid University of Colorado, Boulder Boulder, CO
Exposure to natural environments, often called “green space” or greenness, has been associated with numerous beneficial health outcomes, particularly in urban areas. Researchers have proposed several pathways by which green space may affect health, but most green space-health mediation studies find that at least some of the effect is through psychosocial pathways. Due to the consistent role of psychosocial pathways linking green space to better health outcomes, it is possible that the exposure to green space that truly matters is how an individual perceives their green space exposure rather than their objective exposure. While some researchers have investigated perception of green space, most have not focused on perceptions of green space exposure nor on whether perceived or objective green space exposure better predicts health. I propose a project to better understand the influence on health of objective versus perceived measures of green space exposure.

Environmental Justice

Environmental Justice Report Card for Colorado Cities
Katherine Dickinson Colorado School of Public Health Aurora, CO
Environmental justice (EJ) requires that all people live, work, and play in a healthy environment and have a voice in shaping what that environment looks like and includes (or excludes). Too often, environmental policies and actions reflect the interests of people with power, creating an inequitable distribution of environmental benefits and burdens. This proposal builds a research agenda aimed at motivating and empowering cities to improve EJ outcomes through a detailed and actionable diagnosis of current EJ patterns and drivers. Specifically, we will develop a comprehensive EJ Report Card reflecting EJ Plans, Actions, and Outcomes in Colorado’s largest cities. In this phase, the first aim is to generate an EJ Planning Score focused on cities’ planning documents, while the second aim is to analyze secondary data on EJ Outcomes and assess patterns of (mis)alignment between plans and outcomes. Results will shed light on potential avenues towards better integration of environmental and social justice actions at multiple scales, to be further tested in subsequent work.

Built Environment

A Multimethod Approach to Assess Sanitary Risks and Microbial Exposures Associated with Waterborne Illnesses and Infrastructure Management in Baltimore, Maryland
Marccus D. Hendricks University of Maryland
Past studies in public health have demonstrated an association between disease and poor sanitation, such as waterborne illnesses and exposure to sewage-laden waters. Modern stormwater and sanitary systems are some of history’s most lifesaving infrastructures. However, failure to maintain and rehabilitate these systems over the years, as well as changing environmental conditions, have created some pre-modern circumstances in cities across the world including Baltimore, Maryland. These risks may be particularly evident in marginalized urban neighborhoods that often have poorer stormwater and sanitation infrastructure and public works services. The Baltimore City sewer system has frequent overflows of its sanitary sewers due to an old and failing system and more frequent and intense rainfall events further overwhelming the system. Likewise, the city has a number of larger sanitation and waste management issues that can have consequences for ecological and public health. This study uses a multimethod approach to assess sanitary sewer overflow (SSO), among other sanitary risks and exposure to bacteria from contaminated surfaces within the built environment across Baltimore neighborhoods. The study will use SSO incident data, waste and trash data, land use data, and American Community Survey Data to map and statistically model incident risks, along with environmental sampling data and household surveys to understand exposure and impacts.

Gauging Effects of Neighborhood Trends and Sickness (GENTS) Study: Examining the Perception of Transit-Induced Gentrification in Prince George’s County
Jennifer Roberts University of Maryland School of Public Health
Impoverished neighborhoods and communities of color often bear the brunt of unintended transit-oriented development impacts. These impacts have been known to come in the form of transit-induced gentrification (TIG), a socioeconomic by-product of transit-oriented development defined as a phenomenon that occurs when the provision of transit service, particularly light rail transit (LRT), “upscales” nearby neighborhood(s) and displaces existing residents. Consequently, TIG or even the perception of TIG can impact health outcomes (e.g., psychological stress) and social determinants of health (SDOH) (e.g., crime). In Spring 2022, the Purple Line (PL), a 16.2-mile LRT line, is opening in Prince George’s County, Maryland, a suburb of Washington, D.C. comprised of over 80% African American and Hispanic residents. By taking advantage of this natural experiment, we are proposing the GENTS Study in order to evaluate perceived TIG related to the PL LRT and associated health outcome and SDOH changes among Prince George’s County adults in a prospective case-comparison design.

Environmental Health

Environmental exposures in the home environment and COPD exacerbation
Raphael Arku University of Massachusetts Amherst. Amherst, MA
COPD (Chronic obstructive pulmonary disease) is among the leading causes of death in the U.S. and costs billions in healthcare cost, with most of the costs due to hospital readmissions from exacerbation of existing COPD. Although environmental exposures are known to worsen COPD symptoms, limited studies exist on preventable environmental triggers. Compared to the vast data linking environmental tobacco smoke and ambient air pollution, little is known about other environmental exposures in the home environment and the risk of COPD exacerbation. Since COPD patients spend more time at home than their healthy counterparts, addressing triggers in the home environment will improve quality of life for patients and reduce healthcare cost, a win-win situation for both healthcare providers and patients. Our long-term goal is to identify, quantify, and ultimately intervene on factors in the home environment that may trigger exacerbation of existing COPD. Being preliminary in nature, this proposal aims to: 1) establish local partnerships with community-based organizations and health researchers; and 2) generate a pilot data for future grant submission to conduct intervention study in Western Massachusetts communities that are disproportionately affected by high rates of COPD, and by poor COPD control. Future intervention studies following this pilot would provide avenues for cost-effective and novel management of a disease with limited treatment options

Assessing Capacity for Deployments of Data and Technology in Public Engagements with Oil and Gas Pipeline Projects
Kirk Jalbert Arizona State University Tempe, AZ
Oil and gas pipelines are a new flashpoint in an environmental movement mobilizing against the fossil fuel industry. However, knowledge gaps and power asymmetries can prevent communities from making sense of these large-scale infrastructure projects. One response is the rise of advocacy coalitions developing resources and expertise to contest official impact assessments of pipelines, where obtaining, analyzing, and mobilizing around environmental and public health data is a cornerstone of their mobilizing strategies. The objective of this study is to understand the nature of these technical practices, how such practices inform legal and political campaigns, and the extent to which their enactment furthermore shapes coalition member’s understanding of environmental and public health issues pertaining to pipelines. This study is intellectually significant in its potential to identify how unique forms of public engagement in regulatory processes may reduce the environmental and public health risks of large-scale infrastructure projects, as well as create pathways for a more educated public.

Housing

Improving Assessment of Residential Exposures for Home Energy Efficiency and Health Studies
Ellison Carter Colorado State University Fort Collins, CO
Rigorous evaluation of well characterized housing interventions and the extent to which they achieve their intended benefits is crucial to shaping effective housing policy and investments in the United States. Although home energy efficiency upgrades are anticipated to positively influence health through multiple physiological and psychological pathways, only a very limited number of studies have been able to provide evidence to support this hypothesis. One major obstacle to this work has been a lack of clear indicators to track that bear robust relationships with residential exposures to physiological stressors of chemical and psychosocial origin. Another major obstacle is a lack of methods and tools that are low-burden to implement in a large number of homes for sufficient follow up periods. The proposed pilot study seeks to lower persistent barriers to measurement and modeling of home-based exposures and narrow key knowledge gaps on relationships between housing and health by leveraging an existing field-based housing study and developing foundational datasets needed for larger-scale housing studies through the blended application of measurement tools from the engineering, health, and social sciences.

Exploring Associations between Temperature Exposure, Housing Quality, and Health During the Winter in Energy Poor Households.
Tony Reames University of Michigan Ann Arbor, MI
Chronic energy poverty affects millions of US households. One in three US households report suffering some form of energy insecurity such as leaving their homes at an unhealthy temperature or being unable to afford to use or repair broken heating equipment. Environmental health hazards and indoor temperature extremes in cold, drafty homes may contribute to illness or death. The Federal Government spends billions of dollars each year to assist energy poor households with their utility bills, however, we know little about the housing conditions of Low-income Home Energy Assistance Program recipients and the potential dangerous environmental exposures. This study explores the lived experience of 50 energy poor households seeking to understand their indoor temperature exposure during winter, the energy efficiency of their homes, and physical and mental health outcome associated with energy poverty and temperature exposure in southeast Michigan. The study conducts objective measurements of temperature and energy efficiency and perceptions of physical and mental health.

Stress & Resilience

From the city to the cell: neighborhood determinants of adverse birth outcomes
Lara Cushing, San Francisco State University San Francisco, CA
Racial disparities in adverse birth outcomes such as preterm and low weight births are not fully explained by known maternal risk factors such as smoking or socioeconomic status, leading to calls for more research on the role of neighborhood-level factors, including environmental pollutants and psychosocial stressors which often co-occur in disadvantaged neighborhoods. A lack of cohort studies with robust measures of both environmental and social stressors has hindered efforts to understand their joint effects on perinatal health. This 2-year project will leverage data from an existing cohort of pregnant women from California to create a unique dataset of prenatal measures of 1) neighborhood-level built and social environment characteristics (greenspace, noise, and crime), 2) exposure to traffic, 3) individual-level perceptual and biomarker psychosocial stress measures, and 4) birth outcome data to evaluate the cumulative effects of traffic-related exposures and psychosocial stressors on the length of gestation and fetal growth. Outcomes will include at least three peer-reviewed publications contributing new knowledge regarding neighborhood determinants of adverse birth outcomes.

Collaborative Projects