Quantifying Multipollutant Health Impacts Using the Environmental Benefits Mapping and Analysis Program–Community Edition (BenMAP-CE): A Case Study in Atlanta, Georgia
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SUBMITTER: Coffman E
PROVIDER: S-EPMC10916644 | biostudies-literature | 2024 Mar
REPOSITORIES: biostudies-literature
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Project description:A number of software tools exist to estimate the health and economic impacts associated with air quality changes. Over the past 15 years, the U.S. Environmental Protection Agency and its partners invested substantial time and resources in developing the Environmental Benefits Mapping and Analysis Program - Community Edition (BenMAP-CE). BenMAP-CE is a publicly available, PC-based open source software program that can be configured to conduct health impact assessments to inform air quality policies anywhere in the world. The developers coded the platform in C# and made the source code available in GitHub, with the goal of building a collaborative relationship with programmers with expertise in other environmental modeling programs. The team recently improved the BenMAP-CE user experience and incorporated new features, while also building a cadre of analysts and BenMAP-CE training instructors in Latin America and Southeast Asia.
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Project description:Using survey data from participants in a public housing relocation program in Atlanta, Georgia, we examine post-relocation changes in healthcare access (having a usual source of care, having an unmet need) and utilization (receiving a medical exam). Although participants moved to safer, less impoverished neighborhoods, some participants experienced improvements in access and utilization whereas others experienced declines. The supply of healthcare providers in the new neighborhood and having health insurance were associated with improvements in access for this population. Future relocation efforts may seek to assist individuals with choosing a new neighborhood that has accessible healthcare resources for low-income populations.
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Project description:PurposeExtreme heat events will likely increase in frequency with climate change. Heat-related health effects are better documented among the elderly than among younger age groups. We assessed associations between warm-season ambient temperature and emergency department (ED) visits across ages in Atlanta during 1993-2012.MethodsWe examined daily counts of ED visits with primary diagnoses of heat illness, fluid/electrolyte imbalances, renal disease, cardiorespiratory diseases, and intestinal infections by age group (0-4, 5-18, 19-64, 65+years) in relation to daily maximum temperature (TMX) using Poisson time series models that included cubic terms for TMX at single-day lags of 0-6 days, controlling for maximum dew-point temperature, time trends, week day, holidays, and hospital participation periods. We estimated rate ratios (RRs) and 95% confidence intervals (CI) for TMX changes from 27°C to 32°C (25th to 75th percentile) and conducted extensive sensitivity analyses.ResultsWe observed associations between TMX and ED visits for all internal causes, heat illness, fluid/electrolyte imbalances, renal diseases, asthma/wheeze, diabetes, and intestinal infections. Age groups with the strongest observed associations were 65+years for all internal causes [lag 0 RR (CI)=1.022 (1.016-1.028)] and diabetes [lag 0 RR=1.050 (1.008-1.095)]; 19-64 years for fluid/electrolyte imbalances [lag 0 RR=1.170 (1.136-1.205)] and renal disease [lag 1 RR=1.082 (1.065-1.099)]; and 5-18 years for asthma/wheeze [lag 2 RR=1.059 (1.030-1.088)] and intestinal infections [lag 1 RR=1.120 (1.041-1.205)].ConclusionsVarying strengths of associations between TMX and ED visits by age suggest that optimal interventions and health-impact projections would account for varying heat health impacts across ages.
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Project description:This paper quantifies and aggregates the multiple lifetime benefits of an influential high-quality early childhood program with outcomes measured through midlife. Guided by economic theory, we supplement experimental data with non-experimental data to forecast the life-cycle benefits and costs of the program. Our point estimate of the internal rate of return is 13.7% with an associated benefit/cost ratio of 7.3. We account for model estimation and forecasting error and present estimates from extensive sensitivity analyses. This paper is a template for synthesizing experimental and non-experimental data using economic theory to estimate the long-run life-cycle benefits of social programs.
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Project description:The completion of a meaningful, hands-on international experience is a critical and required component of the Master of International Agricultural degree Program (MIAP) at Oklahoma State University. Understanding the impacts of the international experience/internship is important in designing a curriculum that well-prepares students for their personal, social, academic, and future professional life. Hence, the objective of this study is to evaluate the MIAP students' international experiences and to determine the factors that impact international experience outcomes. The benefits of international experiences are divided into five outcome areas that include personal, interpersonal, academic, employment, and civic impacts. The data is collected through an online survey of MIAP students. The variance based partial least squares structural equation modeling is used to develop three separate models with the goal of statistically measuring academic, employment, and civic impacts. The results of this study show that interns believe that international experience had enhanced each of their abilities. The findings of all three models show that the Humphreys travel grant has a statistically significant effect on interpersonal impacts. Additionally, the length of internship has a statistically significant association with personal impact in all three models, while it has a statistically positive indirect impact on academic, employment, and civic impact models, which indicates the full mediation effect. In addition, the number of hours worked weekly during the internship is found to have a significant positive relationship with employment impacts.
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Project description:The spread of antibiotic resistance genes (ARGs) in the aquatic environment is an emerging concern in the interest of protecting public health. Stemming the environmental dissemination of ARGs will require a better understanding of the sources and drivers of ARGs in the water environment. In this study, we used direct measurement of sewage-associated molecular markers, the class 1 integron gene, standard water quality parameters, and watershed characteristics to evaluate the sources and drivers of ARGs in an urban watershed impacted by a gradient of human activities. Quantitative polymerase chain reaction (qPCR) was used to quantify the abundance of the sewage-associated HF183, the E. coli fecal indicator, class 1 integron gene (int1), and the ARGs sulI, sulII, tetW, tetM, ampC, and blaSHV in stream water samples collected from the Proctor Creek watershed in Atlanta, Georgia. Our findings show that ARGs were widely distributed, with detection frequencies of 96% (sulI and sulII), 82% (tetW and tetM), and 49% (ampC and blaSHV). All the ARGs were positively and significantly correlated (r > 0.5) with the HF183 and E. coli markers. Non-linear machine learning models developed using generalized boosting show that more than 70% of the variation in ARG loads in the watershed could be explained by fecal source loading, with other factors such as class 1 integron, which is associated with acquired antibiotic resistance, and environmental factors contributing < 30% to ARG variation. These results suggest that input from fecal sources is a more critical driver of ARG dissemination than environmental stressors or horizontal gene transfer in aquatic environments highly impacted by anthropogenic pollution. Finally, our results provide local watershed managers and stakeholders with information to mitigate the burden of ARGs and fecal bacteria in urban streams.
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Project description:To determine the effectiveness of the Metropolitan Atlanta community adolescent rapid testing initiative (MACARTI) intervention relative to standard of care (SOC), in achieving early diagnosis, linkage, and retention among HIV-infected youth ages 18-24 years.MACARTI was a pilot single-center, prospective, nonrandomized study.MACARTI combined nontraditional venue HIV testing, motivational interviewing, and case management. We collected demographic, clinical variables and calculated linkage and appointment adherence rates. We obtained SOC data from an adolescent HIV clinic. Longitudinal data were analyzed using inverse propensity treatment-weighted linear growth models; medians, interquartile ranges (IQR), means, and 95% confidence intervals are provided.MACARTI screened 435 participants and identified 49 (11.3%) HIV infections. The SOC arm enrolled 49 new HIV-infected individuals. The 98 participants, (49 in each arm) were: 85% men; 91% Black; mean age?=?21 years (SD?:?1.8). Overall, 63% were linked within 3 months of diagnosis; linkage was higher for MACARTI compared to SOC (96 vs. 57%, P?<?0.001). Median linkage time for MACARTI participants compared to SOC was 0.39 (IQR?:?0.20-0.72) vs. 1.77 (IQR?:?1.12-12.65) months (P?<?0.001). MACARTI appointment adherence was higher than SOC (86.1 vs. 77.2%, P?=?0.018). In weight-adjusted models, mean CD4 T-cell counts increased and mean HIV-1 RNA levels decreased in both arms over 12 months, but the differences were more pronounced in the MACARTI arm.MACARTI successfully identified and linked HIV-infected youth in Atlanta, USA. MACARTI may serve as an effective linkage and care model for clinics serving HIV-infected youth.
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Project description:OBJECTIVES:Consistent condom use is essential to reducing heterosexual transmission of HIV. African Americans are disproportionately affected by HIV in the United States despite comprising a small percentage of the population. Our objectives were to evaluate factors associated with self-reported condom use in a cohort of predominantly African American women receiving HIV care in Atlanta, Georgia. METHODS:A cross-sectional study of reproductive knowledge, attitudes, and practices among adult, sexually-active, HIV-positive women attending the Grady Infectious Disease Clinic in Atlanta, Georgia was conducted from July, 2013 to November, 2014 to evaluate factors associated with self-reported condom use. Primary outcomes included: condom use at last vaginal intercourse and consistent condom use with vaginal intercourse over the last six months. Descriptive, bivariable, and multivariable logistic regression analyses were performed. RESULTS:Of 187 women enrolled, 170 reported having vaginal intercourse in the last six months. Seventy-four percent used condoms at last vaginal intercourse, whereas 53% reported consistent condom use over the last six months. In adjusted analyses, factors associated with condom use at last intercourse included decreased frequency of sex, no history of drug use, and confidence to discuss condom use with sexual partners (p<0.05). Factors associated with consistent condom use in the past six months were older age, being single/dating, and confidence to discuss condom use with sexual partners. History of drug use, having HIV-positive partners, and unprotected anal intercourse were associated with inconsistent use (p<0.05). CONCLUSIONS:Improved strategies are needed to educate women on the importance of safe sexual practices and condom negotiation. Healthcare providers should strive to have an open dialogue with patients about condom use, whether they engage in anal sex, and its risks.
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