Public Health Commons^™

The Influence Of Microorganisms On Human Health, Tiffany Bui

University Honors Theses

The purpose of this thesis is to explore the interplay between the environment, lifestyle, and composition of human microbiomes across different communities, with a specific focus on immune and digestive health. This literature review investigates three distinct types of communities: isolated/traditional, transitional, and urban/industrialized communities, each characterized by unique environments, societal structures, and interactions. These factors contribute to the distinct microbial populations and compositions within each community. It is impossible to avoid contact with microorganisms as they are present in every aspect of our lives, from the air we breathe, the water we drink, the soil we walk on, the …

Housing Quality In Philadelphia, Pa: An Urban Health Equity Indicators Approach, Jennifer Piacentini

OHSU-PSU School of Public Health Annual Conference

Philadelphia is also the poorest large city in the country, and many residents live in substandard housing. Poor housing quality is associated with poor physical health outcomes as well as mental health issues (Schilling et al., 2022). Many homes in Philadelphia are of poor quality partially due to the median house age being 93 years, and the fact that 75% of homes are more than 50 years old (Jay, 2017). It has also been found that Black households are disproportionately impacted by housing quality issues. The Habitat for Humanity Philadelphia’s Home Repair programs are invaluable, and work with homeowners to …

Understanding The Transport And Chemistry Of Indoor Air During Wildfire Smoke Events With Elliott Gall, Elliott T. Gall

PDXPLORES Podcast

Dr. Elliott Gall, Associate Professor in the Mechanical and Materials Engineering Department at Portland State University, studies indoor air quality in order to better understand how to improve building designs to promote health.

Wildfires are increasing in frequency and intensity. So, too, are wildfire smoke events. Smoke from wildfires pose serious health risks. That is why the Environmental Protection Agency recommends individuals remain indoors during smoke events.

In this episode, Professor Gall discusses the importance of understanding the chemistry of wildfire smoke indoors and how smoke is transported into buildings.

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Disaster And The Built Environment: How The Prephub Has The Potential To Impact Preparedness And Create Resilience During Natural Disasters., Sequoia Bellanca

University Honors Theses

Around the world, natural disasters pose a common threat to most communities. In 2015, Thecho, Nepal, suffered a magnitude 7.8 earthquake, killing 9,000 people and injuring nearly 22,000 (Reid, 2018). In the Pacific Northwest, the coast awaits a catastrophic earthquake, known as "The Really Big One" (Schulz, 2020), scientifically predicted to cause mass destruction. Although communities continue to experience and anticipate these disasters, the preparedness rate amongst individuals is shockingly low. Using this information, researchers developed a structure, rooted in interdisciplinary design, that will aid in the passive education of disaster preparedness amongst individuals and communities. Through unobtrusive qualitative research, …

How Urban Land Use Contributes To Inequitable Health Outcomes: An Interdisciplinary Review & Analysis, Bliss Storm Croton

University Honors Theses

Using existing literature as a basis for initial review, this paper seeks to explore the relationship between urban land use and socioeconomic status as both pertain to the prevalence of psychological health diagnoses among neighborhood residents. The purpose of this analysis is to investigate the combined literature from multiple areas of research in order to gain a more holistic, up-to-date scope of knowledge regarding how discriminatory neighborhood land use may result in poorer psychological health outcomes for urban populations. By utilizing an interdisciplinary approach, some of the locally relevant, long-term impacts of uneven development and environmental injustice are examined based …

Towards A People’S Social Epidemiology: Envisioning A More Inclusive And Equitable Future For Social Epi Research And Practice In The 21st Century, Ryan J. Petteway, Mahasin Mujahid, Rachel Morello-Frosch, Amani Allen

OHSU-PSU School of Public Health Faculty Publications and Presentations

Social epidemiology has made critical contributions to understanding population health. However, translation of social epidemiology science into action remains a challenge, raising concerns about the impacts of the field beyond academia. With so much focus on issues related to social position, discrimination, racism, power, and privilege, there has been surprisingly little deliberation about the extent and value of social inclusion and equity within the field itself. Indeed, the challenge of translation/action might be more readily met through re-envisioning the role of the people within the research/practice enterprise—reimagining what “social” could, or even should, mean for the future of the field. …

Air Pollution, Neighborhood Deprivation, And Autism Spectrum Disorder In The Study To Explore Early Development, Laura A. Mcguinn, Gayle C. Windham, Lynne C. Messer, Di Qian, Joel Schwartz, Lisa A. Croen, Eric J. Moody, Ana G. Rappold, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: To examine whether neighborhood deprivation modifies the association between early life air pollution exposure and autism spectrum disorder (ASD), we used resources from a multisite case–control study, the Study to Explore Early Development.

Methods: Cases were 674 children with confirmed ASD born in 2003–2006; controls were 855 randomly sampled children born during the same time period and residents of the same geographic areas as cases. Air pollution was assessed by roadway proximity and particulate matter

Results: Neighborhood deprivation modified (P_{for interaction} = 0.08) the association between PM2.5 exposure during the first year of life …

Preventing Infectious Hematopoietic Necrosis In Salmonid Fish Along The Columbia River Basin, Whitney L. Wright

OHSU-PSU School of Public Health Annual Conference

Infectious hematopoietic necrosis virus (IHNV) is a member of the Rhabdoviridae family and causes infectious hematopoietic necrosis (IHN) disease in many salmonid species during the juvenile or “fry” stage of life. IHNV is endemic to Western North America and occurs in the Columbia River Basin, where Steelhead and Chinook salmon are the most abundant IHNV-vulnerable species. IHNV can cause an epidemic in wild or farmed stocks, killing 90-95 percent of the fish it infects. Transmission is currently understood to occur by direct exposure through the gills, and the virus is shed typically from asymptomatic or clinically ill carrier adults at …

Social Norms, Misperceptions, And Mosquito Net Use: A Population‑Based, Cross‑Sectional Study In Rural Uganda, Jessica M. Perkins, Paul J. Krezanoski, Sae Takada, Bernard Kakuhikire, Vincent Batwala, Alexander Tsai, Nicholas A. Christakis, David R. Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Mosquito net use is an essential part of malaria prevention. Although previous research has shown that many people sleep under a mosquito net in endemic areas, it is unknown whether people underestimate how common it is to sleep under a net every night. Furthermore, perceived social norms about whether most others sleep under a mosquito net every night may contribute to personally sleeping under a net, given decades of research showing that people often mimic others’ behaviours.

Methods: Population-based data were collected from 1669 adults across eight villages in one rural parish in southwestern Uganda. Individuals’ perception about whether …

Geospatial-Temporal, Demographic, And Programmatic Adoption Characteristics Of A Large-Scale Water Filter And Improved Cookstove Intervention In Western Province, Rwanda, Katie Fankhauser, Corey L. Nagel, Christina Barstow, Miles Kirby, Evan A. Thomas

OHSU-PSU School of Public Health Faculty Publications and Presentations

Lowering the global disease burden of preventable disease has been addressed in part by the distribution of health products and behavior change campaigns in low-income countries. Realizing a health impact requires adoption by participants, and the topic of program uptake and sustained adoption has been studied extensively, although an ecological context is largely missing from existing work. This study characterizes self-reported and observed adoption of improved cookstoves and point-of-use water filters among nearly 80,000 households in Rwanda using demographic and programmatic variables from implementer surveys and integration of geospatial and temporal data based on differentiated recipient location. The odds of …

Analyzing Policies Through A Dohad Lens: What Can We Learn?, Julia M. Goodman, Janne Boone-Heinonen, Dawn M. Richardson, Sarah B. Andrea, Lynne C. Messer

OHSU-PSU School of Public Health Faculty Publications and Presentations

Social, health, and environmental policies are critical tools for providing the conditions needed for healthy populations. However, current policy analyses fall short of capturing their full potential impacts across the life course and from generation to generation. We argue that the field of Developmental Origins of Health and Disease (DOHaD), a conceptual and research framework positing that early life experiences significantly affect health trajectories across the lifespan and into future generations, provides an important lens through which to analyze social policies. To illustrate this point, we synthesized evidence related to policies from three domains—family leave, nutrition, and housing—to examine the …

Associations Between Environmental Quality And Infant Mortality In The United States, 2000–2005, Achal P. Patel, Jyotsna S. Jagai, Lynne C. Messer, Christine L. Gray, Kristen M. Rappazzo

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: The United States (U.S.) suffers from high infant mortality (IM) rates and there are significant racial/ethnic differences in these rates. Prior studies on the environment and infant mortality are generally limited to singular exposures. We utilize the Environmental Quality Index (EQI), a measure of cumulative environmental exposure (across air, water, land, sociodemographic, and land domains) for U.S. counties from 2000 to 2005, to investigate associations between ambient environment and IM across maternal race/ethnicity.

Methods: We linked 2000–2005 infant data from the U.S. Centers for Disease Control and Prevention to the EQI (n = 22,702,529; 144,741 deaths). We utilized multi-level …

Associations Between Environmental Quality And Adult Asthma Prevalence In Medical Claims Data, Christine L. Gray, Danelle T. Lobdell, Kristen M. Rappazzo, Yun Jian, Jyotsna S. Jagai, Lynne Messer Phd, Mph, Achal P. Patel, Stephanie A. Deflorio-Barker, Christopher Lyttle, Julian Solway, Andrey Rzhetsky

OHSU-PSU School of Public Health Faculty Publications and Presentations

As of 2014, approximately 7.4% of U.S. adults had current asthma. The etiology of asthma is complex, involving genetics, behavior, and environmental factors. To explore the association between cumulative environmental quality and asthma prevalence in U.S. adults, we linked the U.S. Environmental Protection Agency's Environmental Quality Index (EQI) to the MarketScan® Commercial Claims and Encounters Database. The EQI is a summary measure of five environmental domains (air, water, land, built, sociodemographic). We defined asthma as having at least 2 claims during the study period, 2003–2013. We used a Bayesian approach with non-informative priors, implementing mixed-effects regression modeling with a Poisson …

Food Insecurity, Social Networks And Symptoms Of Depression Among Men And Women In Rural Uganda: A Cross-Sectional, Population-Based Study, Jessica M. Perkins, Viola N. Nyakato, Bernard Kakuhikire, Alexander C. Tsai, Sv Subramanian, David Bangsberg, Nicholas A. Christakis

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective: To assess the association between food insecurity and depression symptom severity stratified by sex, and test for evidence of effect modification by social network characteristics.

Design: A population-based cross-sectional study. The nine-item Household Food Insecurity Access Scale captured food insecurity. Five name generator questions elicited network ties. A sixteen-item version of the Hopkins Symptom Checklist for Depression captured depression symptom severity. Linear regression was used to estimate the association between food insecurity and depression symptom severity while adjusting for potential confounders and to test for potential network moderators.

Setting: In-home survey interviews in south-western Uganda. Subjects: All adult residents …

Water Insecurity And Gendered Risk For Depression In Rural Uganda: A Hotspot Analysis, Christine E. Cooper-Vince, Hawk Arachy, Bernard Kakuhikire, Dagmar Vořechovská, Rumbidzai Mushavi, C. Baguma, Amy Q. Mcdonough, David R. Bangsberg, Alexander C. Tsai

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background:

Water insecurity is linked to depression in low- and middle-income countries (LMICs), though it remains unclear how geospatial clustering of water insecurity in rural regions is associated with risk for depression.

Methods: We conducted a population-based survey of a rural parish in southwestern Uganda (N = 1603) to evaluate the joint geospatial clustering of water insecurity and risk for depression among men and women living in rural Uganda.

Results:

Geospatial clustering of self-reported water insecurity and depressive symptoms was found to be present among both men and women. Depression hotspots were more often observed near water insecurity hotspots among …

County-Level Cumulative Environmental Quality Associated With Cancer Incidence, Jyotsna S. Jagai, Lynne C. Messer, Kristen M. Rappazzo, Christine L. Gray, Shannon C. Grabich, Danelle T. Lobdell

Institute for Sustainable Solutions Publications and Presentations

BACKGROUND: Individual environmental exposures are associated with cancer development; however, environmental exposures occur simultaneously. The Environmental Quality Index (EQI) is a county-level measure of cumulative environmental exposures that occur in 5 domains.

METHODS: The EQI was linked to county-level annual age-adjusted cancer incidence rates from the Surveillance, Epidemiology, and End Results (SEER) Program state cancer profiles. All-site cancer and the top 3 site-specific cancers for male and female subjects were considered. Incident rate differences (IRDs; annual rate difference per 100,000 persons) and 95% confidence intervals (CIs) were estimated using fixed-slope, random intercept multilevel linear regression models. Associations were assessed with …

Is Housing Making People Sick?: An Overview Of Seven Studies That Raise Questions To Consider As We Incorporate Health Into Planning And Build New Housing To Address Shortages And Energy Efficiency, Merilee D. Karr

Metroscape

The article discusses the unintended consequences of some of the strategies for housing energy efficiency: they can lead to indoor air pollution that is making people sick. As we pursue ways to reduce the cost of housing, we must pursue innovation in building materials and techniques that might reduce the negative health consequences of sealing our homes from the elements.

Micrometeorological Simulations To Predict The Impacts Of Heat Mitigation Strategies On Pedestrian Thermal Comfort In A Los Angeles Neighborhood, Mohammad Taleghani, David J. Sailor, George A. Ban-Weiss

Mechanical and Materials Engineering Faculty Publications and Presentations

The urban heat island impacts the thermal comfort of pedestrians in cities. In this paper, the effects of four heat mitigation strategies on micrometeorology and the thermal comfort of pedestrians were simulated for a neighborhood in eastern Los Angeles County. The strategies investigated include solar reflective ‘cool roofs’, vegetative ‘green roofs’, solar reflective ‘cool pavements’, and increased streetlevel trees. Aseries of micrometeorological simulations for an extreme heat day were carried out assuming widespread adoption of each mitigation strategy. Comparing each simulation to the control simulation assuming current land cover for the neighborhood showed that additional street-trees and cool pavements reduced …

Exposure To Elemental Carbon, Organic Carbon, Nitrate, And Sulfate Fractions Of Fine Particulate Matter And Risk Of Preterm Birth In New Jersey, Ohio, And Pennsylvania (2000–2005), Kristen M. Rappazzo, Julie L. Daniels, Lynne C. Messer, Charles Poole, Danelle T. Lobdell

Community Health Faculty Publications and Presentations

Background: Particulate matter ≤ 2.5 μm in aerodynamic diameter (PM2.5) has been consistently associated with preterm birth (PTB) to varying degrees, but roles of PM2.5 species have been less studied.

Objective: We estimated risk differences (RD) of PTB (reported per 106 pregnancies) associated with change in ambient concentrations of elemental carbon (EC), organic carbon (OC), nitrates (NO3), and sulfates (SO4).

Methods: From live birth certificates from three states, we constructed a cohort of singleton pregnancies at or beyond 20 weeks of gestation from 2000 through 2005 (n = 1,771,225; 8% PTB). We estimated mean species exposures for each week of …

The Associations Between Environmental Quality And Preterm Birth In The United States, 2000–2005: A Cross-Sectional Analysis, Kristen M. Rappazzo, Lynne C. Messer, Jyotsna S. Jagai, Christine L. Gray, Shannon C. Grabich, Danelle T. Lobdell

Community Health Faculty Publications and Presentations

Background: Many environmental factors have been independently associated with preterm birth (PTB). However, exposure is not isolated to a single environmental factor, but rather to many positive and negative factors that co-occur. The environmental quality index (EQI), a measure of cumulative environmental exposure across all US counties from 2000—2005, was used to investigate associations between ambient environment and PTB.

Methods: With 2000–2005 birth data from the National Center for Health Statistics for the United States (n = 24,483,348), we estimated the association between increasing quintiles of the EQI and county-level and individual-level PTB; we also considered environmental domain-specific (air, …

Participation, Information, Values, And Community Interests Within Health Impact Assessments, Nicole Iroz-Elardo

Dissertations and Theses

Health impact assessment (HIA) has emerged in the U.S. as one promising process to increase social and environmental justice through addressing health equity issues within planning. HIA practice is guided by values such as democracy and equity and grounded in broad social determinants of health. The most readily applied definition of democracy is problematic because it implies an element of direct, participatory engagement with the public. This is at odds with HIA practice that largely relies on stakeholder engagement strategies.

This dissertation critically examines the engagement strategies of three transportation planning HIA cases to more fully understand how the HIA …

Exposure To Fine Particulate Matter During Pregnancy And Risk Of Preterm Birth Among Women In New Jersey, Ohio, And Pennsylvania, 2000–2005, Kristen M. Rappazzo, Julie L. Daniels, Lynne C. Messer, Charles Poole, Danelle T. Lobdell

Community Health Faculty Publications and Presentations

Background: Particulate matter < 2.5 micrometers in aerodynamic diameter (PM2.5) has been variably associated with preterm birth (PTB).

Objective: We classified preterm births into four categories (20–27, 28–31, 32–34, and 35–36 weeks completed gestation) and estimated risk differences (RD) for each category in association with a 1-µg/m3 increase in PM2.5 exposure during each week of gestation.

Methods: We assembled a cohort of singleton pregnancies that completed at least 20 weeks of gestation during 2000-2005 using live birth certificate data from three states (Pennsylvania, Ohio, and New Jersey) (n = 1,940,213; 8% PTB). We estimated mean PM2.5 exposures for each week of gestation from monitor-corrected Community Multi-Scale Air Quality modeling data. RDs were …

Transport And Health: A Look At Three Latin American Cities, Janeth Mosquera Becerra, Rodrigo S. Reis, Lawrence D. Frank, Farah A. Ramirez-Marrero, Benjamin Welle, Eugenio Arriaga Cordero, Fabian Mendez Paz, Carlos J. Crespo, Veronica Dujon, Enrique Jacoby, Jennifer Dill, Lynn Weigand, Carlos M. Padin

Community Health Faculty Publications and Presentations

Transport is associated with environmental problems, economic losses, health and social inequalities. A number of European and US cities have implemented initiatives to promote multimodal modes of transport. In Latin America changes are occurring in public transport systems and a number of projects aimed at stimulating non-motorized modes of transport (walking and cycling) have already been implemented. Based on articles from peer-reviewed academic journals, this paper examines experiences in Bogota (Colombia), Curitiba (Brazil), and Santiago (Chile), and identifies how changes to the transport system contribute to encourage active transportation. Bus rapid transit, ciclovias, bike paths/lanes, and car use restriction are …

Associations Between The Quality Of The Residential Built Environment And Pregnancy Outcomes Among Women In North Carolina, Marie Lynn Miranda, Lynne C. Messer, Gretchen L. Kroeger

Community Health Faculty Publications and Presentations

Background: The built environment, a key component of environmental health, may be an important contributor to health disparities, particularly for reproductive health outcomes.Objective: In this study we investigated the relationship between seven indices of residential built environment quality and adverse reproductive outcomes for the City of Durham, North Carolina (USA).

Methods: We surveyed approximately 17,000 residential tax parcels in central Durham, assessing > 50 individual variables on each. These data, collected using direct observation, were combined with tax assessor, public safety, and U.S. Census data to construct seven indices representing impor­tant domains of the residential built environment: housing damage, property disorder, …

Conceptualizing Neighborhood Space: Consistency And Variation Of Associations For Neighborhood Factors And Pregnancy Health Across Multiple Neighborhood Units, Lynne C. Messer, Lisa C. Vinikoor-Imler, Barbara A. Laraia

Community Health Faculty Publications and Presentations

The purpose of this research was to assess the consistency of associations between neighborhood characteristics and pregnancy-related behaviors and outcomes across four nested neighborhood boundaries using race-stratified fixed-slope random-intercept multilevel logistic models. High incivilities was associated with increased smoking, inadequate weight gain and pregnancy-induced hypertension (PIH), while walkability was associated with decreased smoking and PIH for white women across all neighborhood definitions. For African American women, high incivilities was associated with increased smoking and inadequate gestational weight gain, while more walkable neighborhoods appeared protective against smoking and inadequate weight gain in all but the smallest neighborhoods. Associations with neighborhood attributes …

Thirdhand Tobacco Smoke: Emerging Evidence And Arguments For A Multidisciplinary Research Agenda, Georg E. Matt, Penelope J. Quintana, Hugo Destaillats, Lara A. Gundel, Mohamad Sleiman, Brett C. Singer, Peyton Jacob, Jonathan P. Winickoff, Prue Talbot, Suzaynn Schick, Yinsheng Wang, Bo Hang, Manuela Martins-Green, James F. Pankow, Melbourne F. Hovell, Neal L. Benowitz, Virender K. Rehan, Jonathan M. Samet

Civil and Environmental Engineering Faculty Publications and Presentations

There is broad consensus regarding the health impact of tobacco use and secondhand smoke exposure, yet considerable ambiguity exists about the nature and consequences of thirdhand smoke (THS). We introduce definitions of THS and THS exposure and review recent findings about constituents, indoor sorption-desorption dynamics, and transformations of THS; distribution and persistence of THS in residential settings; implications for pathways of exposure; potential clinical significance and health effects; and behavioral and policy issues that affect and are affected by THS. Physical and chemical transformations of tobacco smoke pollutants take place over time scales ranging from seconds to months and include …

An Examination Of The Relationship Between Population Density, Density Related Social Factors, And Physical Morbidities, Douglas King Huebner

Dissertations and Theses

The relationship between the number of persons per room in the home and the relative occurrence of stress-related morbidities of hospitalized patients is investigated. The social factors of age, social class, and level of social support also are examined as they relate to both density and morbidity type occurrence. The population under study is composed of all Kaiser-Permanente Medical Care Program members twenty years of age and older, discharged from Bess Kaiser Hospital during 1974, and whose diagnosed morbidity was included in specific morbidity categories. All data were obtained through the facilities of the Health Services Research Center, Kaiser Foundation …