The growth in this literature has been facilitated by the increasing availability of national-scale air pollution concentration estimates at high geographic resolution that can be coupled with ...national-scale census data on sociodemographic patterns. Census data also limit the ability to conduct truly intersectional analyses or to incorporate attributes, such as sexual orientation or gender identity, that are underrepresented in the environmental justice literature (Collins et al. 2017). There is strong evidence of disparities by income or race/ethnicity in housing attributes (Adamkiewicz et al. 2011; Swope and Hernández 2019), and a modeling study demonstrated that disparities in pollutant infiltration can exacerbate disparities in ambient air pollution concentrations (Rosofsky et al. 2019).
Inequities in Coronavirus Disease 2019 (COVID-19) vaccine and booster coverage may contribute to future disparities in morbidity and mortality within and between Massachusetts (MA) communities.
We ...conducted a population-based cross-sectional study of primary series vaccination and booster coverage 18 months into the general population vaccine rollout. We obtained public-use data on residents vaccinated and boosted by ZIP code (and by age group: 5 to 19, 20 to 39, 40 to 64, 65+) from MA Department of Public Health, as of October 10, 2022. We constructed population denominators for postal ZIP codes by aggregating census tract population estimates from the 2015-2019 American Community Survey. We excluded nonresidential ZIP codes and the smallest ZIP codes containing 1% of the state's population. We mapped variation in ZIP code-level primary series vaccine and booster coverage and used regression models to evaluate the association of these measures with ZIP code-level socioeconomic and demographic characteristics. Because age is strongly associated with COVID-19 severity and vaccine access/uptake, we assessed whether observed socioeconomic and racial/ethnic inequities persisted after adjusting for age composition and plotted age-specific vaccine and booster coverage by deciles of ZIP code characteristics. We analyzed data on 418 ZIP codes. We observed wide geographic variation in primary series vaccination and booster rates, with marked inequities by ZIP code-level education, median household income, essential worker share, and racial/ethnic composition. In age-stratified analyses, primary series vaccine coverage was very high among the elderly. However, we found large inequities in vaccination rates among younger adults and children, and very large inequities in booster rates for all age groups. In multivariable regression models, each 10 percentage point increase in "percent college educated" was associated with a 5.1 (95% confidence interval (CI) 3.9 to 6.3, p < 0.001) percentage point increase in primary series vaccine coverage and a 5.4 (95% CI 4.5 to 6.4, p < 0.001) percentage point increase in booster coverage. Although ZIP codes with higher "percent Black/Latino/Indigenous" and higher "percent essential workers" had lower vaccine coverage (-0.8, 95% CI -1.3 to -0.3, p < 0.01; -5.5, 95% CI -7.3 to -3.8, p < 0.001), these associations became strongly positive after adjusting for age and education (1.9, 95% CI 1.0 to 2.8, p < 0.001; 4.8, 95% CI 2.6 to 7.1, p < 0.001), consistent with high demand for vaccines among Black/Latino/Indigenous and essential worker populations within age and education groups. Strong positive associations between "median household income" and vaccination were attenuated after adjusting for age. Limitations of the study include imprecision of the estimated population denominators, lack of individual-level sociodemographic data, and potential for residential ZIP code misreporting in vaccination data.
Eighteen months into MA's general population vaccine rollout, there remained large inequities in COVID-19 primary series vaccine and booster coverage across MA ZIP codes, particularly among younger age groups. Disparities in vaccination coverage by racial/ethnic composition were statistically explained by differences in age and education levels, which may mediate the effects of structural racism on vaccine uptake. Efforts to increase booster coverage are needed to limit future socioeconomic and racial/ethnic disparities in COVID-19 morbidity and mortality.
New Frontiers of Environmental Justice Levy, Jonathan I; Hernández, Diana
American journal of public health,
01/2022, Volume:
112, Issue:
1
Journal Article
Peer reviewed
Open access
A decade ago, AJPH published a special supplement on environmental justice (https://ajph.aphapublications. org/toc/ajph/101/S1), with dozens of articles addressing themes such as residential ...proximity to hazardous facilities, expanded risk assessment frameworks that acknowledged cumulative exposures and differential vulnerability, and perspectives on community engagement, empowerment, and capacity building.Much has changed over the past decade. The escalating burden of climate change, growing recognition of the insidiousness of racism, and political extremism have had profound influences on public health and environmental justice. Given this, we put out a call for papers on "New Frontiers of Environmental Justice," soliciting articles that address novel topics, utilize innovative methods, and reflect on approaches for addressing environmental justice in the future. In the current and subsequent issues of AJPH, we present articles that grapple with some of these complex questions.This special section features complementary framing and research articles that beckon more inclusive understandings of oppression and action-oriented processes to pursue justice. For instance, Goldsmith and Bell (p. 79) explore how environmental exposures disproportionately affect the LGBTQ + (lesbian, gay, bisexual, transgender, queer or questioning, and others) population while Collins et al. (p. 54) and Gaard (p. 57) discuss the implications of an intersectional approach within environmental justice research and policy. Relatedly, McDonald etal. (p. 50) expose toxic disparities in beauty products marketed toward people of color, including LGBTQ+ members, and call for regulatory changes within the cosmetics industry.
There has been growing interest among exposure assessors, epidemiologists, and policymakers in the concept of "hot spots", or more broadly, the "spatial extent" of impacts from traffic-related air ...pollutants. This review attempts to quantitatively synthesize findings about the spatial extent under various circumstances.
We include both the peer-reviewed literature and government reports, and focus on four significant air pollutants: carbon monoxide, benzene, nitrogen oxides, and particulate matter (including both ultrafine particle counts and fine particle mass). From the identified studies, we extracted information about significant factors that would be hypothesized to influence the spatial extent within the study, such as the study type (e.g., monitoring, air dispersion modeling, GIS-based epidemiological studies), focus on concentrations or health risks, pollutant under study, background concentration, emission rate, and meteorological factors, as well as the study's implicit or explicit definition of spatial extent. We supplement this meta-analysis with results from some illustrative atmospheric dispersion modeling.
We found that pollutant characteristics and background concentrations best explained variability in previously published spatial extent estimates, with a modifying influence of local meteorology, once some extreme values based on health risk estimates were removed from the analysis. As hypothesized, inert pollutants with high background concentrations had the largest spatial extent (often demonstrating no significant gradient), and pollutants formed in near-source chemical reactions (e.g., nitrogen dioxide) had a larger spatial extent than pollutants depleted in near-source chemical reactions or removed through coagulation processes (e.g., nitrogen oxide and ultrafine particles). Our illustrative dispersion model illustrated the complex interplay of spatial extent definitions, emission rates, background concentrations, and meteorological conditions on spatial extent estimates even for non-reactive pollutants. Our findings indicate that, provided that a health risk threshold is not imposed, the spatial extent of impact for mobile sources reviewed in this study is on the order of 100-400 m for elemental carbon or particulate matter mass concentration (excluding background concentration), 200-500 m for nitrogen dioxide and 100-300 m for ultrafine particle counts.
First, to allow for meaningful comparisons across studies, it is important to state the definition of spatial extent explicitly, including the comparison method, threshold values, and whether background concentration is included. Second, the observation that the spatial extent is generally within a few hundred meters for highway or city roads demonstrates the need for high resolution modeling near the source. Finally, our findings emphasize that policymakers should be able to develop reasonable estimates of the "zone of influence" of mobile sources, provided that they can clarify the pollutant of concern, the general site characteristics, and the underlying definition of spatial extent that they wish to utilize.
Traffic congestion is a significant issue in urban areas in the United States and around the world. Previous analyses have estimated the economic costs of congestion, related to fuel and time wasted, ...but few have quantified the public health impacts or determined how these impacts compare in magnitude to the economic costs. Moreover, the relative magnitudes of economic and public health impacts of congestion would be expected to vary significantly across urban areas, as a function of road infrastructure, population density, and atmospheric conditions influencing pollutant formation, but this variability has not been explored.
In this study, we evaluate the public health impacts of ambient exposures to fine particulate matter (PM2.5) concentrations associated with a business-as-usual scenario of predicted traffic congestion. We evaluate 83 individual urban areas using traffic demand models to estimate the degree of congestion in each area from 2000 to 2030. We link traffic volume and speed data with the MOBILE6 model to characterize emissions of PM2.5 and particle precursors attributable to congestion, and we use a source-receptor matrix to evaluate the impact of these emissions on ambient PM2.5 concentrations. Marginal concentration changes are related to a concentration-response function for mortality, with a value of statistical life approach used to monetize the impacts.
We estimate that the monetized value of PM2.5-related mortality attributable to congestion in these 83 cities in 2000 was approximately $31 billion (2007 dollars), as compared with a value of time and fuel wasted of $60 billion. In future years, the economic impacts grow (to over $100 billion in 2030) while the public health impacts decrease to $13 billion in 2020 before increasing to $17 billion in 2030, given increasing population and congestion but lower emissions per vehicle. Across cities and years, the public health impacts range from more than an order of magnitude less to in excess of the economic impacts.
Our analyses indicate that the public health impacts of congestion may be significant enough in magnitude, at least in some urban areas, to be considered in future evaluations of the benefits of policies to mitigate congestion.
There has been increasing interest in accounting for inequality in health risks and benefits within regulatory impact analyses, both given more general interest in the distributions of benefits and ...growing concerns about inequity (defined as those inequalities deemed unjust or unfair) and environmental injustice (in this context, those health risk inequalities that are correlated with race/ethnicity and certain other sociodemographic factors). Although there has been growing literature on this topic, there has been limited progress in practice, and the lack of quantification limits consideration of inequality in the policy process. Controversy remains regarding the best approaches to formally incorporate inequality, when these approaches should be used, and even whether it makes sense to quantify inequality in this context. The objective of this article is to review the literature on approaches for incorporating estimates of, and concerns for, inequality into regulatory impact analyses, especially those where environmental justice considerations are relevant, and consider the interpretation of these approaches and the implications for decision making. Using the case example of the Transportation and Climate Initiative, a collaboration among Northeast and Mid‐Atlantic states to reduce carbon emissions from the transportation sector, multiple strategies are described that could be used to shed light on health risk inequality and inequity, consider them in pending policy decisions, and evaluate their implications for the policy or instrument choice. Given appropriate contextualization and acknowledgment of the multidimensionality of equity, quantitative inequality indicators can provide meaningful insight about both inequality and inequity in health risks.
Empathy is a core human social ability shaped by biological dispositions and caregiving experiences; yet the mechanisms sustaining maturation of the neural basis of empathy are unknown. Here, we ...followed eighty-four children, including 42 exposed to chronic war-related adversity, across the first decade of life, and assessed parenting, child temperament, and anxiety disorders as contributors to the neural development of empathy. At preadolescence, participants underwent magenetoencephalography while observing others' distress. Preadolescents show a widely-distributed response in structures implicating the overlap of affective (automatic) and cognitive (higher-order) empathy, which is predicted by mother-child synchrony across childhood. Only temperamentally reactive young children growing in chronic adversity, particularly those who later develop anxiety disorders, display additional engagement of neural nodes possibly reflecting hyper-mentalizing and ruminations over the distressing stimuli. These findings demonstrate how caregiving patterns fostering interpersonal resonance, reactive temperament, and chronic adversity combine across early development to shape the human empathic brain.
Most genetic variants that contribute to disease
are challenging to correct efficiently and without excess byproducts
. Here we describe prime editing, a versatile and precise genome editing method ...that directly writes new genetic information into a specified DNA site using a catalytically impaired Cas9 endonuclease fused to an engineered reverse transcriptase, programmed with a prime editing guide RNA (pegRNA) that both specifies the target site and encodes the desired edit. We performed more than 175 edits in human cells, including targeted insertions, deletions, and all 12 types of point mutation, without requiring double-strand breaks or donor DNA templates. We used prime editing in human cells to correct, efficiently and with few byproducts, the primary genetic causes of sickle cell disease (requiring a transversion in HBB) and Tay-Sachs disease (requiring a deletion in HEXA); to install a protective transversion in PRNP; and to insert various tags and epitopes precisely into target loci. Four human cell lines and primary post-mitotic mouse cortical neurons support prime editing with varying efficiencies. Prime editing shows higher or similar efficiency and fewer byproducts than homology-directed repair, has complementary strengths and weaknesses compared to base editing, and induces much lower off-target editing than Cas9 nuclease at known Cas9 off-target sites. Prime editing substantially expands the scope and capabilities of genome editing, and in principle could correct up to 89% of known genetic variants associated with human diseases.
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