Exploring Social, Economic and Environmental Determinants of Health
BTC PROJECT GALLERY
RESIDENTIAL CHARACTERISTICS
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Older Houses
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Adverse Social Factors
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Adverse Environmental Factors
Maria Soledad Matus, MD, Trinidad Sánchez, MD, Javiera Martínez-Gutiérrez, MD, MPH, Jaime Cerda, MD, Helia Molina, MD, MPH and Patricia M Valenzuela, MD, MS
Departments of Pediatrics, Public Health, and Family Medicine, Escuela de Medicina, Pontificia Universidad Católica de Chile,
Santiago, Chile
Indoor Environmental Risk Factors for Pediatric Respiratory Diseases in an Underserved Community in Santiago, Chile
In Chile, Acute Respiratory Infection (ARI) is the leading cause of pediatric hospital admissions and repeated health care visits. Household pollution is one of the main risk factors for ARI, particularly in poor areas and crowded homes. Research has been focused mainly on outdoor air pollution, while only a few studies have focused on indoor risk factors. Methods: We conducted a descriptive study to identify indoor risk factors for respiratory symptoms in a poor community in Santiago, Chile. The study included both quantitative and qualitative methodologies to characterize the presence of environmental risk factors, as well as to ascertain the knowledge and attitudes of the children‘s caregivers towards pollution and its effects on health. Results: The population studied included 50 families. Thirty-two percent of the children had histories of past illnesses, of these, 87.5% had asthma. Twenty-four percent of the families reported that at least one person smoked at home and 62% had animals living inside the house. Liquefied gas was identified as the most common primary source of heating energy. Participants reported the subjective presence of air pollution throughout their homes. Conclusions: Poor communities are exposed to numerous indoor environmental risk factors related to respiratory diseases. There is a lack of knowledge among the children's caregivers about the ill effects of pollution on children‘s health. Addressing this issue with the community is crucial for increasing the awareness of parents and thereby improving their children ́s health.
Sharisse Carter, BA,
and Martine Hackett, PhD, MPH
Department of Health Professions, Hofstra University, Hempstead,
New York, US
Hidden in Plain Sight: Community Knowledge, Attitudes and Action Plans to Remediate Briwfields in a Suburban Community
Brownfields in close proximity to residential housing and community buildings is a major concern for the community‘s children and how their mental and physical growth and development may be affected due to contaminates. Roosevelt, New York is a one-square-mile community located in
suburban Nassau County, New York, a county that encompasses some of the most affluent neighborhoods in the United States. However, Roosevelt is an underserved community with a population consisting predominantly of a Black and Hispanic population. Currently, Roosevelt is also the home of three properties that have been identified by the New York State Superfund Program as Brownfield sites in need of remediation due to chemical contamination. Since these sites were designated over five years ago, little has been done to investigate the contamination of local groundwater and soil or the health consequences to children in the community. The purpose of this chapter is to access the community‘s knowledge, behavior, and possible action plans based
on the collaborative discussion regarding Brownfield sites in the Roosevelt, New York community. With residents in close proximity to these hazardous properties, we wanted to investigate whether the community has any knowledge of the existence of a Brownfield or what a Brownfield actually is.
This research is designed to provide education about environmental hazards and to raise awareness of the community to advocate for environmental justice.
Frank Stillo, MSPH,
and Jacqueline MacDonald Gibson, PhD
Gillings School of Global Public Health, Department of Environmental Science and Engineering, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Racial Disparities in Access to Municipal Water Supplies in the American South: Impacts on Children's Health
More than five decades after the Civil Rights Act, systematic exclusion of African-American neighborhoods on the fringes of cities and towns from municipal services, including water service, continues. Throughout the American South, many such neighborhoods still rely on unregulated private wells for their drinking water despite their close proximity to municipal water lines. Little is known about water quality, including lead contamination, in these communities. Method: Kitchen tap water samples were collected and tested for lead in 29 households recruited from peri-urban African-American communities in Wake County, North Carolina, relying on private wells.
The Integrated Exposure Uptake Biokinetic (IEUBK) Model for Lead in Children was used to estimate blood lead levels in children resulting from lead in water. Results: In eight (28%) of the 29 households, tap water lead exceeded the 15-ppb health-based action level in at least one of two
samples. In seven homes, the average lead in two samples exceeded 15 ppb. The IEUBK model predicts that in 3 (10%) of the households, water lead could elevate children’s blood lead above the current 5 μg/dL reference level. Discussion: The lead prevalence in households in this study was comparable to that in the most-exposed neighborhoods of Flint, Michigan, during the recent lead-
in-water crisis. These results indicate the need for interventions to decrease lead exposure in peri-urban African American communities excluded from nearby municipal water services.
Breyanna M Mikel, BS, CHES
Department of Epidemiology, School of Public Health,
Georgia State University, Atlanta, Georgia, USA
Relationship Between Community Characteristics and School Engagement Among United States Children, National Survey of Children's Health, 2011-2012
Neighborhood conditions and the built environment are social determinants and influences for various health outcomes – including chronic diseases, such as heart disease and obesity. However, there is limited information about how the specific structural aspects of the built environment have an impact on educational outcomes among school-aged youth. This study aims to provide
insight into this area by examining the association between the presence of school amenities and school engagement among children 6-17 years of age in the United States. Data from the 2011-2012 National Survey of Children’s Health were analyzed. Bivariate and chi-square analyses were
conducted to analyze the effect that community amenities have on school engagement among school-aged youth across the United States. The results showed that children living in communities with at least one amenity in their neighborhood (i.e., recreation or community center, library,
sidewalks) were more likely to have higher levels of school engagement (OR = 1.37; 95% CI = 1.24-1.52). Findings revealed that males (2.31, 2.20-2.40), youth in middle and high school (1.77; 1.69-1.85), and non-Hispanic Black students (1.15; 1.07-1.23) have increased likelihoods of having lower school engagement. Further, the findings from this study indicate and highlight the significance of
identifying subgroups and demographics of youth with low school engagement living in communities lacking amenities to help build academic engagement.
Prathyusha Chenji
School of Law, Emory University,
Atlanta, Georgia, USA
Invisible Threats: Legal Methods to Address Asthma Triggers in Rental Homes
Federal housing laws dictate certain fundamental rights for tenants living in federally subsidized housing. Most state jurisdictions acknowledge a tacit “implied warranty of habitability” provision in residential lease agreements, which enforces the duty of landlords to fix defects on properties to ensure that rented living spaces are habitable for tenants and comply with local housing codes. Yet these legal baseline standards have not effectively secured healthy and safe living conditions for low-income, minority families. Environmental health hazards found in sub-standard housing, such as mold, lead, dust mites, and rodents serve as asthmatic triggers for children. When these health risks are eventually identified as triggers for their child’s ill health, parents may still forgo opportunities to
confront their landlord for fear of retribution in the form of increased rent, penalties, or eviction. The scope of this project is to develop a resource that would facilitate a “know your rights” education for vulnerable families, offering guidance on how to negotiate with landlords for better housing conditions. The primary goal is to create an educational legal worksheet for families renting sub-standard housing and to guide them in seeking resources and relief to improve their living environment. This project strives to empower families by developing a resource that
raises awareness, facilitates making housing rights more accessible, and highlights legal tools to help address asthmatic triggers within the home, thereby improving the health of vulnerable children.