Friday, January 27, 2023

OHSU researchers find immune response to COVID-19 strengthens over time

Study suggests people who have had COVID-19 benefit from vaccination, even if they’ve delayed it

Peer-Reviewed Publication

OREGON HEALTH & SCIENCE UNIVERSITY

Immunity from COVID-19 appears to gather strength with more time between vaccination and infection, a new laboratory study from researchers at Oregon Health & Science University suggests. The findings carry implications for vaccine recommendations as the pandemic transitions to an endemic state.

Researchers measured the antibody response in blood samples for a group of people who gained so-called “hybrid immunity” through two means: either vaccination followed by a breakthrough infection, or by getting vaccinated after contracting COVID-19. They measured the immune response in blood samples of 96 generally healthy OHSU employees and found that the immune response was uniformly stronger the longer the time period between vaccination and infection. The longest interval measured was 404 days.

Their findings suggest that vaccine boosters should be spaced no more frequently than a year apart, at least among healthy people.

“Longer intervals between natural infection and vaccination appear to strengthen immune response for otherwise healthy people,” said co-senior author Fikadu Tafesse, Ph.D., associate professor of molecular microbiology and immunology in the OHSU School of Medicine.

The study comes as an advisory panel for the Food and Drug Administration is due to meet Thursday, Jan. 26, to consider the nation’s COVID-19 vaccine strategy going forward.

Published in the Journal for Clinical Investigation Insight, the new research is the latest in a series of laboratory discoveries by OHSU scientists revealing a pattern of strengthened immune response through hybrid immunity. Their findings suggest that the magnitude, potency and breadth of hybrid immune response all increased with a longer time period between exposure to the virus — whether through vaccination or natural infection.

This likely is related to the body’s immune response maturing over time, said co-senior author Marcel Curlin, M.D., associate professor of medicine (infectious diseases) in the OHSU School of Medicine and medical director of OHSU Occupational Health.

“The immune system is learning,” Curlin said. “If you’re going to amplify a response, what this study tells us is that you might want to boost that response after a longer period of learning rather than early after exposure.”

Further, the research team found that it didn’t matter whether someone developed hybrid immunity by getting vaccinated after contracting COVID-19 or after a breakthrough infection following vaccination. Both groups developed an equally potent immune response.

The findings suggest long-lasting potency of so-called “memory cells,” the B cells that recognize an invading virus and generate protein antibodies to neutralize the virus and its many variants. The authors write that an ever-growing pool of people who have contracted the SARS-CoV-2 virus stand to benefit from vaccination, even if they’ve delayed it until now.

Relying on natural infection alone is a bad idea, “given the risks of severe illness, long-term complications, and death,” the authors write.

The researchers say the findings are the latest to point toward the virus evolving to an endemic state.

“Our results point to a future where inevitable vaccine breakthrough infections would be expected to help build a reservoir of population-level immunity that can help blunt future waves and reduce the opportunity for further viral evolution,” they write.

The researchers cautioned that the immune response was measured in relatively healthy people, and boosters may be advisable on a more frequent basis among vulnerable people who are older or are immunocompromised.

Funding for this study was supported by the M.J. Murdock Charitable Trust; the OHSU Foundation; the National Institutes of Health training grant T32HL083808; NIH grant R01AI145835; and a grant from the OHSU Innovates IDEA fund. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

COVID toll realized: CVD deaths take big jump, especially among certain populations

American Heart Association 2023 Statistical Update reports largest increase in the number of CVD deaths in the U.S. in years, highest among Asian, Black and Hispanic populations

Peer-Reviewed Publication

AMERICAN HEART ASSOCIATION

Report Highlights:

  • More people died from cardiovascular-related causes in 2020, the first year of the COVID-19 pandemic, than in any year since 2003, according to data reported in the American Heart Association’s 2023 Statistical Update.
  • The largest increases in deaths were seen among Asian, Black and Hispanic people
  • While the pandemic’s effects on death rates may be noticed for several years, lessons learned offer major opportunities to address structural and societal issues that drive health disparities, according to Association leaders.

DALLAS, Jan. 25, 2023 — The number of people dying from cardiovascular disease (CVD) in the U.S. escalated during the first year of the COVID-19 pandemic, from 874,613 CVD-related deaths recorded in 2019 to 928,741 in 2020. The rise in the number of CVD deaths in 2020 represents the largest single-year increase since 2015 and topped the previous high of 910,000 recorded in 2003, according to the latest available data from the Heart Disease and Stroke Statistics — 2023 Update of the American Heart Association, a global force for healthier lives for all, and published today in the Association’s flagship, peer-reviewed journal Circulation.

“While the total number of CVD-related deaths increased from 2019 to 2020, what may be even more telling is that our age-adjusted mortality rate increased for the first time in many years and by a fairly substantial 4.6%,” said the volunteer chair of the Statistical Update writing group Connie W. Tsao, M.D., M.P.H., FAHA, an assistant professor of medicine at Harvard Medical School and attending staff cardiologist at Beth Israel Deaconess Medical Center in Boston. “The age-adjusted mortality rate takes into consideration that the total population may have more older adults from one year to another, in which case you might expect higher rates of death among older people. So even though our total number of deaths have been slowly increasing over the past decade, we have seen a decline each year in our age-adjusted rates – until 2020. I think that is very indicative of what has been going on within our country – and the world – in light of people of all ages being impacted by the COVID-19 pandemic, especially before vaccines were available to slow the spread.”

The biggest increases in the overall number of CVD-related deaths were seen among Asian, Black and Hispanic people, populations most impacted in the early days of the pandemic, and brought to focus increasing structural and societal disparities.

“We know that COVID-19 took a tremendous toll, and preliminary data from the U.S. Centers for Disease Control and Prevention (CDC) have shown that there was a substantial increase in the loss of lives from all causes since the start of the pandemic. That this likely translated to an increase in overall cardiovascular deaths, while disheartening, is not surprising. In fact, the Association predicted this trend, which is now official,” said the American Heart Association’s volunteer president, Michelle A. Albert, M.D., M.P.H., FAHA, the Walter A. Haas-Lucie Stern Endowed Chair in Cardiology, a professor of medicine at the University of California at San Francisco (UCSF) and Admissions Dean for UCSF Medical School. “COVID-19 has both direct and indirect impacts on cardiovascular health. As we learned, the virus is associated with new clotting and inflammation. We also know that many people who had new or existing heart disease and stroke symptoms were reluctant to seek medical care, particularly in the early days of the pandemic. This resulted in people presenting with more advanced stages of cardiovascular conditions and needing more acute or urgent treatment for what may have been manageable chronic conditions. And, sadly, appears to have cost many their lives.”

According to Albert, who also is the director of the CeNter for the StUdy of AdveRsiTy and CardiovascUlaR DiseasE (NURTURE Center) at UCSF and a renowned leader in health equity and adversity research, the larger increases in the number of coronary heart disease deaths among adults of Asian, Black and Hispanic populations appear to correlate with the people most often infected with COVID-19.

“People from communities of color were among those more highly impacted, especially early on, often due to a disproportionate burden of cardiovascular risk factors such as hypertension and obesity. Additionally, there are socioeconomic considerations, as well as the ongoing impact of structural racism on multiple factors including limiting the ability to access quality health care,” Albert said. “The American Heart Association responded quickly at the beginning of the pandemic to address the impact of COVID-19 and  focus on equitable health for all. The Association launched the first-ever rapid response research grants calling on the research community to quickly turn around transformative science; established a COVID-19 CVD hospital registry through the Get With The Guidelines® quality initiative; and also made an unprecedented pledge to aggressively address social determinants while working to support and improve the equitable health of all communities. We are empowering real change that will save lives.”

Cardiovascular disease, overall, includes coronary heart disease, strokeheart failure and hypertension/high blood pressure. Coronary heart disease includes clogged arteries or atherosclerosis of the heart, which can cause a heart attack. Known generally as ‘heart disease’, coronary heart disease remains the #1 cause of death in the U.S. Stroke continues to rank fifth among all causes of death behind heart disease, cancer, COVID-19 and unintentional injuries/accidents. COVID-19 appeared in the list of leading causes of death for the first time in 2020, the most recent year for which final statistics are available from the U.S. Centers for Disease Control and Prevention (CDC).

Appropriately, this year’s statistical update includes many references to COVID-19 and its impact on cardiovascular disease. Data points and scientific research findings are inserted throughout most chapters of the document, including those related to the risk factors for heart disease and stroke such as obesity, diabetes and high blood pressure, all of which also put people at increased risk for COVID. Many of the studies noted identify specific gender, race and ethnicity disparities.

However, disparities don’t only occur among age, sex and racial/ethnic groups, according to a special commentary authored by members of the Statistical Update writing committee. While the Statistical Update has been including various social determinants of health data in its report, the commentary noted that data from other underrepresented populations, such as LGBTQ people and people living in rural vs. urban areas of the U.S. are still lacking. The commentary authors call out the lack of scientific research and cumulative data on the impacts of social identity and social determinants.

“We know that to address discrimination and disparities that impact health, we must better recognize and understand the unique experiences of individuals and populations. This year’s writing group made a concerted effort to gather information on specific social factors related to health risk and outcomes, including sexual orientation, gender identity, urbanization and socioeconomic position,” Tsao said. “However, the data are lacking because these communities are grossly underrepresented in clinical and epidemiological research. We are hopeful that this gap in literature will be filled in coming years as it will be critical to the American Heart Association’s goal to achieve cardiovascular health equity for all in the U.S. and globally.”

Global data

Cardiovascular disease continues to be the #1 killer globally, taking the lives of more than 19 million people around the world each year, including people of all ages, genders and nationalities. Yet, the risk factors that lead to heart disease and stroke continue to disproportionately impact certain populations in the U.S. as well as around the world.

Supplemental tables in this year’s statistical update look at the trend of overall CVD-related deaths globally and regionally, and also provide the number and proportion of deaths caused by various cardiovascular diagnoses. Additionally, the supplemental tables compared all-cause deaths and CVD-related deaths attributable to various risk factors, as well as age-standardized disability-adjusted life years, or DALYs, in various countries and regions. Of special note:

  • Globally, ischemic heart disease and stroke represent the top two causes of CVD-related deaths and account for 16.2% and 11.6% of all causes of deaths, respectively. These rates have increased across the world over the past decade in all but two regions – North America and Europe/Central Asia. Note that ischemic heart disease is the term used in global data sources and is also known as coronary heart disease.
  • In 1990, ischemic heart disease represented 28.2% of all deaths in North America, dropping to 18.7% of all deaths in 2019. Stroke dropped from 7.3% of all deaths in North America in 1990 to 6.4% of all deaths in 2019.
  • In the region of Europe and Central Asia, ischemic heart disease dropped from 27.2% of all causes of death in 1990 to 24.4% in 2019, while stroke represented 15.1% of all causes of death in 1990 and dropped to 12.5% in 2019.
  • The region of East Asia and Pacific is the only region where stroke represents the highest proportion of CVD-related deaths, with the proportion of deaths increasing from 14.8% in 1990 to 18.3% in 2019. During this same time period, the proportion of deaths caused by ischemic heart disease nearly doubled from 8.1% to 15.6%.
  • The region of Sub-Saharan Africa noted the lowest proportion of CVD-related deaths as a percentage of all causes of death. Stroke was the leading cause of CVD-related deaths in the region of Sub-Saharan Africa in 1990, representing 3.6% of all causes, followed by ischemic heart disease (3.1%). In 2019, ischemic heart disease and stroke were both at 5.4% of total deaths.

“As the U.S. prepares to celebrate the 60th annual Heart Month in February 2023, it’s critical that we recognize and redouble the life-saving progress we’ve made in nearly a century of researching, advocating and educating, while identifying and removing those barriers that still put certain people at disproportionately increased risk for cardiovascular disease,” Albert said. “Tracking such trends is one of the reasons the American Heart Association publishes this definitive statistical update annually, providing a comprehensive resource of the most current data, relevant scientific findings and assessment of the impact of cardiovascular disease nationally and globally.”

The annual update represents a compilation of the newest, most relevant statistics on heart disease, stroke and risk factors impacting cardiovascular health. It tracks trends related to ideal cardiovascular health, social determinants of health, global cardiovascular health, cardiovascular health genetics and health care costs. Tsao emphasized the importance of this surveillance as a critical resource for the lay public, policy makers, media professionals, clinicians, health care administrators, researchers, health advocates and others seeking the best available data on these factors and conditions.

This statistical update was prepared by a volunteer writing group on behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee.

Additional author names and authors’ disclosures are listed in the manuscript.

The Association receives funding primarily from individuals. Foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers, and the Association’s overall financial information are available here.

Additional Resources:

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public’s health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.orgFacebookTwitter or by calling 1-800-AHA-USA1.

###

COVID-19 conspiracy theories that spread fastest focused on evil, secrecy

Peer-Reviewed Publication

WASHINGTON STATE UNIVERSITY

PULLMAN, Wash. – In the early pandemic, conspiracy theories that were shared the most on Twitter highlighted malicious purposes and secretive actions of supposed bad actors behind the crisis, according to an analysis of nearly 400,000 posts. 

In the study, researchers identified commonalities in five of the most popular conspiracy theories: those related to Bill Gates, 5G Networks, vaccinations, QAnon and Agenda 21.

While each theory appears to have a different subject, the social media narratives often overlapped, said Porismita Borah, associate professor in Washington State University’s Murrow College of Communications.

“The conspiracy theories might be using different strategies, but the narratives are often connected,” said Borah, the corresponding author on the study published in the journal New Media and Society. “These theories have a lot in common in that they try to make the stories part of a bigger conspiracy so that if people believe in one conspiracy, then they tend to believe in the other.”

To conduct this study, the researchers used Brandwatch, a social media analytics and data library, to collect Twitter posts associated with the five conspiracy theories from the first six months of 2020.  This resulted in a total of 384,592 posts. The researchers then narrowed these down to the top ten most linked to URLs on a weekly basis. This allowed them to conduct a qualitative as well as quantitative study and examine more of the theories’ content beyond Twitter’s character-limited posts.

They found that the most common posts contained statements of belief that a theory was true, but those did not get as much engagement as posts about malicious purposes and secretive actions. The least likely posts to be shared were those that attempted to provide some sort of authentication or sources for these conspiracies.

COVID-19 proved fertile ground for conspiracies, but the authors were surprised by how quickly existing theories adapted the pandemic into their storylines. For instance, prior to the pandemic, there was a relatively minor conspiracy theory that 5G cellular technology could harm human health, but once COVID-19 hit, the theory expanded by falsely claiming that 5G towers were responsible for its spread worldwide.

This quick incorporation of COVID-19 into false narratives was particularly true of the “mega-theories” QAnon and Agenda21. QAnon contains the outlandish idea that the world is run by a cabal of cannibalistic pedophiles. Agenda 21 is a twisted take on a real United Nations climate change initiative, claiming it is instead a secret plan to depopulate the world.

“When you have overarching theories as big as QAnon and Agenda21, they can really fit anything into them,” said Ital Himelboim, study first author and an associate professor at University of Georgia. “Immediately, the pandemic fits into the existing conspiratorial way to explain the world -- and of course, there's a villain.”

During this time period, the most popular conspiracy theory villain was Microsoft-founder Bill Gates. Some posts falsely contended Gates was behind the creation of the disease, wanted to depopulate the world, or intended to benefit from a future vaccine – or some combination of the three. The Bill Gates as a villain appeared in the most posts the researchers examined, bleeding over into other theories.

“There are many ways you might to explain the focus on Bill Gates, but when something people can't control is happening, sometimes they need someone to blame, so they look for that villain in a conspiracy theory,” said Himelboim. “Somehow Bill Gates became that invented villain.”

The authors called for further research to understand the psychological attraction of theories that claim malevolent purposes and secretive actions. Also, regardless of similarities and overlaps, the various conspiracy theories had many differences which points to a need to find different strategies to counter each one.

“To combat these conspiracy theories, we have to keep in mind how the content is created, what people believe and what they share,” said Borah. “It's a very complex situation, but it is important to understand the content to be able to counter it. You need to know what you are fighting.”

Artificial photosynthesis uses sunlight to make biodegradable plastic

Synthesis of fumaric acid by a new method of artificial photosynthesis, using sunlight

Peer-Reviewed Publication

OSAKA METROPOLITAN UNIVERSITY

Fumaric acid synthesis from CO2 using solar energy 

IMAGE: USING SUNLIGHT TO POWER THE PHOTOREDOX SYSTEM PYRUVIC ACID AND CO¬2 ARE CONVERTED INTO FUMARIC ACID, BY MALATE DEHYDROGENASE AND FUMARASE. view more 

CREDIT: YUTAKA AMAO, OSAKA METROPOLITAN UNIVERSITY

Osaka, Japan – In recent years, environmental problems caused by global warming have become more apparent due to greenhouse gases such as CO2. In natural photosynthesis, CO2 is not reduced directly, but is bound to organic compounds which are converted to glucose or starch. Mimicking this, artificial photosynthesis could reduce CO2 by combining it into organic compounds to be used as raw materials, which can be converted into durable forms such as plastic.

A research team led by Professor Yutaka Amao from the Research Center for Artificial Photosynthesis and graduate student Mika Takeuchi, from the Osaka Metropolitan University Graduate School of Science, have succeeded in synthesizing fumaric acid from CO2, a raw material for plastics, powered—for the first time—by sunlight. Their findings were published in Sustainable Energy & Fuels.

Fumaric acid is typically synthesized from petroleum, to be used as a raw material for making biodegradable plastics such as polybutylene succinate, but this discovery shows that fumaric acid can be synthesized from CO2 and biomass-derived compounds using renewable solar energy.

“Toward the practical application of artificial photosynthesis, this research has succeeded in using visible light—renewable energy—as the power source,” explained Professor Amao. “In the future, we aim to collect gaseous CO2 and use it to synthesize fumaric acid directly through artificial photosynthesis.”

###

About OMU
Osaka Metropolitan University is a new public university established by a merger between Osaka City University and Osaka Prefecture University in April 2022. For more science news, see https://www.omu.ac.jp/en/, and follow @OsakaMetUniv_en, or search #OMUScience. 

UK substantially underestimates its methane emissions from oil and gas production – and many other countries probably do too

Peer-Reviewed Publication

PRINCETON SCHOOL OF PUBLIC AND INTERNATIONAL AFFAIRS

A newer, more accurate method for calculating methane emissions from offshore oil and gas production suggests that the United Kingdom severely underestimates its greenhouse gas emissions. Researchers conclude that as much as five times more methane is being leaked from oil and gas production than reported.

Methane is the second most important greenhouse gas after carbon dioxide, contributing about 1 degree Fahrenheit of present-day global warming relative to pre-industrial times. One major source of methane to the atmosphere is the extraction and transport of oil and gas. Countries are obligated to report their greenhouse gas emissions to international bodies such as the United Nations Framework Convention on Climate Change, but recent studies suggest that the current methods for calculating methane emissions rely on outdated and incomplete information and may not accurately represent actual emissions.

recent study from researchers at Princeton University and Colorado State University finds that the current method for estimating methane emissions from offshore oil and gas production in the United Kingdom systematically and severely underestimates emissions. The study finds that as much as five times more methane is being emitted from oil and gas production in the UK than what the government has reported. The researchers reached this conclusion by critically evaluating the UK’s current method of calculating methane emissions, suggesting alternative, peer-review based methods and generating revised emission estimates.

Since many other countries use similar methodologies to calculate methane emissions from oil and gas production, this severe underestimation is likely not confined to the UK alone.

“It is critical to know when, where and how much methane is emitted from each of its sources in order to prioritize emission reductions,” said Denise Mauzerall, a co-author and core faculty member of the Center for Policy Research on Energy and the Environment at Princeton University. “We hope our work will facilitate improved emission estimates and reductions not only from the UK but also from other countries producing methane from oil and gas extraction,” Mauzerall said.

Due to its climate and indirect health impacts (methane is a precursor for ozone which is an air pollutant that damages human health and crops), methane mitigation has recently become a global policy priority. Its relatively short lifetime of about 12 years and high heat trapping ability per molecule makes reducing methane emissions among the most effective ways to slow the rate of climate warming. As a result, in 2021 countries signed the Global Methane Pledge, committing to reduce methane emissions by at least 30% of 2020 levels by 2030. To track progress, countries compile national emissions data into inventories, such as the UK’s National Atmospheric Emissions Inventory (NAEI), which are then reported to international monitoring bodies.

This study focuses on methane leakage associated with discovery, extraction, and production of oil and natural gas. These methane emissions are typically calculated by multiplying the activity level of various processes – namely venting, flaring, processing and combustion activities on production platforms, offshore oil loading, and gas transfer by high-pressure pipelines – by “emission factors,” which are standard estimates of the methane emissions associated with each activity.

The researchers found that the emissions factors used in the UK’s reporting are either outdated, rely on unpublished or publicly unavailable industry research, or use generic values recommended by the IPCC. Furthermore, these emission factors are usually “static,” meaning that they are not sensitive to factors such as environmental conditions and management practices which could affect emissions from various processes. In addition, leakage can occur when the off-shore rigs are idle – an “activity” that does not currently have an associated emission factor.

Noting these shortcomings, the researchers updated and revised estimation techniques for each process, and, wherever possible, used dynamic rather than static emission factor formulations that account for varying environmental conditions. They also incorporated direct boat-based measurements of methane concentrations around offshore gas platforms in the North Sea collected in summer 2017, documented in a study also led by the authors. These updates resulted in a total methane emission estimate more than five times larger than reported emissions.

“Methane emissions from offshore facilities are currently largely uncertain, and because sources on facilities only emit for a short time period, using direct survey methods such as satellite or drones will probably only capture about 25% of the actual emissions,” said Stuart Riddick, lead author and research scientist at Colorado State University. “To generate representative baseline emissions across the sector, we need to work with industry to develop practical, effective, and collaborative measurement strategies,” Riddick said.

Previous research has shown that reducing leakage across the oil and natural gas supply chain can advance climate and air quality goals while also being economically profitable – a win-win opportunity for industry and climate.

This study adds to a growing base of literature finding that current measurements of anthropogenic methane emission inventories are too low. With the world’s first “global stocktake” on progress implementing the Paris Agreement concluding in 2023, the researchers argue that improved measurement of emissions deserves urgent attention.

“We are hopeful that our work will facilitate more accurate emission inventory development and lead to critically important reductions of methane leakage – a win for both industry and the environment,” Mauzerall said.

The article “Likely underestimation of reported methane emissions from United Kingdom upstream oil and gas activities,” was first published in Energy & Environmental Science on Dec 22, 2022. The authors are Stuart Riddick (Colorado State University) and Denise Mauzerall (Princeton University).

Homeless count in LA shows 18% rise in three high-priority neighborhoods

Number higher than once-a-year count done by region's homeless agency

Peer-Reviewed Publication

RAND CORPORATION

A year-long count of unhoused people in three hot-spot neighborhoods in Los Angeles found that their numbers rose by an average of 18% over the period, despite periodic encampment cleanups and other efforts to address the problem, according to a new RAND Corporation report.

The count of unsheltered people conducted from September 2021 to October 2022 in Hollywood, downtown’s Skid Row and Venice found the rise in the number of unhoused people varied by neighborhood. The increase was 14.5% in Hollywood, 13% on Skid Row and 32% in Venice.

Among more than 400 unhoused people surveyed by researchers during the first six months of the project, nearly 80% reported being continuously homeless for over a year, and 57% reported being continuously homeless for more than three years. About half of the sample reported a chronic health and/or mental health condition.

Among this group, 90% indicated interest in receiving housing and 29% reported being on a wait list for housing.

“This project provides new insights about the unhoused in these three high-priority neighborhoods and demonstrates that there is a lot to be learned by measuring progress on homelessness more regularly than the once-a-year count of unsheltered people conducted by the Los Angeles Homeless Services Authority,” said Jason Ward, the report’s lead author and an associate economist at RAND, a nonprofit research organization.

The RAND study, called the Los Angeles Longitudinal Enumeration and Demographic Survey (LA LEADS) Project, was conducted by the research organization’s professional survey staff. Counts of unhoused people during the study period were conducted roughly every two weeks in Skid Row and monthly in Hollywood and Venice.

The RAND project is the largest count of unhoused people in Los Angeles outside the annual point-in-time effort managed by the Los Angeles Homeless Services Authority. The county-wide count, conducted primarily by teams of trained volunteers over a few days every January, has been the primary data source for the number of unhoused people in the region for more than a decade.

While the RAND study is designed differently than the annual county-wide tally, RAND researchers conducted some analysis of small survey areas that had either exact or highly similar boundaries.

While some of the counts of unhoused people were similar, after totaling up the counts for all the comparison areas, the RAND counts were 15% larger over a similar period of time than the comparable counts compiled during the Los Angeles Homeless Services Authority’s last census in January 2022.

However, RAND researchers noted that the set of comparison areas were an arbitrary subset of the larger neighborhoods that were amenable to exact or very close geographic matching.

“Our findings suggest that in many cases, volunteer-led counts result in accurate estimates of the area’s unsheltered population,” Ward said. “But in other cases, we see evidence of fairly

large discrepancies that suggest possible room for improvements to the Los Angeles Homeless Services Authority process.”

Such improvement strategies could include providing better guidance to volunteers or using more-specialized teams of enumerators for dense or high-profile areas of the county.

During the year-long count, the RAND team found that the number of unhoused people in the study neighborhoods varied by as much as 24% from month to month. This was likely influenced, at least in part, by activities such as encampment cleanups and other events that prompted people to move. But the numbers rebounded soon after the declines were noted.

Among the unhoused people surveyed by the RAND project, between 83% and 87% said they would accept offers of placement into permanent supportive housing, a hotel or motel, or a private shelter setting. About 29% reported being on a wait list and 40% reported that they had been offered housing since experiencing homelessness in Los Angeles.

The most common reasons that respondents cited for not moving into housing were never being contacted for move-in (44%), lack of privacy (40%), housing safety (35%) and paperwork issues (29%).

About seven out of 10 unsheltered individuals surveyed were men, half were Black, and about six out of 10 were aged 45 years or older. The respondents from Skid Row were more likely to be older than the respondents in Hollywood and Venice, and also were more likely to be Black.

“Our study contributes to a relatively scant body of evidence about the sizes and characteristics of unsheltered people in these three Los Angeles neighborhoods, their experiences and their preferences for housing,” Ward said. “Improving the accuracy and informativeness of data measuring the size and locations of the region’s unhoused residents is critical to forming effective policies and measuring their success.”

The report, “Recent Trends Among the Unsheltered in Three Los Angeles Neighborhoods: An Annual Report from the Los Angeles Longitudinal Enumeration and Demographic Survey

(LA LEADS) Project,” is available at www.rand.org.

Support for the project was provided by the Lowy Family Group through its funding of the RAND Center for Housing and Homelessness in Los Angeles. Other authors of the report are Rick Garvey and Sarah B. Hunter.

The RAND Social and Economic Well-Being division seeks to actively improve the health, and social and economic well-being of populations and communities throughout the world.

Ignoring Native American data perpetuates misleading white ‘deaths of despair’ narrative, study finds

Native Americans have the highest rates of mortality from deaths of despair, but this data is largely missing from mainstream discussion

Peer-Reviewed Publication

UNIVERSITY OF CALIFORNIA - LOS ANGELES HEALTH SCIENCES

An increase in mortality among middle-aged Americans – largely attributed to “deaths of despair” from suicide, drug overdoses, and alcoholic liver disease – has been frequently portrayed as a phenomenon affecting white communities. Under a common narrative, these deaths have often been explained by the perceived loss of status felt by many less-educated white Americans as their economic opportunities declined and their social standing diminished.

However, a new analysis in The Lancet led by UCLA researchers shows that Native American people in this midlife age group (45-54 years) actually have had the biggest increases in mortality in recent decades, and are now dying at twice the rate of white people of the same age. Further, Native American communities collectively have the highest rates of mortality from each of the causes of “deaths of despair.”

This tragic toll has been overlooked in mainstream discussion about deaths of despair because health policy data on Native American communities are often ignored or incomplete, the researchers write in The Lancet. That includes an influential 2015 study that coined the term and sparked a national conversation about “deaths of despair,” which did not consider mortality data among Native Americans. Many of the follow-up studies on the topic also did not include data on Native Americans.

“Many people reading about the ‘deaths of despair’ in recent years could easily have thought that white individuals were the most affected by premature mortality and decreases in life expectancy, because the theory focused on the ‘uniqueness’ of this phenomenon for white communities. But a careful read of the data shows that Native individuals have had the biggest increases in premature mortality, and overall Black and Native communities have been the most affected in all years of available data. It’s important that these inequalities be shown and discussed, rather than hidden, so that we can mobilize resources and work to improve them,” said corresponding author Joseph Friedman, PhD, MPH, of the David Geffen School of Medicine at UCLA.

Between 1999 and 2013, the final year of data used in the 2015 study, publicly available mortality records from the Centers for Disease Control and Prevention show that midlife mortality among white Americans increased 8.9%. During this period, mortality among midlife Native Americans increased 29.3%, or over three times greater than the observed increase among white Americans.

The researchers also drilled down further to examine deaths of despair-related causes among this midlife group. In 2013, Native Americans had a 75.9% higher midlife death rate than white Americans. In 2020, the first year of the COVID-19 pandemic, that gap expanded to 102.6%, meaning that Native American midlife mortality from deaths of despair-related causes was over twice the rate for white Americans. The gap may be even much wider due to known difficulties with collecting data on Native American deaths, the researchers write. 

The popular narrative that suggested white working-class people are at greater risk of dying from deaths of despair “was only made possible by the erasure of data describing Native American mortality,” the researchers write. The COVID-19 pandemic, which has devastated Native American communities, underscored the dangerous consequences of policymakers having imprecise or incomplete data about these communities.

To ensure these communities aren’t overlooked, the researchers propose that data collection at the national and state levels should specifically enumerate Native American people, rather than exclude them or label them as “other.” The researchers also say it is essential to include Native American leadership on efforts to collect, maintain, and share data, to help build community trust and ensure these efforts do not produce potentially incorrect or stigmatizing data.

Additional authors include Helena Hansen, MD, PhD, interim chair of Psychiatry and Biobehavioral Sciences at UCLA’s medical school and interim director of the Semel Institute for Neuroscience and Human Behavior; and Joseph P. Gone, PhD, professor in the Department of Global Health and Social Medicine at Harvard Medical School.

Rapid plant evolution may make coastal regions more susceptible to flooding and sea level rise, study shows

Peer-Reviewed Publication

UNIVERSITY OF NOTRE DAME

Evolution has occurred more rapidly than previously thought in the Chesapeake Bay wetlands, which may decrease the chance that coastal marshes can withstand future sea level rise, researchers at the University of Notre Dame and collaborators demonstrated in a recent publication in Science.

Jason McLachlan, an associate professor in the Department of Biological Sciences, evaluated the role evolution plays in ecosystems in the Chesapeake Bay by studying a type of grass-like plant, Schoenoplectus americanus, also called chairmaker’s bulrush. The research team used a combination of historical seeds found in core sediment samples, modern plants, and computational models to demonstrate that “resurrected” plants were allocating more resources in their roots below ground, allowing them to store carbon more quickly than modern plants.

“We think this surprising reduction in below-ground growth might be a response to increased pollution in Chesapeake Bay,” McLachlan said. “Decades of pollution have resulted in higher levels of nitrogen and phosphorus in the waters, and since these are plant nutrients, evolution might now favor plants that ‘invest’ less in expensive roots.”

The seeds from the historical plants had remained underground on the property of the Smithsonian Environmental Research Center on the bay, dormant since the mid-1900s. McLachlan and other researchers collected them and allowed them to germinate and grow. Known as resurrection ecology, this type of research provides direct evidence that can support assumptions about evolutionary change.

Computational models had previously established the threat of sea level rise to coastal wetlands, and have incorporated scientists’ understanding of how flooding affects plant growth and how plant growth affects stability. While modern plants and samples from the mid-1900s grew similarly above ground, the modern plants invested less resources into rooting deeper below ground. This created less biomass below ground and could reduce the capacity of wetlands to withstand flooding.

McLachlan and collaborators showed, through computational models, that the modern plants store carbon in soils 15 percent slower than the plants did in the mid-1900s.

McLachlan was astounded by the speed with which evolutionary change occurred in Schoenoplectus americanus.

“The research shows the role evolution plays as ecosystems are increasingly stressed by the impacts of human society,” he said. 

First author Megan Vahsen, a doctoral student at Notre Dame, had discovered the importance of below-ground plant traits as early as 2017 as a first-year graduate student at Notre Dame. Though the researchers cannot specifically say that plants are investing relatively more of their energy above ground and less below ground because of pollution, she believes the combination of techniques used in the current research provides novel predictions about the impact of evolution on ecosystems. She expects the study will motivate researchers to study the causes that drive evolutionary change.

“For reasons of inconvenience, science has often ignored what happens below ground,” she said, noting that she and undergraduates at Notre Dame spent about 500 hours washing and sorting plant roots. “But we have learned so much in this study; there are so many secrets happening below ground.”

McLachlan said the research further demonstrates the role evolution plays as ecosystems are increasingly stressed by the impacts of human society. 

“Evolutionary change over almost a century played a destabilizing role for coastal ecosystems. Other species in other ecosystems might have responded differently to human environmental impact, perhaps providing more resilience to ecosystems, or perhaps having no impact at all,” he said. “Now that we've shown that evolutionary change can be fast enough and large enough to affect ecosystem resilience, we hope other researchers will consider this component of biological response to global environmental change.”

Other collaborators in this research include Michael Blum and Scott Emrich of the University of Tennessee, Jim Holmquist and Patrick Megonigal of the Smithsonian Environmental Research Center, Brady Stiller of the University of Notre Dame and Kathe Todd-Brown of the University of Florida, Gainesville. The study was funded by the National Science Foundation and the United States Coastal Research Program.