THIRD WORLD USA

Yelp star ratings on health care facilities may reveal county-level death rate disparities

Peer-Reviewed Publication

UNIVERSITY OF PENNSYLVANIA SCHOOL OF MEDICINE

A one-star disparity on health care facility Yelp reviews could indicate a 60-death-peryear difference between some United States counties where those facilities are located, according to researchers at the Penn Medicine Center for Digital Health. Their study shows that counties holding health care facilities with the greatest share of 1-star Yelp reviews had the highest death rates, and a difference of just one point – roughly one star – between counties’ average scores could indicate a mortality rate that is better or worse by dozens of lives. This work was published today in the JAMA Network Open.

“Many of the facilities that provide essential care may not otherwise have standardized measures or approaches to collect data about patients’ experience of care. This is a missed opportunity,” said the study’s senior author, Raina Merchant, MD, the director of the Center for Digital Health and a professor of Emergency Medicine in the Perelman School of Medicine at the University of Pennsylvania. “Much of the focus in health care is on quality and outcomes – patient experience is also critically important and should be factored into how to improve care across the board. This appears to be one novel data source for doing that.”

More than 95,000 different facilities that provided some form of care recognized by the Affordable Care Act were included in the study led by Merchant and its lead author, Daniel Stokes, MD, a researcher with the Center for Digital Health and an internal medicine resident at UCLA Health. Each entity included in the study had at least three reviews between 2015 and 2019 on Yelp, a review website which uses a five-star rating system. Each health care facility’s ratings were also coded to the specific United States county it was located in, resulting in more than 1,300 counties (roughly a third of the country) being represented in the work.

Overall, health care facilities achieved an average 2.9 score (out of 5 stars), but reviews were weighted very heavily to either side of the scale: five-star reviews account for 52.9 percent of all reviews, while one-stars made up 33.3 percent.

When the researchers looked at the county-level data of reviews, though, they found that five-star reviews within the group with the lowest death rates made up 55.6 percent of their total, while one-star reviews were at just 29.1 percent. In the group of counties with the highest death rates, five-star reviews made up only 42.9 percent of the total, compared to 38.8 percent one-stars.

The researchers then found that if a county’s health facilities’ reviews were a star higher than their average – one point on the scale – models indicated that it translated to 18 fewer deaths per 100,000 residents. But when the study was refined to include counties with three or more health care facilities, the impact was greater, indicating a reduction in roughly 53 deaths per 100,000. Refined even further to counties with five health care facilities or more, the impact grew to approximately 60 preventable deaths.

“Patient experiences of care are often ignored when it comes to measuring healthcare quality, but how patients feel about the care they are receiving has an impact on how they engage with health care and, in turn, their own health and well-being,” said Stokes. “Improving patient satisfaction is not a secondary outcome, but a primary one. If patients don’t feel as though they are being heard or respected in the care they receive, it doesn’t matter how closely we adhere to evidence-based treatments because the mutual trust and partnership on which quality healthcare depends will continue to erode.”

The fact that the Yelp reviews provide narratives is especially useful. Using natural language processing algorithms, the researchers were able to gain special, categorical insights. They showed that the types of words most associated with one-star reviews related to time (such as “hours” and “waiting”), payment (“money” and “pay”) and interpersonal interactions (“rude” and “told”).

Common language in five-star reviews changed depending on location. In high-mortality counties, “friendly,” “nice,” and “staff” were all typical, while low-mortality counties were associated with “Dr.,” “helpful,” “question,” and, surprisingly, “pain.”

“‘Pain’ could reflect that pain management is an important patient experience metric and that may be better addressed in some facilities than others,” said Merchant, who added that it might be a good topic for further study.

The researchers believe their work adds evidence that unfiltered online repositories like review sites and social media contain valuable patient feedback and are an untapped resource for informing health care providers about what they do.

“With the ubiquity of social media, it is now commonplace for individuals to use the internet to share with others about their experiences – we rely on this for restaurants, clothing purchases, everything,” said Merchant. “These mediums are now similarly being used for sharing experiences about health care. Ideally this democratization of information can help us to improve health care for all and reduce our blindspots.”

Moving forward, Merchant, Stokes, and their team hope to look into how to codify this online information to make it easier to use as a tool for health care entities looking to improve care.

“Online reviews of healthcare facilities provide direct insight into patients' experiences of care and can be a powerful force in shaping the care we provide to be more patient-centered,” Stokes said. “This has important implications for both individual and community health.”

This study was supported, in part, by the National Institutes of Health’s National Institute on Drug Abuse (NIH NIDA 5R21DA050761-02).

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JOURNAL

JAMA Network Open

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Association between crowd-sourced healthcare ratings and mortality in United States counties

ARTICLE PUBLICATION DATE

19-Oct-2021

THIRD WORLD USA

Adding SNAP benefits for older adults in Medicare, Medicaid can reduce hospital visits, healthcare costs

A study published in Annals of Internal Medicine shows that participation in the Supplemental Nutrition Assistance Program (SNAP) by older adults dually enrolled in Medicare and Medicaid is associated with fewer hospital visits and lower healthcare costs.

Peer-Reviewed Publication

UNIVERSITY OF NORTH CAROLINA HEALTH CARE

 

IMAGE: SETH BERKOWITZ, MD, MPH view more 

CREDIT: UNC SCHOOL OF MEDICINE

CHAPEL HILL, NC – Food insecurity among older adults takes a toll on the nutrition and health of those affected. According to data from 2019, 5.2 million people age 60 and above in the U.S. were food insecure – equaling 7.1% of that population – and that number has likely grown during the COVID-19 pandemic.

Older adults facing food insecurity are more likely to have chronic health conditions like depression, asthma, diabetes, congestive heart failure and heart attack. Only 48% of older adults who qualify for the Supplemental Nutrition Assistance Program (SNAP), which provides benefits to supplement budgets to purchase healthy and nutritious foods, are enrolled in the program.

A study published in the Annals of Internal Medicine shows the importance of older adults taking advantage of this nutrition benefit, as it is associated with fewer hospital visits and lower healthcare costs.

“Providing income support for older adults is incredibly important for health,” said study lead author Seth A. Berkowitz, MD, MPH, assistant professor of general medicine and epidemiology at the UNC School of Medicine. “Along with affecting the foods they have access to, food insecurity can force people to choose between food and medications or other basic needs, and worsen mental health. All of this takes a toll on what is already a group at high risk for poor health outcomes.”

The study used a unique circumstance to better evaluate the association between SNAP participation and healthcare use and cost. In 2017, Benefits Data Trust – a national nonprofit dedicated to helping people access essential public benefits and services – was contracted by the North Carolina Department of Health and Human Services to help people age 65 and over who were dually eligible for Medicare and Medicaid enroll in SNAP. BDT provided outreach to these individuals by mail, a telephone-based screening, and – if the person chose to enroll in SNAP – the nonprofit would aid in filing an application. This circumstance allowed for previously unavailable linkages among data sets related to SNAP outreach, SNAP participation, and health care use and cost.

Researchers used data from BDT’s outreach to more than 115,000 people age 65 and older in North Carolina between 2016 and 2020 who were dually eligible for Medicare and Medicaid, and were eligible for SNAP but not enrolled. Almost 5,100 of those who received outreach about SNAP benefits enrolled in the program. SNAP enrollment was associated with a decrease in inpatient hospitalizations, emergency department visits, long-term care admissions, as well as fewer dollars in Medicaid payments per person per year.

“Billions of dollars in food and healthcare assistance go untapped every year, often because people aren’t aware they are eligible or they are not sure how to access them,” said Pauline Abernathy, chief strategy officer at BDT. “These research findings show that data-driven outreach and application assistance significantly increase SNAP participation, which in turn markedly improves health and lowers Medicaid costs. With millions of people 65 and older eligible but not participating in SNAP, this research underscores the urgent need to increase outreach and streamline enrollment.”

Study co-authors include Deepak Palakshappa, MD, MSHP, and Joseph Rigdon, PhD, of Wake Forest School of Medicine; Hilary K. Seligman, MD, MAS, of University of California San Francisco; and Sanjay Basu, MD, PhD, of the Center for Primary Care, Harvard Medical School.

This study was primarily funded by the National Institutes of Health.

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JOURNAL

Annals of Internal Medicine

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Supplemental Nutrition Assistance Program Participation and Health Care Use

ARTICLE PUBLICATION DATE

19-Oct-2021

UMass Lowell to train students how to protect water resources

Program taps university’s commitment to sustainability, diversity

Grant and Award Announcement

UNIVERSITY OF MASSACHUSETTS LOWELL

LOWELL, Mass. – UMass Lowell faculty are pooling their expertise to train young engineers, scientists and policymakers how to protect threatened water resources.

Led by Plastics Engineering Associate Prof. Meg Sobkowicz-Kline and Mechanical Engineering Associate Prof. Chris Hansen, the team has received nearly $3 million from the National Science Foundation to create the Sustainable Water Innovations in Materials – Mentoring, Education and Research (SWIMMER) program at UMass Lowell. The initiative is one of 23 projects to receive a share of $64 million in funding from the National Science Foundation Research Traineeship program as part of the American Rescue Plan Act of 2021.

The program will train 60 UMass Lowell master’s and Ph.D. students to develop sustainable materials and chemicals that will reduce harm to water resources. Participants will be students pursing degrees in plastics, mechanical, chemical, and civil and environmental engineering; as well as chemistry; earth science; biology; public health; economics; and other disciplines.

UMass Lowell faculty members leading the project are developing its curriculum and hope to launch SWIMMER with a dozen students next fall. Participants will pursue their advanced degrees in their chosen fields, while also working across disciplines with other members of the team.

The program will feature a preparatory boot camp, a two-semester core course and team capstone projects. Participants will also complete an internship hosted by partner organizations, such as the Merrimack River Watershed Council, or with a company affiliated with the Green Chemistry and Commerce Council, where UMass Lowell Public Health Prof. Joel Tickner is executive director.

At the Tsongas Industrial History Center, SWIMMER scholars will learn how past pollution in the Merrimack River led to health crises in Lowell. The Merrimack now provides drinking water for about 500,000 people in five Massachusetts communities, including Lowell, and to several communities in New Hampshire.

“They will see what the health of the river was in the past, what it is in the present and how to hopefully prevent pollution in the future,” Hansen said. “We don’t want all of the students’ education to happen just at UMass Lowell or just with their research faculty. The idea is to have real-world engagement.”  

Participants will also address issues such as toxic “forever chemicals,” including polyfluoroalkyl substances (PFAS) in water supplies and how droughts, both in the U.S. and across the world, affect water resources.

“This is a relevant topic that applies to their life,” he said. “They can be a change agent, an agent for good in the world.”

Along with Sobkowicz-Kline, Hansen and Tickner, other UMass Lowell faculty members who will help train participants include Civil and Environmental Engineering Associate Prof. Sheree Pagsuyoin, Chemistry Assistant Prof. James Reuther, Environmental Earth and Atmospheric Sciences Prof. Juliette Rooney-Varga, Biological Sciences Assistant Prof. Frederic Chain, Economics Associate Prof. David Kingsley, and Greg Morose, research manager at UMass Lowell’s Toxics Use Reduction Institute.

“There are a lot of diverse research topics within the field of water and materials interactions that students can take a lot of different ways,” Sobkowicz-Kline said. “We’re grateful to have faculty here at UMass Lowell who can make this go forward successfully.”

To ensure the program includes the talents of a diverse group of students, the initiative will also recruit graduate students from Prairie View A&M University and the University of Puerto Rico Mayaguez. Both universities are deemed minority-serving institutions by the U.S. Department of Education.

Hansen and Sobkowicz-Kline said it’s critical to produce graduates with not only the STEM skills required for innovative solutions, but who are also responsive to societal needs for environmental justice and inclusive decision-making. 

“It’s just a fact that minority communities in America are disproportionately impacted by pollution and by degradation of resources,” Hansen said.

Hansen hopes the SWIMMER program can serve as a springboard for participating students’ careers, be it in industry, at a startup, at a nonprofit, in public service or in the classroom as an educator.

“We want them to form lifelong partnerships and collaborations with the other people in their cohort, and we want them to translate that into amazing research that becomes nationally and internationally known,” he said. “And then ultimately, when they graduate, they’re doing something that really no one else has this skillset to do.”

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UMass Lowell is a national research university located on a high-energy campus in the heart of a global community. The university offers its students bachelor’s, master’s and doctoral degrees in business, education, engineering, fine arts, health, humanities, sciences and social sciences. UMass Lowell delivers high-quality educational programs, vigorous hands-on learning and personal attention from leading faculty and staff, all of which prepare graduates to be leaders in their communities and around the globe. www.uml.edu

 

Targeted interventions to contain pandemics, minimize societal disruption

Spread of coronavirus simulated, targeted interventions proposed

Peer-Reviewed Publication

AMERICAN INSTITUTE OF PHYSICS

 

IMAGE: GEOGRAPHICAL DISTRIBUTION OF THE SYNTHETIC POPULATION AND FACILITIES IN HONG KONG. THE DATA-DRIVEN MOBILITY MODEL COMPRISES 7.55 MILLION AGENTS REPRESENTING THE LOCAL POPULATION. view more 

CREDIT: QINGPENG ZHANG

WASHINGTON, October 19, 2021 -- The COVID-19 pandemic has led to more than 218 million infections and over 4.5 million deaths as of Sept. 3, 2021. Nonpharmaceutical interventions (NPIs), such as case isolation, quarantining contacts, and the complete lockdown of entire countries, were implemented in an effort to contain the pandemic. But these NPIs often come at the expense of economic disruption, harm to social and mental well-being, and costly administration costs to ensure compliance.

Given the slow rollout of vaccination programs worldwide and the rise of several mutations of the coronavirus, the use of these types of interventions will continue for some time. In Chaos, by AIP Publishing, researchers in China use a data-driven agent-based model to identify new and sustainable NPIs to contain outbreaks while minimizing the economic and social costs.

"Based on the proposed model, we proposed targeted interventions, which can contain the outbreak with minimal disruption of society. This is of particular importance in cities like Hong Kong, whose economy relies on international trade," said author Qingpeng Zhang.

The researchers built a data-driven mobility model to simulate COVID-19 spreading in Hong Kong by combining synthetic population, human behavior patterns, and a viral transmission model. This model generated 7.55 million agents to describe the infectious state and movement for each Hong Kong resident.

Since mobile phone data is difficult to obtain in most countries, the researchers calibrated their model with open-source data, so it could be easily extended to the modeling of other metropolises with various demographic and human mobility patterns.

"With the agent-based model, we can simulate very detailed scenarios in Hong Kong, and based on these simulations, we are able to propose targeted interventions in only a small portion of the city instead of city-level NPIs," said Zhang.

The researchers found that by controlling a small percentage (top 1%-2%) of grids in Hong Kong, the virus could be largely contained. While such interventions are not as effective as citywide NPIs and compulsory COVID-19 testing, such targeted control has the benefit of a much smaller disruption of society.

The proposed model leading to the targeted interventions has the potential to guide current citywide NPIs to achieve a balance between lowering the risk and preserving human mobility and economy of the city.

"Our findings also apply to other major cities in the world, such as Beijing, New York, London, and Toyko, as COVID-19 is likely to be around indefinitely, and we have to learn how to live with it," said Zhang.

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The article "Sustainable targeted interventions to mitigate the COVID-19 pandemic: A big data-driven modeling study in Hong Kong" is authored by Qingpeng Zhang, Hanchu Zhou, Zhidong Cao, Helai Huang, and Daniel Zeng. The article will appear in Chaos on Oct. 19, 2021 (DOI: 10.1063/5.0066086). After that date, it can be accessed at https://aip.scitation.org/doi/full/10.1063/5.0066086.

ABOUT THE JOURNAL

Chaos is devoted to increasing the understanding of nonlinear phenomena in all areas of science and engineering and describing their manifestations in a manner comprehensible to researchers from a broad spectrum of disciplines. See https://aip.scitation.org/journal/cha.

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JOURNAL

Chaos An Interdisciplinary Journal of Nonlinear Science

DOI

10.1063/5.0066086 

ARTICLE TITLE

Sustainable targeted interventions to mitigate the COVID-19 pandemic: A big data-driven modeling study in Hong Kong

Pandemic causes dip in building sector CO2 emissions but long-term outlook bleak: UN

Reports and Proceedings

UNITED NATIONS ENVIRONMENT PROGRAMME

 

IMAGE: THE BUILDINGS-GSR PROVIDES AN ANNUAL SNAPSHOT OF THE PROGRESS OF THE BUILDINGS AND CONSTRUCTION SECTOR ON A GLOBAL SCALE AND REVIEWING THE STATUS OF POLICIES, FINANCE, TECHNOLOGIES, AND SOLUTIONS TO MONITOR WHETHER THE SECTOR IS ALIGNED WITH THE PARIS AGREEMENT GOALS. MORE THAN 70 CONTRIBUTORS AND LEADING EXPERTS FROM AROUND THE WORLD WERE INVOLVED IN THE 6TH EDITION OF THE BUILDINGS‐GSR, WHICH FEATURES A FOCUS CHAPTER ON COOLING AND ON WHOLE LIFE CARBON IN EUROPE. view more 

CREDIT: UNEP / GLOBALABC

The economic consequences of the COVID-19 pandemic caused CO2 emissions from buildings and construction to fall significantly in 2020, but a lack of real transformation in the sector means that emissions will keep rising and contribute to dangerous climate change, according to the 2021 Global Status Report for Buildings and Construction.

The report, published by the UN Environment Programme-hosted Global Alliance for Buildings and Construction (GlobalABC), finds that in 2020, the sector accounted for 36 per cent of global final energy consumption and 37 per cent of energy related CO2 emissions, as compared to other end use sectors.

While the level of emissions within the sector are 10 per cent lower than in 2015, reaching lows not seen since 2007, this was largely due to lockdowns, slowing of economies, difficulties households and businesses faced in maintaining and affording energy access and a fall in construction activity. Efforts to decarbonize the sector played only a small role.

With large growth projected in the buildings sector, emissions are set to rise if there is no effort to decarbonize buildings and improve their energy efficiency. In Asia and Africa, building stock is expected to double by 2050. Global material use is expected to more than double by 2060, with a third of this rise attributable to construction materials. 

“This year showed that climate change is an immediate direct threat to every community on this planet, and it is only going to intensify,” said Inger Andersen, Executive Director of UNEP.

“The buildings and construction sector, as a major source of greenhouse gas emissions, must urgently be decarbonized through a triple strategy of reducing energy demand, decarbonizing the power supply and addressing building materials’ carbon footprint, if we are to have any chance of meeting the Paris Agreement goal of limiting global warming to 1.5C.”

Some small progress, but not enough

The GlobalABC’s Global Buildings Climate Tracker found that there have been some incremental improvements in action to decarbonize and improve the energy efficiency of the sector.

In 2015, 90 countries included actions for addressing buildings emissions or improving energy efficiency in their Nationally Determined Contributions (NDCs) under the Paris Agreement. This number has now hit 136, although ambition varies. 

Since 2015, an additional 18 countries have put in place building energy codes – a move that is crucial to shift emissions downwards – bringing the total to 80. Local cities and governments have also developed codes. Investment in energy efficiency rose to over 180 billion USD in 2020, up from 129 billion in 2015. Green building certification has increased by 13.9 per cent compared to 2019.

Overall, however, the report finds that these efforts are insufficient, both in terms of speed and scale. 

Other key findings of the report include: two-thirds of countries still lack mandatory buildings codes; most of the increase in energy efficiency spending came from a small number of European countries; too small a share of finance goes into deep energy retrofits, and there is a lack of ambitious decarbonization targets in NDCs.

What comes next?

Energy demand in the buildings and construction sector is likely to rebound as economic recovery efforts take hold and as pent-up demands for new construction are realized.

By 2030, to be on track to achieving a goal of net-zero emissions by 2050, the International Energy Agency says that direct building CO2 emissions would need to decrease by 50 per cent. Indirect building sector emissions will have to drop through a reduction of 60 per cent in power generation emissions. To achieve these goals, the report finds, the sector has to take advantage of every lever. 

While pandemic recovery spending has not sufficiently prioritized climate friendly approaches to the level required, there is still an opportunity to invest in decarbonizing our buildings while increasing their resilience:

• Countries need to harness the sector’s transformative potential for achieving the energy transition.
• Governments need to commit to further decarbonising the power, as well as heating and cooling energy supply. This includes stepping up ambition in NDCs to include building decarbonization targets that contain the so-far largely overlooked embodied carbon, emissions from the production of building materials.
• The rate of growth of investment in building efficiency needs to double to over 3 per cent per year, and must expand beyond direct government investment to private investors.
• Scope and coverage of building energy codes need to increase. All countries need to have in place mandatory building energy codes, and these would ideally address performance standards for building envelopes, design, heating, cooling, ventilation systems and appliances, and ensure links with integrated urban planning. 
• Buildings’ resilience needs to increase to future proof our homes and work spaces. A typical building constructed today will still be in use in 2070, but the climate it encounters will have changed significantly. The necessary interventions to reduce the climate impact of existing buildings should be combined with investing in adaptation and resilience measures. 
• In addition, both public and private sector need to seize the tremendous investment opportunities this sector offers, e.g. through green bonds or through banks increasing green building construction and mortgage finance.

###

About the Global Alliance for Buildings and Construction (GlobalABC)

The GlobalABC is the leading global platform for governments, the private sector, civil society and intergovernmental and international organizations to increase action towards a zero-emission, efficient and resilient buildings and construction sector. The Global Alliance for Buildings and Construction (GlobalABC) was a key outcome of the 2015 UN climate conference.

globalabc.org

About the UN Environment Programme (UNEP)

UNEP is the leading global voice on the environment. It provides leadership and encourages partnership in caring for the environment by inspiring, informing and enabling nations and peoples to improve their quality of life without compromising that of future generations.

UNEP.org

Older African Americans more physically active in ‘green’ neighborhoods

First nationally representative study of neighborhood open spaces and neighborhood-based walking in older adults

Peer-Reviewed Publication

FLORIDA ATLANTIC UNIVERSITY

 

IMAGE: GROWING EVIDENCE SUGGESTS THAT LIVING IN WALKABLE NEIGHBORHOODS WITH GREENSPACES SUCH AS PARKS AND GREENERY IS ASSOCIATED WITH PHYSICAL ACTIVITY. view more 

CREDIT: FLORIDA ATLANTIC UNIVERSITY/GETTY IMAGES

Adults 50 and older are significantly less active than those younger than 50. Many fall short of the recommended 150 minutes of moderate to vigorous-intensity physical activity per week. However, they still can benefit from some physical activity. Even 15 minutes of daily, moderate-to-vigorous physical activity has shown reductions in all causes of mortality in adults 60 and older. 

Growing evidence suggests that living in walkable neighborhoods with greenspaces such as parks and greenery is associated with physical activity. Yet, evidence of this association in older adults remains limited. In addition, few studies have been nationally representative, have focused on neighborhood walking (versus total walking regardless of location), or examined the differences in association depending on the greenspace type (e.g. open space and forest).

Researchers from Florida Atlantic University’s Charles E. Schmidt College of Science are the first to explore whether greater amounts of neighborhood open space and forest are associated with neighborhood-based walking in older adults in the United States. Moreover, this is the first known nationally representative study to suggest that physical activity levels among older African Americans may benefit from greater amounts of neighborhood open space, including parks.

The study is based on a quantification of minutes of neighborhood walking from travel diaries from a sample of 73,523 adults ages 65 and older from 52,408 households. Researchers investigated whether these associations vary depending on income, race/ethnicity, sex, or neighborhood socioeconomic disadvantage.

Results of the study, published in the American Journal of Preventive Medicine, showed that open spaces, including parks, were associated with 5.4 more minutes of neighborhood walking per day in older African Americans. By contrast, forests were positively associated with more neighborhood walking among whites, where daily neighborhood walking increased by an additional three minutes.

“Although it may seem like an extra three to five minutes of walking per day may not be a clinically significant change in physical activity, it needs to be considered within the context of an additional 35 minutes of physical activity a week,” said Lilah M. Besser, Ph.D., M.S.P.H., first author and an assistant professor in the Department of Urban and Regional Planning, FAU Charles E. Schmidt College of Science, and a member of the FAU Stiles-Nicholson Brain Institute and the FAU Institute for Human Health and Disease Intervention (I-HEALTH). “Importantly, our findings are significant in the context of the established health disparities between African Americans and whites, including greater cardiovascular risk factors/disease among African Americans, and the ever-pressing necessity for health equity.”

Similar associations were not observed for other racial/ethnic groups. However, greater neighborhood forests may be borderline associated with less neighborhood walking in Hispanics. When race and Hispanic ethnicity were entered as separate variables in the adjusted models, greater neighborhood forest was associated with less neighborhood walking in Hispanics.

“In addition to physical health benefits, spending time outside provides opportunities for social interactions with neighbors that can reduce social isolation, depression, and anxiety, which can be common in older adults,” said Diana Mitsova, Ph.D., co-author, professor, John DeGrove Eminent Scholar Chair in Growth Management and Development, and director, Visual Planning Technology Lab, FAU Department of Urban and Regional Planning. “In addition, greenspace exposure helps to restore attention and reduce mental fatigue, which may contribute to a better quality of life and successful aging in place.”

Besser and Mitsova suggest the possibility that a greater amount of neighborhood open space may promote physical activity among African Americans because of the geographic and financial accessibility of neighborhood open spaces/parks for physical activity compared with that of gyms and recreational facilities. 

“Plans, policies and interventions that promote increased time spent in greenspaces and provision of more greenspaces tailored to the underlying neighborhood populations may provide population-level benefits to multiple aspects of health in older adults and may help to reduce health disparities and achieve health equity,” said Besser.

Besser is supported by the National Institutes of Health, National Institute on Aging (K01 AG063895).

- FAU -

About Florida Atlantic University:
Florida Atlantic University, established in 1961, officially opened its doors in 1964 as the fifth public university in Florida. Today, the University serves more than 30,000 undergraduate and graduate students across six campuses located along the southeast Florida coast. In recent years, the University has doubled its research expenditures and outpaced its peers in student achievement rates. Through the coexistence of access and excellence, FAU embodies an innovative model where traditional achievement gaps vanish. FAU is designated a Hispanic-serving institution, ranked as a top public university by U.S. News & World Report and a High Research Activity institution by the Carnegie Foundation for the Advancement of Teaching. For more information, visit www.fau.edu.

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JOURNAL

International Journal of Environmental Research and Public Health

DOI

10.3390/ijerph18157973 

METHOD OF RESEARCH

Meta-analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Longitudinal Associations between the Neighborhood Built Environment and Cognition in US Older Adults: The Multi-Ethnic Study of Atherosclerosis

ARTICLE PUBLICATION DATE

28-Jul-2021

Disclaimer: AAAS and E

Environmental injustice, population density and the spread of COVID-19 in minority communities

Computer modeling shows just two factors can predict how quickly COVID-19 spread

Peer-Reviewed Publication

WASHINGTON UNIVERSITY IN ST. LOUIS

 

IMAGE: DEMONSTRATION OF HOW INTRICACIES CAN BE LOST WITHOUT A BIAS FACTOR. view more 

CREDIT: RAJAN CHAKRABARTY/PAYTON BEELER

During the “first wave” of COVID-19 in the United States, Rajan Chakrabarty, the Harold D. Jolley Career Development Associate Professor at Washington University in St. Louis, learned that African Americans made up 47% of the population in St. Louis, but nearly three quarters of COVID-19 cases. 

That fact was from an article in the Boston Review, written by Jason Purnell, associate professor at Washington University’s Brown School. In it, Purnell noted that in St. Louis, African Americans were 12 times more likely than white residents to live in conditions with higher environmental risks, including poor air quality. 

“It really motivated me to try to connect the dots between environmental injustice and the spread of COVID-19,” said Chakrabarty, who studies aerosol science at the McKelvey School of Engineering. 

And as it turned out, aerosol science had much to say about the matter.

New research analyzed disparities in socioeconomic, environmental and lung health factors to determine how they contributed to R0 — the rapidity at which COVID-19 spread — through 12 metropolitan areas. Researchers found just two factors had an overwhelming influence on R0: population density and long-term exposure to air pollution. 

Results were published in the journal Environmental Research Letters.

These two factors disproportionately affect communities with more minority residents.   

Metropolitan Statistical Areas

• STL | St. Louis (MO & IL)
• CHI | Chicago-Naperville-Elgin (IL, IN, WI)
• DET | Detroit-Warren-Dearborn (MI)
• ATL | Atlanta-Sandy Springs-Alpharetta (GA)
• PHI | Philadelphia-Camden-Wilmington (PA, NJ, DE, MD)
• POR | Portland-Vancouver-Hillsboro (OR & WA)
• DEN | Denver-Aurora-Lakewood (CO)
• NYC | New York-Newark-Jersey City (NY & NJ)
• SFO | San Francisco-Oakland-Berkeley (CA)
• DAL | Dallas-Fort Worth-Arlington (TX)
• CLE | Cleveland-Elyria (OH)
• LOU | Louisville/Jefferson County (KY & IN)

The study, conducted in the Chakrabarty lab, used data from 12 metropolitan statistical areas (MSAs) — a census designation for groupings of counties made up of at least one “urbanized” area of 500,000 or more residents and the nearby areas that it’s tied to socially and economically. 

To narrow in on which factors were directly correlated with R0, first author Payton Beeler, a PhD student in the Chakrabarty lab, looked at data from the first wave of the COVID-19 epidemic between March 1 and April 30, 2020, when the strictest stay-at-home orders were in place.

She considered a few dozen factors — from household income to smoking habits to rates of people working in the service industry — that might affect how quickly COVID-19 spread.

To determine PM2.5 exposure over time, Beeler, who was co-advised on this research by C. Arden Pope of Brigham Young University, calculated average mass concentrations by county from 2000 to 2018 using recently published datasets of ground-based observations, NASA’s GEOS-CHEM model outputs and satellite observations. Population density was obtained from the 2019 Census American Community Survey.

Of all the factors they analyzed, “We found that the combined influence of population density and PM2.5 exposure had the most statistically significant correlations with R0,” Beeler said.

Determining if there were any demographic patterns among the areas with a high R0 required a bit of creativity.

Looking at the 12 MSAs together, nothing jumped off the screen. It was because, Beeler realized, she was trying to compare geographic and demographic apples to oranges. Take, for example, the Portland, Ore., MSA. There are no counties in that MSA with a population of African Americans higher than 10%. Taking the MSA as a whole, it looks rather uniform.

“But if we analyze each MSA individually, what we see is very different,” she said. That’s exactly what she saw in Portland. When she broke the MSA down into counties, she found pockets where minority residents were clustered.

“That’s how I got the idea for the bias factor method.” 

The bias factor is a way to level the playing field, so to speak. To find it, she looked at a variable — race or PM2.5 exposure or population density — in a single county in a particular MSA. Then she compared it to the surrounding counties in that same MSA. In that way, any deviations from the average were visible.

For instance, if a county has a bias factor of two for PM2.5 exposure, that means that the PM2.5 concentration in that county is twice as high as the average county in the same MSA. If it has a bias factor of three for Asian Americans, that means it has an Asian American population three times as high as other counties in the MSA.

This method provided a number that could be used to compare counties in Oregon to those in Missouri to those in Georgia — compare apples to apples, despite the wide variation in populations and in factors such as long-term pollution exposure and population density.

When she made those comparisons, Beeler found higher bias factors for diverse counties — those with more racial and ethnic minorities — correlated with bias factors for long-term pollution exposure and higher population density and, therefore, with faster transmission of COVID-19.

Ultimately, the research showed communities with relatively high Hispanic American populations are associated with the largest relative increase in PM2.5 concentration and population density, followed by Asian Americans and African Americans. Researchers also found that communities with relatively large white populations are associated with relative decreases in PM2.5 concentration and population density.

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JOURNAL

Environmental Research Letters

DOI

10.1088/1748-9326/ac29ea 

METHOD OF RESEARCH

Computational simulation/modeling

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Disparities in PM2.5 exposure and population density influence SARS-CoV-2 transmission among racial and ethnic minorities

ARTICLE PUBLICATION DATE

12-Oct-2021

Disclaimer: AAAS and Eu

Fighting inflammation and oxidative stress: New study finds some benefits of orange juice

Peer-Reviewed Publication

EDIBLE INC, AN EDELMAN COMPANY

BARTOW, Fla. (Oct. 19, 2021) – A new study suggests 100% orange juice has the potential to help fight inflammation and oxidative stress in adults, paving the way for further research on the topic.

Though limited in scope, the study indicates drinking 100% orange juice significantly reduces interleukin 6, a well-established marker of inflammation, in both healthy and high-risk adults. Two additional inflammatory and oxidative stress markers were also reduced; however, the results did not quite reach statistical significance.

The findings of this study, which was funded through an unrestricted grant by the Florida Department of Citrus, harmonize with a previously published FDOC-funded review that reported beneficial effects of hesperidin, the primary bioactive compound found in oranges and 100% orange juice, on reducing some markers of inflammation and oxidative stress.1 Chronic inflammation may play a key role in causing or advancing some chronic diseases, including heart disease and diabetes.

Studies like these are necessary in order to identify gaps in the existing evidence so that future research can be designed to specifically fill those holes. The FDOC’s scientific research department has used these results to outline the scope of work for a larger FDOC-sponsored clinical trial on the benefits of 100% orange juice consumption expected to begin in late 2021.

“We know that 100% orange juice contains a number of nutrients, like vitamin C, as well as beneficial bioactive compounds that have the potential to reduce inflammation and oxidative stress,” said Gail Rampersaud, Florida Department of Citrus registered dietitian. “This review tells us that some studies find benefits with 100% orange juice, but we need more data and large well-designed studies to make more definitive conclusions. This analysis is especially helpful as we and others plan future research related to orange juice.”

The review examined published studies relating to 100% orange juice and markers of inflammation and oxidative stress. Conducted by the Think Healthy Group and researchers at Tufts University and George Mason University, the review was published in the journal, Advances in Nutrition.

The analysis consisted of three parts: a qualitative scoping review of 21 studies with a total of 307 healthy adults and 327 adults at risk for disease; a systematic review of a subset of 16 studies that measured the six most reported biomarkers related to inflammation and oxidative stress in the body; and 10 studies that had sufficient data to conduct a meta-analysis. The researchers also examined the overall quality and potential bias in the studies.

The broad scoping and systematic reviews revealed that, in general, 100% orange juice either had beneficial or null (no adverse) effects on oxidative stress or inflammation. The researchers cautioned that studies included a relatively small number of subjects, had a low strength of evidence, and had a moderate risk of bias; therefore, overall findings should be interpreted with caution.

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About the Florida Department of Citrus

The Florida Department of Citrus is an executive agency of the Florida government charged with the marketing, research, and regulation of the Florida citrus industry.  Its activities are funded by a tax paid by growers on each box of citrus that moves through commercial channels.  The industry employs more than 33,000 people, provides an annual economic impact of $6.762 billion to the state, and contributes hundreds of millions of dollars in tax revenues that help support Florida’s schools, roads, and health care services. For more information about the Florida Department of Citrus, please visit FloridaCitrus.org/newsroom.

 

References

1. Tadros FJ, Andrade JM. Crit Rev Food Sci Nutr. 2021 May 20:1-20.

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JOURNAL

Advances in Nutrition

DOI

10.1093/advances/nmab101 

METHOD OF RESEARCH

Systematic review

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Effects of 100% Orange Juice on Markers of Inflammation and Oxidation in Healthy and At-Risk Adult Populations: A Scoping Review, Systematic Review, and Meta-analysis

ARTICLE PUBLICATION DATE

11-Oct-2021

COI STATEMENT

This study was funded through an unrestricted grant by the Florida Department of Citrus.