In the shadow of the dam - Hydrology of the Little Conemaugh river and its South Fork, with insights about past and future flooding.

The Little Conemaugh River watershed and its South Fork sub-basin figure prominently in historical flooding of Johnstown, Pennsylvania and nearby communities with catastrophic flooding in 1889, 1936, and 1977 (reviewed herein). Historical stream gage data and data from a new gage on the South Fork (established via a novel, portable cableway system) are used with Nexrad rainfall data to assess watershed response and provide novel analysis of flood hydrology in the Little Conemaugh basin and the sub-basin. Using unit hydrograph estimates for longer duration storms (>8 h) and different baseflow conditions, we probe possible effects of several design storms, including those stemming from a hurricane remnant scenario (Agnes in 1972) and 50-, 100-, and 500-year 12-hour precipitation depths. The unit hydrographs provided peak discharge (Qpeak) estimates for 1977 (the only flood event with available hourly rainfall data) that are in good agreement with empirical peak discharges. Significant channel improvements completed in 1943 were designed to carry the largest known natural flow on record at that time (1936 Qpeak). Preliminary results from design storm scenarios indicate the need for a careful evaluation of extreme discharges and their return periods (including snowmelt-related contributions), as future flood levels in Johnstown may occur more frequently than originally thought. The 1977 flood, which triggered 7 dam failures and eclipsed 1936 Qpeak, resulted from less than 40% the estimated probable maximum precipitation (PMP) for a 12-hour storm. Peak discharges of similar magnitude would have ensued in 1972 had remnants of Hurricane Agnes tracked slightly westward. Flooding and infrastructure problems could be compounded for storms of 24-hour or longer durations, similar to record flooding seen in central Pennsylvania and New York in 1972. Flood recurrence, emergency procedures, and dam safety (particularly, spillway capacity in the Little Conemaugh basin and surrounding region) should likely be reassessed and protective early-warning measures (ineffective in 1977) implemented for the people of Johnstown.

A novel gun law strength index and influential state gun laws for firearm homicide in the United States, 1999-2018.

OBJECTIVES: Although some existing indices quantified the mixture strength of state gun laws, methodological supports are still lacking. The study aimed to build a new state gun law strength (GLS) index, evaluate the contribution of all state gun laws to the new index, and assess the association between the new index and firearm homicide mortality. STUDY DESIGN: This is a population-based ecological study. METHODS: We condensed 134 state gun laws into a mixture GLS index at the state level to quantify each state's overall GLS by using the weighted quantile sum regression in each year from 1999 to 2018. The weights of state gun laws in the GLS index revealed their influence on GLS. The model also estimated the association between the GLS index and state-level firearm homicide mortality. RESULTS: From 1999 to 2018, 15 of 134 (11.19%) state gun laws significantly contributed to the GLS index for firearm homicide every year, five of which related to the minimum age of possessing firearms. The most influential gun law was "no possession of handguns until age 21." The GLS index was significantly and negatively associated with firearm homicide mortality; however, the association gradually diminished over time. CONCLUSIONS: The GLS index has methodological support and can take different gun violence outcomes into account. Future research can adopt the GLS index to conduct additional gun violence research or apply the modeling approach to build new GLS indexes for other gun violence outcomes.

An assessment of the relationship of physical activity, obesity, and chronic diseases/conditions between active/obese and sedentary/ normal weight American women in a national sample.

OBJECTIVE: Obesity and physical inactivity are associated with increased rates of chronic diseases and conditions. However, the 'fit but fat' theory posits that cardiopulmonary fitness (or physical activity) can mitigate risks to health associated with obesity. The purpose of this study was to compare chronic diseases and conditions of highly active/obese women with inactive/normal weight women. STUDY DESIGN: This was a cross-sectional study of the 2015 Behavioral Risk Factor Surveillance System data. METHODS: Weighted descriptive statistics were performed to describe the demographic characteristics of the two groups. We calculated odds ratios and adjusted odds ratios for chronic diseases and conditions comparing highly active/obese women with inactive/normal weight women. RESULTS: Highly active/obese women were more likely to report risk factors (hypertension, high cholesterol, and diabetes) for coronary heart disease (CHD) and cardiovascular disease (CVD) than inactive/normal weight women; however, they did not have increased rates of CVD, CHD, or heart attack and had decreased risk for stroke. Highly active/obese women had increased risk for asthma, arthritis, and depression, but not for cancer, kidney disease, or chronic obstructive pulmonary disease. CONCLUSIONS: Highly active/obese women appear to be staving off the actual development of CHD and CVD; however, further research is needed to understand the long-term health benefits of physical activity among obese women.

Health impact assessment as an instrument to examine the health implications of education policies.

OBJECTIVES: Health impact assessment (HIA) is a systematic process that can be used by public health professionals to examine the potential health effects of a policy, plan, program, or project that originates outside of the health sector. This article presents a case study of how an interdisciplinary team utilized an HIA to analyze the potential health impact of full-day kindergarten (FDK) on communities in Nevada. STUDY DESIGN: Case study. METHODS: With stakeholder and community engagement, we conducted a multistage HIA that included qualitative and quantitative data collection and analysis, a review of existing literature, and projections. The team considered several pathways through which FDK could impact health in Nevada: (1) school performance; (2) physical development (physical activity and nutrition education); and (3) access to school-based meals and health screenings. RESULTS: Findings indicated that access to FDK could enhance opportunities for Nevada's children to harness school-based services, increase physical activity, and promote nutrition education. In addition, based on existing research that suggests relationships between (1) FDK attendance and 3rd and 5th grade math and reading standardized test scores and (2) 3rd and 5th grade test scores and high school graduation, as well as available state and national data, we estimated that access to FDK could increase high school graduation in Nevada by 499-820 students per year. CONCLUSIONS: This HIA demonstrated that access to FDK could impact both student and adult health in Nevada. Our engagement of public health professionals along with stakeholders and the community in the HIA process demonstrated that HIAs can be an important tool for public health professionals to examine the effects on community health of policies, programs, plans or projects that arise outside of the health sector.