Deepwater Horizon Oil Spill Exposures and Long-term Self-rated Health Effects Among Parents in Coastal Louisiana.

PURPOSE: To assess whether exposure to the 2010 Deepwater Horizon oil spill (DHOS) was related to parents' self-rated health over time. DESIGN: 3 waves of panel data were drawn from the Gulf Coast Population Impact study (2014) and Resilient Children, Youth, and Communities study (2016, 2018). SETTING: Coastal Louisiana communities in high-impact DHOS areas. PARTICIPANTS: Respondents were parents or guardians aged 18 - 84, culled from a probability sample of households with a child aged 4 to 18 (N = 526) at the time of the 2010 DHOS. MEASURES: Self-rated health was measured at each wave. Self-reported physical exposure to the DHOS, economic exposure to the DHOS, and control variables were measured in 2014. ANALYSIS: We used econometric random effects regression for panel data to assess relationships between DHOS exposures and self-rated health over time, controlling for potentially confounding covariates. RESULTS: Both physical exposure (b = -0.39; P < 0.001) and economic exposure (b = -0.34; P < 0.001) to the DHOS had negative associations with self-rated health over the study period. Physical exposure had a larger effect size. CONCLUSION: Parents' physical contact with, and economic disruption from, the 2010 DHOS were tied to long-term diminished health.

Parental Education and Child Physical Health Following the BP Deepwater Horizon Oil Spill.

PURPOSE: To assess whether trajectories of children's physical health problems differ by parental college degree attainment in Louisiana areas highly impacted by the 2010 BP Deepwater Horizon oil spill (BP-DHOS). DESIGN: Three waves of panel data (2014, 2016, and 2018) from the Gulf Coast Population Impact / Resilient Children, Youth, and Communities studies. SETTING: BP-DHOS-impacted communities in coastal Louisiana. PARTICIPANTS: Parents of children aged 4-18 in a longitudinal probability sample (n = 392). MEASURES: Reported child physical health problems from the BP-DHOS, parental college degree attainment, and covariates. ANALYSIS: Linear growth curve models are used to assess initial levels of and the rate of change in child physical unknown. The current study uses 3 waves physical health problems by parental college degree attainment. Explanatory variables are measured at baseline and the outcome variable is measured at all 3 waves. RESULTS: Compared to children of parents without college degrees, children of college graduates had fewer initial health problems in 2014 (b = -.33; p = .02). Yet, this health advantage decreased over time, as indicated by their positive rate of change (b = .22; p = .01), such that the higher education health advantage was not statistically significant by 2018. CONCLUSION: Children of college graduates experienced a physical health advantage following the BP-DHOS, but this gap closed over time. The closure of the gap was due to the children of college graduates experiencing significant increases in reported health problems over the study period.

A Philanthropic Approach to Supporting Emergent Disaster Response and Recovery.

In August 2017, Hurricane Harvey struck the US Gulf Coast and caused more than US $125 billion in damages in Texas. The loss of lives and the economic damages resulted in an outpouring of support for the recovery efforts in the form of federal assistance and private donations. The latter has supported more creative approaches to recovery. Organizations that normally would not receive funding were able to obtain resources to use in novel manners. Using the framework of Dynes typology to identify groups and their respective structures and tasks, this report from the field analyzes Hurricane Harvey and the financial support mechanisms used to support recovery efforts in Texas, what organizations were funded to do, and where they fit into Dynes typology. The authors close by noting the importance of these emerging organizations and the need to support diversity in funding disaster response and recovery efforts beyond large nonprofit organizations.

Long-term Recovery From Hurricane Sandy: Evidence From a Survey in New York City.

OBJECTIVES: This study aimed to examine a range of factors influencing the long-term recovery of New York City residents affected by Hurricane Sandy. METHODS: In a series of logistic regressions, we analyzed data from a survey of New York City residents to assess self-reported recovery status from Hurricane Sandy. RESULTS: General health, displacement from home, and household income had substantial influences on recovery. Individuals with excellent or fair health were more likely to have recovered than were individuals with poor health. Those with high and middle income were more likely to have recovered than were those with low income. Also, individuals who had not experienced a decrease in household income following Hurricane Sandy had higher odds of recovery than the odds for those with decreased income. Additionally, displacement from the home decreased the odds of recovery. Individuals who applied for assistance from the Build it Back program and the Federal Emergency Management Agency had lower odds of recovering than did those who did not apply. CONCLUSIONS: The study outlines the critical importance of health and socioeconomic factors in long-term disaster recovery and highlights the need for increased consideration of those factors in post-disaster interventions and recovery monitoring. More research is needed to assess the effectiveness of state and federal assistance programs, particularly among disadvantaged populations. (Disaster Med Public Health Preparedness. 2018;12:172-175).

Do shared barriers when reporting to work during an influenza pandemic influence hospital workers' willingness to work? A multilevel framework.

OBJECTIVE: Characteristics associated with interventions and barriers that influence health care workers' willingness to report for duty during an influenza pandemic were identified. Additionally, this study examined whether workers who live in proximal geographic regions shared the same barriers and would respond to the same interventions. METHODS: Hospital employees (n=2965) recorded changes in willingness to work during an influenza pandemic on the basis of interventions aimed at mitigating barriers. Distance from work, hospital type, job role, and family composition were examined by clustering the effects of barriers from reporting for duty and region of residence. RESULTS: Across all workers, providing protection for the family was the greatest motivator for willingness to work during a pandemic. Respondents who expressed the same barriers and lived nearby shared common responses in their willingness to work. Younger employees and clinical support staff were more receptive to interventions. Increasing distance from home to work was significantly associated with a greater likelihood to report to work for employees who received time off. CONCLUSIONS: Hospital administrators should consider the implications of barriers and areas of residence on the disaster response capacity of their workforce. Our findings underscore communication and development of preparedness plans to improve the resilience of hospital workers to mitigate absenteeism.

Measuring the impact of Hurricane Katrina on access to a personal healthcare provider: the use of the National Survey of Children's Health for an external comparison group.

This paper examined the effect of Hurricane Katrina on children's access to personal healthcare providers and evaluated the use of propensity score methods to compare a nationally representative sample of children, as a proxy for an unexposed group, with a smaller exposed sample. 2007 data from the Gulf Coast Child and Family Health (G-CAFH) Study, a longitudinal cohort of households displaced or greatly impacted by Hurricane Katrina, were matched with 2007 National Survey of Children's Health (NSCH) data using propensity score techniques. Propensity scores were created using poverty level, household educational attainment, and race/ethnicity, with and without the addition of child age and gender. The outcome was defined as having a personal healthcare provider. Additional confounders (household structure, neighborhood safety, health and insurance status) were also examined. All covariates except gender differed significantly between the exposed (G-CAFH) and unexposed (NSCH) samples. Fewer G-CAFH children had a personal healthcare provider (65 %) compared to those from NSCH (90 %). Adjusting for all covariates, the propensity score analysis showed exposed children were 20 % less likely to have a personal healthcare provider compared to unexposed children in the US (OR = 0.80, 95 % CI 0.76, 0.84), whereas the logistic regression analysis estimated a stronger effect (OR = 0.28, 95 % CI 0.21, 0.39). Two years after Hurricane Katrina, children exposed to the storm had significantly lower odds of having a personal health care provider compared to unexposed children. Propensity score matching techniques may be useful for combining separate data samples when no clear unexposed group exists.

Comparing the clinical severity of the first versus second wave of 2009 Influenza A (H1N1) in a New York City pediatric healthcare facility.

OBJECTIVE: We previously reported the epidemiology of 2009 Influenza A (H1N1) in our pediatric healthcare facility in New York City during the first wave of illness (May-July 2009). We hypothesized that compared with the first wave, the second wave would be characterized by increased severity of illness and mortality. DESIGN: : Case series conducted from May 2009 to April 2010. SETTING: Pediatric emergency departments and inpatient facilities of New York-Presbyterian Hospital. PATIENTS: All hospitalized patients ÷ 18 yrs of age with positive laboratory tests for influenza A. MEASUREMENTS AND MAIN RESULTS: We compared severity of illness during the first and second wave assessed by the number of hospitalized children, including those in the pediatric intensive care unit, bacterial superinfections, and mortality rate. Compared to the first wave, fewer children were hospitalized during the second wave (n = 115 vs. 76), but a comparable portion were admitted to the pediatric intensive care unit (30.4% vs. 19.7%; p = .10). Pediatric Risk of Mortality III scores, length of hospitalization in the pediatric intensive care unit, incidence of respiratory failure and pneumonia, and peak oxygenation indices were similar during both waves. Bacterial superinfections were comparable in the first vs. second wave (3.5% vs. 1.3%). During the first wave, no child received extracorporeal membrane oxygenation and one died, while during the second wave, one child received extracorporeal membrane oxygenation and there were no deaths. CONCLUSIONS: At our pediatric healthcare facility in New York City, fewer children were hospitalized with 2009 Influenza A (H1N1) during the second wave, but both waves had a similar spectrum of illness severity and low mortality rate.

Differential expression of matrix metalloproteinases during stimulated ovarian recrudescence in Siberian hamsters (Phodopus sungorus).

The matrix metalloproteinases (MMPs) are a family of extracellular matrix-cleaving enzymes involved in ovarian remodeling. In many non-tropical species, including Siberian hamsters, ovarian remodeling is necessary for the functional changes associated with seasonal reproduction. We evaluated MMPs and their endogenous inhibitors (TIMPs), during photoperiod-induced ovarian recrudescence in Siberian hamsters. Hamsters were transferred from long day (LD; 16:8) to short day (SD; 8:16) photoperiods for 14weeks, and then returned to LD for 0, 1, 2, 4, or 8weeks for collection of ovaries and plasma. Post-transfer (PT) LD exposure increased body and ovarian mass. Number of corpora lutea and antral, but not preantral follicles increased in PT groups. Plasma estradiol concentrations were lower in PT weeks 0-4, and returned to LD levels at PT week 8. No change was observed in relative MMP/TIMP mRNA levels at PT week 0 (SD week 14) as compared to LD. Photostimulation increased MMP-2 mRNA at PT week 8 as compared to PT weeks 0-1. MMP-14 mRNA expression peaked at PT weeks 1-2 as compared to LD levels, while MMP-13 expression was low during this time. TIMP-1 mRNA peaked at PT week 8 as compared to PT weeks 0-4. No changes were noted in MMP-9 and TIMP-2 mRNA expression. In general, MMP/TIMP protein immunodetection followed the same patterns with most staining occurring in granulosa cells of follicles and corpora lutea. Our data suggest that mRNA and protein for several members of the MMP/TIMP families are expressed in Siberian hamster ovaries during recrudescence. Because of the variation observed in expression patterns, MMPs and TIMPs may be differentially involved with photostimulated return to ovarian function.