Income disparities and risk: Geographical manifestations of extreme inequities in the United States.

We examined hazard and risk-related metrics of the highest- and lowest-income counties and municipalities in each U.S. state. Indicators of natural and anthropogenic hazards, health outcomes, location of locally unwanted land uses, food insecurity, and other metrics were used to measure social and environmental justice. As expected, the highest-income places have better health outcomes, access to assets that protect health, and high municipal ratings of place quality compared with their poorest counterparts. Yet, they also have higher natural hazard risks and are more likely to live near concentrations of anthropogenic hazards. That is, high-income places have a lot to lose. Although the poorest jurisdictions demonstrate cumulative disadvantages, those in rural areas are exposed to less dense motor vehicle traffic and other hazards and risks associated with urban life. Relationships between income and the geography of hazards and risks are not simple. Even the highest-income areas face challenges. We suggest improvements in databases and tools to increase the focus on and monitoring of the breadth of risks people face in all areas.

A systematic review of animal feeding operations including concentrated animal feeding operations (CAFOs) for exposure, health outcomes, and environmental justice.

BACKGROUND: Despite growing literature on animal feeding operations (AFOs) including concentrated animal feeding operations (CAFOs), research on disproportionate exposure and associated health burden is relatively limited and shows inconclusive findings. OBJECTIVE: We systematically reviewed previous literature on AFOs/CAFOs, focusing on exposure assessment, associated health outcomes, and variables related to environmental justice (EJ) and potentially vulnerable populations. METHODS: We conducted a systematic search of databases (MEDLINE/PubMed and Web of Science) and performed citation screening. Screening of titles, abstracts, and full-text articles and data extraction were performed independently by pairs of reviewers. We summarized information for each study (i.e., study location, study period, study population, study type, study design, statistical methods, and adjusted variables (if health association was examined), and main findings), AFO/CAFO characteristics and exposure assessment (i.e., animal type, data source, measure of exposure, and exposure assessment), health outcomes or symptoms (if health association was examined), and information related to EJ and potentially vulnerable populations (in relation to exposure and/or health associations, vulnerable populations considered, related variables, and main findings in relation to EJ and vulnerable populations). RESULTS: After initial screening of 10,963 papers, we identified 76 eligible studies. This review found that a relatively small number of studies (20 studies) investigated EJ and vulnerability issues related to AFOs/CAFOs exposure and/or associated health outcomes (e.g., respiratory diseases/symptoms, infections). We found differences in findings across studies, populations, the metrics used for AFO/CAFO exposure assessment, and variables related to EJ and vulnerability. The most commonly used metric for AFO/CAFO exposure assessment was presence of or proximity to facilities or animals. The most investigated variables related to disparities were race/ethnicity and socioeconomic status. CONCLUSION: Findings from this review provide suggestive evidence that disparities exist with some subpopulations having higher exposure and/or health response in relation to AFO/CAFO exposure, although results varied across studies.

Applying location quotient methodology to urban park settings with mobile location data: Implications for equity and park planning.

In this study, we pilot a novel use of location quotient and proportional comparison methodology paired with mobile device location data. Specifically, we sought to understand visitation patterns in an urban park context based on visitor home locale socio-demographics, using an example from Fairmount Park in Philadelphia, PA, USA. We examined visitors' home locale demographics (i.e., percent African American and median household income) across a variety of park amenities (e.g., playgrounds, ball fields, splashpads), using location quotients and proportional analyses to compare the home locale demographics of visitors to specific amenities to park visitors as a whole. Findings illustrate amenities with over- or underrepresentation of visitors from certain socio-demographic groups, with bivariate analyses documenting intersectionality between race and income. Results of such analyses can aid park managers in understanding use of particular amenities and service gaps among historically underserved populations, and in turn, support more equitable resource allocation.

Communities Disproportionately Affected by Carbon Monoxide Exposure After Winter Storm Uri.

Extreme cold in February 2021 precipitated prolonged power failure in Texas. In Houston, many patients presented for carbon monoxide exposure from neighborhoods with lower per capita income, higher rates of limited English proficiency, and greater median Social Vulnerability Indices than Greater Houston. Weather-related disasters disproportionately affect socially vulnerable communities.

Enhancing Human Health and Wellbeing through Sustainably and Equitably Unlocking a Healthy Ocean's Potential.

A healthy ocean is essential for human health, and yet the links between the ocean and human health are often overlooked. By providing new medicines, technologies, energy, foods, recreation, and inspiration, the ocean has the potential to enhance human health and wellbeing. However, climate change, pollution, biodiversity loss, and inequity threaten both ocean and human health. Sustainable realisation of the ocean's health benefits will require overcoming these challenges through equitable partnerships, enforcement of laws and treaties, robust monitoring, and use of metrics that assess both the ocean's natural capital and human wellbeing. Achieving this will require an explicit focus on human rights, equity, sustainability, and social justice. In addition to highlighting the potential unique role of the healthcare sector, we offer science-based recommendations to protect both ocean health and human health, and we highlight the unique potential of the healthcare sector tolead this effort.

Socioeconomic Disparities in Urban Forest Diversity and Structure in Green Areas of Santiago de Chile.

Urban trees enhance biodiversity, provide ecosystem services, and improve quality of life in cities. Despite their benefits, trees are not distributed equitably, and many cities exhibit a "luxury effect". Given the importance of public green space for providing access to urban tree benefits, we investigated the relationship between socioeconomic level and tree diversity and structure in 60 green areas in Santiago de Chile. Species richness and total tree abundance did not significantly vary among socioeconomic levels; however, a differential effect was found according to species origin. Introduced tree species exhibited similar abundance and species richness across socioeconomic levels, but native tree species were more abundant and richer in higher socioeconomic level areas compared to lower ones. Tree cover was higher in the high and medium socioeconomic level areas than in the low socioeconomic level area. A higher average DBH was found in the medium socioeconomic level area, which may be explained by older neighborhoods and a legacy of the luxury effect. Our findings reveal that socioeconomic groups are associated with differences in tree cover, width, and the number of native species in public green areas. Consequently, urban residents have different provisions of ecosystem services and opportunities to interact with natural heritage. Increasing the amount of tree cover and native species available to vulnerable groups will reduce disparities.

ACPM Position Statement: Air Pollution & Environmental Justice.

The American Lung Association's "State of the Air" 2023 report reveals almost 36% of Americans live with unhealthy levels of air pollution. Studies link air pollution with acute respiratory symptoms and exacerbation of respiratory and cardiovascular diseases. Differential air pollution exposures between white and non-white communities are significant components of environmental injustices. Even during the COVID-19 lockdown, when the United States experienced significant decreases in polluting activities, these differences persisted. The American College of Preventive Medicine's Science and Translation Committee conducted a nonsystematic literature review to explore initiatives addressing air pollution as a key component of environmental justice, the state of the science regarding health impacts, and evidence supporting mitigations to reduce those impacts. We recommend advocacy for cleaner energy sources and increasing green space; and increasing research, surveillance, and education and training on linkages between air pollutants and health. We recommend preventive medicine physicians raise awareness about increased risks of cardiovascular disease, cancer, asthma, and reduced lung function with air pollution exposure. Preventive medicine physicians may also educate patients and other practitioners about exposures, and how "conventional" disease prevention strategies may have unintended consequences; and influence healthcare leaders to improve efficiency and reduce emissions. We also recommend physicians utilize social determinants of health (SDOH) Z-Codes to capture environmental factors. Private payers should incorporate pollution exposure data into SDOH risk-adjustments for Medicare Advantage programs. Medicaid agencies should develop provider recommendations for pediatric populations, and states should finance in-home interventions for asthma.

Drinking water source and exposure to regulated water contaminants in the California Teachers Study cohort.

BACKGROUND: Pollutants including metals/metalloids, nitrate, disinfection byproducts, and volatile organic compounds contaminate federally regulated community water systems (CWS) and unregulated domestic wells across the United States. Exposures and associated health effects, particularly at levels below regulatory limits, are understudied. OBJECTIVE: We described drinking water sources and exposures for the California Teachers Study (CTS), a prospective cohort of female California teachers and administrators. METHODS: Participants' geocoded addresses at enrollment (1995-1996) were linked to CWS service area boundaries and monitoring data (N = 115,206, 92%); we computed average (1990-2015) concentrations of arsenic, uranium, nitrate, gross alpha (GA), five haloacetic acids (HAA5), total trihalomethanes (TTHM), trichloroethylene (TCE), and tetrachloroethylene (PCE). We used generalized linear regression to estimate geometric mean ratios of CWS exposures across demographic subgroups and neighborhood characteristics. Self-reported drinking water source and consumption at follow-up (2017-2019) were also described. RESULTS: Medians (interquartile ranges) of average concentrations of all contaminants were below regulatory limits: arsenic: 1.03 (0.54,1.71) µg/L, uranium: 3.48 (1.01,6.18) µg/L, GA: 2.21 (1.32,3.67) pCi/L, nitrate: 0.54 (0.20,1.97) mg/L, HAA5: 8.67 (2.98,14.70) µg/L, and TTHM: 12.86 (4.58,21.95) µg/L. Among those who lived within a CWS boundary and self-reported drinking water information (2017-2019), approximately 74% self-reported their water source as municipal, 15% bottled, 2% private well, 4% other, and 5% did not know/missing. Spatially linked water source was largely consistent with self-reported source at follow-up (2017-2019). Relative to non-Hispanic white participants, average arsenic, uranium, GA, and nitrate concentrations were higher for Black, Hispanic and Native American participants. Relative to participants living in census block groups in the lowest socioeconomic status (SES) quartile, participants in higher SES quartiles had lower arsenic/uranium/GA/nitrate, and higher HAA5/TTHM. Non-metropolitan participants had higher arsenic/uranium/nitrate, and metropolitan participants had higher HAA5/TTHM. IMPACT: Though average water contaminant levels were mostly below regulatory limits in this large cohort of California women, we observed heterogeneity in exposures across sociodemographic subgroups and neighborhood characteristics. These data will be used to support future assessments of drinking water exposures and disease risk.

Effects of socioeconomic status and regional inequality on the association between PM2.5 and its components and cardiometabolic multimorbidity: A multicenter population-based survey in eastern China.

BACKGROUND: Despite evidence linking fine particulate matter (PM2.5) to cardiometabolic multimorbidity (CMM), the impact of its components remains unclear. Socioeconomic status (SES) and regional disparities may confound their association. We aim to evaluate the associations between PM2.5 components and CMM and explore how socioeconomic status and regional disparities affect these relationships. METHODS: We recruited 108,941 participants aged 35-76 years from ten cities in eastern China. Individual exposure was assessed using Tracking Air Pollution in China (TAP) data, including PM2.5 and five components: ammonium (NH4+), black carbon (BC), nitrates (NO3-), organic matter (OM), and sulfates (SO42-). Generalized linear models and quantile g-computation models were employed to quantify the effects of PM2.5 components on CMM and to identify key components. Stratified analyses were performed to investigate the modifying effect of SES and regional disparities. RESULTS: For each increase in interquartile range (IQR), BC (odds ratio [OR] 1.37, 95 % CI 1.29-1.47), OM (1.38, 1.29-1.48), NH4+ (1.31, 1.21-1.40), NO3- (1.34, 1.25-1.44), and SO42- (1.28, 1.20-1.38) were positively associated with CMM. Joint exposure to five components was significantly positively associated with CMM (OR: 1.27, 95 % CI: 1.21-1.33), with SO42- having the highest estimated weight, followed by NO3- and BC. These associations were stronger for participants from low socio-economic status and poor regions. CONCLUSION: In summary, we found a stronger hazard effect of PM2.5 and its components on CMM, compared to those suffering from CMDs, particularly among participants with low socioeconomic status and in poor regions. SO42- may be a primary contributor to the association between PM2.5 components and CMM. These findings underscore the importance of prioritizing CMM and targeting SO42-related pollution sources in health policies, particularly amid China's aging population, reducing environmental health inequalities is critical.

Promotion of environmental public health and environmental justice in communities affected by large and long lasting industrial contamination: methods applied and lessons learned from the case study of Porto Torres (Italy).

Introduction: Communities affected by large scale and long lasting industrial contamination are often keen to understand whether their health has been impaired by such contamination. This requires answers that integrate environmental public health and environmental justice perspectives. At these sites, exposure scenarios from environmental contamination over time by multiple chemicals, often involving different environmental matrices, are complex and challenging to reconstruct. Methods: An approach for describing the health of such communities in association with environmental contamination is presented, with the methods applied across the three domains of environmental contamination, population exposure and toxicology, environmental and social epidemiology, and environmental public health communication. The approach is described with examples from its application to the case study of Porto Torres, a town with a substantial industrially conditioned evolution. Results: Activities in the field of environmental contamination, population exposure and toxicology focus on the collection and systematization of available contamination data, the identification of priority pollutants based on their toxicological profiles, the qualitative assessment of the likelihood of exposure for the population to priority pollutants and their known health effects. Environmental and social epidemiology methods are applied to describe the health profiles and socioeconomic conditions of the local population, taking into account multiple health outcomes from local information systems and considering specific diseases based on exposure and toxicological assessments. The environmental public health communication methods are directed to produce a communication plan and for its implementation through interaction with local institutional and social actors. The interpretation of health profiles benefits from a transdisciplinary analysis of the results. Discussion: The proposed approach combines the needs of environmental public health and environmental justice allowing the integration of multidisciplinary knowledge to define recommendations for reducing and/or preventing hazardous environmental exposures and adverse health effects, stimulating the interactions between stakeholders, and making the study results more accessible to citizens.

Air Quality Monitoring and the Safety of Farmworkers in Wildfire Mandatory Evacuation Zones.

The increasing frequency and severity of wildfires due to climate change pose health risks to migrant farm workers laboring in wildfire-prone regions. This study focuses on Sonoma County, California, investigating the effectiveness of air monitoring and safety protections for farmworkers. The analysis employs AirNow and PurpleAir PM2.5 data acquired during the 2020 wildfire season, comparing spatial variability in air pollution. Results show significant differences between the single Sonoma County AirNow station data and the PurpleAir data in the regions directly impacted by wildfire smoke. Three distinct wildfire pollution episodes with elevated PM2.5 levels are identified to examine the regional variations. This study also examines the system used to exempt farmworkers from wildfire mandatory evacuation orders, finding incomplete information, ad hoc decision-making, and scant enforcement. In response, we make policy recommendations that include stricter requirements for employers, real-time air quality monitoring, post-exposure health screenings, and hazard pay. Our findings underscore the need for significant consideration of localized air quality readings and the importance of equitable disaster policies for protecting the health of farmworkers (particularly those who are undocumented migrants) in the face of escalating wildfire risks.

Validating self-reported Toxic Release Inventory data using Benford's Law: investigating toxic chemical release hazards in floodplains.

Introduction: Acute and long-term health impacts from flooding related toxic chemical releases are a significant local health concern and can disproportionately impact communities with vulnerable populations; reliable release data are needed to quantify this hazard. Methods: In this paper, we analyze US Federal Emergency Management Agency designated floodplain data and US Environmental Protection Agency Toxic Release Inventory (TRI) data to determine if geographically manipulated databases adhere to Benford's Law. Results: We investigated multiple variants and discovered pollution releases adhere to Benford's Law and tests which thereby validates the self-reported toxic release dataset. Discussion: We find that Benford's Law applies to self-reported toxic chemical release and disposal data, indicating a lack of widespread data errors or manipulation.

Confined within a sugarcane monoculture: A participatory assessment of water pollution and potential health risks in the community of El Tiple, Colombia.

Communities neighboring monoculture plantations are vulnerable to different forms of pollution associated with agro-industrial operations. Herein, we examine the case of El Tiple, a rural Afro descendant community embedded within one of the largest sugarcane plantations in the Americas. We implemented a participatory approach to assess water pollution, exposure via water ingestion, and non-carcinogenic health risks associated with the use of local water sources available to the community. We conducted household surveys to unveil demographic characteristics and family dynamics linked to water consumption. Additionally, we measured water quality parameters and assessed the concentration glyphosate, its major metabolite (aminomethylphosphonic acid) and metals and metalloids. Drinking water El Tiple households is sourced from three primary sources: the local aqueduct system, water delivery trucks, and private deep wells. Tests on water samples from both the local aqueduct and delivery trucks showed no traces of pesticides, metals, or metalloids surpassing regulatory limits set by Colombian or EPA standards. However, we found concentration of contaminants of primary concern, including mercury (up to 0.0052 ppm) and lead (up to 0.0375 ppm) that exceed the permissible regulatory thresholds in water from groundwater wells. Residents of the peripheric subdivisions of El Tiple are four times more reliant on well water extraction than residents of the central area of the town due to lack of access to public drinking water and sanitation infrastructure. Finally, adult women and school-age children have a higher health risk associated with exposure to local pollutants than adult men due to their constant presence in the town. We conclude that expanding the coverage of clean water and sanitation infrastructure to include all households of the community would be the most recommended measure to minimize exposure and risk via ingestion of water pollutants.

Analysing a private city being built from scratch through a social and environmental justice framework: A research agenda.

A growing body of scholarship examines new cities being built from scratch that are developed and governed by the private sector. While this scholarship explores discourse and rhetoric, economic objectives, and some social and environmental impacts of new private cities, scholars to date have not taken a social or environmental justice approach to analysing new city projects. In this article we examine Forest City, a private city project being built on artificial islands off the coast of Malaysia by one of China's largest property development companies, and its unique governance and claims to being 'eco', despite the significant environmental damage it has caused. Intended as a lush and exclusive gated enclave for Chinese nationals, Forest City is a productive case study through which to consider the consequences of a private city using the frameworks of social and environmental justice. We suggest more critical research that engages with social and environmental justice is needed on the many emerging projects branded as eco-cities of the future, a troubling claim that signals a growing normalisation of mega-scale privatisation and loose or absent regulations regarding social inclusivity and environmental protection.

Mental models for inclusive, socially-just disaster planning: a multi-community study in Saint Martin after Hurricane Irma.

Local perspectives provide different insights into disaster planning and response as compared to those of experts. Eliciting them, however, can be challenging, particularly for marginalised groups whose viewpoints have historically been excluded from planning processes. Fuzzy cognitive mapping (FCM) provides a semi-quantitative approach to representing the collective understanding or 'mental models' of diverse individuals and communities. This study involved 23 FCM interviews across three neighbourhoods of Saint Martin to comprehend: (i) how individuals' mental models of Hurricane Irma (2017) differ based on their context; (ii) how aligned mental models are with policy and planning documents; and (iii) the implications for the inclusiveness and representativeness of disaster response policies. It found that the residents of different neighbourhoods provided unique insights into the factors driving the social-ecological system, and that official policies aligned closely with priorities. The paper argues that the inclusion of the perspectives of different groups in disaster recovery is essential for an equitable process.

Tracing vulnerable communities to ambient air pollution exposure: A geodemographic and remote sensing approach.

Most studies analyzing the effects of air pollution on disadvantaged populations use ground air quality measurements. However, ground stations are generally limited, with nearly 40% of countries having no official PM2.5 stations, not allowing air quality analysis for a significantly large share of the world's population. Furthermore, limited studies analyze community data from a geodemographic perspective, in other words, to delineate the sociodemographic profiles and geographically locate the socioeconomic groups more exposed to ambient air pollution. Therefore, a significant question arises: How can we trace vulnerable communities to air pollution in areas lacking air-quality ground data? Here, we propose a novel methodology to respond to this question. We use NO2, SO2, CO, and HCHO tropospheric column air-quality data from Sentinel-5P, a satellite that quantifies concentrations of atmospheric species from space operationally. We integrate them with census and environmental data and apply the local fuzzy geographically weighted clustering spatial machine learning method for segmentation analysis. Our findings for Bali, Indonesia, provide quantitative evidence for the benefits of this methodology in tracing and delineating the profiles of the communities most exposed to air pollution. For example, results show that communities with highly disadvantaged populations, such as unemployed (over 27.8%), low educated (over 27.9%), and children (over 22.1%) (mainly located around Bali's south and north coast touristic areas), exhibit very high values (over the 75th quartile) across the pollutants studied. The proposed method is reproducible easily, quickly, and at low cost, as it is based on freely available satellite data and not on costly ground station measurements. This will hopefully assist decision-makers in tracing the most vulnerable subpopulations, even in areas with inadequate air-quality monitoring networks, thus allowing local governments around the globe (even those that are financially weak) to achieve environmental justice and their sustainable development goals.

Heatwave frequency and disability status: Thermal inequities in the U.S. South.

BACKGROUND: Although extreme heat has been found to be disproportionately distributed with respect to socially disadvantaged and marginalized groups, persons with disabilities have received limited attention in previous research on heat exposure disparities. OBJECTIVE: This gap is addressed by analyzing the relationship between local heatwave frequency and the percentages of people with a disability and specific disability types in the U.S. South-a region characterized by extremely high summer temperatures and greater disability prevalence. METHODS: Census tract level values of heatwave annualized frequency from the U.S. Federal Emergency Management Agency's National Risk Index are linked to relevant disability variables from the latest American Community Survey five-year estimates. Statistical analyses are based on bivariate correlations and multivariable generalized estimating equations that consider spatial clustering of tracts based on climate zone and county. RESULTS: The overall percentage of civilian noninstitutionalized persons with a disability and more than one disability are significantly greater (p < 0.001) in census tracts with higher heatwave frequency, after controlling for clustering, race/ethnicity, socioeconomic status, older age, population density, and metropolitan status. Heatwave frequency is also positively and significantly associated (p < 0.01) with the percentages of people with hearing, vision, cognitive, ambulatory, self-care, and independent living difficulties. CONCLUSIONS: These heat-related distributive injustices in the U.S. South demonstrate an urgent need to: (1) include disability status in future research on social disparities in heatwave exposure; (2) conduct more detailed investigations in other regions, states, and nations; and (3) develop disability-inclusive policies and interventions that provide equitable protection during extreme weather events.

Gene-environment interactions within a precision environmental health framework.

Understanding the complex interplay of genetic and environmental factors in disease etiology and the role of gene-environment interactions (GEIs) across human development stages is important. We review the state of GEI research, including challenges in measuring environmental factors and advantages of GEI analysis in understanding disease mechanisms. We discuss the evolution of GEI studies from candidate gene-environment studies to genome-wide interaction studies (GWISs) and the role of multi-omics in mediating GEI effects. We review advancements in GEI analysis methods and the importance of large-scale datasets. We also address the translation of GEI findings into precision environmental health (PEH), showcasing real-world applications in healthcare and disease prevention. Additionally, we highlight societal considerations in GEI research, including environmental justice, the return of results to participants, and data privacy. Overall, we underscore the significance of GEI for disease prediction and prevention and advocate for integrating the exposome into PEH omics studies.

Feeling hot is being hot? Comparing the mapping and the surveying paradigm for urban heat vulnerability in Vienna.

With rising global temperatures, cities increasingly need to identify populations or areas that are vulnerable to urban heat waves; however, vulnerability assessments may run into ecological fallacy if data from different scales are misconstrued as equivalent. We assess the heat vulnerability of 1983 residents in Vienna by measuring heat impacts, exposure, sensitivity and adaptive capacity with mirrored indicators in the mapping paradigm (i.e. census tract data referring to the geographic regions where these residents live) and the surveying paradigm (i.e. survey data referring to the residents' individual households). Results obtained in both paradigms diverge substantially: meteorological indicators of hot days and tropical nights are virtually unrelated to self-reported heat strain. Meteorological indicators are explained by mapping indicators (R2 of 15-40 %), but mostly not by surveying indicators. Vice versa, experienced heat stress and subjective heat burden are mostly unassociated with mapping indicators but are partially explained by surveying indicators (R2 of 2-4 %). The results suggest that the two paradigms do not capture the same components of vulnerability; this challenges whether studies conducted in the respective paradigms can complement and cross-validate each other. Policy interventions should first define which heat vulnerability outcome they target and then apply the paradigm that best captures the specific drivers of this outcome.