Individual And Neighborhood Socioeconomic Status Long Term Exposure To Air Pollution And Risk Of Cardiovascular Disease In The Women S Health Initiative Observational Study
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Individual And Neighborhood Socioeconomic Status Long Term Exposure To Air Pollution And Risk Of Cardiovascular Disease In The Women S Health Initiative Observational Study
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Author : Gloria Cheng-yu Chi
language : en
Publisher:
Release Date : 2012
Individual And Neighborhood Socioeconomic Status Long Term Exposure To Air Pollution And Risk Of Cardiovascular Disease In The Women S Health Initiative Observational Study written by Gloria Cheng-yu Chi and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012 with categories.
Background: Previous studies have reported a positive association between exposure to higher levels of air pollution and cardiovascular mortality and morbidity. However, uncertainty remains regarding the potential confounding and effect modification of this association by socioeconomic status (SES). This study examined the roles that individual and neighborhood SES (at the Census tract level, NSES) may play in the association between particles less than 2.5 [microgram] in aerodynamic diameter (PM2.5) and incident cardiovascular disease. Methods: We studied 48,067 women from the Women's Health Initiative Observational Study (WHI OS) who were free of cardiovascular disease at baseline. Outcomes of interest were time to first cardiovascular event and time to death from cardiovascular cause. Exposure data were obtained from nationwide monitors to predict annual average PM2.5 concentrations at each subject's baseline geocoded address. Cox-proportional hazards regression was used. All models were adjusted for age, race, smoking, body mass index, diabetes, hypertension, hypercholesterolemia, systolic blood pressure, and physical activity. Individual and neighborhood SES were further adjusted for as covariates or modeled as linear interactions. Results: A total of 2,446 cardiovascular events and 536 cardiovascular deaths were observed. In our fully adjusted models, each 10 [microgram]/m3 higher PM2.5 exposure was associated with a 1.22 times higher hazard (95% CI, 1.06 to 1.40) for cardiovascular events and a 1.31 times higher hazard (95% CI, 0.95 to 1.81) for cardiovascular deaths. In this cohort, neither individual nor neighborhood SES characteristics were strong confounders and individual SES characteristics also did not modify these associations. Only the following neighborhood SES variables: median family income, percent of adults over 25 years with high school degree, median home value, and the NSES score (a measure of overall deprivation of a neighborhood) were found to be significant effect modifiers. Greater effects tended to be observed among those residing in more disadvantaged neighborhoods. Conclusions: Long term exposure to PM2.5 was associated with increased risk of cardiovascular disease among a cohort of postmenopausal women and this effect cannot be explained by confounding by individual or neighborhood SES. In this cohort, women living in more disadvantaged neighborhoods were disproportionately affected by the adverse effects of PM2.5 exposure on cardiovascular health. These results add to previously published research that tend to show greater effects among the less advantaged groups. Thus, a focus to reduce risks in these susceptible populations may be germane to public health and environmental policy.
U S Health In International Perspective
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Author : National Research Council
language : en
Publisher: National Academies Press
Release Date : 2013-04-12
U S Health In International Perspective written by National Research Council and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013-04-12 with Social Science categories.
The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings. U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.
Ambient Air Pollution And Lung Cancer Risk In The Women S Health Initiative Observational Study
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Author : Shilpa N. Gowda
language : en
Publisher:
Release Date : 2016
Ambient Air Pollution And Lung Cancer Risk In The Women S Health Initiative Observational Study written by Shilpa N. Gowda and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016 with categories.
Background: Outdoor air pollution was recently classified as a human carcinogen by the International Agency for Research on Cancer. However, epidemiologic studies supporting this classification have focused on lung cancer mortality rather than incidence, and most previous studies have included relatively few women. Women in older age groups with higher incidence of lung cancer have been particularly underrepresented. New studies that address these limitations are needed to further explore and quantify the strength of the association between ambient air pollution and lung cancer. Methods: We sought to evaluate this association, using data from the observational arm of the Women’s Health Initiative (WHI) study, a large, U.S.-based cohort of post-menopausal women (final sample size after applying exclusions = 86,146, with 1,332 lung cancer cases). Mean follow-up time of participants was 11 years, with a maximum follow-up time of 15 years. We used previously validated state-of-the-art geospatial models to estimate exposures to fine particulate matter (PM2.5) and nitrogen dioxide (NO2), two major constituents of ambient air pollution, based on participants’ residential addresses. NO2 is considered a proxy measure for traffic- related air pollutants. We also characterized participants’ exposures to traffic-related air pollution by the distances of their residential addresses to a primary limited-access highway. Using Cox proportional hazards regression models, we calculated hazard ratios (HRs) for the risk of lung cancer in association with these exposure metrics. We adjusted for several potential confounders, including age, race, body mass index, region of residence (including urbanicity), smoking habits, and socioeconomic status. Furthermore, we conducted exploratory analyses restricted to never smokers, adjusting for second-hand smoke exposures. Separate exploratory analyses stratified lung cancer outcomes by major histological subtypes. Results: In our primary analyses, no significant associations were observed. For example, when s inclusion of participants from the WHI clinical trial arm would enhance study power and may make results more informative.
Communities In Action
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Author : National Academies of Sciences, Engineering, and Medicine
language : en
Publisher: National Academies Press
Release Date : 2017-04-27
Communities In Action written by National Academies of Sciences, Engineering, and Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-04-27 with Medical categories.
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
The Future Of The Public S Health In The 21st Century
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Author : Institute of Medicine
language : en
Publisher: National Academies Press
Release Date : 2003-02-01
The Future Of The Public S Health In The 21st Century written by Institute of Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2003-02-01 with Medical categories.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
Nature Based Solutions To Climate Change Adaptation In Urban Areas
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Author : Nadja Kabisch
language : en
Publisher: Springer
Release Date : 2017-09-01
Nature Based Solutions To Climate Change Adaptation In Urban Areas written by Nadja Kabisch and has been published by Springer this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-09-01 with Political Science categories.
This open access book brings together research findings and experiences from science, policy and practice to highlight and debate the importance of nature-based solutions to climate change adaptation in urban areas. Emphasis is given to the potential of nature-based approaches to create multiple-benefits for society. The expert contributions present recommendations for creating synergies between ongoing policy processes, scientific programmes and practical implementation of climate change and nature conservation measures in global urban areas. Except where otherwise noted, this book is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
Endocrine Disrupters And Metabolism
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Author : Yann Gibert
language : en
Publisher: Frontiers Media SA
Release Date : 2020-01-20
Endocrine Disrupters And Metabolism written by Yann Gibert and has been published by Frontiers Media SA this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-01-20 with categories.
Biodiversity And Health In The Face Of Climate Change
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Author : Melissa R. Marselle
language : en
Publisher: Springer
Release Date : 2019-06-11
Biodiversity And Health In The Face Of Climate Change written by Melissa R. Marselle and has been published by Springer this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019-06-11 with Medical categories.
This open access book identifies and discusses biodiversity’s contribution to physical, mental and spiritual health and wellbeing. Furthermore, the book identifies the implications of this relationship for nature conservation, public health, landscape architecture and urban planning – and considers the opportunities of nature-based solutions for climate change adaptation. This transdisciplinary book will attract a wide audience interested in biodiversity, ecology, resource management, public health, psychology, urban planning, and landscape architecture. The emphasis is on multiple human health benefits from biodiversity - in particular with respect to the increasing challenge of climate change. This makes the book unique to other books that focus either on biodiversity and physical health or natural environments and mental wellbeing. The book is written as a definitive ‘go-to’ book for those who are new to the field of biodiversity and health.
Urban Sprawl And Public Health
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Author : Howard Frumkin
language : en
Publisher:
Release Date : 2004-07-09
Urban Sprawl And Public Health written by Howard Frumkin and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2004-07-09 with Medical categories.
'Urban Sprawl and Public Health' offers a survey of the impact that the built environment can have on the health of the people who inhabit our cities. The authors go on to suggest ways in which the design of cities could be improved & have a positive impact on the well-being of their citizens.
Promoting Cardiovascular Health In The Developing World
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Author : Institute of Medicine
language : en
Publisher: National Academies Press
Release Date : 2010-06-29
Promoting Cardiovascular Health In The Developing World written by Institute of Medicine and has been published by National Academies Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010-06-29 with Medical categories.
Cardiovascular disease (CVD), once thought to be confined primarily to industrialized nations, has emerged as a major health threat in developing countries. Cardiovascular disease now accounts for nearly 30 percent of deaths in low and middle income countries each year, and is accompanied by significant economic repercussions. Yet most governments, global health institutions, and development agencies have largely overlooked CVD as they have invested in health in developing countries. Recognizing the gap between the compelling evidence of the global CVD burden and the investment needed to prevent and control CVD, the National Heart, Lung, and Blood Institute (NHLBI) turned to the IOM for advice on how to catalyze change. In this report, the IOM recommends that the NHLBI, development agencies, nongovernmental organizations, and governments work toward two essential goals: creating environments that promote heart healthy lifestyle choices and help reduce the risk of chronic diseases, and building public health infrastructure and health systems with the capacity to implement programs that will effectively detect and reduce risk and manage CVD. To meet these goals, the IOM recommends several steps, including improving cooperation and collaboration; implementing effective and feasible strategies; and informing efforts through research and health surveillance. Without better efforts to promote cardiovascular health, global health as a whole will be undermined.