Suchergebnisse

Abstract
Factors associated with structural racism, disenfranchisement, poverty, and other persistent sources of inequity are associated with vulnerability and exposure to environmental hazards. Social, demographic, and environmental factors associated with vulnerability to environmental hazards have been used by many researchers to produce indexes of hazard vulnerability. In preparation for a climate change health risk assessment for Washington state, we compared methods and results from six indexes designed to support environmental health risk assessment. Production of these indexes varies in the number of variables considered, calculation complexity, and exposure of local causal pathways. Results for these indexes are generally very similar, especially at the highest decile of vulnerability, the exception being the Environmental Health Disparities index, the only one to consider hazard exposure. Some indexes used methods that hide causal pathways. Those that exposed causal pathways limited model structure. Results indicate that simpler indexes may be more appropriate for use in decision support tools as they require less overhead for data updates and scenario analysis and that other methodologies may provide a more useful framework for index generation.

AbstractFew studies have assessed how the intersection of social determinants of health and environmental hazards contributes to racial disparities in COVID-19. The aim of our study was to compare COVID-19 disparities in testing and positivity to cumulative environmental health impacts, and to assess how unique social and environmental determinants of health relate to COVID-19 positivity in Seattle, King County, WA, at the census tract level. Publicly available data (n = 397 census tracts) were obtained from Public Health–Seattle & King County, 2018 ACS 5-year estimates, and the Washington Tracking Network. COVID-19 testing and positive case rates as of July 12, 2020, were mapped and compared to Washington State Environmental Health Disparities (EHD) Map cumulative impact rankings. We calculated odds ratios from a series of univariable and multivariable logistic regression analyses using cumulative impact rankings, and community-level socioeconomic, health, and environmental factors as predictors and having ≥ 10% or < 10% census tract positivity as the binary outcome variable. We found a remarkable overlap between Washington EHD cumulative impact rankings and COVID-19 positivity in King County. Census tracts with ≥ 10 % COVID-19 positivity had significantly lower COVID-19 testing rates and higher proportions of people of color and faced a combination of low socioeconomic status–related outcomes, poor community health outcomes, and significantly higher concentrations of fine particulate matter (PM2.5). King County communities experiencing high rates of COVID-19 face a disproportionate cumulative burden of environmental and social inequities. Cumulative environmental health impacts should therefore systematically be considered when assessing for risk of exposure to and health complications resulting from COVID-19.