Developing a National-Scale Exposure Index for Combined Environmental Hazards and Social Stressors and Applications to the Environmental Influences on Child Health Outcomes (ECHO) Cohort

Sheena E. Martenies (), Mingyu Zhang, Anne E. Corrigan, Anton Kvit, Timothy Shields, William Wheaton, Deana Around Him, Judy Aschner, Maria M. Talavera-Barber, Emily S. Barrett, Theresa M. Bastain, Casper Bendixsen, Carrie V. Breton, Nicole R. Bush, Ferdinand Cacho, Carlos A. Camargo, Kecia N. Carroll, Brian S. Carter, Andrea E. Cassidy-Bushrow, Whitney Cowell, Lisa A. Croen, Dana Dabelea, Cristiane S. Duarte, Anne L. Dunlop, Todd M. Everson, Rima Habre, Tina V. Hartert, Jennifer B. Helderman, Alison E. Hipwell, Margaret R. Karagas, Barry M. Lester, Kaja Z. LeWinn, Sheryl Magzamen, Rachel Morello-Frosch, Thomas G. O’Connor, Amy M. Padula, Michael Petriello, Sheela Sathyanarayana, Joseph B. Stanford, Tracey J. Woodruff, Rosalind J. Wright and Amii M. Kress
Additional contact information
Sheena E. Martenies: Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
Mingyu Zhang: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
Anne E. Corrigan: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
Anton Kvit: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
Timothy Shields: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA
William Wheaton: Research Triangle Institute, Research Triangle Park, NC 27709, USA
Deana Around Him: Child Trends, Bethesda, MD 20814, USA
Judy Aschner: Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
Maria M. Talavera-Barber: Avera Research Institute, Sioux Falls, SD 57105, USA
Emily S. Barrett: Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA
Theresa M. Bastain: Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
Casper Bendixsen: Marshfield Clinic Research Institute, Marshfield, WI 54449, USA
Carrie V. Breton: Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
Nicole R. Bush: Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
Ferdinand Cacho: Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA
Carlos A. Camargo: Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
Kecia N. Carroll: Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Brian S. Carter: Department of Pediatrics-Neonatology, Children’s Mercy Hospital, Kansas City, MO 64108, USA
Andrea E. Cassidy-Bushrow: Department of Public Health Sciences, Henry Ford Health, Detroit, MI 48202, USA
Whitney Cowell: Department of Pediatrics, New York University Grossman School of Medicine, New York, NY 10016, USA
Lisa A. Croen: Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA
Dana Dabelea: Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
Cristiane S. Duarte: New York State Psychiatric Institute, Columbia University, New York, NY 10032, USA
Anne L. Dunlop: Department of Obstetrics and Gynecology, Emory University School of Medicine, Atlanta, GA 30322, USA
Todd M. Everson: Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
Rima Habre: Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
Tina V. Hartert: Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
Jennifer B. Helderman: Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
Alison E. Hipwell: Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA
Margaret R. Karagas: Department of Epidemiology, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
Barry M. Lester: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI 02903, USA
Kaja Z. LeWinn: Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA
Sheryl Magzamen: Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO 80523, USA
Rachel Morello-Frosch: Department of Environmental Science, Policy and Management and School of Public Health, University of California Berkeley, Berkeley, CA 94720, USA
Thomas G. O’Connor: Departments of Psychiatry, Psychology, Neuroscience, and Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY 41642, USA
Amy M. Padula: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94158, USA
Michael Petriello: Institute of Environmental Health Sciences and Department of Pharmacology, Wayne State University, Detroit, MI 48202, USA
Sheela Sathyanarayana: Seattle Children’s Research Institute, Seattle, WA 98105, USA
Joseph B. Stanford: Department of Pediatrics, Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
Tracey J. Woodruff: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, CA 94158, USA
Rosalind J. Wright: Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Amii M. Kress: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA

IJERPH, 2023, vol. 20, issue 14, 1-21

Abstract: Tools for assessing multiple exposures across several domains (e.g., physical, chemical, and social) are of growing importance in social and environmental epidemiology because of their value in uncovering disparities and their impact on health outcomes. Here we describe work done within the Environmental influences on Child Health Outcomes (ECHO)-wide Cohort Study to build a combined exposure index. Our index considered both environmental hazards and social stressors simultaneously with national coverage for a 10-year period. Our goal was to build this index and demonstrate its utility for assessing differences in exposure for pregnancies enrolled in the ECHO-wide Cohort Study. Our unitless combined exposure index, which collapses census-tract level data into a single relative measure of exposure ranging from 0–1 (where higher values indicate higher exposure to hazards), includes indicators for major air pollutants and air toxics, features of the built environment, traffic exposures, and social determinants of health (e.g., lower educational attainment) drawn from existing data sources. We observed temporal and geographic variations in index values, with exposures being highest among participants living in the West and Northeast regions. Pregnant people who identified as Black or Hispanic (of any race) were at higher risk of living in a “high” exposure census tract (defined as an index value above 0.5) relative to those who identified as White or non-Hispanic. Index values were also higher for pregnant people with lower educational attainment. Several recommendations follow from our work, including that environmental and social stressor datasets with higher spatial and temporal resolutions are needed to ensure index-based tools fully capture the total environmental context.

Keywords: neighborhoods; environmental hazards; social stressors; health disparities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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