2018 Progress Report: Center for Research on Environmental and Social Stressors in Housing across the Life Course

EPA Grant Number: R836156
Center: Disparities in Exposure and Health Effects of Multiple Environmental Stressors Across the Life Course
Center Director: Laden, Francine
Title: Center for Research on Environmental and Social Stressors in Housing across the Life Course
Investigators: Laden, Francine , Adamkiewicz, Gary , Fabian, Maria Patricia , Levy, Jonathan , Scammell, Madeleine Kangsen , Sprengler, John D , Zanobetti, Antonella
Institution: Harvard T.H. Chan School of Public Health , Boston University
EPA Project Officer: Callan, Richard
Project Period: July 1, 2015 through June 30, 2020
Project Period Covered by this Report: July 1, 2017 through June 30,2018
Project Amount: $1,500,000
RFA: NIH/EPA Centers of Excellence on Environmental Health Disparities Research (2015) RFA Text |  Recipients Lists
Research Category: Health


Environmental health disparities (EHDs) are based on a combination of factors, including sociodemographic and spatial patterns of exposures to chemical and non-chemical stressors. While this phenomenon is well recognized, the methods to characterize and ultimately mitigate EHDs have been lacking. In our Center, we are conducting innovative interdisciplinary and multidisciplinary studies spanning epidemiology, exposure science, risk assessment, and quantitative disparities analysis, with strong community engagement. We are examining multiple health outcomes across the life course, operating within our Center’s targeted low-income communities (Chelsea and Dorchester) as well as across the Commonwealth of Massachusetts (MA). Our projects are synergistic and interdependent, ensuring meaningful collective insights into EHDs. Our Center’s project and core aims are:

Project 1, Health Effects Across the Life course (HEAL) study: 1) develop innovative methods to estimate health effects associated with multiple chemical stressor exposures, accounting for large numbers of potential confounders and interactions; 2) estimate the complex interactions of exposures to multiple chemical stressors with non-chemical stressors and social determinants of health disparities on birth outcomes, growth rates, and cardiovascular mortality; and 3) identify epigenetic profiles associated with air pollution exposures, non-chemical stressors and social determinants of health disparities that modify them.

Project 2, Home-based Observation Monitoring Exposure (HOME) study: 1) use portable, real-time monitoring devices to estimate indoor exposures to multiple chemical stressors, noise, and thermal comfort; 2) determine how resident behaviors and housing characteristics affect indoor-outdoor associations of chemical and non-chemical stressors; and 3) use community-based crowdsourcing approaches to assess housing and household characteristics to develop season-specific determinants that predict ventilation characteristics.

Project 3, Mapping SpAtial Patterns in Environmental Health Disparities (MAP-EHD) study: 1) characterize disparities in exposure to chemical and non-chemical stressors across MA; 2) develop and evaluate multivariable chemical and non-chemical stressor constructs to better characterize exposures hypothesized to be related to EHDs; and 3) develop models of cumulative risk for multiple health outcomes in our two target communities, including quantified health benefits and changes in EHDs associated with simulated interventions.

Community Engagement Core (CEC): 1) design, implement, and evaluate training for community residents to participate in research conducted as part of Project 2; 2) evaluate and inform Project 3 chemical and nonchemical stressor constructs, stressor exposure models, and microdata simulation constraint variables; and 3) develop culturally appropriate educational materials that translate the aims and findings of research from Projects 1, 2, and 3 to improve environmental health literacy while reducing risk.

Pilot Project Program: 1) support EHD research in new and emerging topic areas within the two target communities; 2) support the application of methods and approaches to address EHDs across a wide range of underserved communities in the United States; and 3) provide seed funding that allows junior investigators the chance to maximize opportunities for independent funding.

Administrative Core: 1) provide administrative infrastructure necessary to coordinate activities among projects and facilitate interactions with EPA, NIH, and other Centers; 2) monitor the productivity and resources of the Center to ensure that stated objectives are met; 3) assemble advisory committees, organize regular meetings, and ensure implementation of recommendations; 4) provide mentoring and career development opportunities for the Center’s Career Development Investigators (CDI); 5) connect Center investigators with the wider EHD communities across universities; and 6) provide platforms for disseminating research findings.

Progress Summary:

The Center’s Administrative Core continued to coordinate monthly Executive Committee (EC) meetings. Progress of all scientific manuscripts is updated monthly via a shared Google document and the EC evaluates progress and determines inclusion of appropriate collaborators. All paper ideas, including co-authors, are proposed to the EC using a CRESSH manuscript proposal form. Authorship requirements include being part of the design or intellectual process and revising the manuscript, following standard authorship criteria for biomedical journals.

In Year 3, we continued to engage with external investigators who were interested in CRESSH themes and datasets, to broaden the reach and set of activities within the Center. Two collaborative grants were submitted or are under development (an R01 and an Outstanding New Environmental Scientist Award (ONES) application).

Members of the Internal Steering Committee (ISC) and the External Advisory Board (EAB) attended our Year 3 joint meeting on June 6, 2017, along with project investigators, community partners and study team members (Total N=28). The presentations included project/core updates, information about GreenRoots mission, and questions for ISC and EAB members to help the Center gather insight and feedback.

The ISC includes senior leadership at both universities. Alexandra Shields from Harvard/Massachusetts General Hospital replaced Michelle Williams who resigned when she accepted the Harvard Chan School Dean position in May 2016. The next meeting is planned for May 31, 2018.

Project 1 – HEAL Study: To date, we have performed several epidemiologic analyses using birth data from Massachusetts Department of Public Health (MDPH), mortality data from MDPH, and Boston Children’s HealthWatch (CHW) data. Manuscripts in preparation or recently submitted are: 1) using quantile regression, we estimated changes to birthweight associated with PM2.5 and examined increased susceptibility to particulate air pollution exposure during gestation; 2) we investigated the association between neighborhood socioeconomic status (SES) and birthweight, and effect modification by indicators of individual SES; 3) we examined contributions to low birthweight by different components of ambient particulate air pollution during gestation; 4) we investigated the associations between maternal exposure to residential greenness and birthweight, while accounting for individual level confounders and neighborhood factors; 5) we applied a case-crossover analysis to estimate the effect of PM2.5 on the risk of cardiovascular death and the modification of the association by SES and land use characteristics, considering modification by neighborhood greenness and walkability alone, and jointly with each indicator of SES; 6) we examined the association between PM2.5 and total mortality using case-crossover analysis and assessed effect modification by individual characteristics, area-level census SES indicators and area-level measures of racial and economic segregation; and 7) using electronic medical records and surveys collecting maternal and child demographic information from CHW, we examined associations of weight growth trajectories from birth to age 6 years with prenatal and postnatal PM2.5 and distance to road (traffic) exposure. In addition, in a review paper, we summarized recent studies which examined exposure to natural vegetation, or greenness, and a variety of health outcomes.

Project 2 - HOME Study: All HOME study data collection tools were translated into Vietnamese and recruitment was extended to include Vietnamese participants. An intensive 2-day training was completed in Jun 2017. The HOME study team trained 10 staff (summer students and interns) and community partners. The study team meets biweekly with the CEC and Dorchester community partners (Health Resources in Action - HRiA) to discuss recruitment, establish partners and study timelines, and monthly with the Center EC. We had a staff addition (75% FTE) in Jan 2018.

The two outdoor air monitors placed in Chelsea used to record the same real-time air quality measures as are collected in indoor sampling were removed in Oct 2017 (after all in-home data collection was completed). One outdoor air monitor was placed in Dorchester in Nov 2017, and it is monitored weekly.

Data collection in Chelsea was completed 11/22/2017 with a total of 72 participants enrolled. Dorchester recruitment began in Jun 2017 and to date, 37 participants have been completed.

Dr. Dayna Johnson, a pilot project recipient in Year 2, received (May 2017) a NHLBI K01 Career Development Award (1K01HL138211) focused on interventions for improving sleep in African American communities. Funds from this award are dedicated to enrolling 50 participants in collaboration with the HOME study. To date, 12 HOME study participants have been included in this study.

Two manuscripts are in preparation: 1) a description of the process of selecting, validating, calibrating, and maintaining a multi-pollutant real-time air monitoring platform in an intensive indoor exposure study and 2) an analysis, using the Chelsea data, of key sources of indoor PM2.5 and NO2 concentrations within small spatial scales, and characterizing SES, demographic, and structural drivers of their exposure disparities.

Project 3 - MAP-EHD study: We have continued our work expanding the geographical database, adding walkability, normalized vegetation index (NDVI), and proximity to road. We completed the environmental health disparities constructs across MA started in Year 2, including: infiltration, food access, social stressors, environmental quality, and community health center accessibility. The team continues developing constructs for surface temperature and heat modification and will continue expanding the database as needed. Scientific manuscripts have been published or are being drafted for each of the stressor construct categories.

Disparities Analyses:

1) Trends in disparities in PM2.5 and NO2 exposures: We used 1 km2 modeled PM2.5 and NO2 concentrations over an 8-year period and Census demographic data to quantify inequality between sociodemographic groups and to develop a more nuanced understanding of the drivers and trends in longitudinal air pollution inequality (Rosofsky, et al., Environ Res 2018);

2) Disparities in infiltration constructs: We estimated AER for all Massachusetts residential parcels using publicly available data and regression models associating AER with housing characteristics. We also conducted an exposure disparities analysis, considering ambient PM2.5 concentrations and residential AERs (Rosofsky, et al., JESEE in press).

Photo Survey: Data collection for a summer photo survey was completed in Chelsea to complement the winter photo survey conducted in Year 2 (~5,000 photos each season). These described patterns of window opening and air conditioning use. Expansion of the survey to Dorchester will start in the summer of 2018.

CHW: We geocoded addresses for the CHW cohort participants (n>5000) linked to EHR and linked the geocodes with the air pollution and other exposure databases to support the epidemiological analyses in the HEAL study. This database will also serve as the foundation for analyses examining associations between noise exposures and developmental delays.

Community Engagement Core (CEC)

The CEC has continued to work with HRiA to recruit a diverse sample of study participants in Dorchester. The CEC organized a trip to Dorchester led by community members to provide CRESSH researchers the opportunity to see the environmental and social stressors impacting Dorchester from the perspective of people who live and work there every day.

The CEC and community partners participated in the HOME Study field work training. CEC and HRiA staff participated in home data collection efforts post training. We had a staff addition (50% FTE) in Jan 2018.

We continue to maintain CRESSH’s website as a tool for translating our work to researchers and stakeholders, including community partners and residents. In five quarterly newsletters we reported updates on each project and core, conferences, presentations, publications, and community partner news. We have maintained the CRESSH Twitter account to communicate CRESSH news with followers and engage the public. The CEC is finalizing report-back materials to inform Chelsea participants of the sampling results from their individual homes and their community and is planning community meetings at GreenRoots.

In addition, the CEC conducted an evaluation of airport-related noise in Chelsea. The CEC created a report (Levy JI, Schollaert C, Scammell M. Evaluation of Airport-Related Noise in Chelsea, Massachusetts) on airport-related noise levels in Chelsea and attended a Chelsea City Council meeting to answer questions. The CEC also carried out a project aimed at characterizing the predictive value of street tree damage for identifying natural gas leaks in response to community concerns regarding gas leaks throughout Chelsea and worked with the GreenRoots Environmental Community Organizers (ECO) youth crew to conduct an urban tree health survey and link the results with ambient methane concentrations.

Pilot Project Program

A request for Pilot Project Applications was posted on the CRESSH website and sent by email to all Center investigators at BUSPH and the Chan School, CEC partners and JPB Environmental Health Fellows. Three proposals were received and reviewed; one was selected by Dr. Sara Wylie: Developing community based visceral data performances for cross-disciplinary collaboration on environmental justice in Chelsea.

Year 2 Pilot Program awardee updates:

1) Dr. Dayna Johnson: A multilevel perspective to understand individual and environmental stressors on sleep. To date, 41 participants have been enrolled. Preliminary data analyses demonstrated that a higher percentage of African American participants (62.5%) experienced shorter sleep duration (<7 hours) than other races. Short sleep duration is associated with adverse health outcomes and temperature is strongly related to sleep disruptions.

2) Dr. Diana Ceballos: Assessing the role of occupation on home exposures in a disadvantaged community. To date, 20 workers have been screened for sampling at homes and 3 sampling visits completed. Two training sessions on the prevention of take home exposures were completed in collaboration with MassCOSH to evaluate training tools (9 workers participated in Nov 2017 and 13 workers participated in Mar 2018).

Future Activities:

In the next year, the Administrative Core will: 1) continue to provide the administrative infrastructure necessary to coordinate activities; 2) monitor Center productivity and resources; 3) continue coordination of the EC, ISC and EAB meetings; 4) provide mentoring and career development opportunities for the Center’s CDIs and other early-stage investigators; 5) continue to connect Center investigators and activities with related efforts at both universities; and 6) provide a platform for disseminating research findings.

Project 1 will: 1) finalize and submit the manuscripts using the birth and death records and CHW data described above; 2) using selection methods, identify individual and neighborhood characteristics associated with birthweight; 3) incorporate the infiltration index developed in Project 3 as an exposure modifier and predictor of mortality; 4) examine weight growth trajectories by individual characteristics in CHW; 5) examine birthweight in association with measures of racial and economic segregation and PM in CHW; and 6) perform an exposure misclassification analysis of the association between social stress and mortality.

Project 2 will: 1) continue Chelsea survey and indoor/outdoor exposure assessment data analysis; 2) finalize partnership with CEC on Chelsea report backs and community meeting to present and discuss findings; 3) complete Dorchester recruitment effort; 4) continue data collection in Dorchester; 5) continue effort to manage data storage, QA/QC and analysis of Dorchester data; and 6) manuscript development.

Project 3 will: 1) continue adding to the geographical database, 2) finish and submit manuscripts of disparities analyses for housing, social and environmental factors, 3) expand photo survey and construct regression models predicting resident behavior, and 4) start building synthetic population data.

CEC will: 1) continue to recruit and sample in Dorchester; 2) continue working with community partners between the data collection periods to keep the Chelsea and Dorchester communities engaged; 3) with the help of HRiA, develop partnerships with city managers, inspection services and housing authorities to disseminate our research and advocate for a healthier Dorchester; 4) with the help of GreenRoots, report back the results of our research to Chelsea participants in writing and via an in-person meeting; 5) evaluate the effectiveness of the report back letter and community meetings; 6) work with the GreenRoots ECO crew to measure soil gas concentrations to better understand the predictive value of methane gas leaks; and 7) analyze the relationship between indoor methane concentrations measured in HOME Study participant homes in Chelsea with ambient street methane concentrations.

Pilot Program will: 1) monitor progress from Years 2 and 3 awarded pilot projects and 2) repeat the call for proposals and selection of top applicants.

Journal Articles: 7 Displayed | Download in RIS Format

Other center views: All 42 publications 7 publications in selected types All 7 journal articles
Type Citation Sub Project Document Sources
Journal Article Antonelli J, Han B, Cefalu M. A synthetic estimator for the efficacy of clinical trials with all-or-nothing compliance. Statistics in Medicine 2017;36(29):4604-4615. R836156 (2018)
  • Abstract from PubMed
  • Full-text: Harvard University-Full Text PDF
  • Abstract: Wiley-Abstract
  • Journal Article Fong KC, Hart JE, James P. A review of epidemiologic studies on greenness and health: updated literature through 2017. Current Environmental Health Reports 2018;5(1):77-87. R836156 (2018)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Abstract: Springer-Abstract
  • Other: Digital Science-Abstract
  • Journal Article Jhun I, Mata DA, Nordio F, Lee M, Schwartz J, Zanobetti A. Ambient temperature and sudden infant death syndrome in the United States. Epidemiology 2017;28(5):728-734. R836156 (2017)
    R836156 (2018)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Full-text: Research Gate-Full Text PDF
  • Abstract: Epidemiology-Abstract
  • Journal Article Levy JI, Quiros-Alcala L, Fabian MP, Basra K, Hansel NN. Established and emerging environmental contributors to disparities in asthma and chronic obstructive pulmonary disease. Current Epidemiology Reports 2018;5(2):114-124. R836156 (2018)
    R836152 (2018)
  • Abstract from PubMed
  • Abstract: Springer-Abstract
  • Other: ResearchGate-Abstract
  • Journal Article Rosofsky A, Levy JI, Zanobetti A, Janulewicz P, Fabian MP. Temporal trends in air pollution exposure inequality in Massachusetts. Environmental Research 2018;161:76-86. R836156 (2018)
  • Abstract from PubMed
  • Full-text: ScienceDirect-Full Text HTML
  • Abstract: ScienceDirect-Abstract
  • Other: ScienceDirect-Full Text PDF
  • Journal Article Wang Y, Shi L, Lee M, Liu P, Di Q, Zanobetti A, Schwartz JD. Long-term exposure to PM2.5 and mortality among older adults in the Southeastern US. Epidemiology 2017;28(2):207-214. R836156 (2017)
    R835872 (2016)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Abstract: Epidemiology-Abstract
  • Journal Article Zigler CM, Choirat C, Dominici F. Impact of National Ambient Air Quality Standards nonattainment designations on particulate pollution and health. Epidemiology 2018;29(2):165-174. R836156 (2018)
    R835872 (2016)
  • Abstract from PubMed
  • Abstract: Ovid-Abstract
  • Supplemental Keywords:

    fine particulate matter, nitrogen dioxide, air pollution, temperature, housing, cumulative risk, birth weight, mortality

    Relevant Websites:

    Center for Research on Environmental and Social Stressors in Housing Across the Life Course (CRESSH) Exit

    This site provides an overview of CRESSH, including project team members and project aims, information for study participants, publication, Twitter feed, and other relevant content.

    Progress and Final Reports:

    Original Abstract
  • 2016 Progress Report
  • 2017 Progress Report
  • 2019
  • Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
    R836156C001 Multi-Exposure Epidemiology across the Life Course
    R836156C002 Exposure Disparities Related to Resident Behavior and Housing Characteristics
    R836156C003 Cumulative Risk and Geospatial Health Disparities Related to Chemical and Non-Chemical Stressor Exposures