Final Report: Improving Environmental Health Disparities: A Fundamental Cause Approach

EPA Grant Number: NIMHD002
Title: Improving Environmental Health Disparities: A Fundamental Cause Approach
Investigators: Calhoun, Elizabeth , Kim, Seijeoung
Institution: University of Illinois at Chicago
EPA Project Officer: Hahn, Intaek
Project Period: August 1, 2011 through July 31, 2014
Project Amount: $819,428
RFA: Transdisciplinary Networks of Excellence on the Environment and Health Disparities (2012) RFA Text |  Recipients Lists
Research Category: Environmental Justice , Environmental Health Disparities , Health

Objective:

The Center of Excellence in Eliminating Disparities Environmental Supplement established an Environmental Core, which operates in conjunction with other Cores of the University of Illinois at Chicago (UIC) Center of Excellence in Eliminating Disparities maximizing the Center's environmental health disparities research capacity. Data generated from this project are deposited into the Data Core and made available to collaborating health disparities researchers and partners. This core supports a research project that explores mechanisms explaining racial differences in exposure to environmental hazards and access to care, and in health outcomes. To achieve this objective, we are compiling relevant neighborhood-level data on environmental hazards and access to care in Cook County, and linking them to other social determinants data compiled in the data repository.

We are using three approaches to examine the associations:

  1. We are examining the effect of racial residential segregation on the physical and social environment variables (the presence of environmental hazards and access to health care facilities).
  2. We are examining incidence and late stage diagnosis of breast, cervical, and lung cancer in relation to environmental risk factors.
  3. We are examining changes in environmental conditions on health outcomes, we are exploring the effect of changes in racial composition and socioeconomic status between 2000 and 2010 (relocation of racial/ethnic minorities who moved from inner-city Chicago to suburban Cook County).

Summary/Accomplishments (Outputs/Outcomes):

The specific goals of the second year of the research were to: 1) examine the patterns of environmental hazard distribution in Cook County, IL; and 2) identify neighborhood contextual factors that are associated with environmental disparities.

Toward the specific goals, we completed data analysis, including: 1) traditional statistical analyses exploring the relationships between racial residential segregation and the distribution of hazard sites in Chicago, 2) mapping of the patterns of the distribution of environmental hazards using a geographic information system, and 3) spatial statistical analysis to pinpoint ‘hotspots’. Four manuscripts have been submitted for publication so far. We also presented our findings at scientific meetings.

The Environmental Core manages key “health disparities research data” in collaboration with the Data Core. Our overall aims are to encourage research addressing health disparities in cancer; the Data Core aims to build a disparities research data infrastructure that can assist researchers and students with data acquisition, linkage and collaboration. Overall, 13 presentations resulted from the data that we have put together. Five manuscripts were published/acceted in scientific journals, and seven manuscripts currently are under review. In addition, one doctoral student successfully completed her dissertation using our data and supported by the Data Core faculty. She currently is a post doctoral fellow in Texas, focusing on issues concerning health disparities and the environment. Another MS student successfully finished his MS thesis with data we provided. He currently is applying for PhD programs.

In an effort to build a wider data infrastructure for disparities research, the Data Core continues to add and refine datasets for use. After a long logistical negotiation between the UIC and Cook County, the Data Core finally acquired the Cook County Assessor’s Office (CCAO) assessment data (about 3.7 million records) for all properties in Cook County, which contain property characteristics such as age, type, class, land and building assessed values, grocery stores, and gas stations and other important variables for analysis. We are planning on applying for a subsequent grant to expand our analysis to incorporate the new data. Using the assessment data, along with the American Community Survey data, we plan to conduct asset mapping to better understand complex neighborhood environments and their role in health disparities. We intend to use the data to create maps and other visualizations. This dataset has been made available to UIC researchers and students who are interested in conducting health disparities research.

We have successfully worked with the Urban Data Visualization Lab (UDVL), which is a UIC research center dedicated to data visualization and geographic mapping. So far, we were able to build a prototype website that can provide healthcare access information to the wider Cook County residents. This website includes locations of Federally Qualified Health Centers (FQHCs), local and state public health clinics, and community health centers.

One of the achievements of the project was that we established ways in which we reconcile data measured in different units (census tract, ZIP code, community area, and ward). We developed our own crosswalk mechanism to estimate measures between community area level and ward level data, and using the U.S. Department of Housing and Urban Development (HUD) crosswalk file, we were able to convert data between census tract and ZIP code.

Often times, geographic units of ZIP code and census tract do not match, while some data are available at ZIP code and some are at census tract, which is a major obstacle for health disparities research. We were able to convert from ZIP to census and vice versa. In addition, we were able to get 16 major health outcomes measures by community area level from the Chicago Department of Public Health, which includes asthma and other environment-related health measures. We successfully established data cooperation between the University of Illinois at Chicago School of Public Health (UIC SPH) and the Illinois Department of Public Health.

Conclusions:

As we described above, we hypothesized that historically disadvantaged minority neighborhoods lacking social capital would be more likely to be exposed to environmental hazards. Increased environmental risks in neighborhoods then would drive out middle class residents, resulting in increased disadvantage, which consequently results in even worse social capital in recent years: a vicious cycle of environmental disparities and neighborhood disadvantage. Interestingly, however, our findings indicate that the NATA cancer risk does not predict the cancer incidence. Moreover, demographic characteristics (racial composition and income) do not correlate with the cancer risk. From our GIS spatial analysis, however, we do see clusters of cancer risk, which means cancer risks and environmental hazard scores are spatially clustered, but unlike findings from other studies, not by race and income in Cook County, IL. This finding is quite significant and calls for further investigation based on subdomain risks, which we currently are working on.

Working closely with the Training Core of our Health Disparities Research Institution, we also established our presence in mentoring students as part of training and dissemination efforts. We offer a health disparities research course (HPA 462 Quantitative Methods of Health Disparities Research), which covers a broad range of methodological issues in disparities research. We examine quantitative and qualitative methods of measuring health disparities and health equity through the lens of local data on death and disease in Chicago neighborhoods. This course incorporates environmental and occupational health topics. Drawing on numerous studies of Chicago, students learn the strengths and drawbacks of major data sources for public health research, how to link them to census and survey data, and how to measure changes over time.


Journal Articles on this Report : 7 Displayed | Download in RIS Format

Other project views: All 30 publications 7 publications in selected types All 7 journal articles
Type Citation Project Document Sources
Journal Article Kim S, Chukwudozie B, Calhoun E. Sociodemographic characteristics, distance to the clinic, and breast cancer screening results. Journal of Health Disparities Research and Practice 2013;6(1):70-88. NIMHD002 (2013)
NIMHD002 (Final)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Full-text: UNLV-Full Text-PDF
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  • Abstract: UNLV-Abstract
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  • Journal Article Kim S, Mazza J. Reliability, validity, and item response of MOS social support score among incarcerated women. Women & Criminal Justice 2014;24(1):1-21. NIMHD002 (2013)
    NIMHD002 (Final)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Abstract: Taylor & Francis-Abstract
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  • Journal Article Kim S, Mazza J, Zwanziger J, Henry D. School and behavioral outcomes among inner city children: five-year follow-up. Urban Education 2014;49(7):835-856. NIMHD002 (2013)
    NIMHD002 (Final)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Abstract: Urban Education-Abstract
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  • Journal Article Molina Y, Kim S, Berrios N, Calhoun EA. Medical mistrust and patient satisfaction with mammography: the mediating effects of perceived self-efficacy among navigated African American women. Health Expectations 2015;18(6):2941-2950. NIMHD002 (Final)
  • Abstract from PubMed
  • Abstract: Wiley-Abstract
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  • Journal Article Osiecki KM, Kim S, Chukwudozie IB, Calhoun EA. Utilizing exploratory spatial data analysis to examine health and environmental disparities in disadvantaged neighborhoods. Environmental Justice 2013;6(3):81-87. NIMHD002 (2013)
    NIMHD002 (Final)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Full-text: Mary Ann Liebert-Full Text-HTML
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  • Abstract: Mary Ann Liebert-Abstract
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  • Other: Mary Ann Liebert-Full Text-PDF
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  • Journal Article Peterson CE, Rauscher GH, Johnson TP, Kirschner CV, Barrett RE, Kim S, Fitzgibbon ML, Joslin CE, Davis FG. The association between neighborhood socioeconomic status and ovarian cancer tumor characteristics. Cancer Causes and Control 2014;25(5):633-637. NIMHD002 (Final)
  • Abstract from PubMed
  • Abstract: Springer-Abstract
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  • Journal Article Williams CT, Kim S, Meyer J, Spaulding A, Teixeira P, Avery A, Moore K, Altice F, Murphy-Swallow D, Simon D, Wickersham J, Ouellet LJ. Gender differences in baseline health, needs at release, and predictors of care engagement among HIV-positive clients leaving jail. AIDS and Behavior 2013;17(Suppl 2):195-202. NIMHD002 (2013)
    NIMHD002 (Final)
  • Full-text from PubMed
  • Abstract from PubMed
  • Associated PubMed link
  • Full-text: ResearchGate-Abstract & Full Text-PDF
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  • Abstract: Springer-Abstract
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  • Supplemental Keywords:

    environmental health disparity, cancer risk, demography, GIS, disadvantaged minority neighborhoods

    Relevant Websites:

    http://researchguides.uic.edu/ceed Exit
    http://www.ihrp.uic.edu/study/reducing-environmental-health-disparities-fundamental-cause-approach Exit
    http://publichealth.uic.edu/health-disparities-research Exit
    http://www.chicagohealthatlas.org Exit
    http://healthmap.mjspieglan.com Exit
    http://illinoishealthmatters.org Exit

    Progress and Final Reports:

    Original Abstract
  • 2012 Progress Report
  • 2013 Progress Report