Grantee Research Project Results
Final Report: Center for Research on Environmental and Social Stressors in Housing across the Life Course
EPA Grant Number: R836156Center: Health Effects Institute (2015 - 2020)
Center Director: Greenbaum, Daniel S.
Title: Center for Research on Environmental and Social Stressors in Housing across the Life Course
Investigators: Laden, Francine , Adamkiewicz, Gary , Levy, Jonathan , Zanobetti, Antonella , Scammell, Madeleine Kangsen , Sprengler, John D , Fabian, Maria Patricia , Lane, Kevin J
Institution: Harvard University , Boston University
EPA Project Officer: Callan, Richard
Project Period: July 1, 2015 through June 30, 2020 (Extended to June 30, 2021)
Project Amount: $1,500,000
RFA: NIH/EPA Centers of Excellence on Environmental Health Disparities Research (2015) RFA Text | Recipients Lists
Research Category: Human Health
Objective:
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. We conducted innovative interdisciplinary and multidisciplinary studies spanning epidemiology, exposure science, risk assessment, and quantitative disparities analysis, with strong community engagement. We examined multiple health outcomes across the life course, operating within our Center’s targeted low-income communities (Chelsea and Dorchester) as well as across Massachusetts (MA). Our Center’s project and core aims are:
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.
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; and 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.
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.
Summary/Accomplishments (Outputs/Outcomes):
PROJECT 1: Health Effects Across the Life course (HEAL) study
During the period of the grant we completed epidemiologic analyses using birth data from Massachusetts Department of Public Health (MDPH), mortality data from MDPH, and Boston Children’s HealthWatch (CHW) data. We also published several methodological papers that advanced statistical methods relevant to environmental health disparities analyses.
For birthweight, we found that greenness is beneficial to fetal growth exhibited by higher birthweight and lower odds of term low birthweight or small for gestational age. We also determined that PM2.5 was negatively associated with birthweight with more severe associations at lower quantiles of birthweight, and that there were differences in toxicity across four major constituents of PM2.5. When exploring the effect of two indices reflecting residential segregation, racial residential polarization (RRP) and economic residential polarization (ERP), our results suggested that RRP and ERP indicating more privileged groups was associated with healthier birthweight outcomes, with greater estimated effects in babies that were born to White mothers than those born to Black mothers. We then characterized the joint effects of environmental exposure, built environment characteristics, and economic stressors, providing the foundation for our cumulative risk modeling work in Project 3.
For cardiovascular mortality, we found that PM2.5 effects were attenuated by higher greenness only in areas with sociodemographic features that are highly correlated with lower socioeconomic status. We also showed that the association differed between areas with different racial composition and segregation. Our findings suggest that pollution reductions in neighborhoods with the highest percentage of non-Hispanic Blacks would be most beneficial in reducing cardiovascular mortality and disparities. We also developed and applied methods to characterize the public health implications of air pollution exposures below the National Ambient Air Quality Standard (NAAQS) set by the Environmental Protection Agency (EPA), concluding that harmful cardiovascular consequences of PM2.5 exposure can still occur even for those exposed to PM2.5 levels well below the NAAQS.
In the CHW study, a cohort of low-income urban children in Boston from 2007 through 2015, we found that maternal homelessness was associated with reduced birthweight, while participating in WIC was marginally associated with increased birthweight. PM2.5 during the second trimester was also marginally associated with reduced birthweight but with smaller effect sizes. In another study, we found differences in the effect of PM2.5 on growth trajectories by sex and by birthweight.
In a follow up study, we found that PM2.5 significantly modified the association between age and weight in males, with a positive association in children younger than 3 years and a negative association afterwards. We found similar but smaller changes in females, and no differences comparing growth trajectories across quartiles of PM2.5. We also found that most of the effects were in low birthweight children and null for normal birthweight children. Finally, we found that residence in immigrant enclaves was associated with higher birthweight children for foreign-born women, proximity to major roads was negatively associated with birthweight, while trimester-specific PM2.5 concentrations were not associated with birthweight. Collectively, these studies reinforced the importance of both individual and community attributes as elements in characterizing environmental health disparities.
PROJECT 2: Home-based Observation Monitoring Exposure (HOME) studyWe designed an air pollutant sensor platform that measured PM2.5, NO2, NO, CO2, CO, temperature, relative humidity and noise (Environmental Multipollutant Monitoring Assembly, aka
‘EMMA’). VOC measurements were also collected. A total of 150 participants were recruited (N=72 Chelsea and N=78 in Dorchester). Result reporting to participants included report back design and distribution, meeting evaluation surveys, and report back meetings (in person and virtual).
We concluded that our sensor platform could provide valid continuous measurements but emphasized that lower-cost sensors should be deployed with caution, given financial and resource costs that greatly exceed sensor costs. In empirical analyses, we determined that the over 77% of indoor PM2.5 concentrations in homes in Chelsea were of non-ambient origin, with a higher proportion at increasing quantiles of the exposure distribution. Major source predictors of non-ambient PM2.5 concentrations at the upper quantile (0.95) were cooking and smoking, with concentrations also increasing with recirculating range hood use and during the heating season. Across quantiles, renters in multifamily housing experienced a higher proportion of PM2.5 concentrations from non-ambient sources than homeowners in single- and multifamily housing. Additional analyses include using real time NO2 measurements to investigate drivers of elevated concentrations of indoor air and characterizing air exchange rate for use in epidemiological analyses of PM2.5-related mortality.
We also formally assessed the report-back to determine whether it was effective in engagement, understandability, and actionability. Participant understanding generally corresponded with the intended meaning of the research team, suggesting successful data communication. Additionally, many participants reported that they were inspired to act in order to reduce their indoor air pollutant exposure as a result of the report-back process. Additional work includes insights about how to demonstrably ensure accessibility by combing evidence-based health literacy tools and formative qualitative research.
PROJECT 3: Mapping SpAtial Patterns in Environmental Health Disparities (MAP-EHD) study
We built an extensive geographical database of social and environmental determinants of health in Massachusetts. Datasets included publicly available administrative datasets such as parcel level housing, meteorology, and census data, as well as environmental datasets such as particulate matter, nitrogen dioxide and many more. Additionally, we developed disparity constructs reflecting infiltration, food access, social stressors, environmental quality, community health center accessibility, and heat vulnerability. We also conducted a summer and winter photo survey of Chelsea and Dorchester to identify built environment modifiers of exposures such as air conditioners or open windows. In addition to field photos of the entire city, we administered over 2,000 surveys to classify the photos. These were crowdsourced to describe patterns of window opening and window AC use in both locations.
Datasets and constructs were used to: 1) conduct disparities analyses, 2) inform environmental epidemiology analyses in CRESSH-HEAL, 3) inform participant recruitment strategies in CRESSH-HOME, and 4) disseminate datasets and support COVID-19 initiatives in Massachusetts.
We examined trends in disparities in air pollution exposure (PM2.5 and NO2) over 10 years. Annual-average population-weighted PM2.5 concentrations were highest for urban non-Hispanic Black populations, whereas NO2 was highest for urban Hispanic populations. While population groups experienced similar absolute decreases in exposure over time, disparities in population-weighted concentrations increased over time when quantified by the Atkinson Index, a relative inequality measure. We estimated air exchange rate (AER) for all Massachusetts residential parcels using publicly available data and regression models associating AER with housing characteristics. We then conducted an exposure disparities analysis, considering ambient PM2.5 concentrations and residential AERs. Housing parcels above the 90th percentile of both AER and ambient PM2.5 (i.e. the leakiest homes in areas of highest ambient air pollution) – versus the 10th percentile – were located in neighborhoods with higher proportions of Hispanics, households with an annual income of less than $20,000 and individuals with less than a high school degree.
We collaborated closely with the HEAL project to develop multivariable epidemiologic models that incorporate both chemical and non-chemical stressors, including constructs developed in the MAP-EHD project. This has resulted in several published manuscripts described in HEAL. One key manuscript estimated the combined associations between environmental and built environment exposures and birthweight in Massachusetts, which served as the basis for a cumulative health risk analysis. We created geographically resolved synthetic microdata for Chelsea and Dorchester, tailoring the populations to fit sociodemographic characteristics as well as chemical and non-chemical risk factors identified in the epidemiologic study. We showed that mothers with the lowest predicted birthweight were those identifying as Black or Hispanic, with parity > 1, utilization of government prenatal support, and lower educational attainment. Birthweight improvements following hypothetical greenness and temperature improvements were similar for all high-risk groups and were larger than benefits from smoking cessation. Absent private health data, this methodology allows for assessment of cumulative risk and health inequities, and comparison of individual-level impacts of localized health interventions.
COMMUNITY ENGAGEMENT CORE (CEC)
The CEC worked with HOME study and CRESSH community partners to develop a recruitment strategy, fieldwork plan, interview guide, and report-back materials for HOME study participants. Community partners included GreenRoots (Chelsea), Health Resources in Action, and Codman Square Neighborhood Development Corporation (Dorchester). We also helped design a two-step report back process to share air quality results with HOME study participants. The process included generating individualized report back packets mailed to each HOME study participant, and the organization of community meetings to present aggregate findings and answer participants’ questions. CEC staff led the writing and submission of a manuscript on how the Macro for the Compilation of Repot-backs (MCR) can benefit the compilation and personalization process of generating health study reports.
The CEC worked with Project 1: HEAL, investigators with CHW, and Project 3: MAP-EHD to develop strategies to share the data and results of each project. Together we developed methods for sharing data constructs generated within the projects, including hosting a webinar to share data constructs and examples for potential use with invited researchers and policy and advocacy stakeholders.
The CEC also engaged in multiple activities in response to community concerns. We worked with GreenRoots to carry 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. We evaluated airport-related noise in Chelsea given community concerns regarding noise exposures from planes flying overhead. The CEC and Dr. Levy created a report on airport-related noise levels in Chelsea and also attended a Chelsea City Council meeting that was held in response to the report to answer questions from City Council members and Chelsea residents. Additionally, we published a manuscript describing the characteristics of sound levels in Chelsea before and during the COVID-19 pandemic.
PILOT PROJECT PROGRAM
The Pilot Project Program planned logistics, launched the call for applications, and established themes and timelines in years 2-4 of the grant. Pilot Project applications were posted on the CRESSH website and advertising emails were sent to all Center investigators at BUSPH and HSPH, CEC partners, and all JPB Environmental Health Fellows. We asked applicants to submit proposals that were synergistic with Center activities and themes that could produce preliminary data to compete for independent funding. Application topics that were strongly encouraged would leverage CRESSH’s existing research and community engagement activities (Year 2), include elements of research translation and community engagement, either as the primary focus or connected with the research efforts (Year 3), and have an emphasis on activities that could lead to new grant opportunities (Year 4).
Awarded proposals include: 1) A multilevel perspective to understand individual and environmental stressors on sleep (awardee: Dr. Dayna Johnson-Morgan), 2) Assessing the role of occupation on home exposures in a disadvantaged community (awardee: Dr. Diana Ceballos), 3) Developing community based visceral data performances for cross-disciplinary collaboration on environmental justice in Chelsea, MA (awardee: Dr. Sara Wylie), 4) CRESSH Built Environment Deep Learning Algorithms for Massachusetts study (awardee: Dr. Peter James) and 5) Children's health and growth and family material hardships in three US cities (awardee: Children’s HealthWatch).
Pilot grants led to multiple successful outcomes. Drs. Johnson-Morgan and Ceballos both utilized their pilot data to obtain grants as PI, subsequently obtaining faculty positions. Dr. Wylie conducted a well-attended community event and developed multiple outward-facing products in Chelsea. Dr. James created a novel dataset reflecting the built environment in Massachusetts, made available to all CRESSH investigators. The CHW pilot grant allowed for the expansion of environmental health record linkages into two additional cities, which provided the foundation for four grant submissions to NIH.
ADMINISTRATIVE CORE
The Administrative Core provided the overall infrastructure needed to coordinate activities across the Center, tracking progress, maintaining communication with advisory boards, providing fiscal and resource management, and providing mentoring and career development for the Center’s Career Development Investigators (CDIs) and numerous students (master’s and doctoral), post-docs and junior faculty. Our designated CDIs (Drs. Fabian, Scammell, Lane, and Walker) all obtained faculty positions or were promoted from Assistant to Associate Professor, and four additional post-doctoral researchers who received mentorship from CRESSH (Drs. Johnson-Morgan, Ceballos, Nethery, and Yitshak-Sade) all subsequently obtained faculty positions. Our Center also engaged more than 20 other trainees at various stages of career development.
Journal Articles: 27 Displayed | Download in RIS Format
Other center views: | All 92 publications | 27 publications in selected types | All 27 journal articles |
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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) R836156 (2020) |
Exit Exit |
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Antonelli J, Papadogeorgou G, Dominici F. Causal inference in high dimensions:A marriage between Bayesian modeling and good frequentist properties. BIOMETRICS 2022;78(1):100-114. |
R836156 (Final) R835872 (2020) |
Exit Exit |
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Chen F, Chen J, Hart J, Coull B, Scammell M, Chu M, Adamkiewica G. Disparities in joint exposure to environmental and social stressors in urban households in Greater Boston. ENVIRONMENTAL RESEARCH 2023;238(1):11710. |
R836156 (Final) |
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Chu M, Gillooly S, Levy J, Vallarino J, Reyna L, Laurent J, Coull B, Adamkiewicz G. Real-time indoor PM2.5 monitoring in an urban cohort:Implications for exposure disparities and source control. ENVIRONMENTAL RESEARCH 2021;193(110561). |
R836156 (Final) R835872 (2020) |
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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) R836156 (2019) R836156 (2020) |
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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) R836156 (2020) |
Exit Exit |
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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) R836156 (2019) R836156 (2020) R836150 (2019) R836150 (2020) R836152 (2018) R836152 (2019) R836152 (2020) |
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Nethery R, Dominici F. Factors affecting lead Dust in construction workers' homes in the Greater Boston Area. ENVIRONMENTAL RESEARCH 2021;195(110510). |
R836156 (Final) |
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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) R836156 (2020) |
Exit Exit Exit |
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Rosofsky A, Levy JI, Breen MS, Zanobetti A, Fabian MP. The impact of air exchange rate on ambient air pollution exposure and inequalities across all residential parcels in Massachusetts. Journal of Exposure Science & Environmental Epidemiology 2019;29(4):520-530. |
R836156 (2019) R836156 (2020) |
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Tomosho K, Polka E, Chacker S, Queeley D, Alvarez M, Scammell M, Emmons K, Rudd R, Adamkiewicz G. A process for creating data report-back tools to improve equity in environmental health. ENVIRONMENTAL HEALTH 2022;21(1). |
R836156 (Final) |
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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) R836156 (2020) R835872 (2016) R835872 (2017) |
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Wei Y, Wang Y, Wu X, Di Q, Shi L, Koutrakis P, Zanobetti A, Dominici F, Schwartz J. Causal Effects of Air Pollution on Mortality Rate in Massachusetts. AMERICAN JOURNAL OF EPIDEMIOLOGY 2020;189(11):1316-1323. |
R836156 (Final) R835872 (2020) |
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Wei Y, Coull B, Koutrakis P, Yang J, Li L, Zanobetti A, Schowatz J. Assessing additive effects of air pollutants on mortality rate in Massachusetts. ENVIRONMENTAL HEALTH 2021;20(1):19. |
R836156 (Final) R835872 (2020) |
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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) R836156 (2020) R835872 (2016) |
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Antonelli J, Cefalu M, Palmer N, Agniel D. Doubly robust matching estimators for high dimensional confounding adjustment. Biometrics 2018;74(4):1171-1179. |
R836156 (2019) R836156 (2020) |
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Zanobetti A, O’Neill MS. Longer-term outdoor temperatures and health effects:a review. Current Epidemiology Reports 2018;5(2):125-139. |
R836156 (2019) R836156 (2020) R835872 (2018) |
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Wilson A, Zigler CM, Patel CJ, Dominici F. Model‐averaged confounder adjustment for estimating multivariate exposure effects with linear regression. Biometrics 2018;74(3):1034-1044. |
R836156 (2019) R836156 (2020) R835872 (2017) |
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Fong K, Kloog I, Coull B, Koutrakis P, Laden F, Schwartz J, James P. Residential greenness and birthweight in the state of Massachusetts, USA. International Journal of Environmental Research and Public Health 2018;15(6):1248. |
R836156 (2019) R836156 (2020) R835872 (2018) |
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Gillooly SE, Zhou Y, Vallarino J, Chu MT, Michanowicz DR, Levy JI, Adamkiewicz G. Development of an in-home, real-time air pollutant sensor platform and implications for community use. Environmental Pollution 2019;244:440-450. |
R836156 (2019) R836156 (2020) |
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Rhee J, Fabian MP, Ettinger de Cuba S, Coleman S, Sandel M, Lane KJ, Yitshak Sade M, Hart JE, Schwartz J, Kloog I, Laden F. Effects of maternal homelessness, supplemental nutrition programs, and prenatal PM2.5 on birthweight. International Journal of Environmental Research and Public Health 2019;16(21):4154. |
R836156 (2020) R835872 (2019) |
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Nethery RC, Mealli F, Dominici F. Estimating population average causal effects in the presence of non-overlap:the effect of natural gas compressor station exposure on cancer mortality. The Annals of Applied Statistics 2019;13(2):1242-1267. |
R836156 (2019) R836156 (2020) R835872 (2019) |
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Antonelli J, Parmigiani G, Dominici F. High-dimensional confounding adjustment using continuous spike and slab priors. Bayesian Analysis 2019;14(3):805-828. |
R836156 (2020) R835872 (2019) |
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Petropoulos Z, Levy J, Scammell M, Fabian MP. Characterizing community-wide housing attributes using georeferenced street-level photography. J Expo Sci Environ Epidemiol 2020;30(2):299-308. |
R836156 (2020) |
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Rosofsky AS, Fabian MP, Ettinger de Cuba S, Sandel M, Coleman S, Levy JI, Coull BA, Hart JE, Zanobetti A. Prenatal Ambient Particulate Matter Exposure and Longitudinal Weight Growth Trajectories in Early Childhood. International journal of environmental research and public health 2020;17(4):1444. |
R836156 (2020) |
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Fong KC, Yitshak-Sade M, Lane KJ, Fabian MP, Kloog I, Schwartz JD, Coull BA, Koutrakis P, Hart JE, Laden F, Zanobetti A. Racial Disparities in Associations between Neighborhood Demographic Polarization and Birth Weight. International journal of environmental research and public health 2020;17(9):3076. |
R836156 (2020) |
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Qiu X, Wei Y, Weisskopf M, Spiro A, Shi L, Castro E, Coull B, Koutrakis P and Schwartz J. Air pollution, climate conditions and risk of hospital admissions for psychotic disorders in U.S. residents. Environ Res 2023; 216(Pt 2):114636. |
R836156 (Final) |
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Supplemental Keywords:
fine particulate matter; nitrogen dioxide; air pollution; temperature; housing; cumulative risk; birth weight; mortalityRelevant Websites:
Progress and Final Reports:
Original Abstract 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
The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency.
Project Research Results
- 2020 Progress Report
- 2019 Progress Report
- 2018 Progress Report
- 2017 Progress Report
- 2016 Progress Report
- Original Abstract
27 journal articles for this center