Grantee Research Project Results

2012 Progress Report: Analysis and Action on the Environmental Determinants of Health and Health Disparities

EPA Grant Number: NIMHD006
Title: Analysis and Action on the Environmental Determinants of Health and Health Disparities
Investigators: Glover, Saundra , Wilson, Sacoby M. , Williams, Edith , Brandt, Heather , Zhang, Hongmei
Institution: University of South Carolina at Columbia , University of Maryland - College Park
EPA Project Officer: Hahn, Intaek
Project Period: August 1, 2011 through July 31, 2014
Project Period Covered by this Report: September 21, 2011 through September 20,2012
Project Amount: $669,258
RFA: Transdisciplinary Networks of Excellence on the Environment and Health Disparities (2012) RFA Text | Recipients Lists
Research Category: Environmental Justice , Human Health

Objective:

The objective of the research is to expand the NIMHD-funded Center of Excellence’s (CoE) capacity to engage communities of color impacted by health disparities with a focus on environmental justice and environmental health disparity issues within the State of South Carolina. Also, to take the resident expertise in environmental, social and behavioral science at the University of South Carolina-Institute for Partnership to Eliminate Health Disparities ( USC-IPEHD) and University of Maryland (UMD) and an expansive community network to conduct environmental, community-based participatory and translational research focused on addressing environmental stressors in South Carolina. The activities proposed in this project will:

1) build a program to assess environmental health disparities in the state through data collected by the South Carolina Department of Health and Environmental Control (SCDHEC) Environmental Public Health Tracking (EPHT) Program;

2) assess community perception of environmental determinants of cancer risk and disparities in rural and urban communities in South Carolina using a mixed methods approach; and

3) engage and train members of community-based organizations that represent environmental justice communities and environmental health disparity populations in the use of the block assessment methodology to identify ecological stressors and intervene to address disparities in burden, exposure, and health.

Progress Summary:

Pilot Project 1: “Assessment of Environmental Health Disparities in South Carolina”

Beginning in March 2012 and continuing through the six-month reporting period, the Project #1 team met biweekly. Analyses were performed on available environmental health data to assess disparities of environmental hazards in South Carolina and disparities in health risks between different populations based on socio-demographic profile including race/ethnicity and socioeconomic status and geography (rural vs urban location). A spatial database has been expanded to include not only locations of environmental hazards and locally unwanted land uses but also includes salutogenic and pathogenic infrastructure (check cashing locations, payday lenders, banks, schools, gas stations, grocery stores, fast food restaurants, pawn shops, liquor stores). The team has primarily examined the disparities in exposure to air toxics in cancer risks in South Carolina using the National Scale Air Toxics Assessment (NATA). The team has assessed differences in cancer risk in relation to segregation, deprivation as indicated by the Townsend Index, and rural-urban area. In addition, Dr. Zhang is leading efforts to assess possible racial/ethnic and SES disparities in the distribution of Superfund sites, brownfields, and NPDES permitted facilities in the state of South Carolina. Results will be available Fall 2012.

Results from Assessment of Sociodemographic Disparities in Cancer Risk from Air Toxics in South Carolina

Table 1. Simple Linear Regression

Simple Regression				Multivariate Regression
		Coefficient (p-Value)	R2-adj	Coefficient (p-Value)	Urban Area %	Interact	correlation*	R2-adj
Race/ Ethnicity	Black %	0.021	0	-0.088**	0.071**	0.002**	0.028	0.46
	Hispanic %	0.293**	0.01	0.291	0.147**	-0.006*	0.225**	0.42
	Non-white %	0.032**	0.01	-0.085**	0.064**	0.002**	0.076*	0.46
Rich	Owned Home %	-0.252**	0.3	-0.045	0.182**	-0.001**	-0.564**	0.47
	Per Cap Income	0.934*	0	3.674**	0.246**	-0.063**	0.219**	0.45
	Median HH Income	0.019	0	2.349**	0.266**	-0.038**	0.066	0.47
Poor	Poverty %	0.116**	0.02	-0.275**	0.047**	0.005**	0.06	0.48
	Unemployment %	0.496**	0.03	-0.05	0.485**	0.01**	0.098**	0.44
	Home Pre-1950 %	0.19**	0.08	-0.124**	0.086**	0.003**	0.202**	0.47
Education	< HS %	-0.096**	0.02	-0.247**	0.023	0.004**	-0.257**	0.46
Urban-Rural	Urban area %	0.133**	0.41	----	----	----	----	----
Interaction	Poverty black %	0.043	0	-0.152**	0.047**	0.004**	-0.022	0.48
Interaction	LessHS black %	0.029	0	-0.453**	0.078**	0.01**	-0.051	0.49
*correlation between sociodemographic variables and percent urban area

Table 1 shows simple linear regressions were used to examine the crude effects of each sociodemographic characteristic and multiple linear regressions were to evaluate the urban-rural effect on those relationships. Results of simple regression models showed that percent black (p = 0.08), median household income (p = 0.9), and interaction terms (poverty * % black (p = 0.05), < HS education * % black (p = 0.6)) were not statistically significant. Percent homeownership had the highest adjusted-R square value of 0.31 among all SES-related variables. Sociodemographic composition has a different influence on cancer risk in rural areas when compared with urban areas. For example, in urban areas (100% urban), a one percent increase in blacks further increased cancer risk by 0.12 ppl/million which was 6 times higher in all areas (0.021 ppl/million, both rural and urban area).

Table 2. Relative Risk

Census

HR %

Census

Pilot Project 1 is working on continued analyses and interpretations that will lead to further scientific dissemination activities in the form of manuscripts, as well as community-based dissemination. The team plans to present some of this work at the annual North Carolina Community-Based Environmental Justice Summit that will be held October 19-20, 2012. In addition, the team will present four posters related to pilot project one at the NIH Summit on the Science of Eliminating Health Disparities October 31-November 3, 2012 at National Harbor, MD.

Pilot Project #2

o September 18, 2012

§ In-depth analysis and interpretation of Orangeburg Photovoice data

o October 6, 2012

§ “Show and tell” Meeting in North Charleston (Photovoice)

o October-December 2012

§ “Show and tell” Meeting at Claflin University (Photovoice)

§ Analyze and interpret Photovoice data

§ Manuscript writing Photovoice results (will continue throughout project period)

o December 2012

§ Draft and finalize environmental health survey/revisions

§ Finalize survey in Teleform or Qualtrics

§ Pretest survey

§ Submit final version for USC IRB approval

o January 2013

§ Begin environmental health survey – Orangeburg (fielding period: January-March 2013) | Data management

o February 2013

§ Begin environmental health survey – North Charleston (fielding period: February-April 2013) | Data management

o March 2013

§ End survey – Orangeburg | Data management

§ Develop and submit abstracts and at least three manuscripts based on Photovoice implementation by geographic area of implementation (spring 2013).

o April 2013

§ End survey – North Charleston | Data management

o May-September 2013

§ Data analysis and interpretation of survey data | Manuscript development (will continue throughout project period)

§ We anticipate multiple opportunities to develop and submit abstracts and manuscripts based on findings from the environmental health survey (summer 2013).

§ Integration of Photovoice and survey data to inform next steps in collaboration with community partners

§ Preparation of future research grant applications to support next steps

Pilot Project 3 is in the process of inputting and cleaning data from the CBAs, in addition to devising a plan for analysis.

Journal Articles:

No journal articles submitted with this report: View all 24 publications for this project

Supplemental Keywords:

salutogenic and pathogenic infrastructure; environmental hazards in South Carolina; Superfund sites; Brownfields; Photovoice (documentary photography), environmental health survey, community-based approaches; community block assessment

Relevant Websites:

Coordinating Center of Excellence in the Social Promotion of Health Equity through Research, Education, and Community Engagement (CCE-SPHERE) – http://www.sc.edu/CCE-SPHERE/ Exit

Progress and Final Reports:

Original Abstract

2013 Progress Report

Final Report

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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.