DYNAMO-HIA--a Dynamic Modeling tool for generic Health Impact Assessments.

PubMed

Lhachimi, Stefan K; Nusselder, Wilma J; Smit, Henriette A; van Baal, Pieter; Baili, Paolo; Bennett, Kathleen; Fernández, Esteve; Kulik, Margarete C; Lobstein, Tim; Pomerleau, Joceline; Mackenbach, Johan P; Boshuizen, Hendriek C

2012-01-01

Currently, no standard tool is publicly available that allows researchers or policy-makers to quantify the impact of policies using epidemiological evidence within the causal framework of Health Impact Assessment (HIA). A standard tool should comply with three technical criteria (real-life population, dynamic projection, explicit risk-factor states) and three usability criteria (modest data requirements, rich model output, generally accessible) to be useful in the applied setting of HIA. With DYNAMO-HIA (Dynamic Modeling for Health Impact Assessment), we introduce such a generic software tool specifically designed to facilitate quantification in the assessment of the health impacts of policies. DYNAMO-HIA quantifies the impact of user-specified risk-factor changes on multiple diseases and in turn on overall population health, comparing one reference scenario with one or more intervention scenarios. The Markov-based modeling approach allows for explicit risk-factor states and simulation of a real-life population. A built-in parameter estimation module ensures that only standard population-level epidemiological evidence is required, i.e. data on incidence, prevalence, relative risks, and mortality. DYNAMO-HIA provides a rich output of summary measures--e.g. life expectancy and disease-free life expectancy--and detailed data--e.g. prevalences and mortality/survival rates--by age, sex, and risk-factor status over time. DYNAMO-HIA is controlled via a graphical user interface and is publicly available from the internet, ensuring general accessibility. We illustrate the use of DYNAMO-HIA with two example applications: a policy causing an overall increase in alcohol consumption and quantifying the disease-burden of smoking. By combining modest data needs with general accessibility and user friendliness within the causal framework of HIA, DYNAMO-HIA is a potential standard tool for health impact assessment based on epidemiologic evidence.

Quantifying the Impact of Floods on Bacillary Dysentery in Dalian City, China, From 2004 to 2010.

PubMed

Xu, Xin; Ding, Guoyong; Zhang, Ying; Liu, Zhidong; Liu, Qiyong; Jiang, Baofa

2017-04-01

Studies quantifying relationships between floods and diarrheal diseases have mainly been conducted in low-latitude regions. It's therefore increasingly important to examine these relationships in midlatitude regions, where they may have significant public health implications. This study aimed to examine the association between floods and bacillary dysentery in the city of Dalian, China. A generalized additive mixed model was applied to examine the association between floods and bacillary dysentery. The relative risk (RR) of flood impact on bacillary dysentery was estimated. A total of 18,976 cases of bacillary dysentery were reported in Dalian during the study period. Two weeks' lagged effect was detected from the impact of floods on bacillary dysentery. The RR of flood impact on bacillary dysentery was 1.17 (95% CI: 1.03-1.33). Floods have significantly increased the risk of bacillary dysentery in Dalian. More studies should focus on the association between floods and infectious diseases in different regions. Our findings have significant implications for managing the negative health impact of floods in the midlatitude region of China. (Disaster Med Public Health Preparedness. 2017;11:190-195).

National Built Environment Health Impact Assessment Model ...

EPA Pesticide Factsheets

Behavioral (activity, diet, social interaction) and exposure (air pollution, traffic injury, and noise) related health impacts of land use and transportation investment decisions are becoming better understood and quantified. Research has shown relationships between density, mix, street connectivity, access to parks, shops, transit, presence of sidewalks and bikeways, and healthy food with physical activity, obesity, cardiovascular disease, type II diabetes, and some mental health outcomes. This session demonstrates successful integration of health impact assessment into multiple scenario planning tool platforms. Detailed evidence on chronic disease and related costs associated with contrasting land use and transportation investments are built into a general-purpose module that can be accessed by multiple platforms. Funders, researchers, and end users of the tool will present a detailed description of the key elements of the approach, how it has been applied, and how will evolve. A critical focus will be placed on equity and social justice inherent within the assessment of health disparities that will be featured in the session. Health impacts of community design have significant cost benefit implications. Recent research is now extending relationships between community design features and chronic disease to health care costs. This session will demonstrate the recent application of this evidence on health impacts to the newly adopted Los Angeles Regional Transpo

National Built Environment Health Impact Assessment Model: Creation and Application

EPA Science Inventory

Behavioral (activity, diet, social interaction) and exposure (air pollution, traffic injury, and noise) related health impacts of land use and transportation investment decisions are becoming better understood and quantified. Research has shown relationships between density, mix,...

Quantifying Head Impacts in Collegiate Lacrosse.

PubMed

Reynolds, Bryson B; Patrie, James; Henry, Erich J; Goodkin, Howard P; Broshek, Donna K; Wintermark, Max; Druzgal, T Jason

2016-11-01

Concussion and repetitive head impact in sports has increased interest and concern for clinicians, scientists, and athletes. Lacrosse is the fastest growing sport in the United States, but the burden of head impact in lacrosse is unknown. The goal of this pilot study was to quantify head impact associated with practicing and playing collegiate lacrosse while subjects were fitted with wearable accelerometers. Descriptive epidemiology study. In a single year, a collegiate cohort of 14 women's and 15 men's lacrosse players wore mastoid-patch accelerometers to measure the frequency and severity of head impacts during official practices and games. Average impact severity, mean number of impacts, and cumulative acceleration were evaluated, stratified by sport and event type. Men's and women's collegiate lacrosse players did not significantly differ in the number of head impacts received during games (11.5 for men vs 9.2 for women) or practices (3.1 vs 3.1). Men's lacrosse players had significantly higher average head acceleration per impact during games compared with women (21.1g vs 14.7g) but not during practices (21.3g vs 18.1g). For both men and women, more impacts occurred during games than during practices (men, 11.5 vs 3.1; women, 9.2 vs 3.1), but impact severity did not significantly differ between events for either sport (men, 21.1g vs 21.3g; women, 14.7g vs 18.1g). The study data suggest a higher impact burden during games compared with practices, but this effect is driven by the quantity rather than severity of impacts. In contrast, sex-based effects in impact burden are driven by average impact severity rather than quantity. Data collected from larger multisite trials and/or different age groups could be used to inform ongoing debates, including headgear and practice regulations, that might appreciably affect the burden of head impacts in lacrosse. While most head impacts do not result in a clinical diagnosis of concussion, evidence indicates that

Integrating Social impacts on Health and Health-Care Systems in Systemic Seismic Vulnerability Analysis

NASA Astrophysics Data System (ADS)

Kunz-Plapp, T.; Khazai, B.; Daniell, J. E.

2012-04-01

This paper presents a new method for modeling health impacts caused by earthquake damage which allows for integrating key social impacts on individual health and health-care systems and for implementing these impacts in quantitative systemic seismic vulnerability analysis. In current earthquake casualty estimation models, demand on health-care systems is estimated by quantifying the number of fatalities and severity of injuries based on empirical data correlating building damage with casualties. The expected number of injured people (sorted by priorities of emergency treatment) is combined together with post-earthquake reduction of functionality of health-care facilities such as hospitals to estimate the impact on healthcare systems. The aim here is to extend these models by developing a combined engineering and social science approach. Although social vulnerability is recognized as a key component for the consequences of disasters, social vulnerability as such, is seldom linked to common formal and quantitative seismic loss estimates of injured people which provide direct impact on emergency health care services. Yet, there is a consensus that factors which affect vulnerability and post-earthquake health of at-risk populations include demographic characteristics such as age, education, occupation and employment and that these factors can aggravate health impacts further. Similarly, there are different social influences on the performance of health care systems after an earthquake both on an individual as well as on an institutional level. To link social impacts of health and health-care services to a systemic seismic vulnerability analysis, a conceptual model of social impacts of earthquakes on health and the health care systems has been developed. We identified and tested appropriate social indicators for individual health impacts and for health care impacts based on literature research, using available European statistical data. The results will be used to

DEVELOPMENT OF A METHOD TO QUANTIFY THE IMPACT ...

EPA Pesticide Factsheets

Advances in human health risk assessment, especially for contaminants encountered by the inhalation route, have evolved so that the uncertainty factors (UF) used in the extrapolation of non-cancer effects across species (UFA) have been split into the respective pharmacodynamic (PD) and pharmacokinetic (PK) components. Present EPA default values for these components are divided into two half-logs (e.g., 10 to the 0.5 power or 3.16), so that their multiplication yields the 10-fold UF customarily seen in Agency risk assessments as UFA. The state of the science at present does not support a detailed evaluation of species-dependent and human interindividual variance of PD, but more data exist by which PK variance can be examined and quantified both across species and within the human species. Because metabolism accounts for much of the PK variance, we sought to examine the impact that differences in hepatic enzyme content exerts upon risk-relevant PK outcomes among humans. Because of the age and ethnic diversity expressed in the human organ donor population and the wide availability of tissues from these human organ donors, a program was developed to include information from those tissues in characterizing human interindividual PK variance. An Interagency Agreement with CDC/NIOSH Taft Laboratory, a Cooperative Agreement with CIIT Centers for Health Research, and a collaborative agreement with NHEERL/ETD were established to successfully complete the project. The di

Health impact assessment of climate change in Bangladesh

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nelson, Deborah Imel

2003-05-01

Global climate change (GCC) may have serious and irreversible impacts. Improved methods are needed to predict and quantify health impacts, so that appropriate risk management strategies can be focused on vulnerable areas. The disability-adjusted life year (DALY) is proposed as an effective tool in environmental health impact assessment (HIA). The DALY accounts for years of life lost to premature death and/or morbidity. Both the DALY and the determinants-of-health approach are applied to HIA of GCC in Bangladesh. Based on historical data, a major storm event may result in approximately 290 DALY per 1000 population, including both deaths and injuries, comparedmore » to a current all-cause rate of about 280 per 1000 in the region. A more precise result would require a large input of data; however, this level of analysis may be sufficient to rank risks, and to motivate and target risk management efforts.« less

A simulation study to quantify the impacts of exposure ...

EPA Pesticide Factsheets

BackgroundExposure measurement error in copollutant epidemiologic models has the potential to introduce bias in relative risk (RR) estimates. A simulation study was conducted using empirical data to quantify the impact of correlated measurement errors in time-series analyses of air pollution and health.MethodsZIP-code level estimates of exposure for six pollutants (CO, NOx, EC, PM2.5, SO4, O3) from 1999 to 2002 in the Atlanta metropolitan area were used to calculate spatial, population (i.e. ambient versus personal), and total exposure measurement error.Empirically determined covariance of pollutant concentration pairs and the associated measurement errors were used to simulate true exposure (exposure without error) from observed exposure. Daily emergency department visits for respiratory diseases were simulated using a Poisson time-series model with a main pollutant RR = 1.05 per interquartile range, and a null association for the copollutant (RR = 1). Monte Carlo experiments were used to evaluate the impacts of correlated exposure errors of different copollutant pairs.ResultsSubstantial attenuation of RRs due to exposure error was evident in nearly all copollutant pairs studied, ranging from 10 to 40% attenuation for spatial error, 3–85% for population error, and 31–85% for total error. When CO, NOx or EC is the main pollutant, we demonstrated the possibility of false positives, specifically identifying significant, positive associations for copoll

Quantifying climate change impacts on runoff of zoonotic pathogens from land

NASA Astrophysics Data System (ADS)

Sterk, Ankie; de Roda Husman, Ana Maria; Stergiadi, Maria; de Nijs, Ton; Schijven, Jack

2013-04-01

Several studies have shown a correlation between rainfall and waterborne disease outbreaks. One of the mechanisms whereby rainfall may cause outbreaks is through an increase in runoff of animal faeces from fields to surface waters. Faeces originating from wildlife, domestic animals or manure-fertilized fields, is considered an important source of zoonotic pathogens to which people may be exposed by water recreation or drinking-water consumption. Climate changes affect runoff because of increasing winter precipitation and more extreme precipitation events, as well as changes in evaporation. Furthermore, drier summers are leading to longer periods of high soil moisture deficits, increasing the hydrophobicity of soil and consequently changing infiltration capacities. A conceptual model is designed to describe the impacts of climate changes on the terrestrial and aquatic ecosystems, which are both directly and indirectly affecting pathogen loads in the environment and subsequent public health risks. One of the major outcomes was the lack of quantitative data and limited qualitative analyses of impacts of climate changes on pathogen runoff. Quantifying the processes by which micro-organisms are transported from fields to waters is important to be able to estimate such impacts to enable targeted implementation of effective intervention measures. A quantitative model using Mathematica software will be developed to estimate concentrations of pathogens originating from overland flow during runoff events. Different input sources will be included by applying different land-use scenarios, including point source faecal pollution from dairy cows and geese and diffuse source pollution by fertilization. Zoonotic pathogens, i.e. Cryptosporidium and Campylobacter, were selected based on transport properties, faecal loads and disease burden. Transport and survival rates of these pathogens are determined including effects of changes in precipitation but also temperature induced

Are You Making an Impact? Evaluating the Population Health Impact of Community Benefit Programs.

PubMed

Rains, Catherine M; Todd, Greta; Kozma, Nicole; Goodman, Melody S

The Patient Protection and Affordable Care Act includes a change to the IRS 990 Schedule H, requiring nonprofit hospitals to submit a community health needs assessment every 3 years. Such health care entities are challenged to evaluate the effectiveness of community benefit programs addressing the health needs identified. In an effort to determine the population health impact of community benefit programs in 1 hospital outreach department, researchers and staff conducted an impact evaluation to develop priority areas and overarching goals along with program- and department-level objectives. The longitudinal impact evaluation study design consists of retrospective and prospective secondary data analyses. As an urban pediatric hospital, St Louis Children's Hospital provides an array of community benefit programs to the surrounding community. Hospital staff and researchers came together to form an evaluation team. Data from program evaluation and administrative data for analysis were provided by hospital staff. Impact scores were calculated by scoring objectives as met or unmet and averaged across goals to create impact scores that measure how closely programs meet the overarching departmental mission and goals. Over the 4-year period, there is an increasing trend in program-specific impact scores across all programs except one, Healthy Kids Express Asthma, which had a slight decrease in year 4 only. Current work in measuring and assessing the population health impact of community benefit programs is mostly focused on quantifying dollars invested into community benefit work rather than measuring the quality and impact of services. This article provides a methodology for measuring population health impact of community benefit programs that can be used to evaluate the effort of hospitals in providing community benefit. This is particularly relevant in our changing health care climate, as hospitals are being asked to justify community benefit and make meaningful

Health and Climate Impacts of Rural Residential Energy Transition in China

NASA Astrophysics Data System (ADS)

Tao, Shu; Ru, Muye; Du, Wei; Zhu, Xi; Zhong, Qirui

2017-04-01

Over the last two to three decades, energy mix in rural China transit dramatically owing to rapid socioeconomic development. It is expected that such transition can result in changes in emissions of climate forcing components and air pollutants, consequently environmental and climate impacts. Such impacts were quantified by a nationwide survey on rural residential energy consumption, compilation of a series of emission inventories, modeling of atmospheric transport of pollutants, assessment on health risk induced by exposure to ambient air pollutants, and evaluation on rural residential emission originated climate forcing components. Co-benefit of the transition on both health and climate is demonstrated.

A simulation study to quantify the impacts of exposure measurement error on air pollution health risk estimates in copollutant time-series models.

EPA Science Inventory

BackgroundExposure measurement error in copollutant epidemiologic models has the potential to introduce bias in relative risk (RR) estimates. A simulation study was conducted using empirical data to quantify the impact of correlated measurement errors in time-series analyses of a...

Impact of school health management committees on health services delivery in Ghana: A national level assessment.

PubMed

Bowman, Angela S; Owusu, Andrew; Trueblood, Amber B; Bosumtwi-Sam, Cynthia

2018-05-07

To examine the prevalence, determinants, and impact of local school health management committees on implementation of minimum-recommended school health services delivery among basic and secondary schools in Ghana. National level cross-sectional data from the first-ever assessment of Ghana Global-School Health Policies and Practices Survey was utilized. Complex sample analyses were used to quantify school-level implementation of recommended minimum package for health services delivery. Of 307 schools, 98% were basic and government run, and 33% offered at least half of the recommended health service delivery areas measured. Schools with a school health management committee (53%) were 4.8 (95% CI = 3.23-5.18) times as likely to offer at least 50% of the minimum health services package than schools that did not. There is significant deficit concerning delivery of school health services in schools across Ghana. However, school health management committees positively impact implementation of health service delivery. School health management committees provide a significant impact on delivery of school health services; thus, it is recommended that policy makers and programmers place greater emphasis on the value and need for these advisory boards in all Ghanaian schools. Copyright © 2018 John Wiley & Sons, Ltd.

A measure for quantifying the impact of housing quality on respiratory health: a cross-sectional study.

PubMed

Keall, Michael D; Crane, Julian; Baker, Michael G; Wickens, Kristin; Howden-Chapman, Philippa; Cunningham, Malcolm

2012-05-14

Damp and mould in homes have been established as risk factors for respiratory health. There is a need for a relatively straightforward assessment of the home that quantifies this risk. Using data from 891 New Zealand houses, the utility of a Respiratory Hazard Index quantifying key attributes related to damp and mould was tested by studying its associations with self-reported respiratory symptoms. A dose-response relationship was found whereby each unit increase in the Respiratory Hazard Index was associated with an 11% increase in the odds of at least one episode of wheezing/whistling in the chest over the last 12 months (relative odds of 1.11 with a 95% CI 1.04%-1.20%). An 11% increase in the odds of an asthma attack over the last 12 months was estimated (relative odds of 1.11 with a 95% CI 1.01%-1.22%). These estimates were adjusted for household crowding levels, age, sex and smoking status. There was suggestive evidence of more steeply increasing odds of respiratory symptoms with increasing levels of the Respiratory Hazard Index for children aged under 7. In the worst performing houses according to the Index, a 33% reduction in the number of people experiencing respiratory symptoms (relative risk 0.67 with 95% CI 0.53 to 0.85) could be expected if people were housed in the best performing houses. This study showed that increased evidence of housing conditions supporting dampness and mould was associated with increased odds of respiratory symptoms. A valid housing assessment tool can provide a rational basis for investment in improved housing quality to improve respiratory health.

STAR Measurements and Modeling for Quantifying Air Quality and Climatic Impacts of Residential Biomass or Coal Combustion for Cooking, Heating and Lighting Kick-off Meeting

EPA Pesticide Factsheets

STAR grantees and EPA scientists will discuss progress on their projects which aim to quantify the extent to which interventions for cleaner cooking, heating, or lighting can impact air quality and climate, which in turn affect human health and welfare

Regional characterization of freshwater Use in LCA: modeling direct impacts on human health.

PubMed

Boulay, Anne-Marie; Bulle, Cécile; Bayart, Jean-Baptiste; Deschênes, Louise; Margni, Manuele

2011-10-15

Life cycle assessment (LCA) is a methodology that quantifies potential environmental impacts for comparative purposes in a decision-making context. While potential environmental impacts from pollutant emissions into water are characterized in LCA, impacts from water unavailability are not yet fully quantified. Water use can make the resource unavailable to other users by displacement or quality degradation. A reduction in water availability to human users can potentially affect human health. If financial resources are available, there can be adaptations that may, in turn, shift the environmental burdens to other life cycle stages and impact categories. This paper proposes a model to evaluate these potential impacts in an LCA context. It considers the water that is withdrawn and released, its quality and scarcity in order to evaluate the loss of functionality associated with water uses. Regionalized results are presented for impacts on human health for two modeling approaches regarding affected users, including or not domestic uses, and expressed in disability-adjusted life years (DALY). A consumption and quality based scarcity indicator is also proposed as a midpoint. An illustrative example is presented for the production of corrugated board with different effluents, demonstrating the importance of considering quality, process effluents and the difference between the modeling approaches.

Urban-rural variations in air quality and health impacts in northern India

NASA Astrophysics Data System (ADS)

Karambelas, A. N.; Holloway, T.; Fiore, A. M.; Kinney, P.; DeFries, R. S.; Kiesewetter, G.; Heyes, C.

2017-12-01

Ambient air pollution in India is a severe problem, contributing to negative health impacts and early death. Ground-based monitors often used to quantify health impacts are often located in urban regions, however approximately 70% of India's population resides in rural areas. We use high-resolution concentrations from the regional Community Multi-scale Air Quality (CMAQ) model over densely-populated northern India to estimate air quality and health impacts due to anthropogenic emission sectors separately for urban and rural regions. Modeled concentrations inform relative risk calculations and exposure estimates as performed in the Global Burden of Disease. Anthropogenic emissions from the International Institute for Applied Systems Analysis (IIASA) Greenhouse Gas-Air Pollution Interactions and Synergies (GAINS) model following version 5a of the Evaluating the Climate and Air Quality Impacts of Short-Lived Pollutants project gridding structure are updated to reflect urban- and rural-specific activity information for transportation and residential combustion, and industrial and electrical generating unit location and magnitude information. We estimate 314,000 (95% Confidence Interval: 304,000—323,000) and 58,000 (CI: 39,000—70,000) adults (25 years or older) die prematurely each year from PM2.5 and O3 respectively in northern India, with the greatest impacts along the Indo-Gangetic Plain. Using urban and rural population distributions, we estimate that the majority of premature deaths resulting from PM2.5 and O3 are in rural (292,000) as opposed to urban (79,000) regions. These findings indicate the need for designing monitoring networks and ground-based health studies in rural areas of India to more accurately quantify the true health implications of ambient air pollution, in addition to supporting model evaluation. Using this urban-versus-rural emissions framework, we are assessing anthropogenic contributions to regional air quality and health impacts, and

The impact of digital health interventions on health-related outcomes in the workplace: A systematic review

PubMed Central

Quesada, Jose; Silva, Jessica; Judycki, Stephanie; Mills, Peter R

2018-01-01

Background The impact of employee health on productivity in the workplace is generally evidenced through absenteeism and presenteeism. Multicomponent worksite health programmes, with significant online elements, have gained in popularity over the last two decades, due in part to their scalability and low cost of implementation. However, little is known about the impact of digital-only interventions on health-related outcomes in employee groups. The aim of this systematic review was to assess the impact of pure digital health interventions in the workplace on health-related outcomes. Methods Multiple databases, including MEDLINE, EMBASE, PubMed and PsycINFO, were used to review the literature using PRISMA guidelines. Results Of 1345 records screened, 22 randomized controlled trial studies were found to be eligible. Although there was a high level of heterogeneity across these studies, significant improvements were found for a broad range of outcomes such as sleep, mental health, sedentary behaviours and physical activity levels. Standardized measures were not always used to quantify intervention impact. All but one study resulted in at least one significantly improved health-related outcome, but attrition rates ranged widely, suggesting sustaining engagement was an issue. Risk of bias assessment was low for one-third of the studies and unclear for the remaining ones. Conclusions This review found modest evidence that digital-only interventions have a positive impact on health-related outcomes in the workplace. High heterogeneity impacted the ability to confirm what interventions might work best for which health outcomes, although less complex health outcomes appeared to be more likely to be impacted. A focus on engagement along with the use of standardized measures and reporting of active intervention components would be helpful in future evaluations.

Evaluation of the public health impacts of traffic congestion: a health risk assessment

PubMed Central

2010-01-01

Background Traffic congestion is a significant issue in urban areas in the United States and around the world. Previous analyses have estimated the economic costs of congestion, related to fuel and time wasted, but few have quantified the public health impacts or determined how these impacts compare in magnitude to the economic costs. Moreover, the relative magnitudes of economic and public health impacts of congestion would be expected to vary significantly across urban areas, as a function of road infrastructure, population density, and atmospheric conditions influencing pollutant formation, but this variability has not been explored. Methods In this study, we evaluate the public health impacts of ambient exposures to fine particulate matter (PM2.5) concentrations associated with a business-as-usual scenario of predicted traffic congestion. We evaluate 83 individual urban areas using traffic demand models to estimate the degree of congestion in each area from 2000 to 2030. We link traffic volume and speed data with the MOBILE6 model to characterize emissions of PM2.5 and particle precursors attributable to congestion, and we use a source-receptor matrix to evaluate the impact of these emissions on ambient PM2.5 concentrations. Marginal concentration changes are related to a concentration-response function for mortality, with a value of statistical life approach used to monetize the impacts. Results We estimate that the monetized value of PM2.5-related mortality attributable to congestion in these 83 cities in 2000 was approximately $31 billion (2007 dollars), as compared with a value of time and fuel wasted of $60 billion. In future years, the economic impacts grow (to over $100 billion in 2030) while the public health impacts decrease to $13 billion in 2020 before increasing to $17 billion in 2030, given increasing population and congestion but lower emissions per vehicle. Across cities and years, the public health impacts range from more than an order of

Evaluation of the public health impacts of traffic congestion: a health risk assessment.

PubMed

Levy, Jonathan I; Buonocore, Jonathan J; von Stackelberg, Katherine

2010-10-27

Traffic congestion is a significant issue in urban areas in the United States and around the world. Previous analyses have estimated the economic costs of congestion, related to fuel and time wasted, but few have quantified the public health impacts or determined how these impacts compare in magnitude to the economic costs. Moreover, the relative magnitudes of economic and public health impacts of congestion would be expected to vary significantly across urban areas, as a function of road infrastructure, population density, and atmospheric conditions influencing pollutant formation, but this variability has not been explored. In this study, we evaluate the public health impacts of ambient exposures to fine particulate matter (PM2.5) concentrations associated with a business-as-usual scenario of predicted traffic congestion. We evaluate 83 individual urban areas using traffic demand models to estimate the degree of congestion in each area from 2000 to 2030. We link traffic volume and speed data with the MOBILE6 model to characterize emissions of PM2.5 and particle precursors attributable to congestion, and we use a source-receptor matrix to evaluate the impact of these emissions on ambient PM2.5 concentrations. Marginal concentration changes are related to a concentration-response function for mortality, with a value of statistical life approach used to monetize the impacts. We estimate that the monetized value of PM2.5-related mortality attributable to congestion in these 83 cities in 2000 was approximately $31 billion (2007 dollars), as compared with a value of time and fuel wasted of $60 billion. In future years, the economic impacts grow (to over $100 billion in 2030) while the public health impacts decrease to $13 billion in 2020 before increasing to $17 billion in 2030, given increasing population and congestion but lower emissions per vehicle. Across cities and years, the public health impacts range from more than an order of magnitude less to in excess of

Quantifying Projected Heat Mortality Impacts under 21st-Century Warming Conditions for Selected European Countries

PubMed Central

Baccini, Michela; Wolf, Tanja; Paunovic, Elizabet; Menne, Bettina

2017-01-01

Under future warming conditions, high ambient temperatures will have a significant impact on population health in Europe. The aim of this paper is to quantify the possible future impact of heat on population mortality in European countries, under different climate change scenarios. We combined the heat-mortality function estimated from historical data with meteorological projections for the future time laps 2035–2064 and 2071–2099, developed under the Representative Concentration Pathways (RCP) 4.5 and 8.5. We calculated attributable deaths (AD) at the country level. Overall, the expected impacts will be much larger than the impacts we would observe if apparent temperatures would remain in the future at the observed historical levels. During the period 2071–2099, an overall excess of 46,690 and 117,333 AD per year is expected under the RCP 4.5 and RCP 8.5 scenarios respectively, in addition to the 16,303 AD estimated under the historical scenario. Mediterranean and Eastern European countries will be the most affected by heat, but a non-negligible impact will be still registered in North-continental countries. Policies and plans for heat mitigation and adaptation are needed and urgent in European countries in order to prevent the expected increase of heat-related deaths in the coming decades. PMID:28678192

Quantifying Projected Heat Mortality Impacts under 21st-Century Warming Conditions for Selected European Countries.

PubMed

Kendrovski, Vladimir; Baccini, Michela; Martinez, Gerardo Sanchez; Wolf, Tanja; Paunovic, Elizabet; Menne, Bettina

2017-07-05

Under future warming conditions, high ambient temperatures will have a significant impact on population health in Europe. The aim of this paper is to quantify the possible future impact of heat on population mortality in European countries, under different climate change scenarios. We combined the heat-mortality function estimated from historical data with meteorological projections for the future time laps 2035-2064 and 2071-2099, developed under the Representative Concentration Pathways (RCP) 4.5 and 8.5. We calculated attributable deaths (AD) at the country level. Overall, the expected impacts will be much larger than the impacts we would observe if apparent temperatures would remain in the future at the observed historical levels. During the period 2071-2099, an overall excess of 46,690 and 117,333 AD per year is expected under the RCP 4.5 and RCP 8.5 scenarios respectively, in addition to the 16,303 AD estimated under the historical scenario. Mediterranean and Eastern European countries will be the most affected by heat, but a non-negligible impact will be still registered in North-continental countries. Policies and plans for heat mitigation and adaptation are needed and urgent in European countries in order to prevent the expected increase of heat-related deaths in the coming decades.

Quantifying behavioural determinants relating to health professional reporting of medication errors: a cross-sectional survey using the Theoretical Domains Framework.

PubMed

Alqubaisi, Mai; Tonna, Antonella; Strath, Alison; Stewart, Derek

2016-11-01

The aims of this study were to quantify the behavioural determinants of health professional reporting of medication errors in the United Arab Emirates (UAE) and to explore any differences between respondents. A cross-sectional survey of patient-facing doctors, nurses and pharmacists within three major hospitals of Abu Dhabi, the UAE. An online questionnaire was developed based on the Theoretical Domains Framework (TDF, a framework of behaviour change theories). Principal component analysis (PCA) was used to identify components and internal reliability determined. Ethical approval was obtained from a UK university and all hospital ethics committees. Two hundred and ninety-four responses were received. Questionnaire items clustered into six components of knowledge and skills, feedback and support, action and impact, motivation, effort and emotions. Respondents generally gave positive responses for knowledge and skills, feedback and support and action and impact components. Responses were more neutral for the motivation and effort components. In terms of emotions, the component with the most negative scores, there were significant differences in terms of years registered as health professional (those registered longest most positive, p = 0.002) and age (older most positive, p < 0.001) with no differences for gender and health profession. Emotional-related issues are the dominant barrier to reporting and are common to all professions. There is a need to develop, test and implement an intervention to impact health professionals' emotions. Such an intervention should focus on evidence-based behaviour change techniques of reducing negative emotions, focusing on emotional consequences and providing social support. • This research used the Theoretical Domains Framework to quantify the behavioural determinants of health professional reporting of medication errors. • Questionnaire items relating to emotions surrounding reporting generated the most negative responses

Assessing framing assumptions in quantitative health impact assessments: a housing intervention example.

PubMed

Mesa-Frias, Marco; Chalabi, Zaid; Foss, Anna M

2013-09-01

Health impact assessment (HIA) is often used to determine ex ante the health impact of an environmental policy or an environmental intervention. Underpinning any HIA is the framing assumption, which defines the causal pathways mapping environmental exposures to health outcomes. The sensitivity of the HIA to the framing assumptions is often ignored. A novel method based on fuzzy cognitive map (FCM) is developed to quantify the framing assumptions in the assessment stage of a HIA, and is then applied to a housing intervention (tightening insulation) as a case-study. Framing assumptions of the case-study were identified through a literature search of Ovid Medline (1948-2011). The FCM approach was used to identify the key variables that have the most influence in a HIA. Changes in air-tightness, ventilation, indoor air quality and mould/humidity have been identified as having the most influence on health. The FCM approach is widely applicable and can be used to inform the formulation of the framing assumptions in any quantitative HIA of environmental interventions. We argue that it is necessary to explore and quantify framing assumptions prior to conducting a detailed quantitative HIA during the assessment stage. Copyright © 2013 Elsevier Ltd. All rights reserved.

Quantification of the Impact of Endometriosis Symptoms on Health Related Quality of Life and Work Productivity

PubMed Central

Fourquet, Jessica; Báez, Lorna; Figueroa, Michelle; Iriarte, R. Iván; Flores, Idhaliz

2011-01-01

OBJECTIVE To quantify the impact of endometriosis-related symptoms on physical and mental health status, health-related quality of life (HRQoL), and work-related aspects (absenteeism, presenteeism, work productivity, activity impairment). DESIGN Cross-sectional quantitative study. SETTING Academic and research institution. PATIENT(S) Women (n=193) with self-reported surgically diagnosed endometriosis from the Endometriosis Patient Registry at Ponce School of Medicine and Health Sciences (PSMHS). INTERVENTION(S) Patients completed an anonymous questionnaire divided into three sections consisting of questions from the Patient Health Survey (SF-12®), the Endometriosis Health Profile (EHP-5), and the Work Productivity and Activity Impairment Survey (WPAI). MAIN OUTCOME MEASURE(S) Impact of endometriosis symptoms on physical and mental health status, health-related quality of life (HRQoL), absenteeism, presenteeism, work productivity and activity impairment was quantified. RESULTS Patients had SF-12 scores denoting significant disability in the phyisical and mental health components. They also reported an average of 7.41 hrs (approximately one working day) of work time loss during the week the symptoms are worse. In addition, WPAI scores show high impact on work-related domains: 13% of average loss in work time (absenteeism), 65% of their work was impaired (presenteeism), 64% loss in efficiency levels (work productivity loss), and 60% of daily activities perturbed (activity impairment). CONCLUSION Endometriosis symptoms such as chronic, incapacitating pelvic pain and infertility negatively and substantially impact the physical and mental health status, HRQoL, and productivity at work of patients with endometriosis. PMID:21621771

Economic value of U.S. fossil fuel electricity health impacts.

PubMed

Machol, Ben; Rizk, Sarah

2013-02-01

Fossil fuel energy has several externalities not accounted for in the retail price, including associated adverse human health impacts, future costs from climate change, and other environmental damages. Here, we quantify the economic value of health impacts associated with PM(2.5) and PM(2.5) precursors (NO(x) and SO(2)) on a per kilowatt hour basis. We provide figures based on state electricity profiles, national averages and fossil fuel type. We find that the economic value of improved human health associated with avoiding emissions from fossil fuel electricity in the United States ranges from a low of $0.005-$0.013/kWh in California to a high of $0.41-$1.01/kWh in Maryland. When accounting for the adverse health impacts of imported electricity, the California figure increases to $0.03-$0.07/kWh. Nationally, the average economic value of health impacts associated with fossil fuel usage is $0.14-$0.35/kWh. For coal, oil, and natural gas, respectively, associated economic values of health impacts are $0.19-$0.45/kWh, $0.08-$0.19/kWh, and $0.01-$0.02/kWh. For coal and oil, these costs are larger than the typical retail price of electricity, demonstrating the magnitude of the externality. When the economic value of health impacts resulting from air emissions is considered, our analysis suggests that on average, U.S. consumers of electricity should be willing to pay $0.24-$0.45/kWh for alternatives such as energy efficiency investments or emission-free renewable sources that avoid fossil fuel combustion. The economic value of health impacts is approximately an order of magnitude larger than estimates of the social cost of carbon for fossil fuel electricity. In total, we estimate that the economic value of health impacts from fossil fuel electricity in the United States is $361.7-886.5 billion annually, representing 2.5-6.0% of the national GDP. Published by Elsevier Ltd.

Impacts of Air Pollution on Health in Eastern China: Implications for future air pollution and energy policies

NASA Astrophysics Data System (ADS)

Wang, X.; Mauzerall, D.

2004-12-01

Our objective is to establish the link between energy consumption and technologies, air pollution and resulting impacts on public health in eastern China. We quantify the impacts that air pollution in the Shandong region of eastern China has on public health in 2000 and quantify the benefits in improved air quality and health that could be obtained by 2020, relative to business-as-usual, through the implementation of new energy technology. We first develop a highly-resolved emission inventory for the year 2000 for the Shandong region of China including emissions from large point, area, mobile and biogenic sources. We use the Sparse Matrix Operator Kernel Emissions Modeling System (SMOKE) to process emissions from this inventory for use in the Community Multi-scale Air Quality modeling system (CMAQ) which we drive with the NCAR/PSU MM5 meso-scale meteorology model. We evaluate the inventory by comparing CMAQ results with available measurements of PM10 and SO2 from air pollution indices (APIs) reported in various Chinese municipalities during 2002-2004. We use epidemiological dose-response functions to quantify health impacts and values of a statistical life (VSL) and years-of-life-lost (YLL) to establish a range for the monetary value of these impacts. To examine health impacts and their monetary value, we focus explicitly on Zaozhuang, a coal-intensive city in the Shandong region of eastern China, and quantify the mortalities and morbidities resulting from air pollutants emitted from this city in 2000, and in 2020 using business-as-usual, best-available control technology, and advanced coal gasification technology scenarios. In all scenarios most health damages arise from exposure to particulate matter. We find that total health damages due to year 2000 anthropogenic emissions from Zaozhuang accounted for 4-10% of its GDP. If all health damages resulting from coal use were internalized in the market price of coal, the year 2000 price would have doubled. With no new

The real estate factor: quantifying the impact of infarct location on stroke severity.

PubMed

Menezes, Nina M; Ay, Hakan; Wang Zhu, Ming; Lopez, Chloe J; Singhal, Aneesh B; Karonen, Jari O; Aronen, Hannu J; Liu, Yawu; Nuutinen, Juho; Koroshetz, Walter J; Sorensen, A Gregory

2007-01-01

The severity of the neurological deficit after ischemic stroke is moderately correlated with infarct volume. In the current study, we sought to quantify the impact of location on neurological deficit severity and to delineate this impact from that of volume. We developed atlases consisting of location-weighted values indicating the relative importance in terms of neurological deficit severity for every voxel of the brain. These atlases were applied to 80 first-ever ischemic stroke patients to produce estimates of clinical deficit severity. Each patient had an MRI and National Institutes of Health Stroke Scale (NIHSS) examination just before or soon after hospital discharge. The correlation between the location-based deficit predictions and measured neurological deficit (NIHSS) scores were compared with the correlation obtained using volume alone to predict the neurological deficit. Volume-based estimates of neurological deficit severity were only moderately correlated with measured NIHSS scores (r=0.62). The combination of volume and location resulted in a significantly better correlation with clinical deficit severity (r=0.79, P=0.032). The atlas methodology is a feasible way of integrating infarct size and location to predict stroke severity. It can estimate stroke severity better than volume alone.

Public health and chronic low chlordecone exposures in Guadeloupe; Part 2: Health impacts, and benefits of prevention.

PubMed

Nedellec, Vincent; Rabl, Ari; Dab, William

2016-07-19

Inhabitants of Guadeloupe are chronically exposed to low doses of chlordecone via local food due to its past use in banana plantations. The corresponding health impacts have not been quantified. We develop a quantitative method and present the results in two articles: 1. Hazard identification, exposure-response functions, and exposure, 2. Health impacts, and benefits of a program to reduce the exposure of the population. Here is the second article. The exposure-response functions derived in Part 1 (for liver and prostate cancer, renal dysfunction and cognitive development) are combined with the exposure data to calculate the impacts. The corresponding costs are calculated via DALY's and VOLY. A no-effect threshold is included via the marginal fraction of the collective exposure above the reference dose. The health benefits are the impacts in 2002 (before the exposure reduction program) minus the impacts in 2006 (since the program). They are compared to the costs, namely the public annual expenditures for reducing the population exposure. Without threshold, estimated annual cases of liver cancer, prostate cancer and renal dysfunction are respectively 5.4, 2.8, 0.10 in 2002; and 2.0, 1.0, 0.04 in 2006. Annual IQ points lost (cognitive development) are respectively: 1 173 and 1 003. The annual cost of total impacts is 38.3 Million Euros (M€) in 2002 and 23.7 M€ in 2006. Comparing the benefit of 14.6 M€ with the 3.25 M€ spent for prevention, the program appears well justified. With threshold, the costs of the impacts are lower, respectively: 26.5 M€ in 2002 and 12.8 M€ in 2006, but the benefit is not very different: 13.7 M€. This is the first study that quantified chronic non genotoxic effects of chlordecone exposures in Guadeloupe. According to our results, preventive actions should be focused on pregnant women because of the high social cost of development impairment and also because their exposures decreased less rapidly than others. Prevention

Environmental health impacts of tobacco farming: a review of the literature.

PubMed

Lecours, Natacha; Almeida, Guilherme E G; Abdallah, Jumanne M; Novotny, Thomas E

2012-03-01

To review the literature on environmental health impacts of tobacco farming and to summarise the findings and research gaps in this field. A standard literature search was performed using multiple electronic databases for identification of peer-reviewed articles. The internet and organisational databases were also used to find other types of documents (eg, books and reports). The reference lists of identified relevant documents were reviewed to find additional sources. The selected studies documented many negative environmental impacts of tobacco production at the local level, often linking them with associated social and health problems. The common agricultural practices related to tobacco farming, especially in low-income and middle-income countries, lead to deforestation and soil degradation. Agrochemical pollution and deforestation in turn lead to ecological disruptions that cause a loss of ecosystem services, including land resources, biodiversity and food sources, which negatively impact human health. Multinational tobacco companies' policies and practices contribute to environmental problems related to tobacco leaf production. Development and implementation of interventions against the negative environmental impacts of tobacco production worldwide are necessary to protect the health of farmers, particularly in low-income and middle-income countries. Transitioning these farmers out of tobacco production is ultimately the resolution to this environmental health problem. In order to inform policy, however, further research is needed to better quantify the health impacts of tobacco farming and evaluate the potential alternative livelihoods that may be possible for tobacco farmers globally.

A simulation study to quantify the impacts of exposure measurement error on air pollution health risk estimates in copollutant time-series models.

PubMed

Dionisio, Kathie L; Chang, Howard H; Baxter, Lisa K

2016-11-25

Exposure measurement error in copollutant epidemiologic models has the potential to introduce bias in relative risk (RR) estimates. A simulation study was conducted using empirical data to quantify the impact of correlated measurement errors in time-series analyses of air pollution and health. ZIP-code level estimates of exposure for six pollutants (CO, NO x , EC, PM 2.5 , SO 4 , O 3 ) from 1999 to 2002 in the Atlanta metropolitan area were used to calculate spatial, population (i.e. ambient versus personal), and total exposure measurement error. Empirically determined covariance of pollutant concentration pairs and the associated measurement errors were used to simulate true exposure (exposure without error) from observed exposure. Daily emergency department visits for respiratory diseases were simulated using a Poisson time-series model with a main pollutant RR = 1.05 per interquartile range, and a null association for the copollutant (RR = 1). Monte Carlo experiments were used to evaluate the impacts of correlated exposure errors of different copollutant pairs. Substantial attenuation of RRs due to exposure error was evident in nearly all copollutant pairs studied, ranging from 10 to 40% attenuation for spatial error, 3-85% for population error, and 31-85% for total error. When CO, NO x or EC is the main pollutant, we demonstrated the possibility of false positives, specifically identifying significant, positive associations for copollutants based on the estimated type I error rate. The impact of exposure error must be considered when interpreting results of copollutant epidemiologic models, due to the possibility of attenuation of main pollutant RRs and the increased probability of false positives when measurement error is present.

Quantifying Anthropogenic Dust Emissions

NASA Astrophysics Data System (ADS)

Webb, Nicholas P.; Pierre, Caroline

2018-02-01

Anthropogenic land use and land cover change, including local environmental disturbances, moderate rates of wind-driven soil erosion and dust emission. These human-dust cycle interactions impact ecosystems and agricultural production, air quality, human health, biogeochemical cycles, and climate. While the impacts of land use activities and land management on aeolian processes can be profound, the interactions are often complex and assessments of anthropogenic dust loads at all scales remain highly uncertain. Here, we critically review the drivers of anthropogenic dust emission and current evaluation approaches. We then identify and describe opportunities to: (1) develop new conceptual frameworks and interdisciplinary approaches that draw on ecological state-and-transition models to improve the accuracy and relevance of assessments of anthropogenic dust emissions; (2) improve model fidelity and capacity for change detection to quantify anthropogenic impacts on aeolian processes; and (3) enhance field research and monitoring networks to support dust model applications to evaluate the impacts of disturbance processes on local to global-scale wind erosion and dust emissions.

Health impact assessment of traffic noise in Madrid (Spain).

PubMed

Tobías, Aurelio; Recio, Alberto; Díaz, Julio; Linares, Cristina

2015-02-01

The relationship between environmental noise and health has been examined in depth. In view of the sheer number of persons exposed, attention should be focused on road traffic noise. The city of Madrid (Spain) is a densely populated metropolitan area in which 80% of all environmental noise exposure is attributed to traffic. The aim of this study was to quantify avoidable deaths resulting from reducing the impact of equivalent diurnal noise levels (LeqD) on daily cardiovascular and respiratory mortality among people aged ≥65 years in Madrid. A health impact assessment of (average 24h) LeqD and PM2.5 levels was conducted by using previously reported risk estimates of mortality rates for the period 2003-2005: For cardiovascular causes: LeqD 1.048 (1.005, 1.092) and PM2.5 1.041(1.020, 1.062) and for respiratory causes: LeqD 1.060 (1.000, 1.123) and PM2.5 1.030 (1.000, 1.062). The association found between LeqD exposure and mortality for both causes suggests an important health effect. A reduction of 1dB(A) in LeqD implies an avoidable annual mortality of 284 (31, 523) cardiovascular- and 184 (0, 190) respiratory-related deaths in the study population. The magnitude of the health impact is similar to reducing average PM2.5 levels by 10µg/m(3). Regardless of air pollution, exposure to traffic noise should be considered an important environmental factor having a significant impact on health. Copyright © 2014 Elsevier Inc. All rights reserved.

Integrated Assessment of Health-related Economic Impacts of U.S. Air Pollution Policy

NASA Astrophysics Data System (ADS)

Saari, R. K.; Rausch, S.; Selin, N. E.

2012-12-01

We examine the environmental impacts, health-related economic benefits, and distributional effects of new US regulations to reduce smog from power plants, namely: the Cross-State Air Pollution Rule. Using integrated assessment methods, linking atmospheric and economic models, we assess the magnitude of economy-wide effects and distributional consequences that are not captured by traditional regulatory impact assessment methods. We study the Cross-State Air Pollution Rule, a modified allowance trading scheme that caps emissions of nitrogen oxides and sulfur dioxide from power plants in the eastern United States and thus reduces ozone and particulate matter pollution. We use results from the regulatory regional air quality model, CAMx (the Comprehensive Air Quality Model with extensions), and epidemiologic studies in BenMAP (Environmental Benefits Mapping and Analysis Program), to quantify differences in morbidities and mortalities due to this policy. To assess the economy-wide and distributional consequences of these health impacts, we apply a recently developed economic and policy model, the US Regional Energy and Environmental Policy Model (USREP), a multi-region, multi-sector, multi-household, recursive dynamic computable general equilibrium economic model of the US that provides a detailed representation of the energy sector, and the ability to represent energy and environmental policies. We add to USREP a representation of air pollution impacts, including the estimation and valuation of health outcomes and their effects on health services, welfare, and factor markets. We find that the economic welfare benefits of the Rule are underestimated by traditional methods, which omit economy-wide impacts. We also quantify the distribution of benefits, which have varying effects across US regions, income groups, and pollutants, and we identify factors influencing this distribution, including the geographic variation of pollution and population as well as underlying

Measuring the gap: quantifying and comparing local health inequalities.

PubMed

Low, Anne; Low, Allan

2004-12-01

Primary Care Trusts (PCTs) and Local Strategic Partnerships (LSPs) are being asked to assess local health inequalities in order to prioritize local action, to set local targets for reducing levels of health inequality locally and to demonstrate measurable progress. Despite this, little guidance has been provided on how to quantify health inequalities within PCTs and LSPs. This paper advocates the use of a metric, the slope index of inequality, which provides a consistent measure of health inequalities across local populations. The metric can be presented as a relative gap, which is easily understood and enables levels of inequality to be compared between health conditions, lifestyles and rates of service provision at any one time, or across different time periods. The metric is applied to Sunderland Teaching PCT, using routine data sources. Examples of the results and their uses are presented. It is suggested that more widespread use of the metric could enable levels of health inequalities to be compared across PCTs and lead to the development of local health inequality and inequity benchmarks.

Including health in transport policy agendas: the role of health impact assessment analyses and procedures in the European experience.

PubMed Central

Dora, Carlos; Racioppi, Francesca

2003-01-01

From the mid-1990s, research began to highlight the importance of a wide range of health impacts of transport policy decisions. The Third Ministerial Conference on Environment and Health adopted a Charter on Transport, Environment and Health based on four main components: bringing awareness of the nature, magnitude and costs of the health impacts of transport into intergovernmental processes; strengthening the arguments for integration of health into transport policies by developing in-depth analysis of the evidence; developing national case studies; and engaging ministries of environment, health and transport as well as intergovernmental and nongovernmental organizations. Negotiation of the Charter was based on two converging processes: the political process involved the interaction of stakeholders in transport, health and environment in Europe, which helped to frame the issues and the approaches to respond to them; the scientific process involved an international group of experts who produced state-of- the-art reviews of the health impacts resulting from transportation activities, identifying gaps in existing knowledge and methodological tools, specifying the policy implications of their findings, and suggesting possible targets for health improvements. Health arguments were used to strengthen environmental ones, clarify costs and benefits, and raise issues of health equity. The European experience shows that HIA can fulfil the need for simple procedures to be systematically applied to decisions regarding transport strategies at national, regional and local levels. Gaps were identified concerning models for quantifying health impacts and capacity building on how to use such tools. PMID:12894322

A multi-scale modelling procedure to quantify hydrological impacts of upland land management

NASA Astrophysics Data System (ADS)

Wheater, H. S.; Jackson, B.; Bulygina, N.; Ballard, C.; McIntyre, N.; Marshall, M.; Frogbrook, Z.; Solloway, I.; Reynolds, B.

2008-12-01

Recent UK floods have focused attention on the effects of agricultural intensification on flood risk. However, quantification of these effects raises important methodological issues. Catchment-scale data have proved inadequate to support analysis of impacts of land management change, due to climate variability, uncertainty in input and output data, spatial heterogeneity in land use and lack of data to quantify historical changes in management practices. Manipulation experiments to quantify the impacts of land management change have necessarily been limited and small scale, and in the UK mainly focused on the lowlands and arable agriculture. There is a need to develop methods to extrapolate from small scale observations to predict catchment-scale response, and to quantify impacts for upland areas. With assistance from a cooperative of Welsh farmers, a multi-scale experimental programme has been established at Pontbren, in mid-Wales, an area of intensive sheep production. The data have been used to support development of a multi-scale modelling methodology to assess impacts of agricultural intensification and the potential for mitigation of flood risk through land use management. Data are available from replicated experimental plots under different land management treatments, from instrumented field and hillslope sites, including tree shelter belts, and from first and second order catchments. Measurements include climate variables, soil water states and hydraulic properties at multiple depths and locations, tree interception, overland flow and drainflow, groundwater levels, and streamflow from multiple locations. Fine resolution physics-based models have been developed to represent soil and runoff processes, conditioned using experimental data. The detailed models are used to calibrate simpler 'meta- models' to represent individual hydrological elements, which are then combined in a semi-distributed catchment-scale model. The methodology is illustrated using field

Webinar Presentation: Particle-Resolved Simulations for Quantifying Black Carbon Climate Impact and Model Uncertainty

EPA Pesticide Factsheets

This presentation, Particle-Resolved Simulations for Quantifying Black Carbon Climate Impact and Model Uncertainty, was given at the STAR Black Carbon 2016 Webinar Series: Changing Chemistry over Time held on Oct. 31, 2016.

Quantifying the Detrimental Impacts of Land-Use and Management Change on European Forest Bird Populations

PubMed Central

Wade, Amy S. I.; Barov, Boris; Burfield, Ian J.; Gregory, Richard D.; Norris, Ken; Butler, Simon J.

2013-01-01

The ecological impacts of changing forest management practices in Europe are poorly understood despite European forests being highly managed. Furthermore, the effects of potential drivers of forest biodiversity decline are rarely considered in concert, thus limiting effective conservation or sustainable forest management. We present a trait-based framework that we use to assess the detrimental impact of multiple land-use and management changes in forests on bird populations across Europe. Major changes to forest habitats occurring in recent decades, and their impact on resource availability for birds were identified. Risk associated with these changes for 52 species of forest birds, defined as the proportion of each species' key resources detrimentally affected through changes in abundance and/or availability, was quantified and compared to their pan-European population growth rates between 1980 and 2009. Relationships between risk and population growth were found to be significantly negative, indicating that resource loss in European forests is an important driver of decline for both resident and migrant birds. Our results demonstrate that coarse quantification of resource use and ecological change can be valuable in understanding causes of biodiversity decline, and thus in informing conservation strategy and policy. Such an approach has good potential to be extended for predictive use in assessing the impact of possible future changes to forest management and to develop more precise indicators of forest health. PMID:23704997

An experimental method to quantify the impact fatigue behavior of rocks

NASA Astrophysics Data System (ADS)

Wu, Bangbiao; Kanopoulos, Patrick; Luo, Xuedong; Xia, Kaiwen

2014-07-01

Fatigue failure is an important failure mode of engineering materials. The fatigue behavior of both ductile and brittle materials has been under investigation for many years. While the fatigue failure of ductile materials is well established, only a few studies have been carried out on brittle materials. In addition, most fatigue studies on rocks are conducted under quasi-static loading conditions. To address engineering applications involving repeated blasting, this paper proposes a method to quantify the impact fatigue properties of rocks. In this method, a split Hopkinson pressure bar system is adopted to exert impact load on the sample, which is placed in a specially designed steel sleeve to limit the displacement of the sample and thus to enable the recovery of the rock after each impact. The method is then applied to Laurentian granite, which is fine-grained and isotropic material. The results demonstrate that this is a practicable means to conduct impact fatigue tests on rocks and other brittle solids.

Quantifying long-term human impact in contrasting environments: Statistical analysis of modern and fossil pollen records

NASA Astrophysics Data System (ADS)

Broothaerts, Nils; López-Sáez, José Antonio; Verstraeten, Gert

2017-04-01

Reconstructing and quantifying human impact is an important step to understand human-environment interactions in the past. Quantitative measures of human impact on the landscape are needed to fully understand long-term influence of anthropogenic land cover changes on the global climate, ecosystems and geomorphic processes. Nevertheless, quantifying past human impact is not straightforward. Recently, multivariate statistical analysis of fossil pollen records have been proposed to characterize vegetation changes and to get insights in past human impact. Although statistical analysis of fossil pollen data can provide useful insights in anthropogenic driven vegetation changes, still it cannot be used as an absolute quantification of past human impact. To overcome this shortcoming, in this study fossil pollen records were included in a multivariate statistical analysis (cluster analysis and non-metric multidimensional scaling (NMDS)) together with modern pollen data and modern vegetation data. The information on the modern pollen and vegetation dataset can be used to get a better interpretation of the representativeness of the fossil pollen records, and can result in a full quantification of human impact in the past. This methodology was applied in two contrasting environments: SW Turkey and Central Spain. For each region, fossil pollen data from different study sites were integrated, together with modern pollen data and information on modern vegetation. In this way, arboreal cover, grazing pressure and agricultural activities in the past were reconstructed and quantified. The data from SW Turkey provides new integrated information on changing human impact through time in the Sagalassos territory, and shows that human impact was most intense during the Hellenistic and Roman Period (ca. 2200-1750 cal a BP) and decreased and changed in nature afterwards. The data from central Spain shows for several sites that arboreal cover decreases bellow 5% from the Feudal period

Assessing the impact of natural policy experiments on socioeconomic inequalities in health: how to apply commonly used quantitative analytical methods?

PubMed

Hu, Yannan; van Lenthe, Frank J; Hoffmann, Rasmus; van Hedel, Karen; Mackenbach, Johan P

2017-04-20

The scientific evidence-base for policies to tackle health inequalities is limited. Natural policy experiments (NPE) have drawn increasing attention as a means to evaluating the effects of policies on health. Several analytical methods can be used to evaluate the outcomes of NPEs in terms of average population health, but it is unclear whether they can also be used to assess the outcomes of NPEs in terms of health inequalities. The aim of this study therefore was to assess whether, and to demonstrate how, a number of commonly used analytical methods for the evaluation of NPEs can be applied to quantify the effect of policies on health inequalities. We identified seven quantitative analytical methods for the evaluation of NPEs: regression adjustment, propensity score matching, difference-in-differences analysis, fixed effects analysis, instrumental variable analysis, regression discontinuity and interrupted time-series. We assessed whether these methods can be used to quantify the effect of policies on the magnitude of health inequalities either by conducting a stratified analysis or by including an interaction term, and illustrated both approaches in a fictitious numerical example. All seven methods can be used to quantify the equity impact of policies on absolute and relative inequalities in health by conducting an analysis stratified by socioeconomic position, and all but one (propensity score matching) can be used to quantify equity impacts by inclusion of an interaction term between socioeconomic position and policy exposure. Methods commonly used in economics and econometrics for the evaluation of NPEs can also be applied to assess the equity impact of policies, and our illustrations provide guidance on how to do this appropriately. The low external validity of results from instrumental variable analysis and regression discontinuity makes these methods less desirable for assessing policy effects on population-level health inequalities. Increased use of the

Quantifying the impacts of global disasters

NASA Astrophysics Data System (ADS)

Jones, L. M.; Ross, S.; Wilson, R. I.; Borrero, J. C.; Brosnan, D.; Bwarie, J. T.; Geist, E. L.; Hansen, R. A.; Johnson, L. A.; Kirby, S. H.; Long, K.; Lynett, P. J.; Miller, K. M.; Mortensen, C. E.; Perry, S. C.; Porter, K. A.; Real, C. R.; Ryan, K. J.; Thio, H. K.; Wein, A. M.; Whitmore, P.; Wood, N. J.

2012-12-01

The US Geological Survey, National Oceanic and Atmospheric Administration, California Geological Survey, and other entities are developing a Tsunami Scenario, depicting a realistic outcome of a hypothetical but plausible large tsunami originating in the eastern Aleutian Arc, affecting the west coast of the United States, including Alaska and Hawaii. The scenario includes earth-science effects, damage and restoration of the built environment, and social and economic impacts. Like the earlier ShakeOut and ARkStorm disaster scenarios, the purpose of the Tsunami Scenario is to apply science to quantify the impacts of natural disasters in a way that can be used by decision makers in the affected sectors to reduce the potential for loss. Most natural disasters are local. A major hurricane can destroy a city or damage a long swath of coastline while mostly sparing inland areas. The largest earthquake on record caused strong shaking along 1500 km of Chile, but left the capital relatively unscathed. Previous scenarios have used the local nature of disasters to focus interaction with the user community. However, the capacity for global disasters is growing with the interdependency of the global economy. Earthquakes have disrupted global computer chip manufacturing and caused stock market downturns. Tsunamis, however, can be global in their extent and direct impact. Moreover, the vulnerability of seaports to tsunami damage can increase the global consequences. The Tsunami Scenario is trying to capture the widespread effects while maintaining the close interaction with users that has been one of the most successful features of the previous scenarios. The scenario tsunami occurs in the eastern Aleutians with a source similar to the 2011 Tohoku event. Geologic similarities support the argument that a Tohoku-like source is plausible in Alaska. It creates a major nearfield tsunami in the Aleutian arc and peninsula, a moderate tsunami in the US Pacific Northwest, large but not the

A new methodology for quantifying the impact of water repellency on the filtering function of soils

NASA Astrophysics Data System (ADS)

Müller, Karin; Deurer, Markus; Kawamoto, Ken; Hiradate, Syuntaro; Komatsu, Toshiko; Clothier, Brent

2014-05-01

Soils deliver a range of ecosystem services, and some of the most valuable relate to the regulating services resulting from the buffering and filtering of solutes by soil. However, it is commonly accepted that soil water repellency (SWR) can lead to finger flow and preferential flow. Yet, there have been few attempts to quantify the impact of such flow phenomena on the buffering and filtering of solutes. No method is available to quantify directly how SWR affects the transport of reactive solutes. We have closed this gap and developed a new method for quantifying solute transport by novel experiments with water-repellent soils. It involves sequentially applying two liquids, one water, and the other a reference fully wetting liquid, namely, aqueous ethanol, to the same intact soil core with air-drying between the application of the two liquids. Our results highlight that sorption experiments are necessary to complement our new method to ascertain directly the impact of SWR on the filtering of a solute. We conducted transport and sorption experiments, by applying our new method, with the herbicide 2,4-Dichlorophenoxyacetic acid and two Andosol top-soils; one from Japan and the other one from New Zealand. Breakthrough curves from the water experiments were characterized by preferential flow with high initial concentrations, tailing and a long prevalence of solutes remaining in the soil. Our results clearly demonstrate and quantify the impact of SWR on the leaching of this herbicide. This technique for quantifying the reduction of the soil's filtering efficiency by SWR enables assessment of the increased risk of groundwater contamination by solutes exogenously applied to water-repellent soils.

Health impacts of floods.

PubMed

Du, Weiwei; FitzGerald, Gerard Joseph; Clark, Michele; Hou, Xiang-Yu

2010-01-01

Floods are the most common hazard to cause disasters and have led to extensive morbidity and mortality throughout the world. The impact of floods on the human community is related directly to the location and topography of the area, as well as human demographics and characteristics of the built environment. The aim of this study is to identify the health impacts of disasters and the underlying causes of health impacts associated with floods. A conceptual framework is developed that may assist with the development of a rational and comprehensive approach to prevention, mitigation, and management. This study involved an extensive literature review that located >500 references, which were analyzed to identify common themes, findings, and expert views. The findings then were distilled into common themes. The health impacts of floods are wide ranging, and depend on a number of factors. However, the health impacts of a particular flood are specific to the particular context. The immediate health impacts of floods include drowning, injuries, hypothermia, and animal bites. Health risks also are associated with the evacuation of patients, loss of health workers, and loss of health infrastructure including essential drugs and supplies. In the medium-term, infected wounds, complications of injury, poisoning, poor mental health, communicable diseases, and starvation are indirect effects of flooding. In the long-term, chronic disease, disability, poor mental health, and poverty-related diseases including malnutrition are the potential legacy. This article proposes a structured approach to the classification of the health impacts of floods and a conceptual framework that demonstrates the relationships between floods and the direct and indirect health consequences.

Asteroid Geophysics and Quantifying the Impact Hazard

NASA Technical Reports Server (NTRS)

Sears, D.; Wooden, D. H.; Korycanksy, D. G.

2015-01-01

Probably the major challenge in understanding, quantifying, and mitigating the effects of an impact on Earth is understanding the nature of the impactor. Of the roughly 25 meteorite craters on the Earth that have associated meteorites, all but one was produced by an iron meteorite and only one was produced by a stony meteorite. Equally important, even meteorites of a given chemical class produce a wide variety of behavior in the atmosphere. This is because they show considerable diversity in their mechanical properties which have a profound influence on the behavior of meteorites during atmospheric passage. Some stony meteorites are weak and do not reach the surface or reach the surface as thousands of relatively harmless pieces. Some stony meteorites roll into a maximum drag configuration and are strong enough to remain intact so a large single object reaches the surface. Others have high concentrations of water that may facilitate disruption. However, while meteorite falls and meteorites provide invaluable information on the physical nature of the objects entering the atmosphere, there are many unknowns concerning size and scale that can only be determined by from the pre-atmospheric properties of the asteroids. Their internal structure, their thermal properties, their internal strength and composition, will all play a role in determining the behavior of the object as it passes through the atmosphere, whether it produces an airblast and at what height, and the nature of the impact and amount and distribution of ejecta.

Housing interventions and health: Quantifying the impact of indoor particles on mortality and morbidity with disease recovery.

PubMed

Milner, James; Chalabi, Zaid; Vardoulakis, Sotiris; Wilkinson, Paul

2015-08-01

Housing interventions for energy efficiency and greenhouse gas emission reduction have the potential to reduce exposure to indoor air pollution if they are implemented correctly. This work assessed the health impacts of home energy efficiency measures in England and Wales resulting in a reduction in average indoor PM2.5 exposures of 3 μg m(-3). The assessment was performed using a new multistate life table model which allows transition into and between multiple morbid states, including recovery to disease-free status and relapse, with transition rates informed by age- and cause-specific disease prevalence, incidence and mortality data. Such models have not previously included disease recovery. The results demonstrate that incorporation of recovery in the model is necessary for conditions such as asthma which have high incidence in early life but likelihood of recovery in adulthood. The impact assessment of the home energy efficiency intervention showed that the reduction in PM2.5 exposure would be associated with substantial benefits for mortality and morbidity from asthma, coronary heart disease and lung cancer. The overall impact would be an increase in life expectancy of two to three months and approximately 13 million QALYs gained over the 90 year follow-up period. Substantial quality-of-life benefits were also observed, with a decrease in asthma over all age groups and larger benefits due to reduced coronary heart disease and lung cancer, particularly in older age groups. The multistate model with recovery provides important additional information for assessing the impact on health of environmental policies and interventions compared with mortality-only life tables, allowing more realistic representation of diseases with substantial non-mortality burdens. Copyright © 2015 Elsevier Ltd. All rights reserved.

Drought impacts on children's respiratory health in the Brazilian Amazon

NASA Astrophysics Data System (ADS)

Smith, Lauren T.; Aragão, Luiz E. O. C.; Sabel, Clive E.; Nakaya, Tomoki

2014-01-01

Drought conditions in Amazonia are associated with increased fire incidence, enhancing aerosol emissions with degradation in air quality. Quantifying the synergic influence of climate and human-driven environmental changes on human health is, therefore, critical for identifying climate change adaptation pathways for this vulnerable region. Here we show a significant increase (1.2%-267%) in hospitalisations for respiratory diseases in children under-five in municipalities highly exposed to drought. Aerosol was the primary driver of hospitalisations in drought affected municipalities during 2005, while human development conditions mitigated the impacts in 2010. Our results demonstrated that drought events deteriorated children's respiratory health particularly during 2005 when the drought was more geographically concentrated. This indicates that if governments act on curbing fire usage and effectively plan public health provision, as a climate change adaptation procedure, health quality would improve and public expenditure for treatment would decrease in the region during future drought events.

Modeling the impact of tuberculosis interventions on epidemiologic outcomes and health system costs.

PubMed

Oxlade, Olivia; Piatek, Amy; Vincent, Cheri; Menzies, Dick

2015-02-13

Tuberculosis (TB) programs must invest in a variety of TB specific activities in order to reach ambitious global targets. Uncertainty exists surrounding the potential impact of each of these activities. The objective of our study was to model different interventions and quantify their impact on epidemiologic outcomes and costs from the health system perspective. Decision analysis was used to define the TB patient trajectory within the health system of three different countries. We considered up to seven different interventions that could affect either the natural history of TB, or patient trajectories within the health system. The expected impact of interventions were derived from published studies where possible. Epidemiologic outcomes and associated health system costs were projected for each scenario. With no specific intervention, TB related death rates are high and less than 10% of the population starts on correct treatment. Interventions that either prevent cases or affect all patients with TB disease early in their trajectory are expected to have the biggest impact, regardless of underlying epidemiologic characteristics of the setting. In settings with a private sector, improving diagnosis and appropriate treatment across all sectors is expected to have a major impact on outcomes. In all settings, the greatest benefit will come from early diagnosis of all forms of TB. Once this has been achieved more specific interventions, such as those targeting HIV, drug resistance or the private sector can be integrated to increase impact.

Climate Change and Food Security: Health Impacts in Developed Countries

PubMed Central

Hooper, Lee; Abdelhamid, Asmaa; Bentham, Graham; Boxall, Alistair B.A.; Draper, Alizon; Fairweather-Tait, Susan; Hulme, Mike; Hunter, Paul R.; Nichols, Gordon; Waldron, Keith W.

2012-01-01

Background: Anthropogenic climate change will affect global food production, with uncertain consequences for human health in developed countries. Objectives: We investigated the potential impact of climate change on food security (nutrition and food safety) and the implications for human health in developed countries. Methods: Expert input and structured literature searches were conducted and synthesized to produce overall assessments of the likely impacts of climate change on global food production and recommendations for future research and policy changes. Results: Increasing food prices may lower the nutritional quality of dietary intakes, exacerbate obesity, and amplify health inequalities. Altered conditions for food production may result in emerging pathogens, new crop and livestock species, and altered use of pesticides and veterinary medicines, and affect the main transfer mechanisms through which contaminants move from the environment into food. All these have implications for food safety and the nutritional content of food. Climate change mitigation may increase consumption of foods whose production reduces greenhouse gas emissions. Impacts may include reduced red meat consumption (with positive effects on saturated fat, but negative impacts on zinc and iron intake) and reduced winter fruit and vegetable consumption. Developed countries have complex structures in place that may be used to adapt to the food safety consequences of climate change, although their effectiveness will vary between countries, and the ability to respond to nutritional challenges is less certain. Conclusions: Climate change will have notable impacts upon nutrition and food safety in developed countries, but further research is necessary to accurately quantify these impacts. Uncertainty about future impacts, coupled with evidence that climate change may lead to more variable food quality, emphasizes the need to maintain and strengthen existing structures and policies to regulate

Climate change and food security: health impacts in developed countries.

PubMed

Lake, Iain R; Hooper, Lee; Abdelhamid, Asmaa; Bentham, Graham; Boxall, Alistair B A; Draper, Alizon; Fairweather-Tait, Susan; Hulme, Mike; Hunter, Paul R; Nichols, Gordon; Waldron, Keith W

2012-11-01

Anthropogenic climate change will affect global food production, with uncertain consequences for human health in developed countries. We investigated the potential impact of climate change on food security (nutrition and food safety) and the implications for human health in developed countries. Expert input and structured literature searches were conducted and synthesized to produce overall assessments of the likely impacts of climate change on global food production and recommendations for future research and policy changes. Increasing food prices may lower the nutritional quality of dietary intakes, exacerbate obesity, and amplify health inequalities. Altered conditions for food production may result in emerging pathogens, new crop and livestock species, and altered use of pesticides and veterinary medicines, and affect the main transfer mechanisms through which contaminants move from the environment into food. All these have implications for food safety and the nutritional content of food. Climate change mitigation may increase consumption of foods whose production reduces greenhouse gas emissions. Impacts may include reduced red meat consumption (with positive effects on saturated fat, but negative impacts on zinc and iron intake) and reduced winter fruit and vegetable consumption. Developed countries have complex structures in place that may be used to adapt to the food safety consequences of climate change, although their effectiveness will vary between countries, and the ability to respond to nutritional challenges is less certain. Climate change will have notable impacts upon nutrition and food safety in developed countries, but further research is necessary to accurately quantify these impacts. Uncertainty about future impacts, coupled with evidence that climate change may lead to more variable food quality, emphasizes the need to maintain and strengthen existing structures and policies to regulate food production, monitor food quality and safety, and

Emerging Patient-Driven Health Care Models: An Examination of Health Social Networks, Consumer Personalized Medicine and Quantified Self-Tracking

PubMed Central

Swan, Melanie

2009-01-01

A new class of patient-driven health care services is emerging to supplement and extend traditional health care delivery models and empower patient self-care. Patient-driven health care can be characterized as having an increased level of information flow, transparency, customization, collaboration and patient choice and responsibility-taking, as well as quantitative, predictive and preventive aspects. The potential exists to both improve traditional health care systems and expand the concept of health care though new services. This paper examines three categories of novel health services: health social networks, consumer personalized medicine and quantified self-tracking. PMID:19440396

Impact of ambient temperature on children's health: a systematic review.

PubMed

Xu, Zhiwei; Etzel, Ruth A; Su, Hong; Huang, Cunrui; Guo, Yuming; Tong, Shilu

2012-08-01

Children are vulnerable to temperature extremes. This paper aimed to review the literature regarding the relationship between ambient temperature and children's health and to propose future research directions. A literature search was conducted in February 2012 using the databases including PubMed, ProQuest, ScienceDirect, Scopus and Web of Science. Empirical studies regarding the impact of ambient temperature on children's mortality and morbidity were included. The existing literature indicates that very young children, especially children under one year of age, are particularly vulnerable to heat-related deaths. Hot and cold temperatures mainly affect cases of infectious diseases among children, including gastrointestinal diseases, malaria, hand, foot and mouse disease, and respiratory diseases. Pediatric allergic diseases, like eczema, are also sensitive to temperature extremes. During heat waves, the incidences of renal disease, fever and electrolyte imbalance among children increase significantly. Future research is needed to examine the balance between hot- and cold-temperature related mortality and morbidity among children; evaluate the impacts of cold spells on cause-specific mortality in children; identify the most sensitive temperature exposure and health outcomes to quantify the impact of temperature extremes on children; elucidate the possible modifiers of the temperature and children's health relationship; and project children's disease burden under different climate change scenarios. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

Trade-driven relocation of air pollution and health impacts in China.

PubMed

Wang, Haikun; Zhang, Yanxu; Zhao, Hongyan; Lu, Xi; Zhang, Yanxia; Zhu, Weimo; Nielsen, Chris P; Li, Xin; Zhang, Qiang; Bi, Jun; McElroy, Michael B

2017-09-29

Recent studies show that international trade affects global distributions of air pollution and public health. Domestic interprovincial trade has similar effects within countries, but has not been comprehensively investigated previously. Here we link four models to evaluate the effects of both international exports and interprovincial trade on PM 2.5 pollution and public health across China. We show that 50-60% of China's air pollutant emissions in 2007 were associated with goods and services consumed outside of the provinces where they were produced. Of an estimated 1.10 million premature deaths caused by PM 2.5 pollution throughout China, nearly 19% (208,500 deaths) are attributable to international exports. In contrast, interprovincial trade leads to improved air quality in developed coastal provinces with a net effect of 78,500 avoided deaths nationwide. However, both international export and interprovincial trade exacerbate the health burdens of air pollution in China's less developed interior provinces. Our results reveal trade to be a critical but largely overlooked consideration in effective regional air quality planning for China.International and domestic interprovincial trade of China are entangled, but their health impacts have been treated separately in earlier studies. Here Wang. quantify the complex impacts of trade on public health across China within an integrative framework.

Drought impacts on children's respiratory health in the Brazilian Amazon

PubMed Central

Smith, Lauren T.; Aragão, Luiz E. O. C.; Sabel, Clive E.; Nakaya, Tomoki

2014-01-01

Drought conditions in Amazonia are associated with increased fire incidence, enhancing aerosol emissions with degradation in air quality. Quantifying the synergic influence of climate and human-driven environmental changes on human health is, therefore, critical for identifying climate change adaptation pathways for this vulnerable region. Here we show a significant increase (1.2%–267%) in hospitalisations for respiratory diseases in children under-five in municipalities highly exposed to drought. Aerosol was the primary driver of hospitalisations in drought affected municipalities during 2005, while human development conditions mitigated the impacts in 2010. Our results demonstrated that drought events deteriorated children's respiratory health particularly during 2005 when the drought was more geographically concentrated. This indicates that if governments act on curbing fire usage and effectively plan public health provision, as a climate change adaptation procedure, health quality would improve and public expenditure for treatment would decrease in the region during future drought events. PMID:24430803

Quantifying the indirect impacts of climate on agriculture: an inter-method comparison

DOE PAGES

Calvin, Kate; Fisher-Vanden, Karen

2017-10-27

Climate change and increases in CO2 concentration affect the productivity of land, with implications for land use, land cover, and agricultural production. Much of the literature on the effect of climate on agriculture has focused on linking projections of changes in climate to process-based or statistical crop models. However, the changes in productivity have broader economic implications that cannot be quantified in crop models alone. How important are these socio-economic feedbacks to a comprehensive assessment of the impacts of climate change on agriculture? In this paper, we attempt to measure the importance of these interaction effects through an inter-method comparisonmore » between process models, statistical models, and integrated assessment model (IAMs). We find the impacts on crop yields vary widely between these three modeling approaches. Yield impacts generated by the IAMs are 20%-40% higher than the yield impacts generated by process-based or statistical crop models, with indirect climate effects adjusting yields by between - 12% and + 15% (e.g. input substitution and crop switching). The remaining effects are due to technological change.« less

Quantifying the indirect impacts of climate on agriculture: an inter-method comparison

NASA Astrophysics Data System (ADS)

Calvin, Kate; Fisher-Vanden, Karen

2017-11-01

Climate change and increases in CO2 concentration affect the productivity of land, with implications for land use, land cover, and agricultural production. Much of the literature on the effect of climate on agriculture has focused on linking projections of changes in climate to process-based or statistical crop models. However, the changes in productivity have broader economic implications that cannot be quantified in crop models alone. How important are these socio-economic feedbacks to a comprehensive assessment of the impacts of climate change on agriculture? In this paper, we attempt to measure the importance of these interaction effects through an inter-method comparison between process models, statistical models, and integrated assessment model (IAMs). We find the impacts on crop yields vary widely between these three modeling approaches. Yield impacts generated by the IAMs are 20%-40% higher than the yield impacts generated by process-based or statistical crop models, with indirect climate effects adjusting yields by between -12% and +15% (e.g. input substitution and crop switching). The remaining effects are due to technological change.

Quantifying the indirect impacts of climate on agriculture: an inter-method comparison

DOE Office of Scientific and Technical Information (OSTI.GOV)

Calvin, Kate; Fisher-Vanden, Karen

Climate change and increases in CO2 concentration affect the productivity of land, with implications for land use, land cover, and agricultural production. Much of the literature on the effect of climate on agriculture has focused on linking projections of changes in climate to process-based or statistical crop models. However, the changes in productivity have broader economic implications that cannot be quantified in crop models alone. How important are these socio-economic feedbacks to a comprehensive assessment of the impacts of climate change on agriculture? In this paper, we attempt to measure the importance of these interaction effects through an inter-method comparisonmore » between process models, statistical models, and integrated assessment model (IAMs). We find the impacts on crop yields vary widely between these three modeling approaches. Yield impacts generated by the IAMs are 20%-40% higher than the yield impacts generated by process-based or statistical crop models, with indirect climate effects adjusting yields by between - 12% and + 15% (e.g. input substitution and crop switching). The remaining effects are due to technological change.« less

A New Metric for Quantifying the Relative Impact of Risk Factors on Loss of Working Life Illustrated in a Population of Working Dogs.

PubMed

Caron-Lormier, Geoffrey; Harvey, Naomi D; England, Gary C W; Asher, Lucy

2016-01-01

In a resource-limited world, organisations attempting to reduce the impact of health or behaviour issues need to choose carefully how to allocate resources for the highest overall impact. However, such choices may not always be obvious. Which has the biggest impact? A large change to a small number of individuals, or a small change to a large number of individuals? The challenge is identifying the issues that have the greatest impact on the population so potential interventions can be prioritised. We addressed this by developing a score to quantify the impact of health conditions and behaviour problems in a population of working guide dogs using data from Guide Dogs, UK. The cumulative incidence of different issues was combined with information about their impact, in terms of reduction in working life, to create a work score. The work score was created at population-level to illustrate issues with the greatest impact on the population and to understand contributions of breeds or crossbreeds to the workforce. An individual work deficit score was also created and means of this score used to illustrate the impact on working life within a subgroup of the population such as a breed, or crossbreed generation. The work deficit scores showed that those removed for behavioural issues had a greater impact on the overall workforce than those removed for health reasons. Additionally trends over time illustrated the positive influence of interventions Guide Dogs have made to improve their workforce. Information highlighted by these scores is pertinent to the effort of Guide Dogs to ensure partnerships are lasting. Recognising that the scores developed here could be transferable to a wide variety of contexts and species, most notably human work force decisions; we discuss possible uses and adaptations such as reduction in lifespan, quality of life and yield in production animals.

A New Metric for Quantifying the Relative Impact of Risk Factors on Loss of Working Life Illustrated in a Population of Working Dogs

PubMed Central

Caron-Lormier, Geoffrey; England, Gary C. W.; Asher, Lucy

2016-01-01

In a resource-limited world, organisations attempting to reduce the impact of health or behaviour issues need to choose carefully how to allocate resources for the highest overall impact. However, such choices may not always be obvious. Which has the biggest impact? A large change to a small number of individuals, or a small change to a large number of individuals? The challenge is identifying the issues that have the greatest impact on the population so potential interventions can be prioritised. We addressed this by developing a score to quantify the impact of health conditions and behaviour problems in a population of working guide dogs using data from Guide Dogs, UK. The cumulative incidence of different issues was combined with information about their impact, in terms of reduction in working life, to create a work score. The work score was created at population-level to illustrate issues with the greatest impact on the population and to understand contributions of breeds or crossbreeds to the workforce. An individual work deficit score was also created and means of this score used to illustrate the impact on working life within a subgroup of the population such as a breed, or crossbreed generation. The work deficit scores showed that those removed for behavioural issues had a greater impact on the overall workforce than those removed for health reasons. Additionally trends over time illustrated the positive influence of interventions Guide Dogs have made to improve their workforce. Information highlighted by these scores is pertinent to the effort of Guide Dogs to ensure partnerships are lasting. Recognising that the scores developed here could be transferable to a wide variety of contexts and species, most notably human work force decisions; we discuss possible uses and adaptations such as reduction in lifespan, quality of life and yield in production animals. PMID:27829045

Health Impact Assessment: Linking Public Health to ...

EPA Pesticide Factsheets

The goal of this presentation is to explore how HIA can help inform hazardous waste permitting regulations and incorporate community vulnerability and cumulative impacts to their potential health risks into permitting decision making by the California Department of Toxic Substances Control. Presented the Health Impact Assessment (HIA) at the State of California Cumulative Impacts and Community Vulnerability Symposium on July 27 in Diamond Bar, CA.

A Bayesian model for quantifying the change in mortality associated with future ozone exposures under climate change.

PubMed

Alexeeff, Stacey E; Pfister, Gabriele G; Nychka, Doug

2016-03-01

Climate change is expected to have many impacts on the environment, including changes in ozone concentrations at the surface level. A key public health concern is the potential increase in ozone-related summertime mortality if surface ozone concentrations rise in response to climate change. Although ozone formation depends partly on summertime weather, which exhibits considerable inter-annual variability, previous health impact studies have not incorporated the variability of ozone into their prediction models. A major source of uncertainty in the health impacts is the variability of the modeled ozone concentrations. We propose a Bayesian model and Monte Carlo estimation method for quantifying health effects of future ozone. An advantage of this approach is that we include the uncertainty in both the health effect association and the modeled ozone concentrations. Using our proposed approach, we quantify the expected change in ozone-related summertime mortality in the contiguous United States between 2000 and 2050 under a changing climate. The mortality estimates show regional patterns in the expected degree of impact. We also illustrate the results when using a common technique in previous work that averages ozone to reduce the size of the data, and contrast these findings with our own. Our analysis yields more realistic inferences, providing clearer interpretation for decision making regarding the impacts of climate change. © 2015, The International Biometric Society.

Health impacts of workplace heat exposure: an epidemiological review.

PubMed

Xiang, Jianjun; Bi, Peng; Pisaniello, Dino; Hansen, Alana

2014-01-01

With predicted increasing frequency and intensity of extremely hot weather due to changing climate, workplace heat exposure is presenting an increasing challenge to occupational health and safety. This article aims to review the characteristics of workplace heat exposure in selected relatively high risk occupations, to summarize findings from published studies, and ultimately to provide suggestions for workplace heat exposure reduction, adaptations, and further research directions. All published epidemiological studies in the field of health impacts of workplace heat exposure for the period of January 1997 to April 2012 were reviewed. Finally, 55 original articles were identified. Manual workers who are exposed to extreme heat or work in hot environments may be at risk of heat stress, especially those in low-middle income countries in tropical regions. At risk workers include farmers, construction workers, fire-fighters, miners, soldiers, and manufacturing workers working around process-generated heat. The potential impacts of workplace heat exposure are to some extent underestimated due to the underreporting of heat illnesses. More studies are needed to quantify the extent to which high-risk manual workers are physiologically and psychologically affected by or behaviourally adapt to workplace heat exposure exacerbated by climate change.

Health Impacts of Workplace Heat Exposure: An Epidemiological Review

PubMed Central

XIANG, Jianjun; BI, Peng; PISANIELLO, Dino; HANSEN, Alana

2013-01-01

With predicted increasing frequency and intensity of extremely hot weather due to changing climate, workplace heat exposure is presenting an increasing challenge to occupational health and safety. This article aims to review the characteristics of workplace heat exposure in selected relatively high risk occupations, to summarize findings from published studies, and ultimately to provide suggestions for workplace heat exposure reduction, adaptations, and further research directions. All published epidemiological studies in the field of health impacts of workplace heat exposure for the period of January 1997 to April 2012 were reviewed. Finally, 55 original articles were identified. Manual workers who are exposed to extreme heat or work in hot environments may be at risk of heat stress, especially those in low-middle income countries in tropical regions. At risk workers include farmers, construction workers, fire-fighters, miners, soldiers, and manufacturing workers working around process-generated heat. The potential impacts of workplace heat exposure are to some extent underestimated due to the underreporting of heat illnesses. More studies are needed to quantify the extent to which high-risk manual workers are physiologically and psychologically affected by or behaviourally adapt to workplace heat exposure exacerbated by climate change. PMID:24366537

Speculating on health: public health meets finance in 'health impact bonds'.

PubMed

Rowe, Rachel; Stephenson, Niamh

2016-11-01

Where modern public health developed techniques to calculate probability, potentiality, risk and uncertainty, contemporary finance introduces instruments that redeploy these. This article traces possibilities for interrogating the connection between health and financialisation as it is arising in one particular example - the health impact bond. It locates the development of this very recent financial innovation in an account of public health's role within governance strategies over the 20th century to the present. We examine how social impact bonds for chronic disease prevention programmes bring two previously distinct ways of thinking about and addressing risk into the same domain. Exploring the derivative-type properties of health impact bonds elucidates the financial processes of exchange, hedging, bundling and leveraging. As tools for speculation, the functions of health impact bonds can be delinked from any particular outcome for participants in health interventions. How public health techniques for knowing and acting on risks to population health will contest, rework or be subsumed within finance's speculative response to risk, is to be seen. © 2016 Foundation for the Sociology of Health & Illness.

Evaluating the impact of equity focused health impact assessment on health service planning: three case studies.

PubMed

Harris-Roxas, Ben; Haigh, Fiona; Travaglia, Joanne; Kemp, Lynn

2014-09-05

Health impact assessment has been identified internationally as a mechanism to ensure potential health impacts and health equity impacts of proposals are considered before implementation. This paper looks at the impact of three equity focused health impact assessments (EFHIAs) of health service plans on subsequent decision-making and implementation, and then utilises these findings to test and refine an existing conceptual framework for evaluating the impact and effectiveness of health impact assessments for use in relation to EFHIAs. Case study analysis of three EFHIAs conducted on health sector plans in New South Wales, Australia. Data was drawn from 14 semi-structured interviews and the analysis of seven related documents (draft plans and EFHIA reports). The case studies showed that the EFHIAs all had some impact on the decision-making about the plans and their implementation, most clearly in relation to participants' understandings of equity and in the development of options for modifying service plans to ensure this was addressed. The timing of the EFHIA and individual responses to the EFHIA process and its recommendations were identified as critical factors influencing the impact of the EFHIAs. Several modifications to the conceptual framework are identified, principally adding factors to recognise the role individuals play in influencing the impact and effectiveness of EFHIAs. EFHIA has the potential to improve the consideration of health equity in health service planning processes, though a number of contextual and individual factors affect this. Current approaches can be strengthened by taking into account personal and organisational responses to the EFHIA process.

Quantifying the relative contribution of climate and human impacts on streamflow at seasonal scale

NASA Astrophysics Data System (ADS)

Xin, Z.; Zhang, L.; Li, Y.; Zhang, C.

2017-12-01

Both climate change and human activities have induced changes to hydrology. The quantification of their impacts on streamflow is a challenge, especially at the seasonal scale due to seasonality of climate and human impacts, i.e., water use for irrigation and water storage and release due to reservoir operation. In this study, the decomposition method based on the Budyko hypothesis is extended to the seasonal scale and is used to quantify the climate and human impacts on annual and seasonal streamflow changes. The results are further compared and verified with those simulated by the hydrological method of abcd model. Data are split into two periods (1953-1974 and 1975-2005) to quantify the change. Three seasons, including wet, dry and irrigation seasons are defined by introducing the monthly aridity index. In general, results showed a satisfactory agreement between the Budyko decomposition method and abcd model. Both climate change and human activities were found to induce a decrease in streamflow at the annual scale, with 67% of the change contributed by human activities. At the seasonal scale, the human-induced contribution to the reduced stream flow was 64% and 73% for dry and wet seasons, respectively; whereas in the irrigation season, the impact of human activities on reducing the streamflow was more pronounced (180%) since the climate contributes to increased streamflow. In addition, the quantification results were analyzed for each month in the wet season to reveal the effects of intense precipitation and reservoir operation rules during flood season.

Quantifying App Store Dynamics: Longitudinal Tracking of Mental Health Apps

PubMed Central

Nicholas, Jennifer; Christensen, Helen

2016-01-01

Background For many mental health conditions, mobile health apps offer the ability to deliver information, support, and intervention outside the clinical setting. However, there are difficulties with the use of a commercial app store to distribute health care resources, including turnover of apps, irrelevance of apps, and discordance with evidence-based practice. Objective The primary aim of this study was to quantify the longevity and rate of turnover of mental health apps within the official Android and iOS app stores. The secondary aim was to quantify the proportion of apps that were clinically relevant and assess whether the longevity of these apps differed from clinically nonrelevant apps. The tertiary aim was to establish the proportion of clinically relevant apps that included claims of clinical effectiveness. We performed additional subgroup analyses using additional data from the app stores, including search result ranking, user ratings, and number of downloads. Methods We searched iTunes (iOS) and the Google Play (Android) app stores each day over a 9-month period for apps related to depression, bipolar disorder, and suicide. We performed additional app-specific searches if an app no longer appeared within the main search Results On the Android platform, 50% of the search results changed after 130 days (depression), 195 days (bipolar disorder), and 115 days (suicide). Search results were more stable on the iOS platform, with 50% of the search results remaining at the end of the study period. Approximately 75% of Android and 90% of iOS apps were still available to download at the end of the study. We identified only 35.3% (347/982) of apps as being clinically relevant for depression, of which 9 (2.6%) claimed clinical effectiveness. Only 3 included a full citation to a published study. Conclusions The mental health app environment is volatile, with a clinically relevant app for depression becoming unavailable to download every 2.9 days. This poses

Where You Live Matters: Localising Environmental Impacts on Health, Nutrition and Poverty in Cambodia Using Small Area Estimation Techniques

NASA Astrophysics Data System (ADS)

Nilsen, K.; van Soesbergen, A.; Matthews, Z.

2016-12-01

Socioeconomic development depends on local environments. However, the scientific evidence quantifying the impact of environmental factors on health, nutrition and poverty at subnational levels is limited. This is because socioeconomic indicators are derived from sample surveys representative only at aggregate levels compared to environmental variables mostly available in high-resolution grids. Cambodia was selected because of its commitment to development in the context of a rapidly deteriorating environment. Having made considerable progress since 2005, access to health services is limited, a quarter of the population is still poor and 40% rural children are malnourished. Cambodia is also facing considerable environmental challenges including high deforestation rates, land degradation and natural hazards. Addressing existing gaps in the knowledge of environmental impacts on health and livelihoods, this study applies small area estimation (SAE) to quantify health, nutritional and poverty outcomes in the context of local environments. SAE produces reliable subnational estimates of socioeconomic outcomes available only from sample surveys by combining them with information from auxiliary sources (census). A model is used to explain common trades across areas and a random effect structure is applied to explain the observed extra heterogeneity. SAE models predicting health, nutrition and poverty outcomes excluding and including contextual environmental variables on natural hazards vulnerability, forest cover, climate, and agricultural production are compared. Results are mapped at regional and district levels to spatially assess the impacts of environmental variation on the outcomes. Inter and intra-regional inequalities are also estimated to examine the efficacy of health/socioeconomic policy targeting based on geographic location. Preliminary results suggest that localised environmental factors have considerable impacts on the indicators estimated and should

Assessment and longitudinal analysis of health impacts and stressors perceived to result from unconventional shale gas development in the Marcellus Shale region.

PubMed

Ferrar, Kyle J; Kriesky, Jill; Christen, Charles L; Marshall, Lynne P; Malone, Samantha L; Sharma, Ravi K; Michanowicz, Drew R; Goldstein, Bernard D

2013-01-01

Concerns for health and social impacts have arisen as a result of Marcellus Shale unconventional natural gas development. Our goal was to document the self-reported health impacts and mental and physical health stressors perceived to result from Marcellus Shale development. Two sets of interviews were conducted with a convenience sample of community members living proximal to Marcellus Shale development, session 1 March-September 2010 (n = 33) and session 2 January-April 2012 (n = 20). Symptoms of health impacts and sources of psychological stress were coded. Symptom and stressor counts were quantified for each interview. The counts for each participant were compared longitudinally. Participants attributed 59 unique health impacts and 13 stressors to Marcellus Shale development. Stress was the most frequently-reported symptom. Over time, perceived health impacts increased (P = 0·042), while stressors remained constant (P = 0·855). Exposure-based epidemiological studies are needed to address identified health impacts and those that may develop as unconventional natural gas extraction continues. Many of the stressors can be addressed immediately.

Impact of user fees on maternal health service utilization and related health outcomes: a systematic review.

PubMed

Dzakpasu, Susie; Powell-Jackson, Timothy; Campbell, Oona M R

2014-03-01

To assess the evidence of the impact of user fees on maternal health service utilization and related health outcomes in low- and middle-income countries, as well as their impact on inequalities in these outcomes. Studies were identified by modifying a search strategy from a related systematic review. Primary studies of any design were included if they reported the effect of fee changes on maternal health service utilization, related health outcomes and inequalities in these outcomes. For each study, data were systematically extracted and a quality assessment conducted. Due to the heterogeneity of study methods, results were examined narratively. Twenty studies were included. Designs and analytic approaches comprised: two interrupted time series, eight repeated cross-sectional, nine before-and-after without comparison groups and one before-and-after in three groups. Overall, the quality of studies was poor. Few studies addressed potential sources of bias, such as secular trends over time, and even basic tests of statistical significance were often not reported. Consistency in the direction of effects provided some evidence of an increase in facility delivery in particular after fees were removed, as well as possible increases in the number of managed delivery complications. There was little evidence of the effect on health outcomes or inequality in accessing care and, where available, the direction of effect varied. Despite the global momentum to abolish user fees for maternal and child health services, robust evidence quantifying impact remains scant. Improved methods for evaluating and reporting on these interventions are recommended, including better descriptions of the interventions and context, looking at a range of outcome measures, and adopting robust analytical methods that allow for adjustment of underlying and seasonal trends, reporting immediate as well as longer-term (e.g. at 6 months and 1 year) effects and using comparison groups where possible.

Quantifying the environmental impact of an integrated human/industrial-natural system using life cycle assessment; a case study on a forest and wood processing chain.

PubMed

Schaubroeck, Thomas; Alvarenga, Rodrigo A F; Verheyen, Kris; Muys, Bart; Dewulf, Jo

2013-01-01

Life Cycle Assessment (LCA) is a tool to assess the environmental sustainability of a product; it quantifies the environmental impact of a product's life cycle. In conventional LCAs, the boundaries of a product's life cycle are limited to the human/industrial system, the technosphere. Ecosystems, which provide resources to and take up emissions from the technosphere, are not included in those boundaries. However, similar to the technosphere, ecosystems also have an impact on their (surrounding) environment through their resource usage (e.g., nutrients) and emissions (e.g., CH4). We therefore propose a LCA framework to assess the impact of integrated Techno-Ecological Systems (TES), comprising relevant ecosystems and the technosphere. In our framework, ecosystems are accounted for in the same manner as technosphere compartments. Also, the remediating effect of uptake of pollutants, an ecosystem service, is considered. A case study was performed on a TES of sawn timber production encompassing wood growth in an intensively managed forest ecosystem and further industrial processing. Results show that the managed forest accounted for almost all resource usage and biodiversity loss through land occupation but also for a remediating effect on human health, mostly via capture of airborne fine particles. These findings illustrate the potential relevance of including ecosystems in the product's life cycle of a LCA, though further research is needed to better quantify the environmental impact of TES.

Quantifying Acoustic Impacts on Marine Mammals and Sea Turtles: Methods and Analytical Approach for Phase III Training and Testing

DTIC Science & Technology

2017-06-16

Acoustic Impacts on Marine Mammals and Sea Turtles: Methods and Analytical Approach for Phase III Training and Testing Sarah A. Blackstock Joseph O...December 2017 4. TITLE AND SUBTITLE Quantifying Acoustic Impacts on Marine Mammals and Sea Turtles: Methods and Analytical Approach for Phase III...Navy’s Phase III Study Areas as described in each Environmental Impact Statement/ Overseas Environmental Impact Statement and describes the methods

Quantifying soil moisture impacts on light use efficiency across biomes.

PubMed

Stocker, Benjamin D; Zscheischler, Jakob; Keenan, Trevor F; Prentice, I Colin; Peñuelas, Josep; Seneviratne, Sonia I

2018-06-01

Terrestrial primary productivity and carbon cycle impacts of droughts are commonly quantified using vapour pressure deficit (VPD) data and remotely sensed greenness, without accounting for soil moisture. However, soil moisture limitation is known to strongly affect plant physiology. Here, we investigate light use efficiency, the ratio of gross primary productivity (GPP) to absorbed light. We derive its fractional reduction due to soil moisture (fLUE), separated from VPD and greenness changes, using artificial neural networks trained on eddy covariance data, multiple soil moisture datasets and remotely sensed greenness. This reveals substantial impacts of soil moisture alone that reduce GPP by up to 40% at sites located in sub-humid, semi-arid or arid regions. For sites in relatively moist climates, we find, paradoxically, a muted fLUE response to drying soil, but reduced fLUE under wet conditions. fLUE identifies substantial drought impacts that are not captured when relying solely on VPD and greenness changes and, when seasonally recurring, are missed by traditional, anomaly-based drought indices. Counter to common assumptions, fLUE reductions are largest in drought-deciduous vegetation, including grasslands. Our results highlight the necessity to account for soil moisture limitation in terrestrial primary productivity data products, especially for drought-related assessments. © 2018 The Authors. New Phytologist © 2018 New Phytologist Trust.

Impact of multisectoral health determinants on child mortality 1980-2010: An analysis by country baseline mortality.

PubMed

Cohen, Robert L; Murray, John; Jack, Susan; Arscott-Mills, Sharon; Verardi, Vincenzo

2017-01-01

Some health determinants require relatively stronger health system capacity and socioeconomic development than others to impact child mortality. Few quantitative analyses have analyzed how the impact of health determinants varies by mortality level. 149 low- and middle-income countries were stratified into high, moderate, low, and very low baseline levels of child mortality in 1990. Data for 52 health determinants were collected for these countries for 1980-2010. To quantify how changes in health determinants were associated with mortality decline, univariable and multivariable regression models were constructed. An advanced statistical technique that is new for child mortality analyses-MM-estimation with first differences and country clustering-controlled for outliers, fixed effects, and variation across decades. Some health determinants (immunizations, education) were consistently associated with child mortality reduction across all mortality levels. Others (staff availability, skilled birth attendance, fertility, water and sanitation) were associated with child mortality reduction mainly in low or very low mortality settings. The findings indicate that the impact of some health determinants on child mortality was only apparent with stronger health systems, public infrastructure and levels of socioeconomic development, whereas the impact of other determinants was apparent at all stages of development. Multisectoral progress was essential to mortality reduction at all baseline mortality levels. Policy-makers can use such analyses to direct investments in health and non-health sectors and to set five-year child mortality targets appropriate for their baseline mortality levels and local context.

Quantification of the impact of endometriosis symptoms on health-related quality of life and work productivity.

PubMed

Fourquet, Jessica; Báez, Lorna; Figueroa, Michelle; Iriarte, R Iván; Flores, Idhaliz

2011-07-01

To quantify the impact of endometriosis-related symptoms on physical and mental health status, health-related quality of life, and work-related aspects (absenteeism, presenteeism, work productivity, and activity impairment). Cross-sectional quantitative study. Academic and research institution. Women (n = 193) with self-reported surgically diagnosed endometriosis from the Endometriosis Patient Registry at Ponce School of Medicine and Health Sciences (PSMHS). Anonymous questionnaire divided into three sections consisting of questions from the Patient Health Survey (SF-12), the Endometriosis Health Profile (EHP-5), and the Work Productivity and Activity Impairment Survey (WPAI). Quantification of impact of endometriosis symptoms on physical and mental health status, health-related quality of life, absenteeism, presenteeism, work productivity, and activity impairment. Patients had SF-12 scores denoting statistically significant disability in the physical and mental health components. They also reported an average of 7.41 hours (approximately one working day) of work time lost during the week when the symptoms are worse. In addition, the WPAI scores showed a high impact on work-related domains: 13% of average loss in work time (absenteeism), 65% of work impaired (presenteeism), 64% of loss in efficiency levels (work productivity loss), and 60% of daily activities perturbed (activity impairment). Endometriosis symptoms such as chronic, incapacitating pelvic pain and infertility negatively and substantially impact the physical and mental health status, health-related quality of life, and productivity at work of women. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

The Relationships Between Fatigue, Quality of Life, and Family Impact Among Children With Special Health Care Needs

PubMed Central

Anderson, Mary; Gandhi, Pranav; Tuli, Sanjeev; Krull, Kevin; Lai, Jin-Shei; Nackashi, John; Shenkman, Elizabeth

2013-01-01

Objective To examine the relationships among pediatric fatigue, health-related quality of life (HRQOL), and family impact among children with special health care needs (CSHCNs), specifically whether HRQOL mediates the influence of fatigue on family impact. Methods 266 caregivers of CSHCNs were studied. The Pediatric Quality of Life Inventory Multidimensional Fatigue Scale, Pediatric Quality of Life Inventory Generic Scale, and Impact on Family Scale were used to measure fatigue, HRQOL, and family impact, respectively. Linear regressions were used to analyze the designated relationships; path analyses were performed to quantify the mediating effects of HRQOL on fatigue–family impact relationship. Results Although greater fatigue was associated with family impact (p < .05), the association was not significant after accounting for HRQOL. Path analyses indicated the direct effect of fatigue on family impact was not significant (p > .05), whereas physical and emotional functioning significantly mediated the fatigue–family impact relationship (p < .001). Conclusion Fatigue is related to family impact among CSHCNs, acting through the impairment in HRQOL. PMID:23584707

Impact of smoke from prescribed burning: Is it a public health concern?

PubMed

Haikerwal, Anjali; Reisen, Fabienne; Sim, Malcolm R; Abramson, Michael J; Meyer, Carl P; Johnston, Fay H; Dennekamp, Martine

2015-05-01

Given the increase in wildfire intensity and frequency worldwide, prescribed burning is becoming a more common and widespread practice. Prescribed burning is a fire management tool used to reduce fuel loads for wildfire suppression purposes and occurs on an annual basis in many parts of the world. Smoke from prescribed burning can have a substantial impact on air quality and the environment. Prescribed burning is a significant source of fine particulate matter (PM2.5 aerodynamic diameter<2.5µm) and these particulates are found to be consistently elevated during smoke events. Due to their fine nature PM2.5 are particularly harmful to human health. Here we discuss the impact of prescribed burning on air quality particularly focussing on PM2.5. We have summarised available case studies from Australia including a recent study we conducted in regional Victoria, Australia during the prescribed burning season in 2013. The studies reported very high short-term (hourly) concentrations of PM2.5 during prescribed burning. Given the increase in PM2.5 concentrations during smoke events, there is a need to understand the influence of prescribed burning smoke exposure on human health. This is important especially since adverse health impacts have been observed during wildfire events when PM2.5 concentrations were similar to those observed during prescribed burning events. Robust research is required to quantify and determine health impacts from prescribed burning smoke exposure and derive evidence based interventions for managing the risk. Given the increase in PM2.5 concentrations during PB smoke events and its impact on the local air quality, the need to understand the influence of PB smoke exposure on human health is important. This knowledge will be important to inform policy and practice of the integrated, consistent, and adaptive approach to the appropriate planning and implementation of public health strategies during PB events. This will also have important implications

A framework to assess the impacts of climate change on stream health indicators in Michigan watersheds

NASA Astrophysics Data System (ADS)

Woznicki, S. A.; Nejadhashemi, A. P.; Tang, Y.; Wang, L.

2016-12-01

Climate change is projected to alter watershed hydrology and potentially amplify nonpoint source pollution transport. These changes have implications for fish and macroinvertebrates, which are often used as measures of aquatic ecosystem health. By quantifying the risk of adverse impacts to aquatic ecosystem health at the reach-scale, watershed climate change adaptation strategies can be developed and prioritized. The objective of this research was to quantify the impacts of climate change on stream health in seven Michigan watersheds. A process-based watershed model, the Soil and Water Assessment Tool (SWAT), was linked to adaptive neuro-fuzzy inferenced (ANFIS) stream health models. SWAT models were used to simulate reach-scale flow regime (magnitude, frequency, timing, duration, and rate of change) and water quality variables. The ANFIS models were developed based on relationships between the in-stream variables and sampling points of four stream health indicators: the fish index of biotic integrity (IBI), macroinvertebrate family index of biotic integrity (FIBI), Hilsenhoff biotic index (HBI), and number of Ephemeroptera, Plecoptera, and Trichoptera (EPT) taxa. The combined SWAT-ANFIS models extended stream health predictions to all watershed reaches. A climate model ensemble from the Coupled Model Intercomparison Project Phase 5 (CMIP5) was used to develop projections of changes to flow regime (using SWAT) and stream health indicators (using ANFIS) from a baseline of 1980-2000 to 2020-2040. Flow regime variables representing variability, duration of extreme events, and timing of low and high flow events were sensitive to changes in climate. The stream health indicators were relatively insensitive to changing climate at the watershed scale. However, there were many instances of individual reaches that were projected to experience declines in stream health. Using the probability of stream health decline coupled with the magnitude of the decline, maps of

Tobacco-free economy: A SAM-based multiplier model to quantify the impact of changes in tobacco demand in Bangladesh.

PubMed

Husain, Muhammad Jami; Khondker, Bazlul Haque

2016-01-01

In Bangladesh, where tobacco use is pervasive, reducing tobacco use is economically beneficial. This paper uses the latest Bangladesh social accounting matrix (SAM) multiplier model to quantify the economy-wide impact of demand-driven changes in tobacco cultivation, bidi industries, and cigarette industries. First, we compute various income multiplier values (i.e. backward linkages) for all production activities in the economy to quantify the impact of changes in demand for the corresponding products on gross output for 86 activities, demand for 86 commodities, returns to four factors of production, and income for eight household groups. Next, we rank tobacco production activities by income multiplier values relative to other sectors. Finally, we present three hypothetical 'tobacco-free economy' scenarios by diverting demand from tobacco products into other sectors of the economy and quantifying the economy-wide impact. The simulation exercises with three different tobacco-free scenarios show that, compared to the baseline values, total sectoral output increases by 0.92%, 1.3%, and 0.75%. The corresponding increases in the total factor returns (i.e. GDP) are 1.57%, 1.75%, and 1.75%. Similarly, total household income increases by 1.40%, 1.58%, and 1.55%.

Tobacco-free economy: A SAM-based multiplier model to quantify the impact of changes in tobacco demand in Bangladesh

PubMed Central

Husain, Muhammad Jami; Khondker, Bazlul Haque

2017-01-01

In Bangladesh, where tobacco use is pervasive, reducing tobacco use is economically beneficial. This paper uses the latest Bangladesh social accounting matrix (SAM) multiplier model to quantify the economy-wide impact of demand-driven changes in tobacco cultivation, bidi industries, and cigarette industries. First, we compute various income multiplier values (i.e. backward linkages) for all production activities in the economy to quantify the impact of changes in demand for the corresponding products on gross output for 86 activities, demand for 86 commodities, returns to four factors of production, and income for eight household groups. Next, we rank tobacco production activities by income multiplier values relative to other sectors. Finally, we present three hypothetical ‘tobacco-free economy’ scenarios by diverting demand from tobacco products into other sectors of the economy and quantifying the economy-wide impact. The simulation exercises with three different tobacco-free scenarios show that, compared to the baseline values, total sectoral output increases by 0.92%, 1.3%, and 0.75%. The corresponding increases in the total factor returns (i.e. GDP) are 1.57%, 1.75%, and 1.75%. Similarly, total household income increases by 1.40%, 1.58%, and 1.55%. PMID:28845091

Participatory quantitative health impact assessment of urban and transport planning in cities: A review and research needs.

PubMed

Nieuwenhuijsen, Mark J; Khreis, Haneen; Verlinghieri, Ersilia; Mueller, Natalie; Rojas-Rueda, David

2017-06-01

Urban and transport planning have large impacts on public health, but these are generally not explicitly considered and/or quantified, partly because there are no comprehensive models, methods and tools readily available. Air pollution, noise, temperature, green space, motor vehicle crashes and physical activity are important pathways linking urban and transport planning and public health. For policy decision-making, it is important to understand and be able to quantify the full-chain from source through pathways to health effects and impacts to substantiate and effectively target actions. In this paper, we aim to provide an overview of recent studies on the health impacts related to urban and transport planning in cities, describe the need for novel participatory quantitative health impact assessments (HIA) and provide recommendations. To devise our searches and narrative, we were guided by a recent conceptual framework linking urban and transport planning, environmental exposures, behaviour and health. We searched PubMed, Web of Science, Science Direct, and references from relevant articles in English language from January 1, 1980, to November 1, 2016, using pre-defined search terms. The number of HIA studies is increasing rapidly, but there is lack of participatory integrated and full-chain HIA models, methods and tools. These should be based on the use of a systemic multidisciplinary/multisectorial approach and state-of-the-art methods to address questions such as what are the best, most feasible and needed urban and transport planning policy measures to improve public health in cities? Active citizen support and new forms of communication between experts and citizens and the involvement of all major stakeholders are crucial to find and successfully implement health promoting policy measures. We provided an overview of the current state-of-the art of HIA in cities and made recommendations for further work. The process on how to get there is as important and

When things don't add up: quantifying impacts of multiple stressors from individual metabolism to ecosystem processing.

PubMed

Galic, Nika; Sullivan, Lauren L; Grimm, Volker; Forbes, Valery E

2018-04-01

Ecosystems are exposed to multiple stressors which can compromise functioning and service delivery. These stressors often co-occur and interact in different ways which are not yet fully understood. Here, we applied a population model representing a freshwater amphipod feeding on leaf litter in forested streams. We simulated impacts of hypothetical stressors, individually and in pairwise combinations that target the individuals' feeding, maintenance, growth and reproduction. Impacts were quantified by examining responses at three levels of biological organisation: individual-level body sizes and cumulative reproduction, population-level abundance and biomass and ecosystem-level leaf litter decomposition. Interactive effects of multiple stressors at the individual level were mostly antagonistic, that is, less negative than expected. Most population- and ecosystem-level responses to multiple stressors were stronger than expected from an additive model, that is, synergistic. Our results suggest that across levels of biological organisation responses to multiple stressors are rarely only additive. We suggest methods for efficiently quantifying impacts of multiple stressors at different levels of biological organisation. © 2018 John Wiley & Sons Ltd/CNRS.

Quantifying ecological impacts of mass extinctions with network analysis of fossil communities

PubMed Central

Muscente, A. D.; Prabhu, Anirudh; Zhong, Hao; Eleish, Ahmed; Meyer, Michael B.; Fox, Peter; Hazen, Robert M.; Knoll, Andrew H.

2018-01-01

Mass extinctions documented by the fossil record provide critical benchmarks for assessing changes through time in biodiversity and ecology. Efforts to compare biotic crises of the past and present, however, encounter difficulty because taxonomic and ecological changes are decoupled, and although various metrics exist for describing taxonomic turnover, no methods have yet been proposed to quantify the ecological impacts of extinction events. To address this issue, we apply a network-based approach to exploring the evolution of marine animal communities over the Phanerozoic Eon. Network analysis of fossil co-occurrence data enables us to identify nonrandom associations of interrelated paleocommunities. These associations, or evolutionary paleocommunities, dominated total diversity during successive intervals of relative community stasis. Community turnover occurred largely during mass extinctions and radiations, when ecological reorganization resulted in the decline of one association and the rise of another. Altogether, we identify five evolutionary paleocommunities at the generic and familial levels in addition to three ordinal associations that correspond to Sepkoski’s Cambrian, Paleozoic, and Modern evolutionary faunas. In this context, we quantify magnitudes of ecological change by measuring shifts in the representation of evolutionary paleocommunities over geologic time. Our work shows that the Great Ordovician Biodiversification Event had the largest effect on ecology, followed in descending order by the Permian–Triassic, Cretaceous–Paleogene, Devonian, and Triassic–Jurassic mass extinctions. Despite its taxonomic severity, the Ordovician extinction did not strongly affect co-occurrences of taxa, affirming its limited ecological impact. Network paleoecology offers promising approaches to exploring ecological consequences of extinctions and radiations. PMID:29686079

Quantifying ecological impacts of mass extinctions with network analysis of fossil communities.

PubMed

Muscente, A D; Prabhu, Anirudh; Zhong, Hao; Eleish, Ahmed; Meyer, Michael B; Fox, Peter; Hazen, Robert M; Knoll, Andrew H

2018-05-15

Mass extinctions documented by the fossil record provide critical benchmarks for assessing changes through time in biodiversity and ecology. Efforts to compare biotic crises of the past and present, however, encounter difficulty because taxonomic and ecological changes are decoupled, and although various metrics exist for describing taxonomic turnover, no methods have yet been proposed to quantify the ecological impacts of extinction events. To address this issue, we apply a network-based approach to exploring the evolution of marine animal communities over the Phanerozoic Eon. Network analysis of fossil co-occurrence data enables us to identify nonrandom associations of interrelated paleocommunities. These associations, or evolutionary paleocommunities, dominated total diversity during successive intervals of relative community stasis. Community turnover occurred largely during mass extinctions and radiations, when ecological reorganization resulted in the decline of one association and the rise of another. Altogether, we identify five evolutionary paleocommunities at the generic and familial levels in addition to three ordinal associations that correspond to Sepkoski's Cambrian, Paleozoic, and Modern evolutionary faunas. In this context, we quantify magnitudes of ecological change by measuring shifts in the representation of evolutionary paleocommunities over geologic time. Our work shows that the Great Ordovician Biodiversification Event had the largest effect on ecology, followed in descending order by the Permian-Triassic, Cretaceous-Paleogene, Devonian, and Triassic-Jurassic mass extinctions. Despite its taxonomic severity, the Ordovician extinction did not strongly affect co-occurrences of taxa, affirming its limited ecological impact. Network paleoecology offers promising approaches to exploring ecological consequences of extinctions and radiations. Copyright © 2018 the Author(s). Published by PNAS.

An uncertainty-based framework to quantifying climate change impacts on coastal flood vulnerability: case study of New York City.

PubMed

Zahmatkesh, Zahra; Karamouz, Mohammad

2017-10-17

The continued development efforts around the world, growing population, and the increased probability of occurrence of extreme hydrologic events have adversely affected natural and built environments. Flood damages and loss of lives from the devastating storms, such as Irene and Sandy on the East Coast of the USA, are examples of the vulnerability to flooding that even developed countries have to face. The odds of coastal flooding disasters have been increased due to accelerated sea level rise, climate change impacts, and communities' interest to live near the coastlines. Climate change, for instance, is becoming a major threat to sustainable development because of its adverse impacts on the hydrologic cycle. Effective management strategies are thus required for flood vulnerability reduction and disaster preparedness. This paper is an extension to the flood resilience studies in the New York City coastal watershed. Here, a framework is proposed to quantify coastal flood vulnerability while accounting for climate change impacts. To do so, a multi-criteria decision making (MCDM) approach that combines watershed characteristics (factors) and their weights is proposed to quantify flood vulnerability. Among the watershed characteristics, potential variation in the hydrologic factors under climate change impacts is modeled utilizing the general circulation models' (GCMs) outputs. The considered factors include rainfall, extreme water level, and sea level rise that exacerbate flood vulnerability through increasing exposure and susceptibility to flooding. Uncertainty in the weights as well as values of factors is incorporated in the analysis using the Monte Carlo (MC) sampling method by selecting the best-fitted distributions to the parameters with random nature. A number of low impact development (LID) measures are then proposed to improve watershed adaptive capacity to deal with coastal flooding. Potential range of current and future vulnerability to flooding is

Quantifying the costs and benefits of privacy-preserving health data publishing.

PubMed

Khokhar, Rashid Hussain; Chen, Rui; Fung, Benjamin C M; Lui, Siu Man

2014-08-01

Cost-benefit analysis is a prerequisite for making good business decisions. In the business environment, companies intend to make profit from maximizing information utility of published data while having an obligation to protect individual privacy. In this paper, we quantify the trade-off between privacy and data utility in health data publishing in terms of monetary value. We propose an analytical cost model that can help health information custodians (HICs) make better decisions about sharing person-specific health data with other parties. We examine relevant cost factors associated with the value of anonymized data and the possible damage cost due to potential privacy breaches. Our model guides an HIC to find the optimal value of publishing health data and could be utilized for both perturbative and non-perturbative anonymization techniques. We show that our approach can identify the optimal value for different privacy models, including K-anonymity, LKC-privacy, and ∊-differential privacy, under various anonymization algorithms and privacy parameters through extensive experiments on real-life data. Copyright © 2014 Elsevier Inc. All rights reserved.

System impact research - increasing public health and health care system performance.

PubMed

Malmivaara, Antti

2016-01-01

Interventions directed to system features of public health and health care should increase health and welfare of patients and population. To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. System Impact Research - creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population. Key messages The new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features. SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency, and equality of services. SIR creates the

Adaptation strategies for health impacts of climate change in Western Australia: Application of a Health Impact Assessment framework

DOE Office of Scientific and Technical Information (OSTI.GOV)

Spickett, Jeffery T., E-mail: J.Spickett@curtin.edu.a; Brown, Helen L., E-mail: h.brown@curtin.edu.a; Katscherian, Dianne, E-mail: Dianne.Katscherian@health.wa.gov.a

2011-04-15

Climate change is one of the greatest challenges facing the globe and there is substantial evidence that this will result in a number of health impacts, regardless of the level of greenhouse gas mitigation. It is therefore apparent that a combined approach of mitigation and adaptation will be required to protect public health. While the importance of mitigation is recognised, this project focused on the role of adaptation strategies in addressing the potential health impacts of climate change. The nature and magnitude of these health impacts will be determined by a number of parameters that are dependent upon the location.more » Firstly, climate change will vary between regions. Secondly, the characteristics of each region in terms of population and the ability to adapt to changes will greatly influence the extent of the health impacts that are experienced now and into the future. Effective adaptation measures therefore need to be developed with these differences in mind. A Health Impact Assessment (HIA) framework was used to consider the implications of climate change on the health of the population of Western Australia (WA) and to develop a range of adaptive responses suited to WA. A broad range of stakeholders participated in the HIA process, providing informed input into developing an understanding of the potential health impacts and potential adaptation strategies from a diverse sector perspective. Potential health impacts were identified in relation to climate change predictions in WA in the year 2030. The risk associated with each of these impacts was assessed using a qualitative process that considered the consequences and the likelihood of the health impact occurring. Adaptations were then developed which could be used to mitigate the identified health impacts and provide responses which could be used by Government for future decision making. The periodic application of a HIA framework is seen as an ideal tool to develop appropriate adaptation strategies

Carcinogenic Air Toxics Exposure and Their Cancer-Related Health Impacts in the United States.

PubMed

Zhou, Ying; Li, Chaoyang; Huijbregts, Mark A J; Mumtaz, M Moiz

2015-01-01

Public health protection from air pollution can be achieved more effectively by shifting from a single-pollutant approach to a multi-pollutant approach. To develop such multi-pollutant approaches, identifying which air pollutants are present most frequently is essential. This study aims to determine the frequently found carcinogenic air toxics or hazardous air pollutants (HAPs) combinations across the United States as well as to analyze the health impacts of developing cancer due to exposure to these HAPs. To identify the most commonly found carcinogenic air toxics combinations, we first identified HAPs with cancer risk greater than one in a million in more than 5% of the census tracts across the United States, based on the National-Scale Air Toxics Assessment (NATA) by the U.S. EPA for year 2005. We then calculated the frequencies of their two-component (binary), and three-component (ternary) combinations. To quantify the cancer-related health impacts, we focused on the 10 most frequently found HAPs with national average cancer risk greater than one in a million. Their cancer-related health impacts were calculated by converting lifetime cancer risk reported in NATA 2005 to years of healthy life lost or Disability-Adjusted Life Years (DALYs). We found that the most frequently found air toxics with cancer risk greater than one in a million are formaldehyde, carbon tetrachloride, acetaldehyde, and benzene. The most frequently occurring binary pairs and ternary mixtures are the various combinations of these four air toxics. Analysis of urban and rural HAPs did not reveal significant differences in the top combinations of these chemicals. The cumulative annual cancer-related health impacts of inhaling the top 10 carcinogenic air toxics included was about 1,600 DALYs in the United States or 0.6 DALYs per 100,000 people. Formaldehyde and benzene together contribute nearly 60 percent of the total cancer-related health impacts. Our study shows that although there are many

The Population Impact of Childhood Health Conditions on Dropout from Upper-Secondary Education.

PubMed

Mikkonen, Janne; Moustgaard, Heta; Remes, Hanna; Martikainen, Pekka

2018-05-01

To quantify how large a part of educational dropout is due to adverse childhood health conditions and to estimate the risk of dropout across various physical and mental health conditions. A registry-based cohort study was conducted on a 20% random sample of Finns born in 1988-1995 (n = 101 284) followed for school dropout at ages 17 and 21. Four broad groups of health conditions (any, somatic, mental, and injury) and 25 specific health conditions were assessed from inpatient and outpatient care records at ages 10-16 years. We estimated the immediate and more persistent risks of dropout due to health conditions and calculated population-attributable fractions to quantify the population impact of childhood health on educational dropout, while accounting for a wide array of sociodemographic confounders and comorbidity. Children with any health condition requiring inpatient or outpatient care at ages 10-16 years were more likely to be dropouts at ages 17 years (risk ratio 1.71, 95% CI 1.61-1.81) and 21 years (1.46, 1.37-1.54) following adjustment for individual and family sociodemographic factors. A total of 30% of school dropout was attributable to health conditions at age 17 years and 21% at age 21 years. Mental disorders alone had an attributable fraction of 11% at age 21 years, compared with 5% for both somatic conditions and injuries. Adjusting for the presence of mental disorders reduced the effects of somatic conditions. More than one fifth of educational dropout is attributable to childhood health conditions. Early-onset mental disorders emerge as key targets in reducing dropout. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Development of a framework for quantifying the environmental impacts of urban development and construction practices.

PubMed

Li, Ke; Zhang, Peng; Crittenden, John C; Guhathakurta, Subhrajit; Chen, Yongsheng; Fernando, Harindra; Sawhney, Anil; McCartney, Peter; Grimm, Nancy; Kahhat, Ramzy; Joshi, Himanshu; Konjevod, Goran; Choi, Yu-Jin; Fonseca, Ernesto; Allenby, Braden; Gerrity, Daniel; Torrens, Paul M

2007-07-15

To encourage sustainable development, engineers and scientists need to understand the interactions among social decision-making, development and redevelopment, land, energy and material use, and their environmental impacts. In this study, a framework that connects these interactions was proposed to guide more sustainable urban planning and construction practices. Focusing on the rapidly urbanizing setting of Phoenix, Arizona, complexity models and deterministic models were assembled as a metamodel, which is called Sustainable Futures 2100 and were used to predict land use and development, to quantify construction material demands, to analyze the life cycle environmental impacts, and to simulate future ground-level ozone formation.

Health impact assessment of cycling network expansions in European cities.

PubMed

Mueller, Natalie; Rojas-Rueda, David; Salmon, Maëlle; Martinez, David; Ambros, Albert; Brand, Christian; de Nazelle, Audrey; Dons, Evi; Gaupp-Berghausen, Mailin; Gerike, Regine; Götschi, Thomas; Iacorossi, Francesco; Int Panis, Luc; Kahlmeier, Sonja; Raser, Elisabeth; Nieuwenhuijsen, Mark

2018-04-01

We conducted a health impact assessment (HIA) of cycling network expansions in seven European cities. We modeled the association between cycling network length and cycling mode share and estimated health impacts of the expansion of cycling networks. First, we performed a non-linear least square regression to assess the relationship between cycling network length and cycling mode share for 167 European cities. Second, we conducted a quantitative HIA for the seven cities of different scenarios (S) assessing how an expansion of the cycling network [i.e. 10% (S1); 50% (S2); 100% (S3), and all-streets (S4)] would lead to an increase in cycling mode share and estimated mortality impacts thereof. We quantified mortality impacts for changes in physical activity, air pollution and traffic incidents. Third, we conducted a cost-benefit analysis. The cycling network length was associated with a cycling mode share of up to 24.7% in European cities. The all-streets scenario (S4) produced greatest benefits through increases in cycling for London with 1,210 premature deaths (95% CI: 447-1,972) avoidable annually, followed by Rome (433; 95% CI: 170-695), Barcelona (248; 95% CI: 86-410), Vienna (146; 95% CI: 40-252), Zurich (58; 95% CI: 16-100) and Antwerp (7; 95% CI: 3-11). The largest cost-benefit ratios were found for the 10% increase in cycling networks (S1). If all 167 European cities achieved a cycling mode share of 24.7% over 10,000 premature deaths could be avoided annually. In European cities, expansions of cycling networks were associated with increases in cycling and estimated to provide health and economic benefits. Copyright © 2018 Elsevier Inc. All rights reserved.

Evolutions in food marketing, quantifying the impact, and policy implications.

PubMed

Cairns, Georgina

2013-03-01

A case study on interactive digital marketing examined the adequacy of extant policy controls and their underpinning paradigms to constrain the effects of this rapidly emerging practice. Findings were interactive digital marketing is expanding the strategies available to promote products, brands and consumer behaviours. It facilitates relational marketing; the collection of personal data for marketing; integration of the marketing mix, and provides a platform for consumers to engage in the co-creation of marketing communications. The paradigmatic logic of current policies to constrain youth-oriented food marketing does not address the interactive nature of digital marketing. The evidence base on the effects of HFSS marketing and policy interventions is based on conceptualizations of marketing as a force promoting transactions rather than interactions. Digital technologies are generating rich consumer data. Interactive digital technologies increase the complexity of the task of quantifying the impact of marketing. The rapidity of its uptake also increases urgency of need to identify appropriate effects measures. Independent analysis of commercial consumer data (appropriately transformed to protect commercial confidentiality and personal privacy) would provide evidence sources for policy on the impacts of commercial food and beverage marketing and policy controls. Copyright © 2012 Elsevier Ltd. All rights reserved.

The impact of heat waves on children's health: a systematic review.

PubMed

Xu, Zhiwei; Sheffield, Perry E; Su, Hong; Wang, Xiaoyu; Bi, Yan; Tong, Shilu

2014-03-01

Young children are thought to be particularly sensitive to heat waves, but relatively less research attention has been paid to this field to date. A systematic review was conducted to elucidate the relationship between heat waves and children's health. Literature published up to August 2012 were identified using the following MeSH terms and keywords: "heatwave", "heat wave", "child health", "morbidity", "hospital admission", "emergency department visit", "family practice", "primary health care", "death" and "mortality". Of the 628 publications identified, 12 met the selection criteria. The existing literature does not consistently suggest that mortality among children increases significantly during heat waves, even though infants were associated with more heat-related deaths. Exposure to heat waves in the perinatal period may pose a threat to children's health. Pediatric diseases or conditions associated with heat waves include renal disease, respiratory disease, electrolyte imbalance and fever. Future research should focus on how to develop a consistent definition of a heat wave from a children's health perspective, identifying the best measure of children's exposure to heat waves, exploring sensitive outcome measures to quantify the impact of heat waves on children, evaluating the possible impacts of heat waves on children's birth outcomes, and understanding the differences in vulnerability to heat waves among children of different ages and from different income countries. Projection of the children's disease burden caused by heat waves under climate change scenarios, and development of effective heat wave mitigation and adaptation strategies that incorporate other child protective health measures, are also strongly recommended.

The impact of heat waves on children's health: a systematic review

NASA Astrophysics Data System (ADS)

Xu, Zhiwei; Sheffield, Perry E.; Su, Hong; Wang, Xiaoyu; Bi, Yan; Tong, Shilu

2014-03-01

Young children are thought to be particularly sensitive to heat waves, but relatively less research attention has been paid to this field to date. A systematic review was conducted to elucidate the relationship between heat waves and children's health. Literature published up to August 2012 were identified using the following MeSH terms and keywords: "heatwave", "heat wave", "child health", "morbidity", "hospital admission", "emergency department visit", "family practice", "primary health care", "death" and "mortality". Of the 628 publications identified, 12 met the selection criteria. The existing literature does not consistently suggest that mortality among children increases significantly during heat waves, even though infants were associated with more heat-related deaths. Exposure to heat waves in the perinatal period may pose a threat to children's health. Pediatric diseases or conditions associated with heat waves include renal disease, respiratory disease, electrolyte imbalance and fever. Future research should focus on how to develop a consistent definition of a heat wave from a children's health perspective, identifying the best measure of children's exposure to heat waves, exploring sensitive outcome measures to quantify the impact of heat waves on children, evaluating the possible impacts of heat waves on children's birth outcomes, and understanding the differences in vulnerability to heat waves among children of different ages and from different income countries. Projection of the children's disease burden caused by heat waves under climate change scenarios, and development of effective heat wave mitigation and adaptation strategies that incorporate other child protective health measures, are also strongly recommended.

Quantifying autonomous vehicles national fuel consumption impacts: A data-rich approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, Yuche; Gonder, Jeffrey; Young, Stanley

Autonomous vehicles are drawing significant attention from governments, manufacturers and consumers. Experts predict them to be the primary means of transportation by the middle of this century. Recent literature shows that vehicle automation has the potential to alter traffic patterns, vehicle ownership, and land use, which may affect fuel consumption from the transportation sector. In this paper, we developed a data-rich analytical framework to quantify system-wide fuel impacts of automation in the United States by integrating (1) a dynamic vehicle sales, stock, and usage model, (2) an historical transportation network-level vehicle miles traveled (VMT)/vehicle activity database, and (3) estimates ofmore » automation's impacts on fuel efficiency and travel demand. The vehicle model considers dynamics in vehicle fleet turnover and fuel efficiency improvements of conventional and advanced vehicle fleet. The network activity database contains VMT, free-flow speeds, and historical speeds of road links that can help us accurately identify fuel-savings opportunities of automation. Based on the model setup and assumptions, we found that the impacts of automation on fuel consumption are quite wide-ranging - with the potential to reduce fuel consumption by 45% in our 'Optimistic' case or increase it by 30% in our 'Pessimistic' case. Second, implementing automation on urban roads could potentially result in larger fuel savings compared with highway automation because of the driving features of urban roads. Lastly, through scenario analysis, we showed that the proposed framework can be used for refined assessments as better data on vehicle-level fuel efficiency and travel demand impacts of automation become available.« less

Quantifying autonomous vehicles national fuel consumption impacts: A data-rich approach

DOE PAGES

Chen, Yuche; Gonder, Jeffrey; Young, Stanley; ...

2017-11-06

Autonomous vehicles are drawing significant attention from governments, manufacturers and consumers. Experts predict them to be the primary means of transportation by the middle of this century. Recent literature shows that vehicle automation has the potential to alter traffic patterns, vehicle ownership, and land use, which may affect fuel consumption from the transportation sector. In this paper, we developed a data-rich analytical framework to quantify system-wide fuel impacts of automation in the United States by integrating (1) a dynamic vehicle sales, stock, and usage model, (2) an historical transportation network-level vehicle miles traveled (VMT)/vehicle activity database, and (3) estimates ofmore » automation's impacts on fuel efficiency and travel demand. The vehicle model considers dynamics in vehicle fleet turnover and fuel efficiency improvements of conventional and advanced vehicle fleet. The network activity database contains VMT, free-flow speeds, and historical speeds of road links that can help us accurately identify fuel-savings opportunities of automation. Based on the model setup and assumptions, we found that the impacts of automation on fuel consumption are quite wide-ranging - with the potential to reduce fuel consumption by 45% in our 'Optimistic' case or increase it by 30% in our 'Pessimistic' case. Second, implementing automation on urban roads could potentially result in larger fuel savings compared with highway automation because of the driving features of urban roads. Lastly, through scenario analysis, we showed that the proposed framework can be used for refined assessments as better data on vehicle-level fuel efficiency and travel demand impacts of automation become available.« less

Health Impact Assessment Impact Characterization Table

EPA Pesticide Factsheets

The potential health impacts of the proposed decision should be characterized based on the following criteria: Direction, Likelihood, Magnitude, Distribution, Severity, Permanence, Strength of Evidence.

Quantitative health impact assessment of transport policies: two simulations related to speed limit reduction and traffic re-allocation in the Netherlands.

PubMed

Schram-Bijkerk, D; van Kempen, E; Knol, A B; Kruize, H; Staatsen, B; van Kamp, I

2009-10-01

Few quantitative health impact assessments (HIAs) of transport policies have been published so far and there is a lack of a common methodology for such assessments. To evaluate the usability of existing HIA methodology to quantify health effects of transport policies at the local level. Health impact of two simulated but realistic transport interventions - speed limit reduction and traffic re-allocation - was quantified by selecting traffic-related exposures and health endpoints, modelling of population exposure, selecting exposure-effect relations and estimating the number of local traffic-related cases and disease burden, expressed in disability-adjusted life-years (DALYs), before and after the intervention. Exposure information was difficult to retrieve because of the local scale of the interventions, and exposure-effect relations for subgroups and combined effects were missing. Given uncertainty in the outcomes originating from this kind of missing information, simulated changes in population health by two local traffic interventions were estimated to be small (<5%), except for the estimated reduction in DALYs by less traffic accidents (60%) due to speed limit reduction. Quantitative HIA of transport policies at a local scale is possible, provided that data on exposures, the exposed population and their baseline health status are available. The interpretation of the HIA information should be carried out in the context of the quality of input data and assumptions and uncertainties of the analysis.

Quantifying the impact of between-study heterogeneity in multivariate meta-analyses

PubMed Central

Jackson, Dan; White, Ian R; Riley, Richard D

2012-01-01

Measures that quantify the impact of heterogeneity in univariate meta-analysis, including the very popular I2 statistic, are now well established. Multivariate meta-analysis, where studies provide multiple outcomes that are pooled in a single analysis, is also becoming more commonly used. The question of how to quantify heterogeneity in the multivariate setting is therefore raised. It is the univariate R2 statistic, the ratio of the variance of the estimated treatment effect under the random and fixed effects models, that generalises most naturally, so this statistic provides our basis. This statistic is then used to derive a multivariate analogue of I2, which we call . We also provide a multivariate H2 statistic, the ratio of a generalisation of Cochran's heterogeneity statistic and its associated degrees of freedom, with an accompanying generalisation of the usual I2 statistic, . Our proposed heterogeneity statistics can be used alongside all the usual estimates and inferential procedures used in multivariate meta-analysis. We apply our methods to some real datasets and show how our statistics are equally appropriate in the context of multivariate meta-regression, where study level covariate effects are included in the model. Our heterogeneity statistics may be used when applying any procedure for fitting the multivariate random effects model. Copyright © 2012 John Wiley & Sons, Ltd. PMID:22763950

Impact of drug shortages on U.S. health systems.

PubMed

Kaakeh, Rola; Sweet, Burgunda V; Reilly, Cynthia; Bush, Colleen; DeLoach, Sherry; Higgins, Barb; Clark, Angela M; Stevenson, James

2011-10-01

A study was performed to quantify the personnel resources required to manage drug shortages, define the impact of drug shortages on health systems nationwide, and assess the adequacy of information resources available to manage drug shortages. An online survey was sent to the 1322 members of the American Society of Health-System Pharmacists who were identified as directors of pharmacy. Survey recipients were asked to identify which of the 30 most recent drug shortages listed affected their health system, to identify actions taken to manage the shortage, and to rate the impact of each shortage. Employees responsible for completing predefined tasks were identified, and the average time spent by each type of employee completing these tasks was estimated. Labor costs associated with managing shortages were calculated. A total of 353 respondents completed the survey, yielding a response rate of 27%. Pharmacists and pharmacy technicians spent more time managing drug shortages than did physicians and nurses. There was a significant association between the time spent managing shortages and the size of the institution, the number of shortages managed, and the institution's level of automation. Overall, 70% of the respondents felt that the information resources available to manage drug shortages were not good. The labor costs associated with managing shortages in the United States is an estimated $216 million annually. A survey of directors of pharmacy revealed that labor costs and the time required to manage drug shortages are significant and that current information available to manage drug shortages is considered suboptimal.

Implicit motivational impact of pictorial health warning on cigarette packs.

PubMed

Volchan, Eliane; David, Isabel A; Tavares, Gisella; Nascimento, Billy M; Oliveira, Jose M; Gleiser, Sonia; Szklo, Andre; Perez, Cristina; Cavalcante, Tania; Pereira, Mirtes G; Oliveira, Leticia

2013-01-01

The use of pictorial warning labels on cigarette packages is one of the provisions included in the first ever global health treaty by the World Health Organization against the tobacco epidemic. There is substantial evidence demonstrating the effectiveness of graphic health warning labels on intention to quit, thoughts about health risks and engaging in cessation behaviors. However, studies that address the implicit emotional drives evoked by such warnings are still underexplored. Here, we provide experimental data for the use of pictorial health warnings as a reliable strategy for tobacco control. Experiment 1 pre-tested nineteen prototypes of pictorial warnings to screen for their emotional impact. Participants (n = 338) were young adults balanced in gender, smoking status and education. Experiment 2 (n = 63) tested pictorial warnings (ten) that were stamped on packs. We employed an innovative set-up to investigate the impact of the warnings on the ordinary attitude of packs' manipulation, and quantified judgments of warnings' emotional strength and efficacy against smoking. Experiment 1 revealed that women judged the warning prototypes as more aversive than men, and smokers judged them more aversive than non-smokers. Participants with lower education judged the prototypes more aversive than participants with higher education. Experiment 2 showed that stamped warnings antagonized the appeal of the brands by imposing a cost to manipulate the cigarette packs, especially for smokers. Additionally, participants' judgments revealed that the more aversive a warning, the more it is perceived as effective against smoking. Health warning labels are one of the key components of the integrated approach to control the global tobacco epidemic. The evidence presented in this study adds to the understanding of how implicit responses to pictorial warnings may contribute to behavioral change.

Implicit Motivational Impact of Pictorial Health Warning on Cigarette Packs

PubMed Central

Volchan, Eliane; David, Isabel A.; Tavares, Gisella; Nascimento, Billy M.; Oliveira, Jose M.; Gleiser, Sonia; Szklo, Andre; Perez, Cristina; Cavalcante, Tania; Pereira, Mirtes G.; Oliveira, Leticia

2013-01-01

Objective The use of pictorial warning labels on cigarette packages is one of the provisions included in the first ever global health treaty by the World Health Organization against the tobacco epidemic. There is substantial evidence demonstrating the effectiveness of graphic health warning labels on intention to quit, thoughts about health risks and engaging in cessation behaviors. However, studies that address the implicit emotional drives evoked by such warnings are still underexplored. Here, we provide experimental data for the use of pictorial health warnings as a reliable strategy for tobacco control. Methods Experiment 1 pre-tested nineteen prototypes of pictorial warnings to screen for their emotional impact. Participants (n = 338) were young adults balanced in gender, smoking status and education. Experiment 2 (n = 63) tested pictorial warnings (ten) that were stamped on packs. We employed an innovative set-up to investigate the impact of the warnings on the ordinary attitude of packs’ manipulation, and quantified judgments of warnings’ emotional strength and efficacy against smoking. Findings Experiment 1 revealed that women judged the warning prototypes as more aversive than men, and smokers judged them more aversive than non-smokers. Participants with lower education judged the prototypes more aversive than participants with higher education. Experiment 2 showed that stamped warnings antagonized the appeal of the brands by imposing a cost to manipulate the cigarette packs, especially for smokers. Additionally, participants’ judgments revealed that the more aversive a warning, the more it is perceived as effective against smoking. Conclusions Health warning labels are one of the key components of the integrated approach to control the global tobacco epidemic. The evidence presented in this study adds to the understanding of how implicit responses to pictorial warnings may contribute to behavioral change. PMID:23977223

How have Global Health Initiatives impacted on health equity?

PubMed

Hanefeld, Johanna

2008-01-01

This review examines the impact of Global Health Initiatives (GHIs) on health equity, focusing on low- and middle-income countries. It is a summary of a literature review commissioned by the WHO Commission on the Social Determinants of Health. GHIs have emerged during the past decade as a mechanism in development assistance for health. The review focuses on three GHIs, the US President's Emergency Plan For AIDS Relief (PEPFAR), the World Bank's Multi-country AIDS Programme (MAP) and the Global Fund to Fight AIDS, TB and Malaria. All three have leveraged significant amounts of funding for their focal diseases - together these three GHIs provide an estimated two-thirds of external resources going to HIV/AIDS. This paper examines their impact on gender equity. An analysis of these Initiatives finds that they have a significant impact on health equity, including gender equity, through their processes of programme formulation and implementation, and through the activities they fund and implement, including through their impact on health systems and human resources. However, GHIs have so far paid insufficient attention to health inequities. While increasingly acknowledging equity, including gender equity, as a concern, Initiatives have so far failed to adequately translate this into programmes that address drivers of health inequity, including gender inequities. The review highlights the comparative advantage of individual GHIs, which point to an increased need for, and continued difficulties in, harmonisation of activities at country level. On the basis of this comparative analysis, key recommendations are made. They include a call for equity-sensitive targets, the collection of gender-disaggregated data, the use of policy-making processes for empowerment, programmes that explicitly address causes of health inequity and impact assessments of interventions' effect on social inequities.

Quantifying the costs and benefits of occupational health and safety interventions at a Bangladesh shipbuilding company

PubMed Central

Thiede, Irene; Thiede, Michael

2015-01-01

Background: This study is the first cost–benefit analysis (CBA) of occupational health and safety (OHS) in a low-income country. It focuses on one of the largest shipbuilding companies in Bangladesh, where globally recognised Occupational Health and Safety Advisory Services (OHSAS) 18001 certification was achieved in 2012. Objectives: The study examines the relative costs of implementing OHS measures against qualitative and quantifiable benefits of implementation in order to determine whether OHSAS measures are economically advantageous. Methods: Quantifying past costs and benefits and discounting future ones, this study looks at the returns of OHS measures at Western Marine Shipbuilding Company Ltd. Results: Costs included investments in workplace and environmental safety, a new clinic that also serves the community, and personal protective equipment (PPE) and training. The results are impressive: previously high injury statistics dropped to close to zero. Conclusions: OHS measures decrease injuries, increase efficiency, and bring income security to workers’ families. Certification has proven a competitive edge for the shipyard, resulting in access to greater markets. Intangible benefits such as trust, motivation and security are deemed crucial in the CBA, and this study finds the high investments made are difficult to offset with quantifiable benefits alone. PMID:25589369

Quantifying the costs and benefits of occupational health and safety interventions at a Bangladesh shipbuilding company.

PubMed

Thiede, Irene; Thiede, Michael

2015-01-01

This study is the first cost-benefit analysis (CBA) of occupational health and safety (OHS) in a low-income country. It focuses on one of the largest shipbuilding companies in Bangladesh, where globally recognised Occupational Health and Safety Advisory Services (OHSAS) 18001 certification was achieved in 2012. The study examines the relative costs of implementing OHS measures against qualitative and quantifiable benefits of implementation in order to determine whether OHSAS measures are economically advantageous. Quantifying past costs and benefits and discounting future ones, this study looks at the returns of OHS measures at Western Marine Shipbuilding Company Ltd. Costs included investments in workplace and environmental safety, a new clinic that also serves the community, and personal protective equipment (PPE) and training. The results are impressive: previously high injury statistics dropped to close to zero. OHS measures decrease injuries, increase efficiency, and bring income security to workers' families. Certification has proven a competitive edge for the shipyard, resulting in access to greater markets. Intangible benefits such as trust, motivation and security are deemed crucial in the CBA, and this study finds the high investments made are difficult to offset with quantifiable benefits alone.

RETHINKING HUMAN HEALTH IMPACT ASSESSMENT. (R825758)

EPA Science Inventory

Most EIA programs around the world require the consideration of human health impacts. Yet relatively few EIA documents adequately address those impacts. This article examines how, why, and to what extent health impacts are analyzed in environmental impact assessments in the U.S. ...

The Impact of Childhood Obesity on Health and Health Service Use.

PubMed

Kinge, Jonas Minet; Morris, Stephen

2018-06-01

To test the impact of obesity on health and health care use in children, by the use of various methods to account for reverse causality and omitted variables. Fifteen rounds of the Health Survey for England (1998-2013), which is representative of children and adolescents in England. We use three methods to account for reverse causality and omitted variables in the relationship between BMI and health/health service use: regression with individual, parent, and household control variables; sibling fixed effects; and instrumental variables based on genetic variation in weight. We include all children and adolescents aged 4-18 years old. We find that obesity has a statistically significant and negative impact on self-rated health and a positive impact on health service use in girls, boys, younger children (aged 4-12), and adolescents (aged 13-18). The findings are comparable in each model in both boys and girls. Using econometric methods, we have mitigated several confounding factors affecting the impact of obesity in childhood on health and health service use. Our findings suggest that obesity has severe consequences for health and health service use even among children. © Health Research and Educational Trust.

Quantifying Ocean Acidification and its Impacts to Coral Reef Ecosystems

NASA Astrophysics Data System (ADS)

Manzello, D.; Gledhill, D. K.; Enochs, I.; Andersson, A. J.

2013-05-01

Ocean Acidification (OA) describes the uptake of anthropogenic CO2 by the world's oceans and consequent decline in seawater pH and calcium carbonate saturation state. OA is of particular concern for coral reef ecosystems because it is expected to reduce the calcification rates of reef-building corals and other calcifiers, and may simultaneously increase the erosive abilities of key bioeroding taxa. Despite these concerns, we have little understanding of how OA will manifest in the real-world or, if, and how much of the world-wide trajectory of reef decline can be attributed to OA. With this in mind, we will present recommendations for monitoring OA of coral reef waters, as well as its ecosystem impacts over time. Different approaches and metrics, including their individual strengths and weaknesses, will be discussed. The ultimate goal of these efforts is to quantify the effects of OA on coral reef ecosystems in the real-world to robustly predict their structure and function in a high-CO2 world.

System impact research – increasing public health and health care system performance

PubMed Central

Malmivaara, Antti

2016-01-01

Abstract Background Interventions directed to system features of public health and health care should increase health and welfare of patients and population. Aims To build a new framework for studies aiming to assess the impact of public health or health care system, and to consider the role of Randomized Controlled Trials (RCTs) and of Benchmarking Controlled Trials (BCTs). Methods The new concept is partly based on the author's previous paper on the Benchmarking Controlled Trial. The validity and generalizability considerations were based on previous methodological studies on RCTs and BCTs. Results The new concept System Impact Research (SIR) covers all the studies which aim to assess the impact of the public health system or of the health care system on patients or on population. There are two kinds of studies in System Impact Research: Benchmarking Controlled Trials (observational) and Randomized Controlled Trials (experimental). The term impact covers in particular accessibility, quality, effectiveness, safety, efficiency, and equality. Conclusions System Impact Research – creating the scientific basis for policy decision making - should be given a high priority in medical, public health and health economic research, and should also be used for improving performance. Leaders at all levels of health and social care can use the evidence from System Impact Research for the benefit of patients and population.Key messagesThe new concept of SIR is defined as a research field aiming at assessing the impacts on patients and on populations of features of public health and health and social care systems or of interventions trying to change these features.SIR covers all features of public health and health and social care system, and actions upon these features. The term impact refers to all effects caused by the public health and health and social care system or parts of it, with particular emphasis on accessibility, quality, effectiveness, adverse effects, efficiency

Government use licenses in Thailand: an assessment of the health and economic impacts.

PubMed

Yamabhai, Inthira; Mohara, Adun; Tantivess, Sripen; Chaisiri, Kakanang; Teerawattananon, Yot

2011-08-14

Between 2006 and 2008, Thailand's Ministry of Public Health (MOPH) granted government use licenses for seven patented drugs in order to improve access to these essential treatments. The decision to grant the government use licenses was contentious both within and beyond the country. In particular, concerns were highlighted that the negative consequences might outweigh the expected benefits of the policy. This study conducted assessments of the health and economic implications of these government use licenses. The health and health-related economic impacts were quantified in terms of i) Quality Adjusted Life Years (QALYs) gained and ii) increased productivity in US dollars (USD) as a result of the increased access to drugs. The study adopted a five-year timeframe for the assessment, commencing from the time of the grant of the government use licenses. Empirical evidence gathered from national databases was used to assess the changes in volume of exports after US Generalized System of Preferences (GSP) withdrawal and level of foreign direct investment (FDI). As a result of the granting of the government use licenses, an additional 84,158 patients were estimated to have received access to the seven drugs over five years. Health gains from the use of the seven drugs compared to their best alternative accounted for 12,493 QALYs gained, which translates into quantifiable incremental benefits to society of USD132.4 million. The government use license on efavirenze was found to have the greatest benefit. In respect of the country's economy, the study found that Thailand's overall exports increased overtime, although exports of the three US GSP withdrawal products to the US did decline. There was also found to be no relationship between the government use licenses and the level of foreign investment over the period 2002 to 2008. The public health benefits of the government use licenses were generally positive. Specifically, the policy helped to increase access to patented

Government use licenses in Thailand: an assessment of the health and economic impacts

PubMed Central

2011-01-01

Background Between 2006 and 2008, Thailand's Ministry of Public Health (MOPH) granted government use licenses for seven patented drugs in order to improve access to these essential treatments. The decision to grant the government use licenses was contentious both within and beyond the country. In particular, concerns were highlighted that the negative consequences might outweigh the expected benefits of the policy. This study conducted assessments of the health and economic implications of these government use licenses. Methods The health and health-related economic impacts were quantified in terms of i) Quality Adjusted Life Years (QALYs) gained and ii) increased productivity in US dollars (USD) as a result of the increased access to drugs. The study adopted a five-year timeframe for the assessment, commencing from the time of the grant of the government use licenses. Empirical evidence gathered from national databases was used to assess the changes in volume of exports after US Generalized System of Preferences (GSP) withdrawal and level of foreign direct investment (FDI). Results As a result of the granting of the government use licenses, an additional 84,158 patients were estimated to have received access to the seven drugs over five years. Health gains from the use of the seven drugs compared to their best alternative accounted for 12,493 QALYs gained, which translates into quantifiable incremental benefits to society of USD132.4 million. The government use license on efavirenze was found to have the greatest benefit. In respect of the country's economy, the study found that Thailand's overall exports increased overtime, although exports of the three US GSP withdrawal products to the US did decline. There was also found to be no relationship between the government use licenses and the level of foreign investment over the period 2002 to 2008. Conclusions The public health benefits of the government use licenses were generally positive. Specifically, the policy

Experience and lessons from health impact assessment for human rights impact assessment.

PubMed

Salcito, Kendyl; Utzinger, Jürg; Krieger, Gary R; Wielga, Mark; Singer, Burton H; Winkler, Mirko S; Weiss, Mitchell G

2015-09-16

As globalisation has opened remote parts of the world to foreign investment, global leaders at the United Nations and beyond have called on multinational companies to foresee and mitigate negative impacts on the communities surrounding their overseas operations. This movement towards corporate impact assessment began with a push for environmental and social inquiries. It has been followed by demands for more detailed assessments, including health and human rights. In the policy world the two have been joined as a right-to-health impact assessment. In the corporate world, the right-to-health approach fulfils neither managers' need to comprehensively understand impacts of a project, nor rightsholders' need to know that the full suite of their human rights will be safe from violation. Despite the limitations of a right-to-health tool for companies, integration of health into human rights provides numerous potential benefits to companies and the communities they affect. Here, a detailed health analysis through the human rights lens is carried out, drawing on a case study from the United Republic of Tanzania. This paper examines the positive and negative health and human rights impacts of a corporate operation in a low-income setting, as viewed through the human rights lens, considering observations on the added value of the approach. It explores the relationship between health impact assessment (HIA) and human rights impact assessment (HRIA). First, it considers the ways in which HIA, as a study directly concerned with human welfare, is a more appropriate guide than environmental or social impact assessment for evaluating human rights impacts. Second, it considers the contributions HRIA can make to HIA, by viewing determinants of health not as direct versus indirect, but as interrelated.

Quantifying Direct and Indirect Impact of Future Climate on Sub-Arctic Hydrology

NASA Astrophysics Data System (ADS)

Endalamaw, A. M.; Bolton, W. R.; Young-Robertson, J. M.; Morton, D.; Hinzman, L. D.

2016-12-01

Projected future climate will have a significant impact on the hydrology of interior Alaskan sub-arctic watersheds, directly though the changes in precipitation and temperature patterns, and indirectly through the cryospheric and ecological impacts. Although the latter is the dominant factor controlling the hydrological processes in the interior Alaska sub-arctic, it is often overlooked in many climate change impact studies. In this study, we aim to quantify and compare the direct and indirect impact of the projected future climate on the hydrology of the interior Alaskan sub-arctic watersheds. The Variable Infiltration Capacity (VIC) meso-scale hydrological model will be implemented to simulate the hydrological processes, including runoff, evapotranspiration, and soil moisture dynamics in the Chena River Basin (area = 5400km2), located in the interior Alaska sub-arctic region. Permafrost and vegetation distribution will be derived from the Geophysical Institute Permafrost Lab (GIPL) model and the Lund-Potsdam-Jena Dynamic Global Model (LPJ) model, respectively. All models will be calibrated and validated using historical data. The Scenario Network for Alaskan and Arctic Planning (SNAP) 5-model average projected climate data products will be used as forcing data for each of these models. The direct impact of climate change on hydrology is estimated using surface parameterization derived from the present day permafrost and vegetation distribution, and future climate forcing from SNAP projected climate data products. Along with the projected future climate, outputs of GIPL and LPJ will be incorporated into the VIC model to estimate the indirect and overall impact of future climate on the hydrology processes in the interior Alaskan sub-arctic watersheds. Finally, we will present the potential hydrological and ecological changes by the end of the 21st century.

Linking environmental effects to health impacts: a computer modelling approach for air pollution

PubMed Central

Mindell, J.; Barrowcliffe, R.

2005-01-01

Study objective and Setting: To develop a computer model, using a geographical information system (GIS), to quantify potential health effects of air pollution from a new energy from waste facility on the surrounding urban population. Design: Health impacts were included where evidence of causality is sufficiently convincing. The evidence for no threshold means that annual average increases in concentration can be used to model changes in outcome. The study combined the "contours" of additional pollutant concentrations for the new source generated by a dispersion model with a population database within a GIS, which is set up to calculate the product of the concentration increase with numbers of people exposed within each enumeration district exposure response coefficients, and the background rates of mortality and hospital admissions for several causes. Main results: The magnitude of health effects might result from the increased PM10 exposure is small—about 0.03 deaths each year in a population of 3 500 000, with 0.04 extra hospital admissions for respiratory disease. Long term exposure might bring forward 1.8–7.8 deaths in 30 years. Conclusions: This computer model is a feasible approach to estimating impacts on human health from environmental effects but sensitivity analyses are recommended. Relevance to clinical or professional practice: The availability of GIS and dispersion models on personal computers enables quantification of health effects resulting from the additional air pollution new industrial development might cause. This approach could also be used in environmental impact assessment. Care must be taken in presenting results to emphasise methodological limitations and uncertainties in the numbers. PMID:16286501

Health impacts of large dams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lerer, L.B.; Scudder, T.

1999-03-01

Large dams have been criticized because of their negative environmental and social impacts. Public health interest largely has focused on vector-borne diseases, such as schistosomiasis, associated with reservoirs and irrigation projects. Large dams also influence health through changes in water and food security, increases in communicable diseases, and the social disruption caused by construction and involuntary resettlement. Communities living in close proximity to large dams often do not benefit from water transfer and electricity generation revenues. A comprehensive health component is required in environmental and social impact assessments for large dam projects.

Potential Impacts of Future Climate Change on Regional Air Quality and Public Health over China

NASA Astrophysics Data System (ADS)

Hong, C.; Zhang, Q.; Zhang, Y.; He, K.

2017-12-01

Future climate change would affect public health through changing air quality. Climate extremes and poor weather conditions are likely to occur at a higher frequency in China under a changing climate, but the air pollution-related health impacts due to future climate change remain unclear. Here the potential impacts of future climate change on regional air quality and public health over China is projected using a coupling of climate, air quality and epidemiological models. We present the first assessment of China's future air quality in a changing climate under the Representative Concentration Pathway 4.5 (RCP4.5) scenario using the dynamical downscaling technique. In RCP4.5 scenario, we estimate that climate change from 2006-2010 to 2046-2050 is likely to adversely affect air quality covering more than 86% of population and 55% of land area in China, causing an average increase of 3% in O3 and PM2.5 concentrations, which are found to be associated with the warmer climate and the more stable atmosphere. Our estimate of air pollution-related mortality due to climate change in 2050 is 26,000 people per year in China. Of which, the PM2.5-related mortality is 18,700 people per year, and the O3-related mortality is 7,300 people per year. The climate-induced air pollution and health impacts vary spatially. The climate impacts are even more pronounced on the urban areas where is densely populated and polluted. 90% of the health loss is concentrated in 20% of land areas in China. We use a simple statistical analysis method to quantify the contributions of climate extremes and find more intense climate extremes play an important role in climate-induced air pollution-related health impacts. Our results indicate that global climate change will likely alter the level of pollutant management required to meet future air quality targets as well as the efforts to protect public health in China.

Quantifying the impact of expanded age group campaigns for polio eradication.

PubMed

Wagner, Bradley G; Behrend, Matthew R; Klein, Daniel J; Upfill-Brown, Alexander M; Eckhoff, Philip A; Hu, Hao

2014-01-01

A priority of the Global Polio Eradication Initiative (GPEI) 2013-2018 strategic plan is to evaluate the potential impact on polio eradication resulting from expanding one or more Supplementary Immunization Activities (SIAs) to children beyond age five-years in polio endemic countries. It has been hypothesized that such expanded age group (EAG) campaigns could accelerate polio eradication by eliminating immunity gaps in older children that may have resulted from past periods of low vaccination coverage. Using an individual-based mathematical model, we quantified the impact of EAG campaigns in terms of probability of elimination, reduction in polio transmission and age stratified immunity levels. The model was specifically calibrated to seroprevalence data from a polio-endemic region: Zaria, Nigeria. We compared the impact of EAG campaigns, which depend only on age, to more targeted interventions which focus on reaching missed populations. We found that EAG campaigns would not significantly improve prospects for polio eradication; the probability of elimination increased by 8% (from 24% at baseline to 32%) when expanding three annual SIAs to 5-14 year old children and by 18% when expanding all six annual SIAs. In contrast, expanding only two of the annual SIAs to target hard-to-reach populations at modest vaccination coverage-representing less than one tenth of additional vaccinations required for the six SIA EAG scenario-increased the probability of elimination by 55%. Implementation of EAG campaigns in polio endemic regions would not improve prospects for eradication. In endemic areas, vaccination campaigns which do not target missed populations will not benefit polio eradication efforts.

The game-theoretic national interstate economic model : an integrated framework to quantify the economic impacts of cyber-terrorist behavior.

DOT National Transportation Integrated Search

2014-12-01

This study suggests an integrated framework to quantify cyber attack impacts on the U.S. airport security system. A cyber attack by terrorists on the U.S. involves complex : strategic behavior by the terrorists because they could plan to invade an ai...

Quantifying and Monetizing Potential Climate Change Policy Impacts on Terrestrial Ecosystem Carbon Storage and Wildfires in the United States

EPA Science Inventory

This paper quantifies and monetizes climate change impacts on carbon stored in terrestrial vegetation and wildfire incidence in the contiguous United States to assess the benefits of alternative mitigation policies. The MC-1 dynamic global vegetation model was used to develop int...

Elucidative analysis and sequencing of two respiratory health monitoring methods to study the impact of varying atmospheric composition on human health

NASA Astrophysics Data System (ADS)

Awasthi, Amit; Hothi, Navjot; Kaur, Prabhjot; Singh, Nirankar; Chakraborty, Monojit; Bansal, Sangeeta

2017-12-01

Atmospheric composition of ambient air consists of different gases in definite proportion that affect the earth's climate and its ecological system. Due to varied anthropogenic reasons, this composition is changed, which ultimately have an impact on the health of living beings. For survival, the human respiratory system is one of the sensitive systems, which is easily and closely affected by the change in atmospheric composition of an external environment. Many studies have been conducted to quantify the effects of atmospheric pollution on human health by using different approaches. This article presents different scenario of studies conducted to evaluate the effects on different human groups. Differences between the studies conducted using spirometry and survey methods are presented in this article to extract a better sequence between these two methodologies. Many studies have been conducted to measure the respiratory status by evaluating the respiratory symptoms and hospital admissions. Limited numbers of studies are found with repeated spirometry on the same subjects for long duration to nullify the error arising due to decrease in efforts by the same subjects during manoeuvre of pulmonary function tests. Present study reveals the importance of methodological sequencing in order to obtain more authentic and reliable results. This study suggests that impacts of deteriorating atmospheric composition on human health can be more significantly studied if spirometry is done after survey analysis. The article also proposes that efficiency and authenticity of surveys involving health impacts will increase, if medical data information of patients is saved in hospitals in a proper format.

The impact of positive affect on health cognitions and behaviours: a meta-analysis of the experimental evidence.

PubMed

Cameron, David S; Bertenshaw, Emma J; Sheeran, Paschal

2015-01-01

Several reviews suggest that positive affect is associated with improved longevity, fewer physical symptoms, and biological indicators of good health. It is possible that positive affect could influence these outcomes by promoting healthful cognitions and behaviours. The present review identified conceptual pathways from positive affect to health cognitions and behaviour, and used random effects meta-analysis to quantify the impact of positive affect inductions (versus neutral affect conditions) on these outcomes. Literature searches located 54 independent tests that could be included in the review. Across all studies, the findings revealed no reliable effects on intentions (d+ = -.12, 95% CI = -.32 to .08, k = 15) or behaviour (d+ = .15, 95% CI = -.03 to .33, k = 23). There were four reliable effects involving specific cognitions and behaviours, but little clear evidence for generalised benefits or adverse effects of positive emotions on health-related cognitions or actions. Conclusions must be cautious given the paucity of tests available for analysis. The review offers suggestions about research designs that might profitably be deployed in future studies, and calls for additional tests of the impact of discrete positive emotions on health cognitions and behaviour.

BlueHealth: a study programme protocol for mapping and quantifying the potential benefits to public health and well-being from Europe’s blue spaces

PubMed Central

White, Mathew P; Albin, Maria; Bell, Simon; Elliott, Lewis R; Gascón, Mireia; Gualdi, Silvio; Mancini, Laura; Nieuwenhuijsen, Mark J; Sarigiannis, Denis A; van den Bosch, Matilda; Wolf, Tanja; Wuijts, Susanne; Fleming, Lora E

2017-01-01

Introduction Proximity and access to water have long been central to human culture and accordingly deliver countless societal benefits. Over 200 million people live on Europe’s coastline, and aquatic environments are the top recreational destination in the region. In terms of public health, interactions with ‘blue space’ (eg, coasts, rivers, lakes) are often considered solely in terms of risk (eg, drowning, microbial pollution). Exposure to blue space can, however, promote health and well-being and prevent disease, although underlying mechanisms are poorly understood. Aims and methods The BlueHealth project aims to understand the relationships between exposure to blue space and health and well-being, to map and quantify the public health impacts of changes to both natural blue spaces and associated urban infrastructure in Europe, and to provide evidence-based information to policymakers on how to maximise health benefits associated with interventions in and around aquatic environments. To achieve these aims, an evidence base will be created through systematic reviews, analyses of secondary data sets and analyses of new data collected through a bespoke international survey and a wide range of community-level interventions. We will also explore how to deliver the benefits associated with blue spaces to those without direct access through the use of virtual reality. Scenarios will be developed that allow the evaluation of health impacts in plausible future societal contexts and changing environments. BlueHealth will develop key inputs into policymaking and land/water-use planning towards more salutogenic and sustainable uses of blue space, particularly in urban areas. Ethics and dissemination Throughout the BlueHealth project, ethics review and approval are obtained for all relevant aspects of the study by the local ethics committees prior to any work being initiated and an ethics expert has been appointed to the project advisory board. So far, ethical approval

An assessment of the impact of the NHS Health Technology Assessment Programme.

PubMed

Hanney, S; Buxton, M; Green, C; Coulson, D; Raftery, J

2007-12-01

To consider how the impact of the NHS Health Technology Assessment (HTA) Programme should be measured. To determine what models are available and their strengths and weaknesses. To assess the impact of the first 10 years of the NHS HTA programme from its inception in 1993 to June 2003 and to identify the factors associated with HTA research that are making an impact. Main electronic databases from 1990 to June 2005. The documentation of the National Coordinating Centre for Health Technology Assessment (NCCHTA). Questionnaires to eligible researchers. Interviews with lead investigators. Case study documentation. A literature review of research programmes was carried out, the work of the NCCHTA was reviewed, lead researchers were surveyed and 16 detailed case studies were undertaken. Each case study was written up using the payback framework. A cross-case analysis informed the analysis of factors associated with achieving payback. Each case study was scored for impact before and after the interview to assess the gain in information due to the interview. The draft write-up of each study was checked with each respondent for accuracy and changed if necessary. The literature review identified a highly diverse literature but confirmed that the 'payback' framework pioneered by Buxton and Hanney was the most widely used and most appropriate model available. The review also confirmed that impact on knowledge generation was more easily quantified than that on policy, behaviour or especially health gain. The review of the included studies indicated a higher level of impact on policy than is often assumed to occur. The survey showed that data pertinent to payback exist and can be collected. The completed questionnaires showed that the HTA Programme had considerable impact in terms of publications, dissemination, policy and behaviour. It also showed, as expected, that different parts of the Programme had different impacts. The Technology Assessment Reports (TARs) for the

Health impact assessment of liquid biofuel production.

PubMed

Fink, Rok; Medved, Sašo

2013-01-01

Bioethanol and biodiesel as potential substitutes for fossil fuels in the transportation sector have been analyzed for environmental suitability. However, there could be impacts on human health during the production, therefore adverse health effects have to be analyzed. The aim of this study is to analyze to what health risk factors humans are exposed to in the production of biofuels and what the size of the health effects is. A health impact assessment expressed as disability adjusted life years (DALYs) was conducted in SimaPro 7.1 software. The results show a statistically significant lower carcinogenic impact of biofuels (p < 0.05) than fossil fuels. Meanwhile, the impact of organic respirable compounds is smaller for fossil fuels (p < 0.05) than for biofuels. Analysis of inorganic compounds like PM₁₀,₂.₅, SO₂ or NO(x) shows some advantages of sugar beet bioethanol and soybean biodiesel production (p < 0.05), although production of sugarcane bioethanol shows larger impacts of respirable inorganic compounds than for fossil fuels (p < 0.001). Although liquid biofuels are made of renewable energy sources, this does not necessary mean that they do not represent any health hazards.

Health equity impact assessment.

PubMed

Povall, Susan L; Haigh, Fiona A; Abrahams, Debbie; Scott-Samuel, Alex

2014-12-01

The World Health Organization's Commission on Social Determinants of Health has called for 'health equity impact assessments' of all economic agreements, market regulation and public policies. We carried out an international study to clarify if existing health impact assessment (HIA) methods are adequate for the task of global health equity assessments. We triangulated data from a scoping review of the international literature, in-depth interviews with health equity and HIA experts and an international stakeholder workshop. We found that equity is not addressed adequately in HIAs for a variety of reasons, including inadequate guidance, absence of definitions, poor data and evidence, perceived lack of methods and tools and practitioner unwillingness or inability to address values like fairness and social justice. Current methods can address immediate, 'downstream' factors, but not the root causes of inequity. Extending HIAs to cover macro policy and global equity issues will require new tools to address macroeconomic policies, historical roots of inequities and upstream causes like power imbalances. More sensitive, participatory methods are also required. There is, however, no need for the development of a completely new methodology. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

An evidence base for International Health Regulations: quantitative measurement of the impacts of epidemic disease on international trade.

PubMed

Kimball, A M; Wong, K Y; Taneda, K

2005-12-01

When cholera broke out in Mozambique, Kenya, Tanzania and Uganda in 1997, an urgent measure was filed with the Sanitary and Phytosanitary Committee of the World Trade Organization, by the European Union, citing the protection of human health, to limit imports of fish products. The authors analysed import data on specified products over time to quantify the trade impact of this measure. Using previous specific trade trends, the authors modelled expected trade flows and compared observed imports with expected imports to calculate the potential cost of lost trade. The conclusion of this analysis was that the impact of European restrictions on fish exports from Mozambique, Kenya, Tanzania and Uganda on the economies of these African countries was at least US dollar 332,217,415 for the years 1998 to 2002. Insights from such quantitative studies will be important in making policy choices under the revised International Health Regulations of the World Health Organization and should inform the discussion about the adoption of these regulations.

Health Consequence Scales for Use in Health Impact Assessments of Climate Change

PubMed Central

Brown, Helen; Spickett, Jeffery

2014-01-01

While health impact assessment (HIA) has typically been applied to projects, plans or policies, it has significant potential with regard to strategic considerations of major health issues facing society such as climate change. Given the complexity of climate change, assessing health impacts presents new challenges that may require different approaches compared to traditional applications of HIA. This research focuses on the development of health consequence scales suited to assessing and comparing health effects associated with climate change and applied within a HIA framework. This assists in setting priorities for adaptation plans to minimize the public health impacts of climate change. The scales presented in this paper were initially developed for a HIA of climate change in Perth in 2050, but they can be applied across spatial and temporal scales. The design is based on a health effects pyramid with health measures expressed in orders of magnitude and linked to baseline population and health data. The health consequence measures are combined with a measure of likelihood to determine the level of risk associated with each health potential health impact. In addition, a simple visual framework that can be used to collate, compare and communicate the level of health risks associated with climate change has been developed. PMID:25229697

Quantifying electrical impacts on redundant wire insertion in 7nm unidirectional designs

NASA Astrophysics Data System (ADS)

Mohyeldin, Ahmed; Schroeder, Uwe Paul; Srinivasan, Ramya; Narisetty, Haritez; Malik, Shobhit; Madhavan, Sriram

2017-04-01

In nano-meter scale Integrated Circuits, via fails due to random defects is a well-known yield detractor, and via redundancy insertion is a common method to help enhance semiconductors yield. For the case of Self Aligned Double Patterning (SADP), which might require unidirectional design layers as in the case of some advanced technology nodes, the conventional methods of inserting redundant vias don't work any longer. This is because adding redundant vias conventionally requires adding metal shapes in the non-preferred direction, which will violate the SADP design constraints in that case. Therefore, such metal layers fabricated using unidirectional SADP require an alternative method for providing the needed redundancy. This paper proposes a post-layout Design for Manufacturability (DFM) redundancy insertion method tailored for the design requirements introduced by unidirectional metal layers. The proposed method adds redundant wires in the preferred direction - after searching for nearby vacant routing tracks - in order to provide redundant paths for electrical signals. This method opportunistically adds robustness against failures due to silicon defects without impacting area or incurring new design rule violations. Implementation details of this redundancy insertion method will be explained in this paper. One known challenge with similar DFM layout fixing methods is the possible introduction of undesired electrical impact, causing other unintentional failures in design functionality. In this paper, a study is presented to quantify the electrical impacts of such redundancy insertion scheme and to examine if that electrical impact can be tolerated. The paper will show results to evaluate DFM insertion rates and corresponding electrical impact for a given design utilization and maximum inserted wire length. Parasitic extraction and static timing analysis results will be presented. A typical digital design implemented using GLOBALFOUNDRIES 7nm technology is used for

BlueHealth: a study programme protocol for mapping and quantifying the potential benefits to public health and well-being from Europe's blue spaces.

PubMed

Grellier, James; White, Mathew P; Albin, Maria; Bell, Simon; Elliott, Lewis R; Gascón, Mireia; Gualdi, Silvio; Mancini, Laura; Nieuwenhuijsen, Mark J; Sarigiannis, Denis A; van den Bosch, Matilda; Wolf, Tanja; Wuijts, Susanne; Fleming, Lora E

2017-06-14

Proximity and access to water have long been central to human culture and accordingly deliver countless societal benefits. Over 200 million people live on Europe's coastline, and aquatic environments are the top recreational destination in the region. In terms of public health, interactions with 'blue space' (eg, coasts, rivers, lakes) are often considered solely in terms of risk (eg, drowning, microbial pollution). Exposure to blue space can, however, promote health and well-being and prevent disease, although underlying mechanisms are poorly understood. The BlueHealth project aims to understand the relationships between exposure to blue space and health and well-being, to map and quantify the public health impacts of changes to both natural blue spaces and associated urban infrastructure in Europe, and to provide evidence-based information to policymakers on how to maximise health benefits associated with interventions in and around aquatic environments. To achieve these aims, an evidence base will be created through systematic reviews, analyses of secondary data sets and analyses of new data collected through a bespoke international survey and a wide range of community-level interventions. We will also explore how to deliver the benefits associated with blue spaces to those without direct access through the use of virtual reality. Scenarios will be developed that allow the evaluation of health impacts in plausible future societal contexts and changing environments. BlueHealth will develop key inputs into policymaking and land/water-use planning towards more salutogenic and sustainable uses of blue space, particularly in urban areas. Throughout the BlueHealth project, ethics review and approval are obtained for all relevant aspects of the study by the local ethics committees prior to any work being initiated and an ethics expert has been appointed to the project advisory board. So far, ethical approval has been obtained for the BlueHealth International Survey and

Trends and drivers of ozone human health and vegetation impact metrics from UK EMEP supersite measurements (1990-2013)

NASA Astrophysics Data System (ADS)

Malley, C. S.; Heal, M. R.; Mills, G.; Braban, C. F.

2015-04-01

Analyses have been undertaken of the spatial and temporal trends and drivers of the distributions of ground-level O3 concentrations associated with potential impacts on human health and vegetation using measurements at the two UK European Monitoring and Evaluation Program (EMEP) supersites of Harwell and Auchencorth. These two sites provide representation of rural O3 over the wider geographic areas of south-east England and northern UK respectively. The O3 exposures associated with health and vegetation impacts were quantified respectively by the SOMO10 and SOMO35 metrics and by the flux-based PODY metrics for wheat, potato, beech and Scots pine. Statistical analyses of measured O3 and NOx concentrations were supplemented by analyses of meteorological data and NOx emissions along air-mass back trajectories. The findings highlight the differing responses of impact metrics to the decreasing contribution of regional O3 episodes in determining O3 concentrations at Harwell between 1990 and 2013, associated with European NOx emission reductions. An improvement in human health-relevant O3 exposure observed when calculated by SOMO35, which decreased significantly, was not observed when quantified by SOMO10. The decrease in SOMO35 is driven by decreases in regionally produced O3 which makes a larger contribution to SOMO35 than to SOMO10. For the O3 vegetation impacts at Harwell, no significant trend was observed for the PODY metrics of the four species, in contrast to the decreasing trend in vegetation-relevant O3 exposure perceived when calculated using the crop AOT40 metric. The decreases in regional O3 production have not decreased PODY as climatic and plant conditions reduced stomatal conductance and uptake of O3 during regional O3 production. Ozone concentrations at Auchencorth (2007-2013) were more influenced by hemispheric background concentrations than at Harwell. For health-related O3 exposures this resulted in lower SOMO35 but similar SOMO10 compared with Harwell

Trends and drivers of ozone human health and vegetation impact metrics from UK EMEP supersite measurements (1990-2013)

NASA Astrophysics Data System (ADS)

Malley, C. S.; Heal, M. R.; Mills, G.; Braban, C. F.

2015-01-01

Analyses have been undertaken of the trends and drivers of the distributions of ground-level O3 concentrations associated with potential impacts on human health and vegetation using measurements at the two UK EMEP supersites of Harwell and Auchencorth. These two sites provide representation of rural O3 over the wider geographic areas of south-east England and northern UK, respectively. The O3 exposures associated with health and vegetation impacts were quantified, respectively, by the SOMO10 and SOMO35 metrics, and by the flux-based PODY metrics for wheat, potato, beech and Scots pine. Statistical analyses of measured O3 and NOx concentrations was supplemented by analyses of meteorological data and NOx emissions along air-mass back trajectories. The findings highlight the differing responses of impact metrics to the decreasing contribution of regional O3 episodes in determining O3 concentrations at Harwell between 1990 and 2013, associated with European NOx emission reductions. An improvement in human health-relevant O3 exposure observed when calculated by SOMO35, which decreased significantly, was not observed when quantified by SOMO10. The decrease in SOMO35 is driven by decreases in regionally-produced O3 which makes a larger contribution to SOMO35 than to SOMO10. For the O3 vegetation impacts at Harwell, no significant trend was observed for the PODY metrics of the four species, in contrast to the decreasing trend in vegetation-relevant O3 exposure perceived when calculated using the crop AOT40 metric. The decreases in regional O3 production have not decreased PODY as climatic and plant conditions reduced stomatal conductance and uptake of O3 during regional O3 production. Ozone concentrations at Auchencorth (2007-2013) were more influenced by hemispheric background concentrations than at Harwell. For health-related O3 exposures this resulted in lower SOMO35 but similar SOMO10 compared with Harwell; for vegetation PODY values, this resulted in greater impacts

The Public Health Impact of the So-Called "Fluad Effect" on the 2014/2015 Influenza Vaccination Campaign in Italy: Ethical Implications for Health-Care Workers and Health Communication Practitioners.

PubMed

Rosselli, Roberto; Martini, Mariano; Bragazzi, Nicola Luigi; Watad, Abdulla

2017-01-01

Seasonal influenza, causing complications, hospitalizations and deaths, generates a serious socio-economic burden, especially among elderly and high-risk subjects, as well as among adult individuals. Despite the availability and active free-of charge offer of influenza vaccines, vaccine coverage rates remain low and far from the target established by the Ministry of Health. Notwithstanding their effectiveness, vaccines are victims of prejudices and false myths, that contribute to the increasing phenomenon of vaccine hesitancy and loss of confidence. Media and, in particular, new media and information and communication technologies (ICTs) play a major role in disseminating health-related information. They are extremely promising devices for delivering health education and promoting disease prevention, including immunization. However, they can also have a negative impact on population's health attitudes and behaviors when channeling wrong, misleading information. During the 2014/2015 influenza vaccination campaign, the report of four deaths allegedly caused by administration of an adjuvanted influenza vaccine, Fluad - the so-called "Fluad case" - received an important media coverage, which contributed to the failure of the vaccination campaign, dramatically reducing the influenza vaccine uptake. In the extant literature, there is a dearth of information concerning the effect of the "Fluad case". The current study aims at quantifying the impact of the "Fluad effect" at the level of the Local Health Unit 3 (LHU3) ASL3 Genovese, Genoa, Italy. Ethical implications for health-care workers and health communication practitioners are also envisaged.

Production-based emissions, consumption-based emissions and consumption-based health impacts of PM2.5 carbonaceous aerosols in Asia

NASA Astrophysics Data System (ADS)

Takahashi, Kei; Nansai, Keisuke; Tohno, Susumu; Nishizawa, Masato; Kurokawa, Jun-ichi; Ohara, Toshimasa

2014-11-01

This study determined the production-based emissions, the consumption-based emissions, and the consumption-based health impact of primary carbonaceous aerosols (black carbon: BC, organic carbon: OC) in nine countries and regions in Asia (Indonesia, Malaysia, the Philippines, Singapore, Thailand, China, Taiwan, South Korea, and Japan) in 2008. For the production-based emissions, sectoral emissions inventory of BC and OC for the year of 2008 based on the Asian international input-output tables (AIIOT) was compiled including direct emissions from households. Then, a multiregional environmental input-output analysis with the 2008 AIIOT which was originally developed by updating the table of 2000 was applied for calculating the consumption-based emissions for each country and region. For the production-based emissions, China had the highest BC and OC emissions of 4520 Gg-C in total, which accounted for 75% of the total emissions in the nine countries and regions. For consumption-based emissions, China was estimated to have had a total of 4849 Gg-C of BC and OC emissions, which accounted for 77% of the total emissions in the Asia studied. We also quantified how much countries and regions induced emissions in other countries and regions. Furthermore, taking account of the source-receptor relationships of BC and OC among the countries and regions, we converted their consumption-based emissions into the consumption-based health impact of each country and region. China showed the highest consumption-based health impact of BC and OC totaling 111 × 103 premature deaths, followed by Indonesia, Japan, Thailand and South Korea. China accounted for 87% of the sum total of the consumption-based health impacts of the countries/regions, indicating that China's contribution to consumption-based health impact in Asia was greater than its consumption-based emissions. By elucidating the health impacts that each country and region had on other countries and from which country the impacts

[Health impact assessment: one way to introduce health in all policies. SESPAS Report 2010].

PubMed

Esnaola, Santiago; Bacigalupe, Amaia; Sanz, Elvira; Aldasoro, Elena; Calderón, Carlos; Zuazagoitia, Juan; Cambra, Koldo

2010-12-01

Health impact assessment is a predictive tool to support decisions in policy-making. Current experience shows that health impact assessment could play an important role in the development of the Health in All Policies strategy. This strategy has been extensively used in other European countries and in a wide range of policy and administrative sectors. Health impact assessment is hardly ever mandatory and is frequently carried out separately from other impact assessments. The use of this process in Spain is relatively new, limited and fundamentally based on local level experiences and the screening of regional interventions. The current normative and organizational reform of public health in Spain provides an excellent opportunity to promote the development of health impact assessment. Some of the barriers to the development of this process are related to the biomedical model of health prevailing among health professionals, politicians, and the general population, political disaffection, lack of assessment culture, underdevelopment of community participation processes, and insufficient intersectoral work. Health impact assessment provides an opportunity to move toward improving the population's health and reducing inequalities in health. Consequently, political commitment, as well as investment in education and research, is needed to introduce and develop health impact assessment in all administrative settings and policy sectors. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

Avenues of Influence: the Relationship between Health Impact Assessment and Determinants of Health and Health Equity.

PubMed

Sohn, Elizabeth Kelley; Stein, Lauren J; Wolpoff, Allison; Lindberg, Ruth; Baum, Abigail; Simoncelli, Arielle Mc-Innis; Pollack, Keshia M

2018-06-11

This study aims to identify perceived impacts of Health Impact Assessment (HIA) on decision-making, determinants of health, and determinants of health equity and outline the mechanisms through which these impacts can occur. The research team conducted a mixed-methods study of HIAs in the USA. First, investigators collected data regarding perceived HIA impacts through an online questionnaire, which was completed by 149 stakeholders representing 126 unique HIAs. To explore in greater depth the themes that arose from the online survey, investigators conducted semi-structured interviews with 46 stakeholders involved with 27 HIAs related to the built environment. This preliminary study suggests that HIAs can strengthen relationships and build trust between community and government institutions. In addition, this study suggests that HIA recommendations can inform policy and decision-making systems that determine the distribution of health-promoting resources and health risks. HIA outcomes may in turn lead to more equitable access to health resources and reduce exposure to environmental harms among at-risk populations. Future research should further explore associations between HIAs and changes in determinants of health and health equity by corroborating findings with other data sources and documenting potential impacts and outcomes of HIAs in other sectors.

Socioeconomic disparities and health: impacts and pathways.

PubMed

Kondo, Naoki

2012-01-01

Growing socioeconomic disparity is a global concern, as it could affect population health. The author and colleagues have investigated the health impacts of socioeconomic disparities as well as the pathways that underlie those disparities. Our meta-analysis found that a large population has risks of mortality and poor self-rated health that are attributable to income inequality. The study results also suggested the existence of threshold effects (ie, a threshold of income inequality over which the adverse impacts on health increase), period effects (ie, the potential for larger impacts in later years, specifically after the 1990s), and lag effects between income inequality and health outcomes. Our other studies using Japanese national representative survey data and a large-scale cohort study of Japanese older adults (AGES cohort) support the relative deprivation hypothesis, namely, that invidious social comparisons arising from relative deprivation in an unequal society adversely affect health. A study with a natural experiment design found that the socioeconomic gradient in self-rated health might actually have become shallower after the 1997-98 economic crisis in Japan, due to smaller health improvements among middle-class white-collar workers and middle/upper-income workers. In conclusion, income inequality might have adverse impacts on individual health, and psychosocial stress due to relative deprivation may partially explain those impacts. Any study of the effects of macroeconomic fluctuations on health disparities should also consider multiple potential pathways, including expanding income inequality, changes in the labor market, and erosion of social capital. Further studies are needed to attain a better understanding of the social determinants of health in a rapidly changing society.

Digital health and the biopolitics of the Quantified Self

PubMed Central

Ajana, Btihaj

2017-01-01

Recent years have witnessed an intensive growth of systems of measurement and an increasing integration of data processes into various spheres of everyday life. From smartphone apps that measure our activity and sleep, to digital devices that monitor our health and performance at the workplace, the culture of measurement is currently on the rise. Encouraged by movements such as the Quantified Self, whose motto is ‘self knowledge through numbers’, a growing number of people across the globe are embracing practices of self-quantification and tracking in the spirit of improving their wellbeing and productivity or charting their fitness progress. In this article, I examine the biopolitical aspects of the Quantified Self practices, exploring some of the ideologies and rationalities underlying self-tracking culture. I argue that such practices represent an instantiation of a ‘biopolitics of the self’ whereby the body is made amenable to management and monitoring techniques that often echo the ethos of neoliberalism. Rather than being restricted to an individualized form, self-tracking practices are also becoming part of a biosocial and communal phenomenon in which individuals are incited to share with others information about their physical activities and biodata. In exploring some examples of this data sharing culture, I critically address the extent to which the sharing of personal physical data can be seen as a ‘solidaristic’ act that can contribute to a larger Big Data ecosystem and inform the wider medical community and healthcare research and policy. I link this discussion to debates on ‘data philanthropy’, highlighting the emerging tension between philanthropic discourses of data sharing and issues of privacy. From here, I go on to discuss further ethical and political concerns, particularly in relation to data security and the marked shifts in healthcare responsibilities.

Using a computational model to quantify the potential impact of changing the placement of healthy beverages in stores as an intervention to "Nudge" adolescent behavior choice.

PubMed

Wong, Michelle S; Nau, Claudia; Kharmats, Anna Yevgenyevna; Vedovato, Gabriela Milhassi; Cheskin, Lawrence J; Gittelsohn, Joel; Lee, Bruce Y

2015-12-23

Product placement influences consumer choices in retail stores. While sugar sweetened beverage (SSB) manufacturers expend considerable effort and resources to determine how product placement may increase SSB purchases, the information is proprietary and not available to the public health and research community. This study aims to quantify the effect of non-SSB product placement in corner stores on adolescent beverage purchasing behavior. Corner stores are small privately owned retail stores that are important beverage providers in low-income neighborhoods--where adolescents have higher rates of obesity. Using data from a community-based survey in Baltimore and parameters from the marketing literature, we developed a decision-analytic model to simulate and quantify how placement of healthy beverage (placement in beverage cooler closest to entrance, distance from back of the store, and vertical placement within each cooler) affects the probability of adolescents purchasing non-SSBs. In our simulation, non-SSB purchases were 2.8 times higher when placed in the "optimal location"--on the second or third shelves of the front cooler--compared to the worst location on the bottom shelf of the cooler farthest from the entrance. Based on our model results and survey data, we project that moving non-SSBs from the worst to the optional location would result in approximately 5.2 million more non-SSBs purchased by Baltimore adolescents annually. Our study is the first to quantify the potential impact of changing placement of beverages in corner stores. Our findings suggest that this could be a low-cost, yet impactful strategy to nudge this population--highly susceptible to obesity--towards healthier beverage decisions.

Quantifying renewable groundwater stress with GRACE

NASA Astrophysics Data System (ADS)

Richey, Alexandra S.; Thomas, Brian F.; Lo, Min-Hui; Reager, John T.; Famiglietti, James S.; Voss, Katalyn; Swenson, Sean; Rodell, Matthew

2015-07-01

Groundwater is an increasingly important water supply source globally. Understanding the amount of groundwater used versus the volume available is crucial to evaluate future water availability. We present a groundwater stress assessment to quantify the relationship between groundwater use and availability in the world's 37 largest aquifer systems. We quantify stress according to a ratio of groundwater use to availability, which we call the Renewable Groundwater Stress ratio. The impact of quantifying groundwater use based on nationally reported groundwater withdrawal statistics is compared to a novel approach to quantify use based on remote sensing observations from the Gravity Recovery and Climate Experiment (GRACE) satellite mission. Four characteristic stress regimes are defined: Overstressed, Variable Stress, Human-dominated Stress, and Unstressed. The regimes are a function of the sign of use (positive or negative) and the sign of groundwater availability, defined as mean annual recharge. The ability to mitigate and adapt to stressed conditions, where use exceeds sustainable water availability, is a function of economic capacity and land use patterns. Therefore, we qualitatively explore the relationship between stress and anthropogenic biomes. We find that estimates of groundwater stress based on withdrawal statistics are unable to capture the range of characteristic stress regimes, especially in regions dominated by sparsely populated biome types with limited cropland. GRACE-based estimates of use and stress can holistically quantify the impact of groundwater use on stress, resulting in both greater magnitudes of stress and more variability of stress between regions.

Quantifying renewable groundwater stress with GRACE

PubMed Central

Richey, Alexandra S.; Thomas, Brian F.; Lo, Min‐Hui; Reager, John T.; Voss, Katalyn; Swenson, Sean; Rodell, Matthew

2015-01-01

Abstract Groundwater is an increasingly important water supply source globally. Understanding the amount of groundwater used versus the volume available is crucial to evaluate future water availability. We present a groundwater stress assessment to quantify the relationship between groundwater use and availability in the world's 37 largest aquifer systems. We quantify stress according to a ratio of groundwater use to availability, which we call the Renewable Groundwater Stress ratio. The impact of quantifying groundwater use based on nationally reported groundwater withdrawal statistics is compared to a novel approach to quantify use based on remote sensing observations from the Gravity Recovery and Climate Experiment (GRACE) satellite mission. Four characteristic stress regimes are defined: Overstressed, Variable Stress, Human‐dominated Stress, and Unstressed. The regimes are a function of the sign of use (positive or negative) and the sign of groundwater availability, defined as mean annual recharge. The ability to mitigate and adapt to stressed conditions, where use exceeds sustainable water availability, is a function of economic capacity and land use patterns. Therefore, we qualitatively explore the relationship between stress and anthropogenic biomes. We find that estimates of groundwater stress based on withdrawal statistics are unable to capture the range of characteristic stress regimes, especially in regions dominated by sparsely populated biome types with limited cropland. GRACE‐based estimates of use and stress can holistically quantify the impact of groundwater use on stress, resulting in both greater magnitudes of stress and more variability of stress between regions. PMID:26900185

Health impact assessment of decreases in PM10 and ozone concentrations in the Mexico City Metropolitan Area: a basis for a new air quality management program.

PubMed

Riojas-Rodríguez, Horacio; Álamo-Hernández, Urinda; Texcalac-Sangrador, José Luis; Romieu, Isabelle

2014-01-01

To conduct a health impact assessment (HIA) to quantify health benefits for several PM and O3 air pollution reduction scenarios in the Mexico City Metropolitan Area (MCMA). Results from this HIA will contribute to the scientific support of the MCMA air quality management plan (PROAIRE) for the period 2011-2020. The HIA methodology consisted of four steps: 1) selection of the air pollution reduction scenarios, 2) identification of the at-risk population and health outcomes for the 2005 baseline scenario, 3) selection of concentration-response functions and 4) estimation of health impacts. Reductions of PM10 levels to 20 μg/m³ and O3 levels to 0.050ppm (98 µg/m³) would prevent 2300 and 400 annual deaths respectively. The greatest health impact was seen in the over-65 age group and in mortality due to cardiopulmonary and cardiovascular disease. Improved air quality in the MCMA could provide significant health benefits through focusing interventions by exposure zones.

A framework for quantifying net benefits of alternative prognostic models.

PubMed

Rapsomaniki, Eleni; White, Ian R; Wood, Angela M; Thompson, Simon G

2012-01-30

New prognostic models are traditionally evaluated using measures of discrimination and risk reclassification, but these do not take full account of the clinical and health economic context. We propose a framework for comparing prognostic models by quantifying the public health impact (net benefit) of the treatment decisions they support, assuming a set of predetermined clinical treatment guidelines. The change in net benefit is more clinically interpretable than changes in traditional measures and can be used in full health economic evaluations of prognostic models used for screening and allocating risk reduction interventions. We extend previous work in this area by quantifying net benefits in life years, thus linking prognostic performance to health economic measures; by taking full account of the occurrence of events over time; and by considering estimation and cross-validation in a multiple-study setting. The method is illustrated in the context of cardiovascular disease risk prediction using an individual participant data meta-analysis. We estimate the number of cardiovascular-disease-free life years gained when statin treatment is allocated based on a risk prediction model with five established risk factors instead of a model with just age, gender and region. We explore methodological issues associated with the multistudy design and show that cost-effectiveness comparisons based on the proposed methodology are robust against a range of modelling assumptions, including adjusting for competing risks. Copyright © 2011 John Wiley & Sons, Ltd.

A framework for quantifying net benefits of alternative prognostic models‡

PubMed Central

Rapsomaniki, Eleni; White, Ian R; Wood, Angela M; Thompson, Simon G

2012-01-01

New prognostic models are traditionally evaluated using measures of discrimination and risk reclassification, but these do not take full account of the clinical and health economic context. We propose a framework for comparing prognostic models by quantifying the public health impact (net benefit) of the treatment decisions they support, assuming a set of predetermined clinical treatment guidelines. The change in net benefit is more clinically interpretable than changes in traditional measures and can be used in full health economic evaluations of prognostic models used for screening and allocating risk reduction interventions. We extend previous work in this area by quantifying net benefits in life years, thus linking prognostic performance to health economic measures; by taking full account of the occurrence of events over time; and by considering estimation and cross-validation in a multiple-study setting. The method is illustrated in the context of cardiovascular disease risk prediction using an individual participant data meta-analysis. We estimate the number of cardiovascular-disease-free life years gained when statin treatment is allocated based on a risk prediction model with five established risk factors instead of a model with just age, gender and region. We explore methodological issues associated with the multistudy design and show that cost-effectiveness comparisons based on the proposed methodology are robust against a range of modelling assumptions, including adjusting for competing risks. Copyright © 2011 John Wiley & Sons, Ltd. PMID:21905066

Modeling health impact of global health programs implemented by Population Services International

PubMed Central

2013-01-01

Background Global health implementing organizations benefit most from health impact estimation models that isolate the individual effects of distributed products and services - a feature not typically found in intervention impact models, but which allow comparisons across interventions and intervention settings. Population Services International (PSI), a social marketing organization, has developed a set of impact models covering seven health program areas, which translate product/service distribution data into impact estimates. Each model's primary output is the number of disability-adjusted life-years (DALYs) averted by an intervention within a specific country and population context. This paper aims to describe the structure and inputs for two types of DALYs averted models, considering the benefits and limitations of this methodology. Methods PSI employs two modeling approaches for estimating health impact: a macro approach for most interventions and a micro approach for HIV, tuberculosis (TB), and behavior change communication (BCC) interventions. Within each intervention country context, the macro approach determines the coverage that one product/service unit provides a population in person-years, whereas the micro approach estimates an individual's risk of infection with and without the product/service unit. The models use these estimations to generate per unit DALYs averted coefficients for each intervention. When multiplied by program output data, these coefficients predict the total number of DALYs averted by an intervention in a country. Results Model outputs are presented by country for two examples: Water Chlorination DALYs Averted Model, a macro model, and the HIV Condom DALYs Averted Model for heterosexual transmission, a micro model. Health impact estimates measured in DALYs averted for PSI interventions on a global level are also presented. Conclusions The DALYs averted models offer implementing organizations practical measurement solutions for

Modeling the Population Health Impact of Introducing a Modified Risk Tobacco Product into the U.S. Market.

PubMed

Djurdjevic, Smilja; Lee, Peter N; Weitkunat, Rolf; Sponsiello-Wang, Zheng; Lüdicke, Frank; Baker, Gizelle

2018-05-16

Philip Morris International (PMI) has developed the Population Health Impact Model (PHIM) to quantify, in the absence of epidemiological data, the effects of marketing a candidate modified risk tobacco product (cMRTP) on the public health of a whole population. Various simulations were performed to understand the harm reduction impact on the U.S. population over a 20-year period under various scenarios. The overall reduction in smoking attributable deaths (SAD) over the 20-year period was estimated as 934,947 if smoking completely went away and between 516,944 and 780,433 if cMRTP use completely replaces smoking. The reduction in SADs was estimated as 172,458 for the World Health Organization (WHO) 2025 Target and between 70,274 and 90,155 for the gradual cMRTP uptake. Combining the scenarios (WHO 2025 Target and cMRTP uptake), the reductions were between 256,453 and 268,796, depending on the cMRTP relative exposure. These results show how a cMRTP can reduce overall population harm additionally to existing tobacco control efforts.

Human health impacts of ecosystem alteration.

PubMed

Myers, Samuel S; Gaffikin, Lynne; Golden, Christopher D; Ostfeld, Richard S; Redford, Kent H; Ricketts, Taylor H; Turner, Will R; Osofsky, Steven A

2013-11-19

Human activity is rapidly transforming most of Earth's natural systems. How this transformation is impacting human health, whose health is at greatest risk, and the magnitude of the associated disease burden are relatively new subjects within the field of environmental health. We discuss what is known about the human health implications of changes in the structure and function of natural systems and propose that these changes are affecting human health in a variety of important ways. We identify several gaps and limitations in the research that has been done to date and propose a more systematic and comprehensive approach to applied research in this field. Such efforts could lead to a more robust understanding of the human health impacts of accelerating environmental change and inform decision making in the land-use planning, environmental conservation, and public health policy realms.

Human health impacts of ecosystem alteration

PubMed Central

Myers, Samuel S.; Gaffikin, Lynne; Golden, Christopher D.; Ostfeld, Richard S.; H. Redford, Kent; H. Ricketts, Taylor; Turner, Will R.; Osofsky, Steven A.

2013-01-01

Human activity is rapidly transforming most of Earth’s natural systems. How this transformation is impacting human health, whose health is at greatest risk, and the magnitude of the associated disease burden are relatively new subjects within the field of environmental health. We discuss what is known about the human health implications of changes in the structure and function of natural systems and propose that these changes are affecting human health in a variety of important ways. We identify several gaps and limitations in the research that has been done to date and propose a more systematic and comprehensive approach to applied research in this field. Such efforts could lead to a more robust understanding of the human health impacts of accelerating environmental change and inform decision making in the land-use planning, environmental conservation, and public health policy realms. PMID:24218556

Perceptions of Health Impact Assessments in Influencing, Policy Decisions through Health Communications

ERIC Educational Resources Information Center

Ford, Cheryl

2016-01-01

Over the past 30 years, public health Practitioners worldwide have increasingly relied on Health Impact Assessments (HIAs) as a tool for informing decision makers of the potential health impacts of proposed policies, programs, and planning decisions. Adoption of the HIA is significantly less common in the United States than in international…

Global Warming and Its Health Impact.

PubMed

Rossati, Antonella

2017-01-01

Since the mid-19th century, human activities have increased greenhouse gases such as carbon dioxide, methane, and nitrous oxide in the Earth's atmosphere that resulted in increased average temperature. The effects of rising temperature include soil degradation, loss of productivity of agricultural land, desertification, loss of biodiversity, degradation of ecosystems, reduced fresh-water resources, acidification of the oceans, and the disruption and depletion of stratospheric ozone. All these have an impact on human health, causing non-communicable diseases such as injuries during natural disasters, malnutrition during famine, and increased mortality during heat waves due to complications in chronically ill patients. Direct exposure to natural disasters has also an impact on mental health and, although too complex to be quantified, a link has even been established between climate and civil violence. Over time, climate change can reduce agricultural resources through reduced availability of water, alterations and shrinking arable land, increased pollution, accumulation of toxic substances in the food chain, and creation of habitats suitable to the transmission of human and animal pathogens. People living in low-income countries are particularly vulnerable. Climate change scenarios include a change in distribution of infectious diseases with warming and changes in outbreaks associated with weather extreme events. After floods, increased cases of leptospirosis, campylobacter infections and cryptosporidiosis are reported. Global warming affects water heating, rising the transmission of water-borne pathogens. Pathogens transmitted by vectors are particularly sensitive to climate change because they spend a good part of their life cycle in a cold-blooded host invertebrate whose temperature is similar to the environment. A warmer climate presents more favorable conditions for the survival and the completion of the life cycle of the vector, going as far as to speed it up

Environmental health impact assessment: evaluation of a ten-step model.

PubMed

Fehr, R

1999-09-01

"Environmental impact assessment" denotes the attempt to predict and assess the impact of development projects on the environment. A component dealing specifically with human health is often called an "environmental health impact assessment." It is widely held that such impact assessment offers unique opportunities for the protection and promotion of human health. The following components were identified as key elements of an integrated environmental health impact assessment model: project analysis, analysis of status quo (including regional analysis, population analysis, and background situation), prediction of impact (including prognosis of future pollution and prognosis of health impact), assessment of impact, recommendations, communication of results, and evaluation of the overall procedure. The concept was applied to a project of extending a waste disposal facility and to a city bypass highway project. Currently, the coverage of human health aspects in environmental impact assessment still tends to be incomplete, and public health departments often do not participate. Environmental health impact assessment as a tool for health protection and promotion is underutilized. It would be useful to achieve consensus on a comprehensive generic concept. An international initiative to improve the situation seems worth some consideration.

A Framework for Public Health Action: The Health Impact Pyramid

PubMed Central

2010-01-01

A 5-tier pyramid best describes the impact of different types of public health interventions and provides a framework to improve health. At the base of this pyramid, indicating interventions with the greatest potential impact, are efforts to address socioeconomic determinants of health. In ascending order are interventions that change the context to make individuals' default decisions healthy, clinical interventions that require limited contact but confer long-term protection, ongoing direct clinical care, and health education and counseling. Interventions focusing on lower levels of the pyramid tend to be more effective because they reach broader segments of society and require less individual effort. Implementing interventions at each of the levels can achieve the maximum possible sustained public health benefit. PMID:20167880

Use of a normal impairment factor in quantifying avoidable productivity loss because of poor health.

PubMed

Riedel, John E; Grossmeier, Jessica; Haglund-Howieson, Laura; Buraglio, Cherie; Anderson, David R; Terry, Paul E

2009-03-01

Growing evidence demonstrates a relationship between excess health risk and preventable productivity loss. There is a need to quantify how much lost productivity is avoidable through employer-sponsored health management interventions. This study introduced the Normal Impairment Factor (NIF) to recognize the amount of productivity loss that cannot be mitigated through health management interventions. A health assessment questionnaire was administered to 772,750 employees, representing 106 employers within five industry sectors. Researchers used multivariate regression procedures to examine the association between preventable health risks and self-reported productivity loss. Back pain, mental well being, and stress risk were the strongest predictors of on-the-job productivity loss. A strong association was also detected between the number of health risks and productivity loss ranging from 3.4% for those at lowest risk (the NIF group) to 24.0% loss for those at risk for eight risks. This study demonstrated the utility of the NIF in estimating the level of productivity loss that cannot be regained through health management interventions.

Estimating the Public Health Impact of Air Pollution for Informing Policy in the Twin Cities: A Minnesota Tracking Collaboration.

PubMed

Johnson, Jean E; Bael, David L; Sample, Jeannette M; Lindgren, Paula G; Kvale, Dorian L

The Minnesota Department of Health and the Minnesota Pollution Control Agency used local air pollution and public health data to estimate the impacts of particulate matter and ozone on population health, to identify disparities, and to inform decisions that will improve health. While air quality in Minnesota currently meets federal standards, urban communities are concerned about the impact of air pollution on their health. The Twin Cities (Minneapolis-St Paul) metropolitan area includes 7 counties where fine particulate levels and rates of asthma exacerbations are elevated in some communities. We used the Environmental Protection Agency's BenMAP (Environmental Benefits Mapping and Analysis Program) software, along with local PM2.5 (fine particulate) and ozone ambient concentrations, census and population health data, to calculate impacts for 2008 at the zip code level. The impacts were summed across all zip codes for area-wide estimates. American Community Survey data were used to stratify zip codes by poverty and race for assessment of disparities. Attributable fraction, attributable rate and counts for all-cause mortality, asthma and chronic obstructive pulmonary disease hospitalizations, asthma emergency department (ED) visits, and cardiovascular disease hospitalizations. In the Twin Cities (2008), air pollution was a contributing cause for an estimated 2% to 5% of respiratory and cardiovascular hospitalizations and ED visits and between 6% and 13% of premature deaths. The elderly (aged 65+ years) experienced the highest air pollution-attributable rates of death and respiratory hospitalizations; children experienced the highest asthma ED visit rates. Geographical and demographic differences in air pollution-attributable health impacts across the region reflected the differences in the underlying morbidity and mortality rates. Method was effective in demonstrating that changes in air quality can have quantifiable health impacts across the Twin Cities. Key

Quantifying Impacts of Land-use and Land Cover Change in a Changing Climate at the Regional Scale using an Integrated Earth System Modeling Approach

NASA Astrophysics Data System (ADS)

Huang, M.

2016-12-01

Earth System models (ESMs) are effective tools for investigating the water-energy-food system interactions under climate change. In this presentation, I will introduce research efforts at the Pacific Northwest National Laboratory towards quantifying impacts of LULCC on the water-energy-food nexus in a changing climate using an integrated regional Earth system modeling framework: the Platform for Regional Integrated Modeling and Analysis (PRIMA). Two studies will be discussed to showcase the capability of PRIMA: (1) quantifying changes in terrestrial hydrology over the Conterminous US (CONUS) from 2005 to 2095 using the Community Land Model (CLM) driven by high-resolution downscaled climate and land cover products from PRIMA, which was designed for assessing the impacts of and potential responses to climate and anthropogenic changes at regional scales; (2) applying CLM over the CONUS to provide the first county-scale model validation in simulating crop yields and assessing associated impacts on the water and energy budgets using CLM. The studies demonstrate the benefits of incorporating and coupling human activities into complex ESMs, and critical needs to account for the biogeophysical and biogeochemical effects of LULCC in climate impacts studies, and in designing mitigation and adaptation strategies at a scale meaningful for decision-making. Future directions in quantifying LULCC impacts on the water-energy-food nexus under a changing climate, as well as feedbacks among climate, energy production and consumption, and natural/managed ecosystems using an Integrated Multi-scale, Multi-sector Modeling framework will also be discussed.

Quantifying the Impact of Tropospheric Ozone on Crops Productivity at regional scale using JULES-crop

NASA Astrophysics Data System (ADS)

Leung, F.

2016-12-01

Tropospheric ozone (O3) is the third most important anthropogenic greenhouse gas. It is causing significant crop production losses. Currently, O3 concentrations are projected to increase globally, which could have a significant impact on food security. The Joint UK Land Environment Simulator modified to include crops (JULES-crop) is used here to quantify the impacts of tropospheric O3 on crop production at the regional scale until 2100. We evaluate JULES-crop against the Soybean Free-Air-Concentration-Enrichment (SoyFACE) experiment in Illinois, USA. Experimental data from SoyFACE and various literature sources is used to calibrate the parameters for soybean and ozone damage parameters in soybean in JULES-crop. The calibrated model is then applied for a transient factorial set of JULES-crop simulations over 1960-2005. Simulated yield changes are attributed to individual environmental drivers, CO2, O3 and climate change, across regions and for different crops. A mixed scenario of RCP 2.6 and RCP 8.5 climatology and ozone are simulated to explore the implication of policy. The overall findings are that regions with high ozone concentration such as China and India suffer the most from ozone damage, soybean is more sensitive to O3 than other crops. JULES-crop predicts CO2 fertilisation would increase the productivity of vegetation. This effect, however, is masked by the negative impacts of tropospheric O3. Using data from FAO and JULES-crop estimated that ozone damage cost around 55.4 Billion USD per year on soybean. Irrigation improves the simulation of rice only, and it increases the relative ozone damage because drought can reduce the ozone from entering the plant stomata. RCP 8.5 scenario results in a high yield for all crops mainly due to the CO2 fertilisation effect. Mixed climate scenarios simulations suggest that RCP 8.5 CO2 concentration and RCP 2.6 O3 concentration result in the highest yield. Further works such as more crop FACE-O3 experiments and more Crop

Menu labeling as a potential strategy for combating the obesity epidemic: a health impact assessment.

PubMed

Kuo, Tony; Jarosz, Christopher J; Simon, Paul; Fielding, Jonathan E

2009-09-01

We conducted a health impact assessment to quantify the potential impact of a state menu-labeling law on population weight gain in Los Angeles County, California. We utilized published and unpublished data to model consumer response to point-of-purchase calorie postings at large chain restaurants in Los Angeles County. We conducted sensitivity analyses to account for uncertainty in consumer response and in the total annual revenue, market share, and average meal price of large chain restaurants in the county. Assuming that 10% of the restaurant patrons would order reduced-calorie meals in response to calorie postings, resulting in an average reduction of 100 calories per meal, we estimated that menu labeling would avert 40.6% of the 6.75 million pound average annual weight gain in the county population aged 5 years and older. Substantially larger impacts would be realized if higher percentages of patrons ordered reduced-calorie meals or if average per-meal calorie reductions increased. Our findings suggest that mandated menu labeling could have a sizable salutary impact on the obesity epidemic, even with only modest changes in consumer behavior.

Assessing Health Impacts within Environmental Impact Assessments: An Opportunity for Public Health Globally Which Must Not Remain Missed

PubMed Central

Harris, Patrick; Viliani, Francesca; Spickett, Jeff

2015-01-01

Within the member states of the United Nations 190 of 193 have regulated Environmental Impact Assessments (EIA) which is a systematic process to prevent and mitigate the potential environmental impacts of industry development projects before these occur. However, the routine and comprehensive assessment of health impacts within EIAs remains underdeveloped. Focusing, as an example, on the risks to global health from the global shift in the mining industry towards Low and Middle Income Countries LMIC), this viewpoint details why connecting with EIA is an essential task for the health system. Although existing knowledge is out of date in relation to global practice we identify how health has been included, to some extent, in High Income Country EIAs and the institutional requirements for doing so. Using arguments identified by industry themselves about requiring a ‘social license to operate’, we conclude that EIA regulations provide the best current mechanism to ensure health protection is a core aspect in the decision making process to approve projects. PMID:25608592

Nurse Bullying: Impact on Nurses' Health.

PubMed

Sauer, Penny A; McCoy, Thomas P

2017-12-01

Workplace bullying has been experienced by 27% to 80% of nurses who have participated in studies. Bullying behaviors negatively impact the health of nurses. This study examined whether nurses' resilience had an impact on the effects of bullying on the nurse's health. This cross-sectional descriptive study surveyed licensed registered nurses in one state. The sample ( N = 345) was predominately female (89%) and Caucasian (84%), with an average age of 46.6 years. In this sample, 40% of nurses were bullied. Higher incidence of bullying was associated with lower physical health scores ( p = .002) and lower mental health scores ( p = .036). Nurses who are bullied at work experience lower physical and mental health, which can decrease the nurses' quality of life and impede their ability to deliver safe, effective patient care.

The impact of economic globalisation on health.

PubMed

Koivusalo, Meri

2006-01-01

The analysis of the impact of economic globalisation on health depends on how it is defined and should consider how it shapes both health and health policies. I first discuss the ways in which economic globalisation can and has been defined and then why it is important to analyse its impact both in terms of health and health policies. I then explore the ways in which economic globalisation influences health and health policies and how this relates to equity, social justice, and the role of values and social rights in societies. Finally, I argue that the process of economic globalisation provides a common challenge for all health systems across the globe and requires a broader debate on values, accountability, and policy approaches.

Using a One Health approach to assess the impact of parasitic disease in livestock: how does it add value?

PubMed

Rushton, Jonathan; Bruce, Mieghan

2017-01-01

Human population increases, with greater food demands, have resulted in a rapid evolution of livestock food systems, leading to changes in land and water use. The scale of global livestock systems mean that changes in animal health status, particularly in parasite levels, have impacts that go beyond farm and sector levels. To quantify the true impact of parasites in livestock, frameworks that look at both resources and services valued in markets and those that have no true market value are required. Mitigating the effects of parasitic disease in livestock will not only increase productivity, but also improve animal welfare and human health, whilst reducing the environmental burden of livestock production systems. To measure these potential benefits, a One Health approach is needed. This paper discusses the types of methods and the data collection tools needed for a more holistic perspective and provides a framework with its application to coccidiosis in poultry. To build a body of knowledge that allows the ranking of parasite diseases in a wider animal health setting, such One Health frameworks need to be applied more frequently and with rigour. The outcome will improve the allocation of resources to critical constraints on parasite management.

Quantifying potential health impacts of cadmium in cigarettes on smoker risk of lung cancer: a portfolio-of-mechanisms approach.

PubMed

Cox, Louis Anthony Tony

2006-12-01

This article introduces an approach to estimating the uncertain potential effects on lung cancer risk of removing a particular constituent, cadmium (Cd), from cigarette smoke, given the useful but incomplete scientific information available about its modes of action. The approach considers normal cell proliferation; DNA repair inhibition in normal cells affected by initiating events; proliferation, promotion, and progression of initiated cells; and death or sparing of initiated and malignant cells as they are further transformed to become fully tumorigenic. Rather than estimating unmeasured model parameters by curve fitting to epidemiological or animal experimental tumor data, we attempt rough estimates of parameters based on their biological interpretations and comparison to corresponding genetic polymorphism data. The resulting parameter estimates are admittedly uncertain and approximate, but they suggest a portfolio approach to estimating impacts of removing Cd that gives usefully robust conclusions. This approach views Cd as creating a portfolio of uncertain health impacts that can be expressed as biologically independent relative risk factors having clear mechanistic interpretations. Because Cd can act through many distinct biological mechanisms, it appears likely (subjective probability greater than 40%) that removing Cd from cigarette smoke would reduce smoker risks of lung cancer by at least 10%, although it is possible (consistent with what is known) that the true effect could be much larger or smaller. Conservative estimates and assumptions made in this calculation suggest that the true impact could be greater for some smokers. This conclusion appears to be robust to many scientific uncertainties about Cd and smoking effects.

Health Impact Modelling of Active Travel Visions for England and Wales Using an Integrated Transport and Health Impact Modelling Tool (ITHIM)

PubMed Central

Woodcock, James; Givoni, Moshe; Morgan, Andrei Scott

2013-01-01

Background Achieving health benefits while reducing greenhouse gas emissions from transport offers a potential policy win-win; the magnitude of potential benefits, however, is likely to vary. This study uses an Integrated Transport and Health Impact Modelling tool (ITHIM) to evaluate the health and environmental impacts of high walking and cycling transport scenarios for English and Welsh urban areas outside London. Methods Three scenarios with increased walking and cycling and lower car use were generated based upon the Visions 2030 Walking and Cycling project. Changes to carbon dioxide emissions were estimated by environmental modelling. Health impact assessment modelling was used to estimate changes in Disability Adjusted Life Years (DALYs) resulting from changes in exposure to air pollution, road traffic injury risk, and physical activity. We compare the findings of the model with results generated using the World Health Organization's Health Economic Assessment of Transport (HEAT) tools. Results This study found considerable reductions in disease burden under all three scenarios, with the largest health benefits attributed to reductions in ischemic heart disease. The pathways that produced the largest benefits were, in order, physical activity, road traffic injuries, and air pollution. The choice of dose response relationship for physical activity had a large impact on the size of the benefits. Modelling the impact on all-cause mortality rather than through individual diseases suggested larger benefits. Using the best available evidence we found fewer road traffic injuries for all scenarios compared with baseline but alternative assumptions suggested potential increases. Conclusions Methods to estimate the health impacts from transport related physical activity and injury risk are in their infancy; this study has demonstrated an integration of transport and health impact modelling approaches. The findings add to the case for a move from car transport to

Health impact modelling of active travel visions for England and Wales using an Integrated Transport and Health Impact Modelling Tool (ITHIM).

PubMed

Woodcock, James; Givoni, Moshe; Morgan, Andrei Scott

2013-01-01

Achieving health benefits while reducing greenhouse gas emissions from transport offers a potential policy win-win; the magnitude of potential benefits, however, is likely to vary. This study uses an Integrated Transport and Health Impact Modelling tool (ITHIM) to evaluate the health and environmental impacts of high walking and cycling transport scenarios for English and Welsh urban areas outside London. Three scenarios with increased walking and cycling and lower car use were generated based upon the Visions 2030 Walking and Cycling project. Changes to carbon dioxide emissions were estimated by environmental modelling. Health impact assessment modelling was used to estimate changes in Disability Adjusted Life Years (DALYs) resulting from changes in exposure to air pollution, road traffic injury risk, and physical activity. We compare the findings of the model with results generated using the World Health Organization's Health Economic Assessment of Transport (HEAT) tools. This study found considerable reductions in disease burden under all three scenarios, with the largest health benefits attributed to reductions in ischemic heart disease. The pathways that produced the largest benefits were, in order, physical activity, road traffic injuries, and air pollution. The choice of dose response relationship for physical activity had a large impact on the size of the benefits. Modelling the impact on all-cause mortality rather than through individual diseases suggested larger benefits. Using the best available evidence we found fewer road traffic injuries for all scenarios compared with baseline but alternative assumptions suggested potential increases. Methods to estimate the health impacts from transport related physical activity and injury risk are in their infancy; this study has demonstrated an integration of transport and health impact modelling approaches. The findings add to the case for a move from car transport to walking and cycling, and have implications

Opportunities for wind and solar to displace coal and associated health impacts in Texas

NASA Astrophysics Data System (ADS)

Cohan, D. S.; Strasert, B.; Slusarewicz, J.

2017-12-01

Texas uses more coal for power production than any other state, but also leads the nation in wind power while lagging in solar. Many analysts expect that more than half of coal power plants may close within the next decade, unable to compete with cheaper natural gas and renewable electricity. To what extent could displacing coal with wind and solar yield benefits for air quality, health, and climate? Here, we present modeling of the ozone, particulate matter, and associated health impacts of each of 15 coal power plants in Texas, using the CAMx model for air quality and BenMAP for health effects. We show that health impacts from unscrubbed coal plants near urban areas can be an order of magnitude larger than some other facilities. We then analyze the temporal patterns of generation that could be obtained from solar and wind farms in various regions of Texas that could displace these coal plants. We find that winds along the southern Gulf coast of Texas exhibit strikingly different temporal patterns than in west Texas, peaking on summer afternoons rather than winter nights. Thus, wind farms from the two regions along with solar farms could provide complementary sources of power to displace coal. We quantify several metrics to characterize the extent to which wind and solar farms in different regions provide complementary sources of power that can reliably displace traditional sources of electricity.

Long-term Health and Socioeconomic Impacts of Landscape Fire Emissions in Indonesia

NASA Astrophysics Data System (ADS)

Jina, A.; Marlier, M. E.

2013-12-01

negative effect on cognitive ability in adults. The unique data allows us to identify whether it is cumulative exposure, maximum exposure, or exceeding certain thresholds which lead to the largest effects on health. We also test for non-linearity in the response to exposure and for interactions with socioeconomic status. We see worse health outcomes in poorer households, which may contribute the large gradient in health status in Indonesia. Identifying and quantifying these long-term impacts has implications for disaster relief policy in Indonesia, as it demands including populations that may be physically remote from the wildfires themselves. It also changes the cost-benefit analysis of interventions to mitigate the impacts of wildfires. The extra costs associated with these impacts have not been considered in disaster policy, so this research has implications beyond this specific case. It is hoped that the strongly interdisciplinary approach presented herein, of combining physically derived datasets with socioeconomic data, may be applied to identify the effects of many natural hazards in many other settings.

[Health impact assessment of occupational health policy reform at a multinational chemical company in Japan].

PubMed

Fujino, Yoshihisa; Nagata, Tomohisa; Kuroki, Naomi; Dohi, Seitaro; Uehara, Masamichi; Oyama, Ichiro; Kajiki, Shigeyuki; Mori, Koji

2009-09-01

A health impact assessment (HIA) was conducted to identify potential health impacts arising from policy reform of occupational health and safety at S-chemical company, a multinational global company that employs about 13,000 workers. A multidisciplinary team of health professionals including occupational physicians, an epidemiologist, and public health researchers oversaw the HIA. A project manager from S-company was also involved in the whole HIA process. A literature review, profiling using annual health examination data and interviews with stakeholders and key informants were undertaken in order to identify possible impacts. A range of positive and negative health impacts were identified and develop recommendations for implementation of the new occupational health policy were proposed. The HIA added value to the planning process for the occupational health policy reform.

Health and impact assessment: Are we seeing closer integration?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Morgan, Richard K., E-mail: rkm@geography.otago.ac.n

2011-07-15

Health has always had a place in wider impact assessment activities, from the earliest days of the National Environmental Policy Act in the United States. However, early thinking tended to focus on health protection and environmental health issues, especially in relation to the effects of pollution. The adoption of wider models of health was reflected in impact assessment circles from the early 1990s, with particular emphasis on an integrated approach to impact assessment, especially at the project level, which would see health impact assessment benefiting from working with other forms of impact assessment, such as social and ecological. Yet twentymore » years later, integration still seems a distant prospect in many countries. In this paper I examine the case for integrating health considerations within the wider IA process, discuss some of the problems that have historically restricted progress towards this end, and explore the degree to which impact assessment practitioners have been successful in seeking to improve the consideration of health in IA. In New Zealand, project-level impact assessment is based on an integrated model under the Resource Management Act. In addition, HIA was recognised in the early 1990s as a valuable addition to the toolkit for project assessment. Since then policy-level HIA has grown supported by extensive capacity building. If health is being integrated into wider impact assessment, it should be happening in New Zealand where so many enabling conditions are met. Three major project proposals from New Zealand are examined, to characterise the broad trends in HIA development in New Zealand in the last ten years and to assess the degree to which health concerns are being reflected in wider impact assessments. The findings are discussed in the context of the issues outlined in the early part of the paper.« less

Identification of differences in health impact modelling of salt reduction

PubMed Central

Geleijnse, Johanna M.; van Raaij, Joop M. A.; Cappuccio, Francesco P.; Cobiac, Linda C.; Scarborough, Peter; Nusselder, Wilma J.; Jaccard, Abbygail; Boshuizen, Hendriek C.

2017-01-01

We examined whether specific input data and assumptions explain outcome differences in otherwise comparable health impact assessment models. Seven population health models estimating the impact of salt reduction on morbidity and mortality in western populations were compared on four sets of key features, their underlying assumptions and input data. Next, assumptions and input data were varied one by one in a default approach (the DYNAMO-HIA model) to examine how it influences the estimated health impact. Major differences in outcome were related to the size and shape of the dose-response relation between salt and blood pressure and blood pressure and disease. Modifying the effect sizes in the salt to health association resulted in the largest change in health impact estimates (33% lower), whereas other changes had less influence. Differences in health impact assessment model structure and input data may affect the health impact estimate. Therefore, clearly defined assumptions and transparent reporting for different models is crucial. However, the estimated impact of salt reduction was substantial in all of the models used, emphasizing the need for public health actions. PMID:29182636

Quantifying the impact of human activity on temperatures in Germany

NASA Astrophysics Data System (ADS)

Benz, Susanne A.; Bayer, Peter; Blum, Philipp

2017-04-01

Human activity directly influences ambient air, surface and groundwater temperatures. Alterations of surface cover and land use influence the ambient thermal regime causing spatial temperature anomalies, most commonly heat islands. These local temperature anomalies are primarily described within the bounds of large and densely populated urban settlements, where they form so-called urban heat islands (UHI). This study explores the anthropogenic impact not only for selected cities, but for the thermal regime on a countrywide scale, by analyzing mean annual temperature datasets in Germany in three different compartments: measured surface air temperature (SAT), measured groundwater temperature (GWT), and satellite-derived land surface temperature (LST). As a universal parameter to quantify anthropogenic heat anomalies, the anthropogenic heat intensity (AHI) is introduced. It is closely related to the urban heat island intensity, but determined for each pixel (for satellite-derived LST) or measurement point (for SAT and GWT) of a large, even global, dataset individually, regardless of land use and location. Hence, it provides the unique opportunity to a) compare the anthropogenic impact on temperatures in air, surface and subsurface, b) to find main instances of anthropogenic temperature anomalies within the study area, in this case Germany, and c) to study the impact of smaller settlements or industrial sites on temperatures. For all three analyzed temperature datasets, anthropogenic heat intensity grows with increasing nighttime lights and declines with increasing vegetation, whereas population density has only minor effects. While surface anthropogenic heat intensity cannot be linked to specific land cover types in the studied resolution (1 km × 1 km) and classification system, both air and groundwater show increased heat intensities for artificial surfaces. Overall, groundwater temperature appears most vulnerable to human activity; unlike land surface temperature

Integrating a quantitative risk appraisal in a health impact assessment: analysis of the novel smoke-free policy in Hungary.

PubMed

Ádám, Balázs; Molnár, Ágnes; Gulis, Gabriel; Ádány, Róza

2013-04-01

Although the quantification of health outcomes in a health impact assessment (HIA) is scarce in practice, it is preferred by policymakers, as it assists various aspects of the decision-making process. This article provides an example of integrating a quantitative risk appraisal in an HIA performed for the recently adopted Hungarian anti-smoking policy which introduced a smoking ban in closed public places, workplaces and public transport vehicles, and is one of the most effective measures to decrease smoking-related ill health. A comprehensive, prospective HIA was conducted to map the full impact chain of the proposal. Causal pathways were prioritized in a transparent process with special attention given to those pathways for which measures of disease burden could be calculated for the baseline and predicted future scenarios. The proposal was found to decrease the prevalence of active and passive smoking and result in a considerably positive effect on several diseases, among which lung cancer, chronic pulmonary diseases, coronary heart diseases and stroke have the greatest importance. The health gain calculated for the quantifiable health outcomes is close to 1700 deaths postponed and 16,000 life years saved annually in Hungary. The provision of smoke-free public places has an unambiguously positive impact on the health of the public, especially in a country with a high burden of smoking-related diseases. The study described offers a practical example of applying quantification in an HIA, thereby promoting its incorporation into political decision making.

The emergence of translational epidemiology: from scientific discovery to population health impact.

PubMed

Khoury, Muin J; Gwinn, Marta; Ioannidis, John P A

2010-09-01

Recent emphasis on translational research (TR) is highlighting the role of epidemiology in translating scientific discoveries into population health impact. The authors present applications of epidemiology in TR through 4 phases designated T1-T4, illustrated by examples from human genomics. In T1, epidemiology explores the role of a basic scientific discovery (e.g., a disease risk factor or biomarker) in developing a "candidate application" for use in practice (e.g., a test used to guide interventions). In T2, epidemiology can help to evaluate the efficacy of a candidate application by using observational studies and randomized controlled trials. In T3, epidemiology can help to assess facilitators and barriers for uptake and implementation of candidate applications in practice. In T4, epidemiology can help to assess the impact of using candidate applications on population health outcomes. Epidemiology also has a leading role in knowledge synthesis, especially using quantitative methods (e.g., meta-analysis). To explore the emergence of TR in epidemiology, the authors compared articles published in selected issues of the Journal in 1999 and 2009. The proportion of articles identified as translational doubled from 16% (11/69) in 1999 to 33% (22/66) in 2009 (P = 0.02). Epidemiology is increasingly recognized as an important component of TR. By quantifying and integrating knowledge across disciplines, epidemiology provides crucial methods and tools for TR.

The Emergence of Translational Epidemiology: From Scientific Discovery to Population Health Impact

PubMed Central

Khoury, Muin J.; Gwinn, Marta; Ioannidis, John P. A.

2010-01-01

Recent emphasis on translational research (TR) is highlighting the role of epidemiology in translating scientific discoveries into population health impact. The authors present applications of epidemiology in TR through 4 phases designated T1–T4, illustrated by examples from human genomics. In T1, epidemiology explores the role of a basic scientific discovery (e.g., a disease risk factor or biomarker) in developing a “candidate application” for use in practice (e.g., a test used to guide interventions). In T2, epidemiology can help to evaluate the efficacy of a candidate application by using observational studies and randomized controlled trials. In T3, epidemiology can help to assess facilitators and barriers for uptake and implementation of candidate applications in practice. In T4, epidemiology can help to assess the impact of using candidate applications on population health outcomes. Epidemiology also has a leading role in knowledge synthesis, especially using quantitative methods (e.g., meta-analysis). To explore the emergence of TR in epidemiology, the authors compared articles published in selected issues of the Journal in 1999 and 2009. The proportion of articles identified as translational doubled from 16% (11/69) in 1999 to 33% (22/66) in 2009 (P = 0.02). Epidemiology is increasingly recognized as an important component of TR. By quantifying and integrating knowledge across disciplines, epidemiology provides crucial methods and tools for TR. PMID:20688899

Comparison of tobacco control scenarios: quantifying estimates of long-term health impact using the DYNAMO-HIA modeling tool.

PubMed

Kulik, Margarete C; Nusselder, Wilma J; Boshuizen, Hendriek C; Lhachimi, Stefan K; Fernández, Esteve; Baili, Paolo; Bennett, Kathleen; Mackenbach, Johan P; Smit, H A

2012-01-01

There are several types of tobacco control interventions/policies which can change future smoking exposure. The most basic intervention types are 1) smoking cessation interventions 2) preventing smoking initiation and 3) implementation of a nationwide policy affecting quitters and starters simultaneously. The possibility for dynamic quantification of such different interventions is key for comparing the timing and size of their effects. We developed a software tool, DYNAMO-HIA, which allows for a quantitative comparison of the health impact of different policy scenarios. We illustrate the outcomes of the tool for the three typical types of tobacco control interventions if these were applied in the Netherlands. The tool was used to model the effects of different types of smoking interventions on future smoking prevalence and on health outcomes, comparing these three scenarios with the business-as-usual scenario. The necessary data input was obtained from the DYNAMO-HIA database which was assembled as part of this project. All smoking interventions will be effective in the long run. The population-wide strategy will be most effective in both the short and long term. The smoking cessation scenario will be second-most effective in the short run, though in the long run the smoking initiation scenario will become almost as effective. Interventions aimed at preventing the initiation of smoking need a long time horizon to become manifest in terms of health effects. The outcomes strongly depend on the groups targeted by the intervention. We calculated how much more effective the population-wide strategy is, in both the short and long term, compared to quit smoking interventions and measures aimed at preventing the initiation of smoking. By allowing a great variety of user-specified choices, the DYNAMO-HIA tool is a powerful instrument by which the consequences of different tobacco control policies and interventions can be assessed.

Comparison of Tobacco Control Scenarios: Quantifying Estimates of Long-Term Health Impact Using the DYNAMO-HIA Modeling Tool

PubMed Central

Kulik, Margarete C.; Nusselder, Wilma J.; Boshuizen, Hendriek C.; Lhachimi, Stefan K.; Fernández, Esteve; Baili, Paolo; Bennett, Kathleen; Mackenbach, Johan P.; Smit, H. A.

2012-01-01

Background There are several types of tobacco control interventions/policies which can change future smoking exposure. The most basic intervention types are 1) smoking cessation interventions 2) preventing smoking initiation and 3) implementation of a nationwide policy affecting quitters and starters simultaneously. The possibility for dynamic quantification of such different interventions is key for comparing the timing and size of their effects. Methods and Results We developed a software tool, DYNAMO-HIA, which allows for a quantitative comparison of the health impact of different policy scenarios. We illustrate the outcomes of the tool for the three typical types of tobacco control interventions if these were applied in the Netherlands. The tool was used to model the effects of different types of smoking interventions on future smoking prevalence and on health outcomes, comparing these three scenarios with the business-as-usual scenario. The necessary data input was obtained from the DYNAMO-HIA database which was assembled as part of this project. All smoking interventions will be effective in the long run. The population-wide strategy will be most effective in both the short and long term. The smoking cessation scenario will be second-most effective in the short run, though in the long run the smoking initiation scenario will become almost as effective. Interventions aimed at preventing the initiation of smoking need a long time horizon to become manifest in terms of health effects. The outcomes strongly depend on the groups targeted by the intervention. Conclusion We calculated how much more effective the population-wide strategy is, in both the short and long term, compared to quit smoking interventions and measures aimed at preventing the initiation of smoking. By allowing a great variety of user-specified choices, the DYNAMO-HIA tool is a powerful instrument by which the consequences of different tobacco control policies and interventions can be assessed

Public Health Impact of Legal Termination of Pregnancy in the US: 40 Years Later

PubMed Central

Thorp, John M.

2012-01-01

During the 40 years since the US Supreme Court decision in Doe versus Wade and Doe versus Bolton, restrictions on termination of pregnancy (TOP) were overturned nationwide. The use of TOP was much wider than predicted and a substantial fraction of reproductive age women in the U.S. have had one or more TOPs and that widespread uptake makes the downstream impact of any possible harms have broad public health implications. While short-term harms do not appear to be excessive, from a public perspective longer term harm is conceiving, and clearly more study of particular relevance concerns the associations of TOP with subsequent preterm birth and mental health problems. Clearly more research is needed to quantify the magnitude of risk and accurately inform women with the crisis of unintended pregnancy considering TOP. The current US data-gathering mechanisms are inadequate for this important task. PMID:24278765

Health impact assessment for the sustainable futures of Salford

PubMed Central

Douglas, C.; Higgins, A.; Dabbs, C.; Walbank, M.

2004-01-01

Background: The Salford Health Investment for Tomorrow and the Local Improvement Finance Trust proposals for the comprehensive redevelopment of Salford Royal Hospital and the provision of four integrated primary health and social centres in the City of Salford are a response to the challenge of the NHS Plan to modernise delivery and service provision. The scale of the proposed developments will have a major effect on the quality of life in Salford. This health impact assessment was undertaken to determine how these proposals could be amended to ensure that the impacts are optimised so that potential benefits to Salford's communities are realised to maximise their health and wellbeing. Method: This involved a comprehensive prospective health impact assessment and a series of interviews with key stakeholders, community organisations, and local people to identify and prioritise potential positive and negative impacts of the proposals. Results and conclusions: The assessment pointed to a wide range of positive and negative impacts that provided the basis of a set of recommendations, which were linked directly to the themes of the Salford Community Plan. These related to setting employment, education, and training opportunities to maximise health and wellbeing and improve quality of life for all communities in Salford within the framework of the plan. In presenting the findings of the health impact assessment and discussing the recommendations, the paper presents a unique approach in health impact assessment reporting by offering perspectives from the assessor and the project's steering group. PMID:15252065

Health impact assessment for the sustainable futures of Salford.

PubMed

Douglas, Calbert H; Higgins, Alan; Dabbs, Chris; Walbank, Mick

2004-08-01

The Salford Health Investment for Tomorrow and the Local Improvement Finance Trust proposals for the comprehensive redevelopment of Salford Royal Hospital and the provision of four integrated primary health and social centres in the City of Salford are a response to the challenge of the NHS Plan to modernize delivery and service provision. The scale of the proposed developments will have a major effect on the quality of life in Salford. This health impact assessment was undertaken to determine how these proposals could be amended to ensure that the impacts are optimised so that potential benefits to Salford's communities are realised to maximise their health and wellbeing. This involved a comprehensive prospective health impact assessment and a series of interviews with key stakeholders, community organisations, and local people to identify and prioritize potential positive and negative impacts of the proposals. The assessment pointed to a wide range of positive and negative impacts that provided the basis of a set of recommendations, which were linked directly to the themes of the Salford Community Plan. These related to setting employment, education, and training opportunities to maximise health and wellbeing and improve quality of life for all communities in Salford within the framework of the plan. In presenting the findings of the health impact assessment and discussing the recommendations, the paper presents a unique approach in health impact assessment reporting by offering perspectives from the assessor and the project's steering group.

Oral health impact of periodontal diseases in adolescents.

PubMed

López, R; Baelum, V

2007-11-01

The need for treatment of destructive periodontal diseases is based on observations made by oral health professionals, who, prompted by clinical findings, recommend treatment. We hypothesized that clinical signs of periodontal destruction have an impact on the oral-health-related quality of life of adolescents. We conducted a cross-sectional study among 9203 Chilean high school students sampled by a multistage random cluster procedure. We recorded clinical attachment levels and the presence of necrotizing ulcerative gingivitis. The students answered the Spanish version of the Oral Health Impact Profile and provided information on several socio-economic indicators. The results of multivariable logistic regression analyses (adjusted for age, gender, and tooth loss) showed that both attachment loss [OR = 2.0] and necrotizing ulcerative gingivitis [OR = 1.6] were significantly associated with higher impact on the Oral Health Related Quality of Life of adolescents. Individuals in lower socioeconomic positions systematically reported a higher impact on their oral-health-related quality of life.

Health Impacts of the Great Recession: A Critical Review

PubMed Central

Goldman-Mellor, Sidra; Falconi, April; Downing, Janelle

2016-01-01

The severity, sudden onset, and multipronged nature of the Great Recession (2007–2009) provided a unique opportunity to examine the health impacts of macroeconomic downturn. We comprehensively review empirical literature examining the relationship between the Recession and mental and physical health outcomes in developed nations. Overall, studies reported detrimental impacts of the Recession on health, particularly mental health. Macro- and individual-level employment- and housing-related sequelae of the Recession were associated with declining fertility and self-rated health, and increasing morbidity, psychological distress, and suicide, although traffic fatalities and population-level alcohol consumption declined. Health impacts were stronger among men and racial/ethnic minorities. Importantly, strong social safety nets in some European countries appear to have buffered those populations from negative health effects. This literature, however, still faces multiple methodological challenges, and more time may be needed to observe the Recession’s full health impact. We conclude with suggestions for future work in this field. PMID:27239427

Percolation Centrality: Quantifying Graph-Theoretic Impact of Nodes during Percolation in Networks

PubMed Central

Piraveenan, Mahendra; Prokopenko, Mikhail; Hossain, Liaquat

2013-01-01

A number of centrality measures are available to determine the relative importance of a node in a complex network, and betweenness is prominent among them. However, the existing centrality measures are not adequate in network percolation scenarios (such as during infection transmission in a social network of individuals, spreading of computer viruses on computer networks, or transmission of disease over a network of towns) because they do not account for the changing percolation states of individual nodes. We propose a new measure, percolation centrality, that quantifies relative impact of nodes based on their topological connectivity, as well as their percolation states. The measure can be extended to include random walk based definitions, and its computational complexity is shown to be of the same order as that of betweenness centrality. We demonstrate the usage of percolation centrality by applying it to a canonical network as well as simulated and real world scale-free and random networks. PMID:23349699

Quantifying capital goods for biological treatment of organic waste.

PubMed

Brogaard, Line K; Petersen, Per H; Nielsen, Peter D; Christensen, Thomas H

2015-02-01

Materials and energy used for construction of anaerobic digestion (AD) and windrow composting plants were quantified in detail. The two technologies were quantified in collaboration with consultants and producers of the parts used to construct the plants. The composting plants were quantified based on the different sizes for the three different types of waste (garden and park waste, food waste and sludge from wastewater treatment) in amounts of 10,000 or 50,000 tonnes per year. The AD plant was quantified for a capacity of 80,000 tonnes per year. Concrete and steel for the tanks were the main materials for the AD plant. For the composting plants, gravel and concrete slabs for the pavement were used in large amounts. To frame the quantification, environmental impact assessments (EIAs) showed that the steel used for tanks at the AD plant and the concrete slabs at the composting plants made the highest contribution to Global Warming. The total impact on Global Warming from the capital goods compared to the operation reported in the literature on the AD plant showed an insignificant contribution of 1-2%. For the composting plants, the capital goods accounted for 10-22% of the total impact on Global Warming from composting. © The Author(s) 2015.

The impact of a patient support program for multiple sclerosis on patient satisfaction and subjective health status.

PubMed

Kohlmann, Thomas; Wang, Cheng; Lipinski, Jens; Hadker, Nandini; Caffrey, Elizabeth; Epstein, Michael; Sadasivan, Ravi; Gondek, Kathleen

2013-06-01

Leading multiple sclerosis (MS) therapies have patient support programs (PSPs) aimed at improving patients' lives. There is limited knowledge about what drives patient satisfaction with PSPs and little evidence about its impact on patient-reported health status or health-related quality of life. The aims of this study were to evaluate patient needs and the PSP's role in meeting those needs; understand the drivers of PSP satisfaction and loyalty; and assess whether a MS PSP provides quantifiable, incremental benefit to patients, as measured by patient-reported health status, health state utility, and/or health-related quality of life. An Internet survey was conducted among 1,123 adult German MS patients currently enrolled in Bayer's German BETAPLUS PSP. Health status, health state utility, and health-related quality of life were measured using the EQ-5D Visual Analog Scale, the EQ-5D Index, and Short Form-12 Health Survey, respectively. MS patient needs vary by disease severity, duration of disease, and gender. Patients with greater self-reported needs and lower health status, health state utility, and health-related quality of life value and use the PSP more than other patients. Drivers of PSP satisfaction include use of patient hotline, nurse telephone calls, and mail education. Patients estimate that their health status would be 15 points lower if the PSP ceased to exist (translating to 0.15 on the time trade-off utility scale). This impact is significant, as it is nearly two times the minimally important difference. MS patients place inherent value on PSPs. From a patient's viewpoint, PSPs provide real incremental benefit in patient-reported health status at all stages of MS.

An assessment of health research impact in Iran.

PubMed

Yazdizadeh, Bahareh; Majdzadeh, Reza; Janani, Leila; Mohtasham, Farideh; Nikooee, Sima; Mousavi, Abdmohammad; Najafi, Farid; Atabakzadeh, Maryam; Bazrafshan, Azam; Zare, Morteza; Karami, Manoochehr

2016-07-26

In recent years, Iran has made significant developments in the field of health sciences. However, the question is whether this considerable increase has affected public health. The research budget has always been negligible and unsustainable in developing countries. Hence, using the Payback Framework, we conducted this study to evaluate the impact of health research in Iran. By using a cross-sectional method and two-stage stratified cluster sampling, the projects were randomly selected from six medical universities. A questionnaire was designed according to the Payback Framework and completed by the principle investigators of the randomly selected projects. The response rate was 70.4%. Ten point twenty-four percent (10.24%) of the studies had been ordered by a knowledge user organization. The average number of articles published in journals per project was 0.96, and half of the studies had no articles published in Scopus. The results of 12% of the studies had been used in systematic review articles and the same proportion had been utilized in clinical or public health guidelines. The results of 5.3% of the studies had been implemented in the Health Ministry's policymaking. 62% of the studies were expected to affect health directly, 38% of them had been implemented, and among the latter 60% had achieved the expected results. Concerning the economic impacts, the most common expected impact was the reduction of 'days of work missed because of illness or disability' and impact on personal and health system costs. About 36% of these studies had been implemented, and 61% had achieved the expected impact. In most aspects, the status of research impact needs improvement. A comparison of Iran's ranking of knowledge creation and knowledge impact in the Global Innovation Index confirms these findings. The most important problems identified were, not conducting research based on national needs, and the lack of implementation of research results.

Promoting social responsibility for health: health impact assessment and healthy public policy at the community level.

PubMed

Mittelmark, M B

2001-09-01

The 1997 Jakarta Declaration on Health Promotion into the 21st Century called for new responses to address the emerging threats to health. The declaration placed a high priority on promoting social responsibility for health, and it identified equity-focused health impact assessment as a high priority for action. This theme was among the foci at the 2000 Fifth Global Conference on Health Promotion held in Mexico. This paper, which is an abbreviation of a technical report prepared for the Mexico conference, advances arguments for focusing on health impact assessment at the local level. Health impact assessment identifies negative health impacts that call for policy responses, and identifies and encourages practices and policies that promote health. Health impact assessment may be highly technical and require sophisticated technology and expertise. But it can also be a simple, highly practical process, accessible to ordinary people, and one that helps a community come to grips with local circumstances that need changing for better health. To illustrate the possibilities, this paper presents a case study, the People Assessing Their Health (PATH) project from Eastern Nova Scotia, Canada. It places ordinary citizens, rather than community elites, at the very heart of local decision-making. Evidence from PATH demonstrates that low technology health impact assessment, done by and for local people, can shift thinking beyond the illness problems of individuals. It can bring into consideration, instead, how programmes and policies support or weaken community health, and illuminate a community's capacity to improve local circumstances for better health. This stands in contrast to evidence that highly technological approaches to community-level health impact assessment can be self-defeating. Further development of simple, people-centred, low technology approaches to health impact assessment at the local level is called for.

The Emergence of Personalized Health Technology.

PubMed

Allen, Luke Nelson; Christie, Gillian Pepall

2016-05-10

Personalized health technology is a noisy new entrant to the health space, yet to make a significant impact on population health but seemingly teeming with potential. Devices including wearable fitness trackers and healthy-living apps are designed to help users quantify and improve their health behaviors. Although the ethical issues surrounding data privacy have received much attention, little is being said about the impact on socioeconomic health inequalities. Populations who stand to benefit the most from these technologies are unable to afford, access, or use them. This paper outlines the negative impact that these technologies will have on inequalities unless their user base can be radically extended to include vulnerable populations. Frugal innovation and public-private partnership are discussed as the major means for reaching this end.

The Impact of College Student Financial Health on Other Dimensions of Health.

PubMed

Bemel, James E; Brower, Christopher; Chischillie, Alyssa; Shepherd, Jessica

2016-03-01

Researchers examined college students' financial health and other health indicators to determine whether the integration of financial health into undergraduate health courses is justified and justify financial health as the newest dimension of health within the field of health promotion. The study utilized a cross-sectional design. The study was conducted at a large public university located in the western region of the United States. Participants completed the survey from any computer with Internet access. A sample of 3000 undergraduate students was selected. A total of 686 surveys were completed (22.9% response rate). Data were collected from college students ages 18 to 30 during the first 2 weeks of June 2013. Participants completed an online survey regarding their financial health and other dimensions of health. SPSS version 19.0 was used to examine the relationships between financial health and individual health variables using χ(2), independent t-test, analysis of variance, Pearson R, point-biserial correlation, and nonparametric analyses. Every dimension of health was impacted significantly by lower levels of financial health. Participants' emotional health was impacted far more than any other dimension, with significant impacts on concentration (p = .005), usefulness (p = .006), decision making (p = .014), and happiness (p < .001) by the mere presence of a budget. Findings indicate an apparent relationship between financial health and other health indicators and support the need for financial education by parents and middle/high schools and the incorporation of financial health into undergraduate health courses. © The Author(s) 2016.

The impact of communicating information about air pollution events on public health.

PubMed

McLaren, J; Williams, I D

2015-12-15

Short-term exposure to air pollution has been associated with exacerbation of asthma and chronic obstructive pulmonary disease (COPD). This study investigated the relationship between emergency hospital admissions for asthma, COPD and episodes of poor air quality in an English city (Southampton) from 2008-2013. The city's council provides a forecasting service for poor air quality to individuals with respiratory disease to reduce preventable admissions to hospital and this has been evaluated. Trends in nitrogen dioxide, ozone and particulate matter concentrations were related to hospital admissions data using regression analysis. The impacts of air quality on emergency admissions were quantified using the relative risks associated with each pollutant. Seasonal and weekly trends were apparent for both air pollution and hospital admissions, although there was a weak relationship between the two. The air quality forecasting service proved ineffective at reducing hospital admissions. Improvements to the health forecasting service are necessary to protect the health of susceptible individuals, as there is likely to be an increasing need for such services in the future. Copyright © 2015 Elsevier B.V. All rights reserved.

The impact of mHealth interventions on health systems: a systematic review protocol.

PubMed

Fortuin, Jill; Salie, Faatiema; Abdullahi, Leila H; Douglas, Tania S

2016-11-25

Mobile health (mHealth) has been described as a health enabling tool that impacts positively on the health system in terms of improved access, quality and cost of health care. The proposed systematic review will examine the impact of mHealth on health systems by assessing access, quality and cost of health care as indicators. The systematic review will include literature from various sources including published and unpublished/grey literature. The databases to be searched include: PubMed, Cochrane Library, Google Scholar, NHS Health Technology Assessment Database and Web of Science. The reference lists of studies will be screened and conference proceedings searched for additional eligible reports. Literature to be included will have mHealth as the primary intervention. Two authors will independently screen the search output, select studies and extract data; discrepancies will be resolved by consensus and discussion with the assistance of the third author. The systematic review will inform policy makers, investors, health professionals, technologists and engineers about the impact of mHealth in strengthening the health system. In particular, it will focus on three metrics to determine whether mHealth strengthens the health system, namely quality of, access to and cost of health care services. Systematic review registration: PROSPERO CRD42015026070.

Gross national happiness as a framework for health impact assessment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pennock, Michael, E-mail: michael.pennock@viha.c; Ura, Karma

The incorporation of population health concepts and health determinants into Health Impact Assessments has created a number of challenges. The need for intersectoral collaboration has increased; the meaning of 'health' has become less clear; and the distinctions between health impacts, environmental impacts, social impacts and economic impacts have become increasingly blurred. The Bhutanese concept of Gross National Happiness may address these issues by providing an over-arching evidence-based framework which incorporates health, social, environmental and economic contributors as well as a number of other key contributors to wellbeing such as culture and governance. It has the potential to foster intersectoral collaborationmore » by incorporating a more limited definition of health which places the health sector as one of a number of contributors to wellbeing. It also allows for the examination of the opportunity costs of health investments on wellbeing, is consistent with whole-of-government approaches to public policy and emerging models of social progress.« less

Health impact assessment of traffic-related air pollution at the urban project scale: influence of variability and uncertainty.

PubMed

Chart-Asa, Chidsanuphong; Gibson, Jacqueline MacDonald

2015-02-15

This paper develops and then demonstrates a new approach for quantifying health impacts of traffic-related particulate matter air pollution at the urban project scale that includes variability and uncertainty in the analysis. We focus on primary particulate matter having a diameter less than 2.5 μm (PM2.5). The new approach accounts for variability in vehicle emissions due to temperature, road grade, and traffic behavior variability; seasonal variability in concentration-response coefficients; demographic variability at a fine spatial scale; uncertainty in air quality model accuracy; and uncertainty in concentration-response coefficients. We demonstrate the approach for a case study roadway corridor with a population of 16,000, where a new extension of the University of North Carolina (UNC) at Chapel Hill campus is slated for construction. The results indicate that at this case study site, health impact estimates increased by factors of 4-9, depending on the health impact considered, compared to using a conventional health impact assessment approach that overlooks these variability and uncertainty sources. In addition, we demonstrate how the method can be used to assess health disparities. For example, in the case study corridor, our method demonstrates the existence of statistically significant racial disparities in exposure to traffic-related PM2.5 under present-day traffic conditions: the correlation between percent black and annual attributable deaths in each census block is 0.37 (t(114)=4.2, p<0.0001). Overall, our results show that the proposed new campus will cause only a small incremental increase in health risks (annual risk 6×10(-10); lifetime risk 4×10(-8)), compared to if the campus is not built. Nonetheless, the approach we illustrate could be useful for improving the quality of information to support decision-making for other urban development projects. Copyright © 2014 Elsevier B.V. All rights reserved.

Using Health Impact Assessment as an Interdisciplinary Teaching Tool.

PubMed

Chinchilla, Melissa; Arcaya, Mariana C

2017-07-08

Health Impact Assessment (HIA) courses are teaching public health and urban planning students how to assess the likely health effects of proposed policies, plans, and projects. We suggest that public health and urban planning have complimentary frameworks for training practitioners to address the living conditions that affect health. Planning perspectives emphasize practical skills for impacting community change, while public health stresses professional purpose and ethics. Frameworks from both disciplines can enhance the HIA learning experience by helping students tackle questions related to community impact, engagement, social justice, and ethics. We also propose that HIA community engagement processes can be enriched through an empathetic practice that focuses on greater personal introspection.

Untapped potential of health impact assessment.

PubMed

Winkler, Mirko S; Krieger, Gary R; Divall, Mark J; Cissé, Guéladio; Wielga, Mark; Singer, Burton H; Tanner, Marcel; Utzinger, Jürg

2013-04-01

The World Health Organization has promoted health impact assessment (HIA) for over 20 years. At the 2012 United Nations Conference on Sustainable Development (Rio+20), HIA was discussed as a critical method for linking health to "green economy" and "institutional framework" strategies for sustainable development. In countries having a high human development index (HDI), HIA has been added to the overall assessment suite that typically includes potential environmental and social impacts, but it is rarely required as part of the environmental and social impact assessment for large development projects. When they are performed, project-driven HIAs are governed by a combination of project proponent and multilateral lender performance standards rather than host country requirements. Not surprisingly, in low-HDI countries HIA is missing from the programme and policy arena in the absence of an external project driver. Major drivers of global change (e.g. population growth and urbanization, growing pressure on natural resources and climate change) inordinately affect low- and medium-HDI countries; however, in such countries HIA is conspicuously absent. If the cloak of HIA invisibility is to be removed, it must be shown that HIA is useful and beneficial and, hence, an essential component of the 21st century's sustainable development agenda. We analyse where and how HIA can become fully integrated into the impact assessment suite and argue that the impact of HIA must not remain obscure.

Quantifying Ballistic Armor Performance: A Minimally Invasive Approach

NASA Astrophysics Data System (ADS)

Holmes, Gale; Kim, Jaehyun; Blair, William; McDonough, Walter; Snyder, Chad

2006-03-01

Theoretical and non-dimensional analyses suggest a critical link between the performance of ballistic resistant armor and the fundamental mechanical properties of the polymeric materials that comprise them. Therefore, a test methodology that quantifies these properties without compromising an armored vest that is exposed to the industry standard V-50 ballistic performance test is needed. Currently, there is considerable speculation about the impact that competing degradation mechanisms (e.g., mechanical, humidity, ultraviolet) may have on ballistic resistant armor. We report on the use of a new test methodology that quantifies the mechanical properties of ballistic fibers and how each proposed degradation mechanism may impact a vest's ballistic performance.

Quantifying and Valuing Potential Climate Change Impacts on Coral Reefs in the United States

NASA Astrophysics Data System (ADS)

Wobus, C. W.; Lane, D.; Buddemeier, R. W.; Ready, R. C.; Shouse, K. C.; Martinich, J.

2012-12-01

Global climate change presents a two-pronged threat to coral reef ecosystems: increasing sea surface temperatures will increase the likelihood of episodic bleaching events, while increasing ocean carbon dioxide concentrations will change the carbonate chemistry that drives coral growth. Because coral reefs have important societal as well as ecological benefits, climate change mitigation policies that ameliorate these impacts may create substantial economic value. We present a model that evaluates both the ecological and the economic impacts of climate change on coral reefs in the United States. We use a coral reef mortality and bleaching model to project future coral reef declines under a range of climate change policy scenarios for south Florida, Puerto Rico and Hawaii. Using a benefits transfer approach, the outputs from the physical model are then used to quantify the economic impacts of these coral reef declines for each of these regions. We find that differing climate change trajectories create substantial changes in projected coral cover and value for Hawaii, but that the ecological and economic benefits of more stringent emissions scenarios are less clear for Florida and Puerto Rico. Overall, our results indicate that the effectiveness of climate change mitigation policies may be region-specific, but that these policies could result in a net increase of nearly $10 billion in economic value from coral reef-related recreational activities alone, over the 21st century.

Quantifying the negative impact of brain drain on the integration of European science

PubMed Central

Doria Arrieta, Omar A.; Pammolli, Fabio; Petersen, Alexander M.

2017-01-01

The 2004/2007 European Union (EU) enlargement by 12 member states offers a unique opportunity to quantify the impact of EU efforts to expand and integrate the scientific competitiveness of the European Research Area (ERA). We apply two causal estimation schemes to cross-border collaboration data extracted from millions of academic publications from 1996 to 2012, which are disaggregated across 14 subject areas and 32 European countries. Our results illustrate the unintended consequences following the 2004/2007 enlargement, namely, its negative impact on cross-border collaboration in science. First, we use the synthetic control method to show that levels of European cross-border collaboration would have been higher without EU enlargement, despite the 2004/2007 EU entrants gaining access to EU resources incentivizing cross-border integration. Second, we implement a difference-in-difference panel regression, incorporating official intra-European high-skilled mobility statistics, to identify migration imbalance—principally from entrant to incumbent EU member states—as a major factor underlying the divergence in cross-border integration between Western and Eastern Europe. These results challenge central tenets underlying ERA integration policies that unifying labor markets will increase the international competitiveness of the ERA, thereby calling attention to the need for effective home-return incentives and policies. PMID:28439544

Quantifying the negative impact of brain drain on the integration of European science.

PubMed

Doria Arrieta, Omar A; Pammolli, Fabio; Petersen, Alexander M

2017-04-01

The 2004/2007 European Union (EU) enlargement by 12 member states offers a unique opportunity to quantify the impact of EU efforts to expand and integrate the scientific competitiveness of the European Research Area (ERA). We apply two causal estimation schemes to cross-border collaboration data extracted from millions of academic publications from 1996 to 2012, which are disaggregated across 14 subject areas and 32 European countries. Our results illustrate the unintended consequences following the 2004/2007 enlargement, namely, its negative impact on cross-border collaboration in science. First, we use the synthetic control method to show that levels of European cross-border collaboration would have been higher without EU enlargement, despite the 2004/2007 EU entrants gaining access to EU resources incentivizing cross-border integration. Second, we implement a difference-in-difference panel regression, incorporating official intra-European high-skilled mobility statistics, to identify migration imbalance-principally from entrant to incumbent EU member states-as a major factor underlying the divergence in cross-border integration between Western and Eastern Europe. These results challenge central tenets underlying ERA integration policies that unifying labor markets will increase the international competitiveness of the ERA, thereby calling attention to the need for effective home-return incentives and policies.

Perceived Impacts of Health Care Reform on Large Urban Health Departments

PubMed Central

Leider, Jonathon P.; Castrucci, Brian C.; Russo, Pamela; Hearne, Shelley

2015-01-01

Context: The Patient Protection and Affordable Care Act (ACA) is changing the landscape of health systems across the United States, as well as the functioning of governmental public health departments. As a result, local health departments are reevaluating their roles, objectives, and the services they provide. Objective: We gathered perspectives on the current and future impact of the ACA on governmental public health departments from leaders of local health departments in the Big Cities Health Coalition, which represents some of the largest local health departments in the country. Design: We conducted interviews with 45 public health officials in 16 participating Big Cities Health Coalition departments. We analyzed data reflecting participants' perspectives on potential changes in programs and services, as well as on challenges and opportunities created by the ACA. Results: Respondents uniformly indicated that they expected ACA to have a positive impact on population health. Most participants expected to conduct more population-oriented activities because of the ACA, but there was no consensus about how the ACA would impact the clinical services that their departments could offer. Local health department leaders suggested that the ACA might create a broad range of opportunities that would support public health as a whole, including expanded insurance coverage for the community, greater opportunity to collaborate with Accountable Care Organizations, increased focus on core public health issues, and increased integration with health care and social services. Conclusions: Leaders of some of the largest health departments in the United States uniformly acknowledged that realignments in funding prompted by the ACA are changing the roles that their offices can play in controlling infectious diseases, providing robust maternal and child health services, and more generally providing a social safety net for health care services in their communities. Health departments

Using a relative health indicator (RHI) metric to estimate health risk reductions in drinking water.

PubMed

Alfredo, Katherine A; Seidel, Chad; Ghosh, Amlan; Roberson, J Alan

2017-03-01

When a new drinking water regulation is being developed, the USEPA conducts a health risk reduction and cost analysis to, in part, estimate quantifiable and non-quantifiable cost and benefits of the various regulatory alternatives. Numerous methodologies are available for cumulative risk assessment ranging from primarily qualitative to primarily quantitative. This research developed a summary metric of relative cumulative health impacts resulting from drinking water, the relative health indicator (RHI). An intermediate level of quantification and modeling was chosen, one which retains the concept of an aggregated metric of public health impact and hence allows for comparisons to be made across "cups of water," but avoids the need for development and use of complex models that are beyond the existing state of the science. Using the USEPA Six-Year Review data and available national occurrence surveys of drinking water contaminants, the metric is used to test risk reduction as it pertains to the implementation of the arsenic and uranium maximum contaminant levels and quantify "meaningful" risk reduction. Uranium represented the threshold risk reduction against which national non-compliance risk reduction was compared for arsenic, nitrate, and radium. Arsenic non-compliance is most significant and efforts focused on bringing those non-compliant utilities into compliance with the 10 μg/L maximum contaminant level would meet the threshold for meaningful risk reduction.

Human health and wellbeing in environmental impact assessment in New South Wales, Australia: Auditing health impacts within environmental assessments of major projects

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harris, Patrick J., E-mail: patrick.harris@unsw.edu.a; Harris, Elizabeth, E-mail: e.harris@unsw.edu.a; Thompson, Susan, E-mail: s.thompson@unsw.edu.a

Internationally the inclusion of health within environmental impact assessment (EIA) has been shown to be limited. While Australian EIA documentation has not been studied empirically to date, deficiencies in practice have been documented. This research developed an audit tool to undertake a qualitative descriptive analysis of 22 Major Project EAs in New South Wales, Australia. Results showed that health and wellbeing impacts were not considered explicitly. They were, however, included indirectly in the identification of traditional public health exposures associated with the physical environment and to a lesser extent the inclusion of social and economic impacts. However, no health datamore » was used to inform any of the assessments, there was no reference to causal pathways between exposures or determinants and physical or mental health effects, and there was no inclusion of the differential distribution of exposures or health impacts on different populations. The results add conceptually and practically to the long standing integration debate, showing that health is in a position to add value to the EIA process as an explicit part of standard environmental, social and economic considerations. However, to overcome the consistently documented barriers to integrating health in EIA, capacity must be developed amongst EIA professionals, led by the health sector, to progress health related knowledge and tools.« less

Global health impacts of policies: lessons from the UK

PubMed Central

2014-01-01

Background The UK government committed to undertaking impact assessments of its policies on the health of populations in low and middle-income countries in its cross-government strategy “Health is Global”. To facilitate this process, the Department of Health, in collaboration with the National Heart Forum, initiated a project to pilot the use of a global health impact assessment guidance framework and toolkit for policy-makers. This paper aims to stimulate debate about the desirability and feasibility of global health impact assessments by describing and drawing lessons from the first stage of the project. Discussion Despite the attraction of being able to assess and address potential global health impacts of policies, there is a dearth of existing information and experience. A literature review was followed by discussions with policy-makers and an online survey about potential barriers, preferred support mechanisms and potential policies on which to pilot the toolkit. Although policy-makers were willing to engage in hypothetical discussions about the methodology, difficulties in identifying potential pilots suggest a wider problem in encouraging take up without legislative imperatives. This is reinforced by the findings of the survey that barriers to uptake included lack of time, resources and expertise. We identified three lessons for future efforts to mainstream global health impact assessments: 1) Identify a lead government department and champion – to some extent, this role was fulfilled by the Department of Health, however, it lacked a high-level cross-government mechanism to support implementation. 2) Ensure adequate resources and consider embedding the goals and principles of global health impact assessments into existing processes to maximise those resources. 3) Develop an effective delivery mechanism involving both state actors, and non-state actors who can ensure a “voice” for constituencies who are affected by government policies and also

Global health impacts of policies: lessons from the UK.

PubMed

Mwatsama, Modi K; Wong, Sidney; Ettehad, Dena; Watt, Nicola F

2014-03-10

The UK government committed to undertaking impact assessments of its policies on the health of populations in low and middle-income countries in its cross-government strategy "Health is Global". To facilitate this process, the Department of Health, in collaboration with the National Heart Forum, initiated a project to pilot the use of a global health impact assessment guidance framework and toolkit for policy-makers. This paper aims to stimulate debate about the desirability and feasibility of global health impact assessments by describing and drawing lessons from the first stage of the project. Despite the attraction of being able to assess and address potential global health impacts of policies, there is a dearth of existing information and experience. A literature review was followed by discussions with policy-makers and an online survey about potential barriers, preferred support mechanisms and potential policies on which to pilot the toolkit. Although policy-makers were willing to engage in hypothetical discussions about the methodology, difficulties in identifying potential pilots suggest a wider problem in encouraging take up without legislative imperatives. This is reinforced by the findings of the survey that barriers to uptake included lack of time, resources and expertise. We identified three lessons for future efforts to mainstream global health impact assessments: 1) Identify a lead government department and champion--to some extent, this role was fulfilled by the Department of Health, however, it lacked a high-level cross-government mechanism to support implementation. 2) Ensure adequate resources and consider embedding the goals and principles of global health impact assessments into existing processes to maximise those resources. 3) Develop an effective delivery mechanism involving both state actors, and non-state actors who can ensure a "voice" for constituencies who are affected by government policies and also provide the "demand" for the

The impact of financial circumstances on student health.

PubMed

Jessop, Donna C; Herberts, Carolina; Solomon, Lucy

2005-09-01

To explore the impact of students' financial circumstances on their mental and physical health. The study employed a correlational design. An opportunity sample of 89 British students and 98 Finnish students completed a questionnaire which assessed their amount of debt, financial concerns, mental and physical health, smoking and drinking behaviours, work in addition to study, and perceptions of control. British students reported greater levels of debt and financial concern than Finnish students. They also reported significantly worse mental and physical health on a variety of dimensions. Financial concern was a significant linear predictor of mental and physical health, with increased financial concern being consistently associated with worse health. There was no evidence that students' smoking or drinking behaviour, work in addition to study, or perceptions of control substantially mediated the relationship between financial concern and health. The results support the position that students' financial circumstances might have serious implications for their health. It is proposed, therefore, that recent changes in government funding policies for students could have a negative impact on student health and exacerbate finance-related health inequalities. Further research is required to identify factors that may mediate or moderate the impact of financial concern on health.

Menu Labeling as a Potential Strategy for Combating the Obesity Epidemic: A Health Impact Assessment

PubMed Central

Jarosz, Christopher J.; Simon, Paul; Fielding, Jonathan E.

2009-01-01

Objectives. We conducted a health impact assessment to quantify the potential impact of a state menu-labeling law on population weight gain in Los Angeles County, California. Methods. We utilized published and unpublished data to model consumer response to point-of-purchase calorie postings at large chain restaurants in Los Angeles County. We conducted sensitivity analyses to account for uncertainty in consumer response and in the total annual revenue, market share, and average meal price of large chain restaurants in the county. Results. Assuming that 10% of the restaurant patrons would order reduced-calorie meals in response to calorie postings, resulting in an average reduction of 100 calories per meal, we estimated that menu labeling would avert 40.6% of the 6.75 million pound average annual weight gain in the county population aged 5 years and older. Substantially larger impacts would be realized if higher percentages of patrons ordered reduced-calorie meals or if average per-meal calorie reductions increased. Conclusions. Our findings suggest that mandated menu labeling could have a sizable salutary impact on the obesity epidemic, even with only modest changes in consumer behavior. PMID:19608944

Costs of health IT: beginning to understand the financial impact of a dental school EHR.

PubMed

Spallek, Heiko; Johnson, Lynn; Kerr, Joseph; Rankin, David

2014-11-01

Health Information Technology (Health IT) constitutes an integral component of the operations of most academic dental institutions nowadays. However, the expenses associated with the acquisition and the ongoing maintenance of these complex systems have often been buried among costs for other electronic infrastructure systems, distributed across various cost centers including unmeasured central campus support, covered centrally and therefore difficult to quantify, and spread over years, denying school administrators a clear understanding of the resources that have been dedicated to Health IT. The aim of this study was to understand the financial impact of Health IT at four similar U.S. dental schools: two schools using a purchased Electronic Health Record (EHR), and two schools that developed their own EHR. For these schools, the costs of creating ($2.5 million) and sustaining ($174,000) custom EHR software were significantly higher than acquiring ($500,000) and sustaining ($121,000) purchased software. These results are based on historical data and should not be regarded as a gold standard for what a complete Health IT suite should cost. The presented data are intended to inform school administrators about the myriad of costs associated with Health IT and give them a point of reference when comparing costs or making estimates for implementation projects.

[Health policy in the European Union: impact on the Spanish health system].

PubMed

Guimarães, Luisa; Freire, José-Manuel

2007-01-01

This text reviews the impact of European integration on the health sector (public health and health services) by studying European Union (EU) institutions, functioning, and responsibilities through the literature, documents, and authors' observations. The EU does not have direct health responsibilities, but Community legislation has important repercussions on all member states' health policies. This influence affects health protection issues, consumer safety, regulation of medicines and medical devices, mutual recognition of professional qualifications, freedom of movement for health professionals and patients, public contracts and bidding, research, etc. The evolution of EU health policy shows a progressive reinforcement of responsibilities consistent with the objective of reaching a high level of health protection, which in turn affects other European policies. The impact of European integration on the Spanish health system is analyzed as a case study, and key aspects and present and future challenges are highlighted. Lessons are also drawn for regional integration processes to foster equity and efficiency in health.

Understanding the public's health problems: applications of symbolic interaction to public health.

PubMed

Maycock, Bruce

2015-01-01

Public health has typically investigated health issues using methods from the positivistic paradigm. Yet these approaches, although they are able to quantify the problem, may not be able to explain the social reasons of why the problem exists or the impact on those affected. This article will provide a brief overview of a sociological theory that provides methods and a theoretical framework that has proven useful in understanding public health problems and developing interventions. © 2014 APJPH.

Climate change impacts: The challenge of quantifying multi-factor causation, multi-component responses, and leveraging from extremes

NASA Astrophysics Data System (ADS)

Field, C. B.

2012-12-01

Modeling climate change impacts is challenging for a variety of reasons. Some of these are related to causation. A weather or climate event is rarely the sole cause of an impact, and, for many impacts, social, economic, cultural, or ecological factors may play a larger role than climate. Other challenges are related to outcomes. Consequences of an event are often most severe when several kinds of responses interact, typically in unexpected ways. Many kinds of consequences are difficult to quantify, especially when they include a mix of market, cultural, personal, and ecological values. In addition, scale can be tremendously important. Modest impacts over large areas present very different challenges than severe but very local impacts. Finally, impacts may respond non-linearly to forcing, with behavior that changes qualitatively at one or more thresholds and with unexpected outcomes in extremes. Modeling these potentially complex interactions between drivers and impacts presents one set of challenges. Evaluating the models presents another. At least five kinds of approaches can contribute to the evaluation of impact models designed to provide insights in multi-driver, multi-responder, multi-scale, and extreme-driven contexts, even though none of these approaches is a complete or "silver-bullet" solution. The starting point for much of the evaluation in this space is case studies. Case studies can help illustrate links between processes and scales. They can highlight factors that amplify or suppress sensitivity to climate drivers, and they can suggest the consequences of intervening at different points. While case studies rarely provide concrete evidence about mechanisms, they can help move a mechanistic case from circumstantial to sound. Novel approaches to data collection, including crowd sourcing, can potentially provide tools and the number of relevant examples to develop case studies as statistically robust data sources. A critical condition for progress in this

The Impact of Future Emissions Changes on Air Pollution Concentrations and Related Human Health Effects

NASA Astrophysics Data System (ADS)

Mikolajczyk, U.; Suppan, P.; Williams, M.

2015-12-01

Quantification of potential health benefits of reductions in air pollution on the local scale is becoming increasingly important. The aim of this study is to conduct health impact assessment (HIA) by utilizing regionally and spatially specific data in order to assess the influence of future emission scenarios on human health. In the first stage of this investigation, a modeling study was carried out using the Weather Research and Forecasting (WRF) model coupled with Chemistry to estimate ambient concentrations of air pollutants for the baseline year 2009, and for the future emission scenarios in southern Germany. Anthropogenic emissions for the baseline year 2009 are derived from the emission inventory provided by the Netherlands Organization of Applied Scientific Research (TNO) (Denier van der Gon et al., 2010). For Germany, the TNO emissions were replaced by gridded emission data with a high spatial resolution of 1/64 x 1/64 degrees. Future air quality simulations are carried out under different emission scenarios, which reflect possible energy and climate measures in year 2030. The model set-up included a nesting approach, where three domains with horizontal resolution of 18 km, 6 km and 2 km were defined. The simulation results for the baseline year 2009 are used to quantify present-day health burdens. Concentration-response functions (CRFs) for PM2.5 and NO2 from the WHO Health risks of air Pollution in Europe (HRAPIE) project were applied to population-weighted mean concentrations to estimate relative risks and hence to determine numbers of attributable deaths and associated life-years lost. In the next step, future health impacts of projected concentrations were calculated taking into account different emissions scenarios. The health benefits that we assume with air pollution reductions can be used to provide options for future policy decisions to protect public health.

Quantifying the Impact of Accessibility on Preventive Healthcare in Sub-Saharan Africa Using Mobile Phone Data

PubMed Central

Wesolowski, Amy; O’Meara, Wendy Prudhomme; Tatem, Andrew J.; Ndege, Samson; Eagle, Nathan

2015-01-01

Background: Poor physical access to health facilities has been identified as an important contributor to reduced uptake of preventive health services and is likely to be most critical in low-income settings. However, the relation among physical access, travel behavior, and the uptake of healthcare is difficult to quantify. Methods: Using anonymized mobile phone data from 2008 to 2009, we analyze individual and spatially aggregated travel patterns of 14,816,521 subscribers across Kenya and compare these measures to (1) estimated travel times to health facilities and (2) data on the uptake of 2 preventive healthcare interventions in an area of western Kenya: childhood immunizations and antenatal care. Results: We document that long travel times to health facilities are strongly correlated with increased mobility in geographically isolated areas. Furthermore, we found that in areas with equal physical access to healthcare, mobile phone-derived measures of mobility predict which regions are lacking preventive care. Conclusions: Routinely collected mobile phone data provide a simple and low-cost approach to mapping the uptake of preventive healthcare in low-income settings. PMID:25643101

Quantifying the impact of accessibility on preventive healthcare in sub-Saharan Africa using mobile phone data.

PubMed

Wesolowski, Amy; O'Meara, Wendy Prudhomme; Tatem, Andrew J; Ndege, Samson; Eagle, Nathan; Buckee, Caroline O

2015-03-01

Poor physical access to health facilities has been identified as an important contributor to reduced uptake of preventive health services and is likely to be most critical in low-income settings. However, the relation among physical access, travel behavior, and the uptake of healthcare is difficult to quantify. Using anonymized mobile phone data from 2008 to 2009, we analyze individual and spatially aggregated travel patterns of 14,816,521 subscribers across Kenya and compare these measures to (1) estimated travel times to health facilities and (2) data on the uptake of 2 preventive healthcare interventions in an area of western Kenya: childhood immunizations and antenatal care. We document that long travel times to health facilities are strongly correlated with increased mobility in geographically isolated areas. Furthermore, we found that in areas with equal physical access to healthcare, mobile phone-derived measures of mobility predict which regions are lacking preventive care. Routinely collected mobile phone data provide a simple and low-cost approach to mapping the uptake of preventive healthcare in low-income settings.

Modeling Key Malaria Drugs' Impact on Global Health: A Reason to Invest in the Global Health Impact Index.

PubMed

Hassoun, Nicole

2016-05-04

Millions of people cannot access good quality essential medicines they need for some of the world's worst diseases like malaria. The World Health Organization estimates that, in 2013, 198 million people became sick with malaria and 584,000 people died of the disease, while the Institute for Health Metrics Evaluation estimates that there were 164,929,872 cases of malaria in 2013 and 854,568 deaths in 2013. There are many attempts to model different aspects of the global burden of tropical diseases like malaria, but it is also important to measure success in averting malaria-related death and disability. This perspective proposes investing in a systematic effort to measure the benefits of health interventions for malaria along the lines of a model embodied in the Global Health Impact Index (global-health-impact.org). © The American Society of Tropical Medicine and Hygiene.

Quantifiers are incrementally interpreted in context, more than less

PubMed Central

Urbach, Thomas P.; DeLong, Katherine A.; Kutas, Marta

2015-01-01

Language interpretation is often assumed to be incremental. However, our studies of quantifier expressions in isolated sentences found N400 event-related brain potential (ERP) evidence for partial but not full immediate quantifier interpretation (Urbach & Kutas, 2010). Here we tested similar quantifier expressions in pragmatically supporting discourse contexts (Alex was an unusual toddler. Most/Few kids prefer sweets/vegetables…) while participants made plausibility judgments (Experiment 1) or read for comprehension (Experiment 2). Control Experiments 3A (plausibility) and 3B (comprehension) removed the discourse contexts. Quantifiers always modulated typical and/or atypical word N400 amplitudes. However, only the real-time N400 effects only in Experiment 2 mirrored offline quantifier and typicality crossover interaction effects for plausibility ratings and cloze probabilities. We conclude that quantifier expressions can be interpreted fully and immediately, though pragmatic and task variables appear to impact the speed and/or depth of quantifier interpretation. PMID:26005285

Choice Experiments to Quantify Preferences for Health and Healthcare: State of the Practice.

PubMed

Mühlbacher, Axel; Johnson, F Reed

2016-06-01

Stated-preference methods increasingly are used to quantify preferences in health economics, health technology assessment, benefit-risk analysis and health services research. The objective of stated-preference studies is to acquire information about trade-off preferences among treatment outcomes, prioritization of clinical decision criteria, likely uptake or adherence to healthcare products and acceptability of healthcare services or policies. A widely accepted approach to eliciting preferences is discrete-choice experiments. Patient, physician, insurant or general-public respondents choose among constructed, experimentally controlled alternatives described by decision-relevant features or attributes. Attributes can represent complete health states, sets of treatment outcomes or characteristics of a healthcare system. The observed pattern of choice reveals how different respondents or groups of respondents implicitly weigh, value and assess different characteristics of treatments, products or services. An important advantage of choice experiments is their foundation in microeconomic utility theory. This conceptual framework provides tests of internal validity, guidance for statistical analysis of latent preference structures, and testable behavioural hypotheses. Choice experiments require expertise in survey-research methods, random-utility theory, experimental design and advanced statistical analysis. This paper should be understood as an introduction to setting up a basic experiment rather than an exhaustive critique of the latest findings and procedures. Where appropriate, we have identified topics of active research where a broad consensus has not yet been established.

Untapped potential of health impact assessment

PubMed Central

Krieger, Gary R; Divall, Mark J; Cissé, Guéladio; Wielga, Mark; Singer, Burton H; Tanner, Marcel; Utzinger, Jürg

2013-01-01

Abstract The World Health Organization has promoted health impact assessment (HIA) for over 20 years. At the 2012 United Nations Conference on Sustainable Development (Rio+20), HIA was discussed as a critical method for linking health to “green economy” and “institutional framework” strategies for sustainable development. In countries having a high human development index (HDI), HIA has been added to the overall assessment suite that typically includes potential environmental and social impacts, but it is rarely required as part of the environmental and social impact assessment for large development projects. When they are performed, project-driven HIAs are governed by a combination of project proponent and multilateral lender performance standards rather than host country requirements. Not surprisingly, in low-HDI countries HIA is missing from the programme and policy arena in the absence of an external project driver. Major drivers of global change (e.g. population growth and urbanization, growing pressure on natural resources and climate change) inordinately affect low- and medium-HDI countries; however, in such countries HIA is conspicuously absent. If the cloak of HIA invisibility is to be removed, it must be shown that HIA is useful and beneficial and, hence, an essential component of the 21st century’s sustainable development agenda. We analyse where and how HIA can become fully integrated into the impact assessment suite and argue that the impact of HIA must not remain obscure. PMID:23599554

Application of economic impact analysis to a local public health agency and its "Academic Health Department".

PubMed

Livingood, Wiliiam C; Coughlin, Susan; Bowman, Walter; Bryant, Thomas; Goldhagen, Jeffrey

2007-01-01

Public health systems are stressed by increasing demands and inadequate resources. This study was designed to demonstrate how economic impact analysis can estimate the economic value of a local public health system's infrastructure as well as the economic assets of an "Academic Health Department" model. This study involved the secondary analysis of publicly available data on health department finances and employment using proprietary software specifically designed to assess economic impacts. The health department's impact on the local community was estimated at over 100 million dollars, exceeding the economic impact of other recently studied local industries with no additional costs to local taxpayers.

Choices Behind Numbers: a Review of the Major Air Pollution Health Impact Assessments in Europe.

PubMed

Malmqvist, E; Oudin, A; Pascal, M; Medina, S

2018-03-01

The aim of this review is to identify the key contextual and methodological differences in health impact assessments (HIA) of ambient air pollution performed for Europe. We limited our review to multi-country reviews. An additional aim is to quantify some of these differences by applying them in a HIA template in three European cities. Several HIAs of ambient air pollution have been performed for Europe, and their key results have been largely disseminated. Different studies have, however, come up with substantial differences in attributed health effects. It is of importance to review the background contributing to these differences and to quantify their importance for decision makers who will use them. We identified several methodological differences that could explain the discrepancy behind the number of attributable deaths or years of life lost. The main differences are due to the exposure-response functions chosen, the ways of assessing air pollution levels, the air pollution scenarios and the study population. In the quantification part, we found that using risk estimates from the European Study of Cohorts for Air Pollution Effects (ESCAPE) instead of the American Cancer Society (ACS) study could nearly double the attributable burden of ambient air pollution. This study provides some insights into the differential results in previously published HIAs on air pollution in Europe. These results are important for stakeholders in order to make informed decisions.

Social impact bonds and their application to preventive health.

PubMed

Fitzgerald, John L

2013-05-01

Although preventive health in Australia has been acknowledged as central to national health and wellbeing, efforts to reform the delivery of preventive health have to date produced limited results. The financing of preventive health at a national level is based on outcome- or performance-based funding mechanisms; however, delivery of interventions and activities at a state level have not been subjected to outcome-based funding processes. A new financing tool being applied in the area of social services (social impact bonds) has emerged as a possible model for application in the prevention arena. This paper explores key issues in the consideration of this funding model in the prevention arena. When preventive health is conceptualised as a merit good, the role of government is clarified and outcome measures fully articulated, social impact bonds may be a viable funding option to supplement core public health activities. WHAT IS KNOWN ABOUT THE TOPIC? The complexities of outcome monitoring in preventive health are well understood.Likewise, the problem of linking funding to outcomes from preventive health practice has also been debated at length in health policy. However, not much is known about the application of social impact bonds into the preventive health arena.WHAT DOES THIS PAPER ADD? This paper discusses the limitations and opportunities facing the application of the social impact bond financing model in the preventive health arena. This has not been undertaken previously.WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Social impact bonds have received significant recent attention from federal and state government treasury departments as potential financing tools for government. Health policy practitioners are watching this space very closely to see the outcomes of a New South Wales trial. Health promotion practitioners and primary care practitioners who deliver preventive services will need to keep abreast of this issue as it will have significant impact on their

Health impacts of Obesity

PubMed Central

Djalalinia, Shirin; Qorbani, Mostafa; Peykari, Niloofar; Kelishadi, Roya

2015-01-01

The aim of this communication is to provide some evidence linking the overweight/obesity and their impacts on different dimensions of health. We reviewed the related studies published from 1990 up till now through PubMed Central/Medline, which provide evidence linking obesity with health related issues. It is a risk factor for metabolic disorders and leads to serious health consequences for individuals and burden for the health care system as a whole. Literature search showed that it is related to at least 18 co-morbidities which are attributable to overweight and obesity. Moreover obese individuals more often suffer from significant joint pains, disorders and it also has social as well as psychological impairments. It is high time that countries facing the problems of obesity initiate some intervention measures to monitor and control this growing epidemic. PMID:25878654

Urban versus rural health impacts attributable to PM2.5 and O3 in northern India

NASA Astrophysics Data System (ADS)

Karambelas, Alexandra; Holloway, Tracey; Kinney, Patrick L.; Fiore, Arlene M.; DeFries, Ruth; Kiesewetter, Gregor; Heyes, Chris

2018-06-01

Ambient air pollution in India contributes to negative health impacts and early death. Ground-based monitors often used to quantify health impacts are located in urban regions, yet approximately 70% of India’s population lives in rural communities. We simulate high-resolution concentrations of fine particulate matter (PM) and ozone from the regional Community Multi-scale Air Quality model over northern India, including updated estimates of anthropogenic emissions for transportation, residential combustion and location-based industrial and electrical generating emissions in a new anthropogenic emissions inventory. These simulations inform seasonal air quality and health impacts due to anthropogenic emissions, contrasting urban versus rural regions. For our northern India domain, we estimate 463 200 (95% confidence interval: 444 600–482 600) adults die prematurely each year from PM2.5 and that 37 800 (28 500–48 100) adults die prematurely each year from O3. This translates to 5.8 deaths per 10 000 attributable to air pollution out of an annual rate of 72 deaths per 10 000 (8.1% of deaths) using 2010 estimates. We estimate that the majority of premature deaths resulting from PM2.5 and O3 are in rural (383 600) as opposed to urban (117 200) regions, where we define urban as cities and towns with populations of at least 100 000 people. These findings indicate the need for rural monitoring and appropriate health studies to understand and mitigate the effects of ambient air pollution on this population in addition to supporting model evaluation.

Quantitative health impact assessment: taking stock and moving forward.

PubMed

Fehr, Rainer; Hurley, Fintan; Mekel, Odile Cecile; Mackenbach, Johan P

2012-12-01

Over the past years, application of health impact assessment has increased substantially, and there has been a strong growth of tools that allow quantification of health impacts for a range of health relevant policies. We review these developments, and conclude that further tool development is no longer a main priority, although several aspects need to be further developed, such as methods to assess impacts on health inequalities and to assess uncertainties. The main new challenges are, first, to conduct a comparative evaluation of different tools, and, second, to ensure the maintenance and continued availability of the toolkits including their data contents.

Towards environmental health equity in health impact assessment: innovations and opportunities.

PubMed

Buse, Chris G; Lai, Valerie; Cornish, Katie; Parkes, Margot W

2018-06-18

As global environmental change drives inequitable health outcomes, novel health equity assessment methodologies are increasingly required. We review literatures on equity-focused HIA to clarify how equity is informing HIA practice, and to surface innovations for assessing health equity in relation to a range of exposures across geographic and temporal scales. A narrative review of the health equity and HIA literatures analysed English articles published between 2003 and 2017 across PubMed, PubMed Central, Biomed Central and Ovid Medline. Title and abstract reviews of 849 search results yielded 89 articles receiving full text review. Considerations of equity in HIA increased over the last 5 years, but equity continues to be conflated with health disparities rather than their root causes (i.e. inequities). Lessons from six literatures to inform future HIA practice are described: HIA for healthy cities, climate change vulnerability assessment, cumulative health risk assessment, intersectionality-based policy analysis, corporate health impact assessment and global health impact assessment. Academic reporting on incorporating equity in HIA practice has been limited. Nonetheless, significant methodological advancements are being made to examine the health equity implications of multiple environmental exposures.

Urban regeneration as population health intervention: a health impact assessment in the Bay of Pasaia (Spain).

PubMed

Serrano, Elena; Larrañaga, Isabel; Morteruel, Maite; Baixas de Ros, María Dolores; Basterrechea, Mikel; Martinez, Dolores; Aldasoro, Elena; Bacigalupe, Amaia

2016-09-15

An important health issue in urban areas is how changes arising from the regeneration of city-areas affect social determinants of health and equity. This paper examines the impacts attributable to a new fish market and to delays in the regeneration of a port area in a deteriorated region of the Bay of Pasaia (Spain). Potential differential impacts on local residents and socially vulnerable groups were evaluated to determine health inequalities. An in-depth, prospective and concurrent Health-Impact-Assessment (HIA) focused on equity was conducted by the regional Public Health Department, following the Merseyside guidelines. Data from different sources was triangulated and impacts were identified using qualitative and quantitative methods. The intervention area is characterised by poor social, environmental, and health indicators. The distinctness of the two projects generates contrasting health and inequality impacts: generally positive for the new fish market and negative for the port area. The former creates recreational spaces and improves urban quality and social cohesion. By contrast, inaction and stagnation of the project in the port area perpetuates deterioration, a lack of safety, and poor health, as well as increased social frustration. In addition to assessing the health impacts of both projects this HIA promoted intersectoral partnerships, boosted a holistic and positive view of health and incorporated health and equity into the political discourse. Community-level participatory action enabled public health institutions to respond to new urban planning challenges and responsibilities in a more democratic manner.

Describing the impact of health research: a Research Impact Framework

PubMed Central

Kuruvilla, Shyama; Mays, Nicholas; Pleasant, Andrew; Walt, Gill

2006-01-01

Background Researchers are increasingly required to describe the impact of their work, e.g. in grant proposals, project reports, press releases and research assessment exercises. Specialised impact assessment studies can be difficult to replicate and may require resources and skills not available to individual researchers. Researchers are often hard-pressed to identify and describe research impacts and ad hoc accounts do not facilitate comparison across time or projects. Methods The Research Impact Framework was developed by identifying potential areas of health research impact from the research impact assessment literature and based on research assessment criteria, for example, as set out by the UK Research Assessment Exercise panels. A prototype of the framework was used to guide an analysis of the impact of selected research projects at the London School of Hygiene and Tropical Medicine. Additional areas of impact were identified in the process and researchers also provided feedback on which descriptive categories they thought were useful and valid vis-à-vis the nature and impact of their work. Results We identified four broad areas of impact: I. Research-related impacts; II. Policy impacts; III. Service impacts: health and intersectoral and IV. Societal impacts. Within each of these areas, further descriptive categories were identified. For example, the nature of research impact on policy can be described using the following categorisation, put forward by Weiss: Instrumental use where research findings drive policy-making; Mobilisation of support where research provides support for policy proposals; Conceptual use where research influences the concepts and language of policy deliberations and Redefining/wider influence where research leads to rethinking and changing established practices and beliefs. Conclusion Researchers, while initially sceptical, found that the Research Impact Framework provided prompts and descriptive categories that helped them

Evidence Regarding the Impact of Conflicts of Interest on Environmental and Occupational Health Research.

PubMed

Wells, Ellen M

2017-06-01

This review describes published literature providing evidence for financial conflicts of interest in environmental and occupational health research. Secondary goals were to describe evidence that (a) utilized quantitative methods to evaluate the association of conflicts with study outcomes, and (b) assessed undisclosed as well as disclosed conflicts of interest. Forty-three studies were identified which contained descriptions of the impact of financial conflicts of interest on research results; 11 of these conducted quantitative analyses to demonstrate these relationships. All 11 articles which quantified associations identified significant associations of the presence of financial conflicts of interest with study findings. In studies which measured undisclosed conflicts, these comprised a substantial proportion of all conflicts. Suggestions for improving understanding and interpretation of research results are presented.

Ecosystem services impacts associated with environmental reactive nitrogen release in the United States

EPA Science Inventory

Nitrogen release to the environment from human activities can have important and costly impacts on human health, recreation, transportation, fisheries, and ecosystem health. Recent efforts to quantify these damage costs have identified annual damages associated with reactive nit...

Impacts of globalization in health.

PubMed

Ioannou, Andriani; Mechili, Aggelos; Kolokathi, Aikaterini; Diomidous, Marianna

2013-01-01

Globalization is the process of international integration arising from the interchange of world views, products, ideas, and other aspects of culture. Globalization describes the interplay of macro-social forces across cultures. The purpose of this study is a systematic review of the bibliography on the impacts of globalization in health. The consequences of globalization on health present a twofold dimension, on the one hand affects the health of the population and on the other hand organization and functioning of health systems. As a result of globalization, there has been an undeniable economic development and technological progress to support the level of health around the world, improving the health status of certain populations with a beneficial increase in life expectancy. In many aspects globalization is good but there are many problems too.

Modeling The Economic And Health Impact Of Increasing Children's Physical Activity In The United States.

PubMed

Lee, Bruce Y; Adam, Atif; Zenkov, Eli; Hertenstein, Daniel; Ferguson, Marie C; Wang, Peggy I; Wong, Michelle S; Wedlock, Patrick; Nyathi, Sindiso; Gittelsohn, Joel; Falah-Fini, Saeideh; Bartsch, Sarah M; Cheskin, Lawrence J; Brown, Shawn T

2017-05-01

Increasing physical activity among children is a potentially important public health intervention. Quantifying the economic and health effects of the intervention would help decision makers understand its impact and priority. Using a computational simulation model that we developed to represent all US children ages 8-11 years, we estimated that maintaining the current physical activity levels (only 31.9 percent of children get twenty-five minutes of high-calorie-burning physical activity three times a week) would result each year in a net present value of $1.1 trillion in direct medical costs and $1.7 trillion in lost productivity over the course of their lifetimes. If 50 percent of children would exercise, the number of obese and overweight youth would decrease by 4.18 percent, averting $8.1 billion in direct medical costs and $13.8 billion in lost productivity. Increasing the proportion of children who exercised to 75 percent would avert $16.6 billion and $23.6 billion, respectively. Project HOPE—The People-to-People Health Foundation, Inc.

Health Impact Assessment: Linking Public Health to Community Decisions (Cumulative Impacts Community Vulnerability Symposium)

EPA Science Inventory

The goal of this presentation is to explore how HIA can help inform hazardous waste permitting regulations and incorporate community vulnerability and cumulative impacts to their potential health risks into permitting decision making by the California Department of Toxic Substanc...

Identifying and assessing strategies for evaluating the impact of mobile eye health units on health outcomes.

PubMed

Fu, Shiwan; Turner, Angus; Tan, Irene; Muir, Josephine

2017-12-01

To identify and assess strategies for evaluating the impact of mobile eye health units on health outcomes. Systematic literature review. Worldwide. Peer-reviewed journal articles that included the use of a mobile eye health unit. Journal articles were included if outcome measures reflected an assessment of the impact of a mobile eye health unit on health outcomes. Six studies were identified with mobile services offering diabetic retinopathy screening (three studies), optometric services (two studies) and orthoptic services (one study). This review identified and assessed strategies in existing literature used to evaluate the impact of mobile eye health units on health outcomes. Studies included in this review used patient outcomes (i.e. disease detection, vision impairment, treatment compliance) and/or service delivery outcomes (i.e. cost per attendance, hospital transport use, inappropriate referrals, time from diabetic retinopathy photography to treatment) to evaluate the impact of mobile eye health units. Limitations include difficulty proving causation of specific outcome measures and the overall shortage of impact evaluation studies. Variation in geographical location, service population and nature of eye care providers limits broad application. © 2017 National Rural Health Alliance Inc.

Aerosol Health Impact Source Attribution Studies with the CMAQ Adjoint Air Quality Model

NASA Astrophysics Data System (ADS)

Turner, M. D.

Fine particulate matter (PM2.5) is an air pollutant consisting of a mixture of solid and liquid particles suspended in the atmosphere. Knowledge of the sources and distributions of PM2.5 is important for many reasons, two of which are that PM2.5 has an adverse effect on human health and also an effect on climate change. Recent studies have suggested that health benefits resulting from a unit decrease in black carbon (BC) are four to nine times larger than benefits resulting from an equivalent change in PM2.5 mass. The goal of this thesis is to quantify the role of emissions from different sectors and different locations in governing the total health impacts, risk, and maximum individual risk of exposure to BC both nationally and regionally in the US. We develop and use the CMAQ adjoint model to quantify the role of emissions from all modeled sectors, times, and locations on premature deaths attributed to exposure to BC. From a national analysis, we find that damages resulting from anthropogenic emissions of BC are strongly correlated with population and premature death. However, we find little correlation between damages and emission magnitude, suggesting that controls on the largest emissions may not be the most efficient means of reducing damages resulting from BC emissions. Rather, the best proxy for locations with damaging BC emissions is locations where premature deaths occur. Onroad diesel and nonroad vehicle emissions are the largest contributors to premature deaths attributed to exposure to BC, while onroad gasoline emissions cause the highest deaths per amount emitted. Additionally, emissions in fall and winter contribute to more premature deaths (and more per amount emitted) than emissions in spring and summer. From a regional analysis, we find that emissions from outside each of six urban areas account for 7% to 27% of the premature deaths attributed to exposure to BC within the region. Within the region encompassing New York City and Philadelphia

Impacts of gas drilling on human and animal health.

PubMed

Bamberger, Michelle; Oswald, Robert E

2012-01-01

Environmental concerns surrounding drilling for gas are intense due to expansion of shale gas drilling operations. Controversy surrounding the impact of drilling on air and water quality has pitted industry and lease-holders against individuals and groups concerned with environmental protection and public health. Because animals often are exposed continually to air, soil, and groundwater and have more frequent reproductive cycles, animals can be used as sentinels to monitor impacts to human health. This study involved interviews with animal owners who live near gas drilling operations. The findings illustrate which aspects of the drilling process may lead to health problems and suggest modifications that would lessen but not eliminate impacts. Complete evidence regarding health impacts of gas drilling cannot be obtained due to incomplete testing and disclosure of chemicals, and nondisclosure agreements. Without rigorous scientific studies, the gas drilling boom sweeping the world will remain an uncontrolled health experiment on an enormous scale.

Evaluating impacts of air pollution in China on public health: Implications for future air pollution and energy policies

NASA Astrophysics Data System (ADS)

Wang, Xiaoping; Mauzerall, Denise L.

Our objective is to establish the link between energy consumption and technologies, air pollution concentrations, and resulting impacts on public health in eastern China. We use Zaozhuang, a city in eastern China heavily dependent on coal, as a case study to quantify the impacts that air pollution in eastern China had on public health in 2000 and the benefits in improved air quality and health that could be obtained by 2020, relative to business-as-usual (BAU), through the implementation of best available emission control technology (BACT) and advanced coal gasification technologies (ACGT). We use an integrated assessment approach, utilizing state-of-the-science air quality and meteorological models, engineering, epidemiology, and economics, to achieve this objective. We find that total health damages due to year 2000 anthropogenic emissions from Zaozhuang, using the "willingness-to-pay" metric, was equivalent to 10% of Zaozhuang's GDP. If all health damages resulting from coal use were internalized in the market price of coal, the year 2000 price would have more than tripled. With no new air pollution controls implemented between 2000 and 2020 but with projected increases in energy use, we estimate health damages from air pollution exposure to be equivalent to 16% of Zaozhuang's projected 2020 GDP. BACT and ACGT (with only 24% penetration in Zaozhuang and providing 2% of energy needs in three surrounding municipalities) could reduce the potential health damage of air pollution in 2020 to 13% and 8% of projected GDP, respectively. Benefits to public health, of substantial monetary value, can be achieved through the use of BACT; health benefits from the use of ACGT could be even larger. Despite significant uncertainty associated with each element of the integrated assessment approach, we demonstrate that substantial benefits to public health could be achieved in this region of eastern China through the use of additional pollution controls and particularly from the

Health impacts of climate change and health and social inequalities in the UK.

PubMed

Paavola, Jouni

2017-12-05

This article examines how social and health inequalities shape the health impacts of climate change in the UK, and what the implications are for climate change adaptation and health care provision. The evidence generated by the other articles of the special issue were interpreted using social justice reasoning in light of additional literature, to draw out the key implications of health and social inequalities for health outcomes of climate change. Exposure to heat and cold, air pollution, pollen, food safety risks, disruptions to access to and functioning of health services and facilities, emerging infections and flooding are examined as the key impacts of climate change influencing health outcomes. Age, pre-existing medical conditions and social deprivation are found to be the key (but not only) factors that make people vulnerable and to experience more adverse health outcomes related to climate change impacts. In the future, climate change, aging population and decreasing public spending on health and social care may aggravate inequality of health outcomes related to climate change. Health education and public preparedness measures that take into account differential exposure, sensitivity and adaptive capacity of different groups help address health and social inequalities to do with climate change. Adaptation strategies based on individual preparedness, action and behaviour change may aggravate health and social inequalities due to their selective uptake, unless they are coupled with broad public information campaigns and financial support for undertaking adaptive measures.

CONTRIBUTION OF STAKEHOLDER ENGAGEMENT TO THE IMPACT OF A HEALTH TECHNOLOGY ASSESSMENT: AN IRISH CASE STUDY.

PubMed

Ryan, Máirín; Moran, Patrick S; Harrington, Patricia; Murphy, Linda; O'Neill, Michelle; Whelan, Marty; Teljeur, Conor

2017-01-01

The aim of this study was to illustrate the contribution of stakeholder engagement to the impact of health technology assessment (HTA) using an Irish HTA of a national public access defibrillation (PAD) program. In response to draft legislation that proposed a PAD program, the Minister for Health requested that Health Information and Quality Authority undertake an HTA to inform the design and implementation of a national PAD program and the necessary underpinning legislation. The draft legislation outlined a program requiring widespread installation and maintenance of automatic external defibrillators in specified premises. Stakeholder engagement to optimize the impact of the HTA included one-to-one interviews with politicians, engagement with an Expert Advisory Group, public and targeted consultation, and positive media management. The HTA quantified the clinical benefits of the proposed PAD program as modest, identified that substantial costs would fall on small/medium businesses at a time of economic recession, and that none of the programs modeled were cost-effective. The Senator who proposed the Bill actively publicized the HTA process and its findings and encouraged participation in the public consultation. Participation of key stakeholders was important for the quality and acceptability of the HTA findings and advice. Media management promoted public engagement and understanding. The Bill did not progress. The HTA informed the decision not to progress with legislation for a national PAD program. Engagement was tailored to ensure that key stakeholders including politicians and the public were informed of the HTA process, the findings, and the advice, thereby maximizing acceptance. Appropriate stakeholder engagement optimizes the impact of HTA.

The public health impact of tsunami disasters.

PubMed

Keim, Mark E

2011-01-01

Tsunamis have the potential to cause an enormous impact on the health of millions of people. During the last half of the twentieth century, more people were killed by tsunamis than by earthquakes. Most recently, a major emergency response operation has been underway in northeast Japan following a devastating tsunami triggered by the biggest earthquake on record in Japan. This natural disaster has been described as the most expensive in world history. There are few resources in the public health literature that describe the characteristics and epidemiology of tsunami-related disasters, as a whole. This article reviews the phenomenology and impact of tsunamis as a significant public health hazard.

Quantifying the importance of disease burden on perceived general health and depressive symptoms in patients within the Mayo Clinic Biobank.

PubMed

Ryu, Euijung; Takahashi, Paul Y; Olson, Janet E; Hathcock, Matthew A; Novotny, Paul J; Pathak, Jyotishman; Bielinski, Suzette J; Cerhan, James R; Sloan, Jeff A

2015-07-03

Deficits in health-related quality of life (HRQOL) may be associated with worse patient experiences, outcomes and even survival. While there exists evidence to identify risk factors associated with deficits in HRQOL among patients with individual medical conditions such as cancer, it is less well established in more general populations without attention to specific illnesses. This study used patients with a wide range of medical conditions to identify contributors with the greatest influence on HRQOL deficits. Self-perceived general health and depressive symptoms were assessed using data from 21,736 Mayo Clinic Biobank (MCB) participants. Each domain was dichotomized into categories related to poor health: deficit (poor/fair for general health and ≥3 for PHQ-2 depressive symptoms) or non-deficit. Logistic regression models were used to test the association of commonly collected demographic characteristics and disease burden with each HRQOL domain, adjusting for age and gender. Gradient boosting machine (GBM) models were applied to quantify the relative influence of contributors on each HRQOL domain. The prevalence of participants with a deficit was 9.5 % for perception of general health and 4.6 % for depressive symptoms. For both groups, disease burden had the strongest influence for deficit in HRQOL (63 % for general health and 42 % for depressive symptoms). For depressive symptoms, age was equally influential. The prevalence of a deficit in general health increased slightly with age for males, but remained stable across age for females. Deficit in depressive symptoms was inversely associated with age. For both HRQOL domains, risk of a deficit was associated with higher disease burden, lower levels of education, no alcohol consumption, smoking, and obesity. Subjects with deficits were less likely to report that they were currently working for pay than those without a deficit; this association was stronger among males than females. Comorbid health burden has the

The Impact of Residential Combustion Emissions on Air Quality and Human Health in China

NASA Astrophysics Data System (ADS)

Archer-Nicholls, S.; Wiedinmyer, C.; Baumgartner, J.; Brauer, M.; Cohen, A.; Carter, E.; Frostad, J.; Forouzanfar, M.; Xiao, Q.; Liu, Y.; Yang, X.; Hongjiang, N.; Kun, N.

2015-12-01

Solid fuel cookstoves are used heavily in rural China for both residential cooking and heating purposes. Their use contributes significantly to regional emissions of several key pollutants, including carbon monoxide, volatile organic compounds, oxides of nitrogen, and aerosol particles. The residential sector was responsible for approximately 36%, 46% and 81% of China's total primary PM2.5, BC and OC emissions respectively in 2005 (Lei et al., 2011). These emissions have serious consequences for household air pollution, ambient air quality, tropospheric ozone formation, and the resulting population health and climate impacts. This paper presents initial findings from the modeling component of a multi-disciplinary energy intervention study currently being conducted in Sichuan, China. The purpose of this effort is to quantify the impact of residential cooking and heating emissions on regional air quality and human health. Simulations with varying levels of residential emissions have been carried out for the whole of 2014 using the Weather Research and Forecasting model with Chemistry (WRF-Chem), a fully-coupled, "online" regional chemical transport model. Model output is evaluated against surface air quality measurements across China and compared with seasonal (winter and summer) ambient air pollution measurements conducted at the Sichuan study site in 2014. The model output is applied to available exposure—response relationships between PM2.5 and cardiopulmonary health outcomes. The sensitivity in different regions across China to the different cookstove emission scenarios and seasonality of impacts are presented. By estimating the mortality and disease burden risk attributable to residential emissions we demonstrate the potential benefits from large-scale energy interventions. Lei Y, Zhang Q, He KB, Streets DG. 2011. Primary anthropogenic aerosol emission trends for China, 1990-2005. Atmos. Chem. Phys. 11:931-954.

Mobile health is worth it! Economic benefit and impact on health of a population-based mobile screening program in new Mexico.

PubMed

Brown-Connolly, Nancy E; Concha, Jeannie B; English, Jennifer

2014-01-01

HABITS for Life was a 3-year initiative to broadly deliver a statewide biometric and retinal screening program via a mobile unit throughout New Mexico at no charge to participants. The program goal-to identify health risk and improve population health status-was tested over a 3-year period. Value to participants and impact to the healthcare system were measured to quantify impact and value of investing in prevention at the community level. We used the Mobile Health Map Return-on-Investment Calculator, a mobile screening unit, biometric screening, retinography, and community coordination. Our systems included satellite, DSL, and 3G connectivity, a Tanita® (Arlington Heights, IL) automated body mass index-measuring scale, the Cholestec® (Alere™, Waltham, MA) system for biomarkers and glycosylated hemoglobin, a Canon (Melville, NY) CR-1 Mark II camera, and the Picture Archiving Communication System. In this report for the fiscal year 2011 time frame, 6,426 individuals received biometric screening, and 5,219 received retinal screening. A 15:1 return on investment was calculated; this excluded retinal screening for the under-65 year olds, estimated at $10 million in quality-adjusted life years saved. Statistically significant improvement in health status evidenced by sequential screening included a decrease in total cholesterol level (p=0.002) (n=308) and an increase in high-density lipoprotein level after the first and second screening (p=0.02 and p=0.01, respectively), but a decrease in mean random glucose level was not statistically significant (p=0.62). Retinal results indicate 28.4% (n=1,482) with a positive/abnormal finding, of which 1.79% (n=93) required immediate referral for sight-threatening retinopathy and 27% (n=1,389) required follow-up of from 3 months to 1 year. Screening programs are cost-effective and provide value in preventive health efforts. Broad use of screening programs should be considered in healthcare redesign efforts. Community

Development of an Urban Health Impact Assessment methodology: indicating the health equity impacts of urban policies.

PubMed

Pennington, Andy; Dreaves, Hilary; Scott-Samuel, Alex; Haigh, Fiona; Harrison, Annie; Verma, Arpana; Pope, Daniel

2017-05-01

An overarching recommendation of the global Commission on Social Determinants of Health was to measure and understand health inequalities and assess the impact of action. In a rapidly urbanising world, now is the time for Urban HIA. This article describes the development of robust and easy-to-use HIA tools to identify and address health inequalities from new urban policies. Rapid reviews and consultation with experts identified existing HIA screening tools and methodologies which were then analyzed against predefined selection criteria. A draft Urban HIA Screening Tool (UrHIST) and Urban HIA methodology (UrHIA) were synthesised. The draft tools were tested and refined using a modified Delphi approach that included input from urban and public health experts, practitioners and policy makers. The outputs were two easy-to-use stand-alone urban HIA tools. The reviews and consultations identified an underpinning conceptual framework. The screening tool is used to determine whether a full HIA is required, or for a brief assessment. Urban health indicators are a readily available and efficient means of identifying variations in the health of populations potentially affected by policies. Indicators are, however, currently underutilised in HIA practice. This may limit the identification of health inequalities by HIA and production of recommendations. The new tools utilise health indicator data more fully. UrHIA also incorporates a hierarchy of evidence for use during impact analysis. The new urban HIA tools have the potential to enhance the rigour of HIAs and improve the identification and amelioration of health inequalities generated by urban policies. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Integrating Ecosystem Services Into Health Impact Assessment

EPA Science Inventory

Health Impact Assessment (HIA) provides a methodology for incorporating considerations of public health into planning and decision-making processes. HIA promotes interdisciplinary action, stakeholder participation, and timeliness and takes into account equity, sustainability, and...

Impact of traffic-related air pollution on health.

PubMed

Jakubiak-Lasocka, J; Lasocki, J; Siekmeier, R; Chłopek, Z

2015-01-01

Road transport contributes significantly to air quality problems through vehicle emissions, which have various detrimental impacts on public health and the environment. The aim of this study was to assess the impact of traffic-related air pollution on health of Warsaw citizens, following the basics of the Health Impact Assessment (HIA) method, and evaluate its social cost. PM10 was chosen as an indicator of traffic-related air pollution. Exposure-response functions between air pollution and health impacts were employed. The value of statistical life (VSL) approach was used for the estimation of the cost of mortality attributable to traffic-related air pollution. Costs of hospitalizations and restricted activity days were assessed basing on the cost of illness (COI) method. According to the calculations, about 827 Warsaw citizens die in a year as a result of traffic-related air pollution. Also, about 566 and 250 hospital admissions due to cardiovascular and respiratory diseases, respectively, and more than 128,453 restricted activity days can be attributed to the traffic emissions. From the social perspective, these losses generate the cost of 1,604 million PLN (1 EUR-approx. 4.2 PLN). This cost is very high and, therefore, more attention should be paid for the integrated environmental health policy.

Mitigating the Health Impact of Wildfire Smoke: Guidance for Health Professionals

EPA Science Inventory

Abstract: Wildfire Webinar Focuses on Human Health Impacts. A Pediatric Environmental Health Specialty Unit Webinar will be conducted on March 29th targeted to healthcare professionals responsible for the care of children. The content of the webinar for which healthcare provide...

Current issues in the impacts of transport on health.

PubMed

van Schalkwyk, M C I; Mindell, J S

2018-03-01

Transport affects health in many ways. Benefits include access to education, employment, goods, services and leisure, and opportunities for incorporating physical activity into daily living. There are major inequalities: benefits generally accrue to wealthier people and harms to the more deprived, nationally and globally. Health on the Move 2; Journal of Transport and Health. Benefits of travel for access and physical activity. Harms include health impacts of air and noise pollution; injuries and fatalities from falls or collisions; sedentary behaviour with motorized transport; community severance (barrier effect of busy roads and transport infrastructure); global climate change; impacts on inequalities; transport's role in facilitating spread of communicable diseases. Biofuels; cycle safety; driving by older people. Effects of default 20 mph speed limits; impacts of autonomous vehicles on health and inequalities.

Economic Evidence on the Health Impacts of Climate Change in Europe

PubMed Central

Hutton, Guy; Menne, Bettina

2014-01-01

BACKGROUND In responding to the health impacts of climate change, economic evidence and tools inform decision makers of the efficiency of alternative health policies and interventions. In a time when sweeping budget cuts are affecting all tiers of government, economic evidence on health protection from climate change spending enables comparison with other public spending. METHODS The review included 53 countries of the World Health Organization (WHO) European Region. Literature was obtained using a Medline and Internet search of key terms in published reports and peer-reviewed literature, and from institutions working on health and climate change. Articles were included if they provided economic estimation of the health impacts of climate change or adaptation measures to protect health from climate change in the WHO European Region. Economic studies are classified under health impact cost, health adaptation cost, and health economic evaluation (comparing both costs and impacts). RESULTS A total of 40 relevant studies from Europe were identified, covering the health damage or adaptation costs related to the health effects of climate change and response measures to climate-sensitive diseases. No economic evaluation studies were identified of response measures specific to the impacts of climate change. Existing studies vary in terms of the economic outcomes measured and the methods for evaluation of health benefits. The lack of robust health impact data underlying economic studies significantly affects the availability and precision of economic studies. CONCLUSIONS Economic evidence in European countries on the costs of and response to climate-sensitive diseases is extremely limited and fragmented. Further studies are urgently needed that examine health impacts and the costs and efficiency of alternative responses to climate-sensitive health conditions, in particular extreme weather events (other than heat) and potential emerging diseases and other conditions

Economic evidence on the health impacts of climate change in europe.

PubMed

Hutton, Guy; Menne, Bettina

2014-01-01

In responding to the health impacts of climate change, economic evidence and tools inform decision makers of the efficiency of alternative health policies and interventions. In a time when sweeping budget cuts are affecting all tiers of government, economic evidence on health protection from climate change spending enables comparison with other public spending. The review included 53 countries of the World Health Organization (WHO) European Region. Literature was obtained using a Medline and Internet search of key terms in published reports and peer-reviewed literature, and from institutions working on health and climate change. Articles were included if they provided economic estimation of the health impacts of climate change or adaptation measures to protect health from climate change in the WHO European Region. Economic studies are classified under health impact cost, health adaptation cost, and health economic evaluation (comparing both costs and impacts). A total of 40 relevant studies from Europe were identified, covering the health damage or adaptation costs related to the health effects of climate change and response measures to climate-sensitive diseases. No economic evaluation studies were identified of response measures specific to the impacts of climate change. Existing studies vary in terms of the economic outcomes measured and the methods for evaluation of health benefits. The lack of robust health impact data underlying economic studies significantly affects the availability and precision of economic studies. Economic evidence in European countries on the costs of and response to climate-sensitive diseases is extremely limited and fragmented. Further studies are urgently needed that examine health impacts and the costs and efficiency of alternative responses to climate-sensitive health conditions, in particular extreme weather events (other than heat) and potential emerging diseases and other conditions threatening Europe.

A Measure of the Potential Impact of Hospital Community Health Activities on Population Health and Equity.

PubMed

Begun, James W; Kahn, Linda M; Cunningham, Brooke A; Malcolm, Jan K; Potthoff, Sandra

2017-12-13

Many hospitals in the United States are exploring greater investment in community health activities that address upstream causes of poor health. Develop and apply a measure to categorize and estimate the potential impact of hospitals' community health activities on population health and equity. We propose a scale of potential impact on population health and equity, based on the cliff analogy developed by Jones and colleagues. The scale is applied to the 317 activities reported in the community health needs assessment implementation plan reports of 23 health care organizations in the Minneapolis-St Paul, Minnesota metropolitan area in 2015. Using a 5-point ordinal scale, we assigned a score of potential impact on population health and equity to each community health activity. A majority (50.2%) of health care organizations' community health activities are classified as addressing social determinants of health (level 4 on the 5-point scale), though very few (5.4%) address structural causes of health equity (level 5 on the 5-point scale). Activities that score highest on potential impact fall into the topic categories of "community health and connectedness" and "healthy lifestyles and wellness." Lower-scoring activities focus on sick or at-risk individuals, such as the topic category of "chronic disease prevention, management, and screening." Health care organizations in the Minneapolis-St Paul metropolitan area vary substantially in the potential impact of their aggregated community health activities. Hospitals can be significant contributors to investment in upstream community health programs. This article provides a scale that can be used not only by hospitals but by other health care and public health organizations to better align their community health strategies, investments, and partnerships with programming and policies that address the foundational causes of population health and equity within the communities they serve.

Quantifying errors without random sampling.

PubMed

Phillips, Carl V; LaPole, Luwanna M

2003-06-12

All quantifications of mortality, morbidity, and other health measures involve numerous sources of error. The routine quantification of random sampling error makes it easy to forget that other sources of error can and should be quantified. When a quantification does not involve sampling, error is almost never quantified and results are often reported in ways that dramatically overstate their precision. We argue that the precision implicit in typical reporting is problematic and sketch methods for quantifying the various sources of error, building up from simple examples that can be solved analytically to more complex cases. There are straightforward ways to partially quantify the uncertainty surrounding a parameter that is not characterized by random sampling, such as limiting reported significant figures. We present simple methods for doing such quantifications, and for incorporating them into calculations. More complicated methods become necessary when multiple sources of uncertainty must be combined. We demonstrate that Monte Carlo simulation, using available software, can estimate the uncertainty resulting from complicated calculations with many sources of uncertainty. We apply the method to the current estimate of the annual incidence of foodborne illness in the United States. Quantifying uncertainty from systematic errors is practical. Reporting this uncertainty would more honestly represent study results, help show the probability that estimated values fall within some critical range, and facilitate better targeting of further research.

Leadership and globalization: research in health management education.

PubMed

West, Daniel J; Ramirez, Bernardo; Filerman, Gary

2012-01-01

The impact of globalization on graduate health care management education is evident, yet challenging to quantify. The Commission on Healthcare Management Education (CAHME) recently authorized two research studies to gather specific information and answer important questions about accredited graduate programs in the USA and Canada. Two surveys provided the most comprehensive data impacting international health management education efforts by 70 programs. An inventory was made of 22 countries; information was compiled on 21 accrediting or quality improvement organizations. Observations on leadership and the demand for qualified health care professionals is discussed in terms of accreditation, certification, competency models, outcome assessment, improving quality, and the impact of globalization on higher education.

Equity-focused health impact assessment of Portuguese tobacco control legislation.

PubMed

Costa, A; Cortes, M; Sena, C; Nunes, E; Nogueira, P; Shivaji, T

2018-04-01

The World Health Organization recommend the Equity-Focused Health Impact Assessment (HIA) as a means to assess the impact of social and economic policies on the health of populations, and acknowledges their contribution to health inequality. We describe the application of the Equity-focused Impact Assessment methodology on the Portuguese law on Smoking Prevention and Tobacco Control (Law No. 37/2007). A rapid assessment was carried out to issue recommendations which could be incorporated into the law during a revision in 2014. Quantitative (consumption and health status indicators; equity analysis) and qualitative (Focus Group) approaches were taken to evaluate the impact of the law and formulate recommendations. Young people, men and women of low socioeconomic status, and pregnant women were identified as requiring specific and appropriate interventions to prevent smoking and support smoking cessation.

Quantifying the impacts of vegetation changes on catchment storage-discharge dynamics using paired-catchment data

NASA Astrophysics Data System (ADS)

Cheng, Lei; Zhang, Lu; Chiew, Francis H. S.; Canadell, Josep G.; Zhao, Fangfang; Wang, Ying-Ping; Hu, Xianqun; Lin, Kairong

2017-07-01

It is widely recognized that vegetation changes can significantly affect the local water availability. Methods have been developed to predict the effects of vegetation change on water yield or total streamflow. However, it is still a challenge to predict changes in base flow following vegetation change due to limited understanding of catchment storage-discharge dynamics. In this study, the power law relationship for describing catchment storage-discharge dynamics is reformulated to quantify the changes in storage-discharge relationship resulting from vegetation changes using streamflow data from six paired-catchment experiments, of which two are deforestation catchments and four are afforestation catchments. Streamflow observations from the paired-catchment experiments clearly demonstrate that vegetation changes have led to significant changes in catchment storage-discharge relationships, accounting for about 83-128% of the changes in groundwater discharge in the treated catchments. Deforestation has led to increases in groundwater discharge (or base flow) but afforestation has resulted in decreases in groundwater discharge. Further analysis shows that the contribution of changes in groundwater discharge to the total changes in streamflow varies greatly among experimental catchments ranging from 12% to 80% with a mean of 38 ± 22% (μ ± σ). This study proposed a new method to quantify the effects of vegetation changes on groundwater discharge from catchment storage and will improve our predictability about the impacts of vegetation changes on catchment water yields.

Equity-focused health impact assessment: A tool to assist policy makers in addressing health inequalities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Simpson, Sarah; Mahoney, Mary; Harris, Elizabeth

2005-10-15

In Australasia (Australia and New Zealand) the use of health impact assessment (HIA) as a tool for improved policy development is comparatively new. The public health workforce do not routinely assess the potential health and equity impacts of proposed policies or programs. The Australasian Collaboration for Health Equity Impact Assessment was funded to develop a strategic framework for equity-focused HIA (EFHIA) with the intent of strengthening the ways in which equity is addressed in each step of HIA. The collaboration developed a draft framework for EFHIA that mirrored, but modified the commonly accepted steps of HIA; tested the draft frameworkmore » in six different health service delivery settings; analysed the feedback about application of the draft EFHIA framework and modified it accordingly. The strategic framework shows promise in providing a systematic process for identifying potential differential health impacts and assessing the extent to which these are avoidable and unfair. This paper presents the EFHIA framework and discusses some of the issues that arose in the case study sites undertaking equity-focused HIA.« less

Health impact assessment as an instrument to examine the health implications of education policies.

PubMed

Pharr, J; Gakh, M; Coughenour, C; Clark, S

2017-04-01

Health impact assessment (HIA) is a systematic process that can be used by public health professionals to examine the potential health effects of a policy, plan, program, or project that originates outside of the health sector. This article presents a case study of how an interdisciplinary team utilized an HIA to analyze the potential health impact of full-day kindergarten (FDK) on communities in Nevada. Case study. With stakeholder and community engagement, we conducted a multistage HIA that included qualitative and quantitative data collection and analysis, a review of existing literature, and projections. The team considered several pathways through which FDK could impact health in Nevada: (1) school performance; (2) physical development (physical activity and nutrition education); and (3) access to school-based meals and health screenings. Findings indicated that access to FDK could enhance opportunities for Nevada's children to harness school-based services, increase physical activity, and promote nutrition education. In addition, based on existing research that suggests relationships between (1) FDK attendance and 3rd and 5th grade math and reading standardized test scores and (2) 3rd and 5th grade test scores and high school graduation, as well as available state and national data, we estimated that access to FDK could increase high school graduation in Nevada by 499-820 students per year. This HIA demonstrated that access to FDK could impact both student and adult health in Nevada. Our engagement of public health professionals along with stakeholders and the community in the HIA process demonstrated that HIAs can be an important tool for public health professionals to examine the effects on community health of policies, programs, plans or projects that arise outside of the health sector. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The Pagerank-Index: Going beyond Citation Counts in Quantifying Scientific Impact of Researchers

PubMed Central

Senanayake, Upul; Piraveenan, Mahendra; Zomaya, Albert

2015-01-01

Quantifying and comparing the scientific output of researchers has become critical for governments, funding agencies and universities. Comparison by reputation and direct assessment of contributions to the field is no longer possible, as the number of scientists increases and traditional definitions about scientific fields become blurred. The h-index is often used for comparing scientists, but has several well-documented shortcomings. In this paper, we introduce a new index for measuring and comparing the publication records of scientists: the pagerank-index (symbolised as π). The index uses a version of pagerank algorithm and the citation networks of papers in its computation, and is fundamentally different from the existing variants of h-index because it considers not only the number of citations but also the actual impact of each citation. We adapt two approaches to demonstrate the utility of the new index. Firstly, we use a simulation model of a community of authors, whereby we create various ‘groups’ of authors which are different from each other in inherent publication habits, to show that the pagerank-index is fairer than the existing indices in three distinct scenarios: (i) when authors try to ‘massage’ their index by publishing papers in low-quality outlets primarily to self-cite other papers (ii) when authors collaborate in large groups in order to obtain more authorships (iii) when authors spend most of their time in producing genuine but low quality publications that would massage their index. Secondly, we undertake two real world case studies: (i) the evolving author community of quantum game theory, as defined by Google Scholar (ii) a snapshot of the high energy physics (HEP) theory research community in arXiv. In both case studies, we find that the list of top authors vary very significantly when h-index and pagerank-index are used for comparison. We show that in both cases, authors who have collaborated in large groups and/or published less

The Pagerank-Index: Going beyond Citation Counts in Quantifying Scientific Impact of Researchers.

PubMed

Senanayake, Upul; Piraveenan, Mahendra; Zomaya, Albert

2015-01-01

Quantifying and comparing the scientific output of researchers has become critical for governments, funding agencies and universities. Comparison by reputation and direct assessment of contributions to the field is no longer possible, as the number of scientists increases and traditional definitions about scientific fields become blurred. The h-index is often used for comparing scientists, but has several well-documented shortcomings. In this paper, we introduce a new index for measuring and comparing the publication records of scientists: the pagerank-index (symbolised as π). The index uses a version of pagerank algorithm and the citation networks of papers in its computation, and is fundamentally different from the existing variants of h-index because it considers not only the number of citations but also the actual impact of each citation. We adapt two approaches to demonstrate the utility of the new index. Firstly, we use a simulation model of a community of authors, whereby we create various 'groups' of authors which are different from each other in inherent publication habits, to show that the pagerank-index is fairer than the existing indices in three distinct scenarios: (i) when authors try to 'massage' their index by publishing papers in low-quality outlets primarily to self-cite other papers (ii) when authors collaborate in large groups in order to obtain more authorships (iii) when authors spend most of their time in producing genuine but low quality publications that would massage their index. Secondly, we undertake two real world case studies: (i) the evolving author community of quantum game theory, as defined by Google Scholar (ii) a snapshot of the high energy physics (HEP) theory research community in arXiv. In both case studies, we find that the list of top authors vary very significantly when h-index and pagerank-index are used for comparison. We show that in both cases, authors who have collaborated in large groups and/or published less

A health impact assessment of proposed public transportation service cuts and fare increases in Boston, Massachusetts (U.S.A.).

PubMed

James, Peter; Ito, Kate; Buonocore, Jonathan J; Levy, Jonathan I; Arcaya, Mariana C

2014-08-07

Transportation decisions have health consequences that are often not incorporated into policy-making processes. Health Impact Assessment (HIA) is a process that can be used to evaluate health effects of transportation policy. We present a rapid HIA, conducted over eight weeks, evaluating health and economic effects of proposed fare increases and service cuts to Boston, Massachusetts' public transportation system. We used transportation modeling in concert with tools allowing for quantification and monetization of multiple pathways. We estimated health and economic costs of proposed public transportation system changes to be hundreds of millions of dollars per year, exceeding the budget gap the public transportation authority was required to close. Significant health pathways included crashes, air pollution, and physical activity. The HIA enabled stakeholders to advocate for more modest fare increases and service cuts, which were eventually adopted by decision makers. This HIA was among the first to quantify and monetize multiple pathways linking transportation decisions with health and economic outcomes, using approaches that could be applied in different settings. Including health costs in transportation decisions can lead to policy choices with both economic and public health benefits.

A Health Impact Assessment of Proposed Public Transportation Service Cuts and Fare Increases in Boston, Massachusetts (U.S.A.)

PubMed Central

James, Peter; Ito, Kate; Buonocore, Jonathan J.; Levy, Jonathan I.; Arcaya, Mariana C.

2014-01-01

Transportation decisions have health consequences that are often not incorporated into policy-making processes. Health Impact Assessment (HIA) is a process that can be used to evaluate health effects of transportation policy. We present a rapid HIA, conducted over eight weeks, evaluating health and economic effects of proposed fare increases and service cuts to Boston, Massachusetts’ public transportation system. We used transportation modeling in concert with tools allowing for quantification and monetization of multiple pathways. We estimated health and economic costs of proposed public transportation system changes to be hundreds of millions of dollars per year, exceeding the budget gap the public transportation authority was required to close. Significant health pathways included crashes, air pollution, and physical activity. The HIA enabled stakeholders to advocate for more modest fare increases and service cuts, which were eventually adopted by decision makers. This HIA was among the first to quantify and monetize multiple pathways linking transportation decisions with health and economic outcomes, using approaches that could be applied in different settings. Including health costs in transportation decisions can lead to policy choices with both economic and public health benefits. PMID:25105550

[Main indoor air pollutants and their health impacts].

PubMed

Xu, Zhen; Jin, Yinlong

2003-05-01

The quality of indoor air is a very important factor that may directly affect human health. There are many sources as well as a variety of indoor air pollutants. Therefore, the health impact is complicated, affecting different organs and systems of human being such as respiratory and immune system. The main indoor air pollutants are the combustion products from smoking, cooking and heating, the chemical pollutants from renovation materials and the biological contaminants. The kinds, sources and health impacts of these pollutants that affect the indoor air quality are reviewed in this paper.

Development of new impact functions for global risk caused by climate change

NASA Astrophysics Data System (ADS)

Miyazaki, C.

2014-12-01

The purpose of our study is to identify and quantify global-scale risks which can be caused by future climate change. In particular, we focus on the global-scale risks which have critical impacts to human environments. Use of impact functions is one of the common way to quantify global-scale risks. Output of impact function is climate impacts (e.g. economic damage by temperature increasing) and input can be global temperature increasing and/or socioeconomic condition (e.g. GDP). As the first step of study, we referred to AR5 WG II report (AR5, hereafter) and comprehensive inventories of climate change risks developed by Strategic R&D Area Project of the Environment Research and Technology Development Fund (ICA-RUS project). Then we extracted information which can be used to develop impact function from them. By following SPM/AR5, we focused on 11 sectors and extracted quantitative description on climate impacts from the AR5 and paper/reports cited in AR5. As a result, we identified about 40 risk items to focus as global-scale risks by climate change. Using the collected information, we tentatively made impact function on sea level rise and so on. In addition, we also extracted the impact functions used in Integrated Assessment Models (IAMs). The literature survey on IAM suggested the risk items considered in IAMs are limited. For instance, although FUND model provides detailed impact functions compared with most of other IAMs, its impact functions deal with only several sectors (e.g. agriculture, forestry, biodiversity, sea level rise, human health, energy demand and water resources). The survey on impact functions in IAMs also suggested impact function for abrupt climate change (so-called Tipping Element) is premature. Moreover, as example for quantifying health risk by our calculation, we also present the result on global-scale projection of the health burden attributable to childhood undernutrition (Ishida et al., 2014, ERL).

Concept of waste and its impact on human health.

PubMed

Pashkov, Vitalii M; Batyhina, Olena M; Trotska, Maryna V

Impact of the environment on human health is increasingly being paid attention both at the international level and at the level of individual countries. Among the factors that anyhow can affect it negatively, various objects are distinguished and waste is not of the last consequence. It has different nature of origin, ways of further utilization and a degree of impact on human health and the environment. Its generation, utilization and neutralization are determined by the relevant processes; their research allows continuous improvement and reduction of their negative impact on human health and the environment. To analyze provisions of the international legislation concerning the concept of waste and its classification, as well as its potential impacts on human health and the environment. The study analyzes and uses international legal documents, data of international organizations and scientists' deductions. Furthermore, the study integrates information from scientific journals with scientific methods from the medical and legal point of view. Within the framework of the system approach, as well as analysis and synthesis, the concept of waste, its classification and impact on human health and the environment have been researched. In consequence of the conducted study, it has been found that at the European level, considerable attention is paid to waste in the context of its possible negative impact on human health and the environment. Solution of this problem is carried out with the integrated approach, which is expressed both in enacting statutory acts and amending existing ones, as well as elucidating various aspects at the scientific, methodological, statistical and other levels. Waste in itself has different nature of origin, negative impact, ways of its further utilization. Some kinds of it can be used further in order to achieve other goals and needs that are not related to their generation, others can no longer be used for human benefits taking into account

A systematic review of outcome and impact of Master’s in health and health care

PubMed Central

2013-01-01

Background The ‘human resources for health’ crisis has highlighted the need for more health (care) professionals and led to an increased interest in health professional education, including master’s degree programmes. The number of these programmes in low- and middle-income countries (LMIC) is increasing, but questions have been raised regarding their relevance, outcome and impact. We conducted a systematic review to evaluate the outcomes and impact of health-related master’s degree programmes. Methods We searched the databases Scopus, Pubmed, Embase, CINAHL, ERIC, Psychinfo and Cochrane (1999 - November 2011) and selected websites. All papers describing outcomes and impact of health-related Master programmes were included. Three reviewers, two for each article, extracted data independently. The articles were categorised by type of programme, country, defined outcomes and impact, study methods used and level of evidence, and classified according to outcomes: competencies used in practice, graduates’ career progression and impact on graduates’ workplaces and sector/society. Results Of the 33 articles included in the review, most originated from the US and the UK, and only one from a low-income country. The programmes studied were in public health (8), nursing (8), physiotherapy (5), family practice (4) and other topics (8). Outcomes were defined in less than one third of the articles, and impact was not defined at all. Outcomes and impact were measured by self-reported alumni surveys and qualitative methods. Most articles reported that competencies learned during the programme were applied in the workplace and alumni reported career progression or specific job changes. Some articles reported difficulties in using newly gained competencies in the workplace. There was limited evidence of impact on the workplace. Only two articles reported impact on the sector. Most studies described learning approaches, but very few described a mechanism to ensure outcome

Quantifying Queensland patients with cancer health service usage and costs: study protocol.

PubMed

Callander, Emily; Topp, Stephanie M; Larkins, Sarah; Sabesan, Sabe; Bates, Nicole

2017-01-24

The overall mortality rate for cancer has declined in Australia. However, socioeconomic inequalities exist and the out-of-pocket costs incurred by patients in Australia are high compared with some European countries. There is currently no readily available data set to provide a systematic means of measuring the out-of-pocket costs incurred by patients with cancer within Australia. The primary aim of the project is to quantify the direct out-of-pocket healthcare expenditure of individuals in the state of Queensland, who are diagnosed with cancer. This project will build Australia's first model (called CancerCostMod) of out-of-pocket healthcare expenditure of patients with cancer using administrative data from Queensland Cancer Registry, for all individuals diagnosed with any cancer in Queensland between 1 July 2011 and 30 June 2012, linked to their Admitted Patient Data Collection, Emergency Department Information System, Medicare Benefits Schedule and Pharmaceutical Benefits Scheme records from 1 July 2011 to 30 June 2015. No identifiable information will be provided to the authors. The project will use a combination of linear and logistic regression modelling, Cox proportional hazards modelling and machine learning to identify differences in survival, total health system expenditure, total out-of-pocket expenditure and high out-of-pocket cost patients, adjusting for demographic and clinical confounders, and income group, Indigenous status and geographic location. Results will be analysed separately for different types of cancer. Human Research Ethics approval has been obtained from the Townsville Hospital and Health Service Human Research Ethics Committee (HREC/16/QTHS/110) and James Cook University Human Research Ethics Committee (H6678). Permission to waive consent has been sought from Queensland Health under the Public Health Act 2005. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

Quantifying Queensland patients with cancer health service usage and costs: study protocol

PubMed Central

Callander, Emily; Topp, Stephanie M; Larkins, Sarah; Sabesan, Sabe

2017-01-01

Introduction The overall mortality rate for cancer has declined in Australia. However, socioeconomic inequalities exist and the out-of-pocket costs incurred by patients in Australia are high compared with some European countries. There is currently no readily available data set to provide a systematic means of measuring the out-of-pocket costs incurred by patients with cancer within Australia. The primary aim of the project is to quantify the direct out-of-pocket healthcare expenditure of individuals in the state of Queensland, who are diagnosed with cancer. Methods and analysis This project will build Australia's first model (called CancerCostMod) of out-of-pocket healthcare expenditure of patients with cancer using administrative data from Queensland Cancer Registry, for all individuals diagnosed with any cancer in Queensland between 1 July 2011 and 30 June 2012, linked to their Admitted Patient Data Collection, Emergency Department Information System, Medicare Benefits Schedule and Pharmaceutical Benefits Scheme records from 1 July 2011 to 30 June 2015. No identifiable information will be provided to the authors. The project will use a combination of linear and logistic regression modelling, Cox proportional hazards modelling and machine learning to identify differences in survival, total health system expenditure, total out-of-pocket expenditure and high out-of-pocket cost patients, adjusting for demographic and clinical confounders, and income group, Indigenous status and geographic location. Results will be analysed separately for different types of cancer. Ethics and dissemination Human Research Ethics approval has been obtained from the Townsville Hospital and Health Service Human Research Ethics Committee (HREC/16/QTHS/110) and James Cook University Human Research Ethics Committee (H6678). Permission to waive consent has been sought from Queensland Health under the Public Health Act 2005. PMID:28119391

The need for health impact assessment in China: Potential benefits for public health and steps forward

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wu Liming, E-mail: lmwu@scdc.sh.c; Center for Environment and Population Health, Griffith University, Nathan 4111; Rutherford, Shannon

2011-07-15

Health impact assessment (HIA) is a useful tool to predict and estimate the potential health impact associated with programs, projects, and policies by comprehensively identifying relevant health determinants and their consequences. China is undergoing massive and rapid socio-economic changes leading to environment and population health challenges such as a large increase in non-communicable diseases, the emergence and re-emergence of infectious diseases, new health risks associated with environmental pollutants and escalating health inequality. These health issues are affected by multiple determinants which can be influenced by planned policies, programs, and projects. This paper discusses the needs for health impact assessment inmore » China in order to minimize the negative health consequences from projects, programs and policies associated with rapid social and economic development. It first describes the scope of China's current impact assessment system and points out its inadequacy in meeting the requirements of population health protection and promotion. It then analyses the potential use of HIA and why China needs to develop and apply HIA as a tool to identify potential health impacts of proposed programs, projects and policies so as to influence decision-making early in the planning process. Thus, the paper recommends the development of HIA as a useful tool in China to enhance decision-making for the protection and promotion of population health. For this to happen, the paper outlines steps necessary for the establishment and successful implementation of HIA in China: beginning with the establishment of a HIA framework, followed by workforce capacity building, methodology design, and intersectoral collaboration and stakeholder engagement.« less

Health impact assessment as an agent of policy change: improving the health impacts of the mayor of London's draft transport strategy.

PubMed

Mindell, J; Sheridan, L; Joffe, M; Samson-Barry, H; Atkinson, S

2004-03-01

To increase the positive and mitigate the negative health impacts of the mayor's draft transport strategy for London. A rapid prospective health impact assessment (HIA) of the penultimate draft of the strategy, using a review commissioned by the regional director of public health; an appraisal of congestion charging; and a participatory workshop. Two audits of changes were performed to assess the impact on policy of the HIA process. Regional government policy development. Recommendations from the rapid HIA were fed back into the drafting process. Changes (a) between the penultimate draft and the draft for public consultation and (b) between that and the final mayoral strategy. The draft transport strategy published for consultation differed in a number of respects from the previous version. Almost all the recommendations from the HIA were incorporated into the final strategy. Significant changes included promoting sustainable travel plans for workplaces and schools; giving priority to infrastructure and services that benefit London's deprived communities; increased emphasis on promoting walking and cycling and reducing reliance on private cars; and a commitment to track the health impacts of the final strategy and its implementation. Specific additions included re-allocating road space. HIA was successful in influencing the transport strategy for London, resulting in several improvements from a health viewpoint. HIA is an effective method both for bringing about significant change in policy proposals and in increasing policy makers' understanding of determinants of health and hence in changing attitudes of policy makers.

Health risks of energy systems.

PubMed

Krewitt, W; Hurley, F; Trukenmüller, A; Friedrich, R

1998-08-01

Health risks from fossil, renewable and nuclear reference energy systems are estimated following a detailed impact pathway approach. Using a set of appropriate air quality models and exposure-effect functions derived from the recent epidemiological literature, a methodological framework for risk assessment has been established and consistently applied across the different energy systems, including the analysis of consequences from a major nuclear accident. A wide range of health impacts resulting from increased air pollution and ionizing radiation is quantified, and the transferability of results derived from specific power plants to a more general context is discussed.

Climate change and Public health: vulnerability, impacts, and adaptation

NASA Astrophysics Data System (ADS)

Guzzone, F.; Setegn, S.

2013-12-01

Climate Change plays a significant role in public health. Changes in climate affect weather conditions that we are accustomed to. Increases in the frequency or severity of extreme weather events such as storms could increase the risk of dangerous flooding, high winds, and other direct threats to people and property. Changes in temperature, precipitation patterns, and extreme events could enhance the spread of some diseases. According to studies by EPA, the impacts of climate change on health will depend on many factors. These factors include the effectiveness of a community's public health and safety systems to address or prepare for the risk and the behavior, age, gender, and economic status of individuals affected. Impacts will likely vary by region, the sensitivity of populations, the extent and length of exposure to climate change impacts, and society's ability to adapt to change. Transmissions of infectious disease have been associated with social, economic, ecological, health care access, and climatic factors. Some vector-borne diseases typically exhibit seasonal patterns in which the role of temperature and rainfall is well documented. Some of the infectious diseases that have been documented by previous studies, include the correlation between rainfall and drought in the occurrence of malaria, the influence of the dry season on epidemic meningococcal disease in the sub-Saharan African, and the importance of warm ocean waters in driving cholera occurrence in the Ganges River delta in Asia The rise of climate change has been a major concern in the public health sector. Climate change mainly affects vulnerable populations especially in developing countries; therefore, it's important that public health advocates are involve in the decision-making process in order to provide resources and preventative measures for the challenges that are associated with climate change. The main objective of this study is to assess the vulnerability and impact of climate change

Environmental Impacts, Health and Safety Impacts, and Financial Costs of the Front End of the Nuclear Fuel Cycle

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brett W Carlsen; Urairisa Phathanapirom; Eric Schneider

2013-07-01

FEFC processes, unlike many of the proposed fuel cycles and technologies under consideration, involve mature operational processes presently in use at a number of facilities worldwide. This report identifies significant impacts resulting from these current FEFC processes and activities. Impacts considered to be significant are those that may be helpful in differentiating between fuel cycle performance and for which the FEFC impact is not negligible relative to those from the remainder of the full fuel cycle. This report: • Defines ‘representative’ processes that typify impacts associated with each step of the FEFC, • Establishes a framework and architecture for rollingmore » up impacts into normalized measures that can be scaled to quantify their contribution to the total impacts associated with various fuel cycles, and • Develops and documents the bases for estimates of the impacts and costs associated with each of the representative FEFC processes.« less

The impact of globalization on public health: implications for the UK Faculty of Public Health Medicine.

PubMed

Lee, K

2000-09-01

There has been substantial discussion of globalization in the scholarly and popular press yet limited attention so far among public health professionals. This is so despite the many potential impacts of globalization on public health. Defining public health broadly, as focused on the collective health of populations requiring a range of intersectoral activities, globalization can be seen to have particular relevance. Globalization, in turn, can be defined as a process that is changing the nature of human interaction across a wide range of spheres and along at least three dimensions. Understanding public health and globalization in these ways suggests the urgent need for research to better understand the linkages between the two, and effective policy responses by a range of public health institutions, including the UK Faculty of Public Health Medicine. The paper is based on a review of secondary literature on globalization that led to the development of a conceptual framework for understanding potential impacts on the determinants of health and public health. The paper then discusses major areas of public health in relation to these potential impacts. It concludes with recommendations on how the UK Faculty of Public Health Medicine might contribute to addressing these impacts through its various activities. Although there is growing attention to the importance of globalization to public health, there has been limited research and policy development in the United Kingdom. The UK Faculty of Public Health Medicine needs to play an active role in bringing relevant issues to the attention of policy makers, and encourage its members to take up research, teaching and policy initiatives. The potential impacts of globalization support a broader understanding and practice of public health that embraces a wide range of health determinants.

Health impact metrics for air pollution management strategies

PubMed Central

Martenies, Sheena E.; Wilkins, Donele; Batterman, Stuart A.

2015-01-01

Health impact assessments (HIAs) inform policy and decision making by providing information regarding future health concerns, and quantitative HIAs now are being used for local and urban-scale projects. HIA results can be expressed using a variety of metrics that differ in meaningful ways, and guidance is lacking with respect to best practices for the development and use of HIA metrics. This study reviews HIA metrics pertaining to air quality management and presents evaluative criteria for their selection and use. These are illustrated in a case study where PM2.5 concentrations are lowered from 10 to 8 µg/m3 in an urban area of 1.8 million people. Health impact functions are used to estimate the number of premature deaths, unscheduled hospitalizations and other morbidity outcomes. The most common metric in recent quantitative HIAs has been the number of cases of adverse outcomes avoided. Other metrics include time-based measures, e.g., disability-adjusted life years (DALYs), monetized impacts, functional-unit based measures, e.g., benefits per ton of emissions reduced, and other economic indicators, e.g., cost-benefit ratios. These metrics are evaluated by considering their comprehensiveness, the spatial and temporal resolution of the analysis, how equity considerations are facilitated, and the analysis and presentation of uncertainty. In the case study, the greatest number of avoided cases occurs for low severity morbidity outcomes, e.g., asthma exacerbations (n=28,000) and minor-restricted activity days (n=37,000); while DALYs and monetized impacts are driven by the severity, duration and value assigned to a relatively low number of premature deaths (n=190 to 230 per year). The selection of appropriate metrics depends on the problem context and boundaries, the severity of impacts, and community values regarding health. The number of avoided cases provides an estimate of the number of people affected, and monetized impacts facilitate additional economic analyses

Health impact metrics for air pollution management strategies.

PubMed

Martenies, Sheena E; Wilkins, Donele; Batterman, Stuart A

2015-12-01

Health impact assessments (HIAs) inform policy and decision making by providing information regarding future health concerns, and quantitative HIAs now are being used for local and urban-scale projects. HIA results can be expressed using a variety of metrics that differ in meaningful ways, and guidance is lacking with respect to best practices for the development and use of HIA metrics. This study reviews HIA metrics pertaining to air quality management and presents evaluative criteria for their selection and use. These are illustrated in a case study where PM2.5 concentrations are lowered from 10 to 8μg/m(3) in an urban area of 1.8 million people. Health impact functions are used to estimate the number of premature deaths, unscheduled hospitalizations and other morbidity outcomes. The most common metric in recent quantitative HIAs has been the number of cases of adverse outcomes avoided. Other metrics include time-based measures, e.g., disability-adjusted life years (DALYs), monetized impacts, functional-unit based measures, e.g., benefits per ton of emissions reduced, and other economic indicators, e.g., cost-benefit ratios. These metrics are evaluated by considering their comprehensiveness, the spatial and temporal resolution of the analysis, how equity considerations are facilitated, and the analysis and presentation of uncertainty. In the case study, the greatest number of avoided cases occurs for low severity morbidity outcomes, e.g., asthma exacerbations (n=28,000) and minor-restricted activity days (n=37,000); while DALYs and monetized impacts are driven by the severity, duration and value assigned to a relatively low number of premature deaths (n=190 to 230 per year). The selection of appropriate metrics depends on the problem context and boundaries, the severity of impacts, and community values regarding health. The number of avoided cases provides an estimate of the number of people affected, and monetized impacts facilitate additional economic analyses

Assessing Concentrations and Health Impacts of Air Quality Management Strategies: Framework for Rapid Emissions Scenario and Health impact ESTimation (FRESH-EST)

PubMed Central

Milando, Chad W.; Martenies, Sheena E.; Batterman, Stuart A.

2017-01-01

In air quality management, reducing emissions from pollutant sources often forms the primary response to attaining air quality standards and guidelines. Despite the broad success of air quality management in the US, challenges remain. As examples: allocating emissions reductions among multiple sources is complex and can require many rounds of negotiation; health impacts associated with emissions, the ultimate driver for the standards, are not explicitly assessed; and long dispersion model run-times, which result from the increasing size and complexity of model inputs, limit the number of scenarios that can be evaluated, thus increasing the likelihood of missing an optimal strategy. A new modeling framework, called the "Framework for Rapid Emissions Scenario and Health impact ESTimation" (FRESH-EST), is presented to respond to these challenges. FRESH-EST estimates concentrations and health impacts of alternative emissions scenarios at the urban scale, providing efficient computations from emissions to health impacts at the Census block or other desired spatial scale. In addition, FRESH-EST can optimize emission reductions to meet specified environmental and health constraints, and a convenient user interface and graphical displays are provided to facilitate scenario evaluation. The new framework is demonstrated in an SO2 non-attainment area in southeast Michigan with two optimization strategies: the first minimizes emission reductions needed to achieve a target concentration; the second minimizes concentrations while holding constant the cumulative emissions across local sources (e.g., an emissions floor). The optimized strategies match outcomes in the proposed SO2 State Implementation Plan without the proposed stack parameter modifications or shutdowns. In addition, the lower health impacts estimated for these strategies suggest the potential for FRESH-EST to identify pollution control alternatives for air quality management planning. PMID:27318620

Assessing concentrations and health impacts of air quality management strategies: Framework for Rapid Emissions Scenario and Health impact ESTimation (FRESH-EST).

PubMed

Milando, Chad W; Martenies, Sheena E; Batterman, Stuart A

2016-09-01

In air quality management, reducing emissions from pollutant sources often forms the primary response to attaining air quality standards and guidelines. Despite the broad success of air quality management in the US, challenges remain. As examples: allocating emissions reductions among multiple sources is complex and can require many rounds of negotiation; health impacts associated with emissions, the ultimate driver for the standards, are not explicitly assessed; and long dispersion model run-times, which result from the increasing size and complexity of model inputs, limit the number of scenarios that can be evaluated, thus increasing the likelihood of missing an optimal strategy. A new modeling framework, called the "Framework for Rapid Emissions Scenario and Health impact ESTimation" (FRESH-EST), is presented to respond to these challenges. FRESH-EST estimates concentrations and health impacts of alternative emissions scenarios at the urban scale, providing efficient computations from emissions to health impacts at the Census block or other desired spatial scale. In addition, FRESH-EST can optimize emission reductions to meet specified environmental and health constraints, and a convenient user interface and graphical displays are provided to facilitate scenario evaluation. The new framework is demonstrated in an SO2 non-attainment area in southeast Michigan with two optimization strategies: the first minimizes emission reductions needed to achieve a target concentration; the second minimizes concentrations while holding constant the cumulative emissions across local sources (e.g., an emissions floor). The optimized strategies match outcomes in the proposed SO2 State Implementation Plan without the proposed stack parameter modifications or shutdowns. In addition, the lower health impacts estimated for these strategies suggest that FRESH-EST could be used to identify potentially more desirable pollution control alternatives in air quality management planning

Monetary burden of health impacts of air pollution in Mumbai, India: implications for public health policy.

PubMed

Patankar, A M; Trivedi, P L

2011-03-01

Mumbai, a mega city with a population of more than 12 million, is experiencing acute air pollution due to commercial activity, a boom in construction and vehicular traffic. This study was undertaken to investigate the link between air pollution and health impacts for Mumbai, and estimate the monetary burden of these impacts. Cross-sectional data were subjected to logistic regression to analyse the link between air pollution and health impacts, and the cost of illness approach was used to measure the monetary burden of these impacts. Data collected by the Environmental Pollution Research Centre at King Edward Memorial Hospital in Mumbai were analysed using logistic regression to investigate the link between air pollution and morbidity impacts. The monetary burden of morbidity was estimated through the cost of illness approach. For this purpose, information on treatment costs and foregone earnings due to illness was obtained through the household survey and interviews with medical practitioners. Particulate matter (PM(10)) and nitrogen dioxide (NO(2)) emerged as the critical pollutants for a range of health impacts, including symptoms such as cough, breathlessness, wheezing and cold, and illnesses such as allergic rhinitis and chronic obstructive pulmonary disease (COPD). This study developed the concentration-response coefficients for these health impacts. The total monetary burden of these impacts, including personal burden, government expenditure and societal cost, is estimated at 4522.96 million Indian Rupees (INR) or US$ 113.08 million for a 50-μg/m(3) increase in PM(10), and INR 8723.59 million or US$ 218.10 million for a similar increase in NO(2). The estimated monetary burden of health impacts associated with air pollution in Mumbai mainly comprises out-of-pocket expenses of city residents. These expenses form a sizable proportion of the annual income of individuals, particularly those belonging to poor households. These findings have implications for public

Assessing health impact assessment: multidisciplinary and international perspectives

PubMed Central

Krieger, N; Northridge, M; Gruskin, S; Quinn, M; Kriebel, D; Davey, S; Bassett, M; Rehkopf, D; Miller, C

2003-01-01

Health impact assessment (HIA) seeks to expand evaluation of policy and programmes in all sectors, both private and public, to include their impact on population health. While the idea that the public's health is affected by a broad array of social and economic policies is not new and dates back well over two centuries, what is new is the notion—increasingly adopted by major health institutions, such as the World Health Organisation (WHO) and the United Kingdom National Health Services (NHS)—that health should be an explicit consideration when evaluating all public policies. In this article, it is argued that while HIA has the potential to enhance recognition of societal determinants of health and of intersectoral responsibility for health, its pitfalls warrant critical attention. Greater clarity is required regarding criteria for initiating, conducting, and completing HIA, including rules pertaining to decision making, enforcement, compliance, plus paying for their conduct. Critical debate over the promise, process, and pitfalls of HIA needs to be informed by multiple disciplines and perspectives from diverse people and regions of the world. PMID:12933768

Quantifying the Risk Posed by Potential Earth Impacts

NASA Astrophysics Data System (ADS)

Chesley, Steven R.; Chodas, Paul W.; Milani, Andrea; Valsecchi, Giovanni B.; Yeomans, Donald K.

2002-10-01

Predictions of future potential Earth impacts by near-Earth objects (NEOs) have become commonplace in recent years, and the rate of these detections is likely to accelerate as asteroid survey efforts continue to mature. In order to conveniently compare and categorize the numerous potential impact solutions being discovered we propose a new hazard scale that will describe the risk posed by a particular potential impact in both absolute and relative terms. To this end, we measure each event in two ways, first without any consideration of the event's time proximity or its significance relative to the so-called background threat, and then in the context of the expected risk from other objects over the intervening years until the impact. This approach is designed principally to facilitate communication among astronomers, and it is not intended for public communication of impact risks. The scale characterizes impacts across all impact energies, probabilities and dates, and it is useful, in particular, when dealing with those cases which fall below the threshold of public interest. The scale also reflects the urgency of the situation in a natural way and thus can guide specialists in assessing the computational and observational effort appropriate for a given situation. In this paper we describe the metrics introduced, and we give numerous examples of their application. This enables us to establish in rough terms the levels at which events become interesting to various parties.

Working conditions in call-centers, the impact on employee health: a transversal study. Part II.

PubMed

Charbotel, Barbara; Croidieu, Sophie; Vohito, Michel; Guerin, Anne-Céline; Renaud, Liliane; Jaussaud, Joelle; Bourboul, Christian; Imbard, Isabelle; Ardiet, Dominique; Bergeret, Alain

2009-05-01

The present study sought to assess the impact of telephone call center employees' working conditions on health by identifying at-risk employment situations. A transversal study was performed in companies followed by 47 occupational physicians taking part (working conditions have been previously described). A self-administered medical questionnaire was used to collect data on absence due to sick leave, hearing and visual problems, musculoskeletal disorders, psychotropic drug use, etc. An analog-scale self-assessment of health status and a general health questionnaire (GHQ-12) were used. Personal or familial events that might underlie health problems and affect GHQ-12 results were quantified and taken into account in a logistic regression. A total of 2,130 call-handlers were included. Workers who had availed sick leave during the previous 12 months were 60%. The most frequent musculoskeletal complaints over the previous 12-month period concerned the cervical region (59%). During the same period, 77.3% of subjects experienced visual fatigue, 50% reported auditory fatigue signs and 47% vocal disturbance or fatigue. According to the Likert scale, 39.4% of workers had showed psychological distress. Almost 24% of the workers had used psychoactive medication during the previous 12 months. A significant association was found between psychological distress and the frequency of musculoskeletal disorders. Psychological distress and musculoskeletal disorders were significantly greater in workers with Job Strain and Iso Strain. After taking non-occupational factors into account, some occupational factors were found to increase the risk of psychological distress (Likert >12): imposed full-time schedule, being unable to simultaneously meet both quality and quantity requirements, situations of tension with clients, negative comments from superiors, and lack of recognition from superiors. This survey of over 2,000 call center employees highlighted the high frequency of psychological

Quantified self and comprehensive geriatric assessment: older adults are able to evaluate their own health and functional status.

PubMed

Beauchet, Olivier; Launay, Cyrille P; Merjagnan, Christine; Kabeshova, Anastasiia; Annweiler, Cédric

2014-01-01

There is an increased interest of individuals in quantifying their own health and functional status. The aim of this study was to examine the concordance of answers to a self-administered questionnaire exploring health and functional status with information collected during a full clinical examination performed by a physician among cognitively healthy adults (CHI) and older patients with mild cognitive impairment (MCI) or mild-to-moderate Alzheimer disease (AD). Based on cross-sectional design, a total of 60 older adults (20 CHI, 20 patients with MCI, and 20 patients with mild-to-moderate AD) were recruited in the memory clinic of Angers, France. All participants completed a self-administered questionnaire in paper format composed of 33 items exploring age, gender, nutrition, place of living, social resources, drugs daily taken, memory complaint, mood and general feeling, fatigue, activities of daily living, physical activity and history of falls. Participants then underwent a full clinical examination by a physician exploring the same domains. High concordance between the self-administered questionnaire and physician's clinical examination was showed. The few divergences were related to cognitive status, answers of AD and MCI patients to the self-administered questionnaire being less reliable than those of CHI. Older adults are able to evaluate their own health and functional status, regardless of their cognitive status. This result needs to be confirmed and opens new perspectives for the quantified self-trend and could be helpful in daily clinical practice of primary care.

Human Health Impacts of and Public Health Adaptation to Climate Variability and Change

NASA Astrophysics Data System (ADS)

Ebi, K. L.

2007-12-01

Weather and climate are among the factors that determine the geographic range and incidence of several major causes of ill health, including undernutrition, diarrheal diseases and other conditions due to unsafe water and lack of basic sanitation, and malaria. The Human Health chapter in the Fourth Assessment Report of the Intergovernmental Panel on Climate Change concluded that climate change has begun to negatively affect human health, and that projected climate change will increase the risks of climate-sensitive health outcomes, particularly in lower-income populations, predominantly within tropical/subtropical countries. Those at greatest risk include the urban poor, older adults, children, traditional societies, subsistence farmers, and coastal populations, particularly in low income countries. The cause-and-effect chain from climate change to changing patterns of health determinants and outcomes is complex and includes socioeconomic, institutional, and other factors. The severity of future impacts will be determined by changes in climate as well as by concurrent changes in nonclimatic factors and by the adaptation measures implemented to reduce negative impacts. Public health has a long history of effectively intervening to reduce risks to the health of individuals and communities. Lessons learned from more than 150 years of research and intervention can provide insights to guide the design and implementation of effective and efficient interventions to reduce the current and projected impacts of climate variability and change.

Human Health and Economic Impacts of Ozone Reductions by Income Group.

PubMed

Saari, Rebecca K; Thompson, Tammy M; Selin, Noelle E

2017-02-21

Low-income households may be disproportionately affected by ozone pollution and ozone policy. We quantify how three factors affect the relative benefits of ozone policies with household income: (1) unequal ozone reductions; (2) policy delay; and (3) economic valuation methods. We model ozone concentrations under baseline and policy conditions across the full continental United States to estimate the distribution of ozone-related health impacts across nine income groups. We enhance an economic model to include these impacts across household income categories, and present its first application to evaluate the benefits of ozone reductions for low-income households. We find that mortality incidence rates decrease with increasing income. Modeled ozone levels yield a median of 11 deaths per 100 000 people in 2005. Proposed policy reduces these rates by 13%. Ozone reductions are highest among low-income households, which increases their relative welfare gains by up to 4% and decreases them for the rich by up to 8%. The median value of reductions in 2015 is either $30 billion (in 2006 U.S. dollars) or $1 billion if reduced mortality risks are valued with willingness-to-pay or as income from increased life expectancy. Ozone reductions were relatively twice as beneficial for the lowest- compared to the highest-income households. The valuation approach affected benefits more than a policy delay or differential ozone reductions with income.

Modeling The Economic And Health Impact Of Increasing Children’s Physical Activity In The United States

PubMed Central

Lee, Bruce Y.; Adam, Atif; Zenkov, Eli; Hertenstein, Daniel; Ferguson, Marie C.; Wang, Peggy I.; Wong, Michelle S.; Wedlock, Patrick; Nyathi, Sindiso; Gittelsohn, Joel; Falah-Fini, Saeideh; Bartsch, Sarah M.; Cheskin, Lawrence J.; Brown, Shawn T.

2017-01-01

Increasing physical activity among children is a potentially important public health intervention. Quantifying the economic and health effects of the intervention would help decision makers understand its impact and priority. Using a computational simulation model that we developed to represent all US children ages 8–11 years, we estimated that maintaining the current physical activity levels (only 31.9 percent of children get twenty-five minutes of high-calorie-burning physical activity three times a week) would result each year in a net present value of $1.1 trillion in direct medical costs and $1.7 trillion in lost productivity over the course of their lifetimes. If 50 percent of children would exercise, the number of obese and overweight youth would decrease by 4.18 percent, averting $8.1 billion in direct medical costs and $13.8 billion in lost productivity. Increasing the proportion of children who exercised to 75 percent would avert $16.6 billion and $23.6 billion, respectively. PMID:28461358

The Impact of Indonesian Forest Fires on Singaporean Pollution and Health.

PubMed

Sheldon, Tamara L; Sankaran, Chandini

2017-05-01

Between 1990 and 2015, Indonesia lost nearly 25 percent of its forests, largely due to intentional burning to clear land for cultivation of palm oil and timber plantations.1 The neighboring "victim countries" experienced severe deteriorations in air quality as a result of these fires. For example, Singapore experienced record air pollution levels in June of 2013 and again in September of 2015 as a result of the Indonesian forest fires.2 This air pollution is associated with increased incidences of upper respiratory tract infections, acute conjunctivitis, lung disease, asthma, bronchitis, emphysema, and pneumonia, among other ailments.2 Quantifying the impact of air pollution on health outcomes is challenging because pollution levels are often nonrandom for a variety of reasons, including policy endogeneity and sorting (Dominici, Greenstone, and Sunstein 2014). In this paper we offer the first causal analysis of the transboundary health effects of the Indonesian forest burning. The Indonesian fires induce exogenous variation in Singaporean air quality. We take advantage of this by using satellite fire data to instrument for changes in Singaporean air quality. Since Singapore is only 277.6 square miles in area (two-thirds the size of New York City), air pollution resulting from the fires is homogeneously spread so that sorting is less likely to be an issue. Using a two-stage least squares approach, we find that from 2010 through mid-2016, the Indonesian fires caused a statistically significant increase in pollution levels in Singapore. Our study also provides evidence that polyclinic attendances for acute respiratory tract infections and acute conjunctivitis in Singapore increased as a result of the deterioration in air quality. The reduced form estimates show that a one standard deviation increase in our measure of fires causes a 0.7 standard deviation increase in polyclinic attendances for each of these illnesses. These findings provide causal evidence of the

Utilizing a Health Impact Assessment (HIA) to Connect Natural ...

EPA Pesticide Factsheets

Marrying scientific and health research with natural resource management should be a straightforward process. However, differences in purpose, goals, language, levels of detail and implementation authority between the scientists who conduct research and resource managers who plan and implement projects make it difficult for resource managers to include information not specific to the problem at hand. One method to overcome this barrier is a Health Impact Assessment (HIA) or process that uses scientific data, health expertise and public input to factor public health considerations into the decision-making process. An HIA informs decision makers and stakeholders of the potential health effects of a proposed program, policy, project or plan through a systematic investigation of impacts to health and health determinants and deliberative engagement of community members and other stakeholders throughout the HIA process. USEPA will be conducting an HIA on the Minnesota Department of Natural Resources’ sediment remediation and habitat restoration project at Kingsbury Bay and Grassy Point. This poster outlines the HIA process, illustrates how technical and stakeholder committees inform the process, and presents the determinants of health that will be explored in the HIA. This poster will illustrate how a Health Impact Assessment, a process that uses scientific data, health expertise and public input to factor public health considerations into the decision-making proces

Quantifying options for reducing coronary heart disease mortality by 2020.

PubMed

Huffman, Mark D; Lloyd-Jones, Donald M; Ning, Hongyan; Labarthe, Darwin R; Guzman Castillo, Maria; O'Flaherty, Martin; Ford, Earl S; Capewell, Simon

2013-06-25

The American Heart Association (AHA) 2020 Strategic Impact Goal proposes a 20% improvement in cardiovascular health of all Americans. We aimed to estimate the potential reduction in coronary heart disease (CHD) deaths. We used data on 40 373 adults free of cardiovascular disease from the National Health and Nutrition Examination Survey (NHANES; 1988-2010). We quantified recent trends for 6 metrics (total cholesterol, systolic blood pressure, physical inactivity, smoking, diabetes mellitus, and obesity) and generated linear projections to 2020. We projected the expected number of CHD deaths in 2020 if 2006 age- and sex-specific CHD death rates remained constant, which would result in ≈480 000 CHD deaths in 2020 (12% increase). We used the previously validated IMPACT CHD model to project numbers of CHD deaths in 2020 under 2 different scenarios: (1) Assuming a 20% improvement in each cardiovascular health metric, we project 365 000 CHD deaths in 2020 (range 327 000-403 000) a 24% decrease reflecting modest reductions in total cholesterol (-41 000), systolic blood pressure (-36 000), physical inactivity (-12 000), smoking (-10 000), diabetes mellitus (-10 000), and obesity (-5000); (2) Assuming that recent risk factor trends continue to 2020, we project 335 000 CHD deaths (range 274 000-386 000), a 30% decrease reflecting improvements in total cholesterol, systolic blood pressure, smoking, and physical activity (≈167 000 fewer deaths), offset by increases in diabetes mellitus and body mass index (≈24 000 more deaths). Two contrasting scenarios of change in cardiovascular health metrics could prevent 24% to 30% of the CHD deaths expected in 2020, though with differing effects by age. Unfavorable continuing trends in obesity and diabetes mellitus would have substantial adverse effects. This analysis demonstrates the utility of modelling to inform health policy.

The impact of weight gain or loss on health care costs for employees at the Johnson & Johnson Family of Companies.

PubMed

Carls, Ginger Smith; Goetzel, Ron Z; Henke, Rachel Mosher; Bruno, Jennifer; Isaac, Fikry; McHugh, Janice

2011-01-01

To quantify the impact of weight gain or weight loss on health care costs. Employees completing at least two health risk assessments during 2002 to 2008 were classified as adding, losing, or staying at high/low risk for each of the nine health risks including overweight and obesity. Models for each risk were used to compare cost trends by controlling for employee characteristics. Employees who developed high risk for obesity (n = 405) experienced 9.9% points higher annual cost increases (95% confidence interval: 3.0%-16.8%) than those who remained at lower risk (n = 8015). Employees who moved from high to lower risk for obesity (n = 384), experienced annual cost increases that were 2.3% points lower (95% confidence interval: -7.4% to 2.8%) than those who remained high risk (n = 1699). Preventing weight gain through effective employee health promotion programs is likely to result in cost savings for employers.

Impact of war on child health in northern Syria: the experience of Médecins Sans Frontières.

PubMed

Meiqari, Lana; Hoetjes, Maartje; Baxter, Louisa; Lenglet, Annick

2018-03-01

Few data are available to evaluate the impact of Syrian war on civilian population; to describe this impact on child health, this article uses data from Médecins Sans Frontières-Operational Centre Amsterdam's activities in Tal-Abyad and Kobane cities, northern Syria (2013-2016). Data were obtained from routine medical datasets and narrative reports, for out-patient clinics, immunisation, nutritional monitoring and assessments, and in-patient care, and were analysed quantitatively and qualitatively. Infections were the largest contributor to morbidity. The proportion of < 5 year out-patient consultations of infectious diseases that are listed for outbreak monitoring in emergencies was 15% in 2013, 51% in 2014, 75% in 2015 and 70% in 2016. Thalassemia was recorded in 0.5% of 2014 < 5 year out-patient consultations and 3.4% of 2013-2014 < 18-year in-patient admissions. Measles immunisation activities and routine Extended Programme for Immunisation were re-activated across northern Syria; however, immunisation coverage could not be calculated. Results from our routine data must be compared cautiously, due to differences in settings and disease categories. With such scattered interventions, routine data are limited in providing a quantified evidence of emergency's health impact; however, they help in drawing a picture of children's health status and highlighting difficulties in providing curative and preventive services, in order to reflect part of population's plight. What is Known • Few data exist to evaluate the impact of the Syrian war on the health of children; • Médecins Sans Frontières (MSF-OCA) has worked in northern Syria during different times since 2013. What is New • Quantitative and qualitative analysis of MSF's routine medical data and situtation reports show that one fifth of all consultations in children < 5 years in MSF health facilities in northern Syria 2013-2016 were due to communicable diseases; • The analysis also highlights

Non-accidental health impacts of wildfire smoke.

PubMed

Youssouf, Hassani; Liousse, Catherine; Roblou, Laurent; Assamoi, Eric-Michel; Salonen, Raimo O; Maesano, Cara; Banerjee, Soutrik; Annesi-Maesano, Isabella

2014-11-14

Wildfires take a heavy toll on human health worldwide. Climate change may increase the risk of wildfire frequency. Therefore, in view of adapted preventive actions, there is an urgent need to further understand the health effects and public awareness of wildfires. We conducted a systematic review of non-accidental health impacts of wildfire and incorporated lessons learned from recent experiences. Based on the literature, various studies have established the relationship between one of the major components of wildfire, particulate matter (particles with diameter less than 10 µm (PM10) and less than 2.5 µm (PM2.5)) and cardiorespiratory symptoms in terms of Emergency Rooms visits and hospital admissions. Associations between wildfire emissions and various subclinical effects have also been established. However, few relationships between wildfire emissions and mortality have been observed. Certain segments of the population may be particularly vulnerable to smoke-related health risks. Among them, people with pre-existing cardiopulmonary conditions, the elderly, smokers and, for professional reasons, firefighters. Potential action mechanisms have been highlighted. Overall, more research is needed to better understand health impact of wildfire exposure.

Buildings vs. ballistics: Quantifying the vulnerability of buildings to volcanic ballistic impacts using field studies and pneumatic cannon experiments

NASA Astrophysics Data System (ADS)

Williams, G. T.; Kennedy, B. M.; Wilson, T. M.; Fitzgerald, R. H.; Tsunematsu, K.; Teissier, A.

2017-09-01

Recent casualties in volcanic eruptions due to trauma from blocks and bombs necessitate more rigorous, ballistic specific risk assessment. Quantitative assessments are limited by a lack of experimental and field data on the vulnerability of buildings to ballistic hazards. An improved, quantitative understanding of building vulnerability to ballistic impacts is required for informing appropriate life safety actions and other risk reduction strategies. We assessed ballistic impacts to buildings from eruptions at Usu Volcano and Mt. Ontake in Japan and compiled available impact data from eruptions elsewhere to identify common damage patterns from ballistic impacts to buildings. We additionally completed a series of cannon experiments which simulate ballistic block impacts to building claddings to investigate their performance over a range of ballistic projectile velocities, masses and energies. Our experiments provide new insights by quantifying (1) the hazard associated with post-impact shrapnel from building and rock fragments; (2) the effect of impact obliquity on damage; and (3) the additional impact resistance buildings possess when claddings are struck in areas directly supported by framing components. This was not well identified in previous work which may have underestimated building vulnerability to ballistic hazards. To improve assessment of building vulnerability to ballistics, we use our experimental and field data to develop quantitative vulnerability models known as fragility functions. Our fragility functions and field studies show that although unreinforced buildings are highly vulnerable to large ballistics (> 20 cm diameter), they can still provide shelter, preventing death during eruptions.

Process and impact evaluation of the Greater Christchurch Urban Development Strategy Health Impact Assessment

PubMed Central

Mathias, Kaaren R; Harris-Roxas, Ben

2009-01-01

Background despite health impact assessment (HIA) being increasingly widely used internationally, fundamental questions about its impact on decision-making, implementation and practices remain. In 2005 a collaboration between public health and local government authorities performed an HIA on the Christchurch Urban Development Strategy Options paper in New Zealand. The findings of this were incorporated into the Greater Christchurch Urban Development Strategy; Methods using multiple qualitative methodologies including key informant interviews, focus groups and questionnaires, this study performs process and impact evaluations of the Christchurch HIA including evaluation of costs and resource use; Results the evaluation found that the HIA had demonstrable direct impacts on planning and implementation of the final Urban Development Strategy as well as indirect impacts on understandings and ways of working within and between organisations. It also points out future directions and ways of working in this successful collaboration between public health and local government authorities. It summarises the modest resource use and discusses the important role HIA can play in urban planning with intersectoral collaboration and enhanced relationships as both catalysts and outcomes of the HIA process; Conclusion as one of the few evaluations of HIA that have been published to date, this paper makes a substantial contribution to the literature on the impact, utility and effectiveness of HIA. PMID:19344529

Quantifying agricultural drought impacts using soil moisture model and drought indices in South Korea

NASA Astrophysics Data System (ADS)

Nam, W. H.; Bang, N.; Hong, E. M.; Pachepsky, Y. A.; Han, K. H.; Cho, H.; Ok, J.; Hong, S. Y.

2017-12-01

Agricultural drought is defined as a combination of abnormal deficiency of precipitation, increased crop evapotranspiration demands from high-temperature anomalies, and soil moisture deficits during the crop growth period. Soil moisture variability and their spatio-temporal trends is a key component of the hydrological balance, which determines the crop production and drought stresses in the context of agriculture. In 2017, South Korea has identified the extreme drought event, the worst in one hundred years according to the South Korean government. The objective of this study is to quantify agricultural drought impacts using observed and simulated soil moisture, and various drought indices. A soil water balance model is used to simulate the soil water content in the crop root zone under rain-fed (no irrigation) conditions. The model used includes physical process using estimated effective rainfall, infiltration, redistribution in soil water zone, and plant water uptake in the form of actual crop evapotranspiration. Three widely used drought indices, including the Standardized Precipitation Index (SPI), the Standardized Precipitation Evapotranspiration Index (SPEI), and the Self-Calibrated Palmer Drought Severity Index (SC-PDSI) are compared with the observed and simulated soil moisture in the context of agricultural drought impacts. These results demonstrated that the soil moisture model could be an effective tool to provide improved spatial and temporal drought monitoring for drought policy.

Quantifying Variation in Head Start Effects on Young Children's Cognitive and Socio-Emotional Skills Using Data from the National Head Start Impact Study

ERIC Educational Resources Information Center

Bloom, Howard S.; Weiland, Christina

2015-01-01

This paper uses data from the Head Start Impact Study (HSIS), a nationally representative multisite randomized trial, to quantify variation in effects of Head Start during 2002-2003 on children's cognitive and socio-emotional outcomes relative to the effects of other local alternatives, including parent care. We find that (1) treatment and control…

The impact of corporate practices on health: implications for health policy.

PubMed

Freudenberg, Nicholas; Galea, Sandro

2008-04-01

Although corporate practices play a substantial role in shaping health and health behavior, public health researchers have rarely systematically studied these practices as a social determinant of health. We consider case studies of three products - trans fat, a food additive and a preservative; Vioxx, a pain killer; and sports utility vehicles - to illustrate the role of corporate policies and practices in the production of health and disease and the implications for health policy. In recent years, public health advocates, researchers, and lawyers have used strategies to reduce the adverse health impact of corporate practices. Systematic analysis of these experiences yields insights that can guide the development of health policies that increase opportunities for primary prevention by discouraging harmful corporate practices.

The case for systems thinking about climate change and mental health

NASA Astrophysics Data System (ADS)

Berry, Helen L.; Waite, Thomas D.; Dear, Keith B. G.; Capon, Anthony G.; Murray, Virginia

2018-04-01

It is increasingly necessary to quantify the impacts of climate change on populations, and to quantify the effectiveness of mitigation and adaptation strategies. Despite growing interest in the health effects of climate change, the relationship between mental health and climate change has received little attention in research or policy. Here, we outline current thinking about climate change and mental health, and discuss crucial limitations in modern epidemiology for examining this issue. A systems approach, complemented by a new style of research thinking and leadership, can help align the needs of this emerging field with existing and research policy agendas.

Searching for the Impact of Participation in Health and Health Research: Challenges and Methods.

PubMed

Harris, Janet; Cook, Tina; Gibbs, Lisa; Oetzel, John; Salsberg, Jon; Shinn, Carolynne; Springett, Jane; Wallerstein, Nina; Wright, Michael

2018-01-01

Internationally, the interest in involving patients and the public in designing and delivering health interventions and researching their effectiveness is increasing. Several systematic reviews of participation in health research have recently been completed, which note a number of challenges in documenting the impact of participation. Challenges include working across stakeholders with different understandings of participation and levels of experience in reviewing; comparing heterogeneous populations and contexts; configuring findings from often thin descriptions of participation in academic papers; and dealing with different definitions of impact. This paper aims to advance methods for systematically reviewing the impact of participation in health research, drawing on recent systematic review guidance. Practical examples for dealing with issues at each stage of a review are provided based on recent experience. Recommendations for improving primary research on participation in health are offered and key points to consider during the review are summarised.

Searching for the Impact of Participation in Health and Health Research: Challenges and Methods

PubMed Central

Cook, Tina; Salsberg, Jon; Shinn, Carolynne; Springett, Jane; Wallerstein, Nina; Wright, Michael

2018-01-01

Internationally, the interest in involving patients and the public in designing and delivering health interventions and researching their effectiveness is increasing. Several systematic reviews of participation in health research have recently been completed, which note a number of challenges in documenting the impact of participation. Challenges include working across stakeholders with different understandings of participation and levels of experience in reviewing; comparing heterogeneous populations and contexts; configuring findings from often thin descriptions of participation in academic papers; and dealing with different definitions of impact. This paper aims to advance methods for systematically reviewing the impact of participation in health research, drawing on recent systematic review guidance. Practical examples for dealing with issues at each stage of a review are provided based on recent experience. Recommendations for improving primary research on participation in health are offered and key points to consider during the review are summarised. PMID:29862298

Climate change and health: impacts, vulnerability, adaptation and mitigation.

PubMed

Kjellstrom, Tord; Weaver, Haylee J

2009-01-01

Global climate change is progressing and health impacts have been observed in a number of countries, including Australia. The main health impacts will be due to direct heat exposure, extreme weather, air pollution, reduced local food production, food- and vectorborne infectious diseases and mental stress. The issue is one of major public health importance. Adaptation to reduce the effects of climate change involves many different sectors to minimise negative health outcomes. Wide-scale mitigation is also required, in order to reduce the effects of climate change. In addition, future urban design must be modified to mitigate and adapt to the effects of climate change. Strategies for mitigation and adaptation can create co-benefits for both individual and community health, by reducing non-climate-related health hazard exposures and by encouraging health promoting behaviours and lifestyles.

Arms trade and its impact on global health.

PubMed

Mahmudi-Azer, Salahaddin

2006-01-01

The most obvious adverse impact of the arms trade on health is loss of life and maiming from the use of weapons in conflicts. Wealthy countries suffer damage to their health and human services when considerable resources are diverted to military expenditure. However, the relative impact of military expenditures and conflict on third world countries is much greater, and often devastating, by depriving a significant portion of the population of essential food, medicine, shelter, education, and economic opportunities. Further, the physical and psychological damage inflicted specifically on children is debilitating - through loss of (or separation from) families, loss of education, destruction of homes, exposure to murder and other violence, sexual abuse, abduction, torture, slavery, and forcible conscription as soldiers. This article outlines the socio-economic impact of the global arms trade in general and the damage done to human health and the environment, specifically.

Air quality and human health impacts of grasslands and shrublands in the United States

NASA Astrophysics Data System (ADS)

Gopalakrishnan, Varsha; Hirabayashi, Satoshi; Ziv, Guy; Bakshi, Bhavik R.

2018-06-01

Vegetation including canopy, grasslands, and shrublands can directly sequester pollutants onto the plant surface, resulting in an improvement in air quality. Until now, several studies have estimated the pollution removal capacity of canopy cover at the level of a county, but no such work exists for grasslands and shrublands. This work quantifies the air pollution removal capacity of grasslands and shrublands at the county-level in the United States and estimates the human health benefits associated with pollution removal using the i-Tree Eco model. Sequestration of pollutants is estimated based on the Leaf Area Index (LAI) obtained from the Moderate Resolution Imaging Spectroradiometer (MODIS) derived dataset estimates of LAI and the percentage land cover obtained from the National Land Cover Database (NLCD) for the year 2010. Calculation of pollution removal capacity using local environmental data indicates that grasslands and shrublands remove a total of 6.42 million tonnes of air pollutants in the United States and the associated monetary benefits total 268 million. Human health impacts and associated monetary value due to pollution removal was observed to be significantly high in urban areas indicating that grasslands and shrublands are equally critical as canopy in improving air quality and human health in urban regions.

Public Health-Related Impacts of Climate Change inCalifornia

DOE Office of Scientific and Technical Information (OSTI.GOV)

Drechsler, D.M.; Motallebi, N.; Kleeman, M.

2005-12-01

In June 2005 Governor Arnold Schwarzenegger issued Executive Order S-3-05 that set greenhouse gas emission reduction targets for California, and directed the Secretary of the California Environmental Protection Agency to report to the governor and the State legislature by January 2006 and biannually thereafter on the impacts to California of global warming, including impacts to water supply, public health, agriculture, the coastline, and forestry, and to prepare and report on mitigation and adaptation plans to combat these impacts. This report is a part of the report to the governor and legislature, and focuses on public health impacts that have beenmore » associated with climate change. Considerable evidence suggests that average ambient temperature is increasing worldwide, that temperatures will continue to increase into the future, and that global warming will result in changes to many aspects of climate, including temperature, humidity, and precipitation (McMichael and Githeko, 2001). It is expected that California will experience changes in both temperature and precipitation under current trends. Many of the changes in climate projected for California could have ramifications for public health (McMichael and Githeko, 2001), and this document summarizes the impacts judged most likely to occur in California, based on a review of available peer-reviewed scientific literature and new modeling and statistical analyses. The impacts identified as most significant to public health in California include mortality and morbidity related to temperature, air pollution, vector and water-borne diseases, and wildfires. There is considerable complexity underlying the health of a population with many contributing factors including biological, ecological, social, political, and geographical. In addition, the relationship between climate change and changes in public health is difficult to predict for the most part, although more detailed information is available on temperature

Climate Change-Related Water Disasters' Impact on Population Health.

PubMed

Veenema, Tener Goodwin; Thornton, Clifton P; Lavin, Roberta Proffitt; Bender, Annah K; Seal, Stella; Corley, Andrew

2017-11-01

Rising global temperatures have resulted in an increased frequency and severity of cyclones, hurricanes, and flooding in many parts of the world. These climate change-related water disasters (CCRWDs) have a devastating impact on communities and the health of residents. Clinicians and policymakers require a substantive body of evidence on which to base planning, prevention, and disaster response to these events. The purpose of this study was to conduct a systematic review of the literature concerning the impact of CCRWDs on public health in order to identify factors in these events that are amenable to preparedness and mitigation. Ultimately, this evidence could be used by nurses to advocate for greater preparedness initiatives and inform national and international disaster policy. A systematic literature review of publications identified through a comprehensive search of five relevant databases (PubMed, Cumulative Index to Nursing and Allied Health Literature [CINAHL], Embase, Scopus, and Web of Science) was conducted using a modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach in January 2017 to describe major themes and associated factors of the impact of CCRWDs on population health. Three major themes emerged: environmental disruption resulting in exposure to toxins, population susceptibility, and health systems infrastructure (failure to plan-prepare-mitigate, inadequate response, and lack of infrastructure). Direct health impact was characterized by four major categories: weather-related morbidity and mortality, waterborne diseases/water-related illness, vector-borne and zoonotic diseases, and psychiatric/mental health effects. Scope and duration of the event are factors that exacerbate the impact of CCRWDs. Discussion of specific factors amenable to mitigation was limited. Flooding as an event was overrepresented in this analysis (60%), and the majority of the research reviewed was conducted in high-income or upper

Environmental Stressors: The Mental Health Impacts of Living Near Industrial Activity*

PubMed Central

DOWNEY, LIAM; VAN WILLIGEN, MARIEKE

2011-01-01

A growing literature examines whether the poor, the working class, and people of color are disproportionately likely to live in environmentally hazardous neighborhoods. This literature assumes that environmental characteristics such as industrial pollution and hazardous waste are detrimental to human health, an assumption that has not been well tested. Drawing upon the sociology of mental health and environmental inequality studies, we ask whether industrial activity has an impact on psychological well-being. We link individual-level survey data with data from the U.S. Census and the Toxic Release Inventory and find that residential proximity to industrial activity has a negative impact on mental health. This impact is both direct and mediated by individuals’ perceptions of neighborhood disorder and personal powerlessness, and the impact is greater for minorities and the poor than it is for whites and wealthier individuals. These results suggest that public health officials need to take seriously the mental health impacts of living near industrial facilities. PMID:16259150

ENVIRONMENTAL IMPACT ASSESSMENT OF A HEALTH TECHNOLOGY: A SCOPING REVIEW.

PubMed

Polisena, Julie; De Angelis, Gino; Kaunelis, David; Gutierrez-Ibarluzea, Iñaki

2018-06-13

The Health Technology Expert Review Panel is an advisory body to Canadian Agency for Drugs and Technologies in Health (CADTH) that develops recommendations on health technology assessments (HTAs) for nondrug health technologies using a deliberative framework. The framework spans several domains, including the environmental impact of the health technology(ies). Our research objective was to identify articles on frameworks, methods or case studies on the environmental impact assessment of health technologies. A literature search in major databases and a focused gray literature search were conducted. The main search concepts were HTA and environmental impact/sustainability. Eligible articles were those that described a conceptual framework or methods used to conduct an environmental assessment of health technologies, and case studies on the application of an environmental assessment. From the 1,710 citations identified, thirteen publications were included. Two articles presented a framework to incorporate environmental assessment in HTAs. Other approaches described weight of evidence practices and comprehensive and integrated environmental impact assessments. Central themes derived include transparency and repeatability, integration of components in a framework or of evidence into a single outcome, data availability to ensure the accuracy of findings, and familiarity with the approach used. Each framework and methods presented have different foci related to the ecosystem, health economics, or engineering practices. Their descriptions suggested transparency, repeatability, and the integration of components or of evidence into a single outcome as their main strengths. Our review is an initial step of a larger initiative by CADTH to develop the methods and processes to address the environmental impact question in an HTA.

Health Impacts from Human Interaction with the Environment

NASA Astrophysics Data System (ADS)

Hasan, S. E.

2008-12-01

Humans have produced far greater impact on the environment than any other living form. The impact has been so significant-particularly during the past 50 years-that a new word, Anthrposphere has started appearing in recent literature. It is now being used along with the four major components of the system earth to underscore humans' influence on the environment. Human activities have produced a myriad of impacts on the environment that span the scale from local to global. The slow process that brought humanity to the present environmental crisis began with the Industrial Revolution and has greatly accelerated since the World War II. The past 50 years mark a unique period in human history that is characterized by rapid technological advances and unprecedented population growth. While the use of technology has been very effective in meeting the needs of the growing population, it has also produced serious impact on the environment. Large scale exploitation of mineral, fuel, water, forest, and marine resources has led to severe environmental degradation; and the resulting pollution of air, water, and land has caused serious consequences to human and ecological health. The presentation deals with the adverse impact on human health associated with mining, dam and reservoir construction, improper waste management, use of fossil fuels, and climate change. Case studies are included to illustrate health impacts from metal and coal mining; dam and reservoir construction and preponderance of disease vectors; pollution caused by improper waste disposal and the resulting incidence of cancer and other diseases; and emergence of vector-borne diseases at hitherto unknown locations, cardiovascular and respiratory track ailments, and increased morbidity and mortality triggered by elevated temperatures associated with climate change. A brief discussion of possible measures to mitigate the health consequences is also included in the presentation.

The Social Impact of Climate

NASA Astrophysics Data System (ADS)

Hsiang, S. M.

2013-12-01

Managing climate change requires that we understand the social value of climate-related decisions. Rational decision-making demands that we weigh the potential benefits of climate-related investments against their costs. To date, it has been challenging to quantify the relative social benefit of living under different climatic conditions, so policy debates tend to focus on investment costs without considering their benefits. Here I will discuss challenges and advances in the measurement of climate's impact on society. By linking data and methods across physical and social sciences, we are beginning to understand when, where, and how climatic conditions have a causal impact on human wellbeing. I will present examples from this burgeoning interdisciplinary field that quantify the effect of temperature on macroeconomic performance, the effects of climate on human conflict, and the long-term health and economic impact of tropical cyclones. Each of these examples provide new insight into previously unknown benefits of various climate management strategies. I conclude by describing new efforts to systematically gather and compare findings from across the research community to support informed and rational climate management decisions.

Impact of innovations in national public health markets in Europe.

PubMed

McCarthy, Mark; Alexanderson, Kristina; Voss, Margaretha; Conceição, Claudia; Grimaud, Olivier; Narkauskaité, Laura; Katreniakova, Zuzana; Saliba, Amanda; Sammut, Marvic

2013-11-01

Social innovations can contribute to health and wellbeing. PHIRE (Public Health Innovation and Research in Europe) investigated the impacts at national level of innovation projects funded by the European Union Public Health Programme. Through the European Public Health Association, experts assessed the uptake of the eight public health projects, for 30 European countries. Their reports were assembled by country and, thereafter, national public health associations reviewed the reports. Following stakeholder workshops, or internal and external consultations, 11 national reports were produced which included discussion on the impacts of the public health innovations in national product markets. In 11 countries, there were reports on the eight innovations for 45 (51%) of the possible public health markets. The innovations contributed positively to policy, practice and research, across different levels and in different ways, in 35 (39%) market, while competing innovation activities were recorded in 10 (11%) markets. The workshops also discussed contributing factors and limitations in dissemination and timing for policy cycles. The impacts of European Union social innovations in public health markets can be identified through national discussions. Further attention should be given to understanding drivers and incentives for successful public health innovations.

Environmental exposures and health impacts of PFAS ...

EPA Pesticide Factsheets

Environmental exposures and health impacts of PFAS The National Exposure Research Laboratory (NERL) Human Exposure and Atmospheric Sciences Division (HEASD) conducts research in support of EPA mission to protect human health and the environment. HEASD research program supports Goal 1 (Clean Air) and Goal 4 (Healthy People) of EPA strategic plan. More specifically, our division conducts research to characterize the movement of pollutants from the source to contact with humans. Our multidisciplinary research program produces Methods, Measurements, and Models to identify relationships between and characterize processes that link source emissions, environmental concentrations, human exposures, and target-tissue dose. The impact of these tools is improved regulatory programs and policies for EPA.

An automated online instrument to quantify aerosol-bound reactive oxygen species (ROS) for ambient measurement and health-relevant aerosol studies

NASA Astrophysics Data System (ADS)

Wragg, Francis P. H.; Fuller, Stephen J.; Freshwater, Ray; Green, David C.; Kelly, Frank J.; Kalberer, Markus

2016-10-01

The adverse health effects associated with ambient aerosol particles have been well documented, but it is still unclear which aerosol properties are most important for their negative health impact. Some studies suggest the oxidative effects of particle-bound reactive oxygen species (ROS) are potential major contributors to the toxicity of particles. Traditional ROS measurement techniques are labour-intensive, give poor temporal resolution and generally have significant delays between aerosol sampling and ROS analysis. However, many oxidising particle components are reactive and thus potentially short-lived. Thus, a technique to quantify particle-bound ROS online would be beneficial to quantify also the short-lived ROS components. We introduce a new portable instrument to allow online, continuous measurement of particle-bound ROS using a chemical assay of 2'7'-dichlorofluorescein (DCFH) with horseradish peroxidase (HRP), via fluorescence spectroscopy. All components of the new instrument are attached to a containing shell, resulting in a compact system capable of automated continuous field deployment over many hours or days. From laboratory measurements, the instrument was found to have a detection limit of ˜ 4 nmol [H2O2] equivalents per cubic metre (m3) air, a dynamic range up to at least ˜ 2000 nmol [H2O2] equivalents per m3 air and a time resolution of ≤ 12 min. The instrument allows for ˜ 16 h automated measurement if unattended and shows a fast response to changes in concentrations of laboratory-generated oxidised organic aerosol. The instrument was deployed at an urban site in London, and particulate ROS levels of up to 24 nmol [H2O2] equivalents per m3 air were detected with PM2.5 concentrations up to 28 µg m-3. The new and portable Online Particle-bound ROS Instrument (OPROSI) allows fast-response quantification; this is important due to the potentially short-lived nature of particle-bound ROS as well as fast-changing atmospheric conditions

Burning Fossil Fuels: Impact of Climate Change on Health.

PubMed

Sommer, Alfred

2016-01-01

A recent, sophisticated granular analysis of climate change in the United States related to burning fossil fuels indicates a high likelihood of dramatic increases in temperature, wet-bulb temperature, and precipitation, which will dramatically impact the health and well-being of many Americans, particularly the young, the elderly, and the poor and marginalized. Other areas of the world, where they lack the resources to remediate these weather impacts, will be even more greatly affected. Too little attention is being paid to the impending health impact of accumulating greenhouse gases. © The Author(s) 2015.

Impact of a regional distributed medical education program on an underserved community: perceptions of community leaders.

PubMed

Toomey, Patricia; Lovato, Chris Y; Hanlon, Neil; Poole, Gary; Bates, Joanna

2013-06-01

To describe community leaders' perceptions regarding the impact of a fully distributed undergraduate medical education program on a small, medically underserved host community. The authors conducted semistructured interviews in 2007 with 23 community leaders representing, collectively, the education, health, economic, media, and political sectors. They reinterviewed six participants from a pilot study (2005) and recruited new participants using purposeful and snowball sampling. The authors employed analytic induction to organize content thematically, using the sectors as a framework, and they used open coding to identify new themes. The authors reanalyzed transcripts to identify program outcomes (e.g., increased research capacity) and construct a list of quantifiable indicators (e.g., number of grants and publications). Participants reported their perspectives on the current and anticipated impact of the program on education, health services, the economy, media, and politics. Perceptions of impact were overwhelmingly positive (e.g., increased physician recruitment), though some were negative (e.g., strains on health resources). The authors identified new outcomes and confirmed outcomes described in 2005. They identified 16 quantifiable indicators of impact, which they judged to be plausible and measureable. Participants perceive that the regional undergraduate medical education program in their community has broad, local impacts. Findings suggest that early observed outcomes have been maintained and may be expanding. Results may be applicable to medical education programs with distributed or regional sites in similar rural, remote, and/or underserved regions. The areas of impact, outcomes, and quantifiable indicators identified will be of interest to future researchers and evaluators.

Planning changes to health library services on the basis of impact assessment.

PubMed

Urquhart, Christine; Thomas, Rhian; Ovens, Jason; Lucking, Wendy; Villa, Jane

2010-12-01

Various methods of impact assessment for health library services exist, including a toolkit developed for the UK. The Knowledge, Resource and Information service (KRIS) for health promotion, health service commissioning and public health (Bristol area, UK) commissioned an independent team at Aberystwyth University to provide an impact assessment and evaluation of their services and to provide evidence for future planning. The review aimed to provide an action plan for KRIS through assessing the impact of the current service, extent of satisfaction with existing services and views on desirable improvements. Existing impact toolkit guidance was used, with an adapted impact questionnaire, which was distributed by the KRIS staff to 244 users (response rate 62.3%) in early 2009. The independent team analysed the questionnaire data and presented the findings. Users valued the service (93% considered that relevant information was obtained). The most frequent impacts on work were advice to patients, clients or carers, and advice to colleagues. Literature searching and current awareness services saved staff time. Many users were seeking health promotion materials. The adapted questionnaire worked well in demonstrating the service impacts achieved by KRIS, as well as indicating desirable improvements in service delivery. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.

Non-Accidental Health Impacts of Wildfire Smoke

PubMed Central

Youssouf, Hassani; Liousse, Catherine; Roblou, Laurent; Assamoi, Eric-Michel; Salonen, Raimo O.; Maesano, Cara; Banerjee, Soutrik; Annesi-Maesano, Isabella

2014-01-01

Wildfires take a heavy toll on human health worldwide. Climate change may increase the risk of wildfire frequency. Therefore, in view of adapted preventive actions, there is an urgent need to further understand the health effects and public awareness of wildfires. We conducted a systematic review of non-accidental health impacts of wildfire and incorporated lessons learned from recent experiences. Based on the literature, various studies have established the relationship between one of the major components of wildfire, particulate matter (particles with diameter less than 10 µm (PM10) and less than 2.5 µm (PM2.5)) and cardiorespiratory symptoms in terms of Emergency Rooms visits and hospital admissions. Associations between wildfire emissions and various subclinical effects have also been established. However, few relationships between wildfire emissions and mortality have been observed. Certain segments of the population may be particularly vulnerable to smoke-related health risks. Among them, people with pre-existing cardiopulmonary conditions, the elderly, smokers and, for professional reasons, firefighters. Potential action mechanisms have been highlighted. Overall, more research is needed to better understand health impact of wildfire exposure. PMID:25405597

Quantifying the environmental impacts of artisanal fishing gear on Kenya's coral reef ecosystems.

PubMed

Mangi, S C; Roberts, C M

2006-12-01

The environmental impacts of artisanal fishing gear on coral reef ecosystems were studied in the multi-gear fishery of southern Kenya to evaluate which types of gear have the greatest impact on coral reef biodiversity. The gear types studied were large and small traps, gill nets, beach seines, hand lines and spear guns. Levels of coral damage, proportion of juvenile fish and discards, size and maturity stage at first capture were quantified and compared amongst the gear types. Results indicate that fishers using beach seines, spears and gill nets cause the most direct physical damage to corals. Spear fishers showed the highest number of contacts to live corals per unit catch followed by fishers using gill nets (12.6+/-1.8 and 5.9+/-2.0 coral contacts per kg fish caught per trip respectively). Apart from discarding 6.5% of their daily catch in the sea, as it was too small, beach seine fishers also landed the highest percentage of juvenile fish (68.4+/-15.7%), a proportion significantly higher (p<0.001) than in any other gear. The size and maturity stage at first capture for 150 of 195 species caught by all gear types was well below the lengths at which they mature. For example, 100% of Lethrinus xanthochilus, 99% of Lethrinus nebulosus and 94% of Lethrinus harak caught were juveniles. Across all gear types, 50.1+/-22.7% of the catch consisted of juvenile fish, indicating serious growth overfishing. Field assessment of levels of coral density showed that fishing grounds where beach seines were still in use had a significantly lower density than where beach seining was not used. This correlation is likely to arise in part because seines cannot be used in the most coral rich areas, and in part because coral loss is a consequence of seine use. On a per gear basis therefore, beach seines had the most impact on coral reef biodiversity. This study emphasizes the need to enforce restrictions on destructive gear and mesh sizes.

Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study.

PubMed

Brown, V; Moodie, M; Cobiac, L; Mantilla Herrera, A M; Carter, R

2017-05-04

Reducing automobile dependence and improving rates of active transport may reduce the impact of obesogenic environments, thereby decreasing population prevalence of obesity and other diseases where physical inactivity is a risk factor. Increasing the relative cost of driving by an increase in fuel taxation may therefore be a promising public health intervention for obesity prevention. A scoping review of the evidence for obesity or physical activity effect of changes in fuel price or taxation was undertaken. Potential health benefits of an increase in fuel excise taxation in Australia were quantified using Markov modelling to simulate obesity, injury and physical activity related health impacts of a fuel excise taxation intervention for the 2010 Australian population. Health adjusted life years (HALYs) gained and healthcare cost savings from diseases averted were estimated. Incremental cost-effectiveness ratios (ICERs) were reported and results were tested through sensitivity analysis. Limited evidence on the effect of policies such as fuel taxation on health-related behaviours currently exists. Only three studies were identified reporting associations between fuel price or taxation and obesity, whilst nine studies reported associations specifically with physical activity, walking or cycling. Estimates of the cross price elasticity of demand for public transport with respect to fuel price vary, with limited consensus within the literature on a probable range for the Australian context. Cost-effectiveness modelling of a AUD0.10 per litre increase in fuel excise taxation using a conservative estimate of cross price elasticity for public transport suggests that the intervention would be cost-effective from a limited societal perspective (237 HALYs gained, AUD2.6 M in healthcare cost savings), measured against a comparator of no additional increase in fuel excise. Under "best case" assumptions, the intervention would be more cost-effective (3181 HALYs gained, AUD34.2�

Predicting the health impact of lowering salt consumption in Turkey using the DYNAMO health impact assessment tool.

PubMed

Erkoyun, E; Sözmen, K; Bennett, K; Unal, B; Boshuizen, H C

2016-11-01

To estimate the impact of three daily salt consumption scenarios on the prevalence and incidence of ischaemic heart disease (IHD) and cerebrovascular disease in 2025 in the Turkish population aged ≥30 years using the DYNAMO Health Impact Assessment tool. Statistical disease modelling study. DYNAMO health impact assessment was populated using data from Turkey to estimate the prevalence and incidence of IHD and cerebrovascular disease in 2025. TurkSTAT data were used for demographic data, and national surveys were used for salt consumption and disease-specific burden. Three salt consumption scenarios were modelled: (1) reference scenario: mean salt consumption stays the same from 2012-2013 until 2025; (2) gradual decline: daily salt intake reduces steadily by 0.47 g per year by lowering salt intake from bread by 50% and from table salt by 40% by 2025; and (3) World Health Organization (WHO) advice: daily salt intake of 5 g per day from 2013 until 2025. The gradual decline scenario would lead to a decrease in the prevalence of IHD and cerebrovascular disease by 0.3% and 0.2%, respectively, and a decrease in the incidence by 0.6 and 0.4 per 1000, respectively. Following WHO's advice would lead to a decrease in the prevalence of IHD and cerebrovascular disease by 0.8% and 0.5%, respectively, and a decrease in the incidence by 1.0 and 0.7 per 1000, respectively. This model indicates that Turkey can lower its future cardiovascular disease burden by following the gradual decline scenario. Following WHO's advice would achieve an even greater benefit. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Advancing Social Work Education for Health Impact

PubMed Central

Keefe, Robert H.; Ruth, Betty J.; Cox, Harold; Maramaldi, Peter; Rishel, Carrie; Rountree, Michele; Zlotnik, Joan; Marshall, Jamie

2017-01-01

Social work education plays a critical role in preparing social workers to lead efforts that improve health. Because of the dynamic health care landscape, schools of social work must educate students to facilitate health care system improvements, enhance population health, and reduce medical costs. We reviewed the existing contributions of social work education and provided recommendations for improving the education of social workers in 6 key areas: aging, behavioral health, community health, global health, health reform, and health policy. We argue for systemic improvement in the curriculum at every level of education, including substantive increases in content in health, health care, health care ethics, and evaluating practice outcomes in health settings. Schools of social work can further increase the impact of the profession by enhancing the curricular focus on broad content areas such as prevention, health equity, population and community health, and health advocacy. PMID:29236540

Advancing Social Work Education for Health Impact.

PubMed

Browne, Teri; Keefe, Robert H; Ruth, Betty J; Cox, Harold; Maramaldi, Peter; Rishel, Carrie; Rountree, Michele; Zlotnik, Joan; Marshall, Jamie

2017-12-01

Social work education plays a critical role in preparing social workers to lead efforts that improve health. Because of the dynamic health care landscape, schools of social work must educate students to facilitate health care system improvements, enhance population health, and reduce medical costs. We reviewed the existing contributions of social work education and provided recommendations for improving the education of social workers in 6 key areas: aging, behavioral health, community health, global health, health reform, and health policy. We argue for systemic improvement in the curriculum at every level of education, including substantive increases in content in health, health care, health care ethics, and evaluating practice outcomes in health settings. Schools of social work can further increase the impact of the profession by enhancing the curricular focus on broad content areas such as prevention, health equity, population and community health, and health advocacy.

Health Care Reform: How Will It Impact You?

ERIC Educational Resources Information Center

Lukaszewski, Thomas

1993-01-01

Discusses the impact of health care reform on child-care centers and child-care employees. Topics covered include requirements to provide health insurance for all employees; subsidies for businesses with fewer than 50 employees; subsidies for low income employees; family coverage; health are costs for 2 working parents; and costs to day-care…

Impact of conditional cash transfers on maternal and newborn health.

PubMed

Glassman, Amanda; Duran, Denizhan; Fleisher, Lisa; Singer, Daniel; Sturke, Rachel; Angeles, Gustavo; Charles, Jodi; Emrey, Bob; Gleason, Joanne; Mwebsa, Winnie; Saldana, Kelly; Yarrow, Kristina; Koblinsky, Marge

2013-12-01

Maternal and newborn health (MNH) is a high priority for global health and is included among the Millennium Development Goals (MDGs). However, the slow decline in maternal and newborn mortality jeopardizes achievements of the targets of MDGs. According to UNICEF, 60 million women give birth outside of health facilities, and family planning needs are satisfied for only 50%. Further, skilled birth attendance and the use of antenatal care are most inequitably distributed in maternal and newborn health interventions in low- and middle-income countries. Conditional cash transfer (CCT) programmes have been shown to increase health service utilization among the poorest but little is written on the effects of such programmes on maternal and newborn health. We carried out a systematic review of studies on CCT that report maternal and newborn health outcomes, including studies from 8 countries. The CCT programmes have increased antenatal visits, skilled attendance at birth, delivery at a health facility, and tetanus toxoid vaccination for mothers and reduced the incidence of low birthweight. The programmes have not had a significant impact on fertility while the impact on maternal and newborn mortality has not been well-documented thus far. Given these positive effects, we make the case for further investment in CCT programmes for maternal and newborn health, noting gaps in knowledge and providing recommendations for better design and evaluation of such programmes. We recommend more rigorous impact evaluations that document impact pathways and take factors, such as cost-effectiveness, into account.

Benefits Innovations in Employee Behavioral Health.

PubMed

Sherman, Bruce; Block, Lori

2017-01-01

More and more employers recognize the business impact of behavioral health concerns in the workplace. This article provides insights into some of the current innovations in behavioral health benefits, along with their rationale for development. Areas of innovation include conceptual and delivery models, technological advance- ments, tools for engaging employees and ways of quantifying the business value of behavioral health benefits. The rapid growth of innovative behavioral health services should provide employers with confidence that they can tailor a program best suited to their priorities, organizational culture and cost limitations.

Quantifying the Impact of Food Preparation Skills among College Women

ERIC Educational Resources Information Center

Soliah, LuAnn; Walter, Janelle; Antosh, Deeanna

2006-01-01

Food preparation practices have changed dramatically in the past fifty years. This study was designed to quantify food preparation knowledge and practices of college women, to assess the reasons why they do not prepare certain foods, and to determine the frequency of eating outside the home. Distinct food preparation ability emerged (high, medium,…

Knowledge and perceptions about the health impact of climate change among health sciences students in Ethiopia: a cross-sectional study.

PubMed

Nigatu, Andualem S; Asamoah, Benedict O; Kloos, Helmut

2014-06-11

Climate change affects human health in various ways. Health planners and policy makers are increasingly addressing potential health impacts of climate change. Ethiopia is vulnerable to these impacts. Assessing students' knowledge, understanding and perception about the health impact of climate change may promote educational endeavors to increase awareness of health impacts linked to climate change and to facilitate interventions. A cross-sectional study using a questionnaire was carried out among the health science students at Haramaya University. Quantitative methods were used to analyze the results. Over three quarters of the students were aware of health consequences of climate change, with slightly higher rates in females than males and a range from 60.7% (pharmacy students) to 100% (environmental health and post-graduate public health students). Electronic mass media was reportedly the major source of information but almost all (87.7%) students stated that their knowledge was insufficient to fully understand the public health impacts of climate change. Students who knew about climate change were more likely to perceive it as a serious health threat than those who were unaware of these impacts [OR: 17.8, 95% CI: 8.8-32.1] and also considered their departments to be concerned about climate change (OR: 7.3, 95% CI: 2.8-18.8), a perception that was also significantly more common among students who obtained their information from the electronic mass media and schools (p < 0.05). Using electronic mass media was also significantly associated with knowledge about the health impacts of climate change. Health sciences students at Haramaya University may benefit from a more comprehensive curriculum on climate change and its impacts on health.

Urban and Transport Planning Related Exposures and Mortality: A Health Impact Assessment for Cities.

PubMed

Mueller, Natalie; Rojas-Rueda, David; Basagaña, Xavier; Cirach, Marta; Cole-Hunter, Tom; Dadvand, Payam; Donaire-Gonzalez, David; Foraster, Maria; Gascon, Mireia; Martinez, David; Tonne, Cathryn; Triguero-Mas, Margarita; Valentín, Antònia; Nieuwenhuijsen, Mark

2017-01-01

By 2050, nearly 70% of the global population is projected to live in urban areas. Because the environments we inhabit affect our health, urban and transport designs that promote healthy living are needed. We estimated the number of premature deaths preventable under compliance with international exposure recommendations for physical activity (PA), air pollution, noise, heat, and access to green spaces. We developed and applied the Urban and TranspOrt Planning Health Impact Assessment (UTOPHIA) tool to Barcelona, Spain. Exposure estimates and mortality data were available for 1,357,361 residents. We compared recommended with current exposure levels. We quantified the associations between exposures and mortality and calculated population attributable fractions to estimate the number of premature deaths preventable. We also modeled life-expectancy and economic impacts. We estimated that annually, nearly 20% of mortality could be prevented if international recommendations for performance of PA; exposure to air pollution, noise, and heat; and access to green space were followed. Estimations showed that the greatest portion of preventable deaths was attributable to increases in PA, followed by reductions of exposure to air pollution, traffic noise, and heat. Access to green spaces had smaller effects on mortality. Compliance was estimated to increase the average life expectancy by 360 (95% CI: 219, 493) days and result in economic savings of 9.3 (95% CI: 4.9, 13.2) billion EUR/year. PA factors and environmental exposures can be modified by changes in urban and transport planning. We emphasize the need for a) the reduction of motorized traffic through the promotion of active and public transport and b) the provision of green infrastructure, both of which are suggested to provide opportunities for PA and for mitigation of air pollution, noise, and heat. Citation: Mueller N, Rojas-Rueda D, Basagaña X, Cirach M, Cole-Hunter T, Dadvand P, Donaire-Gonzalez D, Foraster M

Urban and Transport Planning Related Exposures and Mortality: A Health Impact Assessment for Cities

PubMed Central

Mueller, Natalie; Rojas-Rueda, David; Basagaña, Xavier; Cirach, Marta; Cole-Hunter, Tom; Dadvand, Payam; Donaire-Gonzalez, David; Foraster, Maria; Gascon, Mireia; Martinez, David; Tonne, Cathryn; Triguero-Mas, Margarita; Valentín, Antònia; Nieuwenhuijsen, Mark

2016-01-01

Background: By 2050, nearly 70% of the global population is projected to live in urban areas. Because the environments we inhabit affect our health, urban and transport designs that promote healthy living are needed. Objective: We estimated the number of premature deaths preventable under compliance with international exposure recommendations for physical activity (PA), air pollution, noise, heat, and access to green spaces. Methods: We developed and applied the Urban and TranspOrt Planning Health Impact Assessment (UTOPHIA) tool to Barcelona, Spain. Exposure estimates and mortality data were available for 1,357,361 residents. We compared recommended with current exposure levels. We quantified the associations between exposures and mortality and calculated population attributable fractions to estimate the number of premature deaths preventable. We also modeled life-expectancy and economic impacts. Results: We estimated that annually, nearly 20% of mortality could be prevented if international recommendations for performance of PA; exposure to air pollution, noise, and heat; and access to green space were followed. Estimations showed that the greatest portion of preventable deaths was attributable to increases in PA, followed by reductions of exposure to air pollution, traffic noise, and heat. Access to green spaces had smaller effects on mortality. Compliance was estimated to increase the average life expectancy by 360 (95% CI: 219, 493) days and result in economic savings of 9.3 (95% CI: 4.9, 13.2) billion EUR/year. Conclusions: PA factors and environmental exposures can be modified by changes in urban and transport planning. We emphasize the need for a) the reduction of motorized traffic through the promotion of active and public transport and b) the provision of green infrastructure, both of which are suggested to provide opportunities for PA and for mitigation of air pollution, noise, and heat. Citation: Mueller N, Rojas-Rueda D, Basagaña X, Cirach M, Cole

Qalibra: a general model for food risk-benefit assessment that quantifies variability and uncertainty.

PubMed

Hart, Andy; Hoekstra, Jeljer; Owen, Helen; Kennedy, Marc; Zeilmaker, Marco J; de Jong, Nynke; Gunnlaugsdottir, Helga

2013-04-01

The EU project BRAFO proposed a framework for risk-benefit assessment of foods, or changes in diet, that present both potential risks and potential benefits to consumers (Hoekstra et al., 2012a). In higher tiers of the BRAFO framework, risks and benefits are integrated quantitatively to estimate net health impact measured in DALYs or QALYs (disability- or quality-adjusted life years). This paper describes a general model that was developed by a second EU project, Qalibra, to assist users in conducting these assessments. Its flexible design makes it applicable to a wide range of dietary questions involving different nutrients, contaminants and health effects. Account can be taken of variation between consumers in their diets and also other characteristics relevant to the estimation of risk and benefit, such as body weight, gender and age. Uncertainty in any input parameter may be quantified probabilistically, using probability distributions, or deterministically by repeating the assessment with alternative assumptions. Uncertainties that are not quantified should be evaluated qualitatively. Outputs produced by the model are illustrated using results from a simple assessment of fish consumption. More detailed case studies on oily fish and phytosterols are presented in companion papers. The model can be accessed as web-based software at www.qalibra.eu. Copyright © 2012. Published by Elsevier Ltd.

Health Impact Assessment as a Student Service Learning Experience

ERIC Educational Resources Information Center

Stone, Cynthia; Greene, Marion S.

2012-01-01

Health Impact Assessments (HIAs) incorporate a combination of tools, methods, and procedures to evaluate the potential health effects of a proposed program, project, or policy. The university public health department, in collaboration with the county health department, and the local planning organization, developed a curriculum for a…

Health impact assessment of transport policies in Rotterdam: Decrease of total traffic and increase of electric car use

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tobollik, Myriam, E-mail: mtobollik@uni-bielefeld.de; German Environment Agency, Section Exposure Assessment and Environmental Health Indicators, Corrensplatz 1, 14195 Berlin; Keuken, Menno

Background: Green house gas (GHG) mitigation policies can be evaluated by showing their co-benefits to health. Method: Health Impact Assessment (HIA) was used to quantify co-benefits of GHG mitigation policies in Rotterdam. The effects of two separate interventions (10% reduction of private vehicle kilometers and a share of 50% electric-powered private vehicle kilometers) on particulate matter (PM{sub 2.5}), elemental carbon (EC) and noise (engine noise and tyre noise) were assessed using Years of Life Lost (YLL) and Years Lived with Disability (YLD). The baseline was 2010 and the end of the assessment 2020. Results: The intervention aimed at reducing trafficmore » is associated with a decreased exposure to noise resulting in a reduction of 21 (confidence interval (CI): 11–129) YLDs due to annoyance and 35 (CI: 20–51) YLDs due to sleep disturbance for the population per year. The effects of 50% electric-powered car use are slightly higher with a reduction of 26 (CI: 13–116) and 41 (CI: 24–60) YLDs, respectively. The two interventions have marginal effects on air pollution, because already implemented traffic policies will reduce PM{sub 2.5} and EC by around 40% and 60% respectively, from 2010 to 2020. Discussion: The evaluation of planned interventions, related to climate change policies, targeting only the transport sector can result in small co-benefits for health, if the analysis is limited to air pollution and noise. This urges to expand the analysis by including other impacts, e.g. physical activity and well-being, as a necessary step to better understanding consequences of interventions and carefully orienting resources useful to build knowledge to improve public health. - Highlights: • We estimated co-benefits of greenhouse gas reduction policies from 2010 to 2020. • The city scale health impact assessment base on real transport policy scenarios. • Effects of particulate matter, elemental carbon and noise on health are assessed. • The

Use of Physiologically Based Pharmacokinetic (PBPK) Models to Quantify the Impact of Human Age and Interindividual Differences in Physiology and Biochemistry Pertinent to Risk (Final Report)

EPA Science Inventory

EPA announced the availability of the final report, Use of Physiologically Based Pharmacokinetic (PBPK) Models to Quantify the Impact of Human Age and Interindividual Differences in Physiology and Biochemistry Pertinent to Risk Final Report for Cooperative Agreement. Th...

Quantifying NMR relaxation correlation and exchange in articular cartilage with time domain analysis

NASA Astrophysics Data System (ADS)

Mailhiot, Sarah E.; Zong, Fangrong; Maneval, James E.; June, Ronald K.; Galvosas, Petrik; Seymour, Joseph D.

2018-02-01

Measured nuclear magnetic resonance (NMR) transverse relaxation data in articular cartilage has been shown to be multi-exponential and correlated to the health of the tissue. The observed relaxation rates are dependent on experimental parameters such as solvent, data acquisition methods, data analysis methods, and alignment to the magnetic field. In this study, we show that diffusive exchange occurs in porcine articular cartilage and impacts the observed relaxation rates in T1-T2 correlation experiments. By using time domain analysis of T2-T2 exchange spectroscopy, the diffusive exchange time can be quantified by measurements that use a single mixing time. Measured characteristic times for exchange are commensurate with T1 in this material and so impacts the observed T1 behavior. The approach used here allows for reliable quantification of NMR relaxation behavior in cartilage in the presence of diffusive fluid exchange between two environments.

Personal health and consumer informatics. The impact of health oriented social media applications on health outcomes.

PubMed

Gibbons, M C

2013-01-01

The rapid evolution in the world-wide use of Social Media tools suggests the emergence of a global phenomenon that may have implications in the Personal Health and Consumer Health Informatics domains. However the impact of these tools on health outcomes is not known. The goal of this research was to review the randomized controlled trial (RCT) evidence of the impact of health oriented Social Media informatics tools on health outcomes. Evaluations of Social Media consumer health tools were systematically reviewed. Research was limited to studies published in the English language, published in Medline, published in the calendar year 2012 and limited to studies that utilized a RCT methodological design. Two high quality Randomized Controlled Trials among over 600 articles published in Medline were identified. These studies indicate that Social Media interventions may be able to significantly improve pain control among patients with chronic pain and enhance weight loss maintenance among individuals attempting to lose weight. Significantly more research needs to be done to confirm these early findings, evaluate additional health outcomes and further evaluate emerging health oriented Social Media interventions. Chronic pain and weight control have both socially oriented determinants. These studies suggest that understanding the social component of a disease may ultimately provide novel therapeutic targets and socio-clinical interventional strategies.

Impact of Obesity on Work Productivity in Different US Occupations: Analysis of the National Health and Wellness Survey 2014 to 2015.

PubMed

Kudel, Ian; Huang, Joanna C; Ganguly, Rahul

2018-01-01

The aim of this study was to quantify the relationship between workers' body mass index and work productivity within various occupations. Data from two administrations (2014 and 2015) of the United States (US) National Health and Wellness Survey, an Internet-based survey administered to an adult sample of the US population, were used for this study (n = 59,772). Occupation was based on the US Department of Labor's 2010 Standardized Occupation Codes. Outcomes included work productivity impairment and indirect costs of missed work time. Obesity had the greatest impact on work productivity in Construction, followed by Arts and Hospitality occupations. Outcomes varied across occupations; multivariable analyses found significant differences in work productivity impairment and indirect costs between normal weight and at least one obesity class. Obesity differentially impacted productivity and costs, depending upon occupation.

Measuring the Impact of the Human Rights on Health in Global Health Financing.

PubMed

Davis, Sara L M

2015-12-10

In response to new scientific developments, UNAIDS, WHO, and global health financing institutions have joined together to promote a "fast-track" global scale-up of testing and treatment programs. They have set ambitious targets toward the goal of ending the three diseases by 2030. These numerical indicators, based on infectious disease modeling, can assist in measuring countries' progressive realization of the right to health. However, they only nominally reference the catastrophic impact that human rights abuses have on access to health services; they also do not measure the positive impact provided by law reform, legal aid, and other health-related human rights programs. Drawing on experience at the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has incorporated expanded stakeholder consultation and human rights programming into its grants, the article argues that addressing human rights barriers to access is often an ad hoc activity occurring on the sidelines of a health grantmaking process that has focused on the scale-up of biomedical programs to meet global health indicators. To ensure that these biomedical programs have impact, UN agencies and health financing mechanisms must begin to more systematically and proactively integrate human rights policy and practice into their modeling and measurement tools. Copyright © 2015 Davis. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

Quantifying Third-Party Impacts and Environmental Externalities from a Cap-And-Trade System for Groundwater Management

NASA Astrophysics Data System (ADS)

Khan, H. F.; Yang, Y. C. E.; Brown, C.

2016-12-01

Economic decision models, such as the cap-and-trade system, have been shown to be useful in the context of groundwater management. A uniformly applied cap-and-trade system can however result in significant spatially and temporally varying hydrogeologic impacts that reduce public welfare. Hydrological challenges associated with the cap-and-trade system for groundwater management include establishing appropriate system boundaries, setting system-wide sustainable yield and limiting third party impacts from extractions. Given these challenges, these economic models need to be supplemented with physically based hydrogeologic models that are able to represent the spatial and temporal heterogeneity in conditions across a region. This investigation assesses third-party impacts and environmental externalities resulting from a cap-and-trade system in a sub-basin of the Republican River Basin, overlying the Ogallala aquifer in the High Plains of the United States. The economic model is coupled with a calibrated physically based groundwater model. The cap-and-trade system is developed using a multi-agent system model where individual benefits of each self-interested agent are maximized subject to bounds on irrigation requirements and water use permits. We then compare the performance of the cap-and-trade system with a smart groundwater market which, in addition to a cap on total groundwater extraction, also incorporates streamflow constraints. The results quantify third-party impacts and environmental externalities resulting from uncontrolled trading. This analysis demonstrates the value added by a well-designed cap-and-trade system able to account for basin-wide heterogeneity in hydrogeologic and ecological conditions by establishing trading limits, managing inter-area transfers and setting exchange rates for permit trading.

Knowledge and perceptions about the health impact of climate change among health sciences students in Ethiopia: a cross-sectional study

PubMed Central

2014-01-01

Background Climate change affects human health in various ways. Health planners and policy makers are increasingly addressing potential health impacts of climate change. Ethiopia is vulnerable to these impacts. Assessing students’ knowledge, understanding and perception about the health impact of climate change may promote educational endeavors to increase awareness of health impacts linked to climate change and to facilitate interventions. Methods A cross-sectional study using a questionnaire was carried out among the health science students at Haramaya University. Quantitative methods were used to analyze the results. Result Over three quarters of the students were aware of health consequences of climate change, with slightly higher rates in females than males and a range from 60.7% (pharmacy students) to 100% (environmental health and post-graduate public health students). Electronic mass media was reportedly the major source of information but almost all (87.7%) students stated that their knowledge was insufficient to fully understand the public health impacts of climate change. Students who knew about climate change were more likely to perceive it as a serious health threat than those who were unaware of these impacts [OR: 17.8, 95% CI: 8.8-32.1] and also considered their departments to be concerned about climate change (OR: 7.3, 95% CI: 2.8-18.8), a perception that was also significantly more common among students who obtained their information from the electronic mass media and schools (p < 0.05). Using electronic mass media was also significantly associated with knowledge about the health impacts of climate change. Conclusion Health sciences students at Haramaya University may benefit from a more comprehensive curriculum on climate change and its impacts on health. PMID:24916631

Financial impact of population health management programs: reevaluating the literature.

PubMed

Grossmeier, Jessica; Terry, Paul E; Anderson, David R; Wright, Steven

2012-06-01

Although many employers offer some components of worksite-based population health management (PHM), most do not yet invest in comprehensive programs. This hesitation to invest in comprehensive programs may be attributed to numerous factors, such as other more pressing business priorities, reluctance to intervene in the personal health choices of employees, or insufficient funds for employee health. Many decision makers also remain skeptical about whether investment in comprehensive programs will produce a financial return on investment (ROI). Most peer-reviewed studies assessing the financial impact of PHM were published before 2000 and include a broad array of program and study designs. Many of these studies have also included indirect productivity savings in their assessment of financial outcomes. In contrast, this review includes only peer-reviewed studies of the direct health care cost impact of comprehensive PHM programs that meet rigorous methodological criteria. A systematic search of health sciences databases identified only 5 studies with program designs and study methods meeting these selection criteria published after 2007. This focused review found that comprehensive PHM programs can yield a positive ROI based on their impact on direct health care costs, but the level of ROI achieved was lower than that reported by literature reviews with less focused and restrictive qualifying criteria. To yield substantial short-term health care cost savings, the longer term financial return that can credibly be associated with a comprehensive, prevention-oriented population health program must be augmented by other financial impact strategies.

Family Impact in Intellectual Disability, Severe Mental Health Disorders and Mental Health Disorders in ID. A Comparison

ERIC Educational Resources Information Center