Jan C. Semenza

Public Perception of Climate Change. Voluntary Mitigation and Barriers to Behavior Change

Mitigating global climate change requires not only government action but also cooperation from consumers. Population-based, cross-sectional surveys were conducted among 1202 respondents in Portland OR and Houston TX between June and September 2007 regarding awareness, concern, and behavior change related to climate change. The data were subjected to both quantitative and qualitative analyses. Awareness about climate change is virtually universal (98% in Portland and 92% in Houston) with the vast majority reporting some level of concern (90% in Portland and 82% in Houston). A multivariate analysis revealed significant predictors of behavior change: individuals with heightened concern about climate change (p<0.001); respondents with higher level of education (p= 0.03); younger compared with older individuals (p<0.001); and Portlanders more likely to change behavior compared with Houstonians (p<0.001). Of those who changed behavior, 43% reported having reduced their energy usage at home, 39% had reduced gasoline consumption, and 26% engaged in other behaviors, largely recycling. Qualitative data indicate a number of cognitive, behavioral, and structural obstacles to voluntary mitigation. Although consumers are interested in global climate change-mitigation strategies and willing to act accordingly, considerable impediments remain. Government policy must eliminate economic, structural, and social barriers to change and advance accessible and economical alternatives. Individual-level mitigation can be a policy option under favorable contextual conditions, as these results indicate, but must be accompanied by mitigation efforts from industry, commerce, and government.

Public perception and behavior change in relationship to hot weather and air pollution

BACKGROUND Changes in climate systems are increasing heat wave frequency and air stagnation, both conditions associated with exacerbating poor air quality and of considerable public health concern. OBJECTIVES Heat and air pollution advisory systems are in place in many cities for early detection and response to reduce health consequences, or severity of adverse conditions. Whereas the ability to forecast heat waves and/or air pollution episodes has become increasingly sophisticated and accurate, little is known about the effectiveness of advisories in altering public behavior. METHODS Air quality and meteorological conditions were measured during advisory and control days in Portland, OR and Houston, TX in 2005 and 2006 and 1962 subjects were interviewed by telephone about their perception and response to these conditions. RESULTS Elevated ambient temperatures were accurately recognized regardless of air conditioning use; in Portland, respondents resorted to active cooling behavior (AC, fan, etc.), while in Houston no such change was observed. More heat-related symptoms were reported in Portland compared to Houston, probably due to low air conditioning use in the northwest. One-third of study participants were aware of air quality advisories but only approximately 10-15% claimed to have changed activities during such an episode. Not the advisory, however, drove their behavior change, but rather the perception of poor air quality, which was not related to PM(2.5) or ozone measurements. CONCLUSIONS Messages are not reaching the public during potentially hazardous weather and air quality conditions. Climatic forecasts are increasingly predictive but public agencies fail to mount an appropriate outreach response.

Breast cancer risk and methylenetetrahydrofolate reductase polymorphism.

AbstractObjective. Methylenetetrahydrofolate reductase (MTHFR), a polymorphic enzyme involved in folate metabolism, plays a role in DNA biosynthesis, methylation, and repair in actively dividing cells. Because breast-cell division occurs in women with active ovulatory cycles, polymorphisms in the MTHFR gene could be a risk factor for breast cancer. Methods. We genotyped 352 clinic-based study subjects for MTHFR, 105 subjects with breast cancer and 247 with benign breast disease, histopathologically classified as high-risk or low-risk for breast cancer. Questionnaire data were collected prior to biopsy to blind subjects and interviewers to diagnoses. Results. Premenopausal women with the MTHFR polymorphism had a threefold increased breast cancer risk (OR = 2.8; 95%CI: 1.02–7.51) compared to the clinic-based controls with benign breast disease. Results were similar using either low- or high-risk controls. However, risk for postmenopausal women was not elevated (OR = 0.8; 95%CI 0.4–1.4). No significant interaction between genotype and smoking or alcohol was found, but polymorphic MTHFR decreased the likelihood of drinking alcohol (OR = 0.5; 95%CI 0.3–0.9). Conclusion. These data suggest that polymorphic MTHFR increases risk of premenopausal, but not postmenopausal, breast cancer. These findings should be explored with a larger sample size in order to analyze gene–environment interactions between MTHFR and folate. Once the intricate relationship between diet and breast cancer has been elucidated, new cancer control initiatives can be considered such as folate chemoprevention trials in high-risk individuals.

Community-initiated urban development: an ecological intervention.

Neglected urban environments have been linked to social isolation, depression, and other health problems. In Portland, OR in 2003, an intervention was implemented and evaluated in three neighborhoods with the objective of promoting community participation in urban renewal and engaging residents in the construction of attractive urban places. Municipal officials approved and permitted community-designed street murals, public benches, planter boxes, information kiosks with bulletin boards, trellises for hanging gardens, all positioned in the public right-of-way. Residents within a two-block radius of the three sites were systematically sampled and interviewed before (N = 325) and after (N = 349) the intervention, of which, 265 individuals completed both surveys of the panel study. After the intervention, multivariate results revealed improvements in mental health (p = 0.03), increased sense of community (p < 0.01), and an overall expansion of social capital (p = 0.04). Through community empowerment, participation, and collective action, the strategy successfully engaged residents in restoring neighborhoods, with direct benefits to community well-being.

An Urban Community-Based Intervention to Advance Social Interactions

Blighted urban environments can be detrimental to community life and result in alienation and isolation. An intervention was developed in 2003 in Portland, Oregon, to engage low- to moderate-income, urban communities in creating pleasant amenities in the public right-of-way, including ecologically built information kiosks, benches, trellises for hanging gardens, and interactive art features such as large street paintings and art walls. As part of a postintervention survey of 359 residents within a two-block radius at three project sites, 53% rated their neighborhood better than before and 44% or 53% rated their present neighborhood as an excellent or good place to live, respectively. In open-ended qualitative comments, 30% mentioned increased social interactions, 13% revealed an enhanced sense of place, 43% described neighborhood participation, and 20% discussed aesthetic aspects of their local environment. Community involvement in urban design can enrich social networks with direct benefits for social capital and well-being.

Design of a Health-Promoting Neighborhood Intervention

Design and implementation of health-promoting community interventions can advance public health and community well-being; however, realization of such programs is often challenging. Even more challenging is the implementation of ecologic interventions to revitalize built urban environments. A structured intervention entitled `Intersection Repair` was devised in Portland, Oregon, by a non-profit organization, to implement urban gathering places in the public right of way; specific steps included situation analysis, community outreach, asset mapping, design workshops, construction permitting, building workshops, and process evaluation. The community created human-scale urban landscapes with interactive art installations to encourage social interactions. Such aesthetic improvements, which included painted street murals, information kiosks, hanging gardens, water fountains, benches, and so on, were intended to strengthen social networks and social capital by providing places for residents to engage in conversation. Community engagement in neighborhood design benefits the public at multiple levels, by promoting a healthier lifestyle, over and above urban landscape improvements.

Building Healthy Cities

Through community organizing this approach has proven to build both localized and bridging social capital that has manifested itself through physical improvements of urban environments. Over its eight years of existence The City Repair Project has created over 30 public gathering places and events in Portland, OR that engage people to connect with the community and place around them. Intersection Repair projects outside the Portland area have been implemented or are in the process of being implemented in Olympia, WA, Ottawa, Ontario, Ashland, NC, Minneapolis, MN, and Ithaca, NY. They all have a core group of people committed to making their neighborhoods better places to live and have strategically organized their community. The goal is to help people physically change their neighborhoods to be more community-oriented, ecologically sustainable, and simply more beautiful. This work is inspired by the idea that localization of decisionmaking, culture, and economy is a necessary foundation for healthy cities.