Sharon Croisant

Epidemiology of asthma: prevalence and burden of disease.

While clinical guidelines clearly define mechanisms for asthma diagnosis based upon history, lung function testing, symptoms, and physical examination, surveillance for asthma is much less straightforward. Epidemiologists have long debated the best means of assessing the scope and burden of asthma, seeking to reduce the potential for confounding introduced by differential means of diagnosis and even slight differences in surveillance questions, both of which can bias surveillance results such that we over- or undercount cases. This chapter will provide an overview of asthma epidemiology in the USA and internationally, as well as review of the data and findings from the major surveillance systems, a discussion of a networked approach to the science and evaluation of therapeutic treatments using the exemplar of the Inner-City Asthma Network, and assessment of public health implications.

Gender Differences in Risk Behaviors Among High School Youth

The US Centers for Disease Control and Preventions (CDC) Youth Risk Behavior Surveillance System (YRBSS) demonstrates that American youth engage in a wide variety of risky behaviors.1 The frequency and type of these behaviors often differ by a number of factors, such as socioeconomic status, race, and ethnicity. For example, results of the 2011 YRBSS revealed that white high school students were most likely to have texted or e-mailed while driving or been bullied on school property, while black high school students were most likely to have engaged in risky sexual behaviors, to have been physically inactive, and to be obese.1 Conversely, Hispanic high school students were most likely to have ridden with a driver who had been drinking alcohol; to have ever used cocaine, inhalants, or ecstasy; and to have failed to use protection to prevent pregnancy during last sexual intercourse.1 However, it is difficult to discern whether differences in risk-taking behaviors between and among ethnic groups can actually be attributed to differences in group norms, socioeconomic status, or cultural beliefs regarding acceptance or rejection of such behaviors,1 suggesting a need for more comprehensive regional investigations.

The Gulf Coast Health Alliance: Health Risks Related to the Macondo Spill (GC-HARMS) Study: Self-Reported Health Effects

The Deepwater Horizon (DWH) explosion in 2010 is the largest oil spill (Macondo) in U.S. history. We focused on gaining an understanding of the physical health and mental health effects attributable to the Macondo oil spill. This is a report of a cross-sectional cohort study (wave 1) to establish ‘baseline’ findings and meant to provide descriptive information to be used for a multi-wave, longitudinal study. Gulf Coast Health Alliance: health Risks related to the Macondo Spill (GC-HARMS) uses a Community-Based Participatory Research approach, thus including multi-disciplinary, multi-institutional academic partners and representatives of three communities impacted by the spill. Three research sites were selected for human sampling along the Gulf of Mexico coast including two from Mississippi and one from Louisiana, with Galveston, Texas, serving as a comparison site, given that it was not directly impacted by the spill. One hundred participants were selected from each community, representing adults, seniors and children, with approximately equal numbers of males and females in each group. Participants completed initial assessments including completion of a ‘baseline’ survey and, rigorous physical assessments. Results from wave 1 data collection reported herein reveal changes in self-reported physical health and mental health status following the oil spill, disparities in access to healthcare, and associations between mental health and emotional conditions related to displacement/unemployment. Few environmental health studies have been conducted in communities impacted by significant oil spills. Results imply potential prolonged effects on mental health and community vulnerability.

Ethical Issues in Patient-Centered Outcomes Research and Comparative Effectiveness Research: A Pilot Study of Community Dialogue

Community bioethics dialogues were held on the topic of patient-centered outcomes research (PCOR) and comparative effectiveness research (CER). Participants were 65 and older and represented either a lower income, African American group (A) or a higher income White group (B). Participants were presented with a variety of background reading and study materials. Meetings were held 2 hr per week for 6 weeks. The groups showed both independence in judgment from the investigators and diversity of opinion between the two groups. Group B addressed more topics than Group A and in some instances explored additional policy nuances. Members of Group A appeared more cognizant of issues of social justice that affect vulnerable populations and appeared leery of approaches that suggested possible disrespect for their own personal experiences. Future plans call for both repeating the dialogue with additional, diverse community groups and repeating community bioethics dialogues on new topics with the same groups.

Building and Maintaining a Citizen Science Network With Fishermen and Fishing Communities Post Deepwater Horizon Oil Disaster Using a CBPR Approach

When the Deepwater Horizon oil rig blew out in 2010, the immediate threats to productive deep water and estuarial fisheries and the region’s fishing and energy economies were obvious. Less immediately obvious, but equally unsettling, were risks to human health posed by potential damage to the regional food web. This paper describes grassroots and regional efforts by the Gulf Coast Health Alliance: health risks related to the Macondo Spill Fishermen’s Citizen Science Network project. Using a community-based participatory research approach and a citizen science structure, the multiyear project measured exposure to petrogenic polycyclic aromatic hydrocarbons, researched the toxicity of these polycyclic aromatic hydrocarbon compounds, and communicated project findings and seafood consumption guidelines throughout the region (coastal Louisiana, Mississippi, and Alabama). Description/analysis focuses primarily on the process of building a network of working fishermen and developing group environmental health literacy competencies.

Studying the Human Health and Ecological Impacts of the Deep Water Horizon Oil Spill Disaster: Introduction to This Special Issue of New Solutions

Gulf Coast Health Alliance: Health Risks Related to the Macondo Spill (GC-HARMS) began in 2011 as a component project of the National Institute of Environmental Health Sciences’ (NIEHS) Deep Water Horizon (DWH) Research Consortia program. This Gulf-wide consortium created regional community-university research partnerships focused on addressing health impacts resulting from oil spill exposures. Findings from this trans-National Institutes of Health program have helped enhance and refine community disaster preparedness and reinforced local–regional disaster response networks. Focal points of individual projects included the following: effects of multiple stressors on individuals and vulnerable populations, exposure to contaminants associated with crude oil, and mental health impacts. This introduction to New Solutions Special Issue on the GC-HARMS response to the DWH disaster presents an overview of the project’s internal structure and relationship to the comprehensive NIEHS consortia response and lists articles and interviews featured currently with brief mention of additional articles slated for the next issue.