Carr Shmool, Jessie L
(2015)
Exposure assessment methods for examining the role of non-chemical stressors in environmental health disparities.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Increases in chronic diseases among children are cause for public health concern and action, particularly as children of color and low socioeconomic position are disproportionately impacted, with far-reaching consequences for health and well-being over the life-course. Environmental toxicants and non-chemical stressors have been linked with adverse health outcomes and disparities. Specifically, recent toxicological and epidemiological evidence suggests that chronic psychosocial stress may modify pollution effects on health. Thus, there is increasing interest in refined methods for assessing and incorporating non-chemical exposures, including social stressors, into environmental health research, towards identifying whether and how psychosocial stress interacts with chemical exposures to influence health and health disparities.
The overall objective of this dissertation is to apply exposure science principles to develop and validate methods for non-chemical exposure assessment, toward examining differential susceptibility and disproportionate exposures in social-environmental epidemiology. To do so, I utilize a spatial approach to characterize intra-urban variation in and correlation among social stressors, socioeconomic position, and air pollution exposures across New York City. I present flexible GIS-based approaches for reformulating aggregate administrative indicators for global correlation analysis, accounting for spatial autocorrelation, and assessing perceived neighborhood geography. I assess multiple foci of the stress process paradigm using qualitative and quantitative methods, and evaluate the extent to which multiple components of social environment are implicated in psychosocial pathways, with specific attention to distinguishing socioeconomic and stress pathways.
Complex interaction between air pollution and area-level deprivation effects on term birth weight suggested differential population susceptibility, and the need for mechanism-specific non-chemical exposure metrics. Spatially, ecologic indicators of social stressor exposures and air pollution were not consistently correlated with each other, or with indicators of socioeconomic position, and were not consistently associated with child asthma exacerbation rates. Community perceptions of important social stressors assessed through a qualitative process informed upon the design and implementation of a systematic survey to validate the resonance of ecologic stressor indicators against individual stress perception and mental health. Overall, these non-chemical exposure assessment methods enable characterization of complex confounding in urban environments, toward refining epidemiologic investigations of separate and combined effects of social and chemical exposures.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
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| Date: |
28 January 2015 |
| Date Type: |
Publication |
| Defense Date: |
3 December 2014 |
| Approval Date: |
28 January 2015 |
| Submission Date: |
22 December 2014 |
| Access Restriction: |
1 year -- Restrict access to University of Pittsburgh for a period of 1 year. |
| Number of Pages: |
195 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Environmental and Occupational Health |
| Degree: |
DrPH - Doctor of Public Health |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
air pollution, disparities, environmental health, focus groups, GIS, social stress, spatial analysis |
| Date Deposited: |
28 Jan 2015 15:50 |
| Last Modified: |
19 Dec 2016 14:42 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/23926 |
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