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Application of the Public Health Exposome Framework to Estimate Phenotypes of Resilience in a Model Ohio African-American Women’s Cohort

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Abstract

We report integration of the United States Environmental Protection Agency’s (USEPA) United States Environmental Justice Screen (EJSCREEN) database with our Public Health Exposome dataset to interrogate 9232 census blocks to model the complexity of relationships among environmental and socio-demographic variables toward estimating adverse pregnancy outcomes [low birth weight (LBW) and pre-term birth (PTB)] in all Ohio counties. Using a hill-climbing algorithm in R software, we derived a Bayesian network that mapped all controlled associations among all variables available by applying a mapping algorithm. The results revealed 17 environmental and socio-demographic variables that were represented by nodes containing 69 links accounting for a network with 32.85% density and average degree of 9.2 showing the most connected nodes in the center of the model. The model predicts that the socio-economic variables low income, minority, and under age five populations are correlated and associated with the environmental variables; particulate matter (PM2.5) level in air, proximity to risk management facilities, and proximity to direct discharges in water are linked to PTB and LBW in 88 Ohio counties. The methodology used to derive significant associations of chemical and non-chemical stressors linked to PTB and LBW from indices of geo-coded environmental neighborhood deprivation serves as a proxy for design of an African-American women’s cohort to be recruited in Ohio counties from federally qualified community health centers within the 9232 census blocks. The results have implications for the development of severity scores for endo-phenotypes of resilience based on associations and linkages for different chemical and non-chemical stressors that have been shown to moderate cardio-metabolic disease within a population health context.

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Abbreviations

PM2.5 :

Particulate matter at 2.5 μm

USEPA:

United States Environmental Protection Agency

EJSCREEN:

United States Environmental Justice Screen

LBW:

low birth weight

PTB:

pre-term birth

IM:

infant mortality

SE:

Stambaugh Elwood

SSHAC:

South Side Health Advisory Committee

CV:

cardiovascular

CVD:

cardiovascular disease

PPGIS:

public participatory geographical information system

TRI:

toxic release inventory

RMP:

risk management plan

NPL site:

national priorities list site

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Acknowledgments

The authors would like to thank the entire Interdisciplinary Cardio-metabolic Exposome Team (ICE Tea) for critical review and comments. This work was supported, in part, by start-up package received from the Ohio State University College of Public Health and US EPA STAR Award RD83927501 (DBH and PDJ). Support was also from a start-up package received from Meharry Medical College for the Health Disparities Research Center of Excellence (PDJ).

Author information

Authors and Affiliations

  1. Department of Evidence and Intelligence for Action, Information Systems for Health Unit, Pan American Health Organization, Washington, DC, 20037, USA

    Patricia Cifuentes

  2. Department of Environmental Health, Risk Science Center, University of Cincinnati, Cincinnati, OH, 45267, USA

    John Reichard

  3. Department of Family and Community Medicine, School of Medicine, Meharry Medical College, Nashville, TN, 37208, USA

    Wansoo Im & Paul D. Juarez

  4. Division of Endocrinology, Diabetes & Metabolism, The Ohio State University Wexner Medical Center, Columbus, OH, 43210, USA

    Sakima Smith

  5. Department of Sociology, The Ohio State University, Columbus, OH, 43210, USA

    Cynthia Colen

  6. Martha S. Pitzer Center for Women, Children, & Youth, College of Nursing, The Ohio State University, Columbus, OH, 43210, USA

    Carmen Giurgescu, Karen Patricia Williams & Shannon Gillespie

  7. Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH, 43210, USA

    Darryl B. Hood

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  1. Patricia Cifuentes
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Cifuentes, P., Reichard, J., Im, W. et al. Application of the Public Health Exposome Framework to Estimate Phenotypes of Resilience in a Model Ohio African-American Women’s Cohort. J Urban Health 96 (Suppl 1), 57–71 (2019). https://doi.org/10.1007/s11524-018-00338-w

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