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Pediatric positive health refers to children's assessments of their well-being. The purpose of this study was to contrast positive health for children aged 8 to 17 years with and without chronic physical and mental health conditions.Data were drawn from the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) research program. Participants included 1764 children ages 8 to 17 years from 13 ECHO cohorts. We measured positive health using the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Global Health and Life Satisfaction patient-reported outcome (PRO) measures. We used multiple regression to examine cross-sectional associations between the PROs and parent-reported health conditions and sociodemographic variables. We defined a meaningful difference in average scores as a PROMIS T-score difference of3.The sample included 45% 13 to 17-year-olds, 50% females, 8% Latinx, and 23% Black/African-American. Fifty-four percent had a chronic health condition. Of the 16 chronic conditions included in the study, only chronic pain (β = -3.5; 95% CI: -5.2 to -1.9) and depression (β = -6.6; 95% CI: -8.5 to -4.6) were associated with scoring3 points lower on global health. Only depression was associated with3 points lower on life satisfaction (β = -6.2; 95% CI: -8.1 to -4.3). Among those with depression, 95% also had another chronic condition.Many children with chronic conditions have similar levels of positive health as counterparts without chronic conditions. The study results suggest that negative associations between chronic conditions and positive health may be primarily attributable to presence or co-occurrence of depression.

Background: Environmental racism, community stressors, and age-related susceptibility play a significant role in environmental inequality. The goal of this article was to use an inequality index (II) to assess the level of equality in environmental threats and hazards based on race, poverty, and age in Washington State. Methods: Using the Washington Environmental Health Disparities Map, we quantified the level of disproportionate burdens on communities with greater populations of people of color, people in poverty, children younger than 5, and people older than 65 using 3 cumulative environmental indices and 10 individual environmental indicators. Results: Census tracts with a higher proportion of people of color and those with people living below 185% federal poverty levels were found to be disproportionately burdened by environmental threats (II = −0.175 and II = −0.167, respectively, p

Postnatal exposures, including breastfeeding, may influence asthma development.To investigate the association between breastfeeding duration and child asthma.We studied 2021 mother-child dyads in the ECHO PATHWAYS consortium of prospective pregnancy cohorts (GAPPS, CANDLE, TIDES). Women reported the duration of any and exclusive breastfeeding and child asthma outcomes during follow-up at child age 4 to 6 years. Outcomes included current wheeze (previous 12 months), ever asthma, current asthma (having ≥2 of current wheeze, ever asthma, medication use in past 12-24 months), and strict current asthma (ever asthma with either or both current wheeze and medication use in past 12-24 months). We used multivariable logistic regression to assess associations (odds ratios and 95% confidence intervals) between breastfeeding and asthma outcomes adjusting for potential confounders. We assessed effect modification by mode of delivery, infant sex, and maternal asthma.Among women, 33%, 13%, 9%, and 45% reported 0 to less than 2, 2 to 4, 5 to 6, and more than 6 months of any breastfeeding, respectively. The duration of any breastfeeding had a protective linear trend with ever asthma but no other outcomes. There was a duration-dependent protective association of exclusive breastfeeding and child asthma outcomes (eg, current asthma adjusted odds ratio [95% confidence interval], 0.64 [0.41-1.02], 0.61 [0.38-0.98], and 0.52 (0.31-0.87) for 2to 4 months, 5 to 6 months, and more than 6 months, respectively, compared with2 months). For exclusive breastfeeding, protective associations were stronger in dyads with children born by vaginal vs cesarean delivery although interactions did not reach statistical significance (PLonger duration of exclusive breastfeeding had a protective association with child asthma.

Rural lower Yakima Valley, Washington is home to the reservation of the Confederated Tribes and Bands of the Yakama Nation, and is a major agricultural region. Episodic poor air quality impacts this area, reflecting sources of particulate matter with a diameter of less than 2.5 micrometers (PM(2.5)) that include residential wood smoke, agricultural biomass burning and other emissions, truck traffic, backyard burning, and wildfire smoke. University of Washington partnered with the Yakama Nation Environmental Management Program to investigate characteristics of PM(2.5) using 9 months of data from a combination of low-cost optical particle counters and a 5-wavelength aethalometer (MA200 Aethlabs) over 4 seasons and an episode of summer wildfire smoke. The greatest percentage of hours sampled with PM(2.5) >12 μg/m(3) occurred during the wildfire smoke episode (59%), followed by fall (23%) and then winter (21%). Mean (SD) values of Delta-C (μg/m(3)), which has been posited as an indicator of wood smoke, and determined as the mass absorbance difference at 375-880nm, were: summer – wildfire smoke 0.34 (0.52), winter 0.27 (0.32), fall 0.10 (0.22), spring 0.05 (0.11), and summer – no wildfire smoke 0.04 (0.14). Mean (95% confidence interval) values of the absorption Ångström exponent, an indicator of the wavelength dependence of the aerosol, were: winter 1.5 (1.2-1.8), summer – wildfire smoke 1.4 (1.0-1.8), fall 1.3 (1.1-1.4), spring 1.2 (1.1-1.4), and summer – no wildfire smoke 1.2 (1.0-1.3). The trends in Delta-C and absorption Ångström exponents are consistent with expectations that a higher value reflects more biomass burning. These results suggest that biomass burning is an important contributor to PM(2.5) in the wintertime, and emissions associated with diesel and soot are important contributors in the fall; however, the variety of emissions sources and combustion conditions present in this region may limit the utility of traditional interpretations of aethalometer data. Further understanding of how to interpret aethalometer data in regions with complex emissions would contribute to much-needed research in communities impacted by air pollution from agricultural as well as residential sources of combustion.

Background: Nitrate contamination in groundwater disproportionately impacts agricultural Latino communities, creating a significant hazard for Latinos that rely on private wells. Private well users must conduct water testing and other well stewardship behaviors to ensure their well water is safe to drink. This study sought to identify the barriers and facilitators of private well water testing in rural, agricultural Latino communities. Methods: We conducted four focus groups with private well users, two in Spanish and two in English. We recruited 37 participants from the Lower Yakima Valley, Washington State, a rural, agricultural community with a large Latino population and elevated nitrate concentrations in groundwater. A semi-structured interview guide was developed to capture testing barriers and facilitators guided by the Risk, Attitudes, Norms, Ability, and Self-Regulation (RANAS) model. Inductive thematic analysis was conducted by two coders to identify common themes. Results: Themes emerged around barriers and facilitators to well stewardship behaviors, including well testing, treatment, and maintenance. Barriers included limited actionable information, economic limitations, lack of technical support, and challenges related to landlords and neighbors. Facilitators of well stewardship included concerns about well water contamination, knowledge of agricultural sources of contamination, do-it-yourself (DIY) home repair experience, and responsibility to protect family. Conclusions: Well stewardship programs in rural, agricultural Latino communities may want to prioritize communication that provides actionable information on well water testing, treatment, and maintenance and emphasizes the responsibility to protect family in its messaging. Additionally, programs that provide financial and technical assistance and well maintenance education that builds on DIY home repair experience may be effective in these communities.

The lower Yakima Valley of Washington State is a rural area home to communities including Latinx farmworker families, the Confederated Tribes and Bands of the Yakama Nation, and Native Americans of...

Ambient PM and NH3 have been associated with measures of asthma health among children in rural Yakima Valley, Washington. Unlike PM, ammonia (NH3) has received little attention as a residential air...

Urban studies demonstrate adverse impacts of home environmental characteristics and caregiver stress on asthma morbidity. We characterize these features at baseline for participants in a rural asth...