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BackgroundThe presence of active or inactive (i.e., postproduction) oil and gas wells in neighborhoods may contribute to ongoing pollution. Racially discriminatory neighborhood security maps developed by the Home-Owners Loan Corporation (HOLC) in the 1930s may contribute to environmental exposure disparities.ObjectiveTo determine whether receiving worse HOLC grades was associated with exposure to more oil and gas wells.MethodsWe assessed exposure to oil and gas wells among HOLC-graded neighborhoods in 33 cities from 13 states where urban oil and gas wells were drilled and operated. Among the 17 cities for which 1940 census data were available, we used propensity score restriction and matching to compare well exposure neighborhoods that were similar on observed 1940 sociodemographic characteristics but that received different grades.ResultsAcross all included cities, redlined D-graded neighborhoods had 12.2 ± 27.2 wells km-2, nearly twice the density in neighborhoods graded A (6.8 ± 8.9 wells km-2). In propensity score restricted and matched analyses, redlined neighborhoods had 2.0 (1.3, 2.7) more wells than comparable neighborhoods with a better grade.SignificanceOur study adds to the evidence that structural racism in federal policy is associated with the disproportionate siting of oil and gas wells in marginalized neighborhoods.

IntroductionRedlining, a racist mortgage appraisal practice of the 1930s, established and exacerbated racial residential segregation boundaries in the United States. Investment risk grades assigned >80y ago through security maps from the Home Owners' Loan Corporation (HOLC) are associated with current sociodemographics and adverse health outcomes. We assessed whether historical HOLC investment grades are associated with 2010 greenspace, a health-promoting neighborhood resource.ObjectivesWe compared 2010 normalized difference vegetation index (NDVI) across previous HOLC neighborhood grades using propensity score restriction and matching.MethodsSecurity map shapefiles were downloaded from the Mapping Inequality Project. Neighborhood investment risk grades included A (best, green), B (blue), C (yellow), and D (hazardous, red, i.e., redlined). We used 2010 satellite imagery to calculate the average NDVI for each HOLC neighborhood. Our main outcomes were 2010 annual average NDVI and summer NDVI. We assigned areal-apportioned 1940 census measures to each HOLC neighborhood. We used propensity score restriction, matching, and targeted maximum likelihood estimation to limit model extrapolation, reduce confounding, and estimate the association between HOLC grade and NDVI for the following comparisons: Grades B vs. A, C vs. B, and D vs. C.ResultsAcross 102 urban areas (4,141 HOLC polygons), annual average ±standard deviation (SD) 2010 NDVI was 0.47 (±0.09), 0.43 (±0.09), 0.39 (±0.09), and 0.36 (±0.10) in Grades A-D, respectively. In analyses adjusted for current ecoregion and census region, 1940s census measures, and 1940s population density, annual average NDVI values in 2010 were estimated at -0.039 (95% CI: -0.045, -0.034), -0.024 (95% CI: -0.030, -0.018), and -0.026 (95% CI: -0.037, -0.015) for Grades B vs. A, C vs. B, and D vs. C, respectively, in the 1930s.DiscussionEstimates adjusted for historical characteristics indicate that neighborhoods assigned worse HOLC grades in the 1930s are associated with reduced present-day greenspace. https://doi.org/10.1289/EHP7495.

BackgroundAsthma disproportionately affects communities of colour in the USA, but the underlying factors for this remain poorly understood. In this study, we assess the role of historical redlining as outlined in security maps created by the Home Owners' Loan Corporation (HOLC), the discriminatory practice of categorising neighbourhoods on the basis of perceived mortgage investment risk, on the burden of asthma in these neighbourhoods.MethodsWe did an ecological study of HOLC risk grades and asthma exacerbations in California using the security maps available for the following eight cities: Fresno, Los Angeles, Oakland, Sacramento, San Diego, San Jose, San Francisco, and Stockton. Each census tract was categorised into one of four risk levels (A, B, C, or D) on the basis of the location of population-weighted centroids on security maps, with the worst risk level (D) indicating historical redlining. We obtained census tract-level rates of emergency department visits due to asthma from CalEnviroScreen 3.0. We assessed the relationship between risk grade and log-transformed asthma visit rates between 2011 and 2013 using ordinary least squares regression. We included potential confounding variables from the 2010 Census and CalEnviroScreen 3.0: diesel exhaust particle emissions, PM2·5, and percent of the population living below 2 times the federal poverty level. We also built random intercept and slope models to assess city-level variation in the relationship between redlining and asthma.FindingsIn the 1431 census tracts assessed (64 [4·5%] grade A, 241 [16·8%] grade B, 719 [50·2%] grade C, and 407 [28·4%] grade D), the proportion of the population that was non-Hispanic black and Hispanic, the percentage of the population living in poverty, and diesel exhaust particle emissions all significantly increased as security map risk grade worsened (p

BackgroundDespite being one of the wealthiest nations, disparities in adverse birth outcomes persist across racial and ethnic lines in the United States. We studied the association between historical redlining and preterm birth, low birth weight (LBW), small-for-gestational age (SGA), and perinatal mortality over a ten-year period (2006-2015) in Los Angeles, Oakland, and San Francisco, California.MethodsWe used birth outcomes data from the California Office of Statewide Health Planning and Development between January 1, 2006 and December 31, 2015. Home Owners' Loan Corporation (HOLC) Security Maps developed in the 1930s assigned neighborhoods one of four grades that pertained to perceived investment risk of borrowers from that neighborhood: green (grade A) were considered "Best", blue (grade B) "Still Desirable", yellow (grade C) "Definitely Declining", and red (grade D, hence the term "redlining") "Hazardous". Geocoded residential addresses at the time of birth were superimposed on HOLC Security Maps to assign each birth a HOLC grade. We adjusted for potential confounders present at the time of Security Map creation by assigning HOLC polygons areal-weighted 1940s Census measures. We then employed propensity score matching methods to estimate the association of historical HOLC grades on current birth outcomes. Because tracts graded A had almost no propensity of receiving grade C or D and because grade B tracts had low propensity of receiving grade D, we examined birth outcomes in the three following comparisons: B vs. A, C vs. B, and D vs. C.ResultsThe prevalence of preterm birth, SGA and mortality tended to be higher in worse HOLC grades, while the prevalence of LBW varied across grades. Overall odds of mortality and preterm birth increased as HOLC grade worsened. Propensity score matching balanced 1940s census measures across contrasting groups. Logistic regression models revealed significantly elevated odds of preterm birth (odds ratio (OR): 1.02, 95% confidence interval (CI): 1.00-1.05), and SGA (OR: 1.03, 95% CI: 1.00-1.05) in the C vs. B comparison and significantly reduced odds of preterm birth (OR: 0.93, 95% CI: 0.91-0.95), LBW (OR: 0.94-95% CI: 0.92-0.97), and SGA (OR: 0.94, 95% CI: 0.92-0.96) in the D vs. C comparison. Results differed by metropolitan area and maternal race.ConclusionSimilar to prior studies on redlining, we found that worsening HOLC grade was associated with adverse birth outcomes, although this relationship was less clear after propensity score matching and stratifying by metropolitan area. Higher odds of preterm birth and SGA in grade C versus grade B neighborhoods may be caused by higher-stress environments, racial segregation, and lack of access to resources, while lower odds of preterm birth, SGA, and LBW in grade D versus grade C neighborhoods may due to population shifts in those neighborhoods related to gentrification.

Purpose of reviewGiven racial disparities in ambient air pollution (AAP) exposure and asthma risk, this review offers an overview of the literature investigating the ambient air pollution-asthma relationship in children of color between 2013 and 2017.Recent findingsAAP is likely a key contributor to the excess burden of asthma in children of color due to pervasive exposure before birth, at home, and in school. Recent findings suggest that psychosocial stressors may modify the relationship between AAP and asthma. The effect of AAP on asthma in children of color is likely modulated by multiple unique psychosocial stressors and gene-environment interactions. Although children of color are being included in asthma studies, more research is still needed on impacts of specific criteria pollutants throughout the life course. Additionally, future studies should consider historical factors when analyzing current exposure profiles.

BackgroundElevated body mass index (BMI) and arsenic are both associated with cancer and with non-malignant lung disease. Using a unique exposure situation in Northern Chile with data on lifetime arsenic exposure, we previously identified the first evidence of an interaction between arsenic and BMI for the development of lung cancer.ObjectivesWe examined whether there was an interaction between arsenic and BMI for the development of non-malignant lung disease.MethodsData on lifetime arsenic exposure, respiratory symptoms, spirometry, BMI, and smoking were collected from 751 participants from cities in Northern Chile with varying levels of arsenic water concentrations. Spirometry values and respiratory symptoms were compared across subjects in different categories of arsenic exposure and BMI.ResultsAdults with both a BMI above the 90th percentile (>33.9kg/m2) and arsenic water concentrations ≥11µg/L exhibited high odds ratios (ORs) for cough (OR = 10.7, 95% confidence interval (CI): 3.03, 50.1), shortness of breath (OR = 14.2, 95% CI: 4.79, 52.4), wheeze (OR = 14.4, 95% CI: 4.80, 53.7), and the combined presence of any respiratory symptom (OR = 9.82, 95% CI: 4.22, 24.5). In subjects with lower BMIs, respiratory symptom ORs for arsenic water concentrations ≥11µg/L were markedly lower. In never-smokers, reductions in forced vital capacity associated with arsenic increased as BMI increased. Analysis of the FEV1/FVC ratio in never-smokers significantly increased as BMI and arsenic concentrations increased. Similar trends were not observed for FEV1 alone or in ever-smokers.ConclusionsThis study provides preliminary evidence that BMI may increase the risk for arsenic-related non-malignant respiratory disease.

BackgroundArsenic in drinking water has been associated with increases in lung disease, but information on the long-term impacts of early-life exposure or moderate exposure levels are limited.MethodsWe investigated pulmonary disease and lung function in 795 subjects from three socio-demographically similar areas in northern Chile: Antofagasta, which had a well-described period of high arsenic water concentrations (860μg/L) from 1958 to 1970; Iquique, which had long-term arsenic water concentrations near 60μg/L; and Arica, with long-term water concentrations ≤10μg/L.ResultsCompared to adults never exposed >10μg/L, adults born in Antofagasta during the high exposure period had elevated odds ratios (OR) of respiratory symptoms (e.g., OR for shortness of breath=5.56, 90% confidence interval (CI): 2.68-11.5), and decreases in pulmonary function (e.g., 224mL decrease in forced vital capacity in nonsmokers, 90% CI: 97-351mL). Subjects with long-term exposure to arsenic water concentrations near 60μg/L also had increases in some pulmonary symptoms and reduced lung function.ConclusionsOverall, these findings provide new evidence that in utero or childhood arsenic exposure is associated with non-malignant pulmonary disease in adults. They also provide preliminary new evidence that long-term exposures to moderate levels of arsenic may be associated with lung toxicity, although the magnitude of these latter findings were greater than expected and should be confirmed.

Using a common protocol across seven countries in the European Union/European Economic Area, we estimated XBB.1.5 monovalent vaccine effectiveness (VE) against COVID‐19 hospitalisation and death in booster‐eligible ≥ 65‐year‐olds, during October–November 2023. We linked electronic records to construct retrospective cohorts and used Cox models to estimate adjusted hazard ratios and derive VE. VE for COVID‐19 hospitalisation and death was, respectively, 67% (95%CI: 58–74) and 67% (95%CI: 42–81) in 65‐ to 79‐year‐olds and 66% (95%CI: 57–73) and 72% (95%CI: 51–85) in ≥ 80‐year‐olds. Results indicate that periodic vaccination of individuals ≥ 65 years has an ongoing benefit and support current vaccination strategies in the EU/EEA. [ABSTRACT FROM AUTHOR]

Background: Within the ECDC‐VEBIS project, we prospectively monitored vaccine effectiveness (VE) against COVID‐19 hospitalisation and COVID‐19‐related death using electronic health registries (EHR), between October 2021 and November 2022, in community‐dwelling residents aged 65–79 and ≥80 years in six European countries. Methods: EHR linkage was used to construct population cohorts in Belgium, Denmark, Luxembourg, Navarre (Spain), Norway and Portugal. Using a common protocol, for each outcome, VE was estimated monthly over 8‐week follow‐up periods, allowing 1 month‐lag for data consolidation. Cox proportional‐hazards models were used to estimate adjusted hazard ratios (aHR) and VE = (1 − aHR) × 100%. Site‐specific estimates were pooled using random‐effects meta‐analysis. Results: For ≥80 years, considering unvaccinated as the reference, VE against COVID‐19 hospitalisation decreased from 66.9% (95% CI: 60.1; 72.6) to 36.1% (95% CI: −27.3; 67.9) for the primary vaccination and from 95.6% (95% CI: 88.0; 98.4) to 67.7% (95% CI: 45.9; 80.8) for the first booster. Similar trends were observed for 65–79 years. The second booster VE against hospitalisation ranged between 82.0% (95% CI: 75.9; 87.0) and 83.9% (95% CI: 77.7; 88.4) for the ≥80 years and between 39.3% (95% CI: −3.9; 64.5) and 80.6% (95% CI: 67.2; 88.5) for 65–79 years. The first booster VE against COVID‐19‐related death declined over time for both age groups, while the second booster VE against death remained above 80% for the ≥80 years. Conclusions: Successive vaccine boosters played a relevant role in maintaining protection against COVID‐19 hospitalisation and death, in the context of decreasing VE over time. Multicountry data from EHR facilitate robust near‐real‐time VE monitoring in the EU/EEA and support public health decision‐making. [ABSTRACT FROM AUTHOR]

Sexually transmitted infections (STIs) are a major public health concern; they can facilitate the transmission of HIV and are associated with severe disease. Treatment for some STIs, especially gonorrhea, has [...]

Background: Our understanding of the global scale of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection remains incomplete: Routine surveillance data underestimate infection and cannot infer on population immunity; there is a predominance of asymptomatic infections, and uneven access to diagnostics. We meta-analyzed SARS-CoV-2 seroprevalence studies, standardized to those described in the World Health Organization's Unity protocol (WHO Unity) for general population seroepidemiological studies, to estimate the extent of population infection and seropositivity to the virus 2 years into the pandemic.Methods and Findings: We conducted a systematic review and meta-analysis, searching MEDLINE, Embase, Web of Science, preprints, and grey literature for SARS-CoV-2 seroprevalence published between January 1, 2020 and May 20, 2022. The review protocol is registered with PROSPERO (CRD42020183634). We included general population cross-sectional and cohort studies meeting an assay quality threshold (90% sensitivity, 97% specificity; exceptions for humanitarian settings). We excluded studies with an unclear or closed population sample frame. Eligible studies-those aligned with the WHO Unity protocol-were extracted and critically appraised in duplicate, with risk of bias evaluated using a modified Joanna Briggs Institute checklist. We meta-analyzed seroprevalence by country and month, pooling to estimate regional and global seroprevalence over time; compared seroprevalence from infection to confirmed cases to estimate underascertainment; meta-analyzed differences in seroprevalence between demographic subgroups such as age and sex; and identified national factors associated with seroprevalence using meta-regression. We identified 513 full texts reporting 965 distinct seroprevalence studies (41% low- and middle-income countries [LMICs]) sampling 5,346,069 participants between January 2020 and April 2022, including 459 low/moderate risk of bias studies with national/subnational scope in further analysis. By September 2021, global SARS-CoV-2 seroprevalence from infection or vaccination was 59.2%, 95% CI [56.1% to 62.2%]. Overall seroprevalence rose steeply in 2021 due to infection in some regions (e.g., 26.6% [24.6 to 28.8] to 86.7% [84.6% to 88.5%] in Africa in December 2021) and vaccination and infection in others (e.g., 9.6% [8.3% to 11.0%] in June 2020 to 95.9% [92.6% to 97.8%] in December 2021, in European high-income countries [HICs]). After the emergence of Omicron in March 2022, infection-induced seroprevalence rose to 47.9% [41.0% to 54.9%] in Europe HIC and 33.7% [31.6% to 36.0%] in Americas HIC. In 2021 Quarter Three (July to September), median seroprevalence to cumulative incidence ratios ranged from around 2:1 in the Americas and Europe HICs to over 100:1 in Africa (LMICs). Children 0 to 9 years and adults 60+ were at lower risk of seropositivity than adults 20 to 29 (p < 0.001 and p = 0.005, respectively). In a multivariable model using prevaccination data, stringent public health and social measures were associated with lower seroprevalence (p = 0.02). The main limitations of our methodology include that some estimates were driven by certain countries or populations being overrepresented.Conclusions: In this study, we observed that global seroprevalence has risen considerably over time and with regional variation; however, over one-third of the global population are seronegative to the SARS-CoV-2 virus. Our estimates of infections based on seroprevalence far exceed reported Coronavirus Disease 2019 (COVID-19) cases. Quality and standardized seroprevalence studies are essential to inform COVID-19 response, particularly in resource-limited regions. [ABSTRACT FROM AUTHOR]

We aimed to estimate the household secondary infection attack rate (hSAR) of SARS‐CoV‐2 in investigations aligned with the WHO Unity Studies Household Transmission Investigations (HHTI) protocol. We conducted a systematic review and meta‐analysis according to PRISMA 2020 guidelines. We searched Medline, Embase, Web of Science, Scopus and medRxiv/bioRxiv for "Unity‐aligned" First Few X cases (FFX) and HHTIs published 1 December 2019 to 26 July 2021. Standardised early results were shared by WHO Unity Studies collaborators (to 1 October 2021). We used a bespoke tool to assess investigation methodological quality. Values for hSAR and 95% confidence intervals (CIs) were extracted or calculated from crude data. Heterogeneity was assessed by visually inspecting overlap of CIs on forest plots and quantified in meta‐analyses. Of 9988 records retrieved, 80 articles (64 from databases; 16 provided by Unity Studies collaborators) were retained in the systematic review; 62 were included in the primary meta‐analysis. hSAR point estimates ranged from 2% to 90% (95% prediction interval: 3%–71%; I2 = 99.7%); I2 values remained >99% in subgroup analyses, indicating high, unexplained heterogeneity and leading to a decision not to report pooled hSAR estimates. FFX and HHTI remain critical epidemiological tools for early and ongoing characterisation of novel infectious pathogens. The large, unexplained variance in hSAR estimates emphasises the need to further support standardisation in planning, conduct and analysis, and for clear and comprehensive reporting of FFX and HHTIs in time and place, to guide evidence‐based pandemic preparedness and response efforts for SARS‐CoV‐2, influenza and future novel respiratory viruses. [ABSTRACT FROM AUTHOR]

HIV-prevention measures specific to injection drug users (IDUs), such as opioid substitution treatment and needle-and-syringe programs, are not provided in many countries where injection drug use is endemic. We describe the incidence of diagnosed HIV infection in IDUs and the availability and coverage of opioid substitution and needle-and-syringe programs in the European Union and 5 middle-and high-income countries. Countries with greater provision of both prevention measures in 2000 to 2004 had lower incidence of diagnosed HIV infection in 2005 and 2006. doi: 10.2105/AJPH.2008.141846)

Objective To evaluate age-specific measles susceptibility in Australia and 17 European countries. Methods As part of the European Sero-Epidemiology Network 2 (ESEN2), 18 countries collected large national serum banks between 1996 and 2004. These banks were tested for measles IgG and the results converted to a common unitage to enable valid intercountry comparisons. Historical vaccination and disease incidence data were also collected. Age-stratified population susceptibility levels were compared to WHO European Region targets for measles elimination of < 15% in those aged 2-4 years, < 10% in 5-9-year-olds and < 5% in older age groups. Findings Seven countries (Czech Republic, Hungary, Luxembourg, Spain, Slovakia, Slovenia and Sweden) met or carne very close to the elimination targets. Four countries (Australia, Israel, Lithuania and Malta) had susceptibility levels above WHO targets in some older age groups indicating possible gaps in protection. Seven countries (Belgium, Bulgaria, Cyprus, England and Wales, Ireland, LaMa and Romania) were deemed to be at risk of epidemics as a result of high susceptibility in children and also, in some cases, adults. Conclusion Although all countries now implement a two-dose measles vaccination schedule, if the WHO European Region target of measles elimination by 2010 is to be achieved higher routine coverage as well as vaccination campaigns in some older age cohorts are needed in some countries. Without these improvements, continued measles transmission and outbreaks are expected in Europe. Bulletin of the World Health Organization 2008;86:197-204. Resume Objectif Evaluer la sensibilite par age a la rougeole en Australie et dans 17 pays europeens. Methodes Dans le cadre du Reseau europeen d&apos;epidemiologie serologique 2 (ESEN2), 18 pays ont constitue entre 1996 et 2004 de grandes banques nationales de serum. On a soumis ces banques a des tests pour detecter les IgG antirougeoleuses et on a converti les resultats de ces tests en unites communes pour permettre des comparaisons valides entre pays. On a egalement recueilli des donnees sur l&apos;historique des vaccinations antirougeoleuses et sur l&apos;incidence de la rougeole. On a compare les niveaux de sensibilite de la population stratifiee par ages aux objectifs pour la Region europeenne de l&apos;OMS concernant l&apos;elimination de la rougeole, a savoir moins de 15% dans la tranche d&apos;ages 2-4 ans, moins de 10% dans la tranche d&apos;ages 5-9 ans et moins de 5% dans les tranches d&apos;ages superieures. Resultats Sept pays (Espagne, Hongrie, Luxembourg, Republique tcheque, Slovaquie, Slovenie et Suede) remplissaient les objectifs ou en etaient tres proches. Quatre pays (Australie, Israel, Lituanie et Malte) presentaient des niveaux de sensibilite dans certaines tranches d&apos;ages indiquant d&apos;eventuelles breches dans la protection. Sept autres pays (Belgique, Bulgarie, Chypre, Angleterre et Pays-de-Galles, Irlande, Lettonie et Roumanie) ont ete juges a risque d&apos;epidemie en raison de la grande sensibilite des enfants et dans certains cas des adultes. Conclusion Bien que tous ces pays appliquent actuellement un calendrier de vaccination antirougeoleuse en deux doses, certains d&apos;entre eux devront etendre la couverture vaccinale systematique et proceder a des campagnes de vaccination dans certaines cohortes plus agees si l&apos;on veut que la Region europeenne de l&apos;OMS atteigne les objectifs d&apos;elimination d&apos;ici 2010. Si ces ameliorations ne sont pas apportees, on peut s&apos;attendre a ce que la transmission se poursuive et a ce que des flambees de rougeole apparaissent en Europe. Resumen Objetivo Evaluar la vulnerabilidad especifica de la edad al sarampion en Australia y 17 paises europeos. Metodos Como parte de la Red Europea de Seroepidemiologia 2 (ESEN2), 18 paises crearon grandes serotecas nacionales entre 1996 y 2004. Tras analizar dichas serotecas para determinar los anticuerpos IgG contra el sarampion, los resultados obtenidos se expresaron en las mismas unidades para poder realizar comparaciones validas interpaises. Se recogieron tambien datos temporales sobre la vacunacion y la incidencia de la enfermedad. Los niveles de vulnerabilidad de la poblacion estratificados por edades se compararon con las metas de la Region de Europa de la OMS para la eliminacion del sarampion: menos del 15% en los ninos de 2-4 anos, menos del 10% en los de 5-9 anos, y menos del 5% en los grupos de mas edad. Resultados Siete paises (Republica Checa, Hungria, Luxemburgo, Espana, Eslovaquia, Eslovenia y Suecia) habian alcanzado las metas de eliminacion o se aproximaban mucho a ellas. Cuatro paises (Australia, Israel, Lituania y Malta) presentaban unos niveles de vulnerabilidad superiores a las metas de la OMS en algunos grupos de mas edad, lo que parece indicar que presentan lagunas en sus sistemas de proteccion. En cuanto a los otros siete paises (Belgica, Bulgaria, Chipre, Inglaterra y Gales, Irlanda, Letonia y Rumania), se considero que corrian el riesgo de sufrir epidemias como resultado de la alta vulnerabilidad de los ninos, y tambien en algunos casos de los adultos. Conclusion Aunque todos los paises aplican hoy dia una pauta de vacunacion antisarampionosa de dos dosis, para alcanzar la meta de la Region de Europa de la OMS de eliminar el sarampion, Introduction Live attenuated measles vaccines have been available since the early 1960s and are now in use worldwide. They have the potential to achieve highly effective measles control and elimination, [...]