Spatiotemporal analysis of adverse birth outcomes in Central Appalachia

阿巴拉契亚中部不良出生结局的时空分析

• 批准号: 9751301
• 负责人: Julia M Gohlke
• 金额: $ 23.29万
• 依托单位: VIRGINIA POLYTECHNIC INST AND ST UNIV
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-01 至 2021-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9751301
• 关键词: Active Sites; Acute; Address; Air; Air Pollution; Appalachian Region; Area; Birth; Birth Records; Caliber; Coal; Communities; County; Data; Data Set; Development; Education; Environmental Epidemiology; Environmental Exposure; Environmental Health; Environmental Risk Factor; Equipment and supply inventories; Excess Mortality; Experimental Designs; Exposure to; Future; Health; Health Policy; Health Status; Individual; Industry; Intake; Knowledge; Lead; Link; Literature; Live Birth; Longitudinal cohort; Low Birth Weight Infant; Metals; Methods; Mining; Modeling; Morbidity - disease rate; Mothers; Movement; Municipalities; Natural experiment; Outcome; Particulate Matter; Perception; Planet Earth; Play; Policies; Population; Positioning Attribute; Poverty; Pregnancy; Premature Birth; Prenatal care; Privatization; Production; Public Health; Recording of previous events; Research; Research Design; Resolution; Resources; Risk; Role; Running; Site; Smoking; Source; Statistical Models; Surface; System; Techniques; Testing; Time; Water; Water Pollution; Work; atmospheric modeling; base; design; developmental toxicology; digital; drinking water; ground water; health care availability; health disparity; improved; innovation; land use; local economy; novel; prenatal exposure; spatiotemporal; trend; water quality; water treatment

PROJECT SUMMARY Significant and increasing health disparities exist in Central Appalachia (encompassing parts of WV, KY, TN and VA) compared to other U.S. regions, yet research addressing environmental factors contributing to these health disparities is lacking. Central Appalachia offers a unique opportunity to examine environmental exposures associated with resource extraction. Coal production from large surface mines was the dominant resource extraction method in the 1990s-2000s and is now decreasing as other resource extraction methods increase. We hypothesize that health risks associated with air and water pollution are increased in Central Appalachian residents living within close proximity to active surface mines. The research proposed here extends our preliminary work in Appalachian communities assessing perceptions of health risks and water quality and fills a critical data gap in the literature, moving beyond county-level ecological studies to link exposure with health outcomes. We propose to: 1) spatiotemporally characterize airshed and watershed boundaries associated with surface mining between 1990 and 2015, and 2) determine associations between adverse birth outcomes and living within active surface mine boundaries during pregnancy. Using a natural experiment design, we will build a retrospective longitudinal cohort of pregnancies resulting in live births between 1990 and 2015 within and outside of air and watershed boundaries of surface mines based on geocoded birth records. We propose innovative methods for defining fine spatial (30m) and temporal (monthly) resolution air and watershed exposure boundaries by combining satellite derived datasets to estimate land use change, air transport modeling, and watershed delineation. Within surface mining airsheds and watersheds, individual pregnancies will be categorized as occurring pre-, during, or post- active surface mining. Using an extension of a difference in differences approach, the proposed research will improve inference and precision in effect estimates by reducing bias associated with unmeasured confounding and secular trends in adverse birth outcomes. The proposed research will aid in defining the causal underpinnings of health disparities in Central Appalachian communities, ultimately leading to research, policy and practice improvements that may be generalizable to other areas beyond Central Appalachia where surface mining is prevalent.

项目摘要 阿巴拉契亚中部存在重大和增加的健康差异（包括WV，肯塔基州，田纳西州的部分 与其他美国地区相比 缺乏健康差异。阿巴拉契亚中部提供了一个独特的机会来检查环境 与资源提取相关的暴露。从大型地雷的煤生产是主要的 1990年代2000年代的资源提取方法，现在随着其他资源提取方法的减少 增加。我们假设中央与空气和水污染相关的健康风险增加 阿巴拉契亚居民居住在接近活跃地面矿山的近处。这里提出的研究 扩展我们在阿巴拉契亚社区的初步工作，以评估对健康风险和水的看法 质量并填补了文献中的关键数据差距，超越了县级生态学研究 健康结果的暴露。我们建议：1）空间和分水岭的时空特征 与1990年至2015年之间的表面开采相关的边界，以及2）确定关联 怀孕期间的不良出生结果和生活在主动地面矿山边界内。使用天然 实验设计，我们将建立一个回顾性的纵向妊娠，导致活产 在1990年至2015年之间，在空中和外部和外部和外面的地面矿山边界基于 地理编码的出生记录。我们提出了定义精细空间（30m）和时间（每月）的创新方法 通过将卫星衍生的数据集结合起来估算土地的使用来解决空气和流域的暴露边界 更改，航空运输建模和分水岭描述。在地面开采中的空影和流域， 个体怀孕将被归类为发生前，期间或活性后表面挖掘。使用一个 扩展差异方法的差异，拟议的研究将改善推理和精度 实际上，通过减少与不衡量的混杂和世俗趋势相关的偏差来估计 出生结果。拟议的研究将有助于确定健康差异的因果关系 阿巴拉契亚中部社区，最终导致研究，政策和实践改进 可以推广到阿巴拉契亚中部以外的其他地区，那里的表面开采很普遍。