Author Interviews, Environmental Risks, Pediatrics, Race/Ethnic Diversity / 29.09.2023 Interview with:

Dr. Devon Payne-Sturges, DrPH, MPH, MEngr
Associate Professor
Maryland Institute for Applied Environmental Health
School of Public Health
University of Maryland, College Park What is the background for this study?

Response: My co-authors and I conducted this study to fill a knowledge gap and to inform the work of Project TENDR. No systematic or scoping review had examined both exposure disparities and the joint effects of combined exposures of environmental neurotoxicants and social disadvantage as they relate to disparities in neurodevelopmental outcomes specifically among children living in the U.S.

Our study is the first to summarize the evidence on 7 neurotoxicants that children in the U.S. are routinely exposed to and we examined both disparities in these exposures and disparities in the effects of those exposures on children’s brain development, cognition, and behavior by race, ethnicity, and economic status.

We reviewed over 200 independent studies spanning five decades from 1974 to 2022 on social disparities in exposure to 7 exemplar neurotoxic chemicals and pollutants, including chemical mixtures, and their relationship with disparities with neurodevelopmental outcomes among children in the U.S.


Accidents & Violence, Alcohol, Author Interviews / 03.10.2018 Interview with: Pamela Trangenstein, PhD While  a predoctoral fellow at Johns Hopkins Bloomberg School of Public Health's Center on Alcohol Marketing and Youth (CAMY) What is the background for this study? What are the main findings?  Response: Research repeatedly shows that alcohol outlet density (the number of businesses that sell alcohol in an area) is associated with violent crime, but studies disagree about whether alcohol outlets that are on premise (e.g., bars, restaurants) or off premise (e.g., liquor stores, beer and wine stores) have a stronger association with violent crime. We used advanced methods that consider both the number of alcohol outlets and their locations to better understand how the association between alcohol outlets and violent crime differs by type of outlet. We found that alcohol outlets that allow off-premise sales like liquor stores had a stronger association with homicide, aggravated assault, and robbery than on-premise outlets like bars and restaurants. We also found that disadvantaged neighborhoods had higher access to the types of alcohol outlets associated with the most harms: off-premise outlets.  (more…)
Author Interviews, Orthopedics, Rheumatology, Social Issues / 07.11.2017 Interview with: Susan M. Goodman, MD Director of the Integrative Rheumatology and Orthopedics Center of Excellence Hospital for Special Surgery What is the background for this study? What are the main findings? Response: We have previously reported that African Americans who have poorer health outcomes, may be disproportionately impacted by community factors. For African Americans undergoing knee replacement, no difference in pain and function was seen compared to whites in communities with little poverty, while in poor communities, African Americans had poorer outcomes. We wondered if this was generally true or if this only applied to knee replacements. We found similar results; African Americans in richer neighborhoods have comparable outcomes to whites, but as poverty increases- in this study measured as percent with Medicaid coverage- outcomes worsen in a step wise fashion. (more…)
Author Interviews, Education, Pediatrics, Psychological Science, Social Issues / 31.10.2017 Interview with: Angeline Lillard PhD Professor of Psychology University of Virginia Charlottesville, VA What is the background for this study? Response: Montessori education was developed in the first half of the last century, but has been subject to little formal research. Prior research on its outcomes was problematic in using poor control groups, very small samples, demographically limited samples, a single school or classroom, or poor quality Montessori, or data from just a single time point and limited measurements. This study addressed all these issues: it collected data 4 times over 3 years from 141 children, experimental children were in 11 classrooms at 2 high quality Montessori schools at which the control children were waitlisted and admission was done by a randomized lottery, family income ranged from $0-200K, groups were demographically equivalent at the start of the study, and many measures were taken. (more…)
AHA Journals, Author Interviews, Race/Ethnic Diversity, Stroke / 18.06.2017 Interview with: George Howard, Dr.PH PI of the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study Department of Biostatistics University of Alabama at Birmingham Birmingham, AL What is the background for this study? What are the main findings? Response: Rural areas have been known to have a higher death rate than urban, and higher death from stroke in rural areas is a major contributor to this disparity. The goal of the research was to assess if the higher deaths from stroke was because rural people are more likely to have a stroke, or more likely to die from a stroke once it occurs.   This distinction is critically important, since intervention to reduce stroke deaths in rural area would focus on stroke prevention if the former, but would focus on improving stroke care (after the stroke) if the latter. We found that the higher mortality from stroke appears to be almost completely due to more people having stroke.   As such, we need to focus on efforts to reduce the risk of rural areas.   While there are well-documented differences in stroke care between urban and rural areas, resolving these differences will not be likely reduce the rural excess death from stroke. It would seem that the higher risk of having a stroke could be due to the observation that those in rural areas are more likely to have major stroke risk factors, including hypertension, diabetes and cigarette smoking; however, the higher prevalence of these risk factors don’t seem to explain the higher risk.   So what causes the higher risk remains a mystery. (more…)
Author Interviews, Heart Disease, JAMA, Race/Ethnic Diversity, Social Issues / 09.06.2017 Interview with: Dr. Ayodele Odutayo MD MSc DPhil(pending) Centre For Statistics in Medicine, University of Oxford Resident Physician (PGY1), Post-Doctoral Fellow, Applied Health Research Centre St. Michael’s Hospital, University of Toronto What is the background for this study? What are the main findings? Response: Previously published studies have reported increasing gaps in life expectancy among adults belonging to different socioeconomic strata and suggested that much of this gap was mediated through behavioural and metabolic risk factors. In this study, we found that from 1999-2014, there was an increasing gap in the control of cardiovascular risk factors between high income adults compared to adults with incomes at or below the poverty line. The proportion of adults at high cardiovascular risk (predicted risk of a cardiovascular event ≥20%), the mean systolic blood pressure and the percentage of current smokers decreased for high income adults but did not change for adults with incomes at or below the poverty line. Notably, the income disparity in these cardiovascular risk factors was not wholly explained by access to health insurance or educational attainment. Trends in the percentage of adults with diabetes and the average total cholesterol level did not vary by income. (more…)
Author Interviews, Heart Disease, JAMA, Social Issues / 12.05.2016 Interview with: Erica Spatz, MD, MHS Assistant Professor, Section of Cardiovascular Medicine Center for Outcomes Research and Evaluation Yale University School of Medicine/Yale-New Haven Hospital New Haven, CT 06520 What is the background for this study? What are the main findings?  Dr. Spatz: Rates of heart attack have declined during the last 15 years. But whether communities of different economic status or in different geographic regions experienced similar declines is unknown, especially as efforts to prevent cardiovascular disease and manage heart attacks may not have been equally successful in communities with different resource capacity. Our study shows that trends in the incidence of and mortality from heart attack were similar in low, average and high income communities. However, low-income communities had higher hospitalization rates than average and high income communities throughout the 15 year study period. Interestingly mortality rates were similar. (more…)
Author Interviews, CDC, Vaccine Studies / 04.09.2015 Interview with: Holly A. Hill, MD, PhD Immunization Services Division National Center for Immunization and Respiratory Diseases CDC Medical Research: What is the background for this study? What are the main findings? Response: The National Immunization Survey involves random digit-dialing – both landlines and cell phones – to generate a large national sample we use to assess vaccination coverage.  The phone survey is followed by a mail survey sent to the children’s vaccination providers to obtain vaccination histories. This 2014 NIS report is based on 14,893 children 19-35 months of age with provider- reported vaccination records. According to the 2014 NIS, the majority of parents are vaccinating their children against potentially serious diseases. Nationally, there were no significant decreases in vaccination coverage among children 19-35 months for routinely recommended childhood vaccines in 2014. As in past years, lower coverage for vaccines recommended during the second year of life were observed.  We still have opportunities for improvement. While national coverage was high for most vaccines routinely recommended for young children, vaccination coverage does vary by state and poverty status. High coverage rates for childhood vaccines explain why most vaccine-preventable diseases are at record low levels. However, it is crucial to maintain these rates in order to keep outbreaks from happening. (more…)