BCAS: A Web-enabled and GIS-based Decision Support System for the Diagnosis and Treatment of Breast Cancer

For decades, geographical variations in cancer rates have been observed but the precise determinants of such geographic differences in breast cancer development are unclear. Various statistical models have been proposed. Applications of these models, however, require that the data be assembled from a variety of sources, converted into the statistical models’ parameters and delivered effectively to researchers and policy makers. A web-enabled and GIS-based system can be developed to provide the needed functionality. This article overviews the conceptual web-enabled and GIS-based system (BCAS), illustrates the system’s use in diagnosing and treating breast cancer and examines the potential benefits and implications for breast cancer research and practice

Demographic and Deprivation Ratios: examples of their use in understanding underlying spatial patterns in social phenomena

The intention of this paper is to explore the concept of standardized demographic ordeprivation Ratios ? what they are, why they might be useful, for what statisticaldistributions they can be built, how they can be constructed and which research activitiesand policy areas they might inform.Such Ratios are designed to demonstrate the extent to which the local levels of variousstatistical measures are above or below the level that would be ?expected? on the basis ofthe demographic make up of local areas. They would answer questions such as ?Isunemployment in this town high for a place of this sort??; ?Is the reason for the high levelof vodka consumption in Scotland something to do with local history or local culture orcan it be explained as a consequence of the demographics of the Scottish population?? or?Is the level of burglary in Avon and Somerset above the level that it ought to be, bearingin mind the characteristics of its population??The analysis of standardised Ratios is also relevant to the study of regionalization. Weare used to the administrative regions in terms of which government divide the countryand publish statistics. The mapping of Standardised Ratios shows the extent to whichthese administrative boundaries correspond to the boundaries of ?natural? regions, thesebeing defined as sets of adjacent areas sharing similar values on a broad range ofStandardised Ratios.Relating the actual levels of social statistics to some measure of what might be expectedon the basis of the population is clearly relevant to the evaluation of local performance,whether in the private or the public sector and Ratios of this sort, for example MortalityRatios, have been used for many years by health professional to benchmark local levelsof mortality against the level which might be expected on the basis of the gender and age.However the mapping of the difference between actual and expected rates can oftenthrow interesting light on cultural differences between regions and sub regions of thecountry which persist despite the homogenizing tendency of central government andnational or even multinational retail multiples.The paper illustrates the potential meaning and use of these Ratios by means of a set oftwelve demographic and deprivation Ratios created from the 2001 census in the UK

Poverty and Mortality Disparities in Central Appalachia: Mountaintop Mining and Environmental Justice

Objectives. This study investigated the associations between poverty rates, Appalachian mountaintop coal mining, and age-adjusted total mortality rates to determine if persons exposed to this form of mining experience greater poverty and higher death rates compared to other types of mining or other areas of Appalachia. Methods. Mortality rates, poverty rates, Appalachian designation and mining activity were examined for counties in Kentucky, Tennessee, Virginia and West Virginia (N=403). Linear least squares models tested for annual group differences from 2000-2007 in total and child poverty, and total mortality, based on mining type and Appalachian location. Nested linear models accounting for state-level effects were used to determine whether mountaintop mining and poverty were associated with mortality rates controlling for other risks. Results. Mountaintop mining areas had significantly higher mortality rates, total poverty rates and child poverty rates every year compared to other referent counties of these states. Both poverty and mountaintop mining were independently associated with age-adjusted mortality rates in nested models. Conclusions. Persons living in MTM areas experience persistently elevated poverty and mortality rates. Higher mortality is independently associated with both poverty and MTM, the latter effect suggestive of a possible environmental contribution from mining activities. Efforts to reduce longstanding health disparities in Appalachia must focus on those areas where disparities are concentrated: the Appalachian coalfields

A Decision Technology System To Advance the Diagnosis and Treatment of Breast Cancer

Geographical variations in cancer rates have been observed for decades. Described spatial patterns and trends have provided clues for generating hypotheses about the etiology of cancer. For breast cancer, investigators have demonstrated that some variation can be explained by differences in the population distribution of known breast cancer risk factors such as menstrual and reproductive variables (Laden, Spiegelman, and Neas, 1997; Robbins, Bescianini, and Kelsey, 1997; Sturgeon, Schairer, and Gail, 1995). However, regional patterns also may reflect the effects of Workshop on Hormones, Hormone Metabolism, Environment, and Breast Cancer (1995): (a) environmental hazards (such as air and water pollution), (b) demographics and the lifestyle of a mobile population, (c) subgroup susceptibility, (d) changes and advances in medical practice and healthcare management, and (e) other factors. To accurately measure breast cancer risk in individuals and population groups, it is necessary to singly and jointly assess the association between such risk and the hypothesized factors. Various statistical models will be needed to determine the potential relationships between breast cancer development and estimated exposures to environmental contamination. To apply the models, data must be assembled from a variety of sources, converted into the statistical models’ parameters, and delivered effectively to researchers and policy makers. A Web-enabled decision technology system can be developed to provide the needed functionality. This chapter will present a conceptual architecture for such a decision technology system. First, there will be a brief overview of a typical geographical analysis. Next, the chapter will present the conceptual Web-based decision technology system and illustrate how the system can assist users in diagnosing and treating breast cancer. The chapter will conclude with an examination of the potential benefits from system use and the implications for breast cancer research and practice

Ambient Air Toxic Releases and Adverse Pregnancy Outcomes in Allegheny County, Pennsylvania

Previous studies have shown that women exposed to certain air pollutants are at an increased risk for preterm delivery and/or delivering a low birth weight newborn. Preterm delivery and low birth weight are associated with an increased risk for morbidity and mortality. In an effort to better understand the impact of local environmental factors on pregnancy health, duration and outcomes, this study investigated the relationship of hazardous air pollutant chemicals released by local industries and the adverse pregnancy outcomes of preterm delivery and term low birth weight in Allegheny County, PA.This study included 2,798 singleton birth records for deliveries that occurred in Allegheny County in January through March of 2004. The Toxic Release Inventory provided data for 2003 fugitive and stack air releases of all facilities in Allegheny County reporting air releases of lead and toluene. This data was used for determining proxy maternal exposure measurements. ArcGIS software was used to calculate the distance from each maternal residence to each TRI facility. The distances and reported total pounds of release from each facility were then used to calculate a total lead and toluene exposure value for every birth record. Binary logistic regression was used to assess maternal characteristics' effects on birth outcomes. Chi square tests were used to assess maternal characteristics and levels of exposure to lead and toluene. Chi square tests and binary logistic regression were then used to assess pregnancy outcomes in relation to quartiles of exposure.This study found that mothers with certain age, race, education, and marital characteristics were significantly associated with lower exposure levels of lead and toluene. However, exposure to higher levels of lead or toluene, as measured in this study, was not significantly associated with an increased risk for preterm delivery or term low birth weight.Adverse pregnancy outcomes negatively impact an individual's immediate and lifelong health. Decreasing the incidence of preterm delivery and low birth weight are of great importance to public health. Research that helps to identify environmental determinants of adverse pregnancy outcomes is of vital public health significance

Natural Resource Curse and Poverty in Appalachian America

The Appalachian mountain region has long been characterized by deep poverty which led to the formation of the Appalachian Regional Commission (ARC) in 1965. The ARC region covers West Virginia and parts of 12 other states, running from New York to Mississippi (Ziliak 2012). The ARC region had an average county poverty rate of over 40 percent in 1960, about double the national average (Deaton and Niman 2012; Ziliak 2012). While the poverty gap between the ARC region and the rest of the nation closed significantly by 1990, it remained nearly twice as large in Central Appalachia. There are many reasons for higher poverty in Appalachia in general and Central Appalachia in particular. Possible causes include a low-paying industry structure, below average education, low household mobility, and remoteness from to cities (Weber et al. 2005; Partridge and Rickman 2005; Lobao 2004). A key distinction between Central Appalachia and the rest of the ARC region is its historic dependence on coal mining. There is long literature arguing that the area’s dependence on coal mining has contributed to its deep poverty through weaker local governance, entrepreneurship, and educational attainment, as well as degrading the environment, poor health outcomes, and limitations on other economic opportunities (Deaton and Niman 2012; James and Aadland 2011). These factors are broadly associated with the natural resources curse in the international development literature. More recently, the process of mountain top mining (MTM) has expanded coal mining’s environmental footprint in the region, possibly increasing health risks and further reducing the chances for long-term amenity-led growth that can alleviate poverty (Deller 2010; Woods and Gordon 2011). This study reinvestigates the causes of county poverty rates in Appalachia with a special focus on coal mining’s role. Using data over the 1990-2010 period we assess whether coal mining continues to have a positive association with poverty rates, even as the industry’s relative size has declined. We also appraise whether MTM is associated with higher poverty. We do this by comparing the ARC region to the rest of the U.S. and by using more disaggregated employment data that allows us to differentiate the effects of coal mining from other mining (versus aggregating all mining together as in past research). The results suggest that any potential adverse effects of coal mining on poverty have declined over time. Below, we first develop an empirical model followed by the empirical results. The final section provides our concluding thoughts

ECONOMIC IMPACT OF ENVIRONMENTAL HEALTH RISKS ON HOUSE VALUES IN SOUTHEAST REGION: A COUNTY-LEVEL ANALYSIS

A simultaneous model of house values, cancer mortality and total releases is simultaneously estimated to study effects of environmental health risks. Health risks include county level total releases, number of Superfund sites and cancer mortality in Southeastern U.S. Benefits of superfund cleanup and reduced releases are also estimated.Environmental Economics and Policy,