Community-Based Health and Exposure Study around Urban Oil Developments in South Los Angeles.

Oilfield-adjacent communities often report symptoms such as headaches and/or asthma. Yet, little data exists on health experiences and exposures in urban environments with oil and gas development. In partnership with Promotoras de Salud (community health workers), we gathered household surveys nearby two oil production sites in Los Angeles. We tested the capacity of low-cost sensors for localized exposure estimates. Bilingual surveys of 205 randomly sampled residences were collected within two 1500 ft. buffer areas (West Adams and University Park) surrounding oil development sites. We used a one-sample proportion test, comparing overall rates from the California Health Interview Survey (CHIS) of Service Planning Area 6 (SPA6) and Los Angeles County for variables of interest such as asthma. Field calibrated low-cost sensors recorded methane emissions. Physician diagnosed asthma rates were reported to be higher within both buffers than in SPA6 or LA County. Asthma prevalence in West Adams but not University Park was significantly higher than in Los Angeles County. Respondents with diagnosed asthma reported rates of emergency room visits in the previous 12 months similar to SPA6. 45% of respondents were unaware of oil development; 63% of residents would not know how to contact local regulatory authorities. Residents often seek information about their health and site-related activities. Low-cost sensors may be useful in highlighting differences between sites or recording larger emission events and can provide localized data alongside resident-reported symptoms. Regulatory officials should help clarify information to the community on methods for reporting health symptoms. Our community-based participatory research (CBPR) partnership supports efforts to answer community questions as residents seek a safety buffer between sensitive land uses and active oil development

The creation of the Faculty of Community Medicine (now the Faculty of Public Health Medicine) of the Royal Colleges of Physicians of the United Kingdom

The National Health Service Act 1946 transferred responsibility for the non-voluntary hospitals and certain clinical services from the public health departments of counties and county boroughs to new regional hospital boards, thereby substantially reducing the functions of their medical officers of health and creating a separate cadre of doctors concerned with the planning and management of hospital and specialist services. At around the same time there was pressure to develop in each medical school a department of social and preventive medicine with full-time staff involved in research work. Reviewing the situation 20 years later, the Royal Commission on Medical Education recommended that doctors in public health, medical administration or related teaching and research should form a single professional body concerned with the assessment of specialist training for and standards of practice in 'community medicine'. Immediately after the publication of the Commission's Report in 1968, J. N. Morris invited leaders in the three strands of activities to meet and discuss the proposal. A series of informal meetings led to the setting up, in 1969, of a Working Party (chairman, J. N. Morris) which negotiated with the Royal Colleges of Physicians of Edinburgh, Glasgow and London for them to create a faculty of community medicine. In November 1970 the Colleges set up a Provisional Council (chairman, W. G. Harding), later Board, and the Faculty formally came into existence on 15 March 1972. The key decisions and some of the complications and hitches encountered in achieving this radical outcome are described in this paper

Addressing Non-Emergency Medical Transportation Needs in Androscoggin County

Public health and social equity hinge upon the accessibility of medical services to all. Lack of access to transportation for routine and non-emergency medical appointments poses a significant barrier to appointment attendance, a barrier that disproportionately impact low income people and other marginalized groups. Healthcare providers also suffer major financial losses when patients are unable to attend their appointments. Prior research and community forums in Androscoggin County, Maine have identified several shortcomings to existing local non-emergency medical transportation (NEMT) services, illuminating the need for transportation options that better address the specific needs of the local population. In this report, we identify unmet transportation needs in Androscoggin County, detail the findings of our research on alternative models of NEMT across the United States, and propose a pilot program for a NEMT system tailored to the local needs and resources in Androscoggin County. This project is conducted in collaboration with Community Concepts Inc. (CCI). We build on the work of a previous Environmental Studies Capstone group from Bates College that identified the specific shortcomings of the current NEMT ride brokerage system from the perspective of the New Mainer community. Through consultations and scholarly research, we found a number of elevated transportation barriers faced by New Mainer users, rural users, users with disabilities, and non-MaineCare users. Our comparative study of different NEMT programs in Maine, New York, Minnesota, and Oregon allowed us to identify the range of different vehicles, transport styles, scheduling services and payment options that exist in NEMT services on a national scale. We synthesize the findings of this research into a proposal for a six month NEMT pilot program to be implemented in Androscoggin County. The pilot program we propose would be operated by CCI as a means of testing out the viability of an alternative to the current LogistiCare system. The program would operate two vans, one as a demand responsive, taxi-style service, and one on a fixed route with pick-up points in the downtown Lewiston-Auburn area and drop-off points at major healthcare providers. In order to address local and cultural needs present in Androscoggin County, our proposal recommends a multilingual ride-scheduling service, driver trainings on implicit bias and mental health first aid, and a representative community board to receive feedback and implement changes in the program moving forward. Fare options and potential funding options are also discussed. We conclude with a set of recommendations for next steps for working towards more accessible, culturally appropriate NEMT services in Androscoggin County

Door to Door Survey and Community Participation to Implement a New County Mosquito Control Program in Wayne County, North Carolina, USA

Community involvement in mosquito management programs provides more sustainable and effective organization and service. A door to door survey in Wayne County, NC carried out by student volunteers, resulted in 60 household responses. Residents had not previously experienced outreach from the county (88%), and 95% of them thought the student door to door survey was an effective form of outreach. One third of the residents thought mosquitoes were severe where they lived, but only 9% thought they had any containers in their yard that might breed mosquitoes. Only 15% of the residents were concerned about mosquito borne diseases. These responses provide evidence that outreach and education on mosquito control and diseases were necessary steps for future mosquito control community planning. Originally published in International Journal of Environmental Research and Public Health 2009 Vol. 6, No. 8

Supplementation of the Community Action Board of Santa Cruz County’s Commitment to Equity

The Community Action Board of Santa Cruz County, Inc. (CAB) is a non-profit organization that aids low-income clients with emergency, sustaining, and self-sufficiency services through their specialized program areas. Through a micro-level assessment of the County, research indicates a growing rate of poverty among marginalized communities, particularly in the Latinx population. Inequities relating to the low-wage occupational outlook in highly populated Latinx communities coupled with a high unemployment rate in Santa Cruz County only exacerbate the cyclical issue of poverty. Among marginalized community members who are most affected, they are also faced with housing insecurity and lack of health insurance. This project is centered around CAB’s commitment to equity. As service providers tasked with dismantling inequities with culturally grounded and relevant interventions to the diverse community, cultural competency is essential. The project implementation of an intern co-facilitated Equity Academy for staff along with an Equity Library shelved with literature recommendations from the community will help supplement staff\u27s knowledge of equity, social justice, and cultural competence when working with vulnerable populations in the County. Findings concluded positive participant feedback from the Equity Academy with new perspectives on the term “equity” and what it means for the community they serve. Recommendations for the future include: a continued facilitation of Equity Academy classes with an increased number of participants and adding additional literature and materials that relate to CAB’s core value of equity to their new library

Assessing the Vulnerability of Monterey Bay Area Seniors to COVID-19

This paper assesses the vulnerability of seniors residing in the Monterey Bay Tri-County Region to the COVID-19 pandemic. Due to weakened immune systems, seniors are the most at-risk members of our community to COVID-19, and have a death rate that is three times higher than the overall death rate to COVID-19. Using standard ambulance response times from each hospital throughout the area, our objective is to determine what proportion of Tri-County seniors aged 65 and over, including those who are in nursing homes, are living independently, and cannot afford health care, were within an adequate travel time to the hospital. Additionally, we want to know which county is the most underprepared for a potential COVID-19 surge among its senior population. Using ArcGIS Online and Desktop, we addressed our research question by performing drive-time analysis on all Tri-County hospitals, determining the proportion of seniors and nursing homes that were within or outside the drive-time areas. We then compared the results to the number of active COVID-19 cases in each county. Our findings indicate that Monterey County had the most seniors and nursing homes completely outside of the hospital service zones, as well as the highest number of COVID-19 cases. Additionally, Santa Cruz County had the most seniors without health insurance living outside of the service zones, a figure that seems to agree logically with the astronomical cost of living in the area. We conclude that while Monterey County is by far the most at-risk, underprepared, and in need of resources, Santa Cruz could also have a potential problem with large proportions of uninsured (and homeless) seniors who are unable to access desperately needed medical attention