Exploring the Nexus of Energy Burden, Social Capital, and Environmental Quality in Shaping Health in US Counties

The United States spends more on health care than any other OECD country, yet the nation’s health is declining. Recent research has identified multiple sources for this decline, including one’s position in social and economic structures, environmental quality, and individual and collective social capital. This paper assesses the primary hypotheses that the health effects of household energy burden, social capital and environmental quality on aggregated community health levels remain while controlling for other determinants. The analysis moves beyond prior research by integrating multiple secondary data sources to assess those effects across US counties. Three indicators of public health are analyzed (premature mortality, self-reported health, and life expectancy). The county-level energy burden is measured by the percent of household income spent on housing energy bills for low- and moderate-income households. In addition to energy burden, social capital, environmental quality and other determinants are included in the analysis. The results produced by multivariate regression models support the primary hypotheses, even while a number of control variables also have a significant effect on health. The paper concludes that public health is associated with a complex nexus of factors, including environmental quality and social capital, and that energy burden needs to be among the considerations

The Three E’s Revisited: How Do Community-Based Organizations Define Sustainable Communities and Their Role in Pursuit of?

A sustainable community seeks to protect and enhance the environment, meet social needs, and promote economic success. On average, local governments lack meaningfully connecting their environmental and economic sustainability efforts to equity and social justice. Community-based organizations (CBOs) have emerged as local leaders with a growing capacity for pursuing community sustainability. Based on data from a national survey National Community Action Partnership member organizations, this study explores (1) how CBO leaders define sustainable communities; (2) how important each of the three pillars of sustainability are to their mission; and (3) with what organizations do CBOs collaborate in their pursuit of sustainable communities. A content analysis of responses to an open-ended query to define sustainable communities revealed a significant focus on the social equity pillar of sustainability which is closely linked to economic sustainability. Similarly, CBO leaders ranked social equity and economic sustainability as the highest priority for their core mission. Lastly, CBO leaders heavily engaged in local collaboration in their sustainable community efforts. Therefore, serious pursuit of sustainable cities and communities must shift from a go-at-it-alone, centralized government approach to more inclusive, collaborative efforts that take advantage of the economic-social equity sustainability focus of CBOs in both planning and implementation

Unraveling the Links between Organizational Factors and Perceptions of Community Sustainability Performance: An Empirical Investigation of Community-Based Nongovernmental Organizations

Community-based nongovernmental organizations have emerged as leaders in local economic development, with a growing capacity for undertaking community sustainability projects in distressed neighborhoods. Very little is known about what organizational and managerial characteristics contribute to community sustainability performance. This article seeks to address this gap in the literature. Survey data from 134 community action agencies in the U.S. were analyzed to determine which organizational and managerial factors influence the effectiveness of community-based organizations in meeting community sustainability goals. The findings from an ordinary least-square regression model suggest that community engagement, human resource capacity, county/regional government collaboration, government funding, and revenue diversification are important predictors of community sustainability performance

Shifting from “Community-Placed” to “Community-Based” Research to Advance Health Equity: A Case Study of the Heatwaves, Housing, and Health: Increasing Climate Resiliency in Detroit (HHH) Partnership

Extreme summertime heat is a significant public health threat that disproportionately impacts vulnerable urban populations. Research on health impacts of climate change (including increasing intensity, duration, and frequency of hot weather) is sometimes designed and implemented without the involvement of the communities being studied, i.e., “community-placed” not “community-based.” We describe how the Heatwaves, Housing, and Health: Increasing Climate Resiliency in Detroit (HHH) partnership engaged relevant communities by integrating a community-based participatory research (CBPR) approach into an existing, academic-designed research project through a steering committee of community and academic partners. Using a case study approach, we analyze program documentation, partnership evaluation questionnaires, and HHH steering committee meeting notes. We describe the CBPR process by which we successfully collected research data in Detroit during summer 2016, engaged in collaborative analysis of data, and shared results with Detroit residents. Evaluations of the partnership over 2 years show community involvement in research; enhanced capacities; success in securing new grant funding; and ways that CBPR strengthened the validity, relevance, and translation of research. Engaging communities as equal partners using CBPR, even after a study is underway, can strengthen research to understand and address the impacts of extreme heat on health and equity in urban communities

Indoor apparent temperature, cognition, and daytime sleepiness among low‐income adults in a temperate climate

The burden of temperature‐associated mortality and hospital visits is significant, but temperature’s effects on non‐emergency health outcomes is less clear. This burden is potentially greater in low‐income households unable to afford efficient heating and cooling. We examined short‐term associations between indoor temperatures and cognitive function and daytime sleepiness in low‐income residents of Detroit, Michigan. Apparent temperature (AT, based on temperature and humidity) was recorded hourly in 34 participant homes between July 2019‐March 2020. Between July‐October 2019, 18 participants were administered word list immediate (WLL) and delayed (WLD) recall tests (10‐point scales) and the Epworth Sleepiness Scale (24‐point scale) 2–4 times. We applied longitudinal models with nonlinear distributed lags of temperature up to 7 days prior to testing. Indoor temperatures ranged 8–34°C overall and 15–34°C on survey days. We observed a 0.4 (95% CI: 0.0, 0.7) point increase in WLL and 0.4 (95% CI: 0.0, 0.9) point increase in WLD scores per 2°C increase in AT. Results suggested decreasing sleepiness scores with decreasing nighttime AT below 22°C. Low‐income Detroit residents experience uncomfortably high and low indoor temperatures. Indoor temperature may influence cognitive function and sleepiness, although we did not observe deleterious effects of higher temperatures.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/171581/1/ina12972.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/171581/2/ina12972_am.pd