School of Public Health

Permanent URI for this communityhttp://hdl.handle.net/1903/1633

The collections in this community comprise faculty research works, as well as graduate theses and dissertations.

Note: Prior to July 1, 2007, the School of Public Health was named the College of Health & Human Performance.

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Subject: search.filters.subject.cumulative risk

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    Methods for Evaluating the Combined Effects of Chemical and Nonchemical Exposures for Cumulative Environmental Health Risk Assessment
    (MDPI, 2018-12-10) Payne-Sturges, Devon C.; Scammell, Madeleine K.; Levy, Jonathan I.; Cory-Slechta, Deborah A.; Symanski, Elaine; Carr Shmool, Jessie L.; Laumbach, Robert; Linder, Stephen; Clougherty, Jane E.
    Cumulative risk assessment (CRA) has been proposed as a means of evaluating possible additive and synergistic effects of multiple chemical, physical and social stressors on human health, with the goal of informing policy and decision-making, and protecting public health. Routine application of CRA to environmental regulatory and policy decision making, however, has been limited due to a perceived lack of appropriate quantitative approaches for assessing combined effects of chemical and nonchemical exposures. Seven research projects, which represented a variety of disciplines, including population health science, laboratory science, social sciences, geography, statistics and mathematics, were funded by the US Environmental Protection Agency (EPA) to help address this knowledge gap. We synthesize key insights from these unique studies to determine the implications for CRA practice and priorities for further research. Our analyses of these seven projects demonstrate that the necessary analytical methods to support CRA are available but are ultimately context-dependent. These projects collectively provided advancements for CRA in the areas of community engagement, characterization of exposures to nonchemical stressors, and assessment of health effects associated with joint exposures to chemical and psychosocial stressors.
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    Framing Environmental Health Decision-Making: The Struggle over Cumulative Impacts Policy
    (MDPI, 2021-04-09) Payne-Sturges, Devon C.; Sangaramoorthy, Thurka; Mittmann, Helen
    Little progress has been made to advance U.S. federal policy responses to growing scientific findings about cumulative environmental health impacts and risks, which also show that many low income and racial and ethnic minority populations bear a disproportionate share of multiple environmental burdens. Recent scholarship points to a “standard narrative” by which policy makers rationalize their slow efforts on environmental justice because of perceived lack of data and analytical tools. Using a social constructivist approach, ethnographic research methods, and content analysis, we examined the social context of policy challenges related to cumulative risks and impacts in the state of Maryland between 2014 and 2016. We identified three frames about cumulative impacts as a health issue through which conflicts over such policy reforms materialize and are sustained: (a) perceptions of evidence, (b) interpretations of social justice, and (c) expectations of authoritative bodies. Our findings illustrate that policy impasse over cumulative impacts is highly dependent on how policy-relevant actors come to frame issues around legislating cumulative impacts, rather than the “standard narrative” of external constraints. Frame analysis may provide us with more robust understandings of policy processes to address cumulative risks and impacts and the social forces that create health policy change.
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    Adverse Childhood Experiences (ACEs) in Early Childhood and Their Associations with Middle Childhood Behavior Problems
    (2017) Schroeder, Allison; Mittal, Mona; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    Experiences in early childhood lay the foundation for physical and psychological health and wellbeing throughout the life course. A large body of literature demonstrates a graded relationship between adverse childhood experiences (ACEs) and health and social outcomes. Children living in poverty are disproportionately likely to experience multiple adversities, placing them at risk for negative health and developmental outcomes and contributing to widening health disparities. Among the outcomes associated with ACEs are internalizing and externalizing behavior problems, which increase children’s risk of later depression and anxiety, substance use, criminality, low socioeconomic status, and chronic physical health problems. In spite of the substantial knowledge base that has developed around childhood adversity and its association with behavior problems, there are gaps in the literature that warrant further research. Firstly, few studies utilizing prospective longitudinal data have examined the role of timing and duration of exposure to adversities in early childhood, and their relationship with later behaviors. Secondly, researchers have only just begun exploring whether certain patterns or constellations of risk factors are common among different groups of children, and whether these patterns place certain groups at greater risk for behavior problems. A third gap relates to the role of father involvement by unmarried fathers and the potential for these fathers to promote more positive outcomes among children exposed to various levels of early adversity. The three studies in this dissertation analyze data from four waves of the Fragile Families and Child Wellbeing Study to document associations between ACEs experienced at ages 1, 3, and 5, and behavior problems at age 9. Life course theory provides an overarching framework for the dissertation. The first study examines the associations between the accumulation, timing, and duration of ACEs in the first five years of life and odds of behavior problems at age 9. The second study employs latent class analysis to identify patterns of risk exposure and their potential association with age 9 behaviors. The third study investigates whether early father involvement by fathers who were unmarried at the child’s birth moderates the association between early childhood adversity and age 9 behavior problems.