May 2021 highlights from AJPH

Date: Mar 18 2021

To request a full copy of any of these studies or for information on scheduling interviews with an expert, contact APHA Media Relations

American Journal of Public Health May issue research highlights:

  •  Coal-fired power plant closures tied to fewer asthma ER visits for kids
  •  Many who use illicit drugs turn to cannabis for harm reduction
  •  Bed setup, testing access can reduce COVID-19 risks at homeless shelters
  •  Support for pandemic measures varies by age, partisanship, trust in science

Coal-fired power plant closures tied to fewer asthma ER visits for kids

Closing coal-fired power plants can lead to better respiratory health among young children, according to a new study in the May issue of AJPH. 

To conduct the study, researchers analyzed data on wind, population, fine particulate air pollution, and asthma-related emergency department visits by ZIP code. The data included children ages 0 to 4 years old in Chicago between 2009 and 2017, and zeroed in on neighborhoods near three coal-fired power plants before and after their closures. Prior studies have shown a positive link between childhood respiratory issues and exposure to air pollution.

The new AJPH study found that asthma-related emergency department visits among young children decreased by 12% in ZIP codes near the three power plants after their closures, compared to ZIP codes farther away from the shuttered plants. More specifically, emergency department visits went down by more than 35 visits per 10,000 children ages 0 to 4.

“Young children, especially low-income and minority children living near operational power plants, are particularly susceptible and vulnerable to the consequences of exposure to air pollution,” the study stated. “Thus, public health may have much to gain from coal-fired power plant closures.”

[Author contact: Sarah Komisarow, Duke University Sanford School of Public Policy, Durham, North Carolina. “The Effect of Coal-Fired Power Plant Closures on Emergency Department Visits for Asthma-Related Conditions Among 0- to 4-Year-Old Children in Chicago, 2009-2017”]

Many who use illicit drugs turn to cannabis for harm reduction

Cannabis use is a common harm reduction strategy among people who use illicit drugs, finds a new study in May’s AJPH.

Using data from three prospective cohort studies of marginalized people who use drugs in Vancouver, Canada, researchers focused how many used cannabis for harm reduction purposes, which was defined as using it as a substitute for drugs such as heroin, cocaine or alcohol; using it to treat withdrawal symptoms; or using cannabis to help come down off another drug.

Overall, the study found that about one in four people who used cannabis said they did so for harm reduction purposes at least once during the study period, which spanned from June 2016 to May 2018. The most frequent reasons people used cannabis for harm reduction were as substitutes for stimulants and illicit opioids.

Authors noted that in light of the nation’s ongoing opioid addiction crisis, the use of cannabis-related harm reduction strategies should garner more study.

“Further research may allow for a better understanding of circumstances under which individuals choose this harm-reduction strategy,” they wrote. “These insights may contribute to public health–based strategies to address drug-related harms or regulate licit medical and recreational cannabis systems.”

[Author contact: M. Eugenia Socías, British Columbia Centre on Substance Abuse, Vancouver, British Columbia, Canada. “Use of Cannabis for Harm Reduction Among People at High Risk for Overdose in Vancouver, Canada (2016-2018)”]

Bed setup, testing access can reduce COVID-19 risks at homeless shelters

Factors such as sleeping arrangements and on-site medical services can help control the spread of COVID-19 in homeless shelters, according to a new study in May’s AJPH.

Researchers analyzed data from site assessments reported from 63 homeless shelters in seven urban areas in the U.S. Data included information on both shelter characteristics and infection prevention practices, such as staffing policies and face mask use. They found that shelters practicing head-to-toe sleeping — or setting up the beds so that a person’s head lies opposite his or her neighbor’s feet — were also less likely to experience high COVID-19 infection prevalence.

In addition, shelters that made symptomatic staff stay home were also less likely to experience high COVID-19 prevalence, when compared to shelters that let symptomatic staff keep working. Shelters with on-site medical services, including COVID-19 testing, were also less likely to have very high COVID-19 prevalence.

“These data show that universal testing at homeless shelters can identify high prevalence of SARS-CoV-2 infection, even in areas with low incidence of COVID-19, and shelters have adopted a range of infection prevention practices,” researchers wrote.

[Author contact: Julie L. Self, Centers for Disease Control and Prevention, Atlanta, Georgia. “Shelter Characteristics, Infection Prevention Practices, and Universal Testing for SARS-CoV-2 at Homeless Shelters in 7 US Urban Areas”]

Support for pandemic measures varies by age, partisanship, trust in science

As of last November, most Americans still supported mask wearing and contact tracing, with differences most pronounced according to age, partisanship and trust in science, finds new research published in May’s AJPH.

The study is based on data from three waves of a nationally representative survey — the Johns Hopkins COVID-19 Civic Life and Public Health Survey — which gathered information from U.S. adults last April, July and November. Researchers found that support for social distancing dropped from 89% in April to 79% in July and 78% in November. In July and November, over three-quarters still supported wearing face masks and about as many supported contact tracing.

However, researchers found sizeable differences by age, partisanship and trust in science. For example, in November, the support gap between Democrats and Republicans was 28 percentage points for contact tracing. The support gap for mask wearing between adults who trusted in science a lot and those who did not was 46 percentage points. Having a more fluid worldview was also associated with higher support for contact tracing.

Young adults reported much lower support for measures such as mask wearing and contact tracing than people older than 50.

“Developing persuasive communication efforts targeting young adults, political conservatives, and those distrusting science should be a critical priority,” the authors wrote.

[Author contact: Colleen L. Barry, PhD, MPP, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland “Support for Social Distancing, Mask Wearing, and Contact Tracing to Combat the COVID-19 Pandemic in a National Cohort of US Adults in April, July, and November 2020”]

Check out the full list of AJPH research papers that published online in our First Look area.

These articles have undergone peer review, copyediting and approval by authors but have not yet been printed to paper or posted online by issue. AJPH is published by the American Public Health Association and is available at ajph.org.

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